Mobilization and Defense Management Technical Reports Series. Military Health Professional Needs for Mobilization.

DTIC Science & Technology

1983-05-01

Specialist 880 Respiratory Specialist 506 Psychiatric Specialist 248 Orthopedic Specialist 379 Orthotic Specialist 35 Physical Therapist 200... Therapist 4 Physical Therapist 2 Hospital Dietician 26 Nuclear Medicine Service Officer 3 Entomologist 7 Physiologist 3 Podiatrist 17 Psychologist 6...requirements, working conditions, physical requirements, skill levels, etc. with the civilian health professional manpower pool. The first phase of this effort

Enabling factors for specialist outreach in western KwaZulu-Natal

PubMed Central

2018-01-01

Background There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa. Aim This study attempts to uncover some of the factors that enable good multifaceted specialist outreach. Setting The study was conducted in hospitals in western KwaZulu-Natal province. This health area is served by a tertiary hospital and 20 peripheral hospitals; three of these are regional level and the majority are district level hospitals. Specialist outreach emanates from the tertiary hospital. Methods Specialists providing outreach services from the tertiary hospital and medical officers at seven receiving hospitals were interviewed to explore perceptions regarding factors that might enable successful specialist outreach. Framework analysis on the transcribed interviews was carried out using NVivo version 11. Results A major positive finding concerns the relationships formed between outreach specialists and doctors at the recipient hospitals. The management of the programme with respect to structure, dependability, data management, transport provision, communication technology and public health systems was also seen as beneficial in specialist outreach. Conclusion Specialist outreach plays an essential role in providing equality in health care. To enable effectiveness, it is important to make full use of the multifaceted nature of this intervention. PMID:29781691

Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Joyce, Catherine M; Stoelwinder, Johannes

2016-06-01

Objective This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations. Methods The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusive models of rural outreach were studied. Results Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). In comparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21-0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95% CI 2.32-7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately. Conclusions Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services. What is known about this topic? There are numerous case studies describing outreach by specialist doctors. However, there is no systematic evidence describing the distribution of rural outreach services and models of outreach by specialists living in different locations and the broad-level factors that affect this. What does this paper add? The present study provides the first description of outreach service distribution and models of rural outreach by specialist doctors living in rural versus metropolitan areas. It shows that metropolitan and rural-based specialists have different levels of service reach and provide outreach through different models. Further, the paper highlights that practice sector has no effect on metropolitan specialists, but private rural specialists limit their travel distance. What are the implications for practitioners? The complexity of these patterns highlights the need for multilevel policy and planning approaches to promote integrated and accessible outreach in rural and remote Australia.

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

Extension Specialists: A Self-Analysis.

ERIC Educational Resources Information Center

Gerber, John M.

1985-01-01

To document perceived changes in the role of the extension horticulture specialist, a national survey of state horticulture specialists was conducted in 1983. Extension specialists in horticulture appear to be moving away from the traditional activities of farm visits and personal interaction with individual producers. (CT)

[The fiscal position of medical specialists].

PubMed

Stevens, S; Moors, M

2013-01-01

Independent medical specialists in the Netherlands are treated as entrepreneurs for tax purposes and therefore enjoy tax benefits. A change in the legal relationship between medical specialists and hospitals is foreseen in 2015. Independent medical specialists will then no longer be considered to be entrepreneurs. This could negatively affect their tax position. The Dutch government has adopted a policy aimed at controlling expenses arising from medical specialists' fees. According to this policy, the formation of regional practices or mega-practices of specialists will be discouraged. In contrast, the current fiscal legislation encourages medical specialists to incorporate their practice into regional practices or mega-practices or to become shareholders of their hospitals. It has been proposed that fiscal benefits be linked to certain aspects of entrepreneurship, such as investing in medical equipment or employing medical personnel.

Space Shuttle Projects

NASA Image and Video Library

1991-11-01

The STS-42 crew portrait includes from left to right: Stephen S. Oswald, pilot; Roberta L. Bondar, payload specialist 1; Norman E. Thagard, mission specialist 1; Ronald J. Grabe, commander; David C. Hilmers, mission specialist 2; Ulf D. Merbold, payload specialist 2; and William F. Readdy, mission specialist 3. Launched aboard the Space Shuttle Discovery on January 22, 1992 at 9:52:33 am (EST), the STS-42 served as the International Microgravity Laboratory-1 (ML-1 ) mission.

Clarifying the role of the mental health peer specialist in Massachusetts, USA: insights from peer specialists, supervisors and clients.

PubMed

Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith

2014-01-01

Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated and supported in care teams. © 2013 John Wiley & Sons Ltd.

The content of the work of clinical nurse specialists described by use of daily activity diaries.

PubMed

Oddsdóttir, Elín Jakobína; Sveinsdóttir, Herdís

2011-05-01

Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Prospective exploratory study. The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. The development of advanced nursing practice requires that clinical nurse specialists take an active and visible part in direct patient care. © 2011 Blackwell Publishing Ltd.

The Surgical Nosology In Primary-care Settings (SNIPS): a simple bridging classification for the interface between primary and specialist care

PubMed Central

Gruen, Russell L; Knox, Stephanie; Britt, Helena; Bailie, Ross S

2004-01-01

Background The interface between primary care and specialist medical services is an important domain for health services research and policy. Of particular concern is optimising specialist services and the organisation of the specialist workforce to meet the needs and demands for specialist care, particularly those generated by referral from primary care. However, differences in the disease classification and reporting of the work of primary and specialist surgical sectors hamper such research. This paper describes the development of a bridging classification for use in the study of potential surgical problems in primary care settings, and for classifying referrals to surgical specialties. Methods A three stage process was undertaken, which involved: (1) defining the categories of surgical disorders from a specialist perspective that were relevant to the specialist-primary care interface; (2) classifying the 'terms' in the International Classification of Primary Care Version 2-Plus (ICPC-2 Plus) to the surgical categories; and (3) using referral data from 303,000 patient encounters in the BEACH study of general practice activity in Australia to define a core set of surgical conditions. Inclusion of terms was based on the probability of specialist referral of patients with such problems, and specialists' perception that they constitute part of normal surgical practice. Results A four-level hierarchy was developed, containing 8, 27 and 79 categories in the first, second and third levels, respectively. These categories classified 2050 ICPC-2 Plus terms that constituted the fourth level, and which covered the spectrum of problems that were managed in primary care and referred to surgical specialists. Conclusion Our method of classifying terms from a primary care classification system to categories delineated by specialists should be applicable to research addressing the interface between primary and specialist care. By describing the process and putting the bridging classification system in the public domain, we invite comment and application in other settings where similar problems might be faced. PMID:15142280

Brazilian infectious diseases specialists: who and where are they?

PubMed

Cassenote, Alex Jones Flores; Scheffer, Mario César; Segurado, Aluísio Augusto Cotrim

2016-01-01

The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3-58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7yrs; 95% CI 7.9-9.5) than physicians trained elsewhere in the country (13.6yrs: 95% CI 11.8-15.5). Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in metropolitan areas. Copyright © 2016. Published by Elsevier Editora Ltda.

48 CFR 1519.201-72 - Small and disadvantaged business utilization specialists.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prescribed from time to time in furtherance of overall small and small disadvantaged business utilization... business utilization specialists. 1519.201-72 Section 1519.201-72 Federal Acquisition Regulations System... disadvantaged business utilization specialists. (a) Small Business Specialists (SBS) shall be appointed in...

48 CFR 536.570-3 - Specialist.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 536.570-3... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-3 Specialist. Insert 552.236-72, Specialist, in solicitations and contracts for construction if the technical sections...

7 CFR 1955.104 - Authorities and responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Director in this subpart, unless specifically excluded, to a Program Chief, Program Specialist, or Property Management Specialist on the State Office staff. (3) The District Director may redelegate, in writing, any... Loan Specialist. Authority of District Directors in this subpart applies to Area Loan Specialists in...

7 CFR 1955.54 - Redelegation of authority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... excluded, to a Program Chief, Program Specialist, or Property Management Specialist on the State Office... Director in this subpart to an Assistant District Director or District Loan Specialist. Authority of District Directors in this subpart applies to Area Loan Specialists in Alaska and the Director for the...

Administrative Assistant and Correspondence Specialist: Task List Competency Record.

ERIC Educational Resources Information Center

Minnesota Instructional Materials Center, White Bear Lake.

One of a series of 12 in the secretarial/clerical area, this booklet for the vocational instructor contains job descriptions for two word processing occupations, the non-typing administrative assistant and the correspondence specialist (also called word processing correspondence specialist, magnetic keyboard specialist, or word processing…

STS 51-L crewmembers briefed during training session

NASA Technical Reports Server (NTRS)

1986-01-01

Five members of the STS 51-L crew and a backup crewmember are briefed during a training session in JSC's Shuttle mockup and integration laboratory. From left to right are Astronauts Ellison S. Onizuka, mission specialist; Ronald E. McNair, mission specialist; Gregory Jarvis, Hughes payload specialist; Judith A. Resnik, mission specialist; Sharon Christa McAuliffe, citizen observer/payload specialist representing the Teacher in Space project. Barbara R. Morgan, backup to McAuliffe, is in the right foreground.

Assessment of Detainee Medical Operations for OEF, GTMO, and OIF (REDACTED)

DTIC Science & Technology

2005-04-13

Administration Specialist), 74 91 W (Health Care Specialist), 17 91 WM6 (Health Care SpecialistlLicensed Practical Nurse ), 15 91X (Mental Health Specialist), and...91 W (Health Care Specialist), 17 91 WM6 (Licensed Practical Nurse ), 15 91X (Mental Health Specialist), and 40 OBC students. The findings, discussion...and principles of detainee care ." This policy does not identify when the required training should occur, nor who is responsible to provide the

STS-114: Discovery Crew Arrival for Launch at Shuttle Landing Facility

NASA Technical Reports Server (NTRS)

2005-01-01

Live Footage of Discovery's STS-114 Crew Arriving at the Shuttle Landing Facility at Kennedy Space Center is shown. George Diller is the narrator for this event. Commander, Eileen Collins, is seen introducing the STS-114 crew who consists of: Pilot, James Kelley, Mission Specialist, Charles Camarda, Mission Specialist, Wendy Lawrence, Mission Specialist, Soichi Noguchi, Mission Specialist, Steve Robinson, and Mission Specialist Andy Thomas. Each crewmember addresses the news media about their role on this mission.

Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-01-07

The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

Comparison of the capture efficiency, prey processing, and nutrient extraction in a generalist and a specialist spider predator.

PubMed

García, Luis Fernando; Viera, Carmen; Pekár, Stano

2018-04-02

Predators are traditionally classified as generalists and specialists based on the presence of adaptations that increase efficiency of prey capture and consumption and selection of particular prey types. Nevertheless, empirical evidence comparing foraging efficiency between generalist and specialist carnivores is scarce. We compared the prey-capture and feeding efficiency in a generalist and a specialist (araneophagous) spider predator. By using two related species, the generalist Harpactea rubicunda (Dysderidae) and the specialist Nops cf. variabilis (Caponiidae), we evaluated their fundamental trophic niche by studying the acceptance of different prey. Then, we compared their predatory behavior, efficiency in capturing prey of varying sizes, feeding efficiency, and nutrient extraction. Nops accepted only spiders as prey, while Harpactea accepted all offered prey, confirming that Nops is stenophagous, while Harpactea is euryphagous. Further, Nops displayed more specialized (stereotyped) capture behavior than Harpactea, suggesting that Nops is a specialist, while Harpactea is a generalist. The specialist immobilized prey faster, overcame much larger prey, and gained more mass (due to feeding on larger prey) than the generalist. Both the specialist and the generalist spider extracted more proteins than lipids, but the extraction of macronutrients in the specialist was achieved mainly by consuming the prosoma of the focal prey. We show that the specialist has more efficient foraging strategy than the generalist.

Analysis of pharmacologic and nonpharmacologic prescription patterns of general practitioners and specialists in the AMICA study.

PubMed

Scarpa, Raffaele; Sarzi-Puttini, Piercarlo; Cimmino, Marco A; Caporali, Roberto; Parazzini, Fabio; Zaninelli, Augusto; Canesi, Bianca

2005-08-01

To evaluate the prescription modalities of general practitioners (GPs) and specialists in symptomatic osteoarthritis (OA) patients enrolled in the AMICA study. This study started in 2001 as a cohort investigation of OA patients seen by 2764 GPs and 316 specialists. Enrolled were 28,981 patients with symptomatic OA of the hand, hip, or knee. GPs and physical medicine specialists treated OA less frequently with pharmacological therapy than rheumatologists (OR 0.35; CI 0.26 to 0.47) or orthopedic surgeons (OR 0.65; CI 0.54 to 0.77). Pharmacological therapies (alone or in association with nonpharmacological modalities) were selected by 97% of the GPs, 96% of the rheumatologists, 94% of the orthopedic surgeons, and 85% of the physical medicine specialists. In comparison with GPs, all of the specialists more frequently used disease-modifying OA drugs (DMOADs) (rheumatologists: OR 6.86, CI 6.03 to 7.80; orthopedic surgeons: OR 2.20, CI 1.94 to 2.49; physical medicine specialists: OR 2.11, CI 1.69 to 2.63). Nonpharmacological therapies were selected by 44% of the GPs, 54% of the rheumatologists, 71% of the orthopedic surgeons, and 90% of the physical medicine specialists. They were used alone uncommonly (by 3% of the GPs, 3% of the rheumatologists, 6% of the orthopedic surgeons, and 15% of the physical medicine specialists). GPs use nonpharmacological treatment less than specialists: OR 0.53; CI 0.47 to 0.60 versus rheumatologists; OR 0.20; CI 0.18 to 0.21 versus orthopedic surgeons; and OR 0.07; CI 0.05 to 0.09 versus physical medicine specialists. Ultrasound (US) (11%) and transcutaneous electrical nerve stimulation (TENS) (7%) were the nonpharmacological therapies most frequently prescribed by GPs. Among the specialists, physical medicine specialists most frequently prescribed US (35%) and TENS (21%); US was also preferred by rheumatologists, whereas the orthopedic surgeon's choice was magnetotherapy (21%). Exercises and other passive or active rehabilitation strategies were prescribed for only 13% of the patients seen by GPs, but all 3 categories of specialists prescribed exercises and manual techniques far more frequently: rheumatologists, OR 1.63: 1.40 to 1.63; orthopedic surgeons, OR 1.67: 1.48 to 1.88; physical medicine specialists, OR 3.19: 2.66 to 3.82. Italian rheumatologists and orthopedic surgeons are the specialists who most frequently use pharmacological treatment for OA. Nonpharmacological treatment is used commonly among both GPs and specialists but rarely as single therapy. Exercise and passive or active rehabilitation strategies are not frequently prescribed, although they are recommended by all the published guidelines.

STS-55 German payload specialists and backups pose in front of SL-D2 at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists and backup (alternate) payload specialists pose in front of the Spacelab Deutsche 2 (SL-D2) science module at a Kennedy Space Center (KSC) processing facility. These four Germans have been assigned to support the STS-55/SL-D2 mission. Left to right are Payload Specialist 2 Hans Schlegel, backup Payload Specialist Dr. P. Gerhard Thiele (kneeling), Payload Specialist 1 Ulrich Walter, and backup Payload Specialist Renate Brummer. Walter and Schlegel are scheduled to fly aboard OV-102 for the mission while Brummer and Thiele will serve as alternates and fill supportive roles on the ground. Clearly visible on the SL-D2 module are the European Space Agency (ESA) insignia, the feedthrough plate, and the D2 insignia.

Specialist participation in healthcare delivery transformation: influence of patient self-referral.

PubMed

Aliu, Oluseyi; Sun, Gordon; Burke, James; Chung, Kevin C; Davis, Matthew M

2014-01-01

Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base. To examine recent national trends in self-referred new visits to specialists. A descriptive cross-sectional study of new ambulatory visits to specialists from 2000 to 2009 using data from the National Ambulatory Medical Care Survey. We calculated nationally representative estimates of the proportion of new specialist visits through self-referrals among Medicare and private insurance beneficiaries. We also estimated the nationally representative absolute number of self-referred new specialist visits among both groups of beneficiaries. Among Medicare and private insurance beneficiaries, self-referred visits declined from 32.2% (95% confidence interval [CI], 24.0%-40.4%) to 19.6% (95% CI, 13.9%-23.3%) and from 32.4% (95% CI, 27.9%-36.8%) to 24.1% (95% CI,18.8%-29.4%), respectively. Hence, at least 1 in 5 and 1 in 4 new visits to specialists among Medicare and private insurance beneficiaries, respectively, are self-referred. The current considerable rate of self-referred new specialist visits among both Medicare and private insurance beneficiaries may have adverse implications for organizations attempting to transform healthcare delivery with improved care coordination.

The need for PGY2-trained clinical pharmacy specialists.

PubMed

Ragucci, Kelly R; O'Bryant, Cindy L; Campbell, Kristin Bova; Buck, Marcia L; Dager, William E; Donovan, Jennifer L; Emerson, Kayleigh; Gubbins, Paul O; Haight, Robert J; Jackevicius, Cynthia; Murphy, John E; Prohaska, Emily

2014-06-01

The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level. © 2014 Pharmacotherapy Publications, Inc.

Invisible Roles of Doctoral Program Specialists

ERIC Educational Resources Information Center

Bachman, Eva Burns; Grady, Marilyn L.

2016-01-01

The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…

14 CFR § 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialist responsibilities. § 1214.305 Section § 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

Examining Operational Measures of Performance: Performance Measures Matrix

DTIC Science & Technology

1992-06-01

Equipment Mechanic ( 454X1 ); Precision Measuring Equipment Laboratory Specialist (324X0); and Aircrew Life Support Specialist (I122X0). The result is a...454X0 Aerospace Propulsion Specialist (Engines), 455X2 Communication and Navigation System Specialist, 454X1 Aerospace Ground Equipment Mechanic (AGE

38 CFR 17.142 - Authority to approve sharing agreements, contracts for scarce medical specialist services and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... sharing agreements, contracts for scarce medical specialist services and contracts for other medical... medical specialist services and contracts for other medical services. The Under Secretary for Health is... specialist services at Department of Veterans Affairs health care facilities (including, but not limited to...

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

ERIC Educational Resources Information Center

McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

2009-01-01

This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

Spacelab

NASA Image and Video Library

1991-06-05

Launched aboard the Space Shuttle Columbia on June 5, 1991 at 9:24; am (EDT), the STS-40 mission was the fifth dedicated Spacelab Mission, Spacelab Life Sciences-1 (SLS-1), and the first mission dedicated solely to life sciences. The STS-40 crew included 7 astronauts: Bryan D. O’Connor, commander; Sidney M. Gutierrez, pilot; F. Drew Gaffney, payload specialist 1; Milli-Hughes Fulford, payload specialist 2; James P. Bagian, mission specialist 1; Tamara E. Jernigan, mission specialist 2; and M. Rhea Seddon, mission specialist 3.

Space Shuttle Projects

NASA Image and Video Library

1992-11-01

The seven astronauts included in the STS-55 crew portrait are: (front left to right) Terence (Tom) Henricks, pilot; Steven R. Negal, commander; and Charles J. Precourt, mission specialist. On the back row, from left to right, are Bernard A. Harris, mission specialist; Hans Schlegel, payload specialist; Jerry L. Ross, mission specialist; and Ulrich Walter, payload specialist. The crew launched aboard the Space Shuttle Columbia on April 26, 1993 at 10:50:00 am (EDT). The major payload was the German Dedicated Spacelab, D2.

Specialist clinics: a better way to care?

PubMed Central

Mutch, W J

1992-01-01

A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents already ran a specialist clinic. The same proportion felt that a Parkinsonism clinic would be useful despite the fact that only 20% stated that they would run one. It is argued that specialist clinics facilitate the effective management of conditions such as Parkinson's disease, especially if supported by a specialist nurse or other appropriate staff. PMID:1564504

STS-47 crew and backups at MSFC's Payload Crew Training Complex

NASA Technical Reports Server (NTRS)

1992-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Spacelab Japan (SLJ) crewmembers and backup payload specialists stand outside SLJ module mockup at the Payload Crew Training Complex at Marshall SpaceFlight Center (MSFC) in Huntsville, Alabama. From left to right are Payload Specialist Mamoru Mohri, backup Payload Specialist Takao Doi, backup Payload Specialist Chiaki Naito-Mukai, Mission Specialist (MS) Mae C. Jemison, MS N. Jan Davis, backup Payload Specialist Stan Koszelak, and MS and Payload Commander (PLC) Mark C. Lee. The MSFC-managed mission is a joint venture in space-based research between the United States and Japan. Mohri, Doi, and Mukai represent Japan's National Space Development Agency (NASDA). View provided with alternate number 92P-142.

Use of a screening tool and primary health care gerontology nurse specialist for high-needs older people.

PubMed

King, Anna; Boyd, Michal; Dagley, Lynelle

2017-02-01

To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.

The Search for Specialists and Managers. Staff Shortage in Germany.

ERIC Educational Resources Information Center

Stahl, Klaus, Ed.

1999-01-01

Despite its high unemployment level, Germany is experiencing a shortage of specialists and managers. Germany's need for highly qualified information technology (IT) workers and engineers is particularly great. Approximately 10,000 posts for computer scientists and IT specialists remained vacant in 1998. Because of the shortage of such specialists,…

The Visiting Specialist Model of Rural Health Care Delivery: A Survey in Massachusetts

ERIC Educational Resources Information Center

Drew, Jacob; Cashman, Suzanne B.; Savageau, Judith A.; Stenger, Joseph

2006-01-01

Context: Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. Purpose: To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of…

Careers in the U.S. Department of Education: Education Program Specialist.

ERIC Educational Resources Information Center

Horace Mann Learning Center (ED), Washington, DC.

Education program specialists in the United States Department of Education establish and lead the education program, policies, and activities for which the Department of Education is responsible under law. This brochure provides information about the job of education program specialist, describing how the specialists fit into the department's…

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Clinical nurse specialists' services. 410.76... § 410.76 Clinical nurse specialists' services. (a) Definition. As used in this section, the term...) Qualifications. For Medicare Part B coverage of his or her services, a clinical nurse specialist must— (1) Be a...

17 CFR 240.11b-1 - Regulation of specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Regulation of specialists. 240... Securities Exchange Act of 1934 Adoption of Regulation on Conduct of Specialists § 240.11b-1 Regulation of specialists. (a)(1) The rules of a national securities exchange may permit a member of such exchange to...

Animation Augmented Reality Book Model (AAR Book Model) to Enhance Teamwork

ERIC Educational Resources Information Center

Chujitarom, Wannaporn; Piriyasurawong, Pallop

2017-01-01

This study aims to synthesize an Animation Augmented Reality Book Model (AAR Book Model) to enhance teamwork and to assess the AAR Book Model to enhance teamwork. Samples are five specialists that consist of one animation specialist, two communication and information technology specialists, and two teaching model design specialists, selected by…

Perceptions of Information Technology Specialists Regarding Securing Re-Employment after Offshoring Displacement

ERIC Educational Resources Information Center

Gallaway, Ricky A.

2015-01-01

The purpose of this qualitative exploratory case study was to explore why some IT specialists, after experiencing unemployment because of corporate offshoring, acquired gainful re-employment, whereas other similarly unemployed IT specialists had not. To effectively address this case study, two cases were studied: (a) displaced IT specialists who…

STS-130 Nationals Park Visit

NASA Image and Video Library

2010-04-20

NASA STS-130 crew pose with Winter Olympics medalist Apolo Ohno, center, at Nationals Park, Tuesday, April 20, 2010, in Washington. Pictured from left are STS-130 Mission Specialist Robert Benhken, Mission Specialist Nicholas Patrick, Commander George Zamka, Apolo Ohno, Mission Specialist Stephen Robinson, Mission Specialist Kathryn Hire and Pilot Terry Virts. Photo Credit: (NASA/Carla Cioffi)

Changes in Attitudes towards Drug Educators as a Function of Communicator Sex and Role.

ERIC Educational Resources Information Center

Cotten-Huston, Annie L.; Baum, Carlene Stober

1980-01-01

Significant interactions between role and sex of communicator indicated that male ex-addicts produced more positive changes in evaluation than female ex-addicts, while female specialists produced more positive changes in evaluation than male specialists. Female specialists produced more positive changes in ratings of potency than male specialists.…

Personality traits of anaesthetists and physicians: an evaluation using the Cloninger Temperament and Character Inventory (TCI-125).

PubMed

Kluger, M T; Laidlaw, T M; Kruger, N; Harrison, M J

1999-10-01

The personality profiles of Specialist Anaesthetists, Trainee Anaesthetists and Specialist Physicians were examined using Cloninger's Temperament and Character Inventory. These were compared with validated Community Sample 'average values' and a historical Norwegian Physician sample. Completed forms were returned from 364 doctors (Specialist Anaesthetists 222, Trainee Anaesthetists 75, Physicians 67), an overall response rate of 71%. Specialist Anaesthetists were more Cooperative, Harm Avoidant and Self-Directed than the Community Sample but less Reward Dependent, Novelty Seeking and Persistent than the Community Sample. Physicians were more Cooperative than their Specialist Anaesthetist colleagues, but both more so than were the general population. Trainee anaesthetists appear to be more Novelty Seeking and Reward Dependent than the Specialist Anaesthetists, this factor being predominately age related. Extreme/Mild personality traits were identified in 33% of Specialists, 41% of Trainees and 33% of Physicians, whilst personality disorders were found at the expected rates (Specialist Anaesthetists 9%, Trainee Anaesthetists 10%, Physicians 2%). Personality assessment has implications for recruitment, crisis management and professional development within anaesthesia.

Academic learning for specialist nurses: a grounded theory study.

PubMed

Millberg, Lena German; Berg, Linda; Brämberg, Elisabeth Björk; Nordström, Gun; Ohlén, Joakim

2014-11-01

The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful. Copyright © 2014 Elsevier Ltd. All rights reserved.

Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

PubMed

Gruen, Russell; Bailie, Ross

2004-10-01

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom.

PubMed

Bagot, Kathleen L; Cadilhac, Dominique A; Bladin, Christopher F; Watkins, Caroline L; Vu, Michelle; Donnan, Geoffrey A; Dewey, Helen M; Emsley, Hedley C A; Davies, D Paul; Day, Elaine; Ford, Gary A; Price, Christopher I; May, Carl R; McLoughlin, Alison S R; Gibson, Josephine M E; Lightbody, Catherine E

2017-11-21

Stroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations. Specialist participants were identified using purposive sampling from two new services: Australia's Victorian Stroke Telemedicine Program (n = 6; 2010-13) and the United Kingdom's Cumbria and Lancashire telestroke network (n = 5; 2010-2012). Semi-structured interviews were conducted pre- and post-implementation, recorded and transcribed verbatim. Deductive thematic and content analysis (NVivo) was undertaken by two independent coders using Normalisation Process Theory to explore integration of telemedicine into practice. Agreement between coders was M = 91%, SD = 9 and weighted average κ = 0.70. Cross-cultural similarities and differences were found. In both countries, specialists described old and new consulting practices, the purpose and value of telemedicine systems, and concerns regarding confidence in the assessment and diagnostic skills of unknown colleagues requesting telemedicine support. Australian specialists discussed how remote consultations impacted on usual roles and suggested future improvements, while United Kingdom specialists discussed system governance, policy and procedures. Australian and United Kingdom specialists reported telemedicine required changes in work practice and development of new skills. Both groups described potential for improvements in stroke telemedicine systems with Australian specialists more focused on role change and the United Kingdom on system governance issues. Future research should examine if cross-cultural variation reflects different models of care and extends to other networks.

Is specialization an evolutionary dead end? Testing for differences in speciation, extinction and trait transition rates across diverse phylogenies of specialists and generalists.

PubMed

Day, E H; Hua, X; Bromham, L

2016-06-01

Specialization has often been claimed to be an evolutionary dead end, with specialist lineages having a reduced capacity to persist or diversify. In a phylogenetic comparative framework, an evolutionary dead end may be detectable from the phylogenetic distribution of specialists, if specialists rarely give rise to large, diverse clades. Previous phylogenetic studies of the influence of specialization on macroevolutionary processes have demonstrated a range of patterns, including examples where specialists have both higher and lower diversification rates than generalists, as well as examples where the rates of evolutionary transitions from generalists to specialists are higher, lower or equal to transitions from specialists to generalists. Here, we wish to ask whether these varied answers are due to the differences in macroevolutionary processes in different clades, or partly due to differences in methodology. We analysed ten phylogenies containing multiple independent origins of specialization and quantified the phylogenetic distribution of specialists by applying a common set of metrics to all datasets. We compared the tip branch lengths of specialists to generalists, the size of specialist clades arising from each evolutionary origin of a specialized trait and whether specialists tend to be clustered or scattered on phylogenies. For each of these measures, we compared the observed values to expectations under null models of trait evolution and expected outcomes under alternative macroevolutionary scenarios. We found that specialization is sometimes an evolutionary dead end: in two of the ten case studies (pollinator-specific plants and host-specific flies), specialization is associated with a reduced rate of diversification or trait persistence. However, in the majority of studies, we could not distinguish the observed phylogenetic distribution of specialists from null models in which specialization has no effect on diversification or trait persistence. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

The role of imaging specialists as authors of systematic reviews on diagnostic and interventional imaging and its impact on scientific quality: report from the EuroAIM Evidence-based Radiology Working Group.

PubMed

Sardanelli, Francesco; Bashir, Humayun; Berzaczy, Dominik; Cannella, Guglielmo; Espeland, Ansgar; Flor, Nicola; Helbich, Thomas; Hunink, Myriam; Malone, Dermot E; Mann, Ritse; Muzzupappa, Claudia; Petersen, Lars J; Riklund, Katrine; Sconfienza, Luca M; Serafin, Zbigniew; Spronk, Sandra; Stoker, Jaap; van Beek, Edwin J R; Vorwerk, Dierk; Di Leo, Giovanni

2014-08-01

To evaluate the inclusion of radiologists or nuclear medicine physicians (imaging specialists) as authors of systematic reviews (SRs) on imaging and imaging-guided diagnostic procedures and to determine the impact of imaging specialists' presence as authors on the overall quality of the reviews. A MEDLINE and EMBASE search was performed for SRs of diagnostic and interventional image-guided procedures that were published from January 2001 to December 2010. SRs about procedures primarily performed by nonimaging specialists were excluded. The inclusion of imaging specialists among the SR authors and the frequency of publication in imaging journals were evaluated. The quality of a subset of 200 SRs (100 most recent SRs with imaging specialists as authors and 100 most recent SRs without imaging specialists as authors) was rated by using a 12-item modified assessment of multiple SRs (AMSTAR) evaluation tool. Spearman, χ(2), and Mann-Whitney statistics were used. From among 3258 retrieved citations, 867 SRs were included in the study. Neuroimaging had the largest number of SRs (28% [241 of 867]), 41% (354 of 867) of SRs concerned diagnostic performance, and 26% (228 of 867) of SRs were published in imaging journals. Imaging specialists were authors (in any position) in 330 (38%) of 867 SRs; they were first authors of 176 SRs and last authors of 161 SRs. SRs with imaging specialists as authors were more often published in imaging journals than in nonimaging journals (54% [179 of 330] vs 9% [49 of 537]; P < .001). The median number of modified AMSTAR quality indicators was nine in SRs with imaging specialists as authors, while that in SRs without imaging specialists as authors was seven (P = .003). Only 38% (330 of 867) of SRs on radiology or nuclear medicine-related imaging published from January 2001 to December 2010 included imaging specialists as authors. However, the inclusion of imaging specialists as authors was associated with a significant increase in the scientific quality (as judged by using a modified AMSTAR scale) of the SR.

77 FR 32157 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing of Proposed Rule Change Defining a...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-31

... Specialist in Each Options Class and Modifying the Specialist Entitlement Accordingly May 24, 2012. Pursuant... of Substance of the Proposed Rule Change The Exchange proposes to define a Primary Specialist in each options class and modify the Specialist entitlement accordingly. The text of the proposed rule change is...

STS-107 Mission Specialist Laurel Clark at SPACEHAB

NASA Technical Reports Server (NTRS)

2000-01-01

KENNEDY SPACE CENTER, FLA. -- At SPACEHAB, STS-107 Mission Specialist Laurel Clark gets hands-on experience with equipment that will be on the mission. Watching in the left foreground is Mission Specialist Kalpana Chawla; next to her at left is Mission Specialist Michael Anderson. Identified as a research mission, STS-107 is scheduled for launch July 19, 2001

The Multi-Faceted Role of Ohio's Elementary Reading Specialists: Instruction, Assessment, Leadership and beyond

ERIC Educational Resources Information Center

Lipp, Jamie R.

2017-01-01

Over the past 65 years, the roles of the reading specialist have continually evolved. Historically, reading specialists have been hired by schools to work predominantly with struggling readers (Bean, Cassidy, Grumet, Shelton & Wallis, 2002; Bean, Swan & Knaub, 2003). Reading specialists today serve in a variety of roles within their…

US Influence on the Education System in Turkey: An Analysis of Reports by American Education Specialists

ERIC Educational Resources Information Center

Keskin, Yusuf

2014-01-01

This study aimed to analyse reports prepared by American education specialists visiting Turkey from the Proclamation of the Republic till the end of the 1950's to inspect Turkey's education system. In accordance with this purpose, first, the foreign specialists' reports are briefly introduced chronologically and then American specialist reports…

KSC-97pc415

NASA Image and Video Library

1997-03-11

Six of the seven astronauts assigned to the STS-83 crew arrive at Kennedy Space Center's Shuttle Landing Facility in preparation for their Terminal Countdown Demonstration Test. From left to right, they are Payload Specialist Roger K. Crouch, Pilot Susan L. Still, Mission Commander James D. Halsell, Mission Specialist Michael L. Gernhardt, Payload Specialist Gregory T. Linteris, and Mission Specialist Janice E. Voss

STS-95 in-flight crew portrait

NASA Image and Video Library

1998-11-16

STS095-328-031 (29 Oct.-7 Nov. 1998) --- With their feet anchored in the hatchway, the seven STS-95 crew members pose for their traditional in-flight crew portrait. Astronaut Curtis L. Brown Jr., commander, appears at right center in the pyramid. Others, clockwise from there, are Steven W. Lindsey, pilot; Stephen K. Robinson, mission specialist; Pedro Duque, mission specialist representing the European Space Agency (ESA); payload specialist Chiaki Naito-Mukai, who represents Japan's National Space Development Agency (NASDA); Scott E. Parazynski, mission specialist; and United States Senator John H. Glenn Jr. (D.-Ohio), payload specialist.

STS-47 Payload Specialist Mohri and Japanese backups pose in SLJ module at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-47 payload specialists representing Japan's National Space Development Agency (NASDA) examine the interior of the Spacelab Japan (SLJ) laboratory module recently installed in Endeavour's, Orbiter Vehicle (OV) 105's, payload bay (PLB). Left to right are Payload Specialist Mamoru Mohri, backup Payload Specialist Chiaki Naito-Mukai, and backup Payload Specialist Takao Doi. The crewmembers visited OV-105, currently undergoing preflight processing in a high bay area of Kennedy Space Center's (KSC's) Orbiter Processing Facility (OPF). View provided by KSC with alternate KSC number KSC-92PC-1649.

Various views of STS-95 Senator John Glenn during training

NASA Image and Video Library

1998-06-18

S98-08740 (9 April 1998) --- Five members of the STS-95 crew review supplies that may accompany them on the scheduled October launch of the Space Shuttle Discovery. From the left are Stephen K. Robinson, mission specialist; U.S. Sen. John H. Glenn Jr. (D.-Ohio), payload specialist; Pedro Duque, mission specialist representing the European Space Agency (ESA); Scott E. Parazynski, mission specialist; and Chiaki Mukai, payload specialist representing Japan's National Space Development Agency (NASDA). The photo was taken by Joe McNally, National Geographic, for NASA.

STS-61A Crew Portrait

NASA Technical Reports Server (NTRS)

1985-01-01

The crew assigned to the STS-61A mission included (front row left to right) Reinhard Furrer, German payload specialist; Bonnie J. Dunbar, mission specialist; and Henry W. Hartsfield, Jr. commander. On the back row, left to right, are Steven R. Nagel, pilot; Guion S. Bluford, mission specialist; Ernst Messerscmid, German payload specialist; and Wubbo J. Ockels, Dutch payload specialist. Launched aboard the Space Shuttle Challenger on October 30, 1985 at 12:00:00 noon (EST), the STS-61A mission's primary payload was the Spacelab D-1 (German Spacelab mission).

STS-42 Discovery, OV-103, official crew portrait

NASA Image and Video Library

1999-11-24

STS042-S-002 (November 1991) --- Payload specialists representing Canada and the European Space Agency (CSA - ESA) join five NASA astronauts for the January 1992 scheduled STS-42 mission. Left to right are astronauts Stephen S. Oswald, pilot; Roberta L. Bondar, payload specialist; Norman E. Thagard, payload commander; Ronald J. Grabe, mission commander; David C. Hilmers, mission specialist; Ulf Merbold, payload specialist; and William F. Readdy, mission specialist. The STS-42 mission will utilize the Space Shuttle Discovery to carry out experiments for the International Microgravity Laboratory (IML-1).

Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists.

PubMed

Broaddus, Michelle R; Owczarzak, Jill; Schumann, Casey; Koester, Kimberly A

2017-10-01

To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.

Value, Challenges, and Satisfaction of Certification for Multiple Sclerosis Specialists

PubMed Central

Halper, June

2014-01-01

Background: Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. Methods: A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Results: Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS specialists perceived significantly greater value and satisfaction than lapsed-certification MS specialists in terms of employer and peer recognition, validation of MS knowledge, and empowering MS patients. Lapsed-certification MS specialists reported increased confidence and caring for MS patients using evidence-based practice. Both currently certified and lapsed-certification groups reported dissatisfaction with MSCS recognition and pay/salary rewards. Conclusions: The results of this study can be used in efforts to encourage initial certification and recertification of interdisciplinary MS team members. PMID:25061432

Improving School Improvement: Development and Validation of the CSIS-360, a 360-Degree Feedback Assessment for School Improvement Specialists

ERIC Educational Resources Information Center

McDougall, Christie M.

2013-01-01

The purpose of the mixed methods study was to develop and validate the CSIS-360, a 360-degree feedback assessment to measure competencies of school improvement specialists from multiple perspectives. The study consisted of eight practicing school improvement specialists from a variety of settings. The specialists nominated 23 constituents to…

Developing a Vision: Strategic Planning and the Library Media Specialist. Greenwood Professional Guides in School Librarianship.

ERIC Educational Resources Information Center

Crowley, John D.

Although the role of the school library media specialist is frequently undervalued, the media specialist can become a leader in restructuring a school through strategic planning methods. The book shows library media specialists how to help direct the planning team that is developing the vision of the school's future. The overall strategic planning…

Art Appreciation as a Learned Competence: A Museum-Based Qualitative Study of Adult Art Specialist and Art Non-Specialist Visitors

ERIC Educational Resources Information Center

Bracun Sova, Rajka

2015-01-01

Since Bourdieu, it has been argued that art appreciation requires "knowledge". The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three…

Organizational Analysis of Food Service Management

DTIC Science & Technology

2011-06-01

35  d.  Senior Culinary Specialists on “Twilight” Tour ...................35  e.  NAVSUP Controls Quality of Life...Supply Centers COMSUBFOR Commander Submarine Force CS Culinary Specialist CSCS Culinary Specialist Senior Chief CVN Carrier Vessel Nuclear DDG Guided...attention of the Culinary Specialists. The type of assist visit can be tailored to the requirements identified by the requesting command. Normally

Does the specialist nurse enhance or deskill the general nurse?

PubMed

Marshall, Z; Luffingham, N

Much conflict and confusion surrounds the title and role of the specialist nurse, leading in some instances to disharmony between general and specialist nurses. It has been suggested that too many highly specialized nurses in a general area may lead to a deskilled workforce and fragmented care. Attempts to define the key concepts of specialist practice as described by the UKCC has resulted in elitism, conflict and abuse of the title. One suggestion to eliminate this conflict is for specialist nurses to achieve key competencies that encompass the role of the clinical expert. These key competencies should be devised by specialist nurses, in the absence of national guidelines, and be agreed by employers. They should incorporate the key roles of: change agent, expert clinician, educator, researcher and coordinator. It is contended that if all concerned have a clearer definition of the title, role and what is expected from the specialist nurse then this will result in reduced conflict and improved quality of care.

The future of coloproctology in the UK: the trainees view.

PubMed

Goodfellow, P B; Buchanan, G N

2005-01-01

Major changes are imminent in the mode of surgical training and the manner both ''general'' and ''specialist'' surgeons provide services. This is the first interactive survey of UK Coloproctology trainees. At the 2004 DUKES Club (colorectal trainees) meeting an interactive digital-media voting system enabled blinded assessment of members regarding training and organisational issues in Coloproctology. 78% of trainees intended to be colorectal specialists. 92% thought a specialist qualification necessary, 90% believed it should be administered at the time of certificate of completion of training (CCT). Overall, 40%, 40% and 20% would pay 1000 <, 1000-3000 pounds and > 5000 pounds respectively per year for adequate training. Over 80% thought low anterior resection, APER, major lower GI-bleeding, pelvic floor, IBD and rectal cancer surgery should only be performed by specialists, and many thought colonic cancer surgery (46%), diverticular surgery (52%), and perianal sepsis (38%) management was a specialist necessity. UK Colorectal trainees believe a specialist exam necessary, colorectal specialists should treat a defined group of conditions/cases and would pay for adequate training.

