21 CFR 120.5 - Current good manufacturing practice.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS General...

21 CFR 120.5 - Current good manufacturing practice.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS General...

21 CFR 120.5 - Current good manufacturing practice.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS General...

The recovery model and complex health needs: what health psychology can learn from mental health and substance misuse service provision.

PubMed

Webb, Lucy

2012-07-01

This article reviews key arguments around evidence-based practice and outlines the methodological demands for effective adoption of recovery model principles. The recovery model is outlined and demonstrated as compatible with current needs in substance misuse service provision. However, the concepts of evidence-based practice and the recovery model are currently incompatible unless the current value system of evidence-based practice changes to accommodate the methodologies demanded by the recovery model. It is suggested that critical health psychology has an important role to play in widening the scope of evidence-based practice to better accommodate complex social health needs.

Physician tracking in sub-Saharan Africa: current initiatives and opportunities

PubMed Central

2014-01-01

Background Physician tracking systems are critical for health workforce planning as well as for activities to ensure quality health care - such as physician regulation, education, and emergency response. However, information on current systems for physician tracking in sub-Saharan Africa is limited. The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices. Methods This study included a review of the literature, an online search for physician licensing systems, and a document review of publicly available physician registration forms for sub-Saharan African countries. Primary data on physician tracking activities was collected as part of the Medical Education Partnership Initiative (MEPI) - through two rounds over two years of annual surveys to 13 medical schools in 12 sub-Saharan countries. Two innovations were identified during two MEPI school site visits in Uganda and Ghana. Results Out of twelve countries, nine had existing frameworks for physician tracking through licensing requirements. Most countries collected basic demographic information: name, address, date of birth, nationality/citizenship, and training institution. Practice information was less frequently collected. The most frequently collected practice fields were specialty/degree and current title/position. Location of employment and name and sector of current employer were less frequently collected. Many medical schools are taking steps to implement graduate tracking systems. We also highlight two innovative practices: mobile technology access to physician registries in Uganda and MDNet, a public-private partnership providing free mobile-to-mobile voice and text messages to all doctors registered with the Ghana Medical Association. Conclusion While physician tracking systems vary widely between countries and a number of challenges remain, there appears to be increasing interest in developing these systems and many innovative developments in the area. Opportunities exist to expand these systems in a more coordinated manner that will ultimately lead to better workforce planning, implementation of the workforce, and better health. PMID:24754965

Physician tracking in sub-Saharan Africa: current initiatives and opportunities.

PubMed

Chen, Candice; Baird, Sarah; Ssentongo, Katumba; Mehtsun, Sinit; Olapade-Olaopa, Emiola Oluwabunmi; Scott, Jim; Sewankambo, Nelson; Talib, Zohray; Ward-Peterson, Melissa; Mariam, Damen Haile; Rugarabamu, Paschalis

2014-04-23

Physician tracking systems are critical for health workforce planning as well as for activities to ensure quality health care - such as physician regulation, education, and emergency response. However, information on current systems for physician tracking in sub-Saharan Africa is limited. The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices. This study included a review of the literature, an online search for physician licensing systems, and a document review of publicly available physician registration forms for sub-Saharan African countries. Primary data on physician tracking activities was collected as part of the Medical Education Partnership Initiative (MEPI) - through two rounds over two years of annual surveys to 13 medical schools in 12 sub-Saharan countries. Two innovations were identified during two MEPI school site visits in Uganda and Ghana. Out of twelve countries, nine had existing frameworks for physician tracking through licensing requirements. Most countries collected basic demographic information: name, address, date of birth, nationality/citizenship, and training institution. Practice information was less frequently collected. The most frequently collected practice fields were specialty/degree and current title/position. Location of employment and name and sector of current employer were less frequently collected. Many medical schools are taking steps to implement graduate tracking systems. We also highlight two innovative practices: mobile technology access to physician registries in Uganda and MDNet, a public-private partnership providing free mobile-to-mobile voice and text messages to all doctors registered with the Ghana Medical Association. While physician tracking systems vary widely between countries and a number of challenges remain, there appears to be increasing interest in developing these systems and many innovative developments in the area. Opportunities exist to expand these systems in a more coordinated manner that will ultimately lead to better workforce planning, implementation of the workforce, and better health.

The Future of Pork Production in the World: Towards Sustainable, Welfare-Positive Systems

PubMed Central

McGlone, John J.

2013-01-01

Simple Summary More pork is eaten in the world than any other meat. Making production systems and practices more sustainable will benefit the animals, the planet and people. A system is presented by which production practices are evaluated using a sustainability matrix. The matrix shows why some practices are more common in some countries and regions and the impediments to more sustainable systems. This method can be used to assess the sustainability of production practices in the future where objective, science-based information is presented alongside ethical and economic information to make the most informed decisions. Finally, this paper points to current pork production practices that are more and less sustainable. Abstract Among land animals, more pork is eaten in the world than any other meat. The earth holds about one billion pigs who deliver over 100 mmt of pork to people for consumption. Systems of pork production changed from a forest-based to pasture-based to dirt lots and finally into specially-designed buildings. The world pork industry is variable and complex not just in production methods but in economics and cultural value. A systematic analysis of pork industry sustainability was performed. Sustainable production methods are considered at three levels using three examples in this paper: production system, penning system and for a production practice. A sustainability matrix was provided for each example. In a comparison of indoor vs. outdoor systems, the food safety/zoonoses concerns make current outdoor systems unsustainable. The choice of keeping pregnant sows in group pens or individual crates is complex in that the outcome of a sustainability assessment leads to the conclusion that group penning is more sustainable in the EU and certain USA states, but the individual crate is currently more sustainable in other USA states, Asia and Latin America. A comparison of conventional physical castration with immunological castration shows that the less-common immunological castration method is more sustainable (for a number of reasons). This paper provides a method to assess the sustainability of production systems and practices that take into account the best available science, human perception and culture, animal welfare, the environment, food safety, worker health and safety, and economics (including the cost of production and solving world hunger). This tool can be used in countries and regions where the table values of a sustainability matrix change based on local conditions. The sustainability matrix can be used to assess current systems and predict improved systems of the future. PMID:26487410

GN&C Engineering Best Practices for Human-Rated Spacecraft Systems

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Lebsock, Kenneth; West, John

2007-01-01

The NASA Engineering and Safety Center (NESC) recently completed an in-depth assessment to identify a comprehensive set of engineering considerations for the Design, Development, Test and Evaluation (DDT&E) of safe and reliable human-rated spacecraft systems. Reliability subject matter experts, discipline experts, and systems engineering experts were brought together to synthesize the current "best practices" both at the spacecraft system and subsystems levels. The objective of this paper is to summarize, for the larger Community of Practice, the initial set of Guidance, Navigation and Control (GN&C) engineering Best Practices as identified by this NESC assessment process.

GN&C Engineering Best Practices for Human-Rated Spacecraft System

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Lebsock, Kenneth; West, John

2008-01-01

The NASA Engineering and Safety Center (NESC) recently completed an in-depth assessment to identify a comprehensive set of engineering considerations for the Design, Development, Test and Evaluation (DDT&E) of safe and reliable human-rated spacecraft systems. Reliability subject matter experts, discipline experts, and systems engineering experts were brought together to synthesize the current "best practices" both at the spacecraft system and subsystems levels. The objective of this paper is to summarize, for the larger Community of Practice, the initial set of Guidance, Navigation and Control (GN&C) engineering Best Practices as identified by this NESC assessment process.

GN&C Engineering Best Practices For Human-Rated Spacecraft Systems

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Lebsock, Kenneth; West, John

2007-01-01

The NASA Engineering and Safety Center (NESC) recently completed an in-depth assessment to identify a comprehensive set of engineering considerations for the Design, Development, Test and Evaluation (DDT&E) of safe and reliable human-rated spacecraft systems. Reliability subject matter experts, discipline experts, and systems engineering experts were brought together to synthesize the current "best practices" both at the spacecraft system and subsystems levels. The objective of this paper is to summarize, for the larger Community of Practice, the initial set of Guidance, Navigation and Control (GN&C) engineering Best Practices as identified by this NESC assessment process.

Assessment of training capacity in New Zealand general practices: a stocktake in the lower North Island and South Island.

PubMed

Murton, Samantha A; Pullon, Susan Rh

2017-09-22

General practices are providing clinically-based training for rapidly increasing numbers of medical (and other health professional) trainees. This study investigated capacity and intention of general practices to additionally teach junior doctors (now required to undertake community-based attachments by the New Zealand Medical Council) alongside current trainees in their service. A web-based/telephone survey of all general practices was developed and administered November 2015-April 2016. In the Otago study region (lower North Island, South Island), 463 currently operating practices were identified. (A companion Auckland-based study concurrently investigated the upper North Island.) Of the 280/463 (60%) responding practices, 93% (261/280) were currently taking health professional trainees, with 86% (241/280) taking at least one type of medical trainee. Practices indicate that 14% fewer of them will take undergraduate medical students than previously (199 practices down to 162), but more would take junior doctors (42 up to 79) and GP registrars (129 practices up to 142). Most practices in these regions already contribute to teaching. Practices indicated limitations in accommodating continued increases in numbers of trainees in the current poorly coordinated system. Improved support and training for practices is needed to enable practices to take more trainees of multiple types per practice, both concurrently and sequentially.

Traditional and emerging forms of dental practice. Cost, accessibility, and quality factors.

PubMed Central

Rovin, S; Nash, J

1982-01-01

The traditional and predominant manner of delivering dental care is through a fee-for-service, private practice system. A number of alternative dental care delivery systems have emerged and are being tested, and others are just emerging. These systems include department store practices, hospital dental services, health maintenance organizations, the independent practice of dental hygiene, and denturism. Although it is too soon to draw final conclusions about the efficacy and effectiveness of these systems, we examine them for their potential to compete with and change the way dental care is currently delivered. Using the parameters of cost, accessibility, and quality, we compare these systems to traditional dental practice. Some of these emerging forms clearly have the potential to complete favorably with traditional practice. Other seem less likely to alter the existing system substantially. The system which can best control costs, increase accessibility, and enhance quality will gain the competitive edge. PMID:7091453

Looking Back to the Future: Current Issues Facing Nursing Education From the Reflections of a Member of the Silent Generation.

PubMed

Keating, Sarah B

2016-07-01

As a member of the Silent Generation, the author, through her lived experiences, reflects upon the successes and challenges facing nursing education in the mid-20th to 21st centuries. The author looks "back to the future" and reviews current issues that surround four key nursing education milestones. From the early entry-level baccalaureate programs in the 1950s to the current growth of the Doctor of Nursing Practice as entry into advanced practice, milestones in nursing education are linked to the cultural changes and healthcare system demands that took place at the time and their influence on nursing education and the profession. Looking to the future, the author speaks of the implications from the forecasted changes in the healthcare system that will demand interdisciplinary education and practice and the continued need for nursing research to increase the body of scientific knowledge in practice, education, and technology. Keating. © 2015 Wiley Periodicals, Inc.

A Quantitative Assessment of Utility Reporting Practices for Reporting Electric Power Distribution Events

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

Hamachi La Commare, Kristina

Metrics for reliability, such as the frequency and duration of power interruptions, have been reported by electric utilities for many years. This study examines current utility practices for collecting and reporting electricity reliability information and discusses challenges that arise in assessing reliability because of differences among these practices. The study is based on reliability information for year 2006 reported by 123 utilities in 37 states representing over 60percent of total U.S. electricity sales. We quantify the effects that inconsistencies among current utility reporting practices have on comparisons of System Average Interruption Duration Index (SAIDI) and System Average Interruption Frequency Indexmore » (SAIFI) reported by utilities. We recommend immediate adoption of IEEE Std. 1366-2003 as a consistent method for measuring and reporting reliability statistics.« less

Re/creating entrepreneurs of the self: discourses of worker and employee 'value' and current vocational rehabilitation practices.

PubMed

Fadyl, Joanna; McPherson, Kathryn; Nicholls, David

2015-05-01

Vocational rehabilitation for people experiencing work disability is a social practice often situated within health services, but the social and political drivers and effects of this practice are rarely critically analysed in health research or policy. In this study we used a Foucauldian theoretical perspective to analyse the ways in which current vocational rehabilitation practices in New Zealand re/produce notions of worker and employee 'value', and how different approaches to vocational rehabilitation deploy current discourses about value. We also consider the subject positions produced through these different approaches and the identities and actions they make possible for people experiencing work disability. The analysis showed that notions about the importance of worker and employee value in a job market are pervasive in vocational rehabilitation, and reflect wider societal discourses. However, the deployment of those discourses in different approaches to vocational rehabilitation practice are diverse, producing different opportunities and constraints for people experiencing disability. We argue that an examination of these various opportunities and constraints at the level of practice approaches is important, as considerable time and resources are allocated to developing solutions to help those who do not thrive in the current systems, yet we rarely critique the premises on which the systems are based. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

The Current Ecosystem of Learning Management Systems in Higher Education: Student, Faculty, and IT Perspectives

ERIC Educational Resources Information Center

Dahlstrom, Eden; Brooks, D. Christopher; Bichsel, Jacqueline

2014-01-01

This study explores faculty and student perspectives on learning management systems (LMSs) in the context of current institutional investments. In 2013, nearly 800 institutions participated in the EDUCAUSE Core Data Service (CDS) survey, sharing their current information technology practices and metrics across all IT service domains. In 2014, more…

Eddy Current Influences on the Dynamic Behaviour of Magnetic Suspension Systems

NASA Technical Reports Server (NTRS)

Britcher, Colin P.; Bloodgood, Dale V.

1998-01-01

This report will summarize some results from a multi-year research effort at NASA Langley Research Center aimed at the development of an improved capability for practical modelling of eddy current effects in magnetic suspension systems. Particular attention is paid to large-gap systems, although generic results applicable to both large-gap and small-gap systems are presented. It is shown that eddy currents can significantly affect the dynamic behavior of magnetic suspension systems, but that these effects can be amenable to modelling and measurement. Theoretical frameworks are presented, together with comparisons of computed and experimental data particularly related to the Large Angle Magnetic Suspension Test Fixture at NASA Langley Research Center, and the Annular Suspension and Pointing System at Old Dominion University. In both cases, practical computations are capable of providing reasonable estimates of important performance-related parameters. The most difficult case is seen to be that of eddy currents in highly permeable material, due to the low skin depths. Problems associated with specification of material properties and areas for future research are discussed.

Examining the Planning and Management of Principal Succession

ERIC Educational Resources Information Center

Zepeda, Sally J.; Bengtson, Ed; Parylo, Oksana

2012-01-01

Purpose: The purpose of this study is to examine principal succession planning and management by analyzing current practices of handling school leader succession in four Georgia school systems. Design/methodology/approach: Looking through the lens of organizational leadership succession theory, the practices of school systems as they experienced…

GP Networks as enablers of quality of care: implementing a practice engagement framework in a General Practice Network.

PubMed

Pearce, Christopher; Shearer, Marianne; Gardner, Karina; Kelly, Jill; Xu, Tony Baixian

2012-01-01

This paper describes how the Melbourne East General Practice Network supports general practice to enable quality of care, it describes the challenges and enablers of change, and the evidence of practice capacity building and improved quality of care. Primary care is well known as a place where quality, relatively inexpensive medical care occurs. General practice is made up of multiple small sites with fragmented systems and a funding system that challenges a whole-of-practice approach to clinical care. General Practice Networks support GPs to synthesise complexity and crystallise solutions that enhance general practice beyond current capacity. Through a culture of change management, GP Networks create the link between the practice and the big picture of the whole health system and reduce the isolation of general practice. They distribute information (evidence-based learning and resources) and provide individualised support, responding to practice need and capacity.

Test result communication in primary care: a survey of current practice

PubMed Central

Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

2015-01-01

Background The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. Methods We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Results Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. Conclusions The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for reducing the impact of recurring errors in the handling of samples and the reporting of results. Our findings will inform our continuing work with patients and staff to develop, implement and evaluate improvements to existing systems of managing the testing and result communication process. PMID:26243888

Is the medical justice system broken?

PubMed

Howard, Philip K

2003-09-01

The current lawsuit culture is creating a crisis in US health care. The broad perception that anyone can sue for almost anything has fundamentally altered the practice of medicine, eroding the quality and availability of health care. Current reform proposals to "cap" one category of damages are not nearly ambitious enough. Providing relief to doctors squeezed by insurance premiums is important but will not heal the deep distrust that skews daily decisions, nor will it provide incentives to overhaul outdated practices. The United States needs an entirely new system of medical justice. Its first goal is to be reliable: reliable in protecting patients against bad practices, reliable in protecting physicians who act reasonably, and reliable in interpreting standards of care.

Timing Game-Based Practice in a Reading Comprehension Strategy Tutor

ERIC Educational Resources Information Center

Jacovina, Matthew E.; Jackson, G. Tanner; Snow, Erica L.; McNamara, Danielle S.

2016-01-01

Game-based practice within Intelligent Tutoring Systems (ITSs) can be optimized by examining how properties of practice activities influence learning outcomes and motivation. In the current study, we manipulated when game-based practice was available to students. All students (n = 149) first completed lesson videos in iSTART-2, an ITS focusing on…

The Albert Einstein Distinguished Educator Fellowship: Bridging the Gap Between Policy and Practice

NASA Astrophysics Data System (ADS)

Milbourne, Jeff; Wheeler, Sam

2017-02-01

In an ideal world, education policy and practice would exist as parts of a coherent system. Effective practice would inform policy and that policy would, in turn, promote the tenets of effective practice at the local, state, and national levels. Policymakers and practitioners would collaborate and, by extension, have familiarity and respect for one another's perspective. Unfortunately, our current education system is a far cry from the ideal, a fact that we as practitioners know all too well.

Workshop on Assurance for Autonomous Systems for Aviation

NASA Technical Reports Server (NTRS)

Brat, Guillaume; Davies, Misty; Giannakopoulou, Dimitra; Neogi, Natasha

2016-01-01

This report describes the workshop on Assurance for Autonomous Systems for Aviation that was held in January 2016 in conjunction with the SciTech 2016 conference held in San Diego, CA. The workshop explored issues related to assurance for autonomous systems and also the idea of trust in these systems. Specifically, we focused on discussing current practices for assurance of autonomy, identifying barriers specific to autonomy as related to assurance as well as operational scenarios demonstrating the need to address the barriers. Furthermore, attention was given to identifying verification techniques that may be applicable to autonomy, as well as discussing new research directions needed to address barriers, thereby involving potential shifts in current practices.

Transforming nursing education: a review of current curricular practices in relation to Benner's latest work.

PubMed

Handwerker, Sarah M

2012-09-12

Current societal and healthcare system trends highlight the need to transform nursing education to prepare nurses capable of outstanding practice in the 21st century. Patricia Benner and colleagues urged nurse educators to transform their practice in the 2010 publication Educating Nurses, A Call to Radical Transformation. Frequently utilized pedagogical frameworks in nursing education include behaviorism and constructivism. Much of the structure and basis for instruction and evaluation can be found rooted in these philosophies. By first exploring both behaviorism and constructivism and then relating their use in nursing education to the call to transform, educators can be encourage to examine current practice and possibly modify aspects to include more rich experiential learning.

School hearing screening programme in the UK: practice and performance

PubMed Central

Fonseca, S; Forsyth, H; Neary, W

2005-01-01

Background: Paediatric audiology services and screening programmes are currently under review. Aims and Methods: To investigate current practice and performance of the school hearing screening programme (SHSP) by means of a questionnaire. Results: SHSP was found to detect previously unrecognised hearing loss at low cost. Wide variation in practice was shown, and the majority of services had no computerised system for data collection. Conclusion: There is a need for nationally agreed protocols and quality assurance procedures. PMID:15665168

Development, Implementation, and Evaluation of a Strategic Plan for Improving Physical Plant Management at Southwest Texas Junior College.

ERIC Educational Resources Information Center

Box, Wilford Winston

A study was conducted at Southwest Texas Junior College (STJC) to assess current management practices used by the physical plant maintenance department (PPMD) and to develop a strategic plan for physical plant management. Procedures included an analysis of current management practices and systems that affect physical resources, and periodic and…

Mind the Gap: Accounting Information Systems Curricula Development in Compliance with IFAC Standards in a Developing Country

ERIC Educational Resources Information Center

Aleqab, Mahmoud Mohmad Ahmad; Nurunnabi, Mohammad; Adel, Dalia

2015-01-01

The authors examine the consistency between the current practices in designing and teaching accounting information systems (AIS) curricula and the International Federation of Accountants (IFAC) requirements for International Education Practice Statement 2 and International Education Standards 2. Utilizing a survey and interviews data in Jordan,…

A Humanizing Pedagogy: Reinventing the Principles and Practice of Education as a Journey toward Liberation

ERIC Educational Resources Information Center

Salazar, Maria del Carmen

2013-01-01

Students and educators are constrained from finding meaning in the current educational system as a result of the tension between educators' pedagogical practices and systemic constraints, such as high-stakes standardized tests and district-mandated instructional curriculum. Such restrictive educational policies limit educators from developing…

Evaluating the Strength of School Tobacco Policies: The Development of a Practical Rating System

ERIC Educational Resources Information Center

Boyce, Jennifer C.; Mueller, Nancy B.; Hogan-Watts, Melissa; Luke, Douglas A.