STS-95 Crew Portrait

NASA Technical Reports Server (NTRS)

1997-01-01

Five astronauts based at the Johnson Space Center (JSC) and two payload specialists comprising the STS-95 mission take a break from their training schedule to pose for the STS-95 preflight portrait. Seated (left to right) are Steven W. Lindsey, pilot; and Curtis L. Brown, commander. Standing (left to right) are Scott E. Parazynski, mission specialist; Stephen K. Robinson, mission specialist; Chiaki Mukai (NASDA), payload specialist; Pedro Duque (ESA), mission specialist; and John H. Glenn, payload specialist. Glenn was a U.S. Senator and the first American to orbit the Earth in Friendship 7 in February of 1962. The seven launched into Earth orbit aboard the Space Shuttle Discovery on October 29, 1998 at 2:19:34 pm (EST). The primary payload was SPACEHAB, in which many experiments were carried out.

Specialist payment schemes and patient selection in private and public hospitals.

PubMed

Wright, Donald J

2007-09-01

It has been observed that specialist physicians who work in private hospitals are usually paid by fee-for-service while specialist physicians who work in public hospitals are usually paid by salary. This paper provides an explanation for this observation. Essentially, fee-for-service aligns the interests of income preferring specialists with profit maximizing private hospitals and results in private hospitals treating a high proportion of short stay patients. On the other hand, salary aligns the interests of fairness preferring specialists with benevolent public hospitals that commit to admit all patients irrespective of their expected length of stay.

Information specialist for a coming age (1)

NASA Astrophysics Data System (ADS)

Fujii, Kunihiko

It is said that a drastic progress is being made in information service today. Author guesses what talent and quality will be needed for future information specialist, on the assumption of image of the future information service. In the highly computerized society, information specialist will be required to make a quick delivery of high quality information. To meet such a high level request from researchers, information specialist will have to acquire much more information technology than ever. In the coming age of SIS, information specialist should have a qualification for librarian and researcher, and try to offer the active service with the enhanced technology.

STS-45 crewmembers during zero gravity activities onboard KC-135 NASA 930

NASA Technical Reports Server (NTRS)

1991-01-01

STS-45 Atlantis, Orbiter Vehicle (OV) 104, crewmembers and backup payload specialist participate in zero gravity activities onboard KC-135 NASA 930. The crewmembers, wearing flight suits, float and tumble around an inflated globe during the few seconds of microgravity created by parabolic flight. With his hand on the fuselage ceiling is Payload Specialist Dirk D. Frimout. Clockwise from his position are Mission Specialist (MS) C. Michael Foale, Pilot Brian Duffy, backup Payload Specialist Charles R. Chappell, MS and Payload Commander (PLC) Kathryn D. Sullivan (with eye glasses), Commander Charles F. Bolden, and Payload Specialist Byron K. Lichtenberg.

Spacelab

NASA Image and Video Library

1991-01-28

The STS-40 crew portrait includes 7 astronauts. Pictured on the front row from left to right are F. Drew Gaffney, payload specialist 1; Milli-Hughes Fulford, payload specialist 2; M. Rhea Seddon, mission specialist 3; and James P. Bagian, mission specialist 1. Standing in the rear, left to right, are Bryan D. O’Connor, commander; Tamara E. Jernigan, mission specialist 2; and Sidney M. Gutierrez, pilot. Launched aboard the Space Shuttle Columbia on June 5, 1991 at 9:24; am (EDT), the STS-40 mission was the fifth dedicated Spacelab Mission, Spacelab Life Sciences-1 (SLS-1), and the first mission dedicated solely to life sciences.

STS-47 Japanese Payload Specialist Mohri and backups during Homestead training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Japanese Payload Specialist Mamoru Mohri (far left), backup Payload Specialist Takao Doi (center), and backup Payload Specialist Chiaki Mukai (right) participate in water survival training at Homestead Air Force Base, Florida. Dockside, Mohri and Mukai wash the salt water from their personalized helmets after a water exercise. The three-day course was attended by the STS-47 prime and alternate payload specialists shortly after they were announced for the scheduled summer of 1992 Spacelab Japan (SLJ) mission. Mohri, Doi, and Mukai all represent the National Space Development Agency of Japan (NASDA).

Various views of STS-95 Senator John Glenn during training

NASA Image and Video Library

1998-06-18

S98-08736 (9 April 1998) --- The STS-95 crew members sample space food as part of their training agenda for the scheduled late October/early November mission aboard the Space Shuttle Discovery. From the left are Pedro Duque, mission specialist representing the European Space Agency (ESA); Scott E. Parazynski, mission specialist; Steven W. Lindsey, pilot; Stephen K. Robinson, mission specialist; Chiaki Mukai, payload specialist representing Japan's National Space Development Agency (NASDA); U.S. Sen. John H. Glenn Jr., payload specialist; and Curtis L. Brown Jr., commander. The photo was taken by Joe McNally, National Geographic, for NASA.

Various views of STS-95 Senator John Glenn during training

NASA Image and Video Library

1998-06-18

S98-08735 (9 April 1998) --- Five members of the STS-95 crew participate in a food tasting session at NASA's Johnson Space Center. From the left are Pedro Duque, a mission specialist representing the European Space Agency (ESA); Scott E. Parazynski, mission specialist; Steven W. Lindsey, pilot; Stephen K. Robinson, mission specialist; and payload specialist Chiaki Mukai of Japan's National Space Development Agency (NASDA). At the session but not pictured are U.S. Sen. John H. Glenn Jr., payload specialist; and Curtis L. Brown Jr., commander. The photo was taken by Joe McNally, National Geographic, for NASA.

KSC-00pp1852

NASA Image and Video Library

2000-12-05

KENNEDY SPACE CENTER, Fla. -- Taking part in In-Flight Maintenance training, the STS-107 crew poses in front of the SPACEHAB Double Module. In back are Mission Specialist Laurel Clark, Payload Specialist Ilan Ramon of Israel, and Mission Specialist Kalpana Chawla; in front are Mission Specialist David M. Brown, Commander Rick D. Husband, Pilot William C. “Willie” McCool (behind) and Mission Specialist Michael Anderson. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC00pp1852

NASA Image and Video Library

2000-12-05

KENNEDY SPACE CENTER, Fla. -- Taking part in In-Flight Maintenance training, the STS-107 crew poses in front of the SPACEHAB Double Module. In back are Mission Specialist Laurel Clark, Payload Specialist Ilan Ramon of Israel, and Mission Specialist Kalpana Chawla; in front are Mission Specialist David M. Brown, Commander Rick D. Husband, Pilot William C. “Willie” McCool (behind) and Mission Specialist Michael Anderson. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC00pp1853

NASA Image and Video Library

2000-12-05

KENNEDY SPACE CENTER, Fla. -- Taking part in In-Flight Maintenance training, the STS-107 crew poses in front of the SPACEHAB Double Module. In back are Mission Specialist Laurel Clark, Payload Specialist Ilan Ramon of Israel and Mission Specialist Kalpana Chawla; in front are Mission Specialist David M. Brown, Commander Rick D. Husband, Pilot William C. “Willie” McCool (behind) and Mission Specialist Michael Anderson. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC-00pp1853

NASA Image and Video Library

2000-12-05

KENNEDY SPACE CENTER, Fla. -- Taking part in In-Flight Maintenance training, the STS-107 crew poses in front of the SPACEHAB Double Module. In back are Mission Specialist Laurel Clark, Payload Specialist Ilan Ramon of Israel and Mission Specialist Kalpana Chawla; in front are Mission Specialist David M. Brown, Commander Rick D. Husband, Pilot William C. “Willie” McCool (behind) and Mission Specialist Michael Anderson. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

Guidelines for the management of people with foot health problems related to rheumatoid arthritis: a survey of their use in podiatry practice.

PubMed

Williams, Anita E; Graham, Andrea S; Davies, Samantha; Bowen, Catherine J

2013-06-18

In the last decade there has been a significant expansion in the body of knowledge on the effects of rheumatoid arthritis (RA) on the foot and the management of these problems. Aligned with this has been the development of specialist clinical roles for podiatrists. However, despite being recommended by national guidelines, specialist podiatrists are scarce. In order to inform non-specialist podiatrists of the appropriate interventions for these foot problems, management guidelines have been developed and disseminated by a group of specialist podiatrists. The aim of this survey was to investigate the use of these guidelines in clinical practice. Following ethical approval an online questionnaire survey was carried out. The questions were formulated from a focus group and comprised fixed response and open response questions. The survey underwent cognitive testing with two podiatrists before being finalised. An inductive approach using thematic analysis was used with the qualitative data. 245 questionnaires were completed (128-non-specialist working in the private sector, 101 non-specialists working in the NHS and 16 specialist podiatrists). Overall, 97% of the non-specialists (n = 222) had not heard of the guidelines. The non-specialists identified other influences on their management of people with RA, such as their undergraduate training and professional body branch meetings. Three main themes emerged from the qualitative data: (i) the benefits of the foot health management guidelines, (ii) the barriers to the use of guidelines generally and (iii) the features of useable clinical guidelines. This study has revealed some crucial information about podiatrists' level of engagement with the foot health management guidelines and the use of guidelines in general. Specifically, the non-specialist podiatrists were less likely to use the foot health management guidelines than the specialist podiatrists. The positive aspects were that for the specialist practitioners, the guidelines helped them to identify their professional development needs and for the few non-specialists that did use them, they enabled appropriate referral to the rheumatology team for foot health management. The barriers to their use included a lack of understanding of the risk associated with managing people with RA and that guidelines can be too long and detailed for use in clinical practice. Suggestions are made for improving the implementation of foot health guidelines.

Internal medicine specialists' attitudes towards working part-time: a comparison between 1996 and 2004

PubMed Central

Lugtenberg, Marjolein; Heiligers, Phil JM; de Jong, Judith D; Hingstman, Lammert

2006-01-01

Background Although medical specialists traditionally hold negative views towards working part-time, the practice of medicine has evolved. Given the trend towards more part-time work and that there is no evidence that it compromises the quality of care, attitudes towards part-time work may have changed as well in recent years. The aim of this paper was to examine the possible changes in attitudes towards part-time work among specialists in internal medicine between 1996 and 2004. Moreover, we wanted to determine whether these attitudes were associated with individual characteristics (age, gender, investments in work) and whether attitudes of specialists within a partnership showed more resemblance than specialists' attitudes from different partnerships. Methods Two samples were used in this study: data of a survey conducted in 1996 and in 2004. After selecting internal medicine specialists working in general hospitals in The Netherlands, the sample consisted of 219 specialists in 1996 and 363 specialists in 2004. They were sent a questionnaire, including topics on the attitudes towards part-time work. Results Internal medicine specialists' attitudes towards working part-time became slightly more positive between 1996 and 2004. Full-time working specialists in 2004 still expressed concerns regarding the investments of part-timers in overhead tasks, the flexibility of task division, efficiency, communication and continuity of care. In 1996 gender was the only predictor of the attitude, in 2004 being a full- or a part-timer, age and the time invested in work were associated with this attitude. Furthermore, specialists' attitudes were not found to cluster much within partnerships. Conclusion In spite of the increasing number of specialists working or preferring to work part-time, part-time practice among internal medicine specialists seems not to be fully accepted. The results indicate that the attitudes are no longer gender based, but are associated with age and work aspects such as the number of hours worked. Though there is little evidence to support them, negative ideas about the consequences of part-time work for the quality of care still exist. Policy should be aimed at removing the organisational difficulties related to part-time work and create a system in which part-time practice is fully integrated and accepted. PMID:17026741

Perceived Life Satisfaction of Workplace Specialist I Faculty and Mentors Participating in a First-Year STEM Teacher Training Project

ERIC Educational Resources Information Center

Nickolich, David; Feldhaus, Charles; Cotton, Sam; Barrett, Andrew, II; Smallwood, Jim

2010-01-01

The purpose of this study was to measure perceived professional and personal life satisfaction of Indiana Workplace Specialist I (WS I) faculty and their mentors. Workplace Specialist I teachers are all first-year career and technical education (CTE) faculty who must complete the WS I training program to be eligible for the Workplace Specialist II…

Redefining "Community" through Collaboration and Co-Teaching: A Case Study of an ESOL Specialist, a Literacy Specialist, and a Fifth-Grade Teacher

ERIC Educational Resources Information Center

Ahmed Hersi, Afra; Horan, Deborah A.; Lewis, Mark A.

2016-01-01

This article explores the development of a professional learning community through a case study of three teachers--an ESOL specialist, a literacy specialist, and a fifth-grade teacher--who engaged in co-teaching and collaboration. The emerging community of practice offered these teachers a space to learn and problem-solve by utilizing their…

Trends and quality of care in outpatient visits to generalist and specialist physicians delivering primary care in the United States, 1997-2010.

PubMed

Edwards, Samuel T; Mafi, John N; Landon, Bruce E

2014-06-01

Although many specialists serve as primary care physicians (PCPs), the type of patients they serve, the range of services they provide, and the quality of care they deliver is uncertain. To describe trends in patient, physician, and visit characteristics, and compare visit-based quality for visits to generalists and specialists self-identified as PCPs. Cross-sectional study and time trend analysis. Nationally representative sample of visits to office-based physicians from the National Ambulatory Medical Care Survey, 1997-2010. Proportions of primary care visits to generalist and specialists, patient characteristics, principal diagnoses, and quality. Among 84,041 visits to self-identified PCPs representing an estimated 4.0 billion visits, 91.5 % were to generalists, 5.9 % were to medical specialists and 2.6 % were to obstetrician/gynecologists. The proportion of PCP visits to generalists increased from 88.4 % in 1997 to 92.4 % in 2010, but decreased for medical specialists from 8.0 % to 4.8 %, p = 0.04). The proportion of medical specialist visits in which the physician self-identified as the patient's PCP decreased from 30.6 % in 1997 to 9.8 % in 2010 (p < 0.01). Medical specialist PCPs take care of older patients (mean age 61 years), and dedicate most of their visits to chronic disease management (51.0 %), while generalist PCPs see younger patients (mean age 55.4 years) most commonly for new problems (40.5 %). Obstetrician/gynecologists self-identified as PCPs see younger patients (mean age 38.3 p < 0.01), primarily for preventive care (54.0 %, p < 0.01). Quality of care for cardiovascular disease was better in visits to cardiologists than in visits to generalists, but was similar or better in visits to generalists compared to visits to other medical specialists. Medical specialists are less frequently serving as PCPs for their patients over time. Generalist, medical specialist, and obstetrician/gynecologist PCPs serve different primary care roles for different populations. Delivery redesign efforts must account for the evolving role of generalist and specialist PCPs in the delivery of primary care.

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed

Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges

2012-12-31

Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of contracting in for EmOC. Local circumstances dictate balance between introduction or expansion of contracts with private sector and strengthening public provisions and that neither of these disregard the need to strengthen public systems. Sustainability of contracting in arrangements, their effect on increasing coverage of EmOC services in rural areas and overlapping provisions for contracting in EmOC specialists are issues for future consideration.

Part-time and full-time medical specialists, are there differences in allocation of time?

PubMed

de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

2006-03-03

An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part-time work is not only a female concern; there are also (international) trends for male medical specialists that show a decline in the number of hours worked. This indicates an overall change in attitudes towards the number of hours medical specialists should work.

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed Central

2012-01-01

Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of contracting in for EmOC. Local circumstances dictate balance between introduction or expansion of contracts with private sector and strengthening public provisions and that neither of these disregard the need to strengthen public systems. Sustainability of contracting in arrangements, their effect on increasing coverage of EmOC services in rural areas and overlapping provisions for contracting in EmOC specialists are issues for future consideration. PMID:23276148

The growth-defense trade-off and habitat specialization by plants in Amazonian forests.

PubMed

Fine, Paul V A; Miller, Zachariah J; Mesones, Italo; Irazuzta, Sebastian; Appel, Heidi M; Stevens, M Henry H; Sääksjärvi, Ilari; Schultz, Jack C; Coley, Phyllis D

2006-07-01

Tropical forests include a diversity of habitats, which has led to specialization in plants. Near Iquitos, in the Peruvian Amazon, nutrient-rich clay forests surround nutrient-poor white-sand forests, each harboring a unique composition of habitat specialist trees. We tested the hypothesis that the combination of impoverished soils and herbivory creates strong natural selection for plant defenses in white-sand forest, while rapid growth is favored in clay forests. Recently, we reported evidence from a reciprocal-transplant experiment that manipulated the presence of herbivores and involved 20 species from six genera, including phylogenetically independent pairs of closely related white-sand and clay specialists. When protected from herbivores, clay specialists exhibited faster growth rates than white-sand specialists in both habitats. But, when unprotected, white-sand specialists outperformed clay specialists in white-sand habitat, and clay specialists outperformed white-sand specialists in clay habitat. Here we test further the hypothesis that the growth defense trade-off contributes to habitat specialization by comparing patterns of growth, herbivory, and defensive traits in these same six genera of white-sand and clay specialists. While the probability of herbivore attack did not differ between the two habitats, an artificial defoliation experiment showed that the impact of herbivory on plant mortality was significantly greater in white-sand forests. We quantified the amount of terpenes, phenolics, leaf toughness, and available foliar protein for the plants in the experiment. Different genera invested in different defensive strategies, and we found strong evidence for phylogenetic constraint in defense type. Overall, however, we found significantly higher total defense investment for white-sand specialists, relative to their clay specialist congeners. Furthermore, herbivore resistance consistently exhibited a significant trade-off against growth rate in each of the six phylogenetically independent species-pairs. These results confirm theoretical predictions that a trade-off exists between growth rate and defense investment, causing white-sand and clay specialists to evolve divergent strategies. We propose that the growth-defense trade-off is universal and provides an important mechanism by which herbivores govern plant distribution patterns across resource gradients.

Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-07-01

Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are more likely to provide remote outreach services. The RHOF, as a formally structured comprehensive subsidy, further targets the provision of priority services into such locations on a regular, ongoing basis.

[How representative is the healthcare assessment website Zorgkaart Nederland? The evaluation of medical specialists by patients in the Netherlands].

PubMed

Stehmann, Tijs A; Goudriaan, W A Alexander; In 't Veen, J C C M Hans; Kollen, Boudewijn J; Verheyen, C C P M Kees

2016-01-01

To describe the number of ratings and the corresponding scores given to medical specialists on the Dutch healthcare assessment website 'Zorgkaart Nederland.nl', and evaluation of this website as tool for evaluation of quality. Explorative descriptive study. In July 2015, data were gathered from the public section of the healthcare assessment website 'ZorgkaartNederland.nl'. The number of specialists, the mean ratings per department (group mark), the number of evaluations, the number of medical specialists without a rating and the number of specialists with at least 9 ratings were registered per speciality, per hospital. Outcomes measures were the median number of ratings per speciality and the group score. Data were analysed using descriptive and non-parametric statistics. Each month, 763,000 unique visitors access ZorgkaartNederland.nl; on average, 0.08% of these registers a vote. There were 15,337 medical specialists, spread across 97 hospitals and 2,060 specialities on ZorgkaartNederland.nl, with a total of 45,548 evaluations. Of these, 6,682 (43.4%) specialists were not rated, and 1.165 (7.6%) had ≥ 9 ratings. Additionally, 327 (15.9%) departments were unrated. Surgical departments were evaluated more often, and their grades were significantly higher, than those of non-surgical departments. The website ZorgkaartNederland.nl shows ratings for 56.6% of all medical specialists. When the lower limit of at least 9 evaluations per specialist introduced by ZorgkaartNederland.nl was applied, only the grades for 7.6% of all specialists are valid. On average, 0.08% of unique visitors cast a vote. Surgical specialities have a higher number of evaluations and a higher score than non-surgical ones. ZorgkaartNederland.nl in its current form does not constitute a valid tool for evaluation of the quality of medical specialist care in the Netherlands. This article provides recommendations for improvement.

VO2 attained during treadmill running: the influence of a specialist (400-m or 800-m) event.

PubMed

James, David V B; Sandals, Leigh E; Draper, Stephen B; Maldonado-Martin, Sara; Wood, Dan M

2007-06-01

Previously it has been observed that, in well-trained 800-m athletes, VO2max is not attained during middle-distance running events on a treadmill, even when a race-type pacing strategy is adopted. Therefore, the authors investigated whether specialization in a particular running distance (400-m or 800-m) influences the VO2 attained during running on a treadmill. Six 400-m and six 800-m running specialists participated in the study.A 400-m trial and a progressive test to determine VO2max were completed in a counterbalanced order. Oxygen uptakes attained during the 400-m trial were compared to examine the influence of specialist event. A VO2 plateau was observed in all participants for the progressive test, demonstrating the attainment of VO2max. The VO2max values were 56.2 +/- 4.7 and 69.3 +/- 4.5 mL x kg-1 x min-1 for the 400-m- and 800-m-event specialists, respectively (P = .0003). Durations for the 400-m trial were 55.1 +/- 4.2 s and 55.8 +/- 2.3 s for the 400-m- and 800-m-event specialists, respectively. The VO2 responses achieved were 93.1% +/- 2.0% and 85.7% +/- 3.0% VO2max for the 400-m- and 800-m-event specialists, respectively (P = .001). These results demonstrate that specialist running events do appear to influence the percentage of VO2max achieved in the 400-m trial, with the 800-m specialists attaining a lower percentage of VO2max than the 400-m specialists. The 400-m specialists appear to compensate for a lower VO2max by attaining a higher percentage VO2max during a 400-m trial.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

PubMed

Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

2011-10-31

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

The universal, collaborative and dynamic model of specialist and advanced nursing and midwifery practice: A way forward?

PubMed

O'Connor, Laserina; Casey, Mary; Smith, Rita; Fealy, Gerard M; Brien, Denise O'; O'Leary, Denise; Stokes, Diarmuid; McNamara, Martin S; Glasgow, Mary Ellen; Cashin, Andrew

2018-03-01

To inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish healthcare system. A qualitative study was conducted to initiate this important area of inquiry. Purposive sampling was used to generate a sample of informants (n = 15) for the interviews. Nurses and midwives working in specialist and advanced practice and participants from other areas such as legislative, regulatory, policy, medicine and education were included in the sampling frame. Arguments for a new model of specialist and advanced practice were voiced. A number of participants proposed that flexibility within specialist and advanced practitioner career pathways was essential. Otherwise, there existed the possibility of being directed into specialised "silos," precluding movement to another area of integrated practice. Future specialist and advanced practice education programmes need to include topics such as the development of emotional and political intelligence. The contribution of specialist and advanced practice roles to the health service includes providing rapid access to care, seamless patient flow across services, early discharge and lead coordinator of the patient's care trajectory. There was a recommendation of moving towards a universal model to cultivate specialist and advanced nurse and midwife practitioners. The model design has Universal application in a range of contexts "U." It is Collaborative in its inclusivity of all key stakeholders "C." The model is Dynamic pertinent to accommodating movement of nurses and midwives across health continua rather than plateauing in very specialised "silos" "D." © 2017 John Wiley & Sons Ltd.

What Is an Adolescent Health Specialist?

MedlinePlus

... Health Specialists — The Best Care For Teens And Young Adults Adolescents have unique and important health care ... know how to communicate effectively with teens and young adults. Adolescent health specialists are also specially trained ...

Sports Medicine: What is a Sports Medicine Specialist?

MedlinePlus

What is a Sports Medicine Specialist? A physician with significant specialized training in both the treatment and prevention of illness and injury. The Sports Medicine Specialist helps patients maximize function and minimize ...

STS 51-L crewmembers briefed during training session

NASA Image and Video Library

1986-01-08

S86-25186 (December 1985) --- Five members of the prime crew for NASA?s STS-51L mission and a backup crew member are briefed during a training session in the Johnson Space Center?s (JSC) Shuttle Mock-up and Integration Laboratory. From left to right are astronaut Ellison S. Onizuka, mission specialist; Ronald E. McNair, mission specialist; Gregory D. Jarvis, Hughes payload specialist; Judith A. Resnik, mission specialist; Sharon Christa McAuliffe, citizen observer/payload specialist representing the Teacher-in-Space Project; and Barbara R. Morgan, backup payload specialist. The photograph was taken by Keith Meyers of the New York Times. EDITOR?S NOTE: The STS-51L crew members lost their lives in the space shuttle Challenger accident moments after launch on Jan. 28, 1986 from the Kennedy Space Center (KSC). Photo credit: NASA

STS-78 Crew at Pad 39B during TCDT

NASA Technical Reports Server (NTRS)

1996-01-01

STS-78 flight crew members and their alternates pose in front of the Space Shuttle Columbia at Launch Pad 39B during a break in Terminal Countdown Demonstration Test (TCDT) activities for that mission. They are (from left, standing) Alternate Payload Specialist Pedro Duque; Pilot Kevin R. Kregel; Mission Specialist Charles E. Brady, Jr.; Mission Commander Terence T. 'Tom' Henricks; Mission Specialist Richard M. Linnehan; Alternate Payload Specialist Luca Urbani; and Payload Specialist Jean- Jaques Favier. Kneeling in the foreground are Payload Specialist Robert D. Thirsk and Payload Commander Susan J. Helms. The TCDT includes a simulated full-scale countdown, crew pad egress training and other activities. During the nearly 16-day mission, the seven-member crew will conduct 22 medical, materials and physics investigations in the Life and Microgravity Spacelab (LMS) located in Columbia's payload bay.

CSHCN in Texas: meeting the need for specialist care.

PubMed

Young, M Cherilyn; Drayton, Vonna L C; Menon, Ramdas; Walker, Lesa R; Parker, Colleen M; Cooper, Sam B; Bultman, Linda L

2005-06-01

Assuring the sufficiency and suitability of systems of care and services for children with special health care needs (CSHCN) presents a challenge to Texas providers, agencies, and state Title V programs. To meet the need for specialist care, referrals from primary care doctors are often necessary. The objective of this study was to describe the factors associated with the need for specialist care and problems associated with obtaining referrals in Texas. Bivariate and multivariate analyses were performed using the National Survey of Children with Special Health Care Needs (NS-CSHCN) weighted sample for Texas (n = 719,014) to identify variables associated with the need for specialist care and problems obtaining referrals for specialist care. Medical need of the CSHCN and sensitivity to family values/customs was associated with greater need for specialist care, and Hispanic ethnicity and lower maternal education were associated with less need. Medical need, amount of time spent with doctors and sensitivity to values/customs, living in a large metropolitan statistical area, and lack of medical information were associated with problems obtaining a specialist care referral. Findings revealed some similarities and differences with meeting the need for specialist care when comparing Texas results to other studies. In Texas, aspects of customer satisfaction variables, especially doctors' sensitivity to family values/customs and parents' not receiving enough information on medical problems, were significantly associated with problems obtaining specialist referrals. Findings indicate a need to further research relationships and communication among doctors, CSHCN, and their families.

Job satisfaction of Department of Veterans Affairs peer mental health providers.

PubMed

Chang, Bei-Hung; Mueller, Lisa; Resnick, Sandra G; Osatuke, Katerine; Eisen, Susan V

2016-03-01

Department of Veterans Affairs (VA) peer specialists and vocational rehabilitation specialists are Veterans employed in mental health services to help other Veterans with similar histories and experiences. Study objectives were to (a) examine job satisfaction among these employees, (b) compare them to other VA mental health workers, and (c) identify factors associated with job satisfaction across the 3 cohorts. The study sample included 152 VA-employed peer specialists and 222 vocational rehabilitation specialists. A comparison group included 460 VA employees from the same job categories. All participants completed the Job Satisfaction Index (11 aspects and overall satisfaction ratings). Linear regression was used to compare job satisfaction and identify its predictors among the 3 cohorts. Job satisfaction was fairly high, averaging "somewhat satisfied" to "very satisfied" in 6 (peer specialists) and 9 (vocational rehabilitation specialists) of the 11 aspects and overall job ratings. Adjusting for length of employment, age and gender resulted in no significant group differences with 2 exceptions: White peer specialists were less satisfied with pay and promotion opportunities than vocational rehabilitation specialists and comparison-group employees. Across all cohorts, shorter length of time employed in the job was associated with higher job satisfaction. The high job satisfaction levels among the 2 peer cohorts suggest support for the policy of hiring peer specialists in the VA. Furthermore, the results are consistent with those of the nonveteran samples, indicating that integrating peer providers into mental health care is possible in VA and non-VA settings. (c) 2016 APA, all rights reserved).

STS-47 Payload Specialist Mohri adjusts life vest during Homestead training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Payload Specialist Mamoru Mohri adjusts his life jacket with a training instructor's assistance as backup (alternate) payload specialist Takao Doi looks on. The STS-47 prime and alternate payload specialists are participating in a special water survival training course hosted by Homestead Air Force Base in Florida. Mohri and Doi represent the National Space Development Agency of Japan (NASDA).

Survey of management of solitary thyroid nodules in Germany.

PubMed

Dietlein, M; Wegscheider, K; Vaupel, R; Schmidt, M; Schicha, H

2008-01-01

To compare the opinions of practitioners in primary care with those of thyroid specialists in Germany on the management of solitary thyroid nodules (Papillon 2005). Questionnaires were filled in by 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The test cases and their modifications described a solitary thyroid nodule of 2-3 cm with different levels of thyroid function and a hypoechogenic nodule of 1 cm in diameter. TSH determination and sonography were found to be standard procedures, followed by scintigraphy (selected by 84.7% of practitioners and 95.1% of specialists, p < 0.001) and fine needle aspiration cytology (54.5% of practitioners, 57.4% of specialists). For a hypoechogenic nodule calcitonin determination was advocated by 54.0% of endocrinologists and by 32.2% of nuclear medicine physicians (p < 0.001). A euthyroid solitary thyroid nodule would be treated medically by 77.8% of practitioners and by 85.7% of specialists, the combination of levothyroxine and iodine being clearly preferred (60.9% of practitioners and 67.1% of specialists). For a hyperfunctioning nodule the preference of radioiodine therapy was significantly higher in the specialist group (88.8%) than among the practitioners (52.2%). The main differences of opinion between practitioners and specialists focused on calcitonin screening and referral to radioiodine therapy.

Post-graduate education for medical specialists focused on patients with medically unexplained physical symptoms; development of a communication skills training programme.

PubMed

Weiland, Anne; Blankenstein, Annette H; Willems, Mariëtte H A; Van Saase, Jan L C M; Van der Molen, Henk T; Van Dulmen, Alexandra M; Arends, Lidia R

2013-09-01

Stepwise description of the development of a post-graduate communication skills training programme for medical specialists focused on patients with medically unexplained physical symptoms (MUPS) to improve specialist interaction with MUPS patients. Using the 'intervention mapping approach' we accomplished a needs assessment (literature study and pilot) to formulate intervention objectives and identify methods and techniques for a MUPS-focused communication skills training programme for medical specialists. A 14-h training programme which consists of experiential learning, role-play and feedback. Using skills from Cognitive Behavioural Therapy, medical specialists are stimulated to explore interrelating factors that reinforce symptoms, to reassure patients effectively and to provide plausible and understandable explanations for MUPS. Dealing with complex referrals and informing GPs properly are also practiced. By applying the 'intervention mapping approach' we were able to create a feasible and promising intervention to improve specialist interaction with MUPS patients. Intervention effects are currently being assessed in a randomized controlled trial. If the RCT demonstrates sufficient effectiveness and efficiency of the MUPS focused communication skills training programme for medical specialists the intervention could be embedded in post-graduate education of medical specialists and residents. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Exploring the situational motivation of medical specialists: a qualitative study.

PubMed

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M

2018-02-26

The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

Comparative genomics using microarrays reveals divergence and loss of virulence-associated genes in host-specific strains of the insect pathogen Metarhizium anisopliae.

PubMed

Wang, Sibao; Leclerque, Andreas; Pava-Ripoll, Monica; Fang, Weiguo; St Leger, Raymond J

2009-06-01

Many strains of Metarhizium anisopliae have broad host ranges, but others are specialists and adapted to particular hosts. Patterns of gene duplication, divergence, and deletion in three generalist and three specialist strains were investigated by heterologous hybridization of genomic DNA to genes from the generalist strain Ma2575. As expected, major life processes are highly conserved, presumably due to purifying selection. However, up to 7% of Ma2575 genes were highly divergent or absent in specialist strains. Many of these sequences are conserved in other fungal species, suggesting that there has been rapid evolution and loss in specialist Metarhizium genomes. Some poorly hybridizing genes in specialists were functionally coordinated, indicative of reductive evolution. These included several involved in toxin biosynthesis and sugar metabolism in root exudates, suggesting that specialists are losing genes required to live in alternative hosts or as saprophytes. Several components of mobile genetic elements were also highly divergent or lost in specialists. Exceptionally, the genome of the specialist cricket pathogen Ma443 contained extra insertion elements that might play a role in generating evolutionary novelty. This study throws light on the abundance of orphans in genomes, as 15% of orphan sequences were found to be rapidly evolving in the Ma2575 lineage.

Los Angeles Safety-Net Program eConsult System Was Rapidly Adopted And Decreased Wait Times To See Specialists.

PubMed

Barnett, Michael L; Yee, Hal F; Mehrotra, Ateev; Giboney, Paul

2017-03-01

Lack of timely access to specialty care is a significant problem among disadvantaged populations, such as those served by the Los Angeles County Department of Health Services. In 2012 the department implemented an electronic system for the provision of specialty care called the eConsult system, in which all requests from primary care providers for specialty assistance were reviewed by specialists. In many cases, the specialist can address the primary care provider's question via an electronic dialogue, thereby eliminating the need for the patient to see a specialist in person. We observed rapid growth in the use of eConsult: By 2015 the system was in use by over 3,000 primary care providers, and 12,082 consultations were taking place per month, compared to 86 in the third quarter of 2012. The median time to an electronic response from a specialist was one day, and 25 percent of eConsults were resolved without a specialist visit. Three to four years after implementation, the median time to a specialist appointment decreased significantly, while the volume of visits remained stable. eConsult systems are a promising and sustainable intervention that could improve access to specialist care for underserved patients. Project HOPE—The People-to-People Health Foundation, Inc.

One Point of View: Elementary School Mathematics Specialists: Where Are They?

ERIC Educational Resources Information Center

Dossey, John A.

1984-01-01

A plea is made for the mathematics education community to support the need for elementary school mathematics specialists. Roles of such specialists in primary as well as intermediate grades are listed. (MNS)

Protecting an endangered species: the contribution and constraints of nurses working in a specialist role.

PubMed

McCorkell, Gillian; Brown, Geraldine; Michaelides, Bernie; Coates, Vivien

2015-03-01

The project aims to assess current specialist practice in relation to the new and ever-changing healthcare climate and explore some of the issues that specialist nurses encounter. The current financial recession is driving a range of economic policy changes and consequently service provision, in particular the work and impact of nurses working in a specialist role, being examined. This has resulted in many specialist nurses feeling very vulnerable. A cross sectional survey was completed by nurses working in specialist roles (n = 96) in a large health and social care setting in the United Kingdom. A response rate of 62% was achieved: 44% provide nurse led clinics and 42% are nurse prescribers. The mean length of time qualified as a registered nurse was 27 years. Less than a third felt that the current computer system for activity recording reflected their current workload and 65% needed administrative support. This study demonstrates the insufficient resources available to specialist nurses resulting in inappropriate but necessary, use of time and restricted opportunities for learning and development. © 2013 John Wiley & Sons Ltd.

Specialization and competition in dental health services.

PubMed

Grytten, Jostein; Skau, Irene

2009-04-01

The number of specialists within dental health services has increased over the last few years. This raises the issue of how the services should be organized and funded. We describe the effect of one way of organizing the services, which is by relying on competition. In Norway, some oral specialists face real competition with general dental practitioners for the same patients (prosthetists, periodontists and endodontists), while other specialists do not (orthodontists and oral surgeons). The latter specialists have skills that give them exclusive possibilities to practice their profession. We find that competition can be effective for the specialists who experience real competition with general dental practitioners for patients. In situations where real competition does not exist, specialists can obtain market power and raise their fees. Our results are based on an analysis of a representative set of data from general dental practitioners and specialists in Norway. The specialities in which practitioners can exercise market power raise challenges related to the type of public policy that can reduce this market power in an appropriate way, and without involving too large costs for the authorities. (c) 2008 John Wiley & Sons, Ltd.

Simulation-Based Assessment of ECMO Clinical Specialists.

PubMed

Fehr, James J; Shepard, Mark; McBride, Mary E; Mehegan, Mary; Reddy, Kavya; Murray, David J; Boulet, John R

2016-06-01

The aims of the study were (1) to create multiple scenarios that simulate a range of urgent and emergent extracorporeal membrane oxygenation (ECMO) events and (2) to determine whether these scenarios can provide reliable and valid measures of a specialist's advanced skill in managing ECMO emergencies. Multiscenario simulation-based performance assessment was performed. The study was conducted in the Saigh Pediatric Simulation Center at St. Louis Children's Hospital. ECMO clinical specialists participated in the study. Twenty-five ECMO specialists completed 8 scenarios presenting acute events in simulated ECMO patients. Participants were evaluated by 2 separate reviewers for completion of key actions and for global performance. The scores were highest for the hemodilution scenario, whereas the air entrainment scenario had the lowest scores. Psychometric analysis demonstrated that ECMO specialists with more than 1 year of experience outperformed the specialists with less than 1 year of experience. Participants endorsed these sessions as important and representative of events that might be encountered in practice. The scenarios could serve as a component of an ECMO education curriculum and be used to assess clinical specialists' readiness to manage ECMO emergencies.

Negotiating jurisdiction in the workplace: a multiple-case study of nurse prescribing in hospital settings.

PubMed

Kroezen, M; Mistiaen, P; van Dijk, L; Groenewegen, P P; Francke, A L

2014-09-01

This paper reports on a multiple-case study of prescribing by nurse specialists in Dutch hospital settings. Most analyses of interprofessional negotiations over professional boundaries take a macro sociological approach and ignore workplace jurisdictions. Yet boundary blurring takes place and healthcare professionals renegotiate formal policies in the workplace. This paper studies the division of jurisdictional control over prescribing between nurse specialists and medical specialists in the workplace, and examines the relationship between workplace jurisdiction and legal jurisdiction over prescribing. Data collection took place in the Netherlands during the first half of 2013. The study used in-depth interviews with fifteen nurse specialists and fourteen medical specialists, non-participant observation of nurse specialists' prescribing consultations and document analysis. Great variety was found in the extent to which and way in which nurse specialists' legal prescriptive authority had been implemented. These findings suggest that there is considerable discrepancy between the division of jurisdictional control over prescribing at the macro (legal) level and the division at the micro (workplace) level. Copyright © 2014 Elsevier Ltd. All rights reserved.

STS-51B CREW PORTRAIT

NASA Image and Video Library

1984-10-24

S84-43852 (November 1984) --- These seven men have been training for NASA’s Spacelab 3/STS-51B mission scheduled for launch in late April 1985. On the front row are astronauts Robert F. Overmyer (left), commander; and Frederick D. Gregory, pilot. On the back row, left to right, are Don L. Lind, mission specialist; Taylor G. Wang, payload specialist; Norman E. Thagard and William E. Thornton, both mission specialists; and Lodewijk van den Berg, payload specialist.

STS 51-G crewmembers depart KSC's operations and checkout building

NASA Image and Video Library

1985-05-20

51G-S-117 (17 June 1985) --- 51-G crewmembers depart the Kennedy Space Center's operations and checkout building on their way to the launch pad for the launch of the Discovery. Leading the seven are Daniel C. Brandenstein, commander; and John O. Creighton, pilot. Following are Payload specialist Sultan Salman Abdelazize Al-Saud; John M. Fabian, mission specialist; Patrick Baudry, payload specialist; Shannon Lucid and Steven R. Nagel, mission specialists.

STS-78 Crew and alternates arrive at the SLF

NASA Technical Reports Server (NTRS)

1996-01-01

KENNEDY SPACE CENTER, FL. -- STS-78 Mission Commander Terence T. 'Tom' Henricks (third from left) displays an Olympic torch that was presented to the flight crew and their alternates after they arrived at KSC's Shuttle Landing Facility. With Henricks are (from left) Payload Specialist Jean-Jacques Favier (French Space Agency); Alternate Payload Specialist Luca Urbani (Italian Space Agency); Henricks; Mission Specialist Charles E. Brady Jr.; Payload Commander Susan J. Helms; Pilot Kevin R. Kregel; Mission Specialist Richard M. Linnehan; Alternate Payload Specialist Pedro Duque (European Space Agency); and Payload Specialist Robert Brenton Thirsk (Canadian Space Agency). The crew will take the torch with them on their upcoming spaceflight and then present it upon their return to a representative of the Atlanta Committee for the Olympic games (ACOG). The countdown clock began ticking earlier today toward the June 20 launch of the Space Shuttle Columbia on Mission STS-78, the fifth Shuttle flight of 1996.

STS-47 crew & backups pose for portrait in SLJ module at KSC during training

NASA Image and Video Library

1992-07-25

S92-44303 --- STS-47 Endeavour, Orbiter Vehicle (OV) 105, crew members and back-up payload specialists, wearing clean suits, pose for a group portrait in the Spacelab Japan (SLJ) module. The team is at the Kennedy Space Center's (KSC's) Orbiter Processing Facility (OPF) to inspect SLJ configuration and OV-105 preparations. Kneeling, from left, are back-up Payload Specialist Chiaki Naito-Mukai; Mission Specialist N. Jan Davis; and backup Payload Specialist Takao Doi. Standing, from the left, are Pilot Curtis L. Brown,Jr; Payload Commander Mark C. Lee; Jerome Apt; Payload Specialist Mamoru Mohri; Commander Robert L. Gibson; Mae C. Jemison; and back-up Payload Specialist Stanely L. Koszelak. Mohri, Mukai, and Doi represent the National Space Development Agency of Japan (NASDA). View provided by KSC with alternate KSC number KSC-92PC-1647. Photo credit: NASA

Are peer specialists happy on the job?

PubMed

Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina

2018-03-01

This study was designed to examine the impact of role clarity and job training on job satisfaction among peer specialists. A 3-part survey assessing job training, job satisfaction, and role clarity was administered online to 195 peer specialists who are members of the International Association of Peer Specialists. Data was analyzed using descriptive statistics, correlational analyses to include multiple linear regressions and analysis of variance. Self-study and online training methods were negatively correlated with job satisfaction while job shadowing was positively correlated with job satisfaction. Role clarity was positively correlated with job satisfaction and job training satisfaction as well as job shadowing and one-on-one training. The use of self-study and online training for peer specialists is contraindicated by current findings, which suggest the need to utilize job shadowing or training methods that allow for personal interaction between peer specialists and their colleagues. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study.

PubMed

Aldridge, Cassie; Bion, Julian; Boyal, Amunpreet; Chen, Yen-Fu; Clancy, Mike; Evans, Tim; Girling, Alan; Lord, Joanne; Mannion, Russell; Rees, Peter; Roseveare, Chris; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Temple, Mark; Watson, Sam; Lilford, Richard

2016-07-09

Increased mortality rates associated with weekend hospital admission (the so-called weekend effect) have been attributed to suboptimum staffing levels of specialist consultants. However, evidence for a causal association is elusive, and the magnitude of the weekend specialist deficit remains unquantified. This uncertainty could hamper efforts by national health systems to introduce 7 day health services. We aimed to examine preliminary associations between specialist intensity and weekend admission mortality across the English National Health Service. Eligible hospital trusts were those in England receiving unselected emergency admissions. On Sunday June 15 and Wednesday June 18, 2014, we undertook a point prevalence survey of hospital specialists (consultants) to obtain data relating to the care of patients admitted as emergencies. We defined specialist intensity at each trust as the self-reported estimated number of specialist hours per ten emergency admissions between 0800 h and 2000 h on Sunday and Wednesday. With use of data for all adult emergency admissions for financial year 2013-14, we compared weekend to weekday admission risk of mortality with the Sunday to Wednesday specialist intensity ratio within each trust. We stratified trusts by size quintile. 127 of 141 eligible acute hospital trusts agreed to participate; 115 (91%) trusts contributed data to the point prevalence survey. Of 34,350 clinicians surveyed, 15,537 (45%) responded. Substantially fewer specialists were present providing care to emergency admissions on Sunday (1667 [11%]) than on Wednesday (6105 [42%]). Specialists present on Sunday spent 40% more time caring for emergency patients than did those present on Wednesday (mean 5·74 h [SD 3·39] vs 3·97 h [3·31]); however, the median specialist intensity on Sunday was only 48% (IQR 40-58) of that on Wednesday. The Sunday to Wednesday intensity ratio was less than 0·7 in 104 (90%) of the contributing trusts. Mortality risk among patients admitted at weekends was higher than among those admitted on weekdays (adjusted odds ratio 1·10, 95% CI 1·08-1·11; p<0·0001). There was no significant association between Sunday to Wednesday specialist intensity ratios and weekend to weekday mortality ratios (r -0·042; p=0·654). This cross-sectional analysis did not detect a correlation between weekend staffing of hospital specialists and mortality risk for emergency admissions. Further investigation is needed to evaluate whole-system secular change during the implementation of 7 day services. Policy makers should exercise caution before attributing the weekend effect mainly to differences in specialist staffing. National Institute for Health Research Health Services and Delivery Research Programme. Copyright © 2016 Aldridge et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Specialist public health capacity in England: working in the new primary care organizations.

PubMed

Chapman, J; Shaw, S; Congdon, P; Carter, Y H; Abbott, S; Petchey, R

2005-01-01

To determine the capacity and development needs, in relation to key areas of competency and skills, of the specialist public health workforce based in primary care organizations following the 2001 restructuring of the UK National Health Service. Questionnaire survey to all consultants and specialists in public health (including directors of public health) based in primary care trusts (PCTs) and strategic health authorities (SHAs) in England. Participants reported a high degree of competency. However, skill gaps were evident in some areas of public health practice, most notably "developing quality and risk management" and in relation to media communication, computing, management and leadership. In general, medically qualified individuals were weaker on community development than non-medically qualified specialists, and non-medically qualified specialists were less able to perform tasks that require epidemiological or clinical expertise than medically qualified specialists. Less than 50% of specialists felt that their links to external organizations, including public health networks, were strong. Twenty-nine percent of respondents felt professionally isolated and 22% reported inadequate team working within their PCT or SHA. Approximately 21% of respondents expressed concerns that they did not have access to enough expertise to fulfil their tasks and that their skills were not being adequately utilized. Some important skill gaps are evident among the specialist public health workforce although, in general, a high degree of competency was reported. This suggests that the capacity deficit is a problem of numbers of specialists rather than an overall lack of appropriate skills. Professional isolation must be addressed by encouraging greater partnership working across teams.

Early stages of development of a peer specialist fidelity measure

PubMed Central

Chinman, Matthew; McCarthy, Sharon; Mitchell-Miland, Chantele; Daniels, Karin; Youk, Ada; Edelen, Maria

2017-01-01

OBJECTIVE Research on peer specialists (individuals with serious mental illness supporting others with serious mental illness in clinical and other settings), has not yet included the measurement of fidelity. Without measuring fidelity, it’s unclear if the absence of impact in some studies is attributable to ineffective peer specialist services or because the services were not true to the intended role. This paper describes the initial development of a peer specialist fidelity measure for two content areas: services provided by peer specialists and factors that either support or hamper the performance of those services. METHODS A literature search identified 40 domains; an expert panel narrowed the number of domains and helped generate and then review survey items to operationalize those domains. Twelve peer specialists, individuals with whom they work, and their supervisors participated in a pilot test and cognitive interviews regarding item content. RESULTS Peer specialists tended to rate themselves as having engaged in various peer service activities more than supervisors and individuals with whom they work. A subset of items tapping peer specialist services “core” to the role regardless of setting had higher ratings. Participants stated the measure was clear, appropriate, and could be useful in performance improvement. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although preliminary, findings were consistent with organizational research on performance ratings of supervisors and employees made in the workplace. Several changes in survey content and administration were identified. With continued work, the measure could crystalize the role of peer specialists and aid in research and clinical administration. PMID:27618462

Loss to specialist follow-up in congenital heart disease; out of sight, out of mind

PubMed Central

Wray, Jo; Frigiola, Alessandra; Bull, Catherine

2013-01-01

Objective To evaluate the scale and clinical importance of loss to follow-up of past patients with serious congenital heart disease, using a common malformation as an example. To better understand the antecedents of loss to specialist follow-up and patients’ attitudes to returning. Design Cohort study using NHS number functionality. Content and thematic analysis of telephone interviews of subset contacted after loss to follow-up. Patients, intervention and setting Longitudinal follow-up of complete consecutive list of all 1085 UK patients with repair of tetralogy of Fallot from single institution 1964–2009. Main outcome measures Survival, freedom from late pulmonary valve replacement, loss to specialist follow-up, shortfall in late surgical revisions related to loss to follow-up. Patients’ narrative about loss to follow-up. Results 216 (24%) of patients known to be currently alive appear not to be registered with specialist clinics; some are seen in general cardiology clinics. Their median age is 32 years and median duration of loss to follow-up is 22 years; most had been lost before Adult Congenital services had been consolidated in their present form. 48% of the late deaths to date have occurred in patients not under specialist follow-up. None of those lost to specialist follow-up has had secondary pulmonary valve replacement while 188 patients under specialist care have. Patients lost to specialist follow-up who were contacted by telephone had no knowledge of its availability. Conclusions Loss to specialist follow-up, typically originating many years ago, impacts patient management. PMID:23257171

Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish group report.

PubMed

Goenka, N; Turner, B; Vora, J

2011-12-01

The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors.

PubMed

Ashton, Toni; Brown, Paul; Sopina, Elizaveta; Cameron, Linda; Tenbensel, Timothy; Windsor, John

2013-09-27

As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated. Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Sources of job satisfaction and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system.

46 CFR 502.406 - Arbitration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Maritime Commission Dispute Resolution Specialist, binding arbitration may be used to resolve any and all... Judge. The Federal Maritime Commission Dispute Resolution Specialist may withhold such concurrence after... binding arbitration. (c)(1) The Federal Maritime Commission Dispute Resolution Specialist will appoint an...

Payload specialist Reinhard Furrer show evidence of previous blood sampling

NASA Technical Reports Server (NTRS)

1985-01-01

Payload specialist Reinhard Furrer shows evidence of previous blood sampling while Wubbo J. Ockels, Dutch payload specialist (only partially visible), extends his right arm after a sample has been taken. Both men show bruises on their arms.

Assessing the economic burden of Alzheimer's disease patients first diagnosed by specialists.

PubMed

Kirson, Noam Y; Desai, Urvi; Ristovska, Ljubica; Cummings, Alice Kate G; Birnbaum, Howard G; Ye, Wenyu; Andrews, J Scott; Ball, Daniel; Kahle-Wrobleski, Kristin

2016-07-11

It is not known if there is a differential impact on Alzheimer's disease (AD) diagnosis and outcomes if/when patients are diagnosed with cognitive decline by specialists versus non-specialists. This study examined the cost trajectories of Medicare beneficiaries initially diagnosed by specialists compared to similar patients who received their diagnosis in primary care settings. Patients with ≥2 claims for AD were selected from de-identified administrative claims data for US Medicare beneficiaries (5 % random sample). The earliest observed diagnosis of cognitive decline served as the index date. Patients were required to have continuous Medicare coverage for ≥12 months pre-index (baseline) and ≥12 months following the first AD diagnosis, allowing for up to 3 years from index to AD diagnosis. Time from index date to AD diagnosis was compared between those diagnosed by specialists (i.e., neurologist, psychiatrist, or geriatrician) versus non-specialists using Kaplan-Meier analyses with log-rank tests. Patient demographics, Charlson Comorbidity Index (CCI) during baseline, and annual all-cause medical costs (reimbursed by Medicare) in baseline and follow-up periods were compared across propensity-score matched cohorts. Patients first diagnosed with cognitive decline by specialists (n = 2593) were younger (78.8 versus 80.8 years old), more likely to be male (40 % versus 34 %), and had higher CCI scores and higher medical costs at baseline than those diagnosed by non-specialists (n = 13,961). However, patients diagnosed by specialists had a significantly shorter time to AD diagnosis, both before and after matching (mean [after matching]: 3.5 versus 4.6 months, p < 0.0001). In addition, patients diagnosed by specialists had significantly lower average total all-cause medical costs in the first 12 months after their index date, a finding that persisted after matching ($19,824 versus $25,863, p < 0.0001). Total per-patient annual medical costs were similar for the two groups starting in the second year post-index. Before and after matching, patients diagnosed by a specialist had a shorter time to AD diagnosis and incurred lower costs in the year following the initial cognitive decline diagnosis. Differences in costs converged during subsequent years. This suggests that seeking care from specialists may yield more timely diagnosis, appropriate care and reduced costs among those with cognitive decline.

Part-time and full-time medical specialists, are there differences in allocation of time?

PubMed Central

de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

2006-01-01

Background An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. Methods A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Results Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. Conclusion In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part-time work is not only a female concern; there are also (international) trends for male medical specialists that show a decline in the number of hours worked. This indicates an overall change in attitudes towards the number of hours medical specialists should work. PMID:16515698

A typology of specialists' clinical roles.

PubMed

Forrest, Christopher B

2009-06-08

High use of specialist physicians and specialized procedures coupled with low exposure to primary care are distinguishing traits of the US health care system. Although the tasks of the primary care medical home are well established, consensus on the normative clinical roles of specialist physicians has not been achieved, which makes it unlikely that the specialist workforce is being used most effectively and efficiently. This article describes a typology of specialists' clinical roles that is based on the conceptual basis for health care specialism and empirical evaluations of the specialty referral process. The report concludes with a discussion on the implications of the typology for improving the effectiveness and efficiency of the primary-specialty care interface.

"On the doctor's orders": A pilot study of the effects of website marketing for medical specialist providers under gatekeeping arrangements.

PubMed

Zwier, Sandra

2017-01-01

Websites from medical specialist providers are becoming increasingly marketing oriented, but there exists a paucity of empirical research on the effects. This experimental study explored effects of exposure to real websites from medical specialist providers among Dutch adults under physician gatekeeper arrangements. Exposure led to a stronger intention to seek treatment from the specialist provider and motivation to rely on the providers' claims. Weaker to absent effects were found for intention to question the physician gatekeeper's referral and this was chiefly motivated by the belief that "the doctor knows best." Implications for specialist provider marketing under gatekeeping arrangements are discussed.

STS-95 crew members greet families at Launch Pad 39B

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 crew members greet their families from Launch Pad 39B. From left, they are Mission Specialist Scott E. Parazynski, Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA), Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Stephen K. Robinson, Pilot Steven W. Lindsey, Mission Commander Curtis L. Brown Jr., and Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA). The crew were making final preparations for launch, targeted for liftoff at 2 p.m. on Oct. 29. The mission is expected to last 8 days, 21 hours and 49 minutes, returning to KSC at 11:49 a.m. EST on Nov. 7.

STS 51-L crewmembers during training session in flight deck simulation

NASA Technical Reports Server (NTRS)

1985-01-01

Shuttle mission simulator (SMS) scene of Astronauts Michael J. Smith, Ellison S. Onizuka, Judith A. Resnik, and Francis R. (Dick) Scobee in their launch and entry positions on the flight deck (46207); Left to right, Backup payload specialist Barbara R. Morgan, Teacher in Space Payload specialist Christa McAuliffe, Hughes Payload specialist Gregory B. Jarvis, and Mission Specialist Ronald E. McNair in the middeck portion of the Shuttle Mission Simulator at JSC (46208).

STS-45 crewmembers during zero gravity activities onboard KC-135 NASA 930

NASA Image and Video Library

1991-08-21

S91-44453 (21 Aug 1991) --- The crew of STS-45 is already training for its March 1992 mission, including stints on the KC-135 zero-gravity-simulating aircraft. Shown with an inflatable globe are, clockwise from the top, C. Michael Foale, mission specialist; Dirk Frimout, payload specialist; Brian Duffy, pilot; Charles R. (Rick) Chappell, backup payload specialist; Charles F. Bolden, mission commander; Byron K. Lichtenberg, payload specialist; and Kathryn D. Sullivan, payload commander.

STS-86 Mission Specialist David Wolf in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-86 Mission Specialist David A. Wolf, at center facing camera, prepares to enter the Space Shuttle Atlantis at Launch Pad 39A, with the assistance of Rick Welty, in foreground at center, United Space Alliance (USA) orbiter vehicle closeout chief; and closeout team members, in background from left, Jim Davis, NASA quality assurance specialist; and George Schramm, USA mechanical technician. STS-86 Mission Specialist Vladimir Georgievich Titov, in foreground at far left, is awaiting his turn.

[Databases for surgical specialists in Cancún, Quintana Roo].

PubMed

Contla-Hosking, Jorge Eduardo; Ceballos-Martínez, Zoila Inés; Peralta-Bahena, Mónica Esther

2004-01-01

Our aim was to identify the level of knowledge of surgical health-area specialists in Cancún, Quintana Roo, Mexico, from the personal productivity database. We carried out an investigation of 37 surgical specialists: 24 belonged to the Mexican Social Security Institute (IMSS), while 13 belonged to the Mexican Health Secretariat (SSA). In our research, we found that 61% of surgical health-area specialist physicians were familiar with some aspects of the institutional surgical registry, including the following: 54% knew of the existence of a personal registry of surgeries carried out, and 43% keep a record of their personal activities. From the latter percentage, 69% of surgical health-area specialist physicians mentioned keeping their records manually, while 44% used the computer. Results of the research suggest that these physicians would like to have some kind of record of the surgeries carried out by each. An important percentage of these specialists do not keep a personal record on a database; due to this lack of knowledge, we obtain incorrect information in institutional records of the reality of what is actually done. We consider it important to inform surgical specialists concerning the existence of personal institutional records in database form or even of record done manually, as well as correct terminology for the International Codification (CIE-9 & 10). We inform here of the need to encourage a culture in records and databases in the formative stage of surgeon specialists.

Didactical determinants use of information and communication technology in process of training of future specialists.

PubMed

Palamar, Borys I; Vaskivska, Halyna O; Palamar, Svitlana P

In the article the author touches upon the subject of significance of computer equipment for organization of cooperation of professor and future specialists. Such subject-subject interaction may be directed to forming of professional skills of future specialists. By using information and communication technologies in education system range of didactic tasks can be solved. Improving of process of teaching of subjects in high school, self-learning future specialists, motivating to learning and self-learning, the development of reflection in the learning process. The authors considers computer equipment as instrument for development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems on the creative basis. Based on results of researches the author comes to certain conclusions about the effectiveness of usage of computer technologies in process of teaching future specialists and their self-learning. Improper supplying of high schools with computer equipment, lack of appropriate educational programs, professors' teachers' poor knowledge and usage of computers have negative impact on organization of process of teaching disciplines in high schools. Computer equipment and ICT in general are the instruments of development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems. So, the formation of psychosocial environment of development of future specialist is multifaceted, complex and didactically important issue.

The European system of veterinary specialization.

PubMed

Romagnoli, Stefano

2010-01-01

Veterinary specialist diplomas were available in many European countries during the second half of the 20th century. However, such an early recognition of the importance of veterinary specialization actually delayed the concept of the European veterinary specialist in Europe, compared with the United States, where the first specialist colleges were established in the 1960s, because it was felt that the national system was functioning properly and there was therefore no need for a new structure in the European countries. The European Board of Veterinary Specialisation (EBVS) was established in 1996, and currently there are 23 specialist colleges with more than 2,600 veterinarians officially listed in the EBVS register as European specialists. The Advisory Committee on Veterinary Training (ACVT) approved the establishment of EBVS but never implemented a supervising body (with ACVT representation). Such a body, the European Coordinating Committee on Veterinary Training, was later implemented by the profession itself, although it still lacked a political component. Each college depends on the EBVS, which has the function to define standards and criteria for monitoring the quality of college diplomates. To become a European Diplomate, veterinarians must have gone through an intensive period of training supervised by a diplomate, after which candidates must pass an examination. Although the term European veterinary specialist still does not have any legal recognition, national specialist qualifications are being phased out in many countries because of the inherent higher quality of EBVS specialist qualifications.

Impact of specialist palliative care on coping with Parkinson's disease: patients and carers.

PubMed

Badger, Nathan J; Frizelle, Dorothy; Adams, Debi; Johnson, Miriam J

2018-06-01

UK guidelines recommend palliative care access for people with Parkinson's disease; however, this remains sporadic, and it is unknown whether specialist palliative care helps patients and carers cope with this distressing condition. This study aimed to explore whether, and how, access to specialist palliative care services affected patients' and carers' coping with Parkinson's disease. Semistructured interviews were conducted, audio-recorded and verbatim transcribed. Data were analysed using interpretative phenomenological analysis. Participants were patients with advanced idiopathic Parkinson's disease (n=3), and carers of people with Parkinson's disease (n=5, however, one diagnosis was reviewed) receiving care from an integrated specialist palliative care and Parkinson's disease service in North East England. Access to specialist palliative care helped participants cope with some aspects of advanced Parkinson's disease. Three superordinate themes were developed:' managing uncertainty', 'impacts on the self' and 'specialist palliative care maintaining a positive outlook'. Specialist palliative care helped patients and carers cope with advanced Parkinson's disease. Specialist palliative care is a complex intervention that acknowledges the complex and holistic nature of Parkinson's disease, enabling health in some domains despite continued presence of pathology. These exploratory findings support the utility of this approach for people living with Parkinson's disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Variation of fee-for-service specialist direct care work effort with patient overall illness burden.

PubMed

Goodman, Robert

2011-08-01

To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant (P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional cardiology. For many specialties, specialists do vary physician direct patient care utilization with patient overall illness burden. Accounting for patient overall health status is important to fairly compare specialists of certain specialties on utilization for health plan specialist network management. Additional study is required to evaluate health plan application of this methodology.

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

78 FR 14359 - Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

... Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Tampa, Florida; Amended Certification Regarding... Business Networks Services, Inc., Order Management Division, Philadelphia, Pennsylvania and Verizon...

Trying To Reduce Your Technostress?: Helpful Activities for Teachers and Library Media Specialists.

ERIC Educational Resources Information Center

McKenzie, Barbara K.; And Others

1997-01-01

As pressure increases to integrate technology into instruction, many teachers and library media specialists are having difficulty coping with "technostress." Presents suggestions and activities for teachers and library media specialists designed to reduce "technostress." (PEN)

Certification of School Media Specialists.

ERIC Educational Resources Information Center

Hawthorne, Dorothy, Ed.

Recommendations for certification requirements for the school media specialist in Texas were the concern of the conference reported here. Two papers presented were: "The Emerging Profession of Media Specialists," and "Certification for Tomorrow," chapter three of the proceedings gives a panel on "Certification" and…

"The Prognosis, Doctor?"

ERIC Educational Resources Information Center

Everhart, Nancy

1998-01-01

Updates a 1994 report on school library staffing, highlighting states with the best and worst student/librarian ratios, states requiring full-time certified library media specialists, states with site-based management, states replacing librarians with technology specialists. Lists states requiring full-time specialists for elementary,…

[Beginners' operations and medical specialist standards : Avoidance of criminal liability and civil liability].

PubMed

Schneider, H

2018-05-16

In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter. This article portrays the requirements of civil liability and criminal responsibility concerning beginners' operations on the basis of cases and judgments of the Federal Court and the Higher Regional Courts in Germany. Additionally, the reception of the jurisprudence by the relevant legal literature will be discussed. Jurisprudence and legal literature categorize breaches of duty of care. Assistant physicians can be subject to contributory negligence liabilities, while specialists can bear liabilities for negligent selection, organization or supervision. Responsible specialist and assistant physicians can protect themselves (and the patient) and avoid legal risks by only performing operations adequate to their educational level or by delegating operations to beginners and ensuring intervention by a specialist by supervision of the operation which is suitable to the assistant physician's level of education.

Fidelity of Implementation in Project Towards No Drug Abuse (TND): A Comparison of Classroom Teachers and Program Specialists

PubMed Central

Dent, Clyde W.; Skara, Silvana; Sun, Ping; Sussman, Steve

2011-01-01

This paper presents the results of an effectiveness trial of Project Towards No Drug Abuse [TND], in which we compared program delivery by regular classroom teachers and program specialists within the same high schools. Within 18 schools that were randomly assigned to the program or control conditions, health classrooms were assigned to program delivery by teachers or (outside) specialists. Classroom sessions were observed by pairs of observers to assess three domains of implementation fidelity: adherence, classroom process, and perceived student acceptance of the program. Pre- and immediate posttest survey data were collected from 2331 students. Of the four composite indexes of implementation fidelity that were examined, only one (quality of delivery) showed a difference between specialists and teachers, with marginally higher ratings of specialists (p < .10). Both teachers and program specialists achieved effects on three of the five immediate outcome measures, including program-specific knowledge, addiction concern, and social self-control. Students’ posttest ratings of the program overall and the quality of program delivery failed to reveal differences between the teacher- and specialist-led classrooms. These results suggest that motivated, trained classroom teachers can implement evidence-based prevention programs with fidelity and achieve immediate effects. PMID:17180722

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

PubMed

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

22 CFR 41.54 - Intracompany transferees (executives, managers, and specialists).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Intracompany transferees (executives, managers, and specialists). 41.54 Section 41.54 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION....54 Intracompany transferees (executives, managers, and specialists). (a) Requirements for L...

Research in Functionally Distributed Computer Systems Development. Volume XII. Design Considerations in Distributed Data Base Management Systems.

DTIC Science & Technology

1977-04-01

task of data organization, management, and storage has been given to a select group of specialists . These specialists (the Data Base Administrators...report writers, etc.) the task of data organi?9tion, management, and storage has been given to a select group of specialists . These specialists (the...distributed DBMS Involves first identifying a set of two or more tasks blocking each other from a collection of shared 12 records. Once the set of

STS-87 Mission Specialist Scott in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Winston Scott is assisted with his ascent and re-entry flight suit in the white room at Launch Pad 39B by Danny Wyatt, NASA quality assurance specialist. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. Scott is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, during STS-87. Scott also performed a spacewalk on the STS-72 mission.

STS-87 onboard crew portraits

NASA Image and Video Library

1997-12-16

STS087-307-006 (19 November – 5 December 1997) --- One of the crew members' traditional in-flight crew portraits has them posed in other-than traditional attire on the Space Shuttle Columbia's mid-deck. On the front row, from the left, are astronauts Steven W. Lindsey, pilot; Takao Doi, an international mission specialist representing Japan's National Space Development Agency (NASDA); and Winston E. Scott, mission specialist. In the back are astronauts Kevin R. Kregel, mission commander; and Kalpana Chawla, mission specialist, along with Ukrainian payload specialist Leonid K. Kadenyuk.

Can plant resistance to specialist herbivores be explained by plant chemistry or resource use strategy?

PubMed

Kirk, Heather; Vrieling, Klaas; Pelser, Pieter B; Schaffner, Urs

2012-04-01

At both a macro- and micro-evolutionary level, selection of and performance on host plants by specialist herbivores are thought to be governed partially by host plant chemistry. Thus far, there is little evidence to suggest that specialists can detect small structural differences in secondary metabolites of their hosts, or that such differences affect host choice or performance of specialists. We tested whether phytochemical differences between closely related plant species are correlated with specialist host choice. We conducted no-choice feeding trials using 17 plant species of three genera of tribe Senecioneae (Jacobaea, Packera, and Senecio; Asteraceae) and a more distantly related species (Cynoglossum officinale; Boraginaceae) containing pyrrolizidine alkaloids (PAs), and four PA-sequestering specialist herbivores of the genus Longitarsus (Chrysomelidae). We also assessed whether variation in feeding by specialist herbivores is attributable to different resource use strategies of the tested plant species. Plant resource use strategy was quantified by measuring leaf dry matter content, which is related to both plant nutritive value and to plant investment in quantitative defences. We found no evidence that intra-generic differences in PA profiles affect feeding by specialist herbivores. Instead, our results indicate that decisions to begin feeding are related to plant resource use strategy, while decisions to continue feeding are not based on any plant characteristics measured in this study. These findings imply that PA composition does not significantly affect host choice by these specialist herbivores. Leaf dry matter content is somewhat phylogenetically conserved, indicating that plants may have difficulty altering resource use strategy in response to selection pressure by herbivores and other environmental factors on an evolutionary time scale.

Motives that head and neck cancer patients have for contacting a specialist nurse - an empirical study.

PubMed

Salander, Pär; Isaksson, Joakim; Granström, Brith; Laurell, Göran

2016-11-01

The purpose of this study is to systematically explore the motives for patients with head and neck cancer to contact a specialist nurse during two years postdiagnosis. Research focusing on the role of specialist nurses in cancer care almost exclusively concern cancers other than head and neck cancer. Qualitative, descriptive study based on the contacts between patients with head and neck cancer and a specialist nurse. Patients were invited to contact a specialist nurse by telephone. The specialist nurse took systematic field notes, that is, she registered who contacted her, the nature of the call and the outcome. Sixty patients were included. In descending order, the motives for contact were questions about practical and uncomplicated matters, consultations about medical troubles/worries, presenting a report of the patient's situation, requests for additional information about the treatment plan and requests for medical information. The pattern of the patients' motivations for calling was not related to medical or social factors, suggesting that the initiative to make contact is very much a question of the complexity of individual life circumstances. Very few referrals were sent from the specialist nurse to other professionals. The specialist nurse turned out to be more than just a coordinator of health-care resources. The findings bring up questions about the potential of the nurse's function as a coordinator, but also as a potential attachment figure, and questions about the nurse's relationships to other professionals. When implementing a specialist nurse function, it is important to decide whether the function should be inspired by a broader relational perspective. In addition to the indispensible competence and experience in the clinical field of head and neck cancer, training in counselling and acquaintance with object-relational psychology will then be desirable. © 2016 John Wiley & Sons Ltd.

Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.

PubMed

Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn

2016-02-01

This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Helping or hindering: the role of nurse managers in the transfer of practice development learning.

PubMed

Currie, Kay; Tolson, Debbie; Booth, Jo

2007-09-01

This paper reports selected findings from a recent PhD study exploring how graduates from a BSc Specialist Nursing programme, with an NMC-approved Specialist Practitioner Qualification, engage in practice development during their subsequent careers. The UKCC (1998) defines specialist practice as requiring higher levels of judgement, discretion and decision-making, with leadership in clinical practice development forming a core dimension of this level of practice. However, there is little evidence in the published literature that describes or evaluates the practice development role of graduate specialist practitioners. This study applied a modified Glaserian approach to grounded theory methods. A preliminary descriptive survey questionnaire was posted to all graduates from the programme, response rate of 45% (n=102). From these respondents, theoretical sampling decisions directed the selection of 20 participants for interview, permitting data saturation. The grounded theory generated by this study discovered a basic social process labelled 'making a difference', whereby graduate specialist practitioners are increasingly able to impact in developing patient care at a strategic level by coming to own the identity of an expert practitioner (Currie, 2006). Contextual factors strongly influence the practitioner journey, with organizational position and other people presenting enabling or blocking conditions. The line manager plays a crucial role in helping or hindering graduate specialist practitioners to transfer their learning to the clinical setting and become active in practice development. Recommendations to enhance managerial support for the practice development role of graduate specialist practitioners are proposed. ADDING TO CURRENT KNOWLEDGE: This work adds to currently limited knowledge of the graduate specialist practitioners' role in the leadership of clinical practice development. In addition, the findings emphasize the potential influence of the workplace environment by analyzing organizational factors in the specific context of the graduate specialist practitioner attempting to develop practice.

Addressing the unequal geographic distribution of specialist doctors in indonesia: the role of the private sector and effectiveness of current regulations.

PubMed

Meliala, Andreasta; Hort, Krishna; Trisnantoro, Laksono

2013-04-01

As in many countries, the geographic distribution of the health workforce in Indonesia is unequal, with a concentration in urban and more developed areas, and a scarcity in rural and remote areas. There is less information on the distribution of specialist doctors, yet inequalities in their distribution could compromise efforts to achieve universal coverage by 2014. This paper uses data from 2007 and 2008 to describe the geographic distribution of specialist doctors in Indonesia, and to examine two key factors that influence the distribution and are targets of current policies: sources of income for specialist doctors, and specialist doctor engagement in private practice. The data demonstrates large differences in the ratio of specialist doctors to population among the provinces of Indonesia, with higher ratios on the provinces of the islands of Java, and much lower ratios on the more remote provinces in eastern Indonesia. Between 65% and 80% of specialist doctors' income derives from private practice in non-state hospitals or private clinics. Despite regulations limiting practice locations to three, most specialists studied in a provincial capital city were working in more than three locations, with some working in up to 7 locations, and spending only a few hours per week in their government hospital practice. Our study demonstrates that the current regulatory policies and financial incentives have not been effective in addressing the maldistribution of specialist doctors in a context of a growing private sector and predominance of doctors' income from private sources. A broader and more integrated policy approach, including more innovative service delivery strategies for rural and remote areas, is recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

Differences in the diagnosis and management of systemic lupus erythematosus by primary care and specialist providers in the American Indian/Alaska Native population.

PubMed

McDougall, J A; Helmick, C G; Lim, S S; Johnston, J M; Gaddy, J R; Gordon, C; Ferucci, E D

2018-06-01

Objectives The objective of this study is to investigate differences in the diagnosis and management of systemic lupus erythematosus (SLE) by primary care and specialist physicians in a population-based registry. Methods This study includes individuals from the 2009 Indian Health Service lupus registry population with a diagnosis of SLE documented by either a primary care provider or specialist. SLE classification criteria, laboratory testing, and medication use at any time during the course of disease were determined by medical record abstraction. Results Of the 320 individuals with a diagnosis of SLE, 249 had the diagnosis documented by a specialist, with 71 documented by primary care. Individuals with a specialist diagnosis of SLE were more likely to have medical record documentation of meeting criteria for SLE by all criteria sets (American College of Rheumatology, 79% vs 22%; Boston Weighted, 82% vs 32%; and Systemic Lupus International Collaborating Clinics, 83% vs 35%; p < 0.001 for all comparisons). In addition, specialist diagnosis was associated with documentation of ever having been tested for anti-double-stranded DNA antibody and complement 3 and complement 4 ( p < 0.001). Documentation of ever receiving hydroxychloroquine was also more common with specialist diagnosis (86% vs 64%, p < 0.001). Conclusions Within the population studied, specialist diagnosis of SLE was associated with a higher likelihood of having SLE classification criteria documented, being tested for biomarkers of disease, and ever receiving treatment with hydroxychloroquine. These data support efforts both to increase specialist access for patients with suspected SLE and to provide lupus education to primary care providers.

Cracking Taste Codes by Tapping into Sensory Neuron Impulse Traffic

PubMed Central

Frank, Marion E.; Lundy, Robert F.; Contreras, Robert J.

2008-01-01

Insights into the biological basis for mammalian taste quality coding began with electrophysiological recordings from “taste” nerves and this technique continues to produce essential information today. Chorda tympani (geniculate ganglion) neurons, which are particularly involved in taste quality discrimination, are specialists or generalists. Specialists respond to stimuli characterized by a single taste quality as defined by behavioral cross-generalization in conditioned taste tests. Generalists respond to electrolytes that elicit multiple aversive qualities. Na+-salt (N) specialists in rodents and sweet-stimulus (S) specialists in multiple orders of mammals are well-characterized. Specialists are associated with species’ nutritional needs and their activation is known to be malleable by internal physiological conditions and contaminated external caloric sources. S specialists, associated with the heterodimeric G-protein coupled receptor: T1R, and N specialists, associated with the epithelial sodium channel: ENaC, are consistent with labeled line coding from taste bud to afferent neuron. Yet, S-specialist neurons and behavior are less specific thanT1R2-3 in encompassing glutamate and E generalist neurons are much less specific than a candidate, PDK TRP channel, sour receptor in encompassing salts and bitter stimuli. Specialist labeled lines for nutrients and generalist patterns for aversive electrolytes may be transmitting taste information to the brain side by side. However, specific roles of generalists in taste quality coding may be resolved by selecting stimuli and stimulus levels found in natural situations. T2Rs, participating in reflexes via the glossopharynygeal nerve, became highly diversified in mammalian phylogenesis as they evolved to deal with dangerous substances within specific environmental niches. Establishing the information afferent neurons traffic to the brain about natural taste stimuli imbedded in dynamic complex mixtures will ultimately “crack taste codes.” PMID:18824076

The effect of socks on vertical and anteroposterior ground reaction forces in walking and running.

PubMed

Blackmore, Tim; Ball, Nick; Scurr, Joanna

2011-03-01

Previous research suggests that socks may have the potential for injury protection through the absorption and/or redistribution of impact forces. However, there is limited research regarding the shock attenuation qualities of athletic socks in sporting populations and previously observed pressure reductions have not been quantified using a force plate. Firstly to identify the effect of specialist athletic socks on vertical and anteroposterior ground reaction forces (GRFs) during walking and running. Secondly, to compare GRFs between specialist socks, non-specialist socks and barefoot walking and running conditions. Following ethical approval participants (n=5) completed five walking (1.52-1.68 m s(-1)) and running (3.8-4.2 m s(-1)) trials, unshod, over a force plate. This was completed before and after a 5000 m run (3.2 m s(-1)) in their own trainers in three conditions; barefoot, non-specialist socks and specialist running socks. Significant differences were identified between barefoot and specialist sock conditions for pre-intervention time to impact peak (F=3.110((2)), P=.05, r=.11) and maximum propulsive force (F=8.126((2)), P=.001, r=.25) when walking. Post hoc analysis identified an increase of .0016 s in time to impact peak when walking barefoot compared to the specialist sock condition (T=-7.402((4)), P=.002, r=.71). During walking the specialist sock also demonstrated a significant decrease of .075 BWs in maximum propulsive force when compared to the barefoot condition (T=-7.624((4)), P=.002, r=.79). Both significant effects diminished following the 5000 m run. Findings suggest that the specialist running sock has limited effects on GRFs and therefore may be responsible for a limited degree of shock attenuation experienced during walking. Copyright © 2010 Elsevier Ltd. All rights reserved.

Developing a speciality: regearing the specialist public health workforce.

PubMed

Chapman, J; Abbott, S; Carter, Y H

2005-03-01

To identify issues surrounding the future training needs of the specialist public health workforce following the most recent restructuring of the National Health Service (NHS) in England. All directors of public health (DsPH) based in strategic health authorities and nine senior staff working in public health at the regional level were invited to participate in a semi-structured telephone interview. Twenty-six people were interviewed. Many interviewees expressed concern that because consultants and specialists in public health will be working in much smaller teams than hitherto, they will have to generalize their skills to cover a much wider range of functions (including board-level duties). This may result in a loss of specialist expertise. Successful public health practice in the new structures will require new ways of interorganizational working that will add an administrative burden to specialists in public health. Also, the creation of a board-level post in each primary care trust (PCT) has resulted in more time spent on corporate responsibilities and less on public health for DsPH, who are often the only fully trained specialist in public health in their PCT. Furthermore, interviewees expressed their anxiety about the lack of diversity in the posts available to specialists in public health and particularly to those newly completing their specialist training. Generally, interviewees felt that traditional public health roles and responsibilities were being eclipsed by corporate and managerial ones. Professional development activities were being carried out, but in a rather ad-hoc fashion. Interviewees were hopeful that public health networks would lead professional development initiatives once they were more established. It is important that excellence in public health is maintained through a set of accreditable standards, whilst corporate skills, essential to successful public health practice in the new UK NHS, are developed among specialists in public health.

The challenge of the standardization of nursing specializations in Europe.

PubMed

Ranchal, A; Jolley, M J; Keogh, J; Lepiesová, M; Rasku, T; Zeller, S

2015-12-01

The evolution of health care is driving the need for specialist nursing knowledge. Specialist nurses have undertaken a formal training that focuses on a specific clinical area or population and are legitimated by a professional award or legal status. Specialist nurses are better able to provide the most specific and most appropriate care for both people and populations. This paper considers nursing's loose understanding of 'specialization' and the impact this has on those who seek employment outside their own nation but within the family of nations known as the European Union (EU). There is a lack of standardization for nursing specializations across the European Union that leads to lack of mobility across countries. Reports were reviewed from within the European Union, including specialist nursing groups and regulatory nursing bodies. Nurse specialists can be regarded as operating at nursing's 'leading edge'; however, it is here that nursing lacks organization and common standards. This is readily apparent in a EU bound together by the principle of freedom of movement and common professional and academic standards. It is now time for European Union nurses to look beyond the common standards for pre-registration courses and to consider the development of common standards for specialist nursing. Historical attempts to achieve common standards for specialist nursing have largely been unsuccessful due to the diversity of approaches to nurse specialization. It is time now for this challenge to be re-addressed so that specialist nurses can more freely work throughout the European Union. There is a pressing need for policy makers to define specialist nursing and to enable European Union-wide standards. © 2015 International Council of Nurses.

First year undergraduate nursing students and nursing mentors: An evaluation of their experience of specialist areas as their hub practice learning environment.

PubMed

McCallum, Jacqueline; Lamont, David; Kerr, Emma-Louise

2016-01-01

Specialist environments have traditionally not been considered as practice learning environments for year one nursing students. Through implementation of the hub and spoke model of practice learning this was implemented across one health board and Higher Education Institution in Scotland. Sixty nine students from specialist and 147 from general areas out of a total population of 467 students (46.2%) and thirteen mentors from specialist and 26 from general areas out of a total 577 mentors (6.7%) completed a questionnaire. The findings support this initiative and suggest in some cases student experiences are more positive in specialist environments. Copyright © 2015 Elsevier Ltd. All rights reserved.

Herbivores promote habitat specialization by trees in Amazonian forests.

PubMed

Fine, Paul V A; Mesones, Italo; Coley, Phyllis D

2004-07-30

In an edaphically heterogeneous area in the Peruvian Amazon, clay soils and nutrient-poor white sands each harbor distinctive plant communities. To determine whether a trade-off between growth and antiherbivore defense enforces habitat specialization on these two soil types, we conducted a reciprocal transplant study of seedlings of 20 species from six genera of phylogenetically independent pairs of edaphic specialist trees and manipulated the presence of herbivores. Clay specialist species grew significantly faster than white-sand specialists in both soil types when protected from herbivores. However, when unprotected, white-sand specialists dominated in white-sand forests and clay specialists dominated in clay forests. Therefore, habitat specialization in this system results from an interaction of herbivore pressure with soil type.

STS 61-A crew during emergency egress training

NASA Technical Reports Server (NTRS)

1985-01-01

STS 61-A crew during emergency egress training. Henry W. Hartsfield Jr., STS 61-A mission commander, uses a Sky-Genie to practice emergency egress from a Shuttle vehicle. This training was held in the Shuttle mockup and integration laboratory (41244); Ernst Messerschmid, German payload specialist, goes through a rehearsal of procedures involved in preparing for launch and landing aboard the Shuttle. Briefing Messerschmid is Alan N. Rochford (41245); Descending from a simulated Shuttle orbiter, using a Sky-Genie device, is Astronaut Henry M. Hartsfield, Jr. Watching in blue flight garments are other members of the crew. They are, left to right, Ernst Messerschmid, German payload specialist; James F. Buchli, mission specialist; Bonnie J. Dunbar, mission specialist; Wubbo J. Ockels, Dutch payload specialist.

14 CFR § 1214.812 - Payload specialists.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialists. § 1214.812 Section § 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

STS-26 Mission Specialist (MS) Hilmers prepares meal on OV-103's middeck

NASA Image and Video Library

1988-10-03

STS026-06-033 (5 Oct 1988) --- Astronaut David C. Hilmers, STS-26 mission specialist, reads teleprinted message which has been clipped to stowage locker doors on the middeck. Food, a galley and various experiments surround the mission specialist.

42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... incident to the service of, a physician, physician assistant, clinical nurse specialist, or nurse... assistant, clinical nurse specialist, or nurse practitioner, by anyone other than a physician, physician assistant, clinical nurse specialist, or nurse practitioner, the service and the person who furnishes the...

42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... incident to the service of, a physician, physician assistant, clinical nurse specialist, or nurse... assistant, clinical nurse specialist, or nurse practitioner, by anyone other than a physician, physician assistant, clinical nurse specialist, or nurse practitioner, the service and the person who furnishes the...