2009-01-01

Background: School tobacco control policies vary widely in their strength, extensiveness, and enforcement. Currently, no standardized method exists to assess the comprehensiveness of school tobacco policies. The purpose of this study was to develop a new practical rating system for school tobacco policies, assess its reliability, and present…

Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).

PubMed

Strudwick, Gillian; Hardiker, Nicholas R

2016-10-01

In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Document for 270 Voltage Direct Current (270 V dc) System

NASA Astrophysics Data System (ADS)

1992-09-01

The paper presents the technical design and application information established by the SAE Aerospace Recommended Practice concerning the generation, distribution, control, and utilization of aircraft 270 V dc electrical power systems and support equipment. Also presented are references and definitions making it possible to compare various electrical systems and components. A diagram of the generic 270 V Direct Current High-Voltage Direct System is included.

3 CFR - Demonstration Grants for the Development, Implementation, and Evaluation of Alternatives to the...

Code of Federal Regulations, 2010 CFR

2010-01-01

..., Implementation, and Evaluation of Alternatives to the Current Medical Liability System Presidential Documents..., Implementation, and Evaluation of Alternatives to the Current Medical Liability System Memorandum for the... report that fear of lawsuits leads them to practice defensive medicine, which may contribute to higher...

Rehabilitation of Wastewater Collection and Water Distribution Systems -State of Technology Review Report

EPA Science Inventory

This White Paper is intended to provide an overview of the current state-of-the-practice and current state-of-the-art for rehabilitation of pipes and structures within the wastewater collection and water distribution systems. Rehabilitation is defined as repair, renewal, and rep...

A Document Analysis of Teacher Evaluation Systems Specific to Physical Education

ERIC Educational Resources Information Center

Norris, Jason M.; van der Mars, Hans; Kulinna, Pamela; Kwon, Jayoun; Amrein-Beardsley, Audrey

2017-01-01

Purpose: The purpose of this document analysis study was to examine current teacher evaluation systems, understand current practices, and determine whether the instrumentation is a valid measure of teaching quality as reflected in teacher behavior and effectiveness specific to physical education (PE). Method: An interpretive document analysis…

The subtle body: an interoceptive map of central nervous system function and meditative mind-brain-body integration.

PubMed

Loizzo, Joseph J

2016-06-01

Meditation research has begun to clarify the brain effects and mechanisms of contemplative practices while generating a range of typologies and explanatory models to guide further study. This comparative review explores a neglected area relevant to current research: the validity of a traditional central nervous system (CNS) model that coevolved with the practices most studied today and that provides the first comprehensive neural-based typology and mechanistic framework of contemplative practices. The subtle body model, popularly known as the chakra system from Indian yoga, was and is used as a map of CNS function in traditional Indian and Tibetan medicine, neuropsychiatry, and neuropsychology. The study presented here, based on the Nalanda tradition, shows that the subtle body model can be cross-referenced with modern CNS maps and challenges modern brain maps with its embodied network model of CNS function. It also challenges meditation research by: (1) presenting a more rigorous, neural-based typology of contemplative practices; (2) offering a more refined and complete network model of the mechanisms of contemplative practices; and (3) serving as an embodied, interoceptive neurofeedback aid that is more user friendly and complete than current teaching aids for clinical and practical applications of contemplative practice. © 2016 New York Academy of Sciences.

Analyzing Principal Professional Development Practices through the Lens of Adult Learning Theory

ERIC Educational Resources Information Center

Zepeda, Sally J.; Parylo, Oksana; Bengtson, Ed

2014-01-01

This qualitative study sought to identify current principal professional development practices in four school systems in Georgia and to examine them by applying the principles of adult learning theory. The cross-case analysis of principal professional development initiatives in four school districts revealed nine common practices: connecting…

Pilot of a Learning Management System to Enhance Counselors' Relational Qualities through Mindfulness-Based Practices

ERIC Educational Resources Information Center

Ballinger, Julie Ann

2013-01-01

Mindfulness-based practices are associated with increased attentional qualities, improved self-focus styles, enhanced empathic understanding, and strengthened self-compassion, making these practices a viable addition to counselor training programs. However, current mindfulness training models are primarily designed for relief of psychological…

Modeling Speed-Accuracy Tradeoff in Adaptive System for Practicing Estimation

ERIC Educational Resources Information Center

Nižnan, Juraj

2015-01-01

Estimation is useful in situations where an exact answer is not as important as a quick answer that is good enough. A web-based adaptive system for practicing estimates is currently being developed. We propose a simple model for estimating student's latent skill of estimation. This model combines a continuous measure of correctness and response…

A Framework of Working Across Disciplines in Early Design and R&D of Large Complex Engineered Systems

NASA Technical Reports Server (NTRS)

McGowan, Anna-Maria Rivas; Papalambros, Panos Y.; Baker, Wayne E.

2015-01-01

This paper examines four primary methods of working across disciplines during R&D and early design of large-scale complex engineered systems such as aerospace systems. A conceptualized framework, called the Combining System Elements framework, is presented to delineate several aspects of cross-discipline and system integration practice. The framework is derived from a theoretical and empirical analysis of current work practices in actual operational settings and is informed by theories from organization science and engineering. The explanatory framework may be used by teams to clarify assumptions and associated work practices, which may reduce ambiguity in understanding diverse approaches to early systems research, development and design. The framework also highlights that very different engineering results may be obtained depending on work practices, even when the goals for the engineered system are the same.

Interarea Oscillation Damping Control Using High Voltage DC Transmission: a Survey

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

Elizondo, Marcelo Anibal; Fan, Rui; Kirkham, Harold

High-voltage, direct current (HVDC) transmission lines are increasingly being installed in power systems around the world, and this trend is expected to continue with advancements in power electronics technology. These advancements are also bringing multi-terminal direct current (MTDC) systems closer to practical application. In addition, the continued deployment of phasor measurement units (PMUs) makes dynamic information about a large power system readily available for highly controllable components, such as HVDC lines. All these trends have increased the appeal of modulating HVDC lines and MTDC systems to provide grid services in addition to bulk power transfers. This paper provides a literaturemore » survey of HVDC and MTDC damping controllers for interarea oscillations in large interconnected power systems. The literature shows a progression from theoretical research to practical applications. Finally, there are already practical implementations of HVDC modulation for lines in point-to-point configuration, although the modulation of MTDC systems is still in the research stage. As a conclusion, this paper identifies and summarizes open questions that remain to be tackled by researchers and engineers.« less

Interarea Oscillation Damping Control Using High Voltage DC Transmission: a Survey

DOE PAGES

Elizondo, Marcelo Anibal; Fan, Rui; Kirkham, Harold; ...

2018-05-02

High-voltage, direct current (HVDC) transmission lines are increasingly being installed in power systems around the world, and this trend is expected to continue with advancements in power electronics technology. These advancements are also bringing multi-terminal direct current (MTDC) systems closer to practical application. In addition, the continued deployment of phasor measurement units (PMUs) makes dynamic information about a large power system readily available for highly controllable components, such as HVDC lines. All these trends have increased the appeal of modulating HVDC lines and MTDC systems to provide grid services in addition to bulk power transfers. This paper provides a literaturemore » survey of HVDC and MTDC damping controllers for interarea oscillations in large interconnected power systems. The literature shows a progression from theoretical research to practical applications. Finally, there are already practical implementations of HVDC modulation for lines in point-to-point configuration, although the modulation of MTDC systems is still in the research stage. As a conclusion, this paper identifies and summarizes open questions that remain to be tackled by researchers and engineers.« less

The manned transportation system study - Defining human pathways into space

NASA Technical Reports Server (NTRS)

Lance, Nick; Geyer, Mark S.; Gaunce, Michael T.; Anson, H. W.; Bienhoff, D. G.; Carey, D. A.; Emmett, B. R.; Mccandless, B.; Wetzel, E. D.

1992-01-01

Substantiating data developed by a NASA-industry team (NIT) for subsequent NASA decisions on the 'right' set of manned transportation elements needed for human access to space are discussed. Attention is given to the framework for detailed definition of these manned transportation elements. Identifying and defining architecture evaluation criteria, i.e., attributes, specified the amount and type of data needed for each concept under consideration. Several architectures, each beginning with today's transportation systems, were defined using representative systems to explore future options and address specific questions currently being debated. The present solutions emphasize affordability, safety, routineness, and reliability. Key issues associated with current business practices were challenged and the impact associated with these practices quantified.

Reprint Filing: A Profile-Based Solution

PubMed Central

Gass, David A.; Putnam, R. Wayne

1983-01-01

A reprint filing system based on practice profiles can give family physicians easy access to relevant medical information. The use of the ICHPPC classification and some supplemental categories provides a more practical coding mechanism than organ systems, textbook chapter titles or even Index Medicus subject headings. The system can be simply maintained, updated and improved, but users must regularly weed out unused information, and read widely to keep the reprints current. PMID:21283301

Test result communication in primary care: a survey of current practice.

PubMed

Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

2015-11-01

The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for reducing the impact of recurring errors in the handling of samples and the reporting of results. Our findings will inform our continuing work with patients and staff to develop, implement and evaluate improvements to existing systems of managing the testing and result communication process. 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.

Early intervention for substance abuse among youth and young adults with mental health conditions: an exploration of community mental health practices.

PubMed

Anthony, Elizabeth K; Taylor, Sarah A; Raffo, Zulma

2011-05-01

This mixed method study examined current practices and barriers for screening and assessing substance use among youth/young adults in community mental health systems. Substance use rates remain high among youth/young adults in the general population and substance use disorders are prevalent among young people involved in public service systems such as mental health. In an effort to understand the dynamics for early intervention, 64 case managers and/or clinical directors from children's mental health systems in two states participated in an online survey or focus group in fall 2008. Quantitative survey questions and qualitative focus group questions explored attitudes and perspectives about screening and early intervention for substance use among youth/young adults involved in the mental health system and current agency practices. Mixed method results suggest a number of barriers to substance use screening and early intervention and point to innovations that could be more effectively supported.

The current status of 3D imaging in dental practice.

PubMed

McNamara, Clare; House, Kate; Davies, Rebecca; Barker, Chris S; Chawla, Ourvinder; Sandy, Jonathan R; Ireland, Anthony J

2011-12-01

This article aims to describe the current status of 3-dimensional (3D) imaging in dental practice. Advances in this field have made 3D imaging far more accessible in all dental fields. This paper describes methods of imaging dental hard and soft tissues and their clinical uses. In addition, the potential advantages and disadvantages of various systems are discussed, as well as expected future developments.

Trauma-informed juvenile justice systems: A systematic review of definitions and core components.

PubMed

Branson, Christopher Edward; Baetz, Carly Lyn; Horwitz, Sarah McCue; Hoagwood, Kimberly Eaton

2017-11-01

The U.S. Department of Justice has called for the creation of trauma-informed juvenile justice systems in order to combat the negative impact of trauma on youth offenders and frontline staff. Definitions of trauma-informed care have been proposed for various service systems, yet there is not currently a widely accepted definition for juvenile justice. The current systematic review examined published definitions of a trauma-informed juvenile justice system in an effort to identify the most commonly named core elements and specific interventions or policies. A systematic literature search was conducted in 10 databases to identify publications that defined trauma-informed care or recommended specific practices or policies for the juvenile justice system. We reviewed 950 unique records, of which 10 met criteria for inclusion. The 10 publications included 71 different recommended interventions or policies that reflected 10 core domains of trauma-informed practice. We found 8 specific practice or policy recommendations with relative consensus, including staff training on trauma and trauma-specific treatment, while most recommendations were included in 2 or less definitions. The extant literature offers relative consensus around the core domains of a trauma-informed juvenile justice system, but much less agreement on the specific practices and policies. A logical next step is a review of the empirical research to determine which practices or policies produce positive impacts on outcomes for youth, staff, and the broader agency environment, which will help refine the core definitional elements that comprise a unified theory of trauma-informed practice for juvenile justice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Missed, Misused, or Mismanaged: Improving Early Detection Systems to Optimize Child Outcomes

ERIC Educational Resources Information Center

Macy, Marisa; Marks, Kevin; Towle, Alexander

2014-01-01

Early detection efforts have been shown to vary greatly in practice, and there is a general lack of systematic accountability built into monitoring early detection effort impact. This article reviews current early detection practices and the drawbacks of these practices, with particular attention given to prevalent issues of mismeasurement,…

Evaluating the Motivational Impact of CALL Systems: Current Practices and Future Directions

ERIC Educational Resources Information Center

Bodnar, Stephen; Cucchiarini, Catia; Strik, Helmer; van Hout, Roeland

2016-01-01

A major aim of computer-assisted language learning (CALL) is to create computer environments that facilitate students' second language (L2) acquisition. To achieve this aim, CALL employs technological innovations to create novel types of language practice. Evaluations of the new practice types serve the important role of distinguishing effective…

Making It Real: A Practice-Based Early Childhood Teacher Education Program

ERIC Educational Resources Information Center

Vartuli, Sue; Snider, Karrie; Holley, Maggie

2016-01-01

In early childhood teacher education programs, the reality of educational systems must be understood and teacher candidates must be ready to deal with the current challenges schools face. The rationale and application of the principles of practice based teacher education are presented in this article. Practice-based teacher education programs…

Primary Care Practice Transformation Is Hard Work

PubMed Central

Crabtree, Benjamin F.; Nutting, Paul A.; Miller, William L.; McDaniel, Reuben R.; Stange, Kurt C.; Jaén, Carlos Roberto; Stewart, Elizabeth

2010-01-01

Background Serious shortcomings remain in clinical care in the United States despite widespread use of improvement strategies for enhancing clinical performance based on knowledge transfer approaches. Recent calls to transform primary care practice to a patient-centered medical home present even greater challenges and require more effective approaches. Methods Our research team conducted a series of National Institutes of Health funded descriptive and intervention projects to understand organizational change in primary care practice settings, emphasizing a complexity science perspective. The result was a developmental research effort that enabled the identification of critical lessons relevant to enabling practice change. Results A summary of findings from a 15-year program of research highlights the limitations of viewing primary care practices in the mechanistic terms that underlie current or traditional approaches to quality improvement. A theoretical perspective that views primary care practices as dynamic complex adaptive systems with “agents” who have the capacity to learn, and the freedom to act in unpredictable ways provides a better framework for grounding quality improvement strategies. This framework strongly emphasizes that quality improvement interventions should not only use a complexity systems perspective, but also there is a need for continual reflection, careful tailoring of interventions, and ongoing attention to the quality of interactions among agents in the practice. Conclusions It is unlikely that current strategies for quality improvement will be successful in transforming current primary care practice to a patient-centered medical home without a stronger guiding theoretical foundation. Our work suggests that a theoretical framework guided by complexity science can help in the development of quality improvement strategies that will more effectively facilitate practice change. PMID:20856145

Comparing the costs of three prostate cancer follow-up strategies: a cost minimisation analysis.

PubMed

Pearce, Alison M; Ryan, Fay; Drummond, Frances J; Thomas, Audrey Alforque; Timmons, Aileen; Sharp, Linda

2016-02-01

Prostate cancer follow-up is traditionally provided by clinicians in a hospital setting. Growing numbers of prostate cancer survivors mean that this model of care may not be economically sustainable, and a number of alternative approaches have been suggested. The aim of this study was to develop an economic model to compare the costs of three alternative strategies for prostate cancer follow-up in Ireland-the European Association of Urology (EAU) guidelines, the National Institute of Health Care Excellence (NICE) guidelines and current practice. A cost minimisation analysis was performed using a Markov model with three arms (EAU guidelines, NICE guidelines and current practice) comparing follow-up for men with prostate cancer treated with curative intent. The model took a health care payer's perspective over a 10-year time horizon. Current practice was the least cost efficient arm of the model, the NICE guidelines were most cost efficient (74 % of current practice costs) and the EAU guidelines intermediate (92 % of current practice costs). For the 2562 new cases of prostate cancer diagnosed in 2009, the Irish health care system could have saved €760,000 over a 10-year period if the NICE guidelines were adopted. This is the first study investigating costs of prostate cancer follow-up in the Irish setting. While economic models are designed as a simplification of complex real-world situations, these results suggest potential for significant savings within the Irish health care system associated with implementation of alternative models of prostate cancer follow-up care.

21 CFR 110.40 - Equipment and utensils.

Code of Federal Regulations, 2011 CFR

2011-04-01

... HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD... manufacturing systems, including gravimetric, pneumatic, closed, and automated systems, shall be of a design and...

21 CFR 110.40 - Equipment and utensils.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD... manufacturing systems, including gravimetric, pneumatic, closed, and automated systems, shall be of a design and...

21 CFR 110.40 - Equipment and utensils.

Code of Federal Regulations, 2012 CFR

2012-04-01

... HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD... manufacturing systems, including gravimetric, pneumatic, closed, and automated systems, shall be of a design and...

21 CFR 110.40 - Equipment and utensils.

Code of Federal Regulations, 2014 CFR

2014-04-01

... HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD... manufacturing systems, including gravimetric, pneumatic, closed, and automated systems, shall be of a design and...

21 CFR 110.40 - Equipment and utensils.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD... manufacturing systems, including gravimetric, pneumatic, closed, and automated systems, shall be of a design and...

Are there financial savings associated with supplementing current diagnostic practice for preeclampsia with a novel test? Learnings from a modeling analysis from a German payer perspective.

PubMed

Hadker, Nandini; Garg, Suchita; Costanzo, Cory; van der Helm, Wim; Creeden, James

2013-05-01

To quantify the financial impact of adding a novel serum test to the current diagnostic toolkit for preeclampsia (PE) detection in Germany. A decision-analytic model was created to quantify the economic impact of adding a recently developed novel diagnostic test for PE (Roche Diagnostics, Rotkreuz, Switzerland) to current diagnostic practice in Germany. The model simulated a cohort of 1000 pregnant patients receiving obstetric care and quantified the budget impact of adding the novel test to current German PE detection and management practices. The model estimates that the costs associated with managing a typical pregnancy in Germany are €941 when the novel test is used versus €1579 with standard practice. This represents savings of €637 per pregnant woman, even when the test is used as a supplementary diagnostic tool. The savings are attributed to the novel test's ability to better classify patients relative to current practice, specifically, its ability to reduce false negatives by 67% and false positives by 71%. The novel PE test has the potential to provide substantial cost savings to German healthcare payers, even when used as an addition to standard practice. Better classification of patients at risk for developing PE and declassification of those that are not compared to current practice leads to economic savings for the healthcare system. Furthermore, by reducing the rates of false-positive and false-negative classification relative to current standard of care, the test helps better target healthcare spending and lowers overall costs associated with PE care.

High-Performance Home Technologies: Solar Thermal & Photovoltaic Systems

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

Baechler, M.; Gilbride, T.; Ruiz, K.

This document is the sixth volume of the Building America Best Practices Series. It presents information that is useful throughout the United States for enhancing the energy efficiency practices in the specific climate zones that are presented in the first five Best Practices volumes. It provides an introduction to current photovoltaic and solar thermal building practices. Information about window selection and shading is included.

Electrical and Mechanical Performance of Carbon Fiber-Reinforced Polymer Used as the Impressed Current Anode Material.

PubMed

Zhu, Ji-Hua; Zhu, Miaochang; Han, Ningxu; Liu, Wei; Xing, Feng

2014-07-24

An investigation was performed by using carbon fiber-reinforced polymer (CFRP) as the anode material in the impressed current cathodic protection (ICCP) system of steel reinforced concrete structures. The service life and performance of CFRP were investigated in simulated ICCP systems with various configurations. Constant current densities were maintained during the tests. No significant degradation in electrical and mechanical properties was found for CFRP subjected to anodic polarization with the selected applied current densities. The service life of the CFRP-based ICCP system was discussed based on the practical reinforced concrete structure layout.

Revalidation and electronic cataract surgery audit: a Scottish survey on current practice and opinion.

PubMed

Megaw, R; Rane-Malcolm, T; Brannan, S; Smith, R; Sanders, R

2011-11-01

To determine current knowledge and opinion on revalidation, and methods of cataract surgery audit in Scotland and to outline the current and future possibilities for electronic cataract surgery audit. In 2010 we conducted a prospective, cross-sectional, Scottish-wide survey on revalidation knowledge and opinion, and cataract audit practice among all senior NHS ophthalmologists. Results were anonymised and recorded manually for analysis. In all, 61% of the ophthalmologists surveyed took part. Only 33% felt ready to take part in revalidation, whereas 76% felt they did not have adequate information about the process. Also, 71% did not feel revalidation would improve patient care, but 85% agreed that cataract surgery audit is essential for ophthalmic practice. In addition, 91% audit their cataract outcomes; 52% do so continuously. Further, 63% audit their subspecialist surgical results. Only 25% audit their cataract surgery practice electronically, and only 12% collect clinical data using a hospital PAS system. Funding and system incompatibility were the main reasons cited for the lack of electronic audit setup. Currently, eight separate hospital IT patient administration systems are used across 14 health boards in Scotland. Revalidation is set to commence in 2012. The Royal College of Ophthalmologists will use cataract outcome audit as a tool to ensure surgical competency for the process. Retrospective manual auditing of cataract outcome is time consuming, and can be avoided with an electronic system. Scottish ophthalmologists view revalidation with scepticism and appear to have inadequate knowledge of the process. However, they strongly agree with the concept of cataract surgery audit. The existing and future electronic applications that may support surgical audit are commercial electronic records, web-based applications, centrally funded software applications, and robust NHS connections between community and hospital.