Learning Opportunities for Library Media Specialists

ERIC Educational Resources Information Center

Newton, Jennifer W.

2008-01-01

To address the varying needs of media specialists, area Educational Technology Training Centers, Regional Educational Service Agencies (RESA), and larger school systems are forming professional development communities or consortia that cater specifically to the continuing education needs of library media specialists. In addition to academic and…

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

Sports medicine and the accident and emergency medicine specialist.

PubMed

Abernethy, L; McNally, O; MacAuley, D; O'Neill, S

2002-05-01

Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training. To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine. A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements). VALUE OF RESEARCH: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

STS-95 Payload Specialist Glenn participates in a media briefing before returning to JSC

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, participates in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Also participating in the briefing were the other STS-95 crew members: Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

Complementary and Alternative Medicine Use in Musculoskeletal Disorders: Does Medical Skepticism Matter?

PubMed Central

Wiley-Exley, Elizabeth K; Mielenz, Thelma J; Norton, Edward C; Callahan, Leigh F

2007-01-01

Medical skepticism is the reservation about the ability of conventional medical care to significantly improve health. Individuals with musculoskeletal disorders seeing specialists usually experience higher levels of disability; therefore it is expected they might be more skeptical of current treatment and thus more likely to try Complementary and Alternative Medicine (CAM). The goal of this study was to define these relationships. These data were drawn from a cross-sectional survey from two cohorts: those seeing specialists (n=1,344) and non-specialists (n=724). Site-level fixed effects logistic regression models were used to test associations between medical skepticism and 10 CAM use categories. Some form of CAM was used by 88% of the sample. Increased skepticism was associated with one CAM category for the non-specialist group and six categories for the specialist group. Increased medical skepticism is associated with CAM use, but medical skepticism is more often associated with CAM use for those seeing specialists. PMID:19088894

STS-95 Payload Specialist Glenn and his wife pose before their return flight to JSC

NASA Technical Reports Server (NTRS)

1998-01-01

At the Skid Strip at Cape Canaveral Air Station, STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, poses with his wife Annie before their return flight to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew also includes Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

Host plant invests in growth rather than chemical defense when attacked by a specialist herbivore.

PubMed

Arab, Alberto; Trigo, José Roberto

2011-05-01

Plant defensive compounds may be a cost rather than a benefit when plants are attacked by specialist insects that may overcome chemical barriers by strategies such as sequestering plant compounds. Plants may respond to specialist herbivores by compensatory growth rather than chemical defense. To explore the use of defensive chemistry vs. compensatory growth we studied Brugmansia suaveolens (Solanaceae) and the specialist larvae of the ithomiine butterfly Placidina euryanassa, which sequester defensive tropane alkaloids (TAs) from this host plant. We investigated whether the concentration of TAs in B. suaveolens was changed by P. euryanassa damage, and whether plants invest in growth, when damaged by the specialist. Larvae feeding during 24 hr significantly decreased TAs in damaged plants, but they returned to control levels after 15 days without damage. Damaged and undamaged plants did not differ significantly in leaf area after 15 days, indicating compensatory growth. Our results suggest that B. suaveolens responds to herbivory by the specialist P. euryanassa by investing in growth rather than chemical defense.

Factors supporting good partnership working between generalist and specialist palliative care services: a systematic review.

PubMed

Gardiner, Clare; Gott, Merryn; Ingleton, Christine

2012-05-01

The care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, district nurses and others who have not undertaken specialist training in palliative care. A key focus of recent UK policy is improving partnership working across the spectrum of palliative care provision. However there is little evidence to suggest factors which support collaborative working between specialist and generalist palliative care providers. To explore factors that support partnership working between specialist and generalist palliative care providers. Systematic review. A systematic review of studies relating to partnership working between specialist and generalist palliative care providers was undertaken. Six electronic databases were searched for papers published up until January 2011. Of the 159 articles initially identified, 22 papers met the criteria for inclusion. Factors supporting good partnership working included: good communication between providers; clear definition of roles and responsibilities; opportunities for shared learning and education; appropriate and timely access to specialist palliative care services; and coordinated care. Multiple examples exist of good partnership working between specialist and generalist providers; however, there is little consistency regarding how models of collaborative working are developed, and which models are most effective. Little is known about the direct impact of collaborative working on patient outcomes. Further research is required to gain the direct perspectives of health professionals and patients regarding collaborative working in palliative care, and to develop appropriate and cost-effective models for partnership working.

Improving specialist drug prescribing in primary care using task and error analysis: an observational study.

PubMed

Chana, Narinder; Porat, Talya; Whittlesea, Cate; Delaney, Brendan

2017-03-01

Electronic prescribing has benefited from computerised clinical decision support systems (CDSSs); however, no published studies have evaluated the potential for a CDSS to support GPs in prescribing specialist drugs. To identify potential weaknesses and errors in the existing process of prescribing specialist drugs that could be addressed in the development of a CDSS. Semi-structured interviews with key informants followed by an observational study involving GPs in the UK. Twelve key informants were interviewed to investigate the use of CDSSs in the UK. Nine GPs were observed while performing case scenarios depicting requests from hospitals or patients to prescribe a specialist drug. Activity diagrams, hierarchical task analysis, and systematic human error reduction and prediction approach analyses were performed. The current process of prescribing specialist drugs by GPs is prone to error. Errors of omission due to lack of information were the most common errors, which could potentially result in a GP prescribing a specialist drug that should only be prescribed in hospitals, or prescribing a specialist drug without reference to a shared care protocol. Half of all possible errors in the prescribing process had a high probability of occurrence. A CDSS supporting GPs during the process of prescribing specialist drugs is needed. This could, first, support the decision making of whether or not to undertake prescribing, and, second, provide drug-specific parameters linked to shared care protocols, which could reduce the errors identified and increase patient safety. © British Journal of General Practice 2017.

Consumer satisfaction among patients and their general practitioners about involving nurse specialists in primary care for patients with urinary incontinence.

PubMed

Albers-Heitner, Pytha; Winkens, Ron; Berghmans, Bary; Joore, Manuela; Nieman, Fred; Severens, Johan; Lagro-Janssen, Toine

2013-06-01

Urinary incontinence (UI) is a very common problem, but existing guidelines on UI are not followed. To bring care in line with guidelines, we planned an intervention to involve nurse specialists on UI in primary care and assessed this in a randomised controlled trial. Alongside this intervention, we assessed consumer satisfaction among patients and general practitioners (GPs). Patients' satisfaction with the care provided by either nurse specialists (intervention group) or GPs (control group), respectively, was measured with a self-completed questionnaire. GPs' views on the involvement of nurse specialists were measured in a structured telephone interview. The patient satisfaction score on the care offered by nurse specialists was 8.4 (scale 1-10), vs. 6.7 for care-as-usual by GPs. Over 85% of patients would recommend nurse specialist care to their best friends and 77% of the GPs considered the role of the nurse specialist to be beneficial, giving it a mean score of 7.2. Although the sample was relatively small and the stability of the results only provisionally established, substituting UI care from GP to nurse specialist appears to be welcomed by both patients and GPs. Small changes like giving additional UI-specific information and devoting more attention to UI (which had been given little attention before) would provide a simple instrument to stimulate patients to change their behaviour in the right direction. © 2012 Nordic College of Caring Science.

Effect of Early Referral to Specialist in Dementia on Institutionalization and Functional Decline: Findings from a Population-Based Study.

PubMed

Pimouguet, Clément; Le-Goff, Mélanie; Rizzuto, Debora; Berr, Claudine; Leffondré, Karen; Pérès, Karine; Dartigues, Jean FranÇois; Helmer, Catherine

2016-01-01

Although early diagnosis has been hypothesized to benefit both patients and caregivers, until now studies evaluating the effect of early dementia diagnosis are lacking. To investigate the influence of early specialist referral for dementia on the risk of institutionalization and functional decline in Activity of Daily Living (ADL). Incident dementia cases were screened in a prospective population-based cohort, the Three-City Study, and initial specialist consultation for cognitive complaint was assessed at dementia diagnosis. Proportional hazard regression and illness-death models were used to test the association between specialist referral and, respectively, institutionalization and functional decline. Only one third of the incident individuals with dementia had consulted a specialist for cognitive problems early (36%). After adjustment on potential confounders (including cognitive and functional decline) and competing risk of death, participants who had consulted a specialist early in the disease course presented a higher rate of being institutionalized than those who did not (Hazard Ratio = 2.00, 95% Confidence Interval (CI): 1.09- 3.64). But early specialist referral was not associated with further functional decline (HR = 1.09, 95% CI: 0.71- 1.67). Early specialist referral in dementia is associated with increased risk of institutionalization but not with functional decline in ADL. These findings suggest that early care referral in dementia may be a marker of concern for patients and/or caregivers; subsequent medical and social care could be suboptimal or inappropriate to allow patients to stay longer at home.

Specificity of extrafloral nectar induction by herbivores differs among native and invasive populations of tallow tree.

PubMed

Wang, Yi; Carrillo, Juli; Siemann, Evan; Wheeler, Gregory S; Zhu, Lin; Gu, Xue; Ding, Jianqing

2013-08-01

Invasive plants can be released from specialist herbivores and encounter novel generalists in their introduced ranges, leading to variation in defence among native and invasive populations. However, few studies have examined how constitutive and induced indirect defences change during plant invasion, especially during the juvenile stage. Constitutive extrafloral nectar (EFN) production of native and invasive populations of juvenile tallow tree (Triadica sebifera) were compared, and leaf clipping, and damage by a native specialist (Noctuid) and two native generalist caterpillars (Noctuid and Limacodid) were used to examine inducible EFN production. Plants from introduced populations had more leaves producing constitutive EFN than did native populations, but the content of soluble solids of EFN did not differ. Herbivores induced EFN production more than simulated herbivory. The specialist (Noctuid) induced more EFN than either generalist for native populations. The content of soluble solids in EFN was higher (2·1 times), with the specialist vs. the generalists causing the stronger response for native populations, but the specialist response was always comparable with the generalist responses for invasive populations. These results suggest that constitutive and induced indirect defences are retained in juvenile plants of invasive populations even during plant establishment, perhaps due to generalist herbivory in the introduced range. However, responses specific to a specialist herbivore may be reduced in the introduced range where specialists are absent. This decreased defence may benefit specialist insects that are introduced for classical biological control of invasive plants.

Few older people in New Zealand who commit suicide receive specialist psychogeriatric services.

PubMed

Cheung, Gary; Casey, Jane

2014-08-01

Suicide in older people is a growing public health concern in many parts of the world. The literature on this issue is lacking in New Zealand. The aim of this study is to ascertain whether this group is accessing specialist psychogeriatric services. A retrospective case series study of completed suicides in older people (≥65 years) during a three-year period from January 2010 to December 2012 was performed. An online survey detailing demographic and clinical information was completed by psychiatrists in 15 of the 20 District Health Boards in New Zealand. Only about 15% of older people who committed suicide were accessing specialist psychogeriatric services and the group with the highest suicide rate (men≥85 years) did not feature in specialist services. Depression (61%) was the most common diagnosis and nearly half (35%) had had contact with specialist services within three days prior to the suicide. Over half (52%) had a history of past suicide attempt(s). Older people who complete suicide are infrequently accessing specialist services. In those that do, there are questions to be answered regarding suicide prediction and prevention for this high-risk group of vulnerable individuals. More research is required targeting those not accessing specialist services, in particular the high risk group of older men. The role of general practitioner, community care, the assessment and management of depression and whether there is any access issue to specialist psychogeriatric services require elucidation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Service innovation in glaucoma management: using a Web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme.

PubMed

Wright, Heathcote R; Diamond, Jeremy P

2015-03-01

To assess the importance of specialist supervision in a new model of glaucoma service delivery. An optometrist supported by three technicians managed each glaucoma clinic. Patients underwent testing and clinical examination before the optometrist triaged them into one of five groups: 'normal', 'stable', 'low risk', 'unstable' and 'high risk'. Patient data were uploaded to an electronic medical record to facilitate virtual review by a glaucoma specialist. 24 257 glaucoma reviews at three glaucoma clinics during a 31-month period were analysed. The clinic optometrists and glaucoma specialists had substantial agreement (κ 0.69). 13 patients were identified to be high risk by the glaucoma specialist that had not been identified as such by the optometrist. Glaucoma specialists amended 13% of the optometrists' interim decisions resulting in an overall reduction in review appointments by 2.4%. Employing technicians and optometrists to triage glaucoma patients into groups defined by risk of blindness allows higher risk patients to be directed to a glaucoma specialist. Virtual review allows the glaucoma specialist to remain in overall control while reducing the risk that patients are treated or followed-up unnecessarily. Demand for glaucoma appointments can be reduced allowing scarce medical resources to be directed to patients most in need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Low reproducibility between oral radiologists and general dentists with regards to radiographic diagnosis of caries.

PubMed

Pakbaznejad Esmaeili, Elmira; Pakkala, Tuomas; Haukka, Jari; Siukosaari, Päivi

2018-04-12

Early clinical and radiological diagnosis of dental caries is one of the fundamental objectives of clinical dentistry because of the high frequency of the disease and severe complications if caries remains untreated, especially among the elderly and patients with immunodeficiency. Dental panoramic tomography (DPT) is a common radiographic method for evaluating dentition when indicated, especially in an adult population. The aim of this study was to assess the reproducibility of diagnosis between specialists in oral radiology and general dentists with regards to caries lesions based on DPTs of adults. One-hundred DPTs taken from adult patients (average age 35) and then analyzed and reported on by 42 general dentists were then analyzed independently by two specialists in oral radiology with respect to caries lesions in the premolar and molar areas using radiographic criteria established for caries diagnosis. The general dentists versus oral radiologists were not calibrated before. Level of agreement between specialists and general dentists was measured using Cohen's kappa. Comparison between observations of general dentists and specialists in oral radiology showed that 61% of the caries lesions on proximal surfaces of premolars and molars observed by specialists went unobserved by general dentists. Cohen's kappa value for specialists was 0.85 (p < .001) and for each specialist and general dentists 0.48 (p < .001) and 0.44 (p < .001). The reproducibility between specialists in oral radiology and general dentists for detecting caries in DPTs was low.

Embracing technology: patients', family members' and nurse specialists' experience of communicating using e-mail.

PubMed

Cornwall, Amanda; Moore, Sally; Plant, Hilary

2008-07-01

This paper reports on a study exploring the usefulness of e-mail as a means of communication between nurse specialists and patients with lung cancer and their families. The study involved two lung cancer nurse specialists and 16 patients and family members who used e-mail with them during the 6-month study period. Data were collected from three sources: (1) e-mail contact between the nurse specialists and patients/family members, (2) patient/family member questionnaire and (3) a focus group/reflective session with the nurse specialists. Quantitative data collected from the e-mails and the questionnaires were analysed descriptively and are presented as summary statistics. Text data from the questionnaires and e-mails were analysed using content analysis. Findings suggest that e-mail can be an effective and convenient means of communication between nurse specialists, and patients and family members. Patients and family members reported high levels of satisfaction with this method of communication. It was found to be quick and easy, and patients and family members were satisfied with both the response and the speed of response from the nurse specialists. Nurse specialists were also positive about e-mail use and found that the benefits of using e-mail with patients/family members outweighed any disadvantages. Further investigation is recommended involving other health care professionals and different patient groups to ensure the safe and appropriate use of e-mail within health care.

A survey on regenerative surgery performed by Swiss specialists in periodontology with special emphasis on the application of enamel matrix derivatives in infrabony defects.

PubMed

Schröen, Ola; Sahrmann, Philipp; Roos, Malgorzata; Attin, Thomas; Schmidlin, Patrick R

2011-01-01

This survey aimed to evaluate the common practice of regenerative periodontal surgery with special regard to the use of enamel matrix derivatives (EMD, Emdogain® ) by board-certified specialists in periodontology and non-certified, but active members of the Swiss Society of Periodontology (SSP). A cross-sectional postal survey of 533 dentists, representing all members of the SSP practising in Switzerland, was conducted. The questionnaire consisted of three sections, assessing: 1) general personal information regarding the practice setting and education, 2) general questions regarding periodontal surgery practices and 3) specific questions regarding the use of EMD. The information obtained was compared and differences between specialists and non-specialists were calculated. P-values smaller than 5% were considered significant. Sixty-nine percent of the specialists answered the questionnaire, compared to only 37.4% of the non-specialists (overall: 42.4%). In general, specialists performed surgeries more frequently, and presented a significantly higher percentage of EMD users than the non-specialists. The application guidelines were followed in general. Some differences were observed in application and selection criteria. The subjective perception of clinical success varied greatly among clinicians. Residual pockets were reported to be present in approximately one third of the defects after therapy. In conclusion, this survey revealed that EMD was used on a regular basis by dentists performing periodontal therapy. In addition, the answers by both groups generally corresponded well with the current available literature.

42 CFR 485.604 - Personnel qualifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... in a CAH must meet the applicable requirements of this section. (a) Clinical nurse specialist. A clinical nurse specialist must be a person who performs the services of a clinical nurse specialist as.... (b) Nurse practitioner. A nurse practitioner must be a registered professional nurse who is currently...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

20 CFR 702.408 - Evaluation of medical questions; impartial specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Evaluation of medical questions; impartial specialists. 702.408 Section 702.408 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF... PROCEDURE Medical Care and Supervision § 702.408 Evaluation of medical questions; impartial specialists. In...

42 CFR 485.604 - Personnel qualifications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... in a CAH must meet the applicable requirements of this section. (a) Clinical nurse specialist. A clinical nurse specialist must be a person who performs the services of a clinical nurse specialist as.... (b) Nurse practitioner. A nurse practitioner must be a registered professional nurse who is currently...

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... master's degree in a defined clinical area of nursing from an accredited educational institution or a Doctor of Nursing Practice (DNP) doctoral degree; and (3) Be certified as a clinical nurse specialist by....26 are met. (e) Professional services. Clinical nurse specialists can be paid for professional...

The School Librarian as Information Specialist: A Vibrant Species

ERIC Educational Resources Information Center

Harris, Frances Jacobson

2011-01-01

In this article, the author talks about the school librarian as information specialist. She stresses that the school librarian's information specialist role is more important than ever. She offers her personal toolkit that consists of four strategies in helping and teaching students to use content responsibly.

Guidelines for Certification of Media Specialists.

ERIC Educational Resources Information Center

Galey, Minaruth; Grady, William F.

This certification model, which is a refined version of the 1974 AECT Certification Model, is directed to the needs of educational media specialists, their employers and educators, and to certifying and accrediting agencies that approve programs preparing educational media specialists. Included in the document are reports on accreditation and…

Making Generalists Out of Specialists.

ERIC Educational Resources Information Center

Malinowski, Jon C.

2001-01-01

Most camps use specialists to run activities and cabin leaders to manage campers. However, a generalist model offers greater leadership development opportunities. To implement a more generalist paradigm, have camp leaders express their areas of skill and interest, pair up experienced and inexperienced staff, allow specialists to cover activities…

Skill/Knowledge Commonalities in Selected Electronics Specialties.

DTIC Science & Technology

1986-10-01

Maintenance Specialist 241 19 30750 Telecomunications Systems Control Specialist 498 35 30950A Missile Det and Warning Radar Specialistc 18 30 309506... Telecomunications Systems Control Specialist 59 ( 5) 125 (10) 259 (21) :. aNumbers in parenthesis are percentage of total possible (1,257). bBased on principles

Beyond the Stacks: How Librarians Support Students and Schools

ERIC Educational Resources Information Center

Freeman, Joanna

2014-01-01

There are many different job titles for this position around the country: school librarian, library media specialist, information technology specialist, research technology specialist, and library media coordinator. The position has changed from primarily a traditional librarian position to a balance of teaching and librarianship, and it's…

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

Are Specialist Certification Examinations a Reliable Measure of Physician Competence?

ERIC Educational Resources Information Center

Burch, V. C.; Norman, G. R.; Schmidt, H. G.; van der Vleuten, C. P. M.

2008-01-01

High stakes postgraduate specialist certification examinations have considerable implications for the future careers of examinees. Medical colleges and professional boards have a social and professional responsibility to ensure their fitness for purpose. To date there is a paucity of published data about the reliability of specialist certification…

77 FR 24465 - Magnuson-Stevens Act Provisions; General Provisions for Domestic Fisheries; Application for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... . Include in the subject line ``Comments on Fisheries Specialists 2012 Scallop RSA EFP.'' Mail: Daniel S... 01930. Mark the outside of the envelope ``Comments on Fisheries Specialists EFP.'' Fax: (978) 281-9135. FOR FURTHER INFORMATION CONTACT: Christopher Biegel, Fishery Management Specialist, 978-281-9112...

42 CFR 485.604 - Personnel qualifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... in a CAH must meet the applicable requirements of this section. (a) Clinical nurse specialist. A clinical nurse specialist must be a person who— (1) Is a registered nurse and is licensed to practice nursing in the State in which the clinical nurse specialist services are performed in accordance with...

42 CFR 485.604 - Personnel qualifications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... in a CAH must meet the applicable requirements of this section. (a) Clinical nurse specialist. A clinical nurse specialist must be a person who— (1) Is a registered nurse and is licensed to practice nursing in the State in which the clinical nurse specialist services are performed in accordance with...

42 CFR 485.604 - Personnel qualifications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... in a CAH must meet the applicable requirements of this section. (a) Clinical nurse specialist. A clinical nurse specialist must be a person who— (1) Is a registered nurse and is licensed to practice nursing in the State in which the clinical nurse specialist services are performed in accordance with...

Becoming a Specialist Nurse in Psychiatric Mental Health Care

ERIC Educational Resources Information Center

Södergren, Ulrika; Benjaminson, Carin; Mattsson, Janet

2017-01-01

Background: Specialist nurse students are upon graduation certified to have increased their professional competence to an advanced level. But how do specialist nurse students themselves experience and understand their professional competence and its development upon graduation? This is what this study aims at describing. Method: This study has a…

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the statutory exclusions; and (3) Performs them while working in collaboration with a physician. (i) Collaboration is a process in which a clinical nurse specialist works with one or more physicians to deliver... collaboration, collaboration is a process in which a clinical nurse specialist has a relationship with one or...

Peculiarities of Future Social Sphere Specialists' Professional Training in Poland

ERIC Educational Resources Information Center

Zieba, Beata

2016-01-01

The article reviews certain aspects of organising the process of professional training of future specialists in social sphere. It identifies, considers and analyzes the main definitions of scientific research, the object of which is to make specialists in social sphere ready for professional activity. The article highlights peculiarities of…

The Association for Educational Communications and Technology: Division of School Media Specialists.

ERIC Educational Resources Information Center

Miller, Mary Mock

1993-01-01

Reports on the Division of School Media Specialists of the Association for Educational Communications and Technology (AECT). Highlights include the mission statement; publications; board members and committee chairs; activities at the AECT conferences; and future concerns, including public relations and marketing plans for media specialists and…

78 FR 41993 - Transport Handling Specialists, Inc.-Continuance in Control Exemption-RSL Railroad, LLC

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35726] Transport Handling Specialists, Inc.--Continuance in Control Exemption--RSL Railroad, LLC Transport Handling Specialists, Inc. (THS), has filed a verified notice of exemption (Notice) under 49 CFR 1180.2(d)(2) to continue in...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

Preparing Elementary Mathematics-Science Teaching Specialists.

ERIC Educational Resources Information Center

Miller, L. Diane

1992-01-01

Describes a professional development program to train math/science specialists for the upper elementary school grades. Using results from an interest survey, 30 teachers were chosen to participate in a 3-year program to become math/science specialists. Presents the teaching model used and the advantages for teachers and students in having subject…

Higher Education Institutions and Specialist Schools: Potential Partnerships

ERIC Educational Resources Information Center

Penney, Dawn; Houlihan, Barrie

2003-01-01

This paper argues that the development and growth in numbers of Specialist Schools in England raises a number of key questions about the relationships between higher education institutions (HEIs) involved in initial teacher training (ITT) and continuing professional development (CPD) work, and schools now designated as Specialist Schools. It…

22 CFR 501.8 - Reappointment of Foreign Service Officers and Career Overseas Specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Career Overseas Specialists. 501.8 Section 501.8 Foreign Relations BROADCASTING BOARD OF GOVERNORS APPOINTMENT OF FOREIGN SERVICE OFFICERS § 501.8 Reappointment of Foreign Service Officers and Career Overseas... Governors) may reappoint to the Service a former career Overseas Specialist. (a) Requirements for...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

Entomology Specialist 1-1. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

Jones, Jimmie L.

This individualized, self-paced course for training an entomology specialist was adapted from military curriculum materials for use in vocational and technical education. Completion of the course should provide students with basic information needed to accomplish the following duties of an entomology specialist: perform entomological work, apply…

(Power sector efficiency analysis in Costa Rica). [Power Sector Efficiency Analysis in Costa Rica

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

Waddle, D.B.

I traveled to San Jose, Costa Rica, to review the state of the electric power utility with a team of specialists, including a transmission and distribution specialist, a hydroelectric engineering specialist, and a thermal power plant specialist. The purpose of the mission was to determine the costs and benefits of efficiency improvements to supply side technologies employed by the Instituto Costarricense de Electricidad, the national power company in Costa Rica, and the potential contribution of these efficiency measures to the future electric power needs of Costa Rica.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers (in protective clothing) brief STS-117 Mission Specialist James Reilly (center) and STS-115 Mission Specialist Joseph Tanner (right) about the Japanese Experiment Module (JEM). Equipment familiarization is a routine part of astronaut training and launch preparations.

NASA Image and Video Library

2003-10-21

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers (in protective clothing) brief STS-117 Mission Specialist James Reilly (center) and STS-115 Mission Specialist Joseph Tanner (right) about the Japanese Experiment Module (JEM). Equipment familiarization is a routine part of astronaut training and launch preparations.

A Comparison of the Small and Disadvantaged Business Utilization Specialists (SADBUS’) Role at Navy Regional Contracting Center (NRCC) philadelphia, Pennsylvania and Navy Regional Contracting Center (NRCC) San Diego, California Detachment Long Beach

DTIC Science & Technology

1991-12-31

NAVAL POSTGRADUATE SCHOOL Monterey, California ITan THESIS A comparison of the Small and Disadvantaged Business Utilization Specialists (SADBUS...8217A -Approved for public release: distribution is unlimited A Comparison of the small and Disadvantaged Business Utilization-Specialists (SADBUSI) Role...I D TIC ufst Spcati1 ABSTRACT This thesis analyzes the role of the Small and Disadvantaged Business Utii4zati6n Specialist (SADBUS) at the Navy

Payload specialists Millie Hughes-Fulford in Body Mass Measurement Device

NASA Image and Video Library

1985-02-01

S85-26553 (Feb 1985) --- STS-40/SLS-1 payload specialist Millie Hughes-Fulford sits strapped in the special device scientists have developed for determining mass on orbit. As the chair swings back and forth, a timer records how much the crewmember's mass retards the chair's movement. Dr. Hughes-Fulford will be joined by three mission specialists, the mission commander, the pilot and a second payload specialist for the scheduled 10-day Spacelab Life Sciences-1 (SLS-1) mission. The flight is totally dedicated to biological and medical experimentation.

STS-47 Endeavour, OV-105, official crew portrait

NASA Image and Video Library

1992-06-01

STS047-S-002 (June 1992) --- These seven crew members are currently in training for the STS-47/Spacelab J mission scheduled for later this year. Pictured are (left to right, front) Jerome (Jay) Apt, mission specialist; Curtis L. Brown, pilot; and (left to right, rear) N. Jan Davis, mission specialist; Mark C. Lee, payload commander; Robert L. Gibson, mission commander; Mae C. Jemison, mission specialist; and Mamoru Mohri, payload specialist, representing the National Space Development Agency of Japan (NASDA). This is the Space Shuttle Endeavour's second scheduled mission.

A happy "thumbs up" from the crew of the Space Shuttle Endeavour and NASA Dryden Flight Research Center officials heralded the successful completion of mission STS-100

NASA Image and Video Library

2001-05-01

A happy "thumbs up" from the crew of the Space Shuttle Endeavour and NASA Dryden Flight Research Center officials heralded the successful completion of mission STS-100. Standing by the shuttle's rocket nozzles from left to right: Scott E. Prazynski, mission specialist (U.S.); Yuri V. Lonchakov, mission specialist (Russia); Kent V. Rominger, commander (U.S.); Wally Sawyer, NASA Dryden Flight Research Center deputy director; Kevin Petersen, NASA Dryden Flight Research Center director; Umberto Guidoni, mission specialist (European Space Agency); John L. Phillips, mission specialist (U.S.); Jeffrey S. Ashby, pilot (U.S.); and Chris A. Hadfield, mission specialist (Canadian Space Agency). The mission landed at Edwards Air Force Base, California, on May 1, 2001.

Challenging the 'view from nowhere': citizen reflections on specialist expertise in a deliberative process.

PubMed

Davies, Gail; Burgess, Jacquelin

2004-12-01

This paper presents analysis of citizen encounters with specialists in a deliberative process, called Deliberative Mapping, which explored options for addressing the shortage of organs for transplantation in the UK. There is a rich theoretical literature about the extent to which citizens are competent to question the knowledge claims of specialists in complex decision-making processes, suggesting the trustworthiness of scientific expertise will depend on the qualities of social interaction in face-to-face dialogue, but little empirical analysis of specific encounters. This paper presents evidence of how citizens located specialist expertise in making judgements about the legitimacy and credibility of specialist knowledge claims, in ways that reflect differences in epistemic procedures valued by the panels of men and women in this process.

Are cost differences between specialist and general hospitals compensated by the prospective payment system?

PubMed

Longo, Francesco; Siciliani, Luigi; Street, Andrew

2017-10-23

Prospective payment systems fund hospitals based on a fixed-price regime that does not directly distinguish between specialist and general hospitals. We investigate whether current prospective payments in England compensate for differences in costs between specialist orthopaedic hospitals and trauma and orthopaedics departments in general hospitals. We employ reference cost data for a sample of hospitals providing services in the trauma and orthopaedics specialty. Our regression results suggest that specialist orthopaedic hospitals have on average 13% lower profit margins. Under the assumption of break-even for the average trauma and orthopaedics department, two of the three specialist orthopaedic hospitals appear to make a loss on their activity. The same holds true for 33% of departments in our sample. Patient age and severity are the main drivers of such differences.

STS-95 crew members Glenn, Lindsey and Robinson at Launch Pad 39B

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Payload Specialist John H. Glenn Jr., senator from Ohio, smiles at his fellow crew members (middle) Pilot Steven W. Lindsey and (right) Mission Specialist Stephen K. Robinson while visiting Launch Pad 39B. The crew were making final preparations for launch, targeted for liftoff at 2 p.m. on Oct. 29. The other crew members (not shown) are Mission Specialist Scott E. Parazynski, Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA), Mission Commander Curtis L. Brown Jr., and Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA). The STS-95 mission is expected to last 8 days, 21 hours and 49 minutes, returning to KSC at 11:49 a.m. EST on Nov. 7.

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

PubMed

Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

2016-01-01

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

I am quitting my job. Specialist nurses in perioperative context and their experiences of the process and reasons to quit their job.

PubMed

Lögde, Ann; Rudolfsson, Gudrun; Broberg, Roma Runesson; Rask-Andersen, Anna; Wålinder, Robert; Arakelian, Erebouni

2018-05-01

The lack of specialist nurses in operating theatres is a serious problem. The aim of this study was to describe reasons why specialist nurses in perioperative care chose to leave their workplaces and to describe the process from the thought to the decision. Twenty specialist nurses (i.e. anaesthesia, NA, and operating room nurses) from seven university- and county hospitals in Sweden participated in qualitative individual in-depth interviews. Data were analysed by systematic text condensation. We identified four themes of reasons why specialist nurses quitted their jobs: the head nurses' betrayal and dismissive attitude, and not feeling needed; inhumane working conditions leading to the negative health effects; not being free to decide about one's life and family life being more important than work; and, colleagues' diminishing behaviour. Leaving one's job was described as a process and specialist nurses had thought about it for some time. Two main reasons were described; the head nurse manager's dismissive attitude and treatment of their employees and colleagues' mistreatment and colleagues' diminishing behaviour. Increasing knowledge on the role of the head nurse managers in specialist nurses' decision making for leaving their workplace, and creating a friendly, non-violent workplace, may give the opportunity for them to take action before it is too late.

Persistence of Coastal Vegetation in Supratidal Zones of Northern China

PubMed Central

Yang, Hongxiao; Chu, Jianmin

2013-01-01

Coastal vegetation comprises a number of coastal specialists and terrestrial generalists. It remains unclear how they persist on disturbed and undisturbed coastal conditions. We tested the hypothesis that coastal specialists may be superior to terrestrial generalists on supratidal zones of coasts, but their superiority can be influenced by human disturbances. Eight separate sandy coasts of the Shandong Peninsula were sampled, representing for disturbed and undisturbed sandy coasts. Plants growing on their supratidal zones were surveyed. On this basis, we compared the relative dominances, niche widths, and commonness of all species, and also analyzed species diversities of the coasts. Coastal specialists were found to be more common and widespread on supratidal zones of the sandy coasts than terrestrial generalists haphazardly invading from hinterlands. Coastal specialists exhibited lower Sørensen dissimilarities than terrestrial generalists among the coasts. Tourist trampling seemed more detrimental than pond fishery to coastal vegetation. Relative to terrestrial generalists, coastal specialists responded to human disturbances more deterministically, with steady decreases in species diversities. These evidences verify that coastal specialists are intrinsically superior to terrestrial generalists on supratidal zones of coasts, especially of undisturbed coasts, because their dispersal among coasts adapts well to local storm surge regime. They also validate that human disturbances can depress the superiority of coastal specialists, partly by inducing invasion of terrestrial generalists. PMID:24224026

Laboratory medicine education in Lithuania.

PubMed

Kucinskiene, Zita Ausrele; Bartlingas, Jonas

2011-01-01

In Lithuania there are two types of specialists working in medical laboratories and having a university degree: laboratory medicine physicians and medical biologists. Both types of specialists are officially being recognized and regulated by the Ministry of Health of Lithuania. Laboratory medicine physicians become specialists in laboratory medicine after an accredited 4-year multidisciplinary residency study program in Laboratory Medicine. The residency program curriculum for laboratory medicine physicians is presented. On December 9, 2009 the Equivalence of Standards for medical specialists was accepted and Lithuanian medical specialists in Clinical Chemistry and Laboratory Medicine can now apply for EC4 registration. Medical biologists become specialists in laboratory medicine after an accredited 2-year master degree multidisciplinary study program in Medical Biology, consisting of 80 credits. Various postgraduate advanced training courses for the continuous education of specialists in laboratory medicine were first introduced in 1966. Today it covers 1-2-week courses in different subspecialties of laboratory medicine. They are obligatory for laboratory medicine physicians for the renewal of their license. It is not compulsory for medical biologists to participate in these courses. The Centre of Laboratory Diagnostics represents a place for the synthesis and application of the basic sciences, the performance of research in various fields of laboratory medicine, as well as performance of thousands of procedures daily and provision of specific teaching programs.

How Dutch medical specialists perceive the competencies and training needs of medical residents in healthcare management.

PubMed

Berkenbosch, L; Bax, M; Scherpbier, A; Heyligers, I; Muijtjens, A M M; Busari, J O

2013-04-01

The Dutch postgraduate medical training has been revised to focus on seven competencies. The role as manager is one of these competencies. Recent studies show that this competency receives little attention during the residency training. In an earlier study, we discovered that residents perceived their competency as managers to be moderate. In this study, we investigated how medical specialists perceived the managerial competencies of medical residents and their need for management education. In September 2010, a 46-item questionnaire was designed which examined medical specialists' perceptions of the competency and needs of residents in the field of medical management. Two hundred ninety-eight specialists were invited via email to participate. Hundred twenty-nine specialists (43.3%) responded to our survey. They rated the residents' competencies in contract negotiating skills, knowledge of the healthcare system, and specialist department poorly. They felt that residents were competent in updating their medical knowledge. Ninety-four percent reported a need for training in management among residents. Preferred topics were time management and healthcare organization. The preferred training method was a workshop given during residency by an extramural expert. Dutch medical specialists perceive the management competencies of residents in some areas to be inadequate. They feel that training in medical management during residency is necessary.

Rural outreach by specialist doctors in Australia: a national cross-sectional study of supply and distribution.

PubMed

O'Sullivan, Belinda G; Joyce, Catherine M; McGrail, Matthew R

2014-09-04

Outreach has been endorsed as an important global strategy to promote universal access to health care but it depends on health workers who are willing to travel. In Australia, rural outreach is commonly provided by specialist doctors who periodically visit the same community over time. However information about the level of participation and the distribution of these services nationally is limited. This paper outlines the proportion of Australian specialist doctors who participate in rural outreach, describes their characteristics and assesses how these characteristics influence remote outreach provision. We used data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, collected between June and November 2008. Weighted logistic regression analyses examined the effect of covariates: sex, age, specialist residential location, rural background, practice arrangements and specialist group on rural outreach. A separate logistic regression analysis studied the effect of covariates on remote outreach compared with other rural outreach. Of 4,596 specialist doctors, 19% (n = 909) provided outreach; of which, 16% (n = 149) provided remote outreach. Most (75%) outreach providers were metropolitan specialists. In multivariate analysis, outreach was associated with being male (OR 1.38, 1.12 to 1.69), having a rural residence (both inner regional: OR 2.07, 1.68 to 2.54; and outer regional/remote: OR 3.40, 2.38 to 4.87) and working in private consulting rooms (OR 1.24, 1.01 to 1.53). Remote outreach was associated with increasing 5-year age (OR1.17, 1.05 to 1.31) and residing in an outer regional/remote location (OR 10.84, 5.82 to 20.19). Specialists based in inner regional areas were less likely than metropolitan-based specialists to provide remote outreach (OR 0.35, 0.17 to 0.70). There is a healthy level of interest in rural outreach work, but remote outreach is less common. Whilst most providers are metropolitan-based, rural doctors are more likely to provide outreach services. Remote distribution is influenced differently: inner regional specialists are less likely to provide remote services compared with metropolitan specialists. To benefit from outreach services and ensure adequate remote distribution, we need to promote coordinated delivery of services arising from metropolitan and rural locations according to rural and remote health need.

The impact of electronic consultation on a Canadian tertiary care pediatric specialty referral system: A prospective single-center observational study.

PubMed

Lai, Lillian; Liddy, Clare; Keely, Erin; Afkham, Amir; Kurzawa, Julia; Abdeen, Nishard; Audcent, Tobey; Bromwich, Matthew; Brophy, Jason; Carsen, Sasha; Fournier, Annick; Fraser-Roberts, Leigh; Gandy, Hazen; Hui, Charles; Johnston, Donna; Keely, Kathryn; Kontio, Ken; Lamontagne, Christine; Major, Nathalie; O'Connor, Michael; Radhakrishnan, Dhenuka; Reisman, Joe; Robb, Marjorie; Samson, Lindy; Sell, Erick; Splinter, William; van Stralen, Judy; Venkateswaran, Sunita; Murto, Kimmo

2018-01-01

Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults. Prospective observational cohort study. Single Canadian tertiary-care academic pediatric hospital (June 2014-16) servicing 1.2 million people. 1. PCPs already using eConsult. 2.Volunteer pediatric specialists provided services in addition to their regular workload. 3.Pediatric patients (< 18 years-old) referred for none-acute care conditions. Specialty service utilization and access, impact on PCP course-of-action and referral-patterns and survey-based provider satisfaction data were collected. 1064 eConsult requests from 367 PCPs were answered by 23 pediatric specialists representing 14 specialty-services. The top three specialties represented were: General Pediatrics 393 cases (36.9%), Orthopedics 162 (15.2%) and Psychiatry 123 (11.6%). Median specialist response time was 0.9 days (range <1 hour-27 days), most consults (63.2%) required <10minutes to complete and 21/21(100%) specialist survey-respondents reported minimal workload burden. For 515/1064(48.4%) referrals, PCPs received advice for a new or additional course of action; 391/1064(36.7%) referrals resulted in an averted face-to-face specialist visit. In 9 specialties with complete data, the median wait-time was significantly less (p<0.001) for an eConsult (1 day, 95%CI:0.9-1.2) compared with a face-to-face referral (132 days; 95%CI:127-136). The majority (>93.3%) of PCPs rated eConsult as very good/excellent value for both patients and themselves. All specialist survey-respondents indicated eConsult should be a continued service. Similar to adults, eConsult improves PCP access and timeliness to elective pediatric specialist advice and influences their care decisions, while reporting high end-user satisfaction. Further study is warranted to assess impact on resource utilization and clinical outcomes.

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline.

PubMed

Rees, Jon; Abrahams, Mark; Doble, Andrew; Cooper, Alison

2015-10-01

To improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non-specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non-specialist and specialist settings. To promote efficient referral of care between non-specialists and specialists and the involvement of the multidisciplinary team (MDT). The guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high-quality, published evidence was lacking. CBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTS - voiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first-line treatment include antibiotics, α-adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle. Chronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom-based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS. © 2015 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

Specialist nurses' perceptions of inviting patients to participate in clinical research studies: a qualitative descriptive study of barriers and facilitators.

PubMed

French, Caroline; Stavropoulou, Charitini

2016-08-11

Increasing the number of patients participating in research studies is a current priority in the National Health Service (NHS) in the United Kingdom. The role of specialist nurses in inviting patients to participate is important, yet little is known about their experiences of doing so. The aim of this study was to explore the perceptions of barriers and facilitators held by specialist nurses with experience of inviting adult NHS patients to a wide variety of research studies. A cross-sectional qualitative descriptive study was conducted between March and July 2015. Participants were 12 specialist nurses representing 7 different clinical specialties and 7 different NHS Trusts. We collected data using individual semi-structured interviews, and analysed transcripts using the Framework method to inductively gain a descriptive overview of barriers and facilitators. Barriers and facilitators were complex and interdependent. Perceptions varied among individuals, however barriers and facilitators centred on five main themes: i) assessing patient suitability, ii) teamwork, iii) valuing research, iv) the invitation process and v) understanding the study. Facilitators to inviting patients to participate in research often stemmed from specialist nurses' attitudes, skills and experience. Positive research cultures, effective teamwork and strong relationships between research and clinical teams at the local clinical team level were similarly important. Barriers were reported when specialist nurses felt they were providing patients with insufficient information during the invitation process, and when specialist nurses felt they did not understand studies to their satisfaction. Our study offers several new insights regarding the role of specialist nurses in recruiting patients for research. It shows that strong local research culture and teamwork overcome some wider organisational and workload barriers reported in previous studies. In addition, and in contrast to common practice, our findings suggest research teams may benefit from individualising study training and invitation procedures to specialist nurses' preferences and requirements. Findings provide a basis for reflection on practice for specialist nurses, research teams, policymakers, and all with an interest in increasing patient participation in research.

Understanding practice patterns of glaucoma sub-specialists in India

PubMed Central

Choudhari, Nikhil S.; Pathak-Ray, Vanita; Kaushik, Sushmita; Vyas, Prateep; George, Ronnie

2017-01-01

AIM To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI) were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57%) had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%). Goldmann applanation tonometry was preferred by 103 (72%) specialists whilst n=25 (17.4%) used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66%) whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively). Nearly three quarter specialists (n=96; 72%) preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93%) and medical management (prostaglandin analogue, n=104; 78%), respectively. Approximately only a third of the specialists surveyed (n=37; 28%) were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47%) were not operating on congenital glaucoma at all. CONCLUSION This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies. PMID:29062779

Supported employment specialist strategies to assist clients with severe mental illness and criminal justice issues.

PubMed

Whitley, Rob; Kostick, Kristin M; Bush, Philip W

2009-12-01

The aim of this study was to document and analyze common strategies used by supported employment specialists to overcome criminal justice issues among clients with severe mental illness. Semistructured qualitative interviews were conducted with a group of 22 supported employment specialists and their supervisors. Interviews were open ended and supplemented by ethnographic observation. Data were examined thematically by content analysis. Assisting clients with past and present criminal histories to find employment was confirmed as one of the hardest self-identified challenges for employment specialists. Three specific strategies commonly used by specialists for this subpopulation are documented and analyzed. These include taking an incremental approach with clients vis-à-vis obtaining work and career advancement, using a strengths-based model that emphasizes the client's strong points, and focusing the job search on "mom and pop" businesses that typically do not conduct background checks or do not have rigid recruitment policies. Enacting these strategies led to some deviation from the individualized placement and support model of supported employment. Participants noted that they felt most challenged when attempting to serve and assist clients with sex offenses. The findings imply that specialists are challenged when dealing with clients with criminal justice issues and use several approaches to overcome these challenges. Current specialist training may be deficient in preparing staff to effectively serve people with criminal justice issues. Further research should assess the efficacy of the approaches outlined in this article to give more guidance to specialists working with clients with criminal justice issues.

Adolescents and mothers value referral to a specialist service for chronic fatigue syndrome or myalgic encephalopathy (CFS/ME).

PubMed

Beasant, Lucy; Mills, Nicola; Crawley, Esther

2014-04-01

Paediatric chronic fatigue syndrome or myalgic encephalopathy (CFS/ME) is relatively common and disabling. Current guidance recommends referral to specialist services, although some general practitioners believe the label of CFS/ME is harmful and many are not confident about diagnosing CFS/ME. Aim Explore whether or not adolescents and their mothers value referral to a specialist service for young people with CFS/ME. A qualitative study nested within a feasibility study of interventions for CFS/ME [Specialist Medical Intervention and Lightning Evaluation (SMILE)]. In-depth interviews were undertaken with 13 mothers and 12 adolescents participating in the SMILE study. Transcripts were systematically assigned codes using the qualitative data organisation package NVivo and analysed thematically using techniques of constant comparison. Gaining access to the specialist service was difficult and took a long time. Mothers felt that they needed to be proactive and persistent, partly because of a lack of knowledge in primary and secondary care. Having gained access, mothers felt the CFS/ME service was useful because it recognised and acknowledged their child's condition and opened channels of dialogue between health-care professionals and education providers. Adolescents reported that specialist medical care resulted in better symptom management, although some adolescents did not like the fact that the treatment approach limited activity. Adolescents and their mothers value receiving a diagnosis from a specialist service and making progress in managing CFS/ME. General practitioners should support adolescents with CFS/ME in accessing CFS/ME specialist services, consistent with current guidance.

Specificity of extrafloral nectar induction by herbivores differs among native and invasive populations of tallow tree

PubMed Central

Wang, Yi; Carrillo, Juli; Siemann, Evan; Wheeler, Gregory S.; Zhu, Lin; Gu, Xue; Ding, Jianqing

2013-01-01

Background and Aims Invasive plants can be released from specialist herbivores and encounter novel generalists in their introduced ranges, leading to variation in defence among native and invasive populations. However, few studies have examined how constitutive and induced indirect defences change during plant invasion, especially during the juvenile stage. Methods Constitutive extrafloral nectar (EFN) production of native and invasive populations of juvenile tallow tree (Triadica sebifera) were compared, and leaf clipping, and damage by a native specialist (Noctuid) and two native generalist caterpillars (Noctuid and Limacodid) were used to examine inducible EFN production. Key results Plants from introduced populations had more leaves producing constitutive EFN than did native populations, but the content of soluble solids of EFN did not differ. Herbivores induced EFN production more than simulated herbivory. The specialist (Noctuid) induced more EFN than either generalist for native populations. The content of soluble solids in EFN was higher (2·1 times), with the specialist vs. the generalists causing the stronger response for native populations, but the specialist response was always comparable with the generalist responses for invasive populations. Conclusions These results suggest that constitutive and induced indirect defences are retained in juvenile plants of invasive populations even during plant establishment, perhaps due to generalist herbivory in the introduced range. However, responses specific to a specialist herbivore may be reduced in the introduced range where specialists are absent. This decreased defence may benefit specialist insects that are introduced for classical biological control of invasive plants. PMID:23761685

Freedom of choice of specialist physicians is important to Swiss resident: a cross-sectional study.

PubMed

Peytremann-Bridevaux, Isabelle; Ruffieux, Christiane; Burnand, Bernard

2011-12-19

To assess how important the possibility to choose specialist physicians is for Swiss residents and to determine which variables are associated with this opinion. This cross-sectional study used data from the 2007 Swiss population-based health survey and included 13,642 non-institutionalised adults who responded to the telephone and paper questionnaires. The dependent variable included answers to the question "How important is it for you to be able to choose the specialist you would like to visit?" Independent variables included socio-demographics, health and past year healthcare use measures. Crude and adjusted logistic regressions for the importance of being able to choose specialist physicians were performed, accounting for the survey design. 45% of participants found it very important to be able to choose the specialist physician they wanted to visit. The answers "rather important", "rather not important" and "not important" were reported by 28%, 20% and 7% of respondents. Women, individuals in middle/high executive position, those with an ordinary insurance scheme, those reporting ≥2 chronic conditions or poorer subjective health, or those who had had ≥2 outpatient visits in the preceding year were more likely to find this choice very important. In 2007, almost half of all Swiss residents found it very important to be able to choose his/her specialist physician. The further development of physician networks or other chronic disease management initiatives in Switzerland, towards integrated care, need to pay attention to the freedom of choice of specialist physicians that Swiss residents value. Future surveys should provide information on access and consultations with specialist physicians.

Effects of a Malpractice Crisis on Specialist Supply and Patient Access to Care

PubMed Central

Mello, Michelle M.; Studdert, David M.; DesRoches, Catherine M.; Peugh, Jordon; Zapert, Kinga; Brennan, Troyen A.; Sage, William M.

2005-01-01

Objective: To investigate specialist physicians' practice decisions in response to liability concerns and their perceptions of the impact of the malpractice environment on patient access to care. Summary Background Data: A perennial concern during “malpractice crises” is that liability costs will drive physicians in high-risk specialties out of practice, creating specialist shortages and access-to-care problems. Methods: Mail survey of 824 Pennsylvania physicians in general surgery, neurosurgery, orthopedic surgery, obstetrics/gynecology, emergency medicine, and radiology eliciting information on practice decisions made in response to rising liability costs. Results: Strong majorities of specialists reported increases over the last 3 years in patients' driving distances (58%) and waiting times (83%) for specialist care or surgery, waiting times for emergency department care (82%), and the number of patients forced to switch physicians (89%). Professional liability costs and managed care were both considered important contributing factors. Small proportions of specialists reported that they would definitely retire (7%) or relocate their practice out of state (4%) within the next 2 years; another third (32% and 29%, respectively) said they would likely do so. Forty-two percent of specialists have reduced or eliminated high-risk aspects of their practice, and 50% are likely to do so over the next 2 years. Conclusions: Our data suggest that claims of a “physician exodus” from Pennsylvania due to rising liability costs are overstated, but the malpractice situation is having demonstrable effects on the supply of specialist physicians in affected areas and their scope of practice, which likely impinges upon patients' access to care. PMID:16244532

Impact of referral letters on scheduling of hospital appointments: a randomised control trial.

PubMed

Jiwa, Moyez; Meng, Xingqiong; O'Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-07-01

Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ(2) and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed. © British Journal of General Practice 2014.

Scholarly Productivity of School Psychology Faculty Members in Specialist-Level Programs: 2002-2011

ERIC Educational Resources Information Center

Laurent, Jeff; Runia, Elizabeth

2016-01-01

The scholarly productivity of school psychology faculty members in specialist-level only programs was examined. Information was gathered from the School Psychology Program Information portion of the website for the National Association of School Psychologists. A total of 137 specialist-level only school psychology programs were identified.…

Administrative Perceptions on the Role of the School Library Media Specialist

ERIC Educational Resources Information Center

Page, Kayla

2013-01-01

Despite the efforts of local school library media specialists to promote their programming, many administrators do not understand the roles and responsibilities of the school library media specialist. Using a constructivist theoretical framework, this study was designed to examine the local school administrators' perceptions of the role of the…

Health Education Specialist Practice Analysis 2015 (HESPA 2015): Process and Outcomes

ERIC Educational Resources Information Center

McKenzie, James F.; Dennis, Dixie; Auld, M. Elaine; Lysoby, Linda; Doyle, Eva; Muenzen, Patricia M.; Caro, Carla M.; Kusorgbor-Narh, Cynthia S.

2016-01-01

The Health Education Specialist Practice Analysis 2015 (HESPA 2015) was conducted to update and validate the Areas of Responsibilities, Competencies, and Sub-competencies for Entry- and Advanced-Level Health Education Specialists. Two data collection instruments were developed--one was focused on Sub-competencies and the other on knowledge items…

Identifying the educational needs of nursing staff: the role of the clinical nurse specialist in perinatal nursing.

PubMed

Millhaem, Toni Brown; Timm, Kathleen

2007-01-01

One of the priorities of the perinatal clinical nurse specialist is the identification of educational needs. This article describes the experience of 2 perinatal clinical nurse specialists and presents various methods for identifying the educational needs of perinatal nursing staff in the hospital setting.

14 CFR § 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialist relationship with sponsoring institutions. § 1214.306 Section § 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

Ensemble modeling to predict habitat suitability for a large-scale disturbance specialist

Treesearch

Quresh S. Latif; Victoria A. Saab; Jonathan G. Dudley; Jeff P. Hollenbeck

2013-01-01

To conserve habitat for disturbance specialist species, ecologists must identify where individuals will likely settle in newly disturbed areas. Habitat suitability models can predict which sites at new disturbances will most likely attract specialists. Without validation data from newly disturbed areas, however, the best approach for maximizing predictive accuracy can...

Special Education Technology Specialist. Careers in Special Education and Related Services.

ERIC Educational Resources Information Center

National Clearinghouse for Professions in Special Education, Reston, VA.

Designed for high school students interested in careers in special education and related services, this guide outlines the role of the special education technology specialist. It addresses the nature of the work, the education required, personal qualities that technology specialists should have, job outlook and advancement, and how to prepare for…

76 FR 814 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Order Approving a Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-06

... proposes to establish new minimum performance standards for specialist units.\\12\\ Specifically, new Rule... Streamline the Process for Specialist Evaluations and Clarify the Time Within Which SQTs and RSQTs Must Begin...-4 thereunder,\\2\\ a proposed rule change to update and streamline the process for specialist...

STS-40 Payload Specialist Hughes-Fulford "flies" through SLS-1 module

NASA Image and Video Library

1991-06-14

STS040-212-006 (5-14 June 1991) --- Payload specialist Millie Hughes-Fulford floats through the Spacelab Life Sciences (SLS-1) module aboard the Earth-orbiting Columbia. Astronaut James P. Bagian, mission specialist, is at the blood draw station in the background. The scene was photographed with a 35mm camera.

77 FR 13162 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... (``PFOF'') program that helps its Specialists \\5\\ and Directed Registered Options Traders [[Page 13163... flow provider directing some or all of its order flow to that Specialist or Directed ROT. This program is funded through fees paid by Registered Options Traders (``ROTs''), Specialists and Directed ROTs...

The Changing Role of the Reading Specialist: A Case Study

ERIC Educational Resources Information Center

Ginsburg, Victoria Elaine

2012-01-01

This descriptive qualitative case study explored the changing role of the reading specialist through various perceptions of professionals in the Neon Shadow School District. The purpose of the study was to explore what, how, and why the duties and responsibilities of the reading specialist have changed since first employed as an…

42 CFR 424.24 - Requirements for medical and other health services furnished by providers under Medicare Part B.

Code of Federal Regulations, 2012 CFR

2012-10-01

... practitioner, clinical nurse specialist, or physician assistant. (iii) The services were furnished under a plan... physician, nurse practioner, clinical nurse specialist, or physician assistant who has knowledge of the case. (3) Timing. The physician, nurse practioner, clinical nurse specialist, or physician assistant may...

42 CFR 424.24 - Requirements for medical and other health services furnished by providers under Medicare Part B.

Code of Federal Regulations, 2014 CFR

2014-10-01

... practitioner, clinical nurse specialist, or physician assistant. (iii) The services were furnished under a plan... physician, nurse practioner, clinical nurse specialist, or physician assistant who has knowledge of the case. (3) Timing. The physician, nurse practioner, clinical nurse specialist, or physician assistant may...

Specialist or Nonspecialist Physical Education Teachers in Ontario Elementary Schools: Examining Differences in Opportunities for Physical Activity

ERIC Educational Resources Information Center

Faulkner, Guy E. J.; Dwyer, John J. M.; Irving, Hyacinth; Allison, Kenneth R.; Adlaf, Edward M.; Goodman, Jack

2008-01-01

Research supports the position that specialists are the preferred providers of physical education in elementary (primary) school settings. We examined whether specialists delivered more physical education lessons and provided greater opportunities for moderate and vigorous physical activity and whether barriers to curricular and extracurricular…

7 CFR 54.1024 - Who shall perform appeal service.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Appeal service for equipment or utensils shall be performed by the Chief or a design review specialist designated by the Chief. No design review specialist may perform appeal service for any piece of equipment, portion of a piece of equipment or utensil for which the original design review specialist performed the...

The Curriculum Roles and Responsibilities of Library Media Specialists. ERIC Digest.

ERIC Educational Resources Information Center

Berkowitz, Robert E.; Eisenberg, Michael B.

This digest brings together the various views on curriculum-related roles for library media specialists. The first section considers reasons why a disparity between theory and practice exists in regard to the involvement of library media specialists as curriculum consultants. Several sources addressing this issue are reviewed in the second…

Portrait view of STS 41-G crew in civilian clothes

NASA Technical Reports Server (NTRS)

1984-01-01

Portrait view of STS 41-G crew in civilian clothes. Bottom row (l.-r.) Payload specialists Marc Garneau and Paul Scully-Power, crew commander Robert Crippen. Second row (l-.r-) Pilot Jon McBride, and Mission Specialists David Leestma and Sally Ride. At very top is Mission Specialist Kathryn Sullivan.

The Role of Education and Rehabilitation Specialists in the Comprehensive Low Vision Care Process.

ERIC Educational Resources Information Center

Lueck, A. H.

1997-01-01

Outlines the contributions of education and rehabilitation specialists in maximizing specific skills, self-esteem, and quality of life of individuals with low vision. The role of these specialists in evaluating functional vision, teaching methods to compensate for impaired vision, and addressing psychosocial concerns are discussed. (Author/CR)

The Generalist versus the Specialist: The New Oxford Dictionary Reveals a Gap.

ERIC Educational Resources Information Center

Levine, Martin Lyon

1981-01-01

There is a gap, it is suggested, separating the generally cultured person, not just from the scientist, but from specialists in many fields. Dictionary definitions are seen as one means of seeing the extent to which specialists and those in the general culture speak the same language. (MLW)

Professional Insiders/Outsiders? Teacher Professionalism and the Primary School Physical Education Specialist

ERIC Educational Resources Information Center

Brooks, Caroline; DinanThompson, Maree

2013-01-01

This paper provides a context for exploring the positioning of Physical Education specialist teachers (PE specialist teachers) in primary schools in Queensland in the discourses of teacher professionalism. A critical analysis of literature on the history and status of the subject and its practitioners aims to contextualize discourses in and about…

77 FR 27526 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-10

... The Exchange proposes to increase the Remote Specialist Fee from $50 per option allocation per month... Schedule at Section VI. C (Membership Fees) to increase the Exchange's Remote Specialist Fee to better account for and recoup costs associated with maintaining a remote specialist post on the Exchange's...

Management Matters: The Library Media Specialist's Management Toolbox

ERIC Educational Resources Information Center

Pappas, Marjorie L.

2004-01-01

Library media specialists need tools to help them manage the school library media program. The Internet includes a vast array of tools that a library media specialist might find useful. The websites and electronic resources included in this article are only a representative sample and future columns may explore additional tools. All the tools are…

Specialist Schools and Academies Trust Annual Report, 2008-2009

ERIC Educational Resources Information Center

Specialist Schools and Academies Trust, 2010

2010-01-01

This paper presents the annual activities of the Specialist Schools and Academies Trust (SSAT) during 2008-2009. SSAT's activities this year have reflected its commitment to the priorities of the Government's Children's Plan. Its active and expert support of specialist schools, academies and trust schools continued to develop and enrich the…

Reorganization of secondary medical care in the Israeli Defense Forces Medical Corps: A cost-effect analysis.

PubMed

Yagil, Yael; Arnon, Ronen; Ezra, Vered; Ashkenazi, Isaac

2006-12-01

To increase accessibility and availability of secondary medical care, 10 secondary unit specialist clinics were established side-by-side with five existing regional specialist centers, thus achieving decentralization. The purpose was to analyze the impact of this reorganization on overall consumption of secondary medical care and expenditures. Consumption of secondary medical care was analyzed by using computerized clinic and Medical Corps databases. Functional efficiency and budgetary expenditures were evaluated in four representative unit specialist clinics. The reorganization resulted in an 8% increase in total secondary care consumption over 2.5 years. The establishment of unit specialist clinics did not achieve increased accessibility or availability for military personnel. Functional analysis of representative unit specialist clinics showed diversity in efficiency, differences in physicians' performance, and excess expenditures. The decentralizing reorganization of secondary medical care generated an increase in medical care consumption, possibly because of supply-induced demand. The uniform inefficiency of the unit specialist clinics might have been related to incorrect planning and management. The decentralization of secondary medical care within the Israeli Defense Forces has not proved to be cost-efficient.

Medicare rebate for specialist medical practitioners from physiotherapy referrals: analysis of the potential impact on the Australian healthcare system.

PubMed

Byrnes, Joshua M; Comans, Tracy A

2015-02-01

Abstract To identify and examine the likely impact on referrals to specialist medical practitioners, cost to government and patient out-of-pocket costs by providing a rebate under the Medicare Benefits Scheme to patients who attend a specialist medical practitioner upon referral direct from a physiotherapist. A model was constructed to synthesise the costs and benefits of referral with a rebate. Data to inform the model was obtained from administrative sources and from a direct survey of physiotherapists. Given that six referrals per month are made by physiotherapists for a specialist consultation, allowing direct referral to medical specialists and providing patients with a Medicare rebate would result in a likely cost saving to the government ofup to $13 million per year. A range of sensitivity analyses were conducted with all scenarios resulting in some cost savings. The impact of the proposed policy shift to allow direct referral of patients by physiotherapists to specialist medical practitioners and provide patients with a Medicare rebate would be cost saving.

E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course.

PubMed

Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M; Biermann, Martin

2017-07-01

While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. To assess the potential of e-learning in specialist education in medical imaging. An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs.

Physical education, obesity, and academic achievement: a 2-year longitudinal investigation of Australian elementary school children.

PubMed

Telford, Richard D; Cunningham, Ross B; Fitzgerald, Robert; Olive, Lisa S; Prosser, Laurence; Jiang, Xiaoli; Telford, Rohan M

2012-02-01

We determined whether physical education (PE) taught by specialists contributed to academic development and prevention of obesity in elementary school children. Our 2-year longitudinal study involved 620 boys and girls initially in grade 3 in Australia, all receiving 150 minutes per week of PE. One group (specialist-taught PE; n = 312) included 90 minutes per week of PE from visiting specialists; the other (common-practice PE; n = 308) received all PE from generalist classroom teachers. Measurements included percentage of body fat (measured by dual-emission x-ray absorptiometry) and writing, numeracy, and reading proficiency (by government tests). Compared with common-practice PE, specialist-taught PE was associated with a smaller increase in age-related percentage of body fat (P = .02). Specialist-taught PE was also associated with greater improvements in numeracy (P < .03) and writing (P = .13) scores. There was no evidence of a reading effect. The attenuated age-related increases in percentage of body fat and enhanced numeracy development among elementary school children receiving PE from specialists provides support for the role of PE in both preventive medicine and academic development.

KENNEDY SPACE CENTER, FLA. - Members of the STS-114 crew look over flight equipment in the Orbiter Processing Facility. From left are Mission Commander Eileen Collins; Glenda Laws, EVA Task Leader, with United Space Alliance at Johnson Space Center; and Mission Specialists Soichi Noguchi and Charles Camarda. In the foreground is Mission Specialist Wendy Lawrence. Noguchi is with the Japan Aerospace Exploration Agency, JAXA. Not seen are Pilot James Kelly and Mission Specialists Andy Thomas and Stephen Robinson. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - Members of the STS-114 crew look over flight equipment in the Orbiter Processing Facility. From left are Mission Commander Eileen Collins; Glenda Laws, EVA Task Leader, with United Space Alliance at Johnson Space Center; and Mission Specialists Soichi Noguchi and Charles Camarda. In the foreground is Mission Specialist Wendy Lawrence. Noguchi is with the Japan Aerospace Exploration Agency, JAXA. Not seen are Pilot James Kelly and Mission Specialists Andy Thomas and Stephen Robinson. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

Specialist Bibliographic Databases

PubMed Central

2016-01-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls. PMID:27134485

Specialist Bibliographic Databases.

PubMed

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A; Trukhachev, Vladimir I; Kostyukova, Elena I; Gerasimov, Alexey N; Kitas, George D

2016-05-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls.

STS-95 Mission Specialist Duque suits up during TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Pedro Duque of Spain, representing the European Space Agency, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Duque and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

STS-95 Mission Specialist Robinson suits up during TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Stephen K. Robinson, with the help of Carlos Gillis, of Lockheed Martin, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Robinson and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

Role Transition After Clinical Nurse Specialist Education.

PubMed

Ares, Terri L

This study explored the transition of clinical nurse specialists into new roles after completion of their graduate education. A quantitative longitudinal survey was used to measure certification, employment, career commitment, and the imposter phenomenon. An online survey was sent to 113 participants from a previous national study that agreed to follow-up. The Student Nurse Anesthetist Experience Questionnaire and Clance Imposter Phenomenon Scale instruments were used. Each case (N = 68) was matched with data from the primary study, and 2 comparison groups were formed based on employment status as a clinical nurse specialist. The advanced practice certification rate was 66.7%, and 48.5% were employed as a clinical nurse specialist. The employed group perceived more autonomy, a more positive view of the clinical nurse specialist lifestyle, and upset life plans if not able to practice in the role when compared with the not-employed group. Self-image was significantly different based on employment, but career commitment was not particularly strong regardless of employment status. The prevalence of imposter phenomenon experiences was 74.6% in this sample. Recent graduates are struggling with their transition into practice as clinical nurse specialists.

An empirical investigation of differences between mathematics specialists and non-specialists at the high school level in Cyprus: A Logistic regression Approach

NASA Astrophysics Data System (ADS)

Papanastasiou, Elena C.; Zembylas, Michalinos

2006-12-01

AN EMPIRICAL INVESTIGATION OF DIFFERENCES BETWEEN MATHEMATICS SPECIALISTS AND NON-SPECIALISTS AT THE HIGH-SCHOOL LEVEL in Cyprus - The data obtained from high-school seniors for the Third International Mathematics and Science Study (TIMSS) for the country of Cyprus appear to be contradictory. Although Cypriot students did not perform well in mathematics in elementary school, middle school, and in the non-advanced sectors of high school, students in advanced mathematics courses in high school managed to perform exceptionally well. In seeking to account for this apparent disparity, the present study examines the differences between mathematics specialists and non-specialists at the high-school level and discusses the implications that these have for teaching practice. It shows how students educated in an environment that might not be optimal for producing high-achieving students in mathematics and science in elementary and middle school (according to the TIMSS) might nonetheless manage to excel in these fields at the end of their schooling. In conclusion, the authors address the implications of their study for similar educational systems in other developing countries.

Functioning in Women with Cervical Cancer in Brazil: the Perspective of Experts.

PubMed

Castaneda, Luciana; Bergmann, Anke; Castro, Shamyr; Koifman, Rosalina

2018-05-09

 The objective of this study was to identify the perspective of the specialists about functioning in women with cervical cancer (CC).  A study was conducted with specialists using the Delphi methodology. The specialist contacts were found in oncology organizations and associations, as well as in a referral hospital in the treatment of CC. The questions that the experts answered covered the biopsychosocial domains of the International Classification of Functioning, Disability and Health (ICF).  Twenty-five specialists participated in the study. The experts' responses generated 485 significant concepts. The categories that presented the highest frequencies of reporting by the specialists were health services, systems and policies; structure of the reproductive system; health professionals and sexual function.  Regarding the perception of the specialists, this study concluded that 24 categories of ICF are the most relevant in the context of functioning in women with CC. The results suggest that the biopsychosocial perspective was incorporated in the experts' perceptions about the functioning phenomenon in women with CC in Brazil. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

KSC-98pc1555

NASA Image and Video Library

1998-11-07

After nine days and 3.6 million miles in space, orbiter Discovery prepares to land on runway 33 at the Shuttle Landing Facility. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95. The STS-95 crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

STS 51-D crew photograph in orbit

NASA Image and Video Library

1985-04-14

51D-09-034 (12-19 April 1985) --- The seven crew members of STS-51D take time, during a busy full week in space, to pose for a "star-burst" type in-space portrait. Hold picture with astronaut Rhea Seddon at bottom center. Counter-clockwise from the bottom left are Jeffrey A. Hoffman, mission specialist; Dr. Seddon, mission specialist; Charles D. Walker, payload specialist; U. S. Senator E. J. (Jake) Garn, payload specialist; S. David Griggs, mission specialist; Karol J. Bobko, mission commander; and Donald W. Williams, pilot. A pre-set 35mm camera exposed the frame in the mid-deck of the Earth-orbiting Space Shuttle Discovery. The crew launched at 8:59 a.m. (EST), April 12, 1985 and landed at 8:54 a.m. (EST), April 19, 1985 spending five minutes less than a full week on the busy mission.

KSC-98dc1580

NASA Image and Video Library

1998-11-07

After a successful mission of nearly nine days and 3.6 million miles, the orbiter Discovery glides to Earth on runway 33 at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. The STS-95 mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. The crew consisted of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA)

KSC-98pc1548

NASA Image and Video Library

1998-11-07

Orbiter Discovery touches down on runway 33 at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

Discovery touches down after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

After nine days and 3.6 million miles in space, orbiter Discovery prepares to land on runway 33 at the Shuttle Landing Facility. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95. The STS-95 crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Discovery touches down after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

Orbiter Discovery lowers its nose wheel after touching down on runway 33 at the Shuttle Landing Facility. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The STS-95 crew is composed of Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Discovery touches down after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

Orbiter Discovery touches down on runway 33 at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Discovery prepares to land after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

Orbiter Discovery prepares to land on runway 33 at the Shuttle Landing Facility. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar- observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Discovery touches down after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

Orbiter Discovery touches down in a cloud of smoke on runway 33 at the Shuttle Landing Facility. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar- observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Discovery touches down after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

After a successful mission of nearly nine days and 3.6 million miles, the orbiter Discovery glides to Earth on runway 33 at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. The STS-95 mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. The crew consisted of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA).

Official STS-67 preflight crew portrait

NASA Image and Video Library

1994-12-01

STS067-S-002 (December 1994) --- Five NASA astronauts and two payload specialists from the private sector have been named to fly aboard the Space Shuttle Endeavour for the STS-67/ASTRO-2 mission, scheduled for March 1995. In front are astronauts (left to right) Stephen S. Oswald, mission commander; Tamara E. Jernigan, payload commander; and William G. Gregory, pilot. In the back are (left to right) Ronald A. Parise, payload specialist; astronauts Wendy B. Lawrence, and John M. Grunsfeld, both mission specialists; and Samuel T. Durrance, payload specialist. Dr. Durrance is a research scientist in the Department of Physics and Astronomy at Johns Hopkins University, Baltimore, Maryland. Dr. Parise is a senior scientist in the Space Observatories Department, Computer Sciences Corporation, Silver Spring, Maryland. Both payload specialist's flew aboard the Space Shuttle Columbia for the STS-35/ASTRO-1 mission in December 1990.

Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review.

PubMed

Cook, Olivia; McIntyre, Meredith; Recoche, Katrina; Lee, Susan

2017-08-01

The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.

Human resources and models of mental healthcare integration into primary and community care in India: Case studies of 72 programmes

PubMed Central

Maheedhariah, Meera S.; Ghani, Sarah; Raja, Anusha; Patel, Vikram

2017-01-01

Background Given the scarcity of specialist mental healthcare in India, diverse community mental healthcare models have evolved. This study explores and compares Indian models of mental healthcare delivered by primary-level workers (PHW), and health workers’ roles within these. We aim to describe current service delivery to identify feasible and acceptable models with potential for scaling up. Methods Seventy two programmes (governmental and non-governmental) across 12 states were visited. 246 PHWs, coordinators, leaders, specialists and other staff were interviewed to understand the programme structure, the model of mental health delivery and health workers’ roles. Data were analysed using framework analysis. Results Programmes were categorised using an existing framework of collaborative and non-collaborative models of primary mental healthcare. A new model was identified: the specialist community model, whereby PHWs are trained within specialist programmes to provide community support and treatment for those with severe mental disorders. Most collaborative and specialist community models used lay health workers rather than doctors. Both these models used care managers. PHWs and care managers received support often through multiple specialist and non-specialist organisations from voluntary and government sectors. Many projects still use a simple yet ineffective model of training without supervision (training and identification/referral models). Discussion and conclusion Indian models differ significantly to those in high-income countries—there are less professional PHWs used across all models. There is also intensive specialist involvement particularly in the community outreach and collaborative care models. Excessive reliance on specialists inhibits their scalability, though they may be useful in targeted interventions for severe mental disorders. We propose a revised framework of models based on our findings. The current priorities are to evaluate the comparative effectiveness, cost-effectiveness and scalability of these models in resource-limited settings both in India and in other low- and middle- income countries. PMID:28582445

Risk for eye splash injury during administration of intraocular injections: a study of retina specialists and fellows.

PubMed

Bourla, Dan H; Wirthlin, Robert S; Bourla, Nirit; Gupta, Anurag; Stanescu-Segall, Dinu; Schwartz, Steven D; Axer-Siegel, Ruth

2007-06-01

To evaluate the use of eye protection and frequency of eye splash events during intraocular injections as well as infection risk awareness among retina specialists and fellows in training. In a prospective survey of practicing retina specialists and retina fellows, frequency of use and type of eye protection employed during intraocular injections, frequency of eye splash occurrences, description of the eye splash event, number of procedures performed, and awareness of transconjunctival infection risk were investigated. Sixty-four ophthalmologists responded to the questionnaire: 40 retina fellows and 24 retina specialists. The response rate was 100%. Twenty-five percent of the fellows and 33.3% of the specialists reported using eye protection, including corrective glasses, during all intraocular injections. Two of the retina fellows and none of the specialists used special forms of eye protection. Retina fellows had a mean +/- SD of 2.1 +/- 1.3 years experience and the specialists had a mean +/- SD of 10.4 +/- 6.7 years experience in performing intraocular injections. The mean number of injections +/- SD performed by the fellows and specialists was 23 +/- 14.6 and 35 +/- 11.9 per month, respectively. Twelve conjunctival or corneal splash occurrences were reported by six fellows and two retina specialists. Eleven splash events occurred due to reflux of fluid during administration of subconjunctival anesthetic injection, and one event occurred during an anterior chamber tap. Splash events were significantly more likely to occur during procedures performed by fellows, with a relative risk of 8.4 for unprotected procedures (P< 0.001, Fisher exact test). Most (87.5%) of the participants were aware of the risk for transconjunctival viral infection. Special eye protection is seldom used during administration of intraocular injections. Although the risk for eye splash during administration of subconjunctival anesthetic before intraocular injections is relatively small, protective measures may be considered when treating high-risk patients.

Long-term colonization ecology of forest-dwelling species in a fragmented rural landscape - dispersal versus establishment.

PubMed

Lõhmus, Kertu; Paal, Taavi; Liira, Jaan

2014-08-01

Species colonization in a new habitat patch is an efficiency indicator of biodiversity conservation. Colonization is a two-step process of dispersal and establishment, characterized by the compatibility of plant traits with landscape structure and habitat conditions. Therefore, ecological trait profiling of specialist species is initially required to estimate the relative importance of colonization filters. Old planted parks best satisfy the criteria of a newly created and structurally matured habitat for forest-dwelling plant species. We sampled species in 230 ancient deciduous forests (source habitat), 74 closed-canopy manor parks (target habitats), 151 linear wooded habitats (landscape corridors), and 97 open habitats (isolating matrix) in Estonia. We defined two species groups of interest: forest (107 species) and corridor specialists (53 species). An extra group of open habitat specialists was extracted for trait scaling. Differing from expectations, forest specialists have high plasticity in reproduction mechanisms: smaller seeds, larger dispersules, complementary selfing ability, and diversity of dispersal vectors. Forest specialists are shorter, less nutrient-demanding and mycorrhizal-dependent, stress-tolerant disturbance-sensitive competitors, while corridor specialists are large-seeded disturbance-tolerant competitors. About 40% of species from local species pools have immigrated into parks. The historic forest area, establishment-related traits, and stand quality enhance the colonization of forest specialists. The openness of landscape and mowing in the park facilitate corridor specialists. Species traits in parks vary between a forest and corridor specialist, except for earlier flowering and larger propagules. Forest species are not dispersal limited, but they continue to be limited by habitat properties even in the long term. Therefore, the shady parts of historic parks should be appreciated as important forest biodiversity-enhancing landscape structures. The habitat quality of secondary stands can be improved by nurturing a heterogeneous shrub and tree layer, and modest herb layer management.

Long-term colonization ecology of forest-dwelling species in a fragmented rural landscape – dispersal versus establishment

PubMed Central

Lõhmus, Kertu; Paal, Taavi; Liira, Jaan

2014-01-01

Species colonization in a new habitat patch is an efficiency indicator of biodiversity conservation. Colonization is a two-step process of dispersal and establishment, characterized by the compatibility of plant traits with landscape structure and habitat conditions. Therefore, ecological trait profiling of specialist species is initially required to estimate the relative importance of colonization filters. Old planted parks best satisfy the criteria of a newly created and structurally matured habitat for forest-dwelling plant species. We sampled species in 230 ancient deciduous forests (source habitat), 74 closed-canopy manor parks (target habitats), 151 linear wooded habitats (landscape corridors), and 97 open habitats (isolating matrix) in Estonia. We defined two species groups of interest: forest (107 species) and corridor specialists (53 species). An extra group of open habitat specialists was extracted for trait scaling. Differing from expectations, forest specialists have high plasticity in reproduction mechanisms: smaller seeds, larger dispersules, complementary selfing ability, and diversity of dispersal vectors. Forest specialists are shorter, less nutrient-demanding and mycorrhizal-dependent, stress-tolerant disturbance-sensitive competitors, while corridor specialists are large-seeded disturbance-tolerant competitors. About 40% of species from local species pools have immigrated into parks. The historic forest area, establishment-related traits, and stand quality enhance the colonization of forest specialists. The openness of landscape and mowing in the park facilitate corridor specialists. Species traits in parks vary between a forest and corridor specialist, except for earlier flowering and larger propagules. Forest species are not dispersal limited, but they continue to be limited by habitat properties even in the long term. Therefore, the shady parts of historic parks should be appreciated as important forest biodiversity-enhancing landscape structures. The habitat quality of secondary stands can be improved by nurturing a heterogeneous shrub and tree layer, and modest herb layer management. PMID:25247068

Asthma management in a specialist setting: Results of an Italian Respiratory Society survey.

PubMed

Braido, Fulvio; Baiardini, Ilaria; Alleri, Pietro; Bacci, Elena; Barbetta, Carlo; Bellocchia, Michela; Benfante, Alida; Blasi, Francesco; Bucca, Caterina; Busceti, Maria Teresa; Centanni, Stefano; Colanardi, Maria Cristina; Contoli, Marco; Corsico, Angelo; D'Amato, Maria; Di Marco, Fabiano; Marco, Dottorini; Ferrari, Marta; Florio, Giovanni; Fois, Alessandro Giuseppe; Foschino Barbaro, Maria Pia; Silvia, Garuti; Girbino, Giuseppe; Grosso, Amelia; Latorre, Manuela; Maniscalco, Sara; Mazza, Francesco; Mereu, Carlo; Molinengo, Giorgia; Ora, Josuel; Paggiaro, Pierluigi; Patella, Vincenzo; Pelaia, Girolamo; Pirina, Pietro; Proietto, Alfio; Rogliani, Paola; Santus, Pierachille; Scichilone, Nicola; Simioli, Francesca; Solidoro, Paolo; Terraneo, Silvia; Zuccon, Umberto; Canonica, Giorgio Walter

2017-06-01

Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is travel-time to a specialist centre a risk factor for non-referral, non-attendance and loss to follow-up among patients with hepatitis C (HCV) infection?

PubMed

Astell-Burt, Thomas; Flowerdew, Robin; Boyle, Paul; Dillon, John

2012-07-01

Little is known about why many people diagnosed with hepatitis C virus (HCV) infection fail to reach and stay within specialist care services. We used a Geographic Information System and logit regression to investigate whether travel-time to a specialist centre was associated with an increased likelihood of non-referral, non-attendance and loss to follow-up among persons diagnosed with HCV between 1991 and 2003 in Tayside, Scotland (UK). Information was available on referral to, and utilisation of, the single HCV specialist centre in Tayside between 1991 and 2006. Longer travel-time to a specialist centre was associated with an increased likelihood of non-referral to a specialist centre following diagnosis (Odds Ratio: 1.25, 95% Confidence Interval: 1.09, 1.44). Patients living further from an HCV specialist centre were less likely to be referred to it for treatment that could cure their HCV infection. Neither a history of intravenous drug use (IDU), nor area deprivation predicted non-referral. Subsequent to referral, travel-time to a specialist centre was not associated with either non-attendance (0.83 (0.56, 1.21)) or loss to follow-up (0.98 (0.78, 1.22)), although a history of IDU was a strong predictor of both non-attendance and loss to follow-up. Non-attendance was less likely among older patients, while loss to follow-up was more common among those living in deprived areas. Once referred, patients appear able to cope with stress and financial cost of long and frequent journeys to hospital. However, as rates of referral improve from more geographically remote areas, long travel-times to an HCV specialist centre may become an important factor determining future utilisation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Metabolic Flexibility as a Major Predictor of Spatial Distribution in Microbial Communities

PubMed Central

Carbonero, Franck; Oakley, Brian B.; Purdy, Kevin J.

2014-01-01

A better understand the ecology of microbes and their role in the global ecosystem could be achieved if traditional ecological theories can be applied to microbes. In ecology organisms are defined as specialists or generalists according to the breadth of their niche. Spatial distribution is often used as a proxy measure of niche breadth; generalists have broad niches and a wide spatial distribution and specialists a narrow niche and spatial distribution. Previous studies suggest that microbial distribution patterns are contrary to this idea; a microbial generalist genus (Desulfobulbus) has a limited spatial distribution while a specialist genus (Methanosaeta) has a cosmopolitan distribution. Therefore, we hypothesise that this counter-intuitive distribution within generalist and specialist microbial genera is a common microbial characteristic. Using molecular fingerprinting the distribution of four microbial genera, two generalists, Desulfobulbus and the methanogenic archaea Methanosarcina, and two specialists, Methanosaeta and the sulfate-reducing bacteria Desulfobacter were analysed in sediment samples from along a UK estuary. Detected genotypes of both generalist genera showed a distinct spatial distribution, significantly correlated with geographic distance between sites. Genotypes of both specialist genera showed no significant differential spatial distribution. These data support the hypothesis that the spatial distribution of specialist and generalist microbes does not match that seen with specialist and generalist large organisms. It may be that generalist microbes, while having a wider potential niche, are constrained, possibly by intrageneric competition, to exploit only a small part of that potential niche while specialists, with far fewer constraints to their niche, are more capable of filling their potential niche more effectively, perhaps by avoiding intrageneric competition. We suggest that these counter-intuitive distribution patterns may be a common feature of microbes in general and represent a distinct microbial principle in ecology, which is a real challenge if we are to develop a truly inclusive ecology. PMID:24465487

Exploring the differences in general practitioner and health care specialist utilization according to education, occupation, income and social networks across Europe: findings from the European social survey (2014) special module on the social determinants of health.