Health impact assessment in Australia: A review and directions for progress

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

Harris, Patrick, E-mail: patrick.harris@unsw.edu.a; Spickett, Jeff, E-mail: J.Spickett@curtin.edu.a

2011-07-15

This article provides an overview of Health Impact Assessment (HIA) within Australia. We discuss the development and current position of HIA and offer some directions for HIA's progression. Since the early 1990s HIA activity in Australia has increased and diversified in application and practice. This article first highlights the emergent streams of HIA practice across environmental, policy and health equity foci, and how these have developed within Australia. The article then provides summaries of current practice provided by each Australian state and territory. We then offer some insight into current issues that require further progression or resolution if HIA ismore » to progress effectively in Australia. This progress rests both on developing broad system support for HIA across government, led by the health sector, and developing system capacity to undertake, commission or review HIAs. We argue that a unified and clear HIA approach is required as a prerequisite to gaining the understanding and support for HIA in the public and private sectors and the wider community.« less

Engineering youth service system infrastructure: Hawaii's continued efforts at large-scale implementation through knowledge management strategies.

PubMed

Nakamura, Brad J; Mueller, Charles W; Higa-McMillan, Charmaine; Okamura, Kelsie H; Chang, Jaime P; Slavin, Lesley; Shimabukuro, Scott

2014-01-01

Hawaii's Child and Adolescent Mental Health Division provides a unique illustration of a youth public mental health system with a long and successful history of large-scale quality improvement initiatives. Many advances are linked to flexibly organizing and applying knowledge gained from the scientific literature and move beyond installing a limited number of brand-named treatment approaches that might be directly relevant only to a small handful of system youth. This article takes a knowledge-to-action perspective and outlines five knowledge management strategies currently under way in Hawaii. Each strategy represents one component of a larger coordinated effort at engineering a service system focused on delivering both brand-named treatment approaches and complimentary strategies informed by the evidence base. The five knowledge management examples are (a) a set of modular-based professional training activities for currently practicing therapists, (b) an outreach initiative for supporting youth evidence-based practices training at Hawaii's mental health-related professional programs, (c) an effort to increase consumer knowledge of and demand for youth evidence-based practices, (d) a practice and progress agency performance feedback system, and (e) a sampling of system-level research studies focused on understanding treatment as usual. We end by outlining a small set of lessons learned and a longer term vision for embedding these efforts into the system's infrastructure.

Compensation and exotic livestock disease management: the views of animal keepers and veterinarians in England.

PubMed

Hamilton-Webb, A; Naylor, R; Little, R; Maye, D

2016-11-19

Relatively little is known about the perceived influence of different compensation systems on animal keepers' management of exotic livestock disease. This paper aims to address this research gap by drawing on interviews with 61 animal keepers and 21 veterinarians, as well as a series of nine animal keeper focus groups across five different livestock sectors in England. The perceived influence of current compensation systems on disease control behaviour was explored and alternative compensation systems that respectively reward positive practices and penalise poor practices were presented in the form of scenarios, alongside a third system that considered the option of a cost-sharing levy system between industry and government. The results indicate that animal keepers consider themselves to be influenced by a range of non-financial factors, for example, feelings of responsibility, reputation and animal welfare concerns, in the context of their exotic disease management practices. The majority of animal keepers were unaware of the current compensation systems in place for exotic diseases, and were therefore not consciously influenced by financial recompense. Concerns were raised about linking compensation to disease management behaviour due to auditing difficulties. A cost-sharing levy system would likely raise awareness of exotic disease and compensation among animal keepers, but differentiation of payments based upon individual farm-level risk assessments was called for by participants as a strategy to promote positive disease management practices. British Veterinary Association.

Implementation of parental feeding practices: does parenting style matter?

PubMed

Kiefner-Burmeister, Allison; Hoffmann, Debra; Zbur, Samantha; Musher-Eizenman, Dara

2016-09-01

To combat childhood obesity, researchers have focused on parental feeding practices that promote child health. The current study investigated how parenting style relates to twelve parental feeding practices. Data on parenting style and parental feeding practices were obtained for a correlational study from users of Amazon's Mechanical Turk, an online survey system. USA. Mothers of children aged 7-11 years (n 193). Parenting style related differentially to eleven out of the twelve measured practices. Authoritative mothers displayed more feeding practices that promote child health and fewer practices that impede child health. Authoritarian and permissive mothers displayed more unhealthy practices than authoritative mothers, but differed from each other on the practices they employed. Parenting style may relate to more aspects of feeding than previously realized. The inclusion of numerous healthy feeding practices along with unhealthy practices in the current study provides suggestions for the application of healthy feeding behaviours. Instruction on feeding behaviours and parenting style should be a focus of future educational programmes.

A comparative analysis of the dissemination of best practice measures for key populations.

PubMed

Lundy, Jennifer; Santangelo, Jennifer; Rogers, Patrick; Kuehn, Lynn; Christensen, Sharon; Bournique, Judy; Mekhjian, Hagop; Kamal, Jyoti

2008-11-06

In collaboration with the department of Quality and Operations Improvement, Clinical Applications and the Information Warehouse, we have leveraged available Information Warehouse data to build a Best Practice Compliance Measurement Dashboard. This tool combines information from our operating room charting system, our order entry system and coding information from the patient billing and management system to provide 'previous day', data on a patients current course of treatment.

[Regional health systems management: a case study in Rio Grande do Sul, Brazil].

PubMed

Lima, Juliano de Carvalho; Rivera, Francisco Javier Uribe

2006-10-01

This article analyzes the management system in a health district in the State of Rio Grande do Sul, Brazil, through qualitative analysis, using a case study as the methodology and macro-organization theory as the analytical framework. For the current management system in the 6th Health Region, a clear mission statement and wide acceptance by health workers are facilitating factors for the current organizational practices within the health system. Nevertheless, the way health coordinators are currently prioritizing their time has diverted necessary resources from critical problems towards more remedial issues. The 6th Health Region has encouraged social control (or public oversight) in order to improve accountability. However, there is room for improvement in quality assurance management, since there were no well-defined goals, objectives, or accountability. Decentralized consultancy provided to the municipalities and the funding model itself have both promoted decentralization and autonomy, although the strategy requires better regional integration and greater commitment in managerial practices.

Knowing for Nursing Practice: Patterns of Knowledge and Their Emulation in Expert Systems

PubMed Central

Abraham, Ivo L.; Fitzpatrick, Joyce J.

1987-01-01

This paper addresses the issue of clinical knowledge in nursing, and the feasibility of emulating this knowledge into expert system technology. The perspective on patterns of knowing for nursing practice, advanced by Carper (1978), serves as point of departure. The four patterns of knowing -- empirics, esthetics, ethics, personal knowledge -- are evaluated as to the extent to which they can be emulated in clinical expert systems, given constraints imposed by the current technology of these systems.

Cost-effective treatment of existing guardrail systems.

DOT National Transportation Integrated Search

2013-05-01

A cost-effective means for upgrading existing guardrail systems with deviations from current practice (i.e., low-rail heights, antiquated end : treatments, and improper installation) does not exist. As a result these systems remain on U.S. highways. ...

Development and evaluation of best management practices (BMPS) for highway runoff pollution control.

DOT National Transportation Integrated Search

2013-12-01

Polluted storm water runoff is commonly transported through Municipal Separate Storm Sewer Systems (MS4s). Currently, : sufficient information is not available on development and evaluation of Best Management Practices (BMPs) within an MS4 : boundary...

Coordination of care by primary care practices: strategies, lessons and implications.

PubMed

O'Malley, Ann S; Tynan, Ann; Cohen, Genna R; Kemper, Nicole; Davis, Matthew M

2009-04-01

Despite calls from numerous organizations and payers to improve coordination of care, there are few published accounts of how care is coordinated in real-world primary care practices. This study by the Center for Studying Health System Change (HSC) documents strategies that a range of physician practices use to coordinate care for their patients. While there was no single recipe for coordination given the variety of patient, physician, practice and market factors, some cross-cutting lessons were identified, such as the value of a commitment to interpersonal continuity of care as a foundation for coordination. Respondents also identified the importance of system support for the standardization of office processes to foster care coordination. While larger practices may have more resources to invest, many of the innovations described could be scaled to smaller practices. Some coordination strategies resulted in improved efficiency over time for practices, but by and large, physician practices currently pursue these efforts at their own expense. In addition to sharing information on effective strategies among practices, the findings also provide policy makers with a snapshot of the current care coordination landscape and implications for initiatives to improve coordination. Efforts to provide technical support to practices to improve coordination, for example, through medical-home initiatives, need to consider the baseline more typical practices may be starting from and tailor their support to practices ranging widely in size, resources and presence of standardized care processes. If aligned with payment incentives, some of these strategies have the potential to increase quality and satisfaction among patients and providers by helping to move the health care delivery system toward better coordinated care.

Advanced Environmental Monitoring Technologies

NASA Technical Reports Server (NTRS)

Jan, Darrell

2004-01-01

Viewgraphs on Advanced Environmental Monitoring Technologies are presented. The topics include: 1) Monitoring & Controlling the Environment; 2) Illustrative Example: Canary 3) Ground-based Commercial Technology; 4) High Capability & Low Mass/Power + Autonomy = Key to Future SpaceFlight; 5) Current Practice: in Flight; 6) Current Practice: Post Flight; 7) Miniature Mass Spectrometer for Planetary Exploration and Long Duration Human Flight; 8) Hardware and Data Acquisition System; 9) 16S rDNA Phylogenetic Tree; and 10) Preview of Porter.

Hydrological Forecasting Practices in Brazil

NASA Astrophysics Data System (ADS)

Fan, Fernando; Paiva, Rodrigo; Collischonn, Walter; Ramos, Maria-Helena

2016-04-01

This work brings a review on current hydrological and flood forecasting practices in Brazil, including the main forecasts applications, the different kinds of techniques that are currently being employed and the institutions involved on forecasts generation. A brief overview of Brazil is provided, including aspects related to its geography, climate, hydrology and flood hazards. A general discussion about the Brazilian practices on hydrological short and medium range forecasting is presented. Detailed examples of some hydrological forecasting systems that are operational or in a research/pre-operational phase using the large scale hydrological model MGB-IPH are also presented. Finally, some suggestions are given about how the forecasting practices in Brazil can be understood nowadays, and what are the perspectives for the future.

Attacking a practical quantum-key-distribution system with wavelength-dependent beam-splitter and multiwavelength sources

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

Li, Hong-Wei; Zhengzhou Information Science and Technology Institute, Zhengzhou, 450004; Wang, Shuang

2011-12-15

It is well known that the unconditional security of quantum-key distribution (QKD) can be guaranteed by quantum mechanics. However, practical QKD systems have some imperfections, which can be controlled by the eavesdropper to attack the secret key. With current experimental technology, a realistic beam splitter, made by fused biconical technology, has a wavelength-dependent property. Based on this fatal security loophole, we propose a wavelength-dependent attacking protocol, which can be applied to all practical QKD systems with passive state modulation. Moreover, we experimentally attack a practical polarization encoding QKD system to obtain all the secret key information at the cost ofmore » only increasing the quantum bit error rate from 1.3 to 1.4%.« less

NASA Formal Methods Workshop, 1990

NASA Technical Reports Server (NTRS)

Butler, Ricky W. (Compiler)

1990-01-01

The workshop brought together researchers involved in the NASA formal methods research effort for detailed technical interchange and provided a mechanism for interaction with representatives from the FAA and the aerospace industry. The workshop also included speakers from industry to debrief the formal methods researchers on the current state of practice in flight critical system design, verification, and certification. The goals were: define and characterize the verification problem for ultra-reliable life critical flight control systems and the current state of practice in industry today; determine the proper role of formal methods in addressing these problems, and assess the state of the art and recent progress toward applying formal methods to this area.

AN ANALYSIS OF THE RATIONALE AND PROCEDURES FOR LONG-RANGE PLANNING --FOUND IN SELECTED CORPORATE ENTERPRISES, GOVERNMENT AGENCIES OR DEPARTMENTS, AND SCHOOL SYSTEMS--WHICH ARE APPROPRIATE FOR EDUCATIONAL AND ADMINISTRATIVE PLANNING IN LOCAL SCHOOL SYSTEMS.

ERIC Educational Resources Information Center

RULIFFSON, WILLARD ADAMS

THIS STUDY REVIEWS SOME OF THE CURRENT PLANNING PRACTICES IN SCHOOL SYSTEMS WHICH ARE CONSIDERED TO BE ALREADY INVOLVED IN LONG-RANGE PLANNING, AND DESCRIBES FURTHER LONG-RANGE TECHNIQUES WHICH COULD BE ADAPTED FOR SCHOOL SYSTEMS FROM CURRENT CORPORATE AND GOVERNMENTAL PLANNING PROCEDURES. INDIVIDUAL INTERVIEWS WERE CONDUCTED WITH SELECTED…

Expert Systems: Tutors, Tools, and Tutees.

ERIC Educational Resources Information Center

Lippert, Renate C.

1989-01-01

Discusses the current status, research, and practical implications of artificial intelligence and expert systems in education. Topics discussed include computer-assisted instruction; intelligent computer-assisted instruction; intelligent tutoring systems; instructional strategies involving the creation of knowledge bases; decision aids;…

A synthesis of the "state-of-the-practice for advancing planning and operations integration opportunities within transportation agencies".

DOT National Transportation Integrated Search

2014-12-01

Linking Planning and Operations is vital to improving transportation decision-making and overall : efficiency of transportation systems management. This synthesis summarizes current state of : knowledge and practices in Planning and Operations Integr...

For the Heirs of Revolution: Current Educational Practices in North Korea.

ERIC Educational Resources Information Center

Kim, Hyung-chan

1981-01-01

Based on a 10-day visit to North Korean educational establishments by the author, this article discusses educational philosophy, curriculum, teaching methods, educational system organization, and educational practices at all levels from primary school through higher education institutions. (DB)

Guidelines for traffic signal energy back-up systems : final report, August 2009.

DOT National Transportation Integrated Search

2009-07-01

Current practices of responding to power failures are very basic, ranging from 'do nothing' to installing portable generators. The purpose of this research project was to provide the NYSDOT with a better understand the practices of other agencies in ...

The virtual practice: using the residents' continuity clinic to teach practice management and systems-based practice.

PubMed

Perez, Jose A; Faust, Cheryl; Kenyon, Angie

2009-09-01

Education in systems-based practice is a required component of all postgraduate medical education programs in the United States. Competency in this area requires that trainees have an understanding of the health care system sufficient to provide optimal care to patients. Most trainees in residency programs have little understanding of the complexities and challenges of present-day practice in the current system of care and consider themselves unprepared to undertake this activity following completion of training. Training in practice management in residency programs has not been emphasized as an important component of systems-based practice. Historically, practice management training in residency programs has been done using a fully didactic model, and residents have expressed a desire to learn this skill by becoming more directly involved in the operations and management of a practice. The patient visit touches many aspects of the health care system, including clinic operations, insurance, quality, and finances. At our institution, we used the residents' continuity clinic practices as a vehicle to provide education in practice management and systems-based practice by creating a curriculum that included the residents' perceived gaps in knowledge regarding going into practice. This is known as the virtual practice. This curriculum is taught using data obtained from residents' practice to illustrate concepts in many areas, including primary practice operations, malpractice insurance, financial benchmarks, and career planning. Resident self-assessed knowledge of these areas increased after participating in the curriculum, and resident testimonials indicate satisfaction with the project. In addition, residents have become engaged and interested in how their effort translates into performance and how they participate in the health care system.

Optical Information Processing for Aerospace Applications

NASA Technical Reports Server (NTRS)

1981-01-01

Current research in optical processing is reviewed. Its role in future aerospace systems is determined. The development of optical devices and components demonstrates that system concepts can be implemented in practical aerospace configurations.

Challenges to laboratory hematology practice: Egypt perspective.

PubMed

Rizk, S H

2018-05-01

Laboratory hematology is an integral part of all clinical laboratories along the extensive healthcare facilities in Egypt. The aim of this review is to portrait the laboratory hematology practice in Egypt including its unique socioeconomic background, blood disease pattern, education and training, regulatory oversight, and the related challenges. Current practice varies widely between different parts of the healthcare system in terms of the range of tests, applied techniques, workforce experience, and quality of service. The national transfusion service (NBTS) in Egypt has been recently upgraded and standardized according to the World Health Organization (WHO) guidelines. Formal postgraduate education roughly follows the British system. Laboratory hematology specialization is achieved through 2-3 years masters' degree followed by 2-4 years doctorate degree in clinical pathology with training and research in hematology. Improvement of laboratory hematology education is recently undergoing a reform as a part of the modernization of higher education policy and following the standards developed by the National Quality Assurance and Accreditation Agency (NQAAA). Accreditation of medical laboratories is recently progressing with the development of the "Egyptian Accreditation Council" (EGAC) as the sole accreditation body system and training of assessors. Current laboratory system has many challenges, some are related to the inadequate system performance, and others are unique to laboratory hematology issues. The rapid technological advances and therapeutic innovations in hematology practice call for an adapting laboratory system with continuous upgrading. © 2018 John Wiley & Sons Ltd.

An Optimization System with Parallel Processing for Reducing Common-Mode Current on Electronic Control Unit

NASA Astrophysics Data System (ADS)

Okazaki, Yuji; Uno, Takanori; Asai, Hideki

In this paper, we propose an optimization system with parallel processing for reducing electromagnetic interference (EMI) on electronic control unit (ECU). We adopt simulated annealing (SA), genetic algorithm (GA) and taboo search (TS) to seek optimal solutions, and a Spice-like circuit simulator to analyze common-mode current. Therefore, the proposed system can determine the adequate combinations of the parasitic inductance and capacitance values on printed circuit board (PCB) efficiently and practically, to reduce EMI caused by the common-mode current. Finally, we apply the proposed system to an example circuit to verify the validity and efficiency of the system.

The Scope of Practice of Occupational Therapy in U.S. Criminal Justice Settings.

PubMed

Muñoz, Jaime P; Moreton, Emily M; Sitterly, Audra M

2016-09-01

In the past 40 years, prison populations in the U.S. have nearly quadrupled while funding for rehabilitation, education and other programmes has been cut. Despite accounting for a small fraction of the world's population more than 20% of the worlds incarcerated population is in the U.S. and the rate of recidivism remains alarmingly high. Occupational therapists have the capability to play a significant role in addressing the needs of persons within the criminal justice system. However, the profession has been slow to delineate of the role occupational therapy within criminal justice settings. This study sought to provide a descriptive analysis of current occupational therapy roles and practices within the U.S. criminal justice system. Using survey research methods, the researchers collected data from respondents (N = 45; Response Rate + 51.7%) to establish a baseline of the scope of practices employed by occupational therapists working in the U.S. criminal justice system. U.S. practitioners work within institutional and community based criminal justice settings. Primary practice models, assessments and group interventions were catalogued. Respondents strongly valued the creation of networking to build the professions' presence within criminal justice settings. Occupational therapy in the criminal justice system remains an emerging practice arena. Understanding the current scope of practice in the U.S. and creating a mechanism for collaboration may help increase the depth, breadth and overall growth of the profession's role in these settings. The sampling method does not guarantee a representative sample of the population and is limited to practice within the United States. Survey design may not have allowed for respondents to fully describe their practice experiences. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

PubMed

Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

2017-07-01

Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

Current Hale ROA Voice and Control Communication Practices and Performance: White Paper

NASA Technical Reports Server (NTRS)

2007-01-01

The objective of this white paper is to help achieve the ACCESS 5 goal by sharing the UNITE members knowledge of current HALE ROA communication systems with other ACCESS 5 participants so that all interested parties start from a common understanding as we begin the clarification of requirements for voice and C2 communication. This white paper is also intended to describe the point of departure for any future developments that need to be realized to achieve the long term ACCESS 5 goal. Although this white paper describes the current systems, the functional and performance requirements that are also being developed under ACCESS 5 may not require the same levels of functionality and performance as currently exist. The paper addresses the following: 1) A description of a typical current HALE ROA communications system, 2) HALE ROA communications systems performance metrics, 3) HALE ROA communications systems performance, and 5) A comparison of current HALE ROA communications systems with current regulations.

The Effects of the Reverse Current Caused by the Series Compensation on the Current Differential Protection

PubMed Central

Tang, Cui; Yin, Xianggen; Qi, Xuanwei; Zhang, Zhe

2014-01-01

The series capacitor compensation is one of the key technologies in the EHV and UHV long distance power transmission lines. This paper analyzes the operation characteristics of the main protection combined with the engineering practice when the transmission line overcompensation due to the series compensation system is modified and analyzes the influence of the transition resistance and the system operation mode on the current differential protection. According to the simulation results, it presents countermeasure on improving the sensitivity of differential current protection. PMID:25247206

77 FR 16158 - Current Good Manufacturing Practice in Manufacturing, Processing, Packing, or Holding of Drugs...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

... ``cut'' from a sheet or roll of labels--is used. Persistent problems with drug product mislabeling and... believe that development and use of advanced code scanning equipment has made many current electronic... and other advanced scanning techniques have made current electronic systems reliable to the 100...

Practices of traditional birth attendants in Sierra Leone and perceptions by mothers and health professionals familiar with their care.