PubMed

Fjær, Erlend L; Balaj, Mirza; Stornes, Per; Todd, Adam; McNamara, Courtney L; Eikemo, Terje A

2017-02-01

Low socioeconomic position (SEP) tends to be linked to higher use of general practitioners (GPs), while the use of health care specialists is more common in higher SEPs. Despite extensive literature in this area, previous studies have, however, only studied health care use by income or education. The aim of this study is, therefore, to examine inequalities in GP and health care specialist use by four social markers that may be linked to health care utilization (educational level, occupational status, level of financial strain and size and frequency of social networks) across 20 European countries and Israel. Logistic regression models were employed using data from the seventh round of the European Social Survey; this study focused upon people aged 25–75 years, across 21 countries. Health care utilization was measured according to self-reported use of GP or specialist care within 12 months. Analyses tested four social markers: income (financial strain), occupational status, education and social networks. We observed a cross-national tendency that countries with higher or equal probability of GP utilization by lower SEP groups had a more consistent probability of specialist use among high SEP groups. Moreover, countries with inequalities in GP use in favour of high SEP groups had comparable levels of inequalities in specialist care utilization. This was the case for three social markers (education, occupational class and social networks), while the pattern was less pronounced for income (financial strain). There are significant inequalities associated with GP and specialist health care use across Europe—with higher SEP groups more likely to use health care specialists, compared with lower SEP groups. In the context of health care specialist use, education and occupation appear to be particularly important factors. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Are gatekeepers to renal services referring patients equitably?

PubMed

Kee, Frank; Reaney, Elizabeth; Savage, Gerard; O'Reilly, Dermot; Patterson, Chris; Maxwell, Peter; Fogarty, Damian

2007-01-01

Patients with chronic kidney disease (CKD) benefit from specialist interventions to retard progression of renal failure and prevent cardiovascular events. Certain patient groups have poor access to specialist renal services when dialysis is required. This study used a population-based laboratory database to investigate access to and timeliness of referral to renal specialists relatively early in the course of the disease. All tests for serum creatinine and haemoglobin (Hb) A(1)c in Northern Ireland in a two-year period (2001 and 2002) were retrieved for 345,441 adults. Of these, 16,856 patients had at least one serum creatinine level above 150 micromol/L in 2001 not deemed to be due to acute renal failure (crude prevalence 1.42%). This cohort was followed until the end of 2002 and the differences in the time to referral to a specialist were assessed using Cox's proportional hazards regression. Diabetic patients, older patients and those living in deprived areas were significantly more likely to have serum creatinine testing, compared with non-diabetic, younger and those living in more affluent areas. Delays in referral to renal specialists for patients with raised serum creatinine levels were significantly shorter among diabetic patients, women, younger individuals, those living in rural areas, those living close to renal centres and those living in deprived areas. Overall, only 19% of diabetic patients and 6% of non-diabetic patients who had CKD had seen a renal specialist within 12 months of their index creatinine test. Contrary to other diseases, disadvantaged patients do not seem to be under-investigated for renal disease compared with their more affluent neighbours and are generally referred earlier for specialist assessment. However, the absolute rate of timely specialist assessment is low. Recent changes in referral criteria for CKD will result in more referrals and will have serious resource implications. Opportunities for health gain among patients with declining renal function are being missed, particularly among the old and those living furthest from specialist centres.

Do managed care plans' tiered networks lead to inequities in care for minority patients?

PubMed

Brennan, Troyen A; Spettell, Claire M; Fernandes, Joaquim; Downey, Roberta L; Carrara, Lisa M

2008-01-01

This study examined whether specialists designated as meeting efficiency thresholds in an insurance company's performance network were less likely than non-designated specialists to treat minority patients insured by that company. Claims data were used to identify patients treated by specialists. Claimants' race/ethnicity status was self-reported to the insurer at enrollment. In large part, minority patients appeared to be evenly distributed across the performance network, with the exception of Asian/Pacific Islanders, who appeared to be more likely to be treated by nondesignated physicians than by designated "good-performing" specialists.

Earth observations taken by the STS-9 crew

NASA Image and Video Library

2009-06-25

STS009-40-2575 (28 Nov-8 Dec 1983) --- This view of the Fuji volcano, Japan was taken on the 54th orbit of the Space Shuttle Columbia. The center coordinates are 35.5 degrees north latitude and 139.0 degrees east longitude. This was the first time a non-United States crew member was flown aboard the United States Space Shuttle, European Space Agency (ESA) payload specialist Ulf Merbold, Germany. The crew included NASA astronauts John W. Young, commander; Brewster H. Shaw Jr., pilot; Owen K. Garriott, mission specialist, Robert A. Parker, mission specialist; and Byron Lichtenberg, payload specialist.

Understanding the internet-based distance learning preferences of European respiratory specialists.

PubMed

Roberts, C M; Milon, S; Kurosinski, P

2006-08-01

We studied the learning preferences of 160 respiratory specialists from four European countries who participated in ten internet-based learning modules and answered linked survey questions. Specialists were enthusiastic for internet learning amongst all national groups and particularly wanted to access material for teaching others. The value of social interactive learning was acknowledged but British and German subjects appeared more reluctant to participate. Internet delivered distance learning is well perceived amongst respiratory specialists. There is potential for both individual and group learning that could be realized by developing Europe-wide continuing professional development communities.

STS-107 Mission Specialist David Brown arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- STS-107 Mission Specialist David Brown arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists Kalpana Chawla and Laurel Clark and Payload Specialist Ilan Ramon (the first Israeli astronaut). STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-107 Mission Specialist Laurel Clark arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- STS-107 Mission Specialist Laurel Clark arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists Kalpana Chawla and David Brown, and Payload Specialist Ilan Ramon, the first Israeli astronaut. STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-107 Mission Specialist Kalpana Chawla arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. - STS-107 Mission Specialist Kalpana Chawla arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists David Brown and Laurel Clark and Payload Specialist Ilan Ramon (the first Israeli astronaut). STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-115 Mission Specialist Joseph Tanner (left) and STS-117 Mission Specialist James Reilly (right) are donning protective clothing to interface with the Japanese Experiment Module (JEM), in the background. Equipment familiarization is a routine part of astronaut training and launch preparations.

NASA Image and Video Library

2003-10-21

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-115 Mission Specialist Joseph Tanner (left) and STS-117 Mission Specialist James Reilly (right) are donning protective clothing to interface with the Japanese Experiment Module (JEM), in the background. Equipment familiarization is a routine part of astronaut training and launch preparations.

STS-87 Mission Specialist Doi in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, is assisted with his ascent and re- entry flight suit by Dave Law, USA mechanical technician, in the white room at Launch Pad 39B as Dr. Doi prepares to enter the Space Shuttle orbiter Columbia on launch day. At right wearing glasses is Danny Wyatt, NASA quality assurance specialist. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. The 16-day mission will include a spacewalk by Dr. Doi and Mission Specialist Winston Scott.

STS-87 Mission Specialist Doi and his wife pose at LC 39B

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan poses with his wife, Hitomi Doi, in front of Kennedy Space Center's Launch Pad 39B during final prelaunch activities leading up to the scheduled Nov. 19 liftoff. The other STS-87 crew members are Commander Kevin Kregel; Pilot Steven Lindsey; Mission Specialists Kalpana Chawla, Ph.D., and Winston Scott; and Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine. STS-87 will be the fourth flight of the United States Microgravity Payload and the Spartan- 201 deployable satellite.

STS-121 Crew Portrait

NASA Technical Reports Server (NTRS)

2006-01-01

These seven astronauts take a break from training to pose for the STS-121 crew portrait. From the left are mission specialists Stephanie D. Wilson, and Michael E. Fossum, Commander Steven W. Lindsey, mission specialist Piers J. Sellers, pilot Mark E. Kelly; European Space Agency (ESA) astronaut and mission specialist Thomas Reiter of Germany; and mission specialist Lisa M. Nowak. The crew members are attired in training versions of their shuttle launch and entry suit. The crew, first ever to launch on Independence Day, tested new equipment and procedures to improve shuttle safety, as well as delivered supplies and made repairs to the space station.

Clinical nurse specialists: essential resource for an effective NHS.

PubMed

Vidall, Cheryl; Barlow, Helen; Crowe, Maggie; Harrison, Isabel; Young, Annie

Despite emerging evidence for the clinical and financial efficacy of the clinical nurse specialist (CNS), the provision of this role is patchy across the country. There is also a risk that incumbent CNS' may be redirected to less specialist work in trusts that do not appreciate the full value of the service that these nurses provide. Optimal and equitable patient access to CNS care will require the development of a strong evidence base showing that specialist nurses not only deliver patient-focused care, but that they can also help to meet healthcare managers' objectives of streamlined, cost-effective clinical services.

Various views of STS-95 Senator John Glenn during training

NASA Image and Video Library

1998-06-18

S98-08744 (28 April 1998) --- Four members of the STS-95 crew are briefed on video cameras by crew trainer Donald Carico during a training session in the systems integration facility at the Johnson Space Center (JSC). From the left are U.S. Sen. John H. Glenn Jr. (D.-Ohio), payload specialist; astronaut Scott E. Parazynski, mission specialist; Chiaki Mukai, payload specialist representing Japan's National Space Development Agency (NASDA); Carico and astronaut Pedro Duque, mission specialist representing the European Space Agency (ESA). The photo was taken by Joe McNally, National Geographic, for NASA.

KSC-00pp1856

NASA Image and Video Library

2000-12-07

As part of In-Flight Maintenance training at SPACEHAB, in Cape Canaveral, Fla., members of the STS-107 crew learn about Biological Research in Canisters (BRIC) experiments that will be on their mission. Gathered around the table are (from left) Mission Specialist Kalpana Chawla, Pilot William C. “Willie” McCool, Mission Specialists Laurel Clark and Michael Anderson, Roberteen McCray of Bionetics, Commander Rick D. Husband, Payload Specialist Ilan Ramon of Israel and Mission Specialist David M. Brown. STS-107 will carry a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC-00pp1857

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- As part of In-Flight Maintenance training at SPACEHAB, in Cape Canaveral, Fla., members of the STS-107 crew learn about Biological Research in Canisters (BRIC) experiments that will be on their mission. From left are Mission Specialist Kalpana Chawla, Pilot William C. “Willie” McCool, Mission Specialists Laurel Clark and Michael Anderson, Roberteen McCray of Bionetics, Commander Rick D. Husband,; Payload Specialist Ilan Ramon of Israel and Mission Specialist David M. Brown. STS-107 will carry a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC00pp1857

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- As part of In-Flight Maintenance training at SPACEHAB, in Cape Canaveral, Fla., members of the STS-107 crew learn about Biological Research in Canisters (BRIC) experiments that will be on their mission. From left are Mission Specialist Kalpana Chawla, Pilot William C. “Willie” McCool, Mission Specialists Laurel Clark and Michael Anderson, Roberteen McCray of Bionetics, Commander Rick D. Husband,; Payload Specialist Ilan Ramon of Israel and Mission Specialist David M. Brown. STS-107 will carry a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC00pp1856

NASA Image and Video Library

2000-12-07

As part of In-Flight Maintenance training at SPACEHAB, in Cape Canaveral, Fla., members of the STS-107 crew learn about Biological Research in Canisters (BRIC) experiments that will be on their mission. Gathered around the table are (from left) Mission Specialist Kalpana Chawla, Pilot William C. “Willie” McCool, Mission Specialists Laurel Clark and Michael Anderson, Roberteen McCray of Bionetics, Commander Rick D. Husband, Payload Specialist Ilan Ramon of Israel and Mission Specialist David M. Brown. STS-107 will carry a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

The role of specialist nurses in multiple sclerosis: a rapid and systematic review.

PubMed

De Broe, S; Christopher, F; Waugh, N

2001-01-01

Multiple sclerosis (MS) is a disease of the central nervous system. The cause is unknown. There are about 80-160 people with MS per 100,000 population, with twice as many women affected as men. The management of individuals with MS includes treatment of acute relapses and chronic symptoms. The care of MS patients is provided by various healthcare professionals, such as general practitioners (GPs), neurologists, physiotherapists, occupational therapists and nurses. Some MS patients have access to an MS specialist nurse, although this provision varies geographically. The aim of this report is to assess the effectiveness and relative cost-effectiveness of MS specialist nurses in improving care and outcomes for patients with MS. A systematic review of the literature, involving a range of databases, was performed. Full details are described in the main report. Only one study was identified that tried to evaluate the benefit of MS specialist nurses. The study concluded that MS patients and their carers found the MS specialist nurse to be helpful, particularly in improving their knowledge of MS, ability to cope, mood and confidence about the future. GPs also reported finding the nurse to be helpful with their MS patients, and 40% of the GPs stated they would purchase the services of an MS specialist nurse if their practices became fundholding. However, there were considerable methodological weaknesses inherent in the study design, and it was unclear whether the results of the study could be extrapolated to other settings or to other MS patient groups. RESULTS - ONGOING RESEARCH: There are two ongoing research studies regarding MS specialist nurses. One of these studies involves the provision of MS nurses to several areas, but also has two control populations to allow evaluation of the health benefits of the nurses to MS patients and their carers. This study will help to fill the evidence gap. RESULTS - COSTS: The costs of providing MS specialist nurses consist of their yearly salary (usually NHS grade G), as well as additional costs for travelling, administration, computer and telephone use, a pension scheme, National Insurance and study leave. The MS Society of Great Britain and Northern Ireland allows a generous total yearly cost to the employer of 40,000 pounds. The present evidence does not make it possible to comment with any certainty on the value of specialist nurses in MS. The best evidence available to the authors is specialist opinion from neurologists and nurses, and comments from patients with MS; this opinion supports the provision of MS specialist nurses. CONCLUSIONS - RECOMMENDATIONS FOR RESEARCH: Further research is needed before it will be feasible to make firm recommendations on the value of MS specialist nurses relative to other possible uses of funds.

Attitudes and Beliefs of Nonspecialist and Specialist Trainee Health and Physical Education Teachers Toward Obese Children: Evidence for "Anti-Fat" Bias.

PubMed

Lynagh, Marita; Cliff, Ken; Morgan, Philip J

2015-09-01

The aim of this study was to assess the beliefs and attitudes of preservice health and physical education (HPE) specialist and nonspecialist schoolteachers toward obese children. A total of 177 nonspecialist and 62 HPE specialist trainee teachers completed a series of pen-and-paper validated measures of attitudes and beliefs toward obese children. Both groups of preservice teachers reported strong implicit and moderate explicit anti-fat bias. Enrollment in the HPE specialist degree was found to be a significant predictor of both implicit bad/good anti-fat bias (β = 3.97, p = .002) and implicit bias on the stupid/smart scale (β = 2.983, p = .016) of the IAT. Beliefs that obese children were less healthy, more self-conscious, and less satisfied with themselves were strongly endorsed by the majority of participants. HPE specialists were found to have significantly lower expectations for obese children in regard to "reasoning" (mean difference = 0.21, p = .0107) and "cooperation" skills (mean difference = 0.25, p = .0354) compared to nonspecialist trainees. This study is the first to document the strong anti-fat bias of both preservice nonspecialist and HPE specialist teachers. It is also the first to find that preservice HPE specialist teachers have stronger anti-fat biases and differential expectations regarding particular abilities of obese children, compared to nonspecialists. © 2015, American School Health Association.

What is the current NHS service provision for patients severely affected by chronic fatigue syndrome/myalgic encephalomyelitis? A national scoping exercise

PubMed Central

McDermott, Clare; Al Haddabi, Atheer; Akagi, Hiroko; Selby, Michelle; Cox, Diane; Lewith, George

2014-01-01

Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), in its most severe clinical presentation, can result in patients becoming housebound and bedbound so unable to access most available specialist services. This presents particular clinical risks and treatment needs for which the National Institute for Health and Care Excellence (NICE) advises specialist medical care and monitoring. The extent of National Health Service (NHS) specialist provision in England for severe CFS/ME is currently unknown. Objectives To establish the current NHS provision for patients with severe CFS/ME in England. Setting and participants All 49 English NHS specialist CFS/ME adult services in England, in 2013. Method Cross-sectional survey by email questionnaire. Primary outcome measures Adherence to NICE guidelines for severe CFS/ME. Results All 49 services replied (100%). 33% (16/49) of specialist CFS/ME services provided no service for housebound patients. 55% (27/49) services did treat patients with severe CFS/ME and their interventions followed the NICE guidelines. The remaining services (12%, 6/49) offered occasional or minimal support where funding allowed. There was one NHS unit providing specialist inpatient CFS/ME provision in England. Conclusions Study findings highlight substantial variation in access to specialist care for patients with severe presentation of CFS/ME. Where treatment was provided, this appeared to comply with NICE recommendations for this patient group. PMID:24984956

Impact of the introduction of a specialist critical care pharmacist on the level of pharmaceutical care provided to the critical care unit.

PubMed

Richter, Anja; Bates, Ian; Thacker, Meera; Jani, Yogini; O'Farrell, Bryan; Edwards, Caroline; Taylor, Helen; Shulman, Rob

2016-08-01

To evaluate the impact of a dedicated specialist critical care pharmacist service on patient care at a UK critical care unit (CCU). Pharmacist intervention data was collected in two phases. Phase 1 was with the provision of a non-specialist pharmacist chart review service and Phase 2 was after the introduction of a specialist dedicated pharmacy service. Two CCUs with established critical care pharmacist services were used as controls. The impact of pharmacist interventions on optimising drug therapy or preventing harm from medication errors was rated on a 4-point scale. There was an increase in the mean daily rate of pharmacist interventions after the introduction of the specialist critical care pharmacist (5.45 versus 2.69 per day, P < 0.0005). The critical care pharmacist intervened on more medication errors preventing potential harm and optimised more medications. There was no significant change to intervention rates at the control sites. Across all study sites the majority of pharmacist interventions were graded to have at least moderate impact on patient care. The introduction of a specialist critical care pharmacist resulted in an increased rate of pharmacist interventions compared to a non-specialist pharmacist service thus improving the quality of patient care. © 2016 The Authors. IJPP © 2016 Royal Pharmaceutical Society.

The use of Spielberger's State-Trait Personality Inventory (trait anxiety subscale) with naval subaquatic specialists.

PubMed

Van Wijk, Charles H

2014-12-01

Panic behavior poses a particular threat to the health and safety of subaquatic occupational specialists. Trait anxiety has previously been identified as a marker of panic behavior under water, and Spielberger's State-Trait Personality Inventory (trait anxiety subscale) has been previously used to measure trait anxiety among subaquatic specialists. Using archived data, the trait anxiety scores of subaquatic specialists were analyzed to meet 3 objectives: 1stly - to develop a trait anxiety profile of subaquatic specialists; 2ndly - to investigate the predictive value of trait anxiety measures upon entering an occupational field; and 3rdly - to establish the reliability of these scores over time. Archival trait-anxiety data from 322 subjects were analyzed statistically. Analysis of the available scores revealed a highly homogenous as well as a very low trait anxiety profile for the investigated occupational group. Additionally, low trait anxiety was somewhat associated with success during specialist training: fewer candidates with high trait anxiety scores completed their qualification. Moreover, measurement of trait anxiety was stable over time, which suggests that when scores for this occupational group are screened, deviations from previous scores could signify a potential need for referral to an intervention from health professionals. Using the trait anxiety subscale as part of occupational health surveillance of subaquatic specialists could support prevention of accidents by identifying high-risk candidates during their annual health assessments, and referral for timeous intervention.

Development and validation of a tool to improve paediatric referral/consultation communication.

PubMed

Stille, Christopher J; Mazor, Kathleen M; Meterko, Vanessa; Wasserman, Richard C

2011-08-01

To develop a template to promote brief but high-quality communication between paediatric primary care clinicians and consulting specialists. Through an iterative process with academic and community-based paediatric primary care providers and specialists, the authors identified what content elements would be of value when communicating around referrals. The authors then developed a one-page template to encourage both primary care and specialty clinicians to include these elements when communicating about referrals. Trained clinician reviewers examined a sample of 206 referrals from community primary care providers (PCPs) to specialists in five paediatric specialties at an academic medical centre, coding communication content and rating the overall value of the referral communication. The relationship between the value ratings and each content element was examined to determine which content elements contributed to perceived value. Almost all content elements were associated with increased value as rated by clinician reviewers. The most valuable communications from PCP to specialist contained specific questions for the specialist and/or physical exam features, and the most valuable from specialist to PCP contained brief education for the PCP about the condition; all three elements were found in a minority of communications reviewed. A limited set of communication elements is suitable for a brief communication template in communication from paediatric PCPs to specialists. The use of such a template may add value to interphysician communication.

STS-9 payload specialists and backup in training session

NASA Technical Reports Server (NTRS)

1983-01-01

Two Spacelab 1 payload specialists and a backup for that flight prepare for a training session in the JSC mockup and integration laboratory. Fully decked out in the Shuttle constant wear garments (foreground) are Ulf Merbold, left, and Byron K. Licktenberg, prime crewmembers on the STS-9 team. In civilian clothes is payload specialist backup Michael L. Lampton.

Innovative Education? A Test of Specialist Mimicry or Generalist Assimilation in Trends in Charter School Specialization over Time

ERIC Educational Resources Information Center

Renzulli, Linda A.; Barr, Ashley B.; Paino, Maria

2015-01-01

By most media accounts, charter schools are innovative schools. But little empirical work interrogates this idea. We examine the growth and decline of specialist charter school mission statements as one indicator of innovation. In line with theories of resource partitioning, we find that specialist charter school missions--those asserting…

Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

ERIC Educational Resources Information Center

Domina, Thurston; Lewis, Ryan; Agarwal, Priyanka; Hanselman, Paul

2015-01-01

This brief documents the expansion of instructional specialist staffing in U.S. public school districts. We use data from the National Center of Education Statistics' annual Common Core of Data to chart staffing trends in public school districts between 1997-98 and 2012-13. The number of instructional specialists per 1,000 U.S students doubled…

Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

ERIC Educational Resources Information Center

Domina, Thurston; Lewis, Ryan; Agarwal, Priyanka; Hanselman, Paul

2015-01-01

This brief documents the expansion of instructional specialist staffing in U.S. public school districts. We use data from the National Center of Education Statistics' annual Common Core of Data to chart staffing trends in public school districts between 1997-1998 and 2012-2013. The number of instructional specialists per 1,000 U.S students doubled…

Source Dependence and Story Production: A Comparison of Religion News Coverage by Specialists and Non-specialists at Three Newspapers.

ERIC Educational Resources Information Center

Buddenbaum, Judith M.

A study was conducted to compare the news reporting of religion specialists and nonspecialists at three major metropolitan newspapers. Representing different news policies and structural constraints, 1,164 religion news items from the "New York Times," Minneapolis "Star," and the Richmond (Virginia) "Times-Dispatch"…

Module 1--Shared Leadership. School Improvement Specialist Training Materials: Performance Standards, Improving Schools, and Literature Review

ERIC Educational Resources Information Center

Appalachia Educational Laboratory at Edvantia (NJ1), 2005

2005-01-01

The School Improvement Specialist Project prepared seven modules. School improvement specialists, as defined by the Appalachia Educational Laboratory at Edvantia, are change agents who work with schools to help them improve in the following areas so as to increase student achievement. These modules are intended to provide training materials for…

Module 4--Effective Teaching. School Improvement Specialist Training Materials: Performance Standards, Improving Schools, and Literature Review

ERIC Educational Resources Information Center

Appalachia Educational Laboratory at Edvantia (NJ1), 2005

2005-01-01

The School Improvement Specialist Project prepared seven modules. School improvement specialists, as defined by the Appalachia Educational Laboratory at Edvantia, are change agents who work with schools to help them improve in the following areas so as to increase student achievement. These modules are intended to provide training materials for…

The Role of Professional Societies in the Professional Formation of Specialists in Computer Sciences: Experience of Japan

ERIC Educational Resources Information Center

Pododimenko, Inna

2014-01-01

The most urgent problem of training competitive specialists in higher educational establishments in the conditions of socio-economical dynamics of transformation of Ukraine and its entry into the world society has been considered. On the basis of professional requirements' analysis the row of contradictions and disparities among the specialists in…

A Long-Term Model for the Curriculum of Training for an Electric-Power Specialist

ERIC Educational Resources Information Center

Venikov, V. A.

1978-01-01

Long-term planning for professional training of electric-power specialists in Russia will have to (1) recognize the need for specialists to adapt to unforeseen developments in the field, (2) include new mathematics, physics, and computer technology, and (3) be prepared for changes in methods of production and transformation of energy. (AV)

Dancing in a Minefield: An Analysis of Turnaround Specialists in Arizona Schools

ERIC Educational Resources Information Center

McMillie, Kyann L.

2010-01-01

In 2008, educational leaders from the Arizona Department of Education (ADE) assigned a group of turnaround specialists to work in four failing public schools in a large, urban school district in Phoenix, Arizona in hopes of improving those schools. The utilization of turnaround specialists in failing schools was Arizona's method of enacting…

Module 2--Learning Culture. School Improvement Specialist Training Materials: Performance Standards, Improving Schools, and Literature Review

ERIC Educational Resources Information Center

Appalachia Educational Laboratory at Edvantia (NJ1), 2005

2005-01-01

The School Improvement Specialist Project prepared seven modules. School improvement specialists, as defined by the Appalachia Educational Laboratory at Edvantia, are change agents who work with schools to help them improve in the following areas so as to increase student achievement. These modules are intended to provide training materials for…

Physical interaction between floral specialist bees Ptilothrix bombiformis (Cresson) (Hymenoptera: Apidae) enhances pollination of hibiscus (section Trionum: Malvaceae)

USDA-ARS?s Scientific Manuscript database

Specialist bees, those species with narrow dietary niches, rely on a few related species of floral hosts for food. Accordingly, specialists are thought of as being more efficient pollinators than are generalists. There is growing evidence, however, that this is not true in all cases. For example, we...

Interactions between EAL Pupils, Specialist Teachers and TAs during Withdrawal from the Mainstream in UK Primary Schools

ERIC Educational Resources Information Center

Wardman, Clare

2013-01-01

Many primary school children with English as an additional language in the UK receive additional educational support. This article reports on a study comparing withdrawal sessions between teaching assistants (TAs) and specialist teachers. The findings show that the specialist teachers included more personalisation than TAs' sessions, through the…

Characterizing Mathematics Teaching Research Specialists' Mentoring in the Context of Chinese Lesson Study

ERIC Educational Resources Information Center

Gu, Feishi; Gu, Lingyuan

2016-01-01

This study examines how mathematics teaching research specialists mentor practicing teachers during post-lesson debriefs of a lesson study in China. Based on a systematic, fine-grained analysis of 107 h of videotaped mentoring meetings of 20 groups of teachers and teaching research specialists from different elementary schools, this study reveals…

The Concept of Personological Information-Educational System of Forming Professional Effectiveness of a Specialist

ERIC Educational Resources Information Center

Vlasova, Vera K.; Vakhidova, Luycia V.

2016-01-01

Professional self-effectiveness is a key quality of a modern specialist together with cultural, general professional and professional competences, which are realized in his further activity. But in normative documents regulating preparation of a specialist, this quality is not present. The aim of the article is in working out a conception of…

Foreign Area Studies in the USSR. Training and Employment of Specialists.

ERIC Educational Resources Information Center

Gottemoeller, Rose E.; Langer, Paul F.

A study was undertaken to arrive at a broad overview of the Soviet training utilization of foreign area specialists. To gather data for the study, researchers examined European, United States, and Soviet publications and interviewed Soviet emigres and U.S. specialists on the Soviet Union. According to these data sources, specialized training for…

The Top Ten Reasons a Library Media Specialist Is a Teacher's Best Friend

ERIC Educational Resources Information Center

Hylen, Jan

2004-01-01

Many teachers think too little about the role of the library media specialist in their professional lives, and because of this oversight they underutilize this great resource. This article explains the top ten reasons why teachers should work with their library media specialists: (1) Improving test scores and enhancing student academic…

Idaho Marketing Education Core Curriculum. Career Sustaining Level, Specialist Level, Supervisory Level, Entrepreneurial Level.

ERIC Educational Resources Information Center

Allbright, Bruce; Holup, John

This guide lists the competencies expected to be developed in four levels of the marketing education curriculum in Idaho: the career sustaining level, the specialist level, the supervisory level, and the entrepreneurial level. For the career sustaining and specialist levels, 15 competencies are listed: define and apply the role of marketing in the…

Non-Music Specialist Trainee Primary School Teachers' Confidence in Teaching Music in the Classroom

ERIC Educational Resources Information Center

Seddon, Frederick; Biasutti, Michele

2008-01-01

Prior research has revealed that non-music specialist trainee primary school teachers lack confidence in teaching music in spite of changes to teacher training and the introduction of music in the National Curriculum in England. The current study investigated the effects on non-music specialist trainee primary teachers' confidence to teach music…

76 FR 37163 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... PHLX LLC Relating to a Remote Specialist Fee June 20, 2011. Pursuant to Section 19(b)(1) of the... Proposed Rule Change The Exchange proposes to adopt a new fee entitled ``Remote Specialist Fee.'' While fee... proposed rule change is to recoup costs associated with maintaining a remote specialist post on the...

Counseling Relationship Experiences for K-12 School Counselors Who Also Fulfill the Role of Anti-Bullying Specialist

ERIC Educational Resources Information Center

Arcuri, Nicole M.

2018-01-01

This qualitative study explores school counselors' experiences of the counseling relationship with students when also fulfilling the role of anti-bullying specialist. School counselors who also serve students as the anti-bullying specialist embrace a dual role with students. Interviews with school counselors practicing multiple role to include…

Principal Leadership and Reading Specialist Role Understanding in the Era of Test-Based Accountability Policies

ERIC Educational Resources Information Center

Prezyna, Dolores Marie; Garrison, Mark J.; Lockte, Hilary A.; Gold, Carol P.

2017-01-01

This study investigates how the role of the reading specialist (RS) is defined and communicated by principals, and examines to what degree a common understanding of this role exists among teachers, building administrators and reading specialists. The principal's responsibility in defining and communicating role, and the effect these efforts have…

STS-98 on-orbit crew portrait

NASA Image and Video Library

2001-02-07

STS098-365-0034 (7-20 February 2001) --- The crew of the STS-98 mission poses for the traditional inflight portrait on the flight deck of the Space Shuttle Atlantis. From left are astronauts Kenneth D. Cockrell, mission commander; Marsha S. Ivins, mission specialist; Thomas D. Jones, mission specialist; Mark L. Polansky, pilot; and Robert L. Curbeam, mission specialist.

Specialist outreach clinics in primary care and rural hospital settings.

PubMed

Gruen, R L; Weeramanthri, T S; Knight, S E; Bailie, R S

2004-01-01

Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. To undertake a descriptive overview of studies of specialist outreach clinics and to assess the effectiveness of specialist outreach clinics on access, quality, health outcomes, patient satisfaction, use of services, and costs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) specialised register (March 2002), the Cochrane Controlled Trials Register (CCTR) (Cochrane Library Issue 1, 2002), MEDLINE (including HealthStar) (1966 to May 2002), EMBASE (1988 to March 2002), CINAHL (1982 to March 2002), the Primary-Secondary Care Database previously maintained by the Centre for Primary Care Research in the Department of General Practice at the University of Manchester, a collection of studies from the UK collated in "Specialist Outreach Clinics in General Practice" (Roland 1998), and the reference lists of all retrieved articles. Randomised trials, controlled before and after studies and interrupted time series analyses of visiting specialist outreach clinics in primary care or rural hospital settings, either providing simple consultations or as part of complex multifaceted interventions. The participants were patients, specialists, and primary care providers. The outcomes included objective measures of access, quality, health outcomes, satisfaction, service use, and cost. Four reviewers working in pairs independently extracted data and assessed study quality. 73 outreach interventions were identified covering many specialties, countries and settings. Nine studies met the inclusion criteria. Most comparative studies came from urban non-disadvantaged populations in developed countries. Simple 'shifted outpatients' styles of specialist outreach were shown to improve access, but there was no evidence of impact on health outcomes. Specialist outreach as part of more complex multifaceted interventions involving collaboration with primary care, education or other services was associated with improved health outcomes, more efficient and guideline-consistent care, and less use of inpatient services. The additional costs of outreach may be balanced by improved health outcomes. This review supports the hypothesis that specialist outreach can improve access, outcomes and service use, especially when delivered as part of a multifaceted intervention. The benefits of simple outreach models in urban non-disadvantaged settings seem small. There is a need for good comparative studies of outreach in rural and disadvantaged settings where outreach may confer most benefit to access and health outcomes.

[Interdisciplinary teleconsultation: first practical experiences with 100 patients].

PubMed

Gollnick, I; Frehiwot, M; Krause, E M; Schaller, S; Limpert, E; Strauß, G; Lipp, T; Scherz, M; Injac, Z

2013-06-01

PROBLEM DEFINITION: Increasing specialization can be observed in the various medical fields and as a consequence there is little professional exchange between ear nose and throat (ENT) specialists and general practitioners. At the same time there has been significant technological development in telemedicine over the last 5 years; however, this potential is not being sufficiently exploited. The objective of this project is to implement a practicable solution for teleconsulation between ENT specialists and general practitioners. The connection is based on a secure broadband internet connection, the corresponding server structure and a video endoscopic system. In the period from 01 January 2011 to 30 June 2012 (18 months) a total of 102 patients were included in the study in which 4 general practitioners and 5 ENT specialists participated. The protocol comprised the following parameters: indications and typical questions, number of patients presenting to the ENT specialist due to the available teleconsultation service (CBO), number of patients referred to the ENT specialist after teleconsultation (CIO), assessment of the quality of the additional expert opinion (LOQ GP), assessment of the accuracy of the specialist physician tele-diagnosis (TDS-FA) and assessment of the impact of the expert physician diagnosis on the general medical treatment (COS). Teleconsultation was most frequently used for diagnostics on tonsils (37% of the presented cases), the external auditory canal (32%) and the inner nose (15%). Of the patients analyzed were 53.9% presented to the ENT specialist only because the teleconsultation service provided an effortless opportunity and after teleconsultation 40.1% of the patients were referred to the ENT specialist. General practitioners assessed the benefit from the specialist opinion with 64 points. Diagnostic certainty of the specialist opinion, i.e. the validity scale of the diagnosis made, was on average 2.0. In approximately 35.3% of the cases (36 out of 102 patients) participating general practitioners documented a considerable impact of teleconsultation on the diagnosis and/or therapy. Teleconsultation between general practitioners and ENT specialists can provide an advantage in treatment quality and patient comfort. According to the experience gained there is a very low risk of diminishing the professional competency of ENT medicine and the involvement of the expert group in the early project stage allows a greater leeway in project implementation. This could also have an impact on future medical performance specifications. According to the ENT experts involved in the project further applications of teleconsultation are very conceivable.

The impact of electronic consultation on a Canadian tertiary care pediatric specialty referral system: A prospective single-center observational study

PubMed Central

Liddy, Clare; Keely, Erin; Afkham, Amir; Kurzawa, Julia; Abdeen, Nishard; Audcent, Tobey; Bromwich, Matthew; Brophy, Jason; Carsen, Sasha; Fournier, Annick; Fraser-Roberts, Leigh; Gandy, Hazen; Hui, Charles; Johnston, Donna; Keely, Kathryn; Kontio, Ken; Lamontagne, Christine; Major, Nathalie; O’Connor, Michael; Radhakrishnan, Dhenuka; Reisman, Joe; Robb, Marjorie; Samson, Lindy; Sell, Erick; Splinter, William; van Stralen, Judy; Venkateswaran, Sunita; Murto, Kimmo

2018-01-01

Background Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit “elective” clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. Objective To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults. Design Prospective observational cohort study. Setting Single Canadian tertiary-care academic pediatric hospital (June 2014–16) servicing 1.2 million people. Participants 1. PCPs already using eConsult. 2.Volunteer pediatric specialists provided services in addition to their regular workload. 3.Pediatric patients (< 18 years-old) referred for none-acute care conditions. Main outcomes and measures Specialty service utilization and access, impact on PCP course-of-action and referral-patterns and survey-based provider satisfaction data were collected. Results 1064 eConsult requests from 367 PCPs were answered by 23 pediatric specialists representing 14 specialty-services. The top three specialties represented were: General Pediatrics 393 cases (36.9%), Orthopedics 162 (15.2%) and Psychiatry 123 (11.6%). Median specialist response time was 0.9 days (range <1 hour-27 days), most consults (63.2%) required <10minutes to complete and 21/21(100%) specialist survey-respondents reported minimal workload burden. For 515/1064(48.4%) referrals, PCPs received advice for a new or additional course of action; 391/1064(36.7%) referrals resulted in an averted face-to-face specialist visit. In 9 specialties with complete data, the median wait-time was significantly less (p<0.001) for an eConsult (1 day, 95%CI:0.9–1.2) compared with a face-to-face referral (132 days; 95%CI:127–136). The majority (>93.3%) of PCPs rated eConsult as very good/excellent value for both patients and themselves. All specialist survey-respondents indicated eConsult should be a continued service. Conclusions and relevance Similar to adults, eConsult improves PCP access and timeliness to elective pediatric specialist advice and influences their care decisions, while reporting high end-user satisfaction. Further study is warranted to assess impact on resource utilization and clinical outcomes. PMID:29320539

Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists.

PubMed

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Wilschut, Janneke A; Tjin A Tsoi, Sharon L N M; Croiset, Gerda; Peerdeman, Saskia M

2018-05-22

Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Chemical and behavioral integration of army ant-associated rove beetles - a comparison between specialists and generalists.

PubMed

von Beeren, Christoph; Brückner, Adrian; Maruyama, Munetoshi; Burke, Griffin; Wieschollek, Jana; Kronauer, Daniel J C

2018-01-01

Host-symbiont interactions are embedded in ecological communities and range from unspecific to highly specific relationships. Army ants and their arthropod guests represent a fascinating example of species-rich host-symbiont associations where host specificity ranges across the entire generalist - specialist continuum. In the present study, we compared the behavioral and chemical integration mechanisms of two extremes of the generalist - specialist continuum: generalist ant-predators in the genus Tetradonia (Staphylinidae: Aleocharinae: Athetini), and specialist ant-mimics in the genera Ecitomorpha and Ecitophya (Staphylinidae: Aleocharinae: Ecitocharini). Similar to a previous study of Tetradonia beetles, we combined DNA barcoding with morphological studies to define species boundaries in ant-mimicking beetles. This approach found four ant-mimicking species at our study site at La Selva Biological Station in Costa Rica. Community sampling of Eciton army ant parasites revealed that ant-mimicking beetles were perfect host specialists, each beetle species being associated with a single Eciton species. These specialists were seamlessly integrated into the host colony, while generalists avoided physical contact to host ants in behavioral assays. Analysis of the ants' nestmate recognition cues, i.e. cuticular hydrocarbons (CHCs), showed close similarity in CHC composition and CHC concentration between specialists and Eciton burchellii foreli host ants. On the contrary, the chemical profiles of generalists matched host profiles less well, indicating that high accuracy in chemical host resemblance is only accomplished by socially integrated species. Considering the interplay between behavior, morphology, and cuticular chemistry, specialists but not generalists have cracked the ants' social code with respect to various sensory modalities. Our results support the long-standing idea that the evolution of host-specialization in parasites is a trade-off between the range of potential host species and the level of specialization on any particular host.

Implementation and Evaluation of the Safety Net Specialty Care Program in the Denver Metropolitan Area

PubMed Central

Fort, Meredith P; Namba, Lynnette M; Dutcher, Sarah; Copeland, Tracy; Bermingham, Neysa; Fellenz, Chris; Lantz, Deborah; Reusch, John J; Bayliss, Elizabeth A

2017-01-01

Objectives: In response to limited access to specialty care in safety-net settings, an integrated delivery system and three safety-net organizations in the Denver, CO, metropolitan area launched a unique program in 2013. The program offers safety-net providers the option to electronically consult with specialists. Uninsured patients may be seen by specialists in office visits for a defined set of services. This article describes the program, identifies aspects that have worked well and areas that need improvement, and offers lessons learned. Methods: We quantified electronic consultations (e-consults) between safety-net clinicians and specialists, and face-to-face specialist visits between May 2013 and December 2014. We reviewed and categorized all e-consults from November and December 2014. In 2015, we interviewed 21 safety-net clinicians and staff, 12 specialists, and 10 patients, and conducted a thematic analysis to determine factors facilitating and limiting optimal program use. Results: In the first 20 months of the program, safety-net clinicians at 23 clinics made 602 e-consults to specialists, and 81 patients received face-to-face specialist visits. Of 204 primary care clinicians, 103 made e-consults; 65 specialists participated in the program. Aspects facilitating program use were referral case managers’ involvement and the use of clear, concise questions in e-consults. Key recommendations for process improvement were to promote an understanding of the different health care contexts, support provider-to-provider communication, facilitate hand-offs between settings, and clarify program scope. Conclusion: Participants perceived the program as responsive to their needs, yet opportunities exist for continued uptake and expansion. Communitywide efforts to assess and address needs remain important. PMID:28241908

Practice development 'without walls' and the quandary of corporate practice.

PubMed

Graham, Iain; Fielding, Carol; Rooke, Debbie; Keen, Steven

2006-08-01

The context of this study is a group of clinical nurse specialists from across a Trust seeking accreditation as a practice development unit. The university was asked to facilitate the accreditation process via 11 2-hour learning sessions (including a one-hour focus group). During initial discussions between the university and practice development unit, the overarching research question for this study was set as: 'what are the main roles and responsibilities of clinical nurse specialists?' Although there is no known study of a practice development unit based beyond a ward or speciality, the central tenet of the practice development unit literature is that units must demonstrate their worth if they are to survive and harness senior management support in doing so. Data gleaned from the transcribed audio tape-recordings of the learning sessions were studied at least three times to ensure transcription accuracy and produce detailed charts. Ethical approval was granted by the appropriate Local Research Ethics Committee and written informed consent obtained from clinical nurse specialists. The study lasted 30 months and ended in October 2004. The four crucial statements that give meaning to specialist practice are: quality care giver; expert; information giver and initiator of change. Further analysis reveals the area of corporate and political practice as being missing from this and other lists of clinical nurse specialist attributes found in the literature. Clinical nurse specialists characterize their relationship with the Trust in terms of dichotomy--differing agendas and perceptions of value. The specialist role requires professional development in the areas of corporate and political acumen and professional business management. While the findings of this study relate to one Trust and a group of 16 clinical nurse specialists, with careful application they may be transferable to other settings and groups of senior nurses.

How are physicians delivering palliative care? A population-based retrospective cohort study describing the mix of generalist and specialist palliative care models in the last year of life.

PubMed

Brown, Catherine Rl; Hsu, Amy T; Kendall, Claire; Marshall, Denise; Pereira, Jose; Prentice, Michelle; Rice, Jill; Seow, Hsien-Yeang; Smith, Glenys A; Ying, Irene; Tanuseputro, Peter

2018-06-01

To enable coordinated palliative care delivery, all clinicians should have basic palliative care skill sets ('generalist palliative care'). Specialists should have skills for managing complex and difficult cases ('specialist palliative care') and co-exist to support generalists through consultation care and transfer of care. Little information exists about the actual mixes of generalist and specialist palliative care. To describe the models of physician-based palliative care services delivered to patients in the last 12 months of life. This is a population-based retrospective cohort study using linked health care administrative data. Physicians providing palliative care services to a decedent cohort in Ontario, Canada. The decedent cohort consisted of all adults (18+ years) who died in Ontario, Canada between April 2011 and March 2015 ( n = 361,951). We describe four major models of palliative care services: (1) 53.0% of decedents received no physician-based palliative care, (2) 21.2% received only generalist palliative care, (3) 14.7% received consultation palliative care (i.e. care from both specialists and generalists), and (4) 11.1% received only specialist palliative care. Among physicians providing palliative care ( n = 11,006), 95.3% had a generalist palliative care focus and 4.7% a specialist focus; 74.2% were trained as family physicians. We examined how often a coordinated palliative care model is delivered to a large decedent cohort and identified that few actually received consultation care. The majority of care, in both the palliative care generalist and specialist models, was delivered by family physicians. Further research should evaluate how different models of care impact patient outcomes and costs.

Impact of referral letters on scheduling of hospital appointments: a randomised control trial

PubMed Central

Jiwa, Moyez; Meng, Xingqiong; O’Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-01-01

Background Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. Aim To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Design and setting Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. Method GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ2 and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. Results The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). Conclusion In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed. PMID:24982494

Bioinstrumentation for evaluation of workload in payload specialists - Results of ASSESS II

NASA Technical Reports Server (NTRS)

Wegmann, H. M.; Herrmann, R.; Winget, C. M.

1979-01-01

Results of the medical experiment on payload specialist workloads conducted as part of the ASSESS II airborne simulation of Spacelab conditions are reported. Subjects were fitted with temperature probes and ECG, EEG and EOG electrodes, and hormone and electrolyte excretion was monitored in order to evaluate the changes in circadian rhythms, sleep patterns and stress responses brought about by mission schedules over the ten days of the experiment. Internal dissociations of circadian rhythms, sleep disturbances and increased stress levels were observed, especially during the first three days of the experiment, indicating a considerable workload to be imposed upon the payload specialists. An intensive premission simulation is suggested as a means of estimating overall workloads and allowing payload specialist adaptation to mission conditions. The bioinstrumentation which was developed and applied to the airborne laboratory is concluded to be a practical and reliable tool in the assessment of payload specialist workloads.

Stephen K. Robinson arrives at KSC for the STS-95 launch

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Stephen K. Robinson, arrives at Kennedy Space Center's Shuttle Landing Facility aboard a T-38 jet as part of final preparations for launch. The STS-95 mission, targeted for liftoff at 2 p.m. on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. The mission is expected to last 8 days, 21 hours and 49 minutes, and return to KSC on Nov. 7. The other STS-95 crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA).

KSC-98pc1553

NASA Image and Video Library

1998-11-07

Orbiter Discovery prepares to land on runway 33 at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1562

NASA Image and Video Library

1998-11-07

KENNEDY SPACE CENTER, FLA. -- Seen from across the creek bordering runway 33 at the Shuttle Landing Facility, orbiter Discovery touches down after a successful mission of nine days and 3.6 million miles. Flying above it (left) is the Shuttle Training Aircraft. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1551

NASA Image and Video Library

1998-11-07

Orbiter Discovery prepares to land on runway 33 at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1549

NASA Image and Video Library

1998-11-07

Orbiter Discovery startles a great white egret (below) next to runway 33 as it touches down at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1565

NASA Image and Video Library

1998-11-07

The Shuttle Training Aircraft (top) seems to chase orbiter Discovery as it touches down at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. In the background, right, is the Vehicle Assembly Building. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1552

NASA Image and Video Library

1998-11-07

Orbiter Discovery touches down in a cloud of smoke on runway 33 at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1550

NASA Image and Video Library

1998-11-07

Orbiter Discovery smokes its tires as it touches down on runway 33 at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai,M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1554

NASA Image and Video Library

1998-11-07

Orbiter Discovery lowers its nose wheel after touching down on runway 33 at the Shuttle Landing Facility. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. Discovery returns to Earth with its crew of seven after successfully completing mission STS-95, lasting nearly nine days and 3.6 million miles. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., a senator from Ohio; Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, M.D., with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1563

NASA Image and Video Library

1998-11-07

Viewed across the creek bordering runway 33, orbiter Discovery touches down at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. In the background, right, is the Vehicle Assembly Building. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1564

NASA Image and Video Library

1998-11-07

Viewed across the creek bordering runway 33, orbiter Discovery prepares to touch down at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Flying above it is the Shuttle Training Aircraft. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. In the background, right, is the Vehicle Assembly Building. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1579

NASA Image and Video Library

1998-11-08

At the Skid Strip at Cape Canaveral Air Station, STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, poses with his wife Annie before their return flight to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew also includes Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

Tour by Saudi prince Salman Abdelazize Al-Saud prior to mission

NASA Technical Reports Server (NTRS)

1985-01-01

Tour by Saudi prince Salman Abdelazize Al-Saud, payload specialists for STS 51-G mission, prior to mission. Al-Saud and Abdulmohsen Hamad Al-Bassam, the backup payload specialist, man the controls on the flight deck of the crew compartment trainer in the Shuttle mockup and integration laboratory (29788); the Saudi payload specialists share the hatch of the crew compartment trainer (29789); Portrait view of Abdulmohsen Hamad Al-Bassam during a visit to the Shuttle mockup and integraion laboratory (29790); Don Sirroco, left, explains the middeck facilities in the Shuttle mockup and integration laboratory (29791); Portrait view of Sultan Salman Abdelazize Al-Saud in the Shuttle Mockup and Integration laboratory (29792); The Saudi payload specialists witness a space food demonstration in the life sciences laboratory at JSC. Al-Saud (left) and Al-Bassam (second left) listen as Rita M. Rapp, food specialist, discusses three preparations of re-hydratable food for space travelers. Lynn S. Coll

STS-114: Crew Training Clip from JSC

NASA Technical Reports Server (NTRS)

2003-01-01

STS-114 Discovery crew is shown in various training exercises at Johnson Space Center. The crew consists of Eileen Collins, Commander; James Kelley, Pilot; Charles Camarda, Mission Specialist; Wendy Lawrence, Mission Specialist; Soichi Noguchi, Mission Specialist; Steve Robinson, Mission Specialist; and Andy Thomas, Mission Specialist. The exercises include: 1) EVA training in the VR lab; 2) Neutral Buoyancy Laboratory (NBL) EVA Training; 3) Walk to Motion Base Simulator; 4) EVA Preparations in ISS Airlock; and 7) Emergency Egress from Crew Compartment Trainer (CCT). A crew photo session is also presented. Footage of The Space Shuttle Atlantis inside the Kennedy Space Center Vehicle Assembly Building (VAB) after its demating from the Solid Rocket Booster and External Tank is shown. The video ends with techniques for inspecting and repairing Thermal Protection System tiles, a video of external tank production at the Michoud Assembly Facility (MAF) and redesign of the foam from the bipod ramp at Michoud Assembly Facility (MAF).

KSC-98pc1421

NASA Image and Video Library

1998-10-27

STS-95 Payload Specialist Chiaki Mukai (left), with the National Space Development Agency of Japan (NASDA), lifts the cover on a container in the Vestibular Function Experiment Unit holding one of the two toadfish that are the subjects of an experiment. Mission Specialist Scott E. Parazynski is helping her check experiments for mission STS-95. The fish will be electronically monitored to determine the effect of gravitational changes on the inner-ear system. Mukai and Parazynski and other crewmembers were making final preparations for launch, targeted for liftoff at 2 p.m. on Oct. 29. The STS-95 crew also includes Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Specialist Pedro Duque, with the European Space Agency (ESA). The mission is expected to last 8 days, 21 hours and 49 minutes, returning to KSC at 11:49 a.m. EST on Nov. 7

Space Shuttle Discovery lifts off successfully

NASA Technical Reports Server (NTRS)

1998-01-01

Space Shuttle Discovery clears Launch Pad 39B at 2:19 p.m. EST Oct. 29 as it lifts off on mission STS-95. Making his second voyage into space after 36 years is Payload Specialist John H. Glenn Jr., senator from Ohio. Other crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Payload Specialist Chiaki Mukai, (M.D., Ph.D.), with the National Space Development Agency of Japan (NASDA), Mission Specialist Stephen K. Robinson, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), and Mission Specialist Scott E. Parazynski. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Discovery is expected to return to KSC at 11:49 a.m. EST on Nov. 7.

Space Shuttle Discovery lifts off successfully

NASA Technical Reports Server (NTRS)

1998-01-01

Tree branches on the Space Coast frame Space Shuttle Discovery's liftoff from Launch Pad 39B at 2:19 p.m. EST Oct. 29 on mission STS-95. Making his second voyage into space after 36 years is Payload Specialist John H. Glenn Jr., senator from Ohio. Other crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Payload Specialist Chiaki Mukai, (M.D., Ph.D.), with the National Space Development Agency of Japan (NASDA), Mission Specialist Stephen K. Robinson, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), and Mission Specialist Scott E. Parazynski. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Discovery is expected to return to KSC at 11:49 a.m. EST on Nov. 7.

Discovery prepares to land after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

Seen from across the creek bordering runway 33 at the Shuttle Landing Facility, orbiter Discovery touches down after a successful mission of nine days and 3.6 million miles. Flying above it (left) is the Shuttle Training Aircraft. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Pedro Duque arrives at KSC for the STS-95 launch

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Pedro Duque, with the European Space Agency (ESA), arrives at Kennedy Space Center's Shuttle Landing Facility aboard a T-38 jet as part of final preparations for launch. The STS-95 mission, targeted for liftoff at 2 p.m. on Oct. 29, includes research payloads such as the Spartan solar- observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. The mission is expected to last 8 days, 21 hours and 49 minutes, and return to KSC on Nov. 7. The other STS-95 crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA).

Discovery prepares to land after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

Viewed across the creek bordering runway 33, orbiter Discovery touches down at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. In the background, right, is the Vehicle Assembly Building. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

STS-47 crew during fire fighting exercises at JSC's Fire Training Pit

NASA Technical Reports Server (NTRS)

1992-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, crewmembers line up along water hoses to extinguish a blaze in JSC's Fire Training Pit during fire fighting exercises. Manning the hose in the foreground are Payload Specialist Mamoru Mohri, holding the hose nozzle, backup Payload Specialist Takao Doi, Mission Specialist (MS) Jerome Apt, and Commander Robert L. Gibson, at rear. Lined up on the second hose are Pilot Curtis L. Brown, Jr, holding the hose nozzle, followed by MS N. Jan Davis, MS and Payload Commander (PLC) Mark C. Lee, and backup Payload Specialist Stan Koszelak. A veteran firefighter monitors the effort from a position between the two hoses. In the background, backup Payload Specialist Chiaki Naito-Mukai, donning gloves, and MS Mae C. Jemison look on. The Fire Training Pit is located across from the Gilruth Center Bldg 207. Mohri, Doi, and Mukai all represent Japan's National Space Development Agency (NASDA).

Defining "peerness": Developing peer supports for parents with mental illnesses.

PubMed

Nicholson, Joanne; Valentine, Anne

2018-06-01

This article addresses critical considerations in the development of peer supports for parents with mental illnesses, focusing on the question of what makes a peer a peer in the parent peer specialist domain. The implementation and testing of parent peer supports requires specification of the critical components of the model, including the qualities, characteristics, and unique contributions of the parent peer specialist. Themes emerged in Parent Peer Specialist Project Advisory Group discussions, with members drawing from lived experience, practice expertise, and conversations with experts. In addition to literature review, strategic stakeholder interviews were conducted. Lived experience of mental illness and family life, training, and ongoing support for parent peer specialists, along with key ingredients conveyed by perceived peer-parent similarity, will likely enhance the benefits of peer supports to parents and promote job satisfaction and career advancement for parent peer specialists. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Space Shuttle Projects

NASA Image and Video Library

1989-10-25

On November 22, 1989, at 7:23:30pm (EST), 5 astronauts were launched into space aboard the Space Shuttle Orbiter Discovery for the 5th Department of Defense mission, STS-33. Photographed from left to right are Kathryn C. Thornton, mission specialist 3; Manley L. (Sonny) Carter, mission specialist 2; Frederick D. Gregory, commander; John E. Blaha, pilot; and F. Story Musgrave, mission specialist 1.

An Analysis of the Time Use of Elementary School Library Media Specialists and Factors That Influence It.

ERIC Educational Resources Information Center

Deusen, Jean Donham van

1996-01-01

Elementary library media specialists in Iowa recorded their use of time for two days. Descriptive measures indicated nearly equal amounts of time for direct services and for management and operations activities. Automation, scheduling, support staff, and number of buildings served by the media specialist were found to have a significant influence…

Studying Interrelation of Professional Motivation and Professional Concepts of Specialists with Different Professional Orientation as a Basis for Career Building

ERIC Educational Resources Information Center

Rogova, Evgenia E.; Pankratova, Irina A.; Zholudeva, Svetlana V.; Sheveleva, Anna M.; Naumenko, Marina V.; Skrynnik, Natalya E.

2016-01-01

The article focuses on some peculiarities of interrelation of professional motivation and professional concepts of specialists with different professional orientation. The results of empirical research are revealed on the sampling of 164 specialists in the field of management who have been divided into five subgroups according to the types of…

The Role of Media Specialists with Respect to Instructional Technology in an Urban School District in Georgia

ERIC Educational Resources Information Center

Goetzel, Warren Reid

2011-01-01

Due to the absence of a Georgia Educator Certificate in instructional technology, and the lack of state-wide staffing guidelines or requirements for instructional technology specialists, there is a lack of consistency in the qualifications and staffing of P-12 instructional technology specialists in Georgia public schools. The result is a lack of…

Non-Traditional Organizational Design Concepts

DTIC Science & Technology

1982-05-01

specialists benefit, for recognition ave. to ave. have associatelon with project; resembles job enrichment. 9 12 . Structure/concept Yes Synonym for program...provisions Little Wall (1980): Form of recognition is per- for recognition ceived by functional specialists ; resem- bles job enrichment. 12 ...Indirect reward to functional recognition specialists ; resembles job enrichment. 12 . Structure/concept No • S applied in the pub- lic sector 108 U

The ICT Level of Confidence of Course Specialists in Distance Education: The Polytechnic University of the Philippines Experience

ERIC Educational Resources Information Center

Sumande, Caroline T.; Castolo, Carmencita L.; Comendador, Benilda Eleanor V.

2016-01-01

The study addressed two questions: what is the ICT level of confidence of the course specialists handling Open University classes, and to what extent do course specialists integrated ICT applications such as word processing, electronic spread sheet, presentation software, YouTube and etc. in their OUS classes? The instruments were administered to…

Insideness and Outsideness: An Autoethnography of a Primary Physical Education Specialist Teacher

ERIC Educational Resources Information Center

Brooks, Caroline; Thompson, Maree Dinan

2015-01-01

The purpose of this study is to provide an authentic and legitimate voice to the physical education (PE) specialist teacher in the primary school and to give an insight into professional knowledge. An autoethnographic approach has been used to invite readers to enter my world of the primary PE specialist teacher and observe and respond to its…

US Navy Ships Food Service Divisions: Modernizing Inventory Management

DTIC Science & Technology

2010-05-31

relatively unchanged for decades. Culinary Specialists are utilizing an antiquated and unreliable inventory management program (the Food Management System...validities, reduce man-hours and improve the quality of life for Culinary Specialists). 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION...procedures for receipt, inventory, stowage, and issue of provisions onboard ships have remained relatively unchanged for decades. Culinary Specialists

Learning Mathematics for Teaching Mathematics: Non-Specialist Teachers' Mathematics Teacher Identity

ERIC Educational Resources Information Center

Crisan, Cosette; Rodd, Melissa

2017-01-01

A non-specialist teacher of mathematics is a school teacher who qualified to teach in a subject other than mathematics yet teaches mathematics to students in secondary school. There is an emerging interest internationally in this population, a brief report of which is given in the paper. Because of concerns about the quality of non-specialists'…

Partnership in Being a Specialist Mathematics and Computing College--Who Gains What, How and Why?

ERIC Educational Resources Information Center

Sinkinson, Anne J.

2007-01-01

The research took place in a mathematics and computing specialist school. The article reports on part of a case study of the mathematics department's experience of being a major contributor to the requirements of being a specialist school. This article aims to explore and describe one model of partnership within the "community" remit of…

Development of a Screening Methodology for Entry into Medical Technical Training Courses. Final Report for Period October 1975-April 1977.

ERIC Educational Resources Information Center

Leisey, Sandra A.; Guinn, Nancy

At the request of the Air Force School of Aviation Medicine, a project was initiated to evaluate the current screening process used for entry into three medical technical training courses: Aeromedical Specialist, Environmental Health Specialist, and Physiological Training Specialist. A sample of 1,003 students were administered the General…

The Teaching of User Studies as a Subject for the Preparation of Librarians, Documentalists, Archivists and Other Information Specialists.

ERIC Educational Resources Information Center

Sene, H.

This working paper focuses on methods for developing a study program on scientific and technical information users that could serve as a subject of study in the academic preparation of librarians, archivists, and scientific and technical information specialists. Recognizing that in most schools for training specialists of scientific and technical…

Arts Teachers' Perceptions and Attitudes on Arts Integration While Participating in a Statewide Arts Integration Initiative

ERIC Educational Resources Information Center

May, Brittany Nixon; Robinson, Nicole R.

2016-01-01

The purpose of this study was to examine the perceptions and attitudes of the Beverley Taylor Sorenson Arts Learning Program (BTSALP) arts specialists on arts integration. BTSALP arts specialists (N = 50) throughout the state of Utah responded to a 20-item survey. Results indicated that a majority of BTSALP arts specialists believe that arts…

76 FR 41032 - Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy Changes and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5) of the Act) who is...-to-face encounter as a nurse practitioner or clinical nurse specialist, as those terms are defined in... following NPPs: A nurse practitioner or clinical nurse specialist (as those terms are defined in section...

The Impact of Library Media Specialists on Students and How It Is Valued by Administrators and Teachers: Findings from the Latest Studies in Colorado and Idaho

ERIC Educational Resources Information Center

Francis, Briana Hovendick; Lance, Keith Curry

2011-01-01

School library media specialists wear many hats within their school libraries, classrooms, and districts. Whether these roles are formally acknowledged or not, library media specialists (LMSs) are functioning as co-teachers, curriculum designers, website managers, technology troubleshooters, administrators, and in-service staff development…

Small Business Specialists.

DTIC Science & Technology

1997-12-01

located throughout the United States. Each service and agency has an Office of the Director of Small and Disadvantaged Business Utilization. They also...have small business specialists at each of their procurement and contract management offices to assist small businesses , small disadvantaged businesses ...and women-owned small businesses firms in marketing their products and services with the DoD. These specialists provide information and guidance on (1

Module 3--School-Family-Community Connections. School Improvement Specialist Training Materials: Performance Standards, Improving Schools, and Literature Review

ERIC Educational Resources Information Center

Appalachia Educational Laboratory at Edvantia (NJ1), 2005

2005-01-01

The School Improvement Specialist Project prepared seven modules. School improvement specialists, as defined by the Appalachia Educational Laboratory at Edvantia, are change agents who work with schools to help them improve in the following areas so as to increase student achievement. These modules are intended to provide training materials for…

NASA/ESA CV-990 Spacelab Simulation (ASSESS 2)

NASA Technical Reports Server (NTRS)

1977-01-01

Cost effective techniques for addressing management and operational activities on Spacelab were identified and analyzed during a ten day NASA-ESA cooperative mission with payload and flight responsibilities handled by the organization assigned for early Spacelabs. Topics discussed include: (1) management concepts and interface relationships; (2) experiment selection; (3) hardware development; (4) payload integration and checkout; (5) selection and training of mission specialists and payload specialists; (6) mission control center/payload operations control center interactions with ground and flight problems; (7) real time interaction during flight between principal investigators and the mission specialist/payload specialist flight crew; and (8) retrieval of scientific data and its analysis.

Official STS-67 preflight crew portrait

NASA Technical Reports Server (NTRS)

1995-01-01

Official STS-67 preflight crew portrait. In front are astronauts (left to right) Stephen S. Oswald, mission commander; Tamara E. Jernigan, payload commander; and William G. Gregory, pilot. In the back are (left to right) Ronald A. Parise, payload specialist; astronauts Wendy B. Lawrence, and John Grunsfeld, both mission specialists; and Samuel T. Durrance, payload specialist. Dr. Durrance is a research scientist in the Department of Physics and Astronomy at Johns Hopkins University, Baltimore, Maryland. Dr. Parise is a senior scientist in the Space Observatories Department, Computer Sciences Corporation, Silver Spring, Maryland. Both payload specialists flew aboard the Space Shuttle Columbia for STS-35/ASTRO-1 mission in December 1990.

Extending specialist palliative care to all?

PubMed

Field, D; Addington-Hall, J

1999-05-01

How to extend palliative care services to all patients needing them is an issue currently exercising a range of bodies in contemporary Britain. This paper first considers the evidence regarding the needs of dying patients with long term conditions other than cancer and concludes that there is evidence to support their presumed need for palliative care. It then considers five potential barriers to extending specialist palliative care services to non-cancer patients in Britain. These are the skill base of current specialists in palliative care, difficulties in identifying candidates for specialist palliative care, the views of potential users of these services, resource implications and vested interests in present health service arrangements.

STS-55 German payload specialists pose in front of SL-D2 module at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists pose in front of the Spacelab Deutsche 2 (SL-D2) science module at a Kennedy Space Center (KSC) processing facility. These two Germans have been assigned to support the STS-55/SL-D2 mission. They are Payload Specialist 2 Hans Schlegel (left) and Payload Specialist 1 Ulrich Walter. Walter and Schlegel are scheduled to fly aboard OV-102 for the mission, joining five NASA astronauts. Clearly visible on the SL-D2 module are the European Space Agency (ESA) insignia, the feedthrough plate, and the D2 insignia.

STS-87 Mission Specialist Doi addresses the media at the SLF

NASA Technical Reports Server (NTRS)

1997-01-01

As STS-87 Commander Kevin Kregel looks on, Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan addresses members of the press and media at Kennedy Space Center's Shuttle Landing Facility after arriving for the final prelaunch activities leading up to the scheduled Nov. 19 liftoff. Other STS-87 crew members not pictured are Pilot Steven Lindsey; Mission Specialists Kalpana Chawla, Ph.D., and Winston Scott; and Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine. STS-87 will be the fourth flight of the United States Microgravity Payload and the Spartan-201 deployable satellite.

Space Shuttle Projects

NASA Image and Video Library

1997-09-01

Five astronauts and a payload specialist take a break from training at the Johnson Space Center (JSC) to pose for the STS-87 crew portrait. Wearing the orange partial pressure launch and entry suits, from the left, are Kalpana Chawla, mission specialist; Steven W. Lindsey, pilot; Kevin R. Kregel, mission commander; and Leonid K. Kadenyuk, Ukrainian payload specialist. Wearing the white Extravehicular Mobility Unit (EMU) space suits are mission specialists Winston E. Scott (left) and Takao Doi (right). Doi represents Japan’s National Space Development Agency (NASDA). The STS-87 mission launched aboard the Space Shuttle Columbia on November 19, 1997. The primary payload for the mission was the U.S. Microgravity Payload-4 (USMP-4).

KSC-00pp1851

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- The STS-107 crew takes part in In-Flight Maintenance training, learning more about experiments that will be part of the mission. Seated in front (left to right) are Mission Specialist Kalpana Chawla, Payload Specialist Ilan Ramon of Israel; Commander Rick D. Husband; Mission Specialist Laurel Clark; and Pilot William C. “Willie” McCool; in back are Mission Specialists David M. Brown and Michael Anderson. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC00pp1860

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- As part of In-Flight Maintenance training at SPACEHAB, in Cape Canaveral, Fla., the STS-107 crew learns about Biological Research in Canisters (BRIC) experiments that will be on their mission. From left are Mission Specialist Kalpana Chawla, Pilot William C. “Willie” McCool, Roberteen McCray of Bionetics, Commander Rick D. Husband, Payload Specialist Ilan Ramon of Israel, and Mission Specialists David M. Brown and Michael Anderson. At right is Debbie Wells of Bionetics. Not seen is Mission Specialist Laurel Clark. STS-107 will carry a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC00pp1851

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- The STS-107 crew takes part in In-Flight Maintenance training, learning more about experiments that will be part of the mission. Seated in front (left to right) are Mission Specialist Kalpana Chawla, Payload Specialist Ilan Ramon of Israel; Commander Rick D. Husband; Mission Specialist Laurel Clark; and Pilot William C. “Willie” McCool; in back are Mission Specialists David M. Brown and Michael Anderson. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC-00pp1860

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- As part of In-Flight Maintenance training at SPACEHAB, in Cape Canaveral, Fla., the STS-107 crew learns about Biological Research in Canisters (BRIC) experiments that will be on their mission. From left are Mission Specialist Kalpana Chawla, Pilot William C. “Willie” McCool, Roberteen McCray of Bionetics, Commander Rick D. Husband, Payload Specialist Ilan Ramon of Israel, and Mission Specialists David M. Brown and Michael Anderson. At right is Debbie Wells of Bionetics. Not seen is Mission Specialist Laurel Clark. STS-107 will carry a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

Integration of Specialized Pain Control Services in Palliative Care: A Nationwide Web-based Survey.

PubMed

Page, Nivedita Dilip

2017-01-01

Pain control is an important part of palliative care (PC), and conventional analgesics do not provide adequate pain relief to all patients. Many patients present with complex pain syndromes that require interventional pain control measures usually deployed by pain specialists. There is adequate integration of specialized pain control services with PC elsewhere, but information about the same in our country is lacking. An internet survey was conducted among palliative specialists regarding the need and availability of pain specialists for their patients suffering from complex pain syndromes. Their attitude toward integrating specialized pain control services in their practice was also explored. Majority of palliative physicians came across situations where specialists in pain would control the patients' pain better. There was a poor availability of such services, and when available, the cost was significant. It is heartening to note that though there is poor integration of specialized pain control services with palliation, palliative physicians acknowledge the need for pain specialists and their techniques for providing pain relief for their patients. Effective pain control is needed in palliation, barriers however exist, and there is a need to make pain specialists and interventional techniques more freely available.

KENNEDY SPACE CENTER, FLA. - The STS-114 crew gathers around the work stand holding the insert for Discovery’s nose cap. From left are Mission Specialists Soichi Noguchi, and Charles Camarda; Commander Eileen Collins; Mission Specialists Andrew Thomas and Wendy Lawrence; Pilot James Kelly; and Mission Specialist Stephen Robinson. Noguchi represents the Japanese Aerospace and Exploration Agency. The insert is being fitted with thermal protection system insulation blankets. The crew is spending time becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

NASA Image and Video Library

2004-03-05

KENNEDY SPACE CENTER, FLA. - The STS-114 crew gathers around the work stand holding the insert for Discovery’s nose cap. From left are Mission Specialists Soichi Noguchi, and Charles Camarda; Commander Eileen Collins; Mission Specialists Andrew Thomas and Wendy Lawrence; Pilot James Kelly; and Mission Specialist Stephen Robinson. Noguchi represents the Japanese Aerospace and Exploration Agency. The insert is being fitted with thermal protection system insulation blankets. The crew is spending time becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

KENNEDY SPACE CENTER, FLA. - The STS-114 crew stands underneath Discovery in the Orbiter Processing Facility. From left are Mission Specialist Stephen Robinson, Pilot James Kelly, Mission Specialist Charles Camarda, astronaut John Young, Commander Eileen Collins and Mission Specialists Andrew Thomas, Wendy Lawrence and Soichi Noguchi, who is with the Japanese Aerospace and Exploration Agency. Young is associate director, Technical, at Johnson Space Center. The crew is spending time becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

NASA Image and Video Library

2004-03-05

KENNEDY SPACE CENTER, FLA. - The STS-114 crew stands underneath Discovery in the Orbiter Processing Facility. From left are Mission Specialist Stephen Robinson, Pilot James Kelly, Mission Specialist Charles Camarda, astronaut John Young, Commander Eileen Collins and Mission Specialists Andrew Thomas, Wendy Lawrence and Soichi Noguchi, who is with the Japanese Aerospace and Exploration Agency. Young is associate director, Technical, at Johnson Space Center. The crew is spending time becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course

PubMed Central

Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M

2017-01-01

Background While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. Purpose To assess the potential of e-learning in specialist education in medical imaging. Material and Methods An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Results Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. Conclusion E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs. PMID:28804642

Bleeding Hearts, Profiteers, or Both: Specialist Physician Fees in an Unregulated Market.

PubMed

Johar, Meliyanni; Mu, Chunzhou; Van Gool, Kees; Wong, Chun Yee

2017-04-01

This study shows that, in an unregulated fee-setting environment, specialist physicians practise price discrimination on the basis of their patients' income status. Our results are consistent with profit maximisation behaviour by specialists. These findings are based on a large population survey that is linked to administrative medical claims records. We find that, for an initial consultation, specialist physicians charge their high-income patients AU$26 more than their low-income patients. While this gap equates to a 19% lower fees for the poorest patients (bottom 25% of the household income distribution), it is unlikely to remove the substantial financial barriers they face in accessing specialist care. There are large variations across specialties, with neurologists exhibiting the largest fee gap between the high-income and low-income patients. Several possible channels for deducing the patient's income are examined. We find that patient characteristics such as age, health concession card status and private health insurance status are all used by specialists as proxies for income status. These characteristics are particularly important to further practise price discrimination among the low-income patients but are less relevant for the high-income patients. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

What influences the job satisfaction of staff and associate specialist hospital doctors?

PubMed

French, Fiona; Ikenwilo, Divine; Scott, Anthony

2007-08-01

Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.

Tests and measures used by specialist physical therapists when examining patients with stroke.

PubMed

Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C

2008-09-01

Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.

Examining the Promotion of Healthy Eating among Exercise Specialists: A Cross-sectional Study.

PubMed

Johnson, Steven T; Cornish, Stephen M; Lytvyak, Ellina; Taylor, Lorian M; Bell, Gordon; Vallance, Jeff; Fraser, Shawn; Murray, Terra

2015-06-01

The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P < 0.05) and promoting healthy eating (P < 0.01). Confidence was higher among those with more professional experience but who did not meet Canada's Food Guide recommendations (P < 0.05). Professional experience, personal dietary practices, and confidence are important characteristics when considering the assessment and promotion of healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.

Spacelab

NASA Image and Video Library

1983-11-01

This photograph shows activities inside the science module during the Spacelab-1 (STS-9) mission. Left to right are Mission Specialist Robert Parker, Payload Specialist Byron Lichtenberg, Mission Specialist Owen Garriott, and Payload Specialist Ulf Merbold. The overall goal of the Spacelab-1 mission, the first mission of the Spacelab facility, were: (1) To verify the Spacelab system capability, (2) to obtain valuable scientific, applications, and technology data from a U.S./European multidisciplinary payload, and (3) to demonstrate the broad capability of Spacelab for scientific research. More than 70 experiments in 5 disciplines from 14 nations were conducted during the mission. The mission marked the the entry of non-astronaut persornel, called Payload Specialists, into space as working members of the crew. They are fellow scientists representing the international group of investigators using the mission. Mission Specialists are NASA astronauts who have broad scientific training. They operate various Orbiter-Spacelab systems, perform any required activity outside the spacecraft, and support investigations as needed. The Space Shuttle Orbiter Columbia that carried Spacelab-1 was operated by two other NASA astronauts serving as commander and pilot. The STS-9 mission, managed by the Marshall Space Flight Center, was launched on November 28, 1983.

How medical specialists appraise three controversial health innovations: scientific, clinical and social arguments.

PubMed

Lehoux, Pascale; Denis, Jean-Louis; Rock, Melanie; Hivon, Myriam; Tailliez, Stephanie

2010-01-01

Medical specialists play a pivotal role in health innovation evaluation and policy making. Their influence derives not only from their expertise, but also from their social status and the power of their professional organisations. Little is known, however, about how medical specialists determine what makes a health innovation desirable and why. Our qualitative study investigated the views of 28 medical specialists and experts from Quebec and Ontario (Canada) on three controversial innovations: electroconvulsive therapy, prostate-specific antigen screening and prenatal screening for Down's syndrome. Our findings indicate that the scientific, clinical and social arguments of medical specialists combine to create a relatively consistent narrative for each innovation. Our comparative analysis suggests that these narratives bring about a 'soft' resolution to controversies, which relies on a more or less tacit understanding of the social desirability of innovations and which sets the stage for their routinisation. Such an unpacking of medical specialists' arguments both for and against new technologies is needed because such arguments may easily be considered authoritative and because there are few forums for debating the social desirability of innovations not generally deemed to be highly controversial.

Comparing Clinical Nurse Specialist Students' Socialization Based on Magnet Employment.

PubMed

Ares, Terri L

The purpose of this study is to ascertain if clinical nurse specialist students differed on measures of professional socialization based on employment in a Magnet-oriented hospital. A secondary analysis of data from a previous national study of the socialization of clinical nurse specialist students was used. Anticipatory socialization variables (nursing leadership, workplace exposure to the role, and preconceived impression of the role), mentorship by a clinical nurse specialist, and socialization outcomes (self-concept, perceived preparedness for practice, and nursing specialty certification) were explored. Data were divided into 2 groups: Magnet (n = 106) and non-Magnet (n = 119). Comparisons between the groups on researcher-designed items and the Professionalism and Work Ethic subscales of the Nurses Self-Description Form were analyzed. The Magnet group was more likely to be exposed to the clinical nurse specialist role in the workplace. Overall, there were no group differences in socialization outcome measures; but in the subset of students with workplace exposure to the role, those with Magnet experience had higher professionalism self-concept scores. Magnet employment was not a significant socializing factor for nurses pursuing clinical nurse specialist education. The graduate program is likely the primary socializing agent for these students.

Burns education for non-burn specialist clinicians in Western Australia.

PubMed

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona

2015-03-01

Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care. A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session. Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care. Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Physical Education, Obesity, and Academic Achievement: A 2-Year Longitudinal Investigation of Australian Elementary School Children

PubMed Central

Cunningham, Ross B.; Fitzgerald, Robert; Olive, Lisa S.; Prosser, Laurence; Jiang, Xiaoli; Telford, Rohan M.

2012-01-01

Objectives. We determined whether physical education (PE) taught by specialists contributed to academic development and prevention of obesity in elementary school children. Methods. Our 2-year longitudinal study involved 620 boys and girls initially in grade 3 in Australia, all receiving 150 minutes per week of PE. One group (specialist-taught PE; n = 312) included 90 minutes per week of PE from visiting specialists; the other (common-practice PE; n = 308) received all PE from generalist classroom teachers. Measurements included percentage of body fat (measured by dual-emission x-ray absorptiometry) and writing, numeracy, and reading proficiency (by government tests). Results. Compared with common-practice PE, specialist-taught PE was associated with a smaller increase in age-related percentage of body fat (P = .02). Specialist-taught PE was also associated with greater improvements in numeracy (P < .03) and writing (P = .13) scores. There was no evidence of a reading effect. Conclusions. The attenuated age-related increases in percentage of body fat and enhanced numeracy development among elementary school children receiving PE from specialists provides support for the role of PE in both preventive medicine and academic development. PMID:21940922

Attitudes regarding specialist referrals in periodontics.

PubMed

Sharpe, G; Durham, J A; Preshaw, P M

2007-02-24

To examine the attitudes of dental practitioners towards specialist periodontal referral in the North East of England. Semi-structured interviews were conducted with a purposive sample of 10 practitioners. Interviews continued until data saturation occurred. The data were organised using a framework and analysed by two researchers working independently. Perceptions of periodontal disease and treatment appear to be heavily influenced by the NHS remuneration system. Treatment in general practice was limited to simple scaling and there was an apparent reluctance to treat advanced periodontitis. Such cases were commonly referred to specialists, confirming the demand for a referral service in periodontics. The perceived potential for medico-legal consequences was a strong driver of referrals. Distance to the referral centre and the perceived costs of treatment were significant barriers to referral. Dentists valued the specialist's personal reputation and clinical skills more highly than academic status. Deficiencies in communication between primary and secondary care were highlighted. Increased resources are required to manage periodontal diseases within the NHS. There is a need for a periodontal referral service in the North East of England to improve accessibility to specialist care. This would appear to be most appropriately delivered by increased numbers of specialist practitioners.

Proyección de médicos especialistas para el Sector Salud de México a 2030. Un método para estimar requerimientos y planificar su formación.

PubMed

Fajardo-Dolci, Germán; Santacruz-Varela, Javier

2017-01-01

Carry out the projection of medical specialists in the Health Sector Mexico by 2030. A predictive approach was developed to project the number of medical specialists by 2030, according to a trend, a desired goal and two conventional scenarios of increased demand for health services. The methodology was developed based on the General Framework to Assess the Future Supply and Demand of Health Personnel, published in 2013 by the Organization for Economic Co-operation and Development (OECD), and a mathematical model and a software were designed to make projections about the number of specialists. According to the trend, between 2013 and 2030, the number of specialists will be increased by 90,554 to 124,558 and the rate will be change of 77/100.000 population to 91/100,000 population. If is necessary to achieve a goal of 120/100,000, will be necessary to train 40,420 additional specialists to the trend number and if the demand for services increases 15% or 30%, will require further training specialists 65,166 and 89,913, respectively. Even with the trend increase, in the 2030 Mexico will not achieve the desired goal of 126/100,000 population, that the OECD countries had in 2011. The results of the projections made, can help to planning the training of specialists in the medium term. Copyright: © 2017 SecretarÍa de Salud

Specialist Physicians' Attitudes and Practice Patterns Regarding Disclosure of Pre-referral Medical Errors.

PubMed

Dossett, Lesly A; Kauffmann, Rondi M; Lee, Jay S; Singh, Harkamal; Lee, M Catherine; Morris, Arden M; Jagsi, Reshma; Quinn, Gwendolyn P; Dimick, Justin B

2018-06-01

Our objective was to determine specialist physicians' attitudes and practices regarding disclosure of pre-referral errors. Physicians are encouraged to disclose their own errors to patients. However, no clear professional norms exist regarding disclosure when physicians discover errors in diagnosis or treatment that occurred at other institutions before referral. We conducted semistructured interviews of cancer specialists from 2 National Cancer Institute-designated Cancer Centers. We purposively sampled specialists by discipline, sex, and experience-level who self-described a >50% reliance on external referrals (n = 30). Thematic analysis of verbatim interview transcripts was performed to determine physician attitudes regarding disclosure of pre-referral medical errors; whether and how physicians disclose these errors; and barriers to providing full disclosure. Participants described their experiences identifying different types of pre-referral errors including errors of diagnosis, staging and treatment resulting in adverse events ranging from decreased quality of life to premature death. The majority of specialists expressed the belief that disclosure provided no benefit to patients, and might unnecessarily add to their anxiety about their diagnoses or prognoses. Specialists had varying practices of disclosure including none, non-verbal, partial, event-dependent, and full disclosure. They identified a number of barriers to disclosure, including medicolegal implications and damage to referral relationships, the profession's reputation, and to patient-physician relationships. Specialist physicians identify pre-referral errors but struggle with whether and how to provide disclosure, even when clinical circumstances force disclosure. Education- or communication-based interventions that overcome barriers to disclosing pre-referral errors warrant development.

Use of buprenorphine for addiction treatment: perspectives of addiction specialists and general psychiatrists.

PubMed

Thomas, Cindy Parks; Reif, Sharon; Haq, Sayeda; Wallack, Stanley S; Hoyt, Alexander; Ritter, Grant A

2008-08-01

In 2002 buprenorphine (Suboxone or Subutex) was approved by the U.S. Food and Drug Administration for office-based treatment of opioid addiction. The goal of office-based pharmacotherapy is to bring more opiate-dependent people into treatment and to have more physicians address this problem. This study examined prescribing practices for buprenorphine, including facilitators and barriers, and the organizational settings that facilitate its being incorporated into treatment. Addiction specialists and other psychiatrists in four market areas were surveyed by mail and Internet in fall 2005 to examine prescribing practices for buprenorphine. Respondents included 271 addiction specialists (72% response rate) and 224 psychiatrists who were not listed as addiction specialists but who had patients with addictions in their practice (57% response rate). Three years after approval of buprenorphine for office-based addiction treatment, nearly 90% of addiction specialists had been approved to prescribe it and two-thirds treated patients with buprenorphine. However, fewer than 10% of non-addiction specialist psychiatrists prescribed it. Regression-adjusted factors predicting prescribing of buprenorphine included support of training and use of buprenorphine by the physician's main affiliated organization, less time in general psychiatry compared with addictions treatment, more time in group practice rather than solo, ten or more opiate-dependent patients, belief that drugs play a large role in addiction treatment, and patient demand. Office-based pharmacotherapy offers a promising path to improved access to addictions treatment, but prescribing has expanded little beyond the addiction specialist community.