PubMed

Dorwie, Florence M; Pacquiao, Dula F

2014-01-01

Describe practices of traditional birth attendants (TBAs) in assisting women in childbirth and the perceptions of TBAs by mothers and health professionals familiar with their work. Qualitative design using focus groups conducted in urban and rural settings in Sierra Leone. Separate audiotaped focus groups conducted for each group of participants lasting between 45 and 90 minutes. Purposive sample of 20 TBAs, 20 mothers, and 10 health professionals who met the following criteria: (a) at least 18 years of age, (b) TBAs currently practicing, (c) mothers who delivered at least one child assisted by a TBA, and (d) health professionals currently practicing in the hospital and familiar with TBA practices. TBAs are valued by mothers, health professionals, and the community because they provide accessible and affordable care to mothers who may otherwise have no access to health services. TBAs need training, supervision, and resources for effective referral of mothers. Systemic problems in the health care system create enormous barriers to effective care for mothers and children independent of TBA practices that contribute to high maternal and infant mortality rates. The study findings have implications on broad public policy in improving maternal and child health in the country.

Animal Health and Welfare Issues Facing Organic Production Systems.

PubMed

Sutherland, Mhairi A; Webster, Jim; Sutherland, Ian

2013-10-31

The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare.

General practice registrars' intentions for future practice: implications for rural medical workforce planning.

PubMed

Harding, Catherine; Seal, Alexa; McGirr, Joe; Caton, Tim

2016-11-01

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91)=3.528, P=0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88)=-4.280, P<0.001) and women ranked the ability to work part-time higher (t(94)=3.697, P<0.001). Fee-for-service payment alone, or in combination with capitation, was the preferred payment system. Only 22% of Australian medical graduates intend to own their own practice compared with 52% of international medical graduates (χ 2 (1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

International Space Agency CIO Forum Industrial Control System (ICS) and Cyber

NASA Technical Reports Server (NTRS)

Powell, Robert

2017-01-01

This briefing covers Industrial Control System (ICS) best practices for enhancing cyber protection. The briefing provides a very high-level overview of best practices currently being pursued by NASA as well as by other US government agencies such as NIST and DHS ICS-CERT. All information presented in this slide deck is publicly available and no sensitive information is provided in these slides. These slides will be used to generate discussion around best practices within the international community in the area of ICS cyber protections.

Silvicultural systems for managing ponderosa pine

Treesearch

Andrew Youngblood

2005-01-01

Silviculturists have primarily relied on classical even-aged silvicultural systems (the planned series of treatments for tending, harvesting, and re-establishing a stand) for ponderosa pine, with uneven-aged systems used to a lesser degree. Current management practices involve greater innovation because of conflicting management objectives. Silvicultural systems used...

The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide.

PubMed

Korreman, Stine; Rasch, Coen; McNair, Helen; Verellen, Dirk; Oelfke, Uwe; Maingon, Philippe; Mijnheer, Ben; Khoo, Vincent

2010-02-01

The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics of practical relevance for radiation oncology. This report focuses primarily on 3D CT-based in-room image guidance (3DCT-IGRT) systems. It will provide an overview and current standing of 3DCT-IGRT systems addressing the rationale, objectives, principles, applications, and process pathways, both clinical and technical for treatment delivery and quality assurance. These are reviewed for four categories of solutions; kV CT and kV CBCT (cone-beam CT) as well as MV CT and MV CBCT. It will also provide a framework and checklist to consider the capability and functionality of these systems as well as the resources needed for implementation. Two different but typical clinical cases (tonsillar and prostate cancer) using 3DCT-IGRT are illustrated with workflow processes via feedback questionnaires from several large clinical centres currently utilizing these systems. The feedback from these clinical centres demonstrates a wide variability based on local practices. This report whilst comprehensive is not exhaustive as this area of development remains a very active field for research and development. However, it should serve as a practical guide and framework for all professional groups within the field, focussed on clinicians, physicists and radiation therapy technologists interested in IGRT. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

End-user interest in geotechnical data management systems.

DOT National Transportation Integrated Search

2008-12-01

In conducting geotechnical site investigations, large volumes of subsurface information and associated test data : are generated. The current practice relies on paper-based filing systems that are often difficult and cumbersome : to access by users. ...

21 CFR 888.5850 - Nonpowered orthopedic traction apparatus and accessories.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., pulleys, or weights, and that is intended to apply a therapeutic pulling force to the skeletal system. (b... from the current good manufacturing practice requirements of the quality system regulation in part 820...

21 CFR 888.5850 - Nonpowered orthopedic traction apparatus and accessories.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., pulleys, or weights, and that is intended to apply a therapeutic pulling force to the skeletal system. (b... from the current good manufacturing practice requirements of the quality system regulation in part 820...

21 CFR 888.5850 - Nonpowered orthopedic traction apparatus and accessories.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., pulleys, or weights, and that is intended to apply a therapeutic pulling force to the skeletal system. (b... from the current good manufacturing practice requirements of the quality system regulation in part 820...

Onboard processor technology review

NASA Technical Reports Server (NTRS)

Benz, Harry F.

1990-01-01

The general need and requirements for the onboard embedded processors necessary to control and manipulate data in spacecraft systems are discussed. The current known requirements are reviewed from a user perspective, based on current practices in the spacecraft development process. The current capabilities of available processor technologies are then discussed, and these are projected to the generation of spacecraft computers currently under identified, funded development. An appraisal is provided for the current national developmental effort.

Evaluation of Integrated Planning Systems in California Community Colleges

ERIC Educational Resources Information Center

Buckley, Jerry L.; Piland, William E.

2012-01-01

California community colleges are experiencing unprecedented levels of sanctions from their accrediting agency. A survey of planners in these colleges reveals a wide gap between current practice and perceived importance of integrated planning practices, as well as misalignment in budgeting methods. Statistically significant gaps were identified…

Improving the Quality of Electronic Documentation in Critical Care Nursing

ERIC Educational Resources Information Center

Stevens, Brent

2017-01-01

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General…

Instructional Guidelines. Welding.

ERIC Educational Resources Information Center

Fordyce, H. L.; Doshier, Dale

Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

Managing Productive Schools: Toward an Ecology.

ERIC Educational Resources Information Center

Snyder, Karolyn J.; Anderson, Robert H.

Intended for use by graduate students in educational administration and supervision as well as by practicing school administrators, this book is a guide to the most effective practices surrounding the school principalship. Ideas in the book reflect current views of good management, including systems approaches, participative and collaborative…

Best practices for implementing, testing and using a cloud-based communication system in a disaster situation.

PubMed

Makowski, Dale

2016-01-01

This paper sets out the basics for approaching the selection and implementation of a cloud-based communication system to support a business continuity programme, including: • consideration for how a cloud-based communication system can enhance a business continuity programme; • descriptions of some of the more popular features of a cloud-based communication system; • options to evaluate when selecting a cloud-based communication system; • considerations for how to design a system to be most effective for an organisation; • best practices for how to conduct the initial load of data to a cloud-based communication system; • best practices for how to conduct an initial validation of the data loaded to a cloud-based communication system; • considerations for how to keep contact information in the cloud-based communication system current and accurate; • best practices for conducting ongoing system testing; • considerations for how to conduct user training; • review of other potential uses of a cloud-based communication system; and • review of other tools and features many cloud-based communication systems may offer.

Centering Pregnancy: practical tips for your practice.

PubMed

DeCesare, Julie Z; Jackson, Jessica R

2015-03-01

With increased access to care, current health delivery systems will need expansion to meet higher demands and needs. To define Centering Pregnancy and practical tips for implementation into both private and academic practices. Evidence was gathered through literature reviews. It was found that Centering Pregnancy offers a patient-centered, evidence-based approach to helping with access issues, as well as improving outcomes. This article describes the benefits of Centering Pregnancy to the practice, the provider, and the patient. Practical implementation tips will be offered, with suggestions for negating common implementation barriers.

Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

PubMed

Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

2014-07-01

Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs.

Medical home implementation: a sensemaking taxonomy of hard and soft best practices.

PubMed

Hoff, Timothy

2013-12-01

The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. I found two distinct taxonomies of implementation best practices, which I labeled "hard" and "soft" because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. © 2013 Milbank Memorial Fund.

A Review of Developments in Computer-Based Systems to Image Teeth and Produce Dental Restorations

PubMed Central

Rekow, E. Dianne; Erdman, Arthur G.; Speidel, T. Michael

1987-01-01

Computer-aided design and manufacturing (CAD/CAM) make it possible to automate the creation of dental restorations. Currently practiced techniques are described. Three automated systems currently under development are described and compared. Advances in computer-aided design and computer-aided manufacturing (CAD/CAM) provide a new option for dentistry, creating an alternative technique for producing dental restorations. It is possible to create dental restorations that are automatically produced and meet or exceed current requirements for fit and occlusion.

Viable Short-Term Directed Energy Weapon Naval Solutions: A Systems Analysis of Current Prototypes

DTIC Science & Technology

2013-06-01

Background and Issues for Congress 2013). The current DDG-51 electrical plant consists of three Gas Turbine Generator Sets ( GTGs ) rated at 2500 kW each...the generator rating (currently 2500kW), the practice is to have a minimum of two GTGs on line at all times to ensure continuity of service should...there be a system fault, or casualty to one of the GTGs (Mahoney, et al. 2010). This operation of at least two generators at all times essentially

Negligence, genuine error, and litigation

PubMed Central

Sohn, David H

2013-01-01

Not all medical injuries are the result of negligence. In fact, most medical injuries are the result either of the inherent risk in the practice of medicine, or due to system errors, which cannot be prevented simply through fear of disciplinary action. This paper will discuss the differences between adverse events, negligence, and system errors; the current medical malpractice tort system in the United States; and review current and future solutions, including medical malpractice reform, alternative dispute resolution, health courts, and no-fault compensation systems. The current political environment favors investigation of non-cap tort reform remedies; investment into more rational oversight systems, such as health courts or no-fault systems may reap both quantitative and qualitative benefits for a less costly and safer health system. PMID:23426783

Practical cryptographic strategies in the post-quantum era

NASA Astrophysics Data System (ADS)

Kabanov, I. S.; Yunusov, R. R.; Kurochkin, Y. V.; Fedorov, A. K.

2018-02-01

Quantum key distribution technologies promise information-theoretic security and are currently being deployed in com-mercial applications. We review new frontiers in information security technologies in communications and distributed storage applications with the use of classical, quantum, hybrid classical-quantum, and post-quantum cryptography. We analyze the cur-rent state-of-the-art, critical characteristics, development trends, and limitations of these techniques for application in enterprise information protection systems. An approach concerning the selection of practical encryption technologies for enterprises with branched communication networks is discussed.

Variation in clinical coding lists in UK general practice: a barrier to consistent data entry?

PubMed

Tai, Tracy Waize; Anandarajah, Sobanna; Dhoul, Neil; de Lusignan, Simon

2007-01-01

Routinely collected general practice computer data are used for quality improvement; poor data quality including inconsistent coding can reduce their usefulness. To document the diversity of data entry systems currently in use in UK general practice and highlight possible implications for data quality. General practice volunteers provided screen shots of the clinical coding screen they would use to code a diagnosis or problem title in the clinical consultation. The six clinical conditions examined were: depression, cystitis, type 2 diabetes mellitus, sore throat, tired all the time, and myocardial infarction. We looked at the picking lists generated for these problem titles in EMIS, IPS, GPASS and iSOFT general practice clinical computer systems, using the Triset browser as a gold standard for comparison. A mean of 19.3 codes is offered in the picking list after entering a diagnosis or problem title. EMIS produced the longest picking lists and GPASS the shortest, with a mean number of choices of 35.2 and 12.7, respectively. Approximately three-quarters (73.5%) of codes are diagnoses, one-eighth (12.5%) symptom codes, and the remainder come from a range of Read chapters. There was no readily detectable consistent order in which codes were displayed. Velocity coding, whereby commonly-used codes are placed higher in the picking list, results in variation between practices even where they have the same brand of computer system. Current systems for clinical coding promote diversity rather than consistency of clinical coding. As the UK moves towards an integrated health IT system consistency of coding will become more important. A standardised, limited list of codes for primary care might help address this need.

Web-Based Intelligent E-Learning Systems: Technologies and Applications

ERIC Educational Resources Information Center

Ma, Zongmin

2006-01-01

Collecting and presenting the latest research and development results from the leading researchers in the field of e-learning systems, Web-Based Intelligent E-Learning Systems: Technologies and Applications provides a single record of current research and practical applications in Web-based intelligent e-learning systems. This book includes major…

Public Employee Retirement Systems: The Structure and Politics of Teacher Pensions.

ERIC Educational Resources Information Center

Taylor, Suzanne Saunders

This book describes the operation of state and local government pension systems for teachers, explores the rationale behind current administrative and financial practices, and describes the interaction of special interest groups, pension professionals, and investment personnel with the administration of these systems. The pension systems in 23…

An Overview of Skill Standards Systems in Education & Industry. Systems in the U.S. and Abroad. Volume I.

ERIC Educational Resources Information Center

Institute for Educational Leadership, Washington, DC.

This first volume in a four-volume study of industry- and education-driven skill standards in the United States and other countries describes current practice. Chapter I is the executive summary. Chapter II is an overview of historical and current issues that will affect a voluntary network of industry-based skill standards, competencies, and…

High Pulse Repetition Rate, Eye Safe, Visible Wavelength Lidar Systems: Design, Results and Potential

NASA Technical Reports Server (NTRS)

Spinhirne, James; Berkoff, Timothy; Welton, Elsworth; Campbell, James; OCStarr, David (Technical Monitor)

2002-01-01

In 1993 the first of the eye safe visible wavelength lidar systems known now as Micro Pulse Lidar (MPL) became operational. Since that time there have been several dozen of these systems produced and applied for full time profiling of atmospheric cloud and aerosol structure. There is currently an observational network of MPL sites to support global climate research. In the course of application of these instruments there have been significant improvements in understanding, design and performance of the systems. There are addition potential and applications beyond current practice for the high repetition rate, eye safe designs. The MPL network and the current capability, design and future potential of MPL systems are described.

Quality management for the international transport of laboratory animals.

PubMed

Leary, Steven L

2008-01-01

Increased collaboration between investigators at different institutions has increased the number of laboratory animals being transported. The current system of laws and regulations governing animal shipments is inconsistent and government agencies often have areas of overlapping regulatory management. Furthermore, the lack of industry-wide shipping standards and good practices contributes to confusion among those responsible for shipment. One answer to these quality control issues would be the establishment of independent, industry-regulated 'good practices' for animal transport, similar to those used in laboratories for experimental design. These good practices could be based on the existing International Air Transport Association Live Animals Regulations, with contributions from representatives of the specialties involved. Additionally, quality control under the current system of patchwork regulations could be improved if each institution, both academic and commercial, would designate a single point of contact to follow each shipment from start to finish.

Prescribed Burning In Selection Stands of Southern Pine: Current Practice and Future Promise

Treesearch

Robert M. Farrar

1998-01-01

The selection silvicultural system as practiced in stands of the major southern pines is briefly reviewed and the past and present role of prescribed burning in each is discussed. A detailed discussion is given of the burning practices in uneven-aged stands of longleaf (Pinus palustris) in which repeated fire is both highly effective and nearly essential as a...

Scoping the role and education needs of practice nurses in London.

PubMed

Procter, Susan; Griffiths, Lauren; Fanning, Agnes; Wallman, Lizzie; Loveday, Heather P

2017-07-01

Aims To identify education priorities for practice nursing across eight London Clinical Commissioning Groups (CCGs); to identify the education, training, development and support needs of practice nurses in undertaking current and future roles. The education needs of practice nurses have long been recognised but their employment status means that accessing education requires the support of their GP employer. This study scopes the educational requirements of the practice nurse workforce and working with educational providers and commissioners describes a coherent educational pathway for practice nurses. A survey of practice nurses to scope their educational attainment needs was undertaken. Focus groups were carried out which identified the education, training, development and support needs of practice nurses to fulfil current and future roles. Findings A total of 272 respondents completed the survey. Practice nurses took part in three focus groups (n=34) and one workshop (n=39). Findings from this research indicate a practice nurse workforce which lacked career progression, role autonomy or a coherent educational framework. Practice nurses recognised the strength of their role in building relationship-centred care with patients over an extended period of time. They valued this aspect of their role and would welcome opportunities to develop this to benefit patients. This paper demonstrates an appetite for more advanced education among practice nurses, a leadership role by the CCGs in working across the whole system to address the education needs of practice nurses, and a willingness on the part of National Health Service education commissioners to commission education which meets the education needs of the practice nurse workforce. Evidence is still required, however, to inform the scope of the practice nurse role within an integrated system of care and to identify the impact of practice nursing on improving health outcomes and care of local populations.

Using Models to Understand Sea Level Rise

ERIC Educational Resources Information Center

Barth-Cohen, Lauren; Medina, Edwing

2017-01-01

Important science phenomena--such as atomic structure, evolution, and climate change--are often hard to observe directly. That's why an important scientific practice is to use scientific models to represent one's current understanding of a system. Using models has been included as an essential science and engineering practice in the "Next…

The Design of Computerized Practice Fields for Problem Solving and Contextualized Transfer

ERIC Educational Resources Information Center

Riedel, Jens; Fitzgerald, Gail; Leven, Franz; Toenshoff, Burkhard

2003-01-01

Current theories of learning emphasize the importance of learner-centered, active, authentic, environments for meaningful knowledge construction. From this perspective, computerized case-based learning systems afford practice fields for learners to build domain knowledge and problem-solving skills and to support contextualized transfer of…

Poststructuralism as Theory and Practice in the English Classroom. ERIC Digest.

ERIC Educational Resources Information Center

Bush, Harold K., Jr.

This digest provides a historical review of some current literary theories and practices which developed from contemporary philosophy. Structuralism, associated with Ferdinand de Saussure and Claude Levi-Strauss, with a seemingly scientific view of language and culture posited a systemic "center" that organized and sustained an entire…

Managing Corporate Annual Reports. SPEC Kit 258.

ERIC Educational Resources Information Center

O'Connor, Lisa, Comp.

2000-01-01

The purpose of the survey for this SPEC (Systems and Procedures Exchange Center) Kit was to assess the current print corporate annual report collection practices of ARL (Association of Research Libraries) libraries, describe the effects of these collections, and recommend best practices for preserving these significant historical documents. The…

Using Computers in Early Childhood Classrooms: Teachers' Attitudes, Skills and Practices

ERIC Educational Resources Information Center

Chen, Jie-Qi; Chang, Charles

2006-01-01

To better prepare early childhood teachers for computer use, more information about their current skills and classroom practices is needed. Sampling from a large metropolitan public school system in the USA, the study surveyed 297 state pre-kindergarten teachers, gathering information about their attitudes, skills, and instructional methods…

Research Perspectives and Best Practices in Educational Technology Integration

ERIC Educational Resources Information Center

Keengwe, Jared

2013-01-01

With advancements in technology continuing to influence all areas of society, students in current classrooms have a different understanding and perspective of learning than the educational system has been designed to teach. Research Perspectives and Best Practices in Educational Technology Integration highlights the emerging digital age, its…

Overview of practice management in child and adolescent psychiatry.

PubMed

Schreter, Robert K

2010-01-01

The manager of a psychiatric practice must create and direct a clinical delivery system, design and oversee the administrative services necessary to support the system, and guide the business operations that contribute to its success. Regardless of the size of the practice, the psychiatrist administrator must handle seven core administrative responsibilities and oversee individual functions and capabilities within each domain. These responsibilities include practice development, clinical services management, medical office operations, clinical management, information management, business management, and risk management. This article provides a roadmap for creating and sustaining successful clinical and administrative endeavors. It can also be used by existing practices as an audit instrument to provide a snapshot of current capabilities so that strengths as well as opportunities for continued growth can be identified.

The unexpected high practical value of medical ontologies.

PubMed

Pinciroli, Francesco; Pisanelli, Domenico M

2006-01-01

Ontology is no longer a mere research topic, but its relevance has been recognized in several practical fields. Current applications areas include natural language translation, e-commerce, geographic information systems, legal information systems and biology and medicine. It is the backbone of solid and effective applications in health care and can help to build more powerful and more interoperable medical information systems. The design and implementation of ontologies in medicine is mainly focused on the re-organization of medical terminologies. This is obviously a difficult task and requires a deep analysis of the structure and the concepts of such terminologies, in order to define domain ontologies able to provide both flexibility and consistency to medical information systems. The aim of this special issue of Computers in Biology and Medicine is to report the current evolution of research in biomedical ontologies, presenting both papers devoted to methodological issues and works with a more applicative emphasis.

[Physiology in Relation to Anesthesia Practice: Preface and Comments].

PubMed

Yamada, Yoshitsugu

2016-05-01

It has been long recognized that anesthesia practice is profoundly based in physiology. With the advance of the technology of imaging, measurement and information, a serious gap has emerged between anesthesia mainly handling gross systemic parameters and molecular physiology. One of the main reasons is the lack of establishment of integration approach. This special series of reviews deals with systems physiology covering respiratory, cardiovascular, and nervous systems. It also includes metabolism, and fluid, acid-base, and electrolyte balance. Each review focuses on several physiological concepts in each area, explaining current understanding and limits of the concepts based on the new findings. They reaffirm the importance of applying physiological inference in anesthesia practice and underscore the needs of advancement of systems physiology.

Current neurology

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

Appel, S.H.

1988-01-01

The topics covered in this book include: Duchenne muscular dystrophy: DNA diagnosis in practice; Central nervous system magnetic resonance imaging; and Magnetic resonance spectroscopy of neurologic diseases.

JPRS Report, China

DTIC Science & Technology

1989-09-27

essence of abolishing the leadership post life tenure system and putting into effect the practice of cadres being able to go both up and down is...performs badly one will be disciplined. Second, there is the term of office system. This is the essence of putting into effect the practice of cadres...34three essences ." 4. In view of the repeated slides of rural credit cooperative agricultural bank credit funds currently, to ensure that this year’s

A flight test of laminar flow control leading-edge systems

NASA Technical Reports Server (NTRS)

Fischer, M. C.; Wright, A. S., Jr.; Wagner, R. D.

1983-01-01

NASA's program for development of a laminar flow technology base for application to commercial transports has made significant progress since its inception in 1976. Current efforts are focused on development of practical reliable systems for the leading-edge region where the most difficult problems in applying laminar flow exist. Practical solutions to these problems will remove many concerns about the ultimate practicality of laminar flow. To address these issues, two contractors performed studies, conducted development tests, and designed and fabricated fully functional leading-edge test articles for installation on the NASA JetStar aircraft. Systems evaluation and performance testing will be conducted to thoroughly evaluate all system capabilities and characteristics. A simulated airline service flight test program will be performed to obtain the operational sensitivity, maintenance, and reliability data needed to establish that practical solutions exist for the difficult leading-edge area of a future commercial transport employing laminar flow control.

Rewards and Supports

ERIC Educational Resources Information Center

Hershberg, Theodore; Robertson-Kraft, Claire

2010-01-01

Pay-for-performance systems in public schools have long been burdened with controversy. Critics of performance pay systems contend that because teachers' impact cannot be measured without error, it is impossible to create fair and accurate systems for evaluating and rewarding performance. By this standard, however, current practice fails on both…

Center/TRACON Automation System: Development and Evaluation in the Field

DOT National Transportation Integrated Search

1993-10-01

Technological advances are changing the way that advanced air traffic control : automation should be developed and assessed. Current standards and practices of : system development place field testing at the end of the development process. : While su...

Integrated Risk and Knowledge Management Program -- IRKM-P

NASA Technical Reports Server (NTRS)

Lengyel, David M.

2009-01-01

The NASA Exploration Systems Mission Directorate (ESMD) IRKM-P tightly couples risk management and knowledge management processes and tools to produce an effective "modern" work environment. IRKM-P objectives include: (1) to learn lessons from past and current programs (Apollo, Space Shuttle, and the International Space Station); (2) to generate and share new engineering design, operations, and management best practices through preexisting Continuous Risk Management (CRM) procedures and knowledge-management practices; and (3) to infuse those lessons and best practices into current activities. The conceptual framework of the IRKM-P is based on the assumption that risks highlight potential knowledge gaps that might be mitigated through one or more knowledge management practices or artifacts. These same risks also serve as cues for collection of knowledge particularly, knowledge of technical or programmatic challenges that might recur.

Development of a structured approach for decomposition of complex systems on a functional basis

NASA Astrophysics Data System (ADS)

Yildirim, Unal; Felician Campean, I.

2014-07-01

The purpose of this paper is to present the System State Flow Diagram (SSFD) as a structured and coherent methodology to decompose a complex system on a solution- independent functional basis. The paper starts by reviewing common function modelling frameworks in literature and discusses practical requirements of the SSFD in the context of the current literature and current approaches in industry. The proposed methodology is illustrated through the analysis of a case study: design analysis of a generic Bread Toasting System (BTS).

Air Force Geophysics Laboratory Management Information System Study.

DTIC Science & Technology

1985-11-01

management information system (MIS) at AFGL. The study summarizes current management and administrative practices at AFGL. Requirements have been identified for automating several currently manual functions to compile accurate and timely information to better manage and plan AFGL programs. This document describes the functions and relative priorities of five MIS subsystems and provides suggestions for implementation solutions. Creation of a detailed Development Plan is recommended as the follow-on task.

Three Collaborative Models for Scaling Up Evidence-Based Practices

PubMed Central

Roberts, Rosemarie; Jones, Helen; Marsenich, Lynne; Sosna, Todd; Price, Joseph M.

2015-01-01

The current paper describes three models of research-practice collaboration to scale-up evidence-based practices (EBP): (1) the Rolling Cohort model in England, (2) the Cascading Dissemination model in San Diego County, and (3) the Community Development Team model in 53 California and Ohio counties. Multidimensional Treatment Foster Care (MTFC) and KEEP are the focal evidence-based practices that are designed to improve outcomes for children and families in the child welfare, juvenile justice, and mental health systems. The three scale-up models each originated from collaboration between community partners and researchers with the shared goal of wide-spread implementation and sustainability of MTFC/KEEP. The three models were implemented in a variety of contexts; Rolling Cohort was implemented nationally, Cascading Dissemination was implemented within one county, and Community Development Team was targeted at the state level. The current paper presents an overview of the development of each model, the policy frameworks in which they are embedded, system challenges encountered during scale-up, and lessons learned. Common elements of successful scale-up efforts, barriers to success, factors relating to enduring practice relationships, and future research directions are discussed. PMID:21484449

CATV'S Critical Mass Problem.

ERIC Educational Resources Information Center

O'Neill, John J.

The basic premise of this report is that cable television systems, although currently based on subscriber fees, will eventually obtain their capital structure from advertising revenues. Because of this, the report maintains that market saturation must be the prime consideration, even though several currently common practices go against this and…

An Organizational Analysis of Special Education Reform.

ERIC Educational Resources Information Center

Skrtic, Thomas M.

The paper identifies current special education practice and the current organization of schools as instrumental in actually creating the category of mildly handicapped students. A dichotomy between departments of special education and educational administration is noted. Only replacement of the system with an entirely different configuration and…

Issues and Challenges Facing Flexible Lithium-Ion Batteries for Practical Application.

PubMed

Cha, Hyungyeon; Kim, Junhyeok; Lee, Yoonji; Cho, Jaephil; Park, Minjoon

2017-12-27

With the advent of flexible electronics, lithium-ion batteries have become a key component of high performance energy storage systems. Thus, considerable effort is made to keep up with the development of flexible lithium-ion batteries. To date, many researchers have studied newly designed batteries with flexibility, however, there are several significant challenges that need to be overcome, such as degradation of electrodes under external load, poor battery performance, and complicated cell preparation procedures. In addition, an in-depth understanding of the current challenges for flexible batteries is rarely addressed in a systematical and practical way. Herein, recent progress and current issues of flexible lithium-ion batteries in terms of battery materials and cell designs are reviewed. A critical overview of important issues and challenges for the practical application of flexible lithium-ion batteries is also provided. Finally, the strategies are discussed to overcome current limitations of the practical use of flexible lithium-based batteries, providing a direction for future research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach

PubMed Central

MONTANO, Diego

2016-01-01

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach. PMID:26860787

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

PubMed

Montano, Diego

2016-08-05

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

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

PubMed

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

2013-08-15

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

Marine Hydrokinetic (MHK) Systems: A Systems Engineering Approach to Select Locations for the Practical Harvest of Electricity from Shallow Water Tidal Currents

NASA Astrophysics Data System (ADS)

Domenech, John

Due to increasing atmospheric CO2 concentration and its effect on global climates, the United States Environmental Protection Agency (EPA) proposes a Clean Power Plan (CPP) mandating CO2 reductions which will likely force the early retirement of inefficient, aging power plants. Consequentially, removing these plants equates to a shortfall of approximately 66 GW of electricity. These factors add to the looming resource problems of choosing whether to build large replacement power plants or consider alternative energy sources as a means to help close the gap between electricity supply and demand in a given region. One energy source, shallow water tidal currents, represents opportunities to convert kinetic energy to mechanical forms and provide electricity to homes and businesses. Nearly 2,000 National Oceanic Atmospheric Administration (NOAA) tidal current data points from Maine to Texas are considered. This paper, based on systems engineering thinking, provides key attributes (e.g. turbine efficiency, array size, transmission losses) for consideration as decision makers seek to identify where to site Marine Hydrokinetic (MHK) systems and the number of homes powered by the practical harvest of electricity from tidal currents at those locations with given attributes. A systems engineering process model is proposed for consideration as is a regression based equation to estimate MHK machine parameters needed for power a given number of homes.

Assessment of the Orion-SLS Interface Management Process in Achieving the EIA 731.1 Systems Engineering Capability Model Generic Practices Level 3 Criteria

NASA Technical Reports Server (NTRS)

Jellicorse, John J.; Rahman, Shamin A.

2016-01-01

NASA is currently developing the next generation crewed spacecraft and launch vehicle for exploration beyond earth orbit including returning to the Moon and making the transit to Mars. Managing the design integration of major hardware elements of a space transportation system is critical for overcoming both the technical and programmatic challenges in taking a complex system from concept to space operations. An established method of accomplishing this is formal interface management. In this paper we set forth an argument that the interface management process implemented by NASA between the Orion Multi-Purpose Crew Vehicle (MPCV) and the Space Launch System (SLS) achieves the Level 3 tier of the EIA 731.1 System Engineering Capability Model (SECM) for Generic Practices. We describe the relevant NASA systems and associated organizations, and define the EIA SECM Level 3 Generic Practices. We then provide evidence for our compliance with those practices. This evidence includes discussions of: NASA Systems Engineering Interface (SE) Management standard process and best practices; the tailoring of that process for implementation on the Orion to SLS interface; changes made over time to improve the tailored process, and; the opportunities to take the resulting lessons learned and propose improvements to our institutional processes and best practices. We compare this evidence against the practices to form the rationale for the declared SECM maturity level.

Cracking the Code: Synchronizing Policy and Practice for Performance-Based Learning

ERIC Educational Resources Information Center

Patrick, Susan; Sturgis, Chris

2011-01-01

Performance-based learning is one of the keys to cracking open the assumptions that undergird the current educational codes, structures, and practices. By finally moving beyond the traditions of a time-based system, greater customized educational services can flourish, preparing more and more students for college and careers. This proposed policy…

Leveraging Observation Tools for Instructional Improvement: Exploring Variability in Uptake of Ambitious Instructional Practices

ERIC Educational Resources Information Center

Cohen, Julie; Schuldt, Lorien Chambers; Brown, Lindsay; Grossman, Pamela

2016-01-01

Background/Context: Current efforts to build rigorous teacher evaluation systems has increased interest in standardized classroom observation tools as reliable measures for assessing teaching. However, many argue these instruments can also be used to effect change in classroom practice. This study investigates a model of professional development…

Feminism Lives On: Incorporating Contemporary Feminism into Counseling Practice with Families and Youth

ERIC Educational Resources Information Center

Bordeau, Wendy Charkow; Briggs, Michele Kielty; Staton, A. Renee; Wasik, Suzan Zuljani

2008-01-01

Feminist contributions to counseling practice with families and children are reviewed, with a focus on the Third Wave feminist movement and its implications for family development and intervention. Recommendations for empowering young clients and their support systems as well as current challenges and research needs are also considered.

Use of Failure in IS Development Statistics: Lessons for IS Curriculum Design

ERIC Educational Resources Information Center

Longenecker, Herbert H., Jr.; Babb, Jeffry; Waguespack, Leslie; Tastle, William; Landry, Jeff

2016-01-01

The evolution of computing education reflects the history of the professional practice of computing. Keeping computing education current has been a major challenge due to the explosive advances in technologies. Academic programs in Information Systems, a long-standing computing discipline, develop and refine the theory and practice of computing…

Professional Development in the Digital Age: Case Studies of Blended Communities of Practice

ERIC Educational Resources Information Center

Wagner, Jennifer Michelle

2010-01-01

The need for sustainable, meaningful teacher professional development to support the rising professional demands remains an on-going challenge for education. The use of current technologies, such as online learning systems, to leverage the development of learning communities, including communities of practice (CoPs), where teachers with a common…

Accessibility-based evaluation of transportation and land-use planning : from laboratory to practice : USDOT Region V Regional University Transportation Center final report.

DOT National Transportation Integrated Search

2016-12-16

The concept of accessibility has made inroads into planning practice, largely at the system level. That is, accessibility is measured or modeled for current or future regional transportation and land-use scenarios for evaluation or broad policy guida...

From Dissemination to Propagation: A New Paradigm for Education Developers

ERIC Educational Resources Information Center

Froyd, Jeffrey E.; Henderson, Charles; Cole, Renée S.; Friedrichsen, Debra; Khatri, Raina; Stanford, Courtney

2017-01-01

Scholarly studies and national reports document failure of current efforts to achieve broad, sustained adoption of research-based instructional practices, despite compelling bodies of evidence supporting efficacy of many of these practices. The authors of this paper argue that many change agents who are working to promote systemic adoption of…

76 FR 13638 - Ensuring the Safety of Imported Foods and Animal Feed: Comparability of Food Safety Systems and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

... Practices of Foreign Countries; Public Hearing; Request for Comments AGENCY: Food and Drug Administration... regulators in other countries regarding the regulatory policies, practices, and programs they currently use to ensure the safety of foods and animal feed imported into their countries. In a separate notice...

Regional Information System for Educators: Installation and Evaluation.

ERIC Educational Resources Information Center

Kromer, Charles

This document describes the installation and evaluation of the Regional Information System within the Michigan-Ohio Regional Educational Laboratory (MOREL). MOREL is an agency established to develop and test alternatives to current educational practice under Title IV of ESEA. The Regional Information System was established to provide referrals to…

Mapping and monitoring potato cropping systems in Maine: geospatial methods and land use assessments

USDA-ARS?s Scientific Manuscript database

Geospatial frameworks and GIS-based approaches were used to assess current cropping practices in potato production systems in Maine. Results from the geospatial integration of remotely-sensed cropland layers (2008-2011) and soil datasets for Maine revealed a four-year potato systems footprint estima...

Four Pillars for Improving the Quality of Safety-Critical Software-Reliant Systems

DTIC Science & Technology

2013-04-01

Studies of safety-critical software-reliant systems developed using the current practices of build-then-test show that requirements and architecture ... design defects make up approximately 70% of all defects, many system level related to operational quality attributes, and 80% of these defects are

Development of reference practices for the calibration and validation of atmospheric composition satellites

NASA Astrophysics Data System (ADS)

Lambert, Jean-Christopher; Bojkov, Bojan

The Committee on Earth Observation Satellites (CEOS)/Working Group on Calibration and Validation (WGCV) is developing a global data quality strategy for the Global Earth Obser-vation System of Systems (GEOSS). In this context, CEOS WGCV elaborated the GEOSS Quality Assurance framework for Earth Observation (QA4EO, http://qa4eo.org). QA4EO en-compasses a documentary framework and a set of ten guidelines, which describe the top-level approach of QA activities and key requirements that drive the QA process. QA4EO is appli-cable virtually to all Earth Observation data. Calibration and validation activities are a cornerstone of the GEOSS data quality strategy. Proper uncertainty assessment of the satellite measurements and their derived data products is essential, and needs to be continuously monitored and traceable to standards. As a practical application of QA4EO, CEOS WGCV has undertaken to establish a set of best practices, methodologies and guidelines for satellite calibration and validation. The present paper reviews current developments of best practices and guidelines for the vali-dation of atmospheric composition satellites. Aimed as a community effort, the approach is to start with current practices that could be improved with time. The present review addresses current validation capabilities, achievements, caveats, harmonization efforts, and challenges. Terminologies and general principles of validation are reminded. Going beyond elementary def-initions of validation like the assessment of uncertainties, the specific GEOSS context requires considering also the validation of individual service components and against user requirements.

Air Vehicle Integration and Technology Research (AVIATR). Task Order 0003: Condition-Based Maintenance Plus Structural Integrity (CBM+SI) Demonstration (April 2011 to August 2011)

DTIC Science & Technology

2011-08-01

investigated. Implementation of this technology into the maintenance framework depends on several factors, including safety of the structural system, cost... Maintenance Parameters The F-15 Program has indicated that, in practice , maintenance actions are generally performed on flight hour multiples of 200...Risk Analysis or the Perform Cost Benefit Analysis sections of the flowchart. 4.6. Determine System Configurations The current maintenance practice

The personal receiving document management and the realization of email function in OAS

NASA Astrophysics Data System (ADS)

Li, Biqing; Li, Zhao

2017-05-01

This software is an independent software system, suitable for small and medium enterprises, contains personal office, scientific research project management and system management functions, independently run in relevant environment, and to solve practical needs. This software is an independent software system, using the current popular B/S (browser/server) structure and ASP.NET technology development, using the Windows 7 operating system, Microsoft SQL Server2005 Visual2008 and database as a development platform, suitable for small and medium enterprises, contains personal office, scientific research project management and system management functions, independently run in relevant environment, and to solve practical needs.

Functional Observational Battery Testing for Nervous System Effects of Drugs and Other Chemicals

EPA Science Inventory

Screening for behavioral toxicity, or neurotoxicity, has become standard practice in preclinical safety pharmacology and toxicology. Behavior represents the integrated sum of activities mediated by the nervous system. Current screening batteries, such as the functional observat...

AEIS Policy vs. Site-Based Management: Research Agenda Implications.

ERIC Educational Resources Information Center

Nash, John B.

This paper examines the problems of centralized academic-indicator systems in light of the move toward site-based management. Problems with current practice are examined in the framework of critical inquiry. Alternatives to current accountability guidelines are presented that harmonize positivism with critical inquiry, while respecting both local…

Sustainability in medicine.

PubMed

George, Ruth; Coffin, Janis; George, Sierra

2013-01-01

Given the current state of the U.S. healthcare system, with increasingly complicated regulations and paperwork and decreasing reimbursements, the question arises: Is it possible to provide safe, high-quality healthcare and reduce costs? Furthermore, is it possible to care for the health of your patients while simultaneously caring for the financial health of your practice and promoting improvement in the overall health of the planet? This article will review some steps currently being taken by various companies and hopefully stimulate ideas for changes you may want to consider for your own practice, hospital, or institution.

Coliform Bacteria Monitoring in Fish Systems: Current Practices in Public Aquaria.

PubMed

Culpepper, Erin E; Clayton, Leigh A; Hadfield, Catherine A; Arnold, Jill E; Bourbon, Holly M

2016-06-01

Public aquaria evaluate coliform indicator bacteria levels in fish systems, but the purpose of testing, testing methods, and management responses are not standardized, unlike with the coliform bacteria testing for marine mammal enclosures required by the U.S. Department of Agriculture. An online survey was sent to selected aquaria to document current testing and management practices in fish systems without marine mammals. The information collected included indicator bacteria species, the size and type of systems monitored, the primary purpose of testing, sampling frequency, test methods, the criteria for interpreting results, corrective actions, and management changes to limit human exposure. Of the 25 institutions to which surveys were sent, 19 (76%) responded. Fourteen reported testing for fecal indicator bacteria in fish systems. The most commonly tested indicator species were total (86%) and fecal (79%) coliform bacteria, which were detected by means of the membrane filtration method (64%). Multiple types and sizes of systems were tested, and the guidelines for testing and corrective actions were highly variable. Only three institutions performed additional tests to confirm the identification of indicator organisms. The results from this study can be used to compare bacterial monitoring practices and protocols in fish systems, as an aid to discussions relating to the accuracy and reliability of test results, and to help implement appropriate management responses. Received August 23, 2015; accepted December 29, 2015.

An Adverse Drug Event and Medication Error Reporting System for Ambulatory Care (MEADERS)

PubMed Central

Zafar, Atif; Hickner, John; Pace, Wilson; Tierney, William

2008-01-01

The Institute of Medicine (IOM) has identified the mitigation of Adverse Drug Events (ADEs) and Medication Errors (MEs) as top national priorities. Currently available reporting tools are fraught with inefficiencies that prevent widespread adoption into busy primary care practices. Using expert panel input we designed and built a new reporting tool that could be used in these settings with a variety of information technology capabilities. We pilot tested the system in four Practice Based Research Networks (PBRNs) comprising 24 practices. Over 10 weeks we recorded 507 reports, of which 370 were MEs and 137 were ADEs. Clinicians found the system easy to use, with the average time to generating a report under 4 minutes. By using streamlined interface design techniques we were successfully able to improve reporting rates of ADEs and MEs in these practices. PMID:18999053

THE MOVEMENT SYSTEM IN EDUCATION.

PubMed

Hoogenboom, Barbara J; Sulavik, Mark

2017-11-01

Although many physical therapists have begun to focus on movement and function in clinical practice, a significant number continue to focus on impairments or pathoanatomic models to direct interventions. This paradigm may be driven by the current models used to direct and guide curricula used for physical therapist education. The methods by which students are educated may contribute to a focus on independent systems, rather than viewing the body as a functional whole. Students who enter practice must be able to integrate information across multiple systems that affect a patient or client's movement and function. Such integration must be taught to students and it is the responsibility of those in physical therapist education to embrace and teach the next generation of students this identifying professional paradigm of the movement system. The purpose of this clinical commentary is to describe the current state of the movement system in physical therapy education, suggest strategies for enhancing movement system focus in entry level education, and envision the future of physical therapy education related to the movement system. Contributions by a student author offer depth and perspective to the ideas and suggestions presented. 5.