Influence of cnicin, a sesquiterpene lactone ofCentaurea maculosa (Asteraceae), on specialist and generalist insect herbivores.

PubMed

Landau, I; Müller-Schärer, H; Ward, P I

1994-04-01

The sesquiterpene lactone cnicin was extracted fromCentaurea maculosa andCentaurea vallesiaca. We examined its effects on the ovipositional response and larval development of generalist and specialist insect herbivores associated withC. maculosa. For the oviposition trials, three plant species (C. maculosa, Achillea millefolium, andCichorium intybus), half of which were sprayed with 3% of cnicin, were exposed to the specialist mothsStenodes straminea, Agapeta zoegana, andPterolonche inspersa in field cages. All three species significantly preferredC. maculosa to other plants andP. inspersa significantly preferred cnicin-sprayed plants to untreated plants for oviposition. Tested over all species, cnicin significantly increased the number of eggs laid on a given plant. A larval diet test examined the toxicity of cnicin for larvae of the generalist noctuid mothSpodoptera littoralis. Cnicin concentrations of 3% and 6% were lethal and 1% and 0.5% seriously inhibited growth and development. The larvae of theC. maculosa specialistStenodes straminea survived at 6% cnicin, but none of the pupae hatched.Agapeta zoegana was able to survive at 1% and 3% cnicin. Both specialists had difficulties with the artificial diet, but weight increase and survival was not further reduced when cnicin was present compared with on the control diet. In conclusion, cnicin influenced host recognition by the specialist species, and larvae of the generalist did not survive on natural levels of cnicin. Growth and survival of the specialist were not influenced by cnicin but were considerably hampered on artificial diet.

Improving access to specialists in remote communities: a cross-sectional study and cost analysis of the use of eConsult in Nunavut.

PubMed

Liddy, Clare; McKellips, Fanny; Armstrong, Catherine Deri; Afkham, Amir; Fraser-Roberts, Leigh; Keely, Erin

2017-01-01

Residents of remote communities face inequities in access to specialists, excessive wait times, and poorly coordinated care. The Champlain BASE TM (Building Access to Specialists through eConsultation) service facilitates asynchronous communication between primary care providers (PCP) and specialists. The service was extended to several PCPs in Nunavut in 2014. To (1) describe the use of eConsult services in Nunavut, and (2) conduct a costing evaluation. A cross-sectional study and cost analysis of all eConsult cases submitted between August 2014 and April 2016. PCPs from Nunavut submitted 165 eConsult cases. The most popular specialties were dermatology (16%), cardiology (8%), endocrinology (7%), otolaryngology (7%), and obstetrics/gynaecology (7%). Specialists provided a response in a median of 0.9 days (IQR=0.3-3.0, range=0.01-15.02). In 35% of cases, PCPs were able to avoid the face-to-face specialist visits they had originally planned for their patients. Total savings associated with eConsult in Nunavut are estimated at $180,552.73 or $1,100.93 per eConsult. The eConsult service provided patients in Nunavut's remote communities with prompt access to specialist advice. The service's chief advantage in Canada's northern communities is its ability to offer electronic access to a breadth of specialties far greater than could be supported locally. Our findings suggest that a territory-wide adoption of eConsult would generate enormous savings.

Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape.

PubMed

Schoevers, Johan; Jenkins, Louis

2015-04-21

Access to health care often depends on where one lives. Rural populations have significantly poorer health outcomes than their urban counterparts. Specialist outreach to rural communities is one way of improving access to care. A multifaceted style of outreach improves access and health outcomes, whilst a shifted outpatients style only improves access. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary. In practice, however, factors influence whether or not O&S reaches its goals, affecting sustainability.Aim and setting: Our aim was to better understand factors associated with the success or failure of specialist O&S to rural populations in the Eden and Central Karoo districts in the Western Cape. An anonymous parallel three-stage Delphi process was followed to obtain consensus in a specialist and district hospital panel. Twenty eight specialist and 31 district hospital experts were invited, with response rates of 60.7%-71.4% and 58.1%-74.2% respectively across the three rounds. Relationships, communication and planning were found to be factors feeding into a service delivery versus capacity building tension, which affects the efficiency of O&S. The success of the O&S programme is dependent on a site-specific model that is acceptable to both the outreaching specialists and the hosting district hospital. Good communication, constructive feedback and improved planning may improve relationships and efficiency, which might lead to a more sustainable and mutually beneficial O&S system.

Using non-specialist observers in 4AFC human observer studies

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2017-03-01

Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

Leadership capabilities of physiotherapy leaders in Ireland: Part 2. Clinical specialists and advanced physiotherapy practitioners.

PubMed

McGowan, E; Elliott, N; Stokes, E

2018-05-07

Investigation of the leadership capabilities of physiotherapy managers found that they report predominantly demonstrating capabilities associated with the human resource and structural frames. However, little is known about the leadership capabilities of clinical specialists and advanced physiotherapy practitioners (APPs) who also are identified as having responsibility for leadership. To explore clinical specialists´ and APPs' perceptions of their leadership capabilities and compare them with the reported leadership capabilities of physiotherapy managers. Semi-structured interviews were conducted with a purposive sample of 17 physiotherapy clinical specialists and APPs from a range of practice settings across Ireland. The interviews were analyzed using template analysis and the coding template was based on the Bolman and Deal Leadership framework. The participants described demonstrating leadership capabilities associated with each of the four leadership frames. However, the language used by the clinical specialists/APPs suggested that they work predominantly through the human resource frame. Structural frame capabilities were reported by the clinical specialists/APPs and there were some differences to those reported by the managers. In keeping with the reported leadership capabilities of the physiotherapy managers, the employment of capabilities associated with the political frame varied between participants and symbolic frame capabilities were underused. There are many similarities in the self-reported leadership capabilities of managers and clinical specialists/APPs. However, differences were also noted. Both cohorts of physiotherapy leaders may benefit from specific development programs to develop leadership capabilities associated with the political and symbolic frames.

Specialist training of Emergency Medicine in Finland.

PubMed

Naskali, Jarno; Lehtonen, Jarmo; Palomäki, Ari

Emergency Medicine with a six-year specialist training became a main specialty in Finland in the beginning of 2013. Specialist training has developed very quickly over just a few years. In the frontline clinics, the clinical results have already reached high international quality. When developing a new specialty, not only active research and high-quality training but also good co-operation with other specialties are of utmost importance.

Training Information Service Specialists in the Less-Favoured Regions of the European Union (TRAIN-ISS): The Diploma/MSc Programme at the University of Sheffield.

ERIC Educational Resources Information Center

Owens, Ian; And Others

1997-01-01

The primary aim of the training information specialists (TRAIN-ISS) program at the University of Sheffield's Department of Information Studies was to train information service specialists from the less favored regions of the European Union. Describes the course design; selection of participants; student assessment, support, and placement; program…

STS-55 German payload specialist Schlegel and MS3 Harris work in SL-D2 module

NASA Image and Video Library

1993-05-06

STS055-106-090 (26 April- 6 May 1993) --- Hans Schlegel, one of two STS-55 payload specialists representing the German Aerospace Research Establishment (DLR) onboard the Space Shuttle Columbia, finds plenty of room to "spread out" while participating in a Tissue experiment. Astronaut Bernard A. Harris, Jr., mission specialist, monitors an experiment in the background.

Attitudes and Beliefs of Nonspecialist and Specialist Trainee Health and Physical Education Teachers toward Obese Children: Evidence for "Anti-Fat" Bias

ERIC Educational Resources Information Center

Lynagh, Marita; Cliff, Ken; Morgan, Philip J.

2015-01-01

Background: The aim of this study was to assess the beliefs and attitudes of preservice health and physical education (HPE) specialist and nonspecialist schoolteachers toward obese children. Methods: A total of 177 nonspecialist and 62 HPE specialist trainee teachers completed a series of pen-and-paper validated measures of attitudes and beliefs…

The NAICS Code Selection Process And Small Business Participation

DTIC Science & Technology

2016-03-01

specialist 15. NUMBER OF PAGES 59 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT Unclassified 18. SECURITY CLASSIFICATION OF THIS PAGE...FPDS-NG) website and information gathered from interviews with small business specialists . The data include contract actions from 276 contracts with...used interviews to determine if small businesses are affected by inappropriate NAICS code selection. None of the six small business specialists we

"Journal for Specialists in Group Work" ("JSGW") Publication Pattern Review: A Meta-Study of Author and Article Characteristics from 1981-2010

ERIC Educational Resources Information Center

Byrd, Rebekah; Crockett, Stephanie A.; Erford, Bradley T.

2012-01-01

"The Journal for Specialists in Group Work" ("JSGW") is the journal of the Association for Specialists in Group Work (ASGW), a division of the American Counseling Association (ACA). "JSGW" publishes articles related to "group work theory, interventions, training, current issues, and research" (ASGW, 2011). "JSGW" was first published in 1976 and is…

Official portrait of the STS 61-B crew

NASA Technical Reports Server (NTRS)

1985-01-01

Official portrait of the STS 61-B crew. Kneeling next to the Official mission emblam are Astronaut Brewster Shaw, Jr., (right), mission commander; and Bryan D. O'Conner (left), pilot. In the back row are (l.-r.) Charles D. Walker, McDonnell Douglas payload specialist; Jerry L. Ross, Mary L. Cleve and Sherwood C. Spring -- all mission specialists; and Rodolfo Neri, Morelos payload specialist.

Developing the Librarians' Role in Supporting Grant Applications and Reducing Waste in Research: Outcomes from a Literature Review and Survey in the NIHR Research Design Service

ERIC Educational Resources Information Center

Edmunds Otter, Mary L.; Wright, Judy M.; King, Natalie V.

2017-01-01

Librarians and information specialists' involvement during the development of grant applications for external funding can save researchers' time, provide specialist support, and contribute to reducing avoidable waste in research. This article presents a survey of information specialists working for the National Institute for Health Research's…

Holistic Contract Administration in Army Forces Abroad

DTIC Science & Technology

2016-10-01

Defense (DoD) civil- ian personnel—i.e., 1910 Quality Assurance Specialist, 1102 Contract Specialist, and 1103 Industrial Property Management Specialist... 1103 -series civilian property ad- ministrators throughout ACC, the battalion experienced diffi- culties hiring for these positions during its deployment...tasks. Counting on 1103 support, ACOs received minimal property training prior to deploy- ment. This proved to be a major setback as ACOs struggled

Prevention of delayed referrals through the Champlain BASE eConsult service.

PubMed

Liddy, Clare; Drosinis, Paul; Fogel, Adam; Keely, Erin

2017-08-01

To identify the proportion and evaluate the content of eConsults (electronic consultations) in which the Champlain BASE (Building Access to Specialists through eConsultation) eConsult process prompted a referral to a specialist that was not originally contemplated by the primary care provider (PCP). Cross-sectional study of all eConsults submitted between April 15, 2011, and January 31, 2015. Champlain Local Health Integration Network, a large health region in eastern Ontario. Primary care providers registered to use the Champlain BASE eConsult service. Answers from a close-out survey-completed by PCPs at the conclusion of each eConsult-stating that specialist referral was not originally contemplated but that the eConsult process had prompted referral. The logs containing the communication exchanged between the PCPs and the specialists were reviewed, and each prompted referral case was categorized by the type of question asked, if pharmaceutical advice was given, if the referral was redirected to a different specialty group, and if the referral was urgent. A total of 188 (3.4%) of 5601 eConsults completed during the study period were cases in which PCPs stated that they had originally not contemplated referring the patient to a specialist but that the Champlain BASE eConsult process had prompted referral. Prompted referrals were most often directed to cardiologists (10.6%), dermatologists (10.6%), infectious disease specialists (9.0%), hematologists (9.0%), and urologists (8.5%). The most common questions were about diagnosis (34.0%), drug treatment (18.0%), and management (15.0%). Pharmaceutical advice was given in 28.0% of prompted referral cases, and in 26.0% of cases, the face-to-face referral was redirected to another specialty group. In 5.0% of cases, the specialist stated the referral was urgent. The median specialist response time was 0.96 days (interquartile range 0.17 to 3.80 days). By providing PCPs with increased access to specialists, the Champlain BASE eConsult service serves an important role in identifying and preventing the potential detrimental consequences of delayed medical referrals across specialty groups. Copyright© the College of Family Physicians of Canada.

Lesion detectability in 2D-mammography and digital breast tomosynthesis using different targets and observers

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2018-05-01

This work investigates the detection performance of specialist and non-specialist observers for different targets in 2D-mammography and digital breast tomosynthesis (DBT) using the OPTIMAM virtual clinical trials (VCT) Toolbox and a 4-alternative forced choice (4AFC) assessment paradigm. Using 2D-mammography and DBT images of virtual breast phantoms, we compare the detection limits of simple uniform spherical targets and irregular solid masses. Target diameters of 4 mm and 6 mm have been chosen to represent target sizes close to the minimum detectable size found in breast screening, across a range of controlled contrast levels. The images were viewed by a set of specialist observers (five medical physicists and six experienced clinical readers) and five non-specialists. Combined results from both observer groups indicate that DBT has a significantly lower detectable threshold contrast than 2D-mammography for small masses (4 mm: 2.1% [DBT] versus 6.9% [2D]; 6 mm: 0.7% [DBT] versus 3.9% [2D]) and spheres (4 mm: 2.9% [DBT] versus 5.3% [2D]; 6 mm: 0.3% [DBT] versus 2.2% [2D]) (p  <  0.0001). Both observer groups found spheres significantly easier to detect than irregular solid masses for both sizes and modalities (p  <  0.0001) (except 4 mm DBT). The detection performances of specialist and non-specialist observers were generally found to be comparable, where each group marginally outperformed the other in particular detection tasks. Within the specialist group, the clinical readers performed better than the medical physicists with irregular masses (p  <  0.0001). The results indicate that using spherical targets in such studies may produce over-optimistic detection thresholds compared to more complex masses, and that the superiority of DBT for detecting masses over 2D-mammography has been quantified. The results also suggest specialist observers may be supplemented by non-specialist observers (with training) in some types of 4AFC studies.

Balanced scorecards for specialists: a tool for quality improvement.

PubMed

Marr, Thomas J; Mullen, Deborah M

2004-04-01

This article describes a program that HealthPartners uses to assess and compare the performance of specialists that serve its members. HealthPartners' Balanced Scorecards program focuses on cardiologist and orthopedist practices in the Minneapolis/St. Paul metro area and St. Cloud, Minnesota. The scorecards assess the clinical and business processes of specialist practices, their use of resources, the degree to which patients and referring physicians are satisfied with their performance, and their patient outcomes. Unblinded comparative data is made available to referring physicians, employers, and consumers only after each individual specialist group has had the opportunity to review its own data against blinded results, discuss the methodology, and comment on the results.

Development and Validation of the Role Profile of the Nurse Continence Specialist: A Project of the International Continence Society.

PubMed

Paterson, Janice; Ostaszkiewicz, Joan; Suyasa, I Gede Putu Darma; Skelly, Jennifer; Bellefeuille, Lesley

Although nurses have specialized in the management of incontinence, bladder, bowel, and pelvic floor dysfunction for more than 30 years, there is a lack of awareness and underutilization of their role. This article describes a 6-year project to define, characterize, and validate a role profile of the Nurse Continence Specialist. Data collection used a 2-phase, mixed-methods design. Phase 1 of the project resulted in a draft Nurse Continence Specialist role profile and Phase 2 led to validation of the draft profile. The result was a broad consensus about what constitutes the specific skill set for Nurse Continence Specialist specialization within nursing.

Anthropometric survey of the astronaut applicants and astronauts from 1985 to 1991

NASA Technical Reports Server (NTRS)

Rajulu, Sudhakar L.; Klute, Glenn K.

1993-01-01

The Anthropometry and Biomechanics Laboratory at the Johnson Space Center has been collecting anthropometric data from astronaut applicants since 1977. These anthropometric measurements had been taken from 473 applicants. Based on the position they applied for, these applicants were classified as either mission specialists, payload specialists, pilots, or observers. The main objective was to document the variations among these applicants and tabulate the percentile data for each anthropometric dimension. The percentile and the descriptive statistics data were tabulated and graphed for the whole astronaut candidate population; for the male and female groups; for each subject classification such as pilot, mission specialist, and payload specialist; and finally, for those who were selected as astronauts.

KSC00pp1846

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- As part of In-Flight Maintenance training, members of the STS-107 crew check out one of the Biotube experiments that will be part of their research mission . From left (in uniform) are Mission Specialist David M. Brown, Payload Specialist Ilan Ramon of Israel, and Mission Specialist Kalpana Chawla; Pilot William C. “Willie” McCool (crouching behind the table); Commander Rick D. Husband; and Mission Specialist Laurel Clark. At right is project engineer April Boody. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

KSC-00pp1846

NASA Image and Video Library

2000-12-07

KENNEDY SPACE CENTER, FLA. -- As part of In-Flight Maintenance training, members of the STS-107 crew check out one of the Biotube experiments that will be part of their research mission . From left (in uniform) are Mission Specialist David M. Brown, Payload Specialist Ilan Ramon of Israel, and Mission Specialist Kalpana Chawla; Pilot William C. “Willie” McCool (crouching behind the table); Commander Rick D. Husband; and Mission Specialist Laurel Clark. At right is project engineer April Boody. As a research mission, STS-107 will carry the SPACEHAB Double Module in its first research flight into space and a broad collection of experiments ranging from material science to life science. It is scheduled to launch July 19, 2001

The management of clinical laboratories in Europe: a FESCC survey. Forum of the European Societies of Clinical Chemistry and Laboratory Medicine.

PubMed

de Kieviet, Wim; Blaton, Victor; Kovacs, Gabor L; Palicka, Vladimir; Pulkki, Kari

2002-03-01

The professional duties of the specialists in clinical chemistry differ from country to country in Europe. One of the main goals of the Strategic Plan of the Forum of the European Societies of Clinical Chemistry and Laboratory Medicine (FESCC; IFCC-Europe) is to promote a high scientific and professional standard in the field of clinical chemistry and laboratory medicine in Europe. This can be stimulated by the knowledge of the local conditions in each country and by striving towards a strong and harmonised position in all the European countries. In order to enhance the knowledge of the managerial situation of the specialists in clinical chemistry in Europe, FESCC launched a survey in September 2000. This survey provides information about the position of the specialists in clinical chemistry in the various disciplines in the medical laboratories and in hospitals, and about the advisory tasks and the managerial education during the post-graduate training in clinical chemistry. Of the 35 FESCC member countries 33 have participated in the survey (94%). The results show a rather heterogeneous situation in Europe caused by the local historical developments, the differences in academic background and the relative numbers of private and physicians' office laboratories. Large differences exist between the European countries in the disciplines of laboratory medicine that are headed by a specialist in clinical chemistry. In the different countries the clinical chemistry laboratories are headed by specialists in clinical chemistry in between 20% and 100% of the laboratories. The haematology, immunology, microbiology, therapeutic drug monitoring, molecular biology and haemostasis laboratories and departments of blood banking are headed by specialists in clinical chemistry in between 0% and 100% of the laboratories. The responsibilities for the various managerial tasks of the specialists in clinical chemistry show no uniformity in Europe. In the majority of the countries the general management, the purchase of equipment and reagents and the education of technicians are in >90% the responsibility of the specialists in clinical chemistry. In most countries the majority of the specialists in clinical chemistry are members of the medical staff of the hospitals and have a position equivalent to the position of specialists in other medical disciplines. In some countries, however, it only holds true for the specialists with a medical background. In 79% of the countries the law regulates the profession of the specialists in clinical chemistry and in 60% of the countries the law regulates their position in the medical staff of the hospital. The advisory tasks to physicians, general practitioners and other users of laboratory tests are practised by >90% of the laboratories in 64% of the countries. Information is given directly to the patients by >90% of the laboratories in 30% of the countries. Only in a few countries laboratories give information to the public. The post-graduate training in clinical chemistry includes a managerial training in 58% of the countries, the study of information technology in 61% of the countries and an economy and/or a business administration study in 15% of the countries. In 27% of the countries no managerial education forms part of the post-graduate study in clinical chemistry. Harmonisation of the managerial aspects of the profession is one of the challenges for the European specialists in clinical chemistry. A European syllabus for post-graduate training could be helpful.

Charismatic authority in modern healthcare: the case of the 'diabetes specialist podiatrist'.

PubMed

Bacon, Dawn; Borthwick, Alan M

2013-09-01

Professional specialisation is broadly considered to result from increased complexity in professional knowledge and to be linked to specialist education, formalised credentials and registration. However, the degree of formal organisation may vary across professions. In healthcare, although medical specialisation is linked to rigorous selection criteria, formal training programmes and specialist registration, some forms of specialisation in the allied health professions are much less formal. Drawing on Weber's concept of charismatic authority, the establishment of a specialist role in podiatry, the 'diabetes specialist podiatrist', in the absence of codified or credentialed authority, is explored. 'Charismatic' leaders in podiatry, having attracted a following of practitioners, were able to constitute a speciality area of practice in the absence of established career pathways and acquire a degree of legitimacy in the medical field of diabetology. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/JohnWiley & Sons Ltd. Published by John Wiley & Sons Ltd.

STS-121: Discovery Pre-Flight Crew News Briefing

NASA Technical Reports Server (NTRS)

2006-01-01

The STS-121 crew is shown during this pre-flight news briefing. Steve Lindsey, Commander, begins with saying that they are only a few weeks from flight and the vehicle is in good shape. Mark Kelly, Pilot, is introduced by Lindsey and he discusses Kelly's main objective which is to direct the three spacewalks scheduled. Kelly introduces Mike Fossum, Mission Specialist. Kelly says that Fossum will be involved in three spacewalks. Fossum introduces Lisa Nowak, Mission Specialist, who is involved in robotics. Also Stephanie Wilson, Mission Specialist, will be involved in robotics. Piers Sellers, Mission Specialist, is introduced by Wilson, who is the lead spacewalker for this mission. Sellers then introduce Thomas Reiter, Mission Specialist, who is involved in spacewalks. The educational background of each crew member is given. Questions from the news media on the subjects of long term flights on the International Space Station, Ice frost ramp replacement, Orbiter Boom Sensor System (OBSS) stability, foam loss during STS-114 flight, duration of the mission, and mental preparation for test flights are addressed.

KSC-97pc783

NASA Image and Video Library

1997-05-11

STS-84 crew members greet press representatives and other onlookers after their arrival at KSC’s Shuttle Landing Facility Sunday evening (May 12, 1997), about an hour before the countdown clock will begin ticking toward the scheduled May 15 launch of the Space Shuttle Atlantis on Mission STS-84. From left, are Mission Specialist Carlos I. Noriega, Pilot Eileen Marie Collins, Mission Specialist C. Michael Foale, Mission Specialist Elena V. Kondakova of the Russian Space Agency, Commander Charles J. Precourt, Mission Specialist Jean-Francois Clervoy of the European Space Agency, and Mission Specialist Edward Tsang Lu. STS-84 will be the sixth docking of the Space Shuttle with the Russian Space Station Mir. During the docking, Foale will transfer to the Russian space station to become a member of the Mir 23 crew, replacing U.S. astronaut Jerry M. Linenger, who will return to Earth on Atlantis. Foale is scheduled to remain on Mir about four months until his replacement arrives on STS-86 in September

An empirical analysis of public and private medical practice in Australia.

PubMed

Cheng, Terence C; Joyce, Catherine M; Scott, Anthony

2013-06-01

The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. We find considerable variations in the practice patterns, remuneration contracts and professional arrangements across doctors in different work sectors. Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[What is parents' and medical health care specialists knowledge about vaccinations?].

PubMed

Tarczoń, Izabela; Domaradzka, Ewa; Czajka, Hanna

2009-01-01

The aim of the study was to become familiar with parents' and Medical Health Care specialists knowledge and attitude towards vaccinations. The influence of information, provided to patients from various sources, on general opinion about immunization and its coverage within the last year were evaluated. Analysis of questionnaires about vaccinations performed among 151 parents and 180 Medical Health Care specialists. Medical Health Care specialists knowledge was considerably higher in comparison to questioned parents. Surprisingly enough, only approximately 90% of Medical Health Care workers knew about prophylaxis of Hib infections. A doctor is the main and the most reliable source of information for parents. Significant impact on parents' attitude to vaccinations is made not only by campaigns promoting vaccinations, but also by widespread opinions about their harmfulness. The doctor is the major source of reliable information about vaccinations for parents. Therefore, there is the need of continuous improvement of Medical Health Care specialists knowledge, but also the ability of successfully communicating it to parents.

STS-114: Discovery TCDT Flight Crew Test Media Event at Pad 39-B

NASA Technical Reports Server (NTRS)

2005-01-01

The STS-114 Space Shuttle Discovery Terminal Countdown Demonstration Test (TCDT) flight crew is shown at Pad 39-B. Eileen Collins, Commander introduces the astronauts. Andrew Thomas, mission specialist talks about his primary responsibility of performing boom inspections, Wendy Lawrence, Mission Specialist 4 (MS4) describes her role as the robotic arm operator supporting Extravehicular Activities (EVA), Stephen Robinson, Mission Specialist 3 (MS3) talks about his role as flight engineer, Charlie Camarda, Mission Specialist 5 (MS5) says that his duties are to perform boom operations, transfer operations from the space shuttle to the International Space Station and spacecraft rendezvous. Soichi Noguchi, Mission Specialist 1 (MS1) from JAXA, introduces himself as Extravehicular Activity 1 (EVA1), and Jim Kelley, Pilot will operate the robotic arm and perform pilot duties. Questions from the news media about the safety of the external tank, going to the International Space Station and returning, EVA training, and thoughts about the Space Shuttle Columbia crew are answered.

[Use of physical assessment skills and education needs of advanced practice nurses and nurse specialists].

PubMed

Shin, Hyunsook; Kim, Bog-Ja; Kang, Hee Sun

2009-10-01

The study was done to investigate physical assessment skills used by, and educational needs of, advanced practice nurses (APNs) and nurse specialists in Korea. A total of 123 APNs and nurse specialists working in five major hospitals in Seoul were surveyed from July 15 to August 20, 2007. Fourteen skills out of 126 items were reported as being performed on a regular basis by participants. The majority of these skills involved general observation. Forty-six skills were rarely used. Some participants showed a lack of confidence in certain assessment skills, such as in doing a rectal or pelvic exam, and the use of some assessment equipment. Over 90% of participants required in-depth education on health assessment provided by specialists or nursing professional organizations. More educational opportunities in physical assessment should be provided including education programs based on the nurses' skill levels and needs. This effort will help to increase confidence of APNs and nurse specialists in physical assessment skills, ultimately resulting in better nursing outcomes.

STS-87 crew in LC-39B white room during TCDT

NASA Technical Reports Server (NTRS)

1997-01-01

The crew of the STS-87 mission, scheduled for launch Nov. 19 aboard the Space Shuttle Columbia from pad 39B at Kennedy Space Center (KSC), participates in the Terminal Countdown Demonstration Test (TCDT) at KSC. Standing, from left, Mission Specialist Winston Scott; Backup Payload Specialist Yaroslav Pustovyi, Ph.D., of the National Space Agency of Ukraine (NSAU); Payload Specialist Leonid Kadenyuk of NSAU; Pilot Steven Lindsey; Commander Kevin Kregel; Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan; and Mission Specialist Kalpana Chawla, Ph.D. The TCDT is held at KSC prior to each Space Shuttle flight providing the crew of each mission opportunities to participate in simulated countdown activities. The TCDT ends with a mock launch countdown culminating in a simulated main engine cut-off. The crew also spends time undergoing emergency egress training exercises at the pad and has an opportunity to view and inspect the payloads in the orbiter's payload bay.

KSC-98pc1569

NASA Image and Video Library

1998-11-08

Members of the STS-95 crew participate in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. From left to right, they are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-95dep19

NASA Image and Video Library

1998-11-08

Members of the STS-95 crew and their families prepare for their return flight to the Johnson Space Center in Houston, Texas, at the Skid Strip at Cape Canaveral Air Station. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1578

NASA Image and Video Library

1998-11-08

At the Skid Strip at Cape Canaveral Air Station, members of the STS-95 crew and their families prepare for their return flight to the Johnson Space Center in Houston, Texas. Shown are (left to right) Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson; Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); Pilot Steven W. Lindsey (with his daughter, Jill); Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts; Mission Commander Curtis L. Brown Jr.; and Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA). The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1571

NASA Image and Video Library

1998-11-08

Members of the STS-95 crew participate in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. Shown are Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Other members of the crew also at the briefing were Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski and Mission Specialist Stephen K. Robinson. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-95dep07

NASA Image and Video Library

1998-11-08

Members of the STS-95 crew and their families prepare for their return flight to the Johnson Space Center in Houston, Texas, at the Skid Strip at Cape Canaveral Air Station. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-95dep018

NASA Image and Video Library

1998-11-08

Members of the STS-95 crew and their families prepare for their return flight to the Johnson Space Center in Houston, Texas, at the Skid Strip at Cape Canaveral Air Station. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1572

NASA Image and Video Library

1998-11-08

STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, participates in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Also participating in the briefing were the other STS-95 crew members: Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1556

NASA Image and Video Library

1998-11-07

Following touchdown at 12:04 p.m. EST at the Shuttle Landing Facility, the STS-95 crew leave the Crew Transport Vehicle where they are met by (left to right) a Spanish dignitary; Isao Uchida, president of the National Space Development Agency of Japan (NASDA); Center Director Roy Bridges; and NASA Administrator Daniel Goldin. The crew, from left to right, are Mission Commander Curtis L. Brown Jr. (shaking hands with Bridges); Pilot Steven W. Lindsey; Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original Mercury 7 astronauts; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA). The successful mission lasted nine days and included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1570

NASA Image and Video Library

1998-11-08

STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, participates in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Also participating in the briefing were the other STS-95 crew members: Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1575

NASA Image and Video Library

1998-11-08

Members of the STS-95 crew participate in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. From left to right, they are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

KSC-98pc1573

NASA Image and Video Library

1998-11-08

Media representatives from all over the world fill the Kennedy Space Center Press Site Auditorium for a press conference held by the STS-95 crew before their return to the Johnson Space Center in Houston, Texas. The STS-95 crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process

[New business model for medical specialists].

PubMed

Houwen, L G H J Louis

2013-01-01

The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

Old boys' network in general practitioners' referral behavior?

PubMed

Hackl, Franz; Hummer, Michael; Pruckner, Gerald J

2015-09-01

We analyzed the impact of social networks on general practitioners' (GPs) referral behavior based on administrative panel data from 2,684,273 referrals to specialists made between 1998 and 2007. For the definition of social networks, we used information on the doctors' place and time of study and their hospital work history. We found that GPs referred more patients to specialists within their personal networks and that patients referred within a social network had fewer follow-up consultations and less inpatient days thereafter. The effects on patient outcomes (e.g. waiting periods, days in hospital) of referrals within personal networks and affinity-based networks differed. Specifically, whereas empirical evidence showed a concentration on high-quality specialists for referrals within the personal network, suggesting that referrals within personal networks overcome information asymmetry with respect to specialists' abilities, the empirical evidence for affinity-based networks was different and less clear. Same-gender networks tended to refer patients to low-quality specialists. Copyright © 2015 Elsevier B.V. All rights reserved.

KSC-98pc486

NASA Image and Video Library

1998-04-17

KENNEDY SPACE CENTER, FLA. -- The STS-90 flight crew enjoy the traditional pre-liftoff breakfast in the crew quarters of the Operations and Checkout Building. They are, from left, Payload Specialist Jay Buckey, M.D., Mission Specialist Dafydd (Dave) Williams, M.D., with the Canadian Space Agency, Pilot Scott Altman, Commander Richard Searfoss, Mission Specialist Kathryn (Kay) Hire, Mission Specialist Richard Linnehan, D.V.M., and Payload Specialist James Pawelczyk, Ph.D. After a weather briefing, the flight crew will be fitted with their launch and entry suits and depart for Launch Pad 39B. Once there, they will take their positions in the crew cabin of the Space Shuttle Columbia to await liftoff during a two-and-a-half-hour window that will open at 2:19 p.m. EDT, Apr. 17. STS-90 is the launch of Neurolab, a nearly 17-day mission to examine the effects of spaceflight on the brain, spinal cord, peripheral nerves and sensory organs in the human body

The role of rehabilitation specialists in Canadian NICUs: a national survey.

PubMed

Limperopoulos, Catherine; Majnemer, Annette

2002-01-01

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.

STS-90 Crew Breakfast in O&C building

NASA Technical Reports Server (NTRS)

1998-01-01

The STS-90 flight crew enjoy the traditional pre-liftoff breakfast in the crew quarters of the Operations and Checkout Building. They are, from left, Payload Specialist Jay Buckey, M.D., Mission Specialist Dafydd (Dave) Williams, M.D., with the Canadian Space Agency, Pilot Scott Altman, Commander Richard Searfoss, Mission Specialist Kathryn (Kay) Hire, Mission Specialist Richard Linnehan, D.V.M., and Payload Specialist James Pawelczyk, Ph.D. After a weather briefing, the flight crew will be fitted with their launch and entry suits and depart for Launch Pad 39B. Once there, they will take their positions in the crew cabin of the Space Shuttle Columbia to await liftoff during a two-and-a-half-hour window that will open at 2:19 p.m. EDT, Apr. 17. STS-90 is the launch of Neurolab, a nearly 17-day mission to examine the effects of spaceflight on the brain, spinal cord, peripheral nerves and sensory organs in the human body.

KSC-98pc1016

NASA Image and Video Library

1998-09-02

Around a table in Orbiter Processing Facility Bay 2 , STS-95 crew members look over equipment during the Crew Equipment Interface Test (CEIT) for their mission. From left, they are Mission Specialist Pedro Duque, of the European Space Agency; Payload Specialist Chiaki Mukai, of the National Space Development Agency of Japan (NASDA); Mission Specialist Scott E. Parazynski, M.D.; Pilot Steven W. Lindsey; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Stephen K. Robinson; and Mission Commander Curtis L. Brown Jr. Behind them is Adam Flagan, United Space Alliance-Houston. The CEIT gives astronauts an opportunity for a hands-on look at the payloads and equipment with which they will be working on orbit. The launch of the STS-95 mission, aboard Space Shuttle Discovery, is scheduled for Oct. 29, 1998. The mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process

Accompanied by the Shuttle Training Aircraft, Discovery touches down after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

Viewed across the creek bordering runway 33, orbiter Discovery prepares to touch down at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Flying above it is the Shuttle Training Aircraft. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. In the background, right, is the Vehicle Assembly Building. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Space Shuttle Discovery lifts off successfully

NASA Technical Reports Server (NTRS)

1998-01-01

Framed by the foliage of the Canaveral National Sea Shore, Space Shuttle Discovery soars through bright blue skies as it lifts off from Launch Pad 39B at 2:19 p.m. EST Oct. 29 on mission STS-95. Making his second voyage into space after 36 years is Payload Specialist John H. Glenn Jr., senator from Ohio. Other crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Payload Specialist Chiaki Mukai, (M.D., Ph.D.), with the National agency for Space Development (NASDA), Mission Specialist Stephen K. Robinson, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), and Mission Specialist Scott E. Parazynski. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Discovery is expected to return to KSC at 11:49 a.m. EST on Nov. 7.

STS-95 Crew Breakfast in O&C Building before launch

NASA Technical Reports Server (NTRS)

1998-01-01

The STS-95 crew gathers at their traditional pre-launch breakfast in the Operations and Checkout Building. Seated from left are Payload Specialist Chiaki Mukai, (M.D., Ph.D.), with the National Space Development Agency of Japan (NASDA), Payload Specialist John H. Glenn Jr., senator from Ohio, Pilot Steven W. Lindsey, Mission Commander Curtis L. Brown Jr., Mission Specialist Stephen K. Robinson, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), and Mission Specialist Scott E. Parazynski. Targeted for launch at 2 p.m. EST on Oct. 29, the mission is expected to last 8 days, 21 hours and 49 minutes, and return to KSC at 11:49 a.m. EST on Nov. 7. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Space Shuttle Discovery lifts off successfully

NASA Technical Reports Server (NTRS)

1998-01-01

Clouds of exhaust and blazing light fill Launch Pad 39B as Space Shuttle Discovery lifts off at 2:19 p.m. EST Oct. 29 on mission STS-95. Making his second voyage into space after 36 years is Payload Specialist John H. Glenn Jr., senator from Ohio. Other crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Payload Specialist Chiaki Mukai, (M.D., Ph.D.), with the National Space Development Agency of Japan (NASDA), Mission Specialist Stephen K. Robinson, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), and Mission Specialist Scott E. Parazynski. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Discovery is expected to return to KSC at 11:49 a.m. EST on Nov. 7.

Space Shuttle Discovery lifts off successfully

NASA Technical Reports Server (NTRS)

1998-01-01

Clouds of exhaust seem to fill the marsh near Launch Pad 39B as Space Shuttle Discovery lifts off at 2:19 p.m. EST Oct. 29 on mission STS-95. Making his second voyage into space after 36 years is Payload Specialist John H. Glenn Jr., senator from Ohio. Other crew members are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Payload Specialist Chiaki Mukai, (M.D., Ph.D.), with the National Space Development Agency of Japan (NASDA), Mission Specialist Stephen K. Robinson, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), and Mission Specialist Scott E. Parazynski. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Discovery is expected to return to KSC at 11:49 a.m. EST on Nov. 7.

STS-45 crewmembers during LINHOF camera briefing in JSC's Bldg 4 rm 2026A

NASA Image and Video Library

1992-01-14

S92-26522 (Feb 1992) --- Crewmembers assigned to NASA's STS-45 mission are briefed on the use of the Linhof camera in the flight operations facility at the Johnson Space Center (JSC). Charles F. Bolden, mission commander, stands at left. Other crewmembers (seated clockwise around the table from lower left) are Dirk Frimout of Belgium representing the European Space Agency as payload specialist; Charles R. (Rick) Chappell, backup payload specialist; Brian Duffy, pilot; Kathryn D. Sullivan, payload commander; David C. Leestma, mission specialist; Byron K. Lichtenberg, payload specialist; and C. Michael Foale, mission specialist. James H. Ragan (far right), head of the flight equipment section of the flight systems branch in JSC's Man Systems Division, briefs the crewmembers. Donald C. Carico, of the crew training staff and Rockwell International, stands near Bolden. The camera, used for out-the-window observations, is expected to be used frequently on the Atmospheric Laboratory for Applications and Science (ATLAS-1) mission, scheduled for a March date with the Space Shuttle Atlantis.

Accompanied by the Shuttle Training Aircraft, Discovery touches down after successful mission STS-95

NASA Technical Reports Server (NTRS)

1998-01-01

The Shuttle Training Aircraft (top) seems to chase orbiter Discovery as it touches down at the Shuttle Landing Facility after a successful mission of nearly nine days and 3.6 million miles. Main gear touchdown was at 12:04 p.m. EST, landing on orbit 135. In the background, right, is the Vehicle Assembly Building. The STS-95 crew consists of Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Payload Specialist John H. Glenn Jr., senator from Ohio; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Predictors of Acquisition of Competitive Employment for People Enrolled in Supported Employment Programs.

PubMed

Corbière, Marc; Lecomte, Tania; Reinharz, Daniel; Kirsh, Bonnie; Goering, Paula; Menear, Matthew; Berbiche, Djamal; Genest, Karine; Goldner, Elliot M

2017-04-01

This study aims at assessing the relative contribution of employment specialist competencies working in supported employment (SE) programs and client variables in determining the likelihood of obtaining competitive employment. A total of 489 persons with a severe mental illness and 97 employment specialists working in 24 SE programs across three Canadian provinces were included in the study. Overall, 43% of the sample obtained competitive work. Both client variables and employment specialist competencies, while controlling for the quality of SE programs implementation, predicted job acquisition. Multilevel analyses further indicated that younger client age, shorter duration of unemployment, and client use of job search strategies, as well as the working alliance perceived by the employment specialist, were the strongest predictors of competitive employment for people with severe mental illness, with 51% of variance explained. For people with severe mental illness seeking employment, active job search behaviors, relational abilities, and employment specialist competencies are central contributors to acquisition of competitive employment.

Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists.

PubMed

Morais, Fábio Barreto; Arantes, Tiago Eugênio Faria E; Muccioli, Cristina

2018-01-01

To describe treatment practices for ocular toxoplasmosis among members of the Brazilian Uveitis Society. An online questionnaire sent to specialists, between October 2014 and March 2015. Most respondents (67.9%) treat all active cases. Most specialists consider visual acuity <20/200 (88.2%), severe vitreous inflammation (94.1%), and ocular disease during acquired infection (88.2%) as absolute indications for treatment. Systemic steroids are associated with anti-toxoplasmic therapy in most cases by 50.9% of the respondents. For immunocompetent individuals, 57.4% of the respondents chose trimethoprim/sulfamethoxazole. Classical therapy (sulfadiazine/pyrimethamine) is preferred most for patients with central lesions (70.4%), immunosuppression (68.4%), acquired infection (70.4%), and atypical forms (74.1%). For patients with frequent relapses, 84.9% of the respondents preferred antibiotic prophylaxis. Treatment patterns of ocular toxoplasmosis are not uniform among Brazilian specialists. Most specialists treat all cases of active retinochoroiditis. Typical cases are more frequently treated with trimethoprim/sulfamethoxazole. However, classical therapy is the regimen of choice when lesions are considered more severe.

The STS-95 crew participates in a media briefing before returning to JSC

NASA Technical Reports Server (NTRS)

1998-01-01

Members of the STS-95 crew participate in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. From left to right, they are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA); and Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.