Update - Concept of Operations for Integrated Model-Centric Engineering at JPL

NASA Technical Reports Server (NTRS)

Bayer, Todd J.; Bennett, Matthew; Delp, Christopher L.; Dvorak, Daniel; Jenkins, Steven J.; Mandutianu, Sanda

2011-01-01

The increasingly ambitious requirements levied on JPL's space science missions, and the development pace of such missions, challenge our current engineering practices. All the engineering disciplines face this growth in complexity to some degree, but the challenges are greatest in systems engineering where numerous competing interests must be reconciled and where complex system level interactions must be identified and managed. Undesired system-level interactions are increasingly a major risk factor that cannot be reliably exposed by testing, and natural-language single-viewpoint specifications areinadequate to capture and expose system level interactions and characteristics. Systems engineering practices must improve to meet these challenges, and the most promising approach today is the movement toward a more integrated and model-centric approach to mission conception, design, implementation and operations. This approach elevates engineering models to a principal role in systems engineering, gradually replacing traditional document centric engineering practices.

Paradigm shifts: using a participatory leadership process to redesign health systems.

PubMed

Saleeby, Erin; Holschneider, Christine H; Singhal, Rita

2014-12-01

Physicians have increasingly given up private practices to become members of, and key stakeholders in, large healthcare systems. These systems are currently transforming to meet the Triple Aim: guaranteeing the equitable provision of high-quality, evidence-based care at a reasonable cost. Participatory leadership is an organizational change theory that engages key stakeholders as architects in the transformation process. This review highlights the utility of this leadership strategy in designing care for women's health. Our blueprint describing participatory leadership theory in women's health systems change is discussed in three case studies, highlighting what we call the six Ps of participatory leadership: participants, principles, purpose, process, and power. The 'sixth P', product, can then be substantially influential in changing the paradigm of care. Obstetrics and gynecology is increasingly practiced in large health systems responsible for the health of populations. Innovations in clinical practice impact care at the level of the individual. In order for advances in clinical practice to reach broad populations of women, they must be integrated into a delivery system. Physician engagement in leadership during this time of system transformation is of critical importance.

Practice of clinical forensic medicine in Sri Lanka: does it need a new era?

PubMed

Kodikara, Sarathchandra

2012-07-01

Clinical forensic medicine is a sub-specialty of forensic medicine and is intimately associated with the justice system of a country. Practice of clinical forensic medicine is evolving, but deviates from one jurisdiction to another. Most English-speaking countries practice clinical forensic medicine and forensic pathology separately while most non-English-speaking countries practice forensic medicine which includes clinical forensic medicine and forensic pathology. Unlike the practice of forensic pathology, several countries have informal arrangements to deal with forensic patients and there are no international standards of practice or training in this discipline. Besides, this is rarely a topic of discussion. In the adversarial justice system in Sri Lanka, the designated Government Medical Officers practice both clinical forensic medicine and forensic pathology. Practice of clinical forensic medicine, and its teaching and training in Sri Lanka depicts unique features. However, this system has not undergone a significant revision for many decades. In this communication, the existing legal framework, current procedure of practice, examination for drunkenness, investigations, structure of referrals, reports, subsequent legal procedures, undergraduate, in-service, and postgraduate training are discussed with suggestions for reforms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Values and principles evident in current health promotion practice.

PubMed

Gregg, Jane; O'Hara, Lily

2007-04-01

Modern health promotion practice needs to respond to complex health issues that have multiple interrelated determinants. This requires an understanding of the values and principles of health promotion. A literature review was undertaken to explore the values and principles evident in current health promotion theory and practice. A broad range of values and principles are espoused as being integral to modern health promotion theory and practice. Although there are some commonalities across these lists, there is no recognised, authoritative set of values and principles accepted as fundamental and applicable to modern health promotion. There is a continuum of values and principles evident in health promotion practice from those associated with holistic, ecological, salutogenic health promotion to those more in keeping with conventional health promotion. There is a need for a system of values and principles consistent with modern health promotion that enables practitioners to purposefully integrate these values and principles into their understanding of health, as well as their needs assessment, planning, implementation and evaluation practice.

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, DMS Industry Survey

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

Singh, Ravindra; Uluski, Robert; Reilly, James T.

The objective of this survey is to benchmark current practices for DMS implementation to serve as a guide for future system implementations. The survey sought information on current plans to implement DMS, DMS functions of interest, implementation challenges, functional benefits achieved, and other relevant information. These survey results were combined (where possible) with results of similar surveys conducted in the previous four years to observe trends over time.

Tailoring advanced technologies for air traffic control : the importance of the development process

DOT National Transportation Integrated Search

1995-04-01

This paper describes a process that is currently being applied to the : development and assessment of an advanced air traffic control (ATC) system, the : Center TRACON Automation System (CTAS). This process deviates from established : practices of AT...

The Role of System Analysis in Education Management: A Pragmatic Appraisal and a New Perspective.

ERIC Educational Resources Information Center

Evans, John A.

This paper explores the potential of systems analysis for the educational manager. It contains a review of systems concepts with comments on current and proper practice. An application model of systems analysis in an organizational context is provided to foster rational decisionmaking and increased skill in problem finding and solving. The…

Are hospital quality improvement and public accountability compatible?

PubMed

Panzer, R J

1994-07-01

The goals of public accountability and quality improvement are compatible in theory but not necessarily in practice. Both concepts emphasize the customer. However, those working toward these two goals design systems with quite different roles and relationships between the providers and consumers of health care. Superficial interactions obstruct meaningful dialogue about how to build a better system meeting both sets of goals. Current practices of public accountability and quality improvement have fundamentally different paradigms concerning the roles and responsibilities of those who provide and those who consume health care. There are at least three ways to improve the current relationship between public accountability and quality improvement. First, optimizing the design and performance of each effort would be an improvement since the goals are highly compatible. Neither ideal currently meets its own expectations, creating distrust among the proponents of each when reality falls short. Second, the two efforts could be coordinated through joint community-level planning and sharing. Finally and optimally, the two concepts could be made part of the same community-level cooperative system, an approach that offers the greatest opportunity for achieving shared goals.

Topical vs. systemic treatments for acute otitis media.

PubMed

Thornton, Kathy; Parrish, Francie; Swords, Christine

2011-01-01

Acute otitis media (AOM) is a common condition in children that is often treated with systemic antibiotic therapy; however, research suggests that non-complicated AOM will resolve spontaneously using only eardrops. To determine best practice for the use of systematic antibiotics compared to topical treatment of AOM, a systematic review of evidence was conducted. Cochrane, Medline, CINAHL, and other databases were searched. Inclusion criteria were studies published from 1995-2010 that included children with AOM and were randomized controlled trials (RCTs). Five systematic reviews and five RCTs were included in the review. Current evidence recommends using topical and other alternative approaches for treating non-complicated AOM in children 2 years of age or older; however, many practitioners are not currently following these recommendations for various reasons. Additional research to address these reasons may help determine how to improve practitioner adherence to best practice evidence and guidelines to help reduce the unnecessary use of systemic antibiotics.

Adoption of electronic health records and preparations for demonstrating meaningful use: an American Academy of Ophthalmology survey.

PubMed

Boland, Michael V; Chiang, Michael F; Lim, Michele C; Wedemeyer, Linda; Epley, K David; McCannel, Colin A; Silverstone, David E; Lum, Flora

2013-08-01

To assess the current state of electronic health record (EHR) use by ophthalmologists, including adoption rate, user satisfaction, functionality, benefits, barriers, and knowledge of meaningful use criteria. Population-based, cross-sectional study. A total of 492 members of the American Academy of Ophthalmology (AAO). A random sample of 1500 AAO members were selected on the basis of their practice location and solicited to participate in a study of EHR use, practice management, and image management system use. Participants completed the survey via the Internet, phone, or fax. The survey included questions about the adoption of EHRs, available functionality, benefits, barriers, satisfaction, and understanding of meaningful use criteria and health information technology concepts. Current adoption rate of EHRs, user satisfaction, benefits and barriers, and availability of EHR functionality. Overall, 32% of the practices surveyed had already implemented an EHR, 15% had implemented an EHR for some of their physicians or were in the process of implementation, and another 31% had plans to do so within 2 years. Among those with an EHR in their practice, 49% were satisfied or extremely satisfied with their system, 42% reported increased or stable overall productivity, 19% reported decreased or stable overall costs, and 55% would recommend an EHR to a fellow ophthalmologist. For those with an electronic image management system, only 15% had all devices integrated, 33% had images directly uploaded into their system, and 12% had electronic association of patient demographics with the image. The adoption of EHRs by ophthalmology practices more than doubled from 2007 to 2011. The satisfaction of ophthalmologists with their EHR and their perception of beneficial effects on productivity and costs were all lower in 2011 than in 2007. Knowledge about meaningful use is high, but the percentage of physicians actually receiving incentive payments is relatively low. Given the importance of imaging in ophthalmology, the shortcomings in current image management systems need to be addressed. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Medical Home Implementation: A Sensemaking Taxonomy of Hard and Soft Best Practices

PubMed Central

Hoff, Timothy

2013-01-01

Context The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. Methods I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. Findings I found two distinct taxonomies of implementation best practices, which I labeled “hard” and “soft” because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. Conclusions The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. PMID:24320169

Struggle with School Absenteeism in Compulsory Education: Different Country Approaches and Policies

ERIC Educational Resources Information Center

Akbasli, Sait; Sahin, Mehmet; Yilmaz, St. Pinar Mardin

2017-01-01

This research has been conducted to discuss the absenteeism in compulsory education and the proposed policies for reducing this problem with the school practices. In this context, the general situation regarding the absenteeism in the Turkish education system has been put forward and the current practices and policies have been addressed.…

Creative Convergence in Practice and Its Effects on Higher Education: A Mixed-Methods, Neopragmatist Study Examining Media Arts

ERIC Educational Resources Information Center

Rosner, Terre Layng

2017-01-01

This study is a mixed-methods, neopragmatist examination of the systems currently being practiced in creative professional companies and the consequential changes in Higher Education Media Arts curricula, supporting a kind of meta-disciplinary pedagogy emerging from the pressures of content and device convergence in industry. The research…

Interactive-GIS-Tutor (IGIST) Integration: Creating a Digital Space Gateway within a Textbook-Bound South African Geography Class

ERIC Educational Resources Information Center

Fleischmann, E. M-L.; van der Westhuizen, C. P.; Cilliers, D.

2015-01-01

Currently there is a global drive among political and educational institutions to implement geographic information system (GIS) practice in secondary schools. However, Geography teachers worldwide, including in South Africa, face significant practical challenges in this regard. Lack of curriculum aligned GIS resources, funds and teacher GIS…

How Does a School Leader's Role Influence Student Achievements? A Review of Research Findings and Best Practices

ERIC Educational Resources Information Center

Gamage, David; Adams, Don; McCormack, Ann

2009-01-01

Currently, school systems around the globe are focusing on student achievements empowering school leaders along with curriculum and accountability frameworks. This paper focuses on a comprehensive review of literature on the role of school leadership towards improving student achievements based on research findings and best practices. It refers to…

Faculty Issues Pertaining to Institutional Support and Reward Practices in Distance Education.

ERIC Educational Resources Information Center

Wolcott, Linda L.

This paper presents an overview of eight issues that are central to the discussion of distance education and its relationship to institutional support and reward systems. Each section provides a brief description of the issue and a summary of what is currently known about reward practices and policies in distance education. The issues discussed…

Drug samples: friend or foe?

PubMed

Coolidge, Melvin P

2002-07-01

The common practice of drug manufacturers in providing 'free' samples to physicians has influenced the business of medicine in several ways. This article analyzes some of the pros and cons of drug sampling, including from professional, societal, economical, legal, and practical perspectives, and provides suggestions on how to dispense with some of the problems inherent in the current system.

An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

PubMed

McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

2018-05-01

This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and interprofessional collaboration.

Transition to Family Practice in Turkey

ERIC Educational Resources Information Center

Gunes, Evrim Didem; Yaman, Hakan

2008-01-01

Introduction: Turkey's primary health care (PHC) system was established in the beginning of the 1960s and provides preventive and curative basic medical services to the population. This article describes the experience of the Turkish health system, as it tries to adapt to the European health system. It describes the current organization of primary…

Inclusive Education in Sweden? A Critical Analysis

ERIC Educational Resources Information Center

Goransson, Kerstin; Nilholm, Claes; Karlsson, Kristina

2011-01-01

When it comes to pupils in need of special support and pupils with disabilities, Sweden's compulsory school system is sometimes considered a one-track system. This article analyses and critically discusses current policy and practices at various levels of Sweden's compulsory school system for these pupils. The analysis traces three themes at the…

Discrepancies between Ideal Characteristics of a Property Tax System and Current Practice in New York.

ERIC Educational Resources Information Center

Netzer, Dick; Berne, Robert

1995-01-01

Ideally, voters' and state legislatures' policy choices should underlie a property tax system that is straightforward, comprehensible, systematic, and reasonably related to policy objectives. Administration should be uniform and fair. New York State's property tax system lacks a uniform valuation standard and "circuit breaker" and has…

40 CFR 420.12 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... best practicable control technology currently available. (a) By-product cokemaking—iron and steel... for by-product coke plants which have wet desulfurization systems but only to the extent such systems... limitations, are allowed for by-product coke plants which include indirect ammonia recovery systems but only...

Manufacturing waste disposal practices of the chemical propulsion industry

NASA Technical Reports Server (NTRS)

Goldberg, Benjamin E.; Adams, Daniel E.; Schutzenhofer, Scott A.

1995-01-01

The waste production, mitigation and disposal practices of the United States chemical propulsion industry have been investigated, delineated, and comparatively assessed to the U.S. industrial base. Special emphasis has been placed on examination of ozone depleting chemicals (ODC's). The research examines present and anticipated future practices and problems encountered in the manufacture of solid and liquid propulsion systems. Information collected includes current environmental laws and regulations that guide the industry practices, processes in which ODC's are or have been used, quantities of waste produced, funding required to maintain environmentally compliant practices, and preventive efforts.

Developing Practice Guidelines for Psychoanalysis

PubMed Central

GRAY, SHEILA HAFTER

1996-01-01

Consensus-based practice guidelines codify clinical intelligence and the rich oral tradition in medicine. Because they reflect actual practice, they are readily accepted by clinicians as a basis for external review. This article illustrates the development of guidelines for a psychoanalytic approach to the large pool of patients who present with a depression. It suggests an integrated biopsychosocial approach to these individuals that is useful in current practice, and it offers propositions that may be tested in future research undertakings. Eventually, practice guidelines such as these may form the basis of economical systems of health care that avoid arbitrary, clinically untenable limitations on services. PMID:22700290

Report on Financing the New Model of Family Medicine

PubMed Central

Spann, Stephen J.

2004-01-01

PURPOSE To foster redesigning the work and workplaces of family physicians, this Future of Family Medicine task force was created to formulate and recommend a financial model that sustains and promotes a thriving New Model of care by focusing on practice reimbursement and health care finances. The goals of the task force were to develop a financial model that assesses the impact of the New Model on practice finances, and to recommend health care financial policies that, if implemented, would be expected to promote the New Model and the primary medical care function in the United States for the next few decades. METHODS The members of the task force reflected a wide range of professional backgrounds and expertise. The group met in person on 2 occasions and communicated by e-mail and conference calls to achieve consensus. A marketing study was carried out using focus groups to test the concept of the New Model with consumers. External consultants with expertise in health economics, health care finance, health policy, and practice management were engaged to assist the task force with developing the microeconomic (practice level) and macroeconomic (societal level) financial models necessary to achieve its goals. Model assumptions were derived from the published medical literature, existing practice management databases, and discussions with experienced physicians and other content experts. The results of the financial modeling exercise are included in this report. The initial draft report of the findings and recommendations was shared with a reactor panel representing a broad spectrum of constituencies. Feedback from these individuals was reviewed and incorporated, as appropriate, into the final report. RESULTS The practice-level financial model suggests that full implementation of the New Model of care within the current fee-for-service system of reimbursement would result in a 26% increase in compensation (from $167,457 to $210,288 total annual compensation) for prototypical family physicians who maintain their current number of work hours. Alternatively, physicians could choose to decrease their work hours by 12% and maintain their current compensation. This result is sensitive to physician practice group size. The societal level financial model shows that modifications in the current reimbursement system could lead to further improvements in compensation for family physicians practicing the New Model of care. Reimbursement for e-visits and chronic disease management could further increase total annual compensation to $229,849 for prototypical family physicians maintaining their current number of work hours. The widespread introduction of quality-based physician incentive bonus payments similar to some current programs that have been implemented on a limited basis could further increase total annual compensation up to $254,500. The adoption of a mixed reimbursement model, which would add an annual per-patient fee, a chronic care bonus, and an overall performance bonus to the current reimbursement system, could increase total annual compensation for the prototypical family physician continuing the current number of hours worked to as much as $277,800, a 66% increase above current compensation levels. The cost of transition to the New Model is estimated to range from $23,442 to $90,650 per physician, depending on the assumed magnitude of productivity loss associated with implementing an electronic health record. The financial impact of enhanced use of primary care on the costs of health care in the United States was estimated. If every American used a primary care physician as their usual source of care, health care costs would likely decrease by 5.6%, resulting in national savings of $67 billion dollars per year, with an improvement in the quality of the health care provided. CONCLUSIONS Family physicians could use New Model efficiency to increase compensation or to reduce work time. There are alternative reimbursement methodologies compatible with the New Model that would allow family physicians to share in the health care cost savings achieved as a result of effective and efficient delivery of care. The New Model of care should enhance health care while propelling the US system toward improved performance and results that are satisfying to patients, health care professionals, purchasers, and payers. The New Model needs to be implemented now. Given the recognized need for improvements in the US health care system in the areas of quality, safety, access and costs, there is no reason to delay. PMID:15654084

Report on financing the new model of family medicine.

PubMed

Spann, Stephen J

2004-12-02

To foster redesigning the work and workplaces of family physicians, this Future of Family Medicine task force was created to formulate and recommend a financial model that sustains and promotes a thriving New Model of care by focusing on practice reimbursement and health care finances. The goals of the task force were to develop a financial model that assesses the impact of the New Model on practice finances, and to recommend health care financial policies that, if implemented, would be expected to promote the New Model and the primary medical care function in the United States for the next few decades. The members of the task force reflected a wide range of professional backgrounds and expertise. The group met in person on 2 occasions and communicated by e-mail and conference calls to achieve consensus. A marketing study was carried out using focus groups to test the concept of the New Model with consumers. External consultants with expertise in health economics, health care finance, health policy, and practice management were engaged to assist the task force with developing the microeconomic (practice level) and macroeconomic (societal level) financial models necessary to achieve its goals. Model assumptions were derived from the published medical literature, existing practice management databases, and discussions with experienced physicians and other content experts. The results of the financial modeling exercise are included in this report. The initial draft report of the findings and recommendations was shared with a reactor panel representing a broad spectrum of constituencies. Feedback from these individuals was reviewed and incorporated, as appropriate, into the final report. The practice-level financial model suggests that full implementation of the New Model of care within the current fee-for-service system of reimbursement would result in a 26% increase in compensation (from 167,457 dollars to 210,288 dollars total annual compensation) for prototypical family physicians who maintain their current number of work hours. Alternatively, physicians could choose to decrease their work hours by 12% and maintain their current compensation. This result is sensitive to physician practice group size. The societal level financial model shows that modifications in the current reimbursement system could lead to further improvements in compensation for family physicians practicing the New Model of care. Reimbursement for e-visits and chronic disease management could further increase total annual compensation to 229,849 dollars for prototypical family physicians maintaining their current number of work hours. The widespread introduction of quality-based physician incentive bonus payments similar to some current programs that have been implemented on a limited basis could further increase total annual compensation up to 254,500 dollars. The adoption of a mixed reimbursement model, which would add an annual per-patient fee, a chronic care bonus, and an overall performance bonus to the current reimbursement system, could increase total annual compensation for the prototypical family physician continuing the current number of hours worked to as much as 277,800 dollars, a 66% increase above current compensation levels. The cost of transition to the New Model is estimated to range from 23,442 dollars to 90,650 dollars per physician, depending on the assumed magnitude of productivity loss associated with implementing an electronic health record. The financial impact of enhanced use of primary care on the costs of health care in the United States was estimated. If every American used a primary care physician as their usual source of care, health care costs would likely decrease by 5.6%, resulting in national savings of 67 billion dollars per year, with an improvement in the quality of the health care provided. Family physicians could use New Model efficiency to increase compensation or to reduce work time. There are alternative reimbursement methodologies compatible with the New Model that would allow family physicians to share in the health care cost savings achieved as a result of effective and efficient delivery of care. The New Model of care should enhance health care while propelling the US system toward improved performance and results that are satisfying to patients, health care professionals, purchasers, and payers. The New Model needs to be implemented now. Given the recognized need for improvements in the US health care system in the areas of quality, safety, access and costs, there is no reason to delay.

The utility of an online diagnostic decision support system (Isabel) in general practice: a process evaluation.

PubMed

Henderson, Emily J; Rubin, Greg P

2013-05-01

To evaluate the utility of Isabel, an online diagnostic decision support system developed by Isabel Healthcare primarily for secondary medical care, in the general practice setting. Focus groups were conducted with clinicians to understand why and how they used the system. A modified online post-use survey asked practitioners about its impact on their decision-making. Normalization process theory (NPT) was used as a theoretical framework to determine whether the system could be incorporated into routine clinical practice. The system was introduced by NHS County Durham and Darlington in the UK in selected general practices as a three-month pilot. General practitioners and nurse practitioners who had access to Isabel as part of the Primary Care Trust's pilot. General practitioners' views, experiences and usage of the system. Seven general practices agreed to pilot Isabel. Two practices did not subsequently use it. The remaining five practices conducted searches on 16 patients. Post-use surveys (n = 10) indicated that Isabel had little impact on diagnostic decision-making. Focus group participants stated that, although the diagnoses produced by Isabel in general did not have an impact on their decision-making, they would find the tool useful if it were better tailored to the primary care setting. Our analysis concluded that normalization was not likely to occur in its current form. Isabel was of limited utility in this short pilot study and may need further modification for use in general practice.

Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

PubMed

Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

2006-01-01

At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

Applying a knowledge translation model to the uptake of the Baby Friendly Health Initiative in the Australian health care system.

PubMed

Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

2014-06-01

The Baby Friendly Hospital Initiative is a global, evidence-based, public health initiative. The evidence underpinning the Initiative supports practices promoting the initiation and maintenance of breastfeeding and encourages women's informed infant feeding decisions. In Australia, where the Initiative is known as the Baby Friendly Health Initiative (BFHI) the translation of evidence into practice has not been uniform, as demonstrated by a varying number of maternity facilities in each State and Territory currently accredited as 'baby friendly'. This variance has persisted regardless of BFHI implementation in Australia gaining 'in principle' support at a national and governmental level as well as inclusion in health policy in several states. There are many stakeholders that exert an influence on policy development and health care practices. Identify a theory and model to examine where and how barriers occur in the gap between evidence and practice in the uptake of the BFHI in Australia. Knowledge translation theory and the research to practice pipeline model are used to examine the identified barriers to BFHI implementation and accreditation in Australia. Australian and international studies have identified similar issues that have either enabled implementation of the BFHI or acted as a barrier. Knowledge translation theory and the research to practice pipeline model is of practical value to examine barriers. Recommendations in the form of specific targeted strategies to facilitate knowledge transfer and supportive practices into the Australian health care system and current midwifery practice are included. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Expert system verification and validation study. Phase 2: Requirements identification. Delivery 1: Updated survey report

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to report the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of Expert Systems.

Total Water Management, the New Paradigm for Urban Water Systems

EPA Science Inventory

There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current resource management practices put different stresses on local water resources and urban infrastructure. Total Water Manag...

Evaluation of Project Processes in Relation to Transportation System Management and Operations (TSM&O)

DOT National Transportation Integrated Search

2018-01-01

This study was conducted to explore the current state-of-the-practice of Transportation Systems Management and Operations (TSM&O) in the Florida Department of Transportation (FDOT) and determine what would be required to mainstream TSM&O throughout t...

Evaluation of eddy-current proximity devices for measuring thin potassium film thicknesses

NASA Technical Reports Server (NTRS)

Asadourian, A. S.

1972-01-01

Two eddy current proximity probe systems were tested over a range of 0 to 508 micrometers (0 to 20 mils) of simulated potassium film thicknesses for simulated temperatures of 66 C (150 F), 232 C (450 F), and 666 C (1230 F). The results of short time calibration tests are presented. Instrument drift was a problem throughout the testing and, without correction, may limit the use of such systems to short periods of time. Additional development will be required prior to their being usable as practical instrumentation systems.

Evaluation in New Jersey Education: A Survey of Present Practices and Recommendations for Future Action.

ERIC Educational Resources Information Center

Pinkowski, Francis; And Others

Current evaluation activities in the New Jersey school system are surveyed, and recommendations for future evaluation efforts are made. The current activities and future developments of school (or school district), statewide, and project (or program) evaluation are discussed individually. The following program objectives are suggested: to raise…

Who Says You Need to Teach Reading to 11-13-Year-Olds?

ERIC Educational Resources Information Center

Parkhill, Faye Fiona; Fletcher, Jo Florence; Greenwood, Janinka; Grimley, Michael; Bridges, Sue

2013-01-01

Research indicates that as students move through the school system, many begin to experience difficulties with reading. With this mind, this study explored current practices and perceptions about reading programmes for 11-13-year-old students in New Zealand schools. The study employed an online survey designed to investigate current reading…

Kinship Care: Improving Practice through Research.

ERIC Educational Resources Information Center

Gleeson, James P., Ed.; Hairston, Creasie Finney, Ed.

Family members have traditionally provided kinship care for each other in times of crisis. Recently, such care has become part of the child welfare system. This edited volume presents several studies designed to identify current knowledge about kinship care as a child welfare service. Presented in five parts, the book summarizes the current state…

The opinion of Turkish cardiologists on current malpractice system and an alternative patient compensation system proposal: PCS study group.

PubMed

Olcay, Ayhan; Emren, Sadık Volkan; Babür Güler, Gamze; Güler, Ekrem; Ertunç, Vedat; Berilgen, Rida; Aslan, Abdullah; Şimşek, Ersin Çağrı; Gölcük, Şükriye Ebru; Yalın, Kıvanç

2017-10-01

Cardiologists participate in the diagnosis and interventional treatment of numerous high-risk patients. The goal of this study was to investigate how the current malpractice system in Turkey influences cardiologists' diagnostic and interventional behavior and to obtain their opinions about an alternative patient compensation system. The present cross-sectional study assessed the practice of defensive medicine among cardiologists who are actively working in various types of workplace within the Turkish healthcare system. A 24-item questionnaire was distributed to cardiology residents, specialists, and academics in Turkey in print format, by electronic mail, or via cell phone message. A total of 253 cardiologists responded to the survey. Among them, 29 (11.6%) had been sued for malpractice claims in the past. Of the cardiologists who had been sued, 2 (6.9%) had been ordered to pay financial compensation, and 1 (3.4%) was given a sentence of imprisonment due to negligence. In all, 132 (52.8%) of the surveyed cardiologists reported that they had changed their practices due to fear of litigation, and 232 (92.8%) reported that they would prefer the new proposed patient compensation system to the current malpractice system. Among the cardiologists surveyed, 78.8% indicated that malpractice fear had affected their decision-making with regard to requesting computed tomography angiography or thallium scintigraphy, 71.6% for coronary angiography, 20% for stent implantation, and 83.2% for avoiding treating high-risk patients. The results of this survey demonstrated that cardiologists may request unnecessary tests and perform unneeded interventions due to the fear of malpractice litigation fear. Many also avoid high-risk patients and interventions. The majority indicated that they would prefer the proposed alternative patient compensation system to the current malpractice system.

Interpretation of Landscape Scale SWAT Model Outputs in the Western Lake Erie Basin: Potential Implications for Conservation Decision-Making

NASA Astrophysics Data System (ADS)

Johnson, M. V. V.; Behrman, K. D.; Atwood, J. D.; White, M. J.; Norfleet, M. L.

2017-12-01

There is substantial interest in understanding how conservation practices and agricultural management impact water quality, particularly phosphorus dynamics, in the Western Lake Erie Basin (WLEB). In 2016, the US and Canada accepted total phosphorus (TP) load targets recommended by the Great Lakes Water Quality Agreement Annex 4 Objectives and Targets Task Team; these were 6,000 MTA delivered to Lake Erie and 3,660 MTA delivered to WLEB. Outstanding challenges include development of metrics to determine achievement of these goals, establishment of sufficient monitoring capacity to assess progress, and identification of appropriate conservation practices to achieve the most cost-effective results. Process-based modeling can help inform decisions to address these challenges more quickly than can system observation. As part of the NRCS-led Conservation Effects Assessment Project (CEAP), the Soil Water Assessment Tool (SWAT) was used to predict impacts of conservation practice adoption reported by farmers on TP loss and load delivery dynamics in WLEB. SWAT results suggest that once the conservation practices in place in 2003-06 and 2012 are fully functional, TP loads delivered to WLEB will average 3,175 MTA and 3,084 MTA, respectively. In other words, SWAT predicts that currently adopted practices are sufficient to meet Annex 4 TP load targets. Yet, WLEB gauging stations show Annex 4 goals are unmet. There are several reasons the model predictions and current monitoring efforts are not in agreement: 1. SWAT assumes full functionality of simulated conservation practices; 2. SWAT does not simulate changing management over time, nor impacts of past management on legacy loads; 3. SWAT assumes WLEB hydrological system equilibrium under simulated management. The SWAT model runs used to construct the scenarios that informed the Annex 4 targets were similarly constrained by model assumptions. It takes time for a system to achieve equilibrium when management changes and it takes time for monitoring efforts to measure meaningful changes over time. Careful interpretation of model outputs is imperative for appropriate application of current scientific knowledge to inform decision making, especially when models are used to set spatial and temporal goals around conservation practice adoption and water quality.

Reasoning and Data Representation in a Health and Lifestyle Support System.

PubMed

Hanke, Sten; Kreiner, Karl; Kropf, Johannes; Scase, Marc; Gossy, Christian

2017-01-01

Case-based reasoning and data interpretation is an artificial intelligence approach that capitalizes on past experience to solve current problems and this can be used as a method for practical intelligent systems. Case-based data reasoning is able to provide decision support for experts and clinicians in health systems as well as lifestyle systems. In this project we were focusing on developing a solution for healthy ageing considering daily activities, nutrition as well as cognitive activities. The data analysis of the reasoner followed state of the art guidelines from clinical practice. Guidelines provide a general framework to guide clinicians, and require consequent background knowledge to become operational, which is precisely the kind of information recorded in practice cases; cases complement guidelines very well and helps to interpret them. It is expected that the interest in case-based reasoning systems in the health.

Environmental management practices and engineering science: a review and typology for future research.

PubMed

Evangelinos, Konstantinos I; Allan, Stuart; Jones, Keith; Nikolaou, Ioannis E

2014-04-01

Current literature describes a number of environmental management practices and cleaner production methods that facilitate different industrial sectors to address their various environmental impacts. The high number of present practices makes their use especially difficult and complicated. This paper aims to shed light on this field by providing a typology of those environmental management practices (such as environmental management systems, environmental indicators assessment methodologies, and cleaner productions methods) and their limitations. It also describes the strengths and weaknesses of using such tools and thoughts for future research. © 2013 SETAC.

Does an activity based remuneration system attract young doctors to general practice?

PubMed Central

2012-01-01

Background The use of increasingly complex payment schemes in primary care may represent a barrier to recruiting general practitioners (GP). The existing Norwegian remuneration system is fully activity based - 2/3 fee-for-service and 1/3 capitation. Given that the system has been designed and revised in close collaborations with the medical association, it is likely to correspond - at least to some degree - with the preferences of current GPs (men in majority). The objective of this paper was to study which preferences that young doctors (women in majority), who are the potential entrants to general practice have for activity based vs. salary based payment systems. Methods In November-December 2010 all last year medical students and all interns in Norway (n = 1.562) were invited to participate in an online survey. The respondents were asked their opinion on systems of remuneration for GPs; inclination to work as a GP; risk attitude; income preferences; work pace tolerance. The data was analysed using one-way ANOVA and multinomial logistic regression analysis. Results A total of 831 (53%) responded. Nearly half the sample (47%) did not consider the remuneration system to be important for their inclination to work as GP; 36% considered the current system to make general practice more attractive, while 17% considered it to make general practice less attractive. Those who are attracted by the existing system were men and those who think high income is important, while those who are deterred by the system are risk averse and less happy with a high work pace. On the question of preferred remuneration system, half the sample preferred a mix of salary and activity based remuneration (the median respondent would prefer a 50/50 mix). Only 20% preferred a fully activity based system like the existing one. A salary system was preferred by women, and those less concerned with high income, while a fully activity based system was preferred by men, and those happy with a high work pace. Conclusions Given a concern about low recruitment to general practice in Norway, and the fact that an increasing share of medical students is women, we were interested in the extent to which the current Norwegian remuneration system correspond with the preferences of potential GPs. This study suggests that an existing remuneration mechanism has a selection effect on who would like to become a GP. Those most attracted are income motivated men. Those deterred are risk averse, and less happy with a high work pace. More research is needed on the extent to which experienced GPs differ along the questions we asked potential GPs, as well as studying the relative importance of other attributes than payment schemes. PMID:22433750

Expert system verification and validation survey, delivery 4

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Equipment management risk rating system based on engineering endpoints.

PubMed

James, P J

1999-01-01

The equipment management risk ratings system outlined here offers two significant departures from current practice: risk classifications are based on intrinsic device risks, and the risk rating system is based on engineering endpoints. Intrinsic device risks are categorized as physical, clinical and technical, and these flow from the incoming equipment assessment process. Engineering risk management is based on verification of engineering endpoints such as clinical measurements or energy delivery. This practice eliminates the ambiguity associated with ranking risk in terms of physiologic and higher-level outcome endpoints such as no significant hazards, low significance, injury, or mortality.

Expert system verification and validation survey. Delivery 2: Survey results

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and industry applications. This is the first task of the series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Expert system verification and validation survey. Delivery 5: Revised

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Expert system verification and validation survey. Delivery 3: Recommendations

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

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

PubMed Central

2013-01-01

Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular disease, Cushing’s syndrome, psychiatric disturbances and immunosuppression are among the more serious side effects noted with systemic corticosteroid therapy, particularly when used at high doses for prolonged periods. This comprehensive article reviews these adverse events and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors. PMID:23947590

From theory to practice: what drives the core business of public health?

PubMed

Smith, Tina Anderson; Minyard, Karen J; Parker, Christopher A; Van Valkenburg, Rachel Ferencik; Shoemaker, John A

2007-01-01

In 1994, the Public Health Functions Steering Committee proffered a description of the Essential Public Health Services (Essential Services). Questions remain, however, about the relationship between the roles defined therein and current public health practice at state and local levels. This case study describes the core business of public health in Georgia relative to the theoretical ideal and elucidates the primary drivers of the core business, thus providing data to inform future efforts to strengthen practice in the state. The principal finding was that public health in Georgia is not aligned with the Essential Services. Further analysis revealed that the primary drivers or determinants of public health practice are finance-related rather than based in need or strategy, precluding an integrated and intentional focus on health improvement. This case study provides a systems context for public health financing discussions, suggests leverage points for public health system change, and furthers the examination of applications for systems thinking relative to public health finance, practice, and policy.

21 CFR 886.1665 - Ophthalmic rotary prism.

Code of Federal Regulations, 2014 CFR

2014-04-01

... used to measure ocular deviation in patients with latent or manifest strabismus (eye muscle deviation... also exempt from the current good manufacturing practice requirements of the quality system regulation...

21 CFR 886.1665 - Ophthalmic rotary prism.

Code of Federal Regulations, 2013 CFR

2013-04-01

... used to measure ocular deviation in patients with latent or manifest strabismus (eye muscle deviation... also exempt from the current good manufacturing practice requirements of the quality system regulation...

21 CFR 886.1665 - Ophthalmic rotary prism.

Code of Federal Regulations, 2012 CFR

2012-04-01

... used to measure ocular deviation in patients with latent or manifest strabismus (eye muscle deviation... also exempt from the current good manufacturing practice requirements of the quality system regulation...

21 CFR 886.1665 - Ophthalmic rotary prism.

Code of Federal Regulations, 2010 CFR

2010-04-01

... used to measure ocular deviation in patients with latent or manifest strabismus (eye muscle deviation... also exempt from the current good manufacturing practice requirements of the quality system regulation...

21 CFR 886.1665 - Ophthalmic rotary prism.

Code of Federal Regulations, 2011 CFR

2011-04-01

... used to measure ocular deviation in patients with latent or manifest strabismus (eye muscle deviation... also exempt from the current good manufacturing practice requirements of the quality system regulation...

[Artificial intelligence--the knowledge base applied to nephrology].

PubMed

Sancipriano, G P

2005-01-01

The idea that efficacy efficiency, and quality in medicine could not be reached without sorting the huge knowledge of medical and nursing science is very common. Engineers and computer scientists have developed medical software with great prospects for success, but currently these software applications are not so useful in clinical practice. The medical doctor and the trained nurse live the 'information age' in many daily activities, but the main benefits are not so widespread in working activities. Artificial intelligence and, particularly, export systems charm health staff because of their potential. The first part of this paper summarizes the characteristics of 'weak artificial intelligence' and of expert systems important in clinical practice. The second part discusses medical doctors' requirements and the current nephrologic knowledge bases available for artificial intelligence development.

Current status of the joint Mayo Clinic-IBM PACS project

NASA Astrophysics Data System (ADS)

Hangiandreou, Nicholas J.; Williamson, Byrn, Jr.; Gehring, Dale G.; Persons, Kenneth R.; Reardon, Frank J.; Salutz, James R.; Felmlee, Joel P.; Loewen, M. D.; Forbes, Glenn S.

1994-05-01

A multi-phase collaboration between Mayo Clinic and IBM-Rochester was undertaken, with the goal of developing a picture archiving and communication system for routine clinical use in the Radiology Department. The initial phase of this project (phase 0) was started in 1988. The current system has been fully integrated into the clinical practice and, to date, over 6.5 million images from 16 imaging modalities have been archived. Phase 3 of this project has recently concluded.

United States Air and Space Power in the 21st Century: Strategic Appraisal

DTIC Science & Technology

2002-01-01

changes in current U.S. nuclear operational practice. It would require at the very least • suitable planning systems (e.g., near- real - time target...to increase real - time visibility into demands, inventories, and flows will likely be very valuable in this regard. Robust, well-stocked FSLs will...of the type of wholesale shift required. The current system is designed for heavy deployments with fairly long lead times . To sup- port Air

Experimenting Design and Implementation of an Educational Services Management System Based on ISO/IEC 20000 Standard

NASA Astrophysics Data System (ADS)

Lezcano, Jean-Marc; Adachihara, Hatsuo; Prunier, Marc

European higher education organizations are encouraged to implement quality management practices. Existing quality standards and frameworks do not capitalize an important set of best practices addressing educational services delivery. The ISO/IEC 20000 standard, elaborated from IT service management issues, is widening its field of application and may represent an interesting alternative. A specific approach is needed to apprehend the particular nature of educational services, consider the systemic cooperating roles of educational system and learning system, and define ISO/IEC 20000 vocabulary and concepts adapted to the domain. ISO/IEC 20000 may provide an answer to European Standard Guideline compliance and improve educational services management. The current experimentation is expected to cast light on the complexity, practicality and effectiveness of the use of ISO/IEC 20000 in a first field of "non IT" services.

A Constructive Reframing of Student Roles and Systems Learning in Medical Education Using a Communities of Practice Lens.

PubMed

Gonzalo, Jed D; Thompson, Britta M; Haidet, Paul; Mann, Karen; Wolpaw, Daniel R

2017-12-01

Health systems are in the midst of a transformation that is being driven by a variety of forces. This has important implications for medical educators because clinical practice environments play a key role in learning and professional development, and evolving health systems are beginning to demand that providers have "systems-ready" knowledge, attitudes, and skills. Such implications provide a clear mandate for medical schools to modify their goals and prepare physicians to practice flexibly within teams and effectively contribute to the improvement of health care delivery. In this context, the concepts of value-added medical education, authentic student roles, and health systems science are emerging as increasingly important. In this Article, the authors use a lens informed by communities of practice theory to explore these three concepts, examining the implications that the communities of practice theory has in the constructive reframing of educational practices-particularly common student roles and experiences-and charting future directions for medical education that better align with the needs of the health care system. The authors apply several key features of the communities of practice theory to current experiential roles for students, then propose a new approach to students' clinical experiences-value-added clinical systems learning roles-that provides students with opportunities to make meaningful contributions to patient care while learning health systems science at the patient and population level. Finally, the authors discuss implications for professional role formation and anticipated challenges to the design and implementation of value-added clinical systems learning roles.

SUBSTANCE USE SCREENING AND INTERVENTIONS IN DENTAL CLINICS: SURVEY OF PRACTICE-BASED RESEARCH NETWORK DENTISTS ON CURRENT PRACTICES, POLICIES, AND BARRIERS

PubMed Central

Wright, Shana; Matthews, Abigail G.; Rotrosen, John; Shelley, Donna; Buchholz, Matthew P.; Curro, Frederick A.

2013-01-01

Background Dental visits represent an opportunity to identify and assist patients with substance use, but little is known about how dentists are addressing tobacco, alcohol and illicit drugs. We surveyed dentists to learn about the role their practices might play in providing substance use screening and interventions. Methods A 41-item, web-based survey was distributed to all 210 dentists active in the PEARL dental practice-based research network. The questionnaire assessed clinic policies and current practices, attitudes, and perceived barriers to providing services for tobacco, alcohol, and illicit drug use. Results 143 dentists completed the survey (68% response rate). While screening was common, fewer were providing follow-up counseling or referrals for substance use. Insufficient knowledge/training was the most frequently cited barrier to intervention. Many dentists said they would offer assistance for tobacco (67%) or alcohol or illicit drugs (52%) if reimbursed; an affirmative response was more likely among those who saw publicly insured patients. Conclusions Dentists recognize the importance of screening for substance use, but lack clinical training and systems that could facilitate intervention. Practice Implications If barriers were reduced through changes in reimbursement, education, and systems-level support, our findings indicate that dentists may be willing to address substance use, including use of alcohol and illicit drugs as well as tobacco. PMID:23729460

Integrated Medical-Dental Delivery Systems: Models in a Changing Environment and Their Implications for Dental Education.

PubMed

Jones, Judith A; Snyder, John J; Gesko, David S; Helgeson, Michael J

2017-09-01

Models and systems of the dental care delivery system are changing. Solo practice is no longer the only alternative for graduating dentists. Over half of recent graduates are employees, and more than ever before, dentists are practicing in groups. This trend is expected to increase over the next 25 years. This article examines various models of dental care delivery, explains why it is important to practice in integrated medical-dental teams, and defines person-centered care, contrasting it with patient-centered care. Systems of care in which teams are currently practicing integrated oral health care delivery are described, along with speculation on the future of person-centered care and the team approach. Critical steps in the education of dental and other health care professionals and the development of clinical models of care in moving forward are considered. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Interdisciplinary Interactions During R&D and Early Design of Large Engineered Systems

NASA Technical Reports Server (NTRS)

McGowan, Anna-Maria Rivas

2014-01-01

Designing Large-Scale Complex Engineered Systems (LaCES) such as aircraft and submarines requires the input of thousands of engineers and scientists whose work is proximate in neither time nor space. Comprehensive knowledge of the system is dispersed among specialists whose expertise is in typically one system component or discipline. This study examined the interactive work practices among such specialists seeking to improve engineering practice through a rigorous and theoretical understanding of current practice. This research explored current interdisciplinary practices and perspectives during R&D and early LaCES design and identified why these practices and perspectives prevail and persist. The research design consisted of a three-fold, integrative approach that combined an open-ended survey, semi-structured interviews, and ethnography. Significant empirical data from experienced engineers and scientists in a large engineering organization were obtained and integrated with theories from organization science and engineering. Qualitative analysis was used to obtain a holistic, contextualized understanding. The over-arching finding is that issues related to cognition, organization, and social interrelations mostly dominate interactions across disciplines. Engineering issues, such as the integration of hardware or physics-based models, are not as significant. For example, organization culture is an important underlying factor that guided researchers more toward individual sovereignty over cross-disciplinarity. The organization structure and the engineered system architecture also serve as constraints to the engineering work. Many differences in work practices were observed, including frequency and depth of interactions, definition or co-construction of requirements, clarity or creation of the system architecture, work group proximity, and cognitive challenges. Practitioners are often unaware of these differences resulting in confusion and incorrect assumptions regarding work expectations. Cognitively, the enactment and coconstruction of knowledge are the fundamental tasks of the interdisciplinary interactions. Distributed and collective cognition represent most of the efforts. Argument, ignorance, learning, and creativity are interrelated aspects of the interactions that cause discomfort but yield benefits such as problem mitigation, broader understanding, and improved system design and performance. The quality and quantity of social interrelations are central to all work across disciplines with reciprocity, respectful engagement, and heedful interrelations being significant to the effectiveness of the engineering and scientific work.

Tracing organizing principles: learning from the history of systems biology.

PubMed

Green, Sara; Wolkenhauer, Olaf

2013-01-01

With the emergence of systems biology, the identification of organizing principles is being highlighted as a key research aim. Researchers attempt to "reverse engineer" the functional organization of biological systems using methodologies from mathematics, engineering and computer science while taking advantage of data produced by new experimental techniques. While systems biology is a relatively new approach, the quest for general principles of biological organization dates back to systems theoretic approaches in early and mid-twentieth century. The aim of this paper is to draw on this historical background in order to increase the understanding of the motivation behind the search for general principles and to clarify different epistemic aims within systems biology. We pinpoint key aspects of earlier approaches that also underlie the current practice. These are i) the focus on relational and system-level properties, ii) the inherent critique of reductionism and fragmentation of knowledge resulting from overspecialization, and iii) the insight that the ideal of formulating abstract organizing principles is complementary to, rather than conflicting with, the aim of formulating detailed explanations of biological mechanisms. We argue that looking back not only helps us understand the current practice but also points to possible future directions for systems biology.

["Handle with care": about the potential unintended consequences of oracular artificial intelligence systems in medicine.

PubMed

Cabitza, Federico; Alderighi, Camilla; Rasoini, Raffaele; Gensini, Gian Franco

2017-10-01

Decisional support systems based on machine learning (ML) in medicine are gaining a growing interest as some recent articles have highlighted the high diagnostic accuracy exhibited by these systems in specific medical contexts. However, it is implausible that any potential advantage can be obtained without some potential drawbacks. In light of the current gaps in medical research about the side effects of the application of these new AI systems in medical practice, in this article we summarize the main unexpected consequences that may result from the widespread application of "oracular" systems, that is highly accurate systems that cannot give reasonable explanations of their advice as those endowed with predictive models developed with ML techniques usually are. These consequences range from the intrinsic uncertainty in the data that are used to train and feed these systems, to the inadequate explainability of their output; through the risk of overreliance, deskilling and context desensitization of their end-users. Although some of these issues may be currently hard to evaluate due to the still scarce adoption of these decisional systems in medical practice, we advocate the study of these potential consequences also for a more informed policy of approval beyond hype and disenchantment.

21 CFR 874.1500 - Gustometer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... sides of the tongue at different taste centers and that provides a galvanic stimulus resulting in taste... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 874.1500 - Gustometer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... sides of the tongue at different taste centers and that provides a galvanic stimulus resulting in taste... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

The new era of postgraduate certified general practice training in Japan.

PubMed

Takamura, Akiteru

2016-09-01

This paper describes the background to, and the recent evolution of general practice as a recognised medical specialism in Japan (2015), and the evolution of a system of training to support this development. We, the general practitioners (GPs) in Japan have not been recognised as one body of medical specialists and have been training in our own way. A new certified training system will commence in 2018, authorised by a new third organisation, the Japanese Medical Specialty Board. An effective educational system has been developed for medical graduates that have a career intention in general practice that is distinct from other basic medical fields, but collaborates with them. A challenge exists to provide clarity to the Japanese population about what the specialty of general practice is, and what professionals in general practice can do for them. Japan currently has approximately 500 certified GPs and it is unclear at present what numbers will eventually be required. This paper reviews some of the challenges facing the development of general practice from the perspective of the Japan Primary Care Association.

Cost Benefit Analysis of Enterprise Resource Planning System for the Naval Postgraduate School

DTIC Science & Technology

2002-06-01

Department-wide introduction and use of appropriate commercial financial practices and reporting • Develop a strategic plan for implementing a business... Development of a process innovation approach given the current capabilities of the system, recommend possible alternatives to close gaps. E

Research on Parallel Three Phase PWM Converters base on RTDS

NASA Astrophysics Data System (ADS)

Xia, Yan; Zou, Jianxiao; Li, Kai; Liu, Jingbo; Tian, Jun

2018-01-01

Converters parallel operation can increase capacity of the system, but it may lead to potential zero-sequence circulating current, so the control of circulating current was an important goal in the design of parallel inverters. In this paper, the Real Time Digital Simulator (RTDS) is used to model the converters parallel system in real time and study the circulating current restraining. The equivalent model of two parallel converters and zero-sequence circulating current(ZSCC) were established and analyzed, then a strategy using variable zero vector control was proposed to suppress the circulating current. For two parallel modular converters, hardware-in-the-loop(HIL) study based on RTDS and practical experiment were implemented, results prove that the proposed control strategy is feasible and effective.

The Need for Integrating the Back End of the Nuclear Fuel Cycle in the United States of America

DOE PAGES

Bonano, Evaristo J.; Kalinina, Elena A.; Swift, Peter N.

2018-02-26

Current practice for commercial spent nuclear fuel management in the United States of America (US) includes storage of spent fuel in both pools and dry storage cask systems at nuclear power plants. Most storage pools are filled to their operational capacity, and management of the approximately 2,200 metric tons of spent fuel newly discharged each year requires transferring older and cooler fuel from pools into dry storage. In the absence of a repository that can accept spent fuel for permanent disposal, projections indicate that the US will have approximately 134,000 metric tons of spent fuel in dry storage by mid-centurymore » when the last plants in the current reactor fleet are decommissioned. Current designs for storage systems rely on large dual-purpose (storage and transportation) canisters that are not optimized for disposal. Various options exist in the US for improving integration of management practices across the entire back end of the nuclear fuel cycle.« less

The Need for Integrating the Back End of the Nuclear Fuel Cycle in the United States of America

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

Bonano, Evaristo J.; Kalinina, Elena A.; Swift, Peter N.

Current practice for commercial spent nuclear fuel management in the United States of America (US) includes storage of spent fuel in both pools and dry storage cask systems at nuclear power plants. Most storage pools are filled to their operational capacity, and management of the approximately 2,200 metric tons of spent fuel newly discharged each year requires transferring older and cooler fuel from pools into dry storage. In the absence of a repository that can accept spent fuel for permanent disposal, projections indicate that the US will have approximately 134,000 metric tons of spent fuel in dry storage by mid-centurymore » when the last plants in the current reactor fleet are decommissioned. Current designs for storage systems rely on large dual-purpose (storage and transportation) canisters that are not optimized for disposal. Various options exist in the US for improving integration of management practices across the entire back end of the nuclear fuel cycle.« less

Stormwater quality management in rail transportation--past, present and future.

PubMed

Vo, Phuong Tram; Ngo, Huu Hao; Guo, Wenshan; Zhou, John L; Listowski, Andrzej; Du, Bin; Wei, Qin; Bui, Xuan Thanh

2015-04-15

Railways currently play an important role in sustainable transportation systems, owing to their substantial carrying capacity, environmental friendliness and land-saving advantages. Although total pollutant emissions from railway systems are far less than that of automobile vehicles, the pollution from railway operations should not be underestimated. To date, both scientific and practical papers dealing with stormwater management for rail tracks have solely focused on its drainage function. Unlike roadway transport, the potential of stormwater pollution from railway operations is currently mishandled. There have been very few studies into the impact of its operations on water quality. Hence, upon the realisation on the significance of nonpoint source pollution, stormwater management priorities should have been re-evaluated. This paper provides an examination of past and current practices of stormwater management in the railway industry, potential sources of stormwater pollution, obstacles faced in stormwater management and concludes with strategies for future management directions. Copyright © 2015 Elsevier B.V. All rights reserved.

Advanced Life Support Technologies and Scenarios

NASA Technical Reports Server (NTRS)

Barta, Daniel J.

2011-01-01

As NASA looks beyond the International Space Station toward long-duration, deep space missions away from Earth, the current practice of supplying consumables and spares will not be practical nor affordable. New approaches are sought for life support and habitation systems that will reduce dependency on Earth and increase mission sustainability. To reduce launch mass, further closure of Environmental Control and Life Support Systems (ECLSS) beyond the current capability of the ISS will be required. Areas of particular interest include achieving higher degrees of recycling within Atmosphere Revitalization, Water Recovery and Waste Management Systems. NASA is currently investigating advanced carbon dioxide reduction processes that surpass the level of oxygen recovery available from the Sabatier Carbon Dioxide Reduction Assembly (CRA) on the ISS. Improving the efficiency of the recovery of water from spacecraft solid and liquid wastes is possible through use of emerging technologies such as the heat melt compactor and brine dewatering systems. Another significant consumable is that of food. Food production systems based on higher plants may not only contribute significantly to the diet, but also contribute to atmosphere revitalization, water purification and waste utilization. Bioreactors may be potentially utilized for wastewater and solid waste management. The level at which bioregenerative technologies are utilized will depend on their comparative requirements for spacecraft resources including mass, power, volume, heat rejection, crew time and reliability. Planetary protection requirements will need to be considered for missions to other solar system bodies.

Mentoring as the Core Element of New Teacher Induction in the USA: Policies and Practices

ERIC Educational Resources Information Center

Zembytska, Maryna

2016-01-01

The paper focuses on mentoring as the key strategy of novice teacher induction in the USA. The study reviews current mentoring/induction policies and trends in the U.S. system of in-service teacher training and support. The findings suggest that the conceptual framework, standards and practices of new teacher mentoring in the United States conform…

Establishing Systemic Social and Emotional Learning Approaches in Schools: A Framework for Schoolwide Implementation

ERIC Educational Resources Information Center

Oberle, Eva; Domitrovich, Celene E.; Meyers, Duncan C.; Weissberg, Roger P.

2016-01-01

Social and emotional learning (SEL) is a fundamental part of education. Incorporating high-quality SEL programming into day-to-day classroom and school practices has emerged as a main goal for many practitioners over the past decade. The present article overviews the current state of SEL research and practice, with a particular focus on the United…

Psychosocial treatments for schizophrenia.

PubMed

Mueser, Kim T; Deavers, Frances; Penn, David L; Cassisi, Jeffrey E

2013-01-01

The current state of the literature regarding psychosocial treatments for schizophrenia is reviewed within the frameworks of the recovery model of mental health and the expanded stress-vulnerability model. Interventions targeting specific domains of functioning, age groups, stages of illness, and human service system gaps are classified as evidence-based practices or promising practices according to the extent to which their efficacy is currently supported by meta-analyses and individual randomized controlled trials (RCTs). Evidence-based practices include assertive community treatment (ACT), cognitive behavior therapy (CBT) for psychosis, cognitive remediation, family psychoeducation, illness self-management training, social skills training, and supported employment. Promising practices include cognitive adaptive therapy, CBT for posttraumatic stress disorder, first-episode psychosis intervention, healthy lifestyle interventions, integrated treatment for co-occurring disorders, interventions targeting older individuals, peer support services, physical disease management, prodromal stage intervention, social cognition training, supported education, and supported housing. Implications and future directions are discussed.

Moving into the 'patient-centred medical home': reforming Australian general practice.

PubMed

Hayes, Paul; Lynch, Anthony; Stiffe, Jenni

2016-09-01

The Australian healthcare system is a complex network of services and providers funded and administered by federal, state and territory governments, supplemented by private health insurance and patient contributions. The broad geographical range, complexity and increasing demand within the Australian healthcare sector mean health expenditure is high. Aspects of current funding for the healthcare system have attracted criticism from medical practitioners, patients, representative organisations and independent statutory agencies. In response to the problems in primary care funding in Australia, The Royal Australian College of General Practitioners developed the Vision for general practice and a sustainable healthcare system (the Vision). The Vision presents a plan to improve healthcare delivery in Australia through greater quality, access and efficiency by reorienting how general practice services are funded based on the 'patient-centred medical home' model.

21 CFR 26.10 - Regulatory authorities not listed as currently equivalent.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES GENERAL MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT EVALUATION REPORTS: UNITED STATES AND THE...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2014 CFR

2014-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2010 CFR

2010-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2011 CFR

2011-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2013 CFR

2013-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

21 CFR 886.1400 - Maddox lens.

Code of Federal Regulations, 2012 CFR

2012-04-01

... intended to be handheld or placed in a trial frame to evaluate eye muscle dysfunction. (b) Classification... the current good manufacturing practice requirements of the quality system regulation in part 820 of...

Crisis Management for Secondary Education: A Survey of Secondary Education Directors in Greece

ERIC Educational Resources Information Center

Savelides, Socrates; Mihiotis, Athanassios; Koutsoukis, Nikitas-Spiros

2015-01-01

Purpose: The Greek secondary education system lacks a formal crisis management system. The purpose of this paper is to address this problem as follows: elicit current crisis management practices, outline features for designing a formal crisis management system in Greece. Design/methodology/approach: The research is based on a survey conducted with…

Identifying Governance Best Practices in Systems-of-Systems Acquisition

DTIC Science & Technology

2014-02-08

Acquisition Governance ................................................ 28  Figure 3.  Harvest Hercules Airborne Weapons Kit System Components ...... 39 ...acquisition poses considerable challenges that the current Department of Defense (DoD) acquisition governance structure was not necessarily designed to...specify the warship it needed along with the design , construction, and outfitting of the ship. The Navy managed and performed production operations and

Academy of Nutrition and Dietetics: Standards of professional performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems.

PubMed

Tagtow, Angie; Robien, Kim; Bergquist, Erin; Bruening, Meg; Dierks, Lisa; Hartman, Barbara E; Robinson-O'Brien, Ramona; Steinitz, Tamara; Tahsin, Bettina; Underwood, Teri; Wilkins, Jennifer

2014-03-01

Sustainability is the ability of a system to be maintained over the long term. Resilience is the ability of a system to withstand disturbances and continue to function in a sustainable manner. Issues of sustainability and resilience apply to all aspects of nutrition and dietetics practice, can be practiced at both the program and systems level, and are broader than any one specific practice setting or individual intervention. Given an increasing need to apply principles of sustainability and resilience to nutrition and dietetics practice, as well as growing interest among the public and by Registered Dietitian Nutritionists of health issues related to food and water systems, the Hunger and Environmental Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Standards of Professional Performance as a tool for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems to assess their current skill levels and to identify areas for further professional development in this emerging practice area. This Standards of Professional Performance document covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how sustainable, resilient, and healthy food and water systems principles can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A Strategy for Assessing Costs of Implementing New Practices in the Child Welfare System: Adapting the English Cost Calculator in the United States

PubMed Central

Snowden, Lonnie R.; Padgett, Courtenay; Saldana, Lisa; Roles, Jennifer; Holmes, Lisa; Ward, Harriet; Soper, Jean; Reid, John; Landsverk, John

2015-01-01

In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided. PMID:20976620

A strategy for assessing costs of implementing new practices in the child welfare system: adapting the English cost calculator in the United States.

PubMed

Chamberlain, Patricia; Snowden, Lonnie R; Padgett, Courtenay; Saldana, Lisa; Roles, Jennifer; Holmes, Lisa; Ward, Harriet; Soper, Jean; Reid, John; Landsverk, John

2011-01-01

In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided.

Impact of an Event Reporting System on Resident Complication Reporting in Plastic Surgery Training: Addressing an ACGME and Plastic Surgery Milestone Project Core Competency.

PubMed

Parikh, Rajiv P; Snyder-Warwick, Alison; Naidoo, Sybill; Skolnick, Gary B; Patel, Kamlesh B

2017-11-01

The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement. Unfortunately, current methods for capturing a comprehensive profile of complications may significantly underestimate the true occurrence of complications. Therefore, the objectives of this study are to evaluate an intervention for complication reporting and compare this to current practice, in a plastic surgery training program. This is a preintervention and postintervention study evaluating resident reporting of complications on a plastic surgery service. The intervention was an online event reporting system developed by department leadership and patient safety experts. The cohorts consisted of all patients undergoing surgery during two separate 3-month blocks bridged by an implementation period. A trained reviewer recorded complications, and this served as the reference standard. Fisher's exact test was used for binary comparisons. There were 32 complications detected in 219 patients from June to August of 2015 and 35 complications in 202 patients from October to December of 2015. The proportion of complications reported in the preintervention group was nine of 32 (28.1 percent). After the intervention, this significantly increased to 32 of 35 (91.4 percent) (p < 0.001). An intervention using an event reporting system, supported by departmental leadership, led to significant improvements in complication reporting by plastic surgery residents.

Current management of hepatocellular carcinoma

PubMed Central

Tabrizian, Parissa; Roayaie, Sasan; Schwartz, Myron E

2014-01-01

Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and leading cause of death among patients with cirrhosis. Treatment guidelines are based according to the Barcelona Clinic Liver Cancer staging system. The choice among therapeutic options that include liver resection, liver transplantation, locoregional, and systemic treatments must be individualized for each patient. The aim of this paper is to review the outcomes that can be achieved in the treatment of HCC with the heterogeneous therapeutic options currently available in clinical practice. PMID:25132740

Design of an image-distribution service from a clinical PACS

NASA Astrophysics Data System (ADS)

Gehring, Dale G.; Persons, Kenneth R.; Rothman, Melvyn L.; Felmlee, Joel P.; Gerhart, D. J.; Hangiandreou, Nicholas J.; Reardon, Frank J.; Shirk, M.; Forbes, Glenn S.; Williamson, Byrn, Jr.

1994-05-01

A PACS system has been developed through a multi-phase collaboration between the Mayo Clinic and IBM/Rochester. The current system has been fully integrated into the clinical practice of the Radiology Department for the primary purpose of digital image archival, retrieval, and networked workstation review. Work currently in progress includes the design and implementation of a gateway device for providing digital image data to third-party workstations, laser printers, and other devices, for users both within and outside of the Radiology Department.

EHV systems technology - A look at the principles and current status. [Electric and Hybrid Vehicle

NASA Technical Reports Server (NTRS)

Kurtz, D. W.; Levin, R. R.

1983-01-01

An examination of the basic principles and practices of systems engineering is undertaken in the context of their application to the component and subsystem technologies involved in electric and hybrid vehicle (EHV) development. The limitations of purely electric vehicles are contrasted with hybrid, heat engine-incorporating vehicle technology, which is inherently more versatile. A hybrid vehicle concept assessment methodology is presented which employs current technology and yet fully satisfies U.S. Department of Energy petroleum displacement goals.

Future perspectives of personalized medicine in traditional Chinese medicine: a systems biology approach.

PubMed

Zhang, Aihua; Sun, Hui; Wang, Ping; Han, Ying; Wang, Xijun

2012-01-01

Deconstruction of molecular pathways and advances in enabling technology platforms have opened new horizons for disease management, exploring therapeutic solutions to each individual patient beyond the one-size fits all practice. Application of personalized medicine paradigms aims to achieve the right diagnosis and right treatment for the right patient at the right time at the right cost. With the potential to transform medical practice across global communities, personalized medicine is emerging as the flagship of modern medicine. In recent years, the health care paradigm has shifted from a focus on diseases to a major hot of personalized traditional Chinese medicine (TCM) with holistic approach. TCM focuses on health maintenance, emphasizes on enhancing the body's resistance to diseases and especially showes great advantages in early intervention, personalized and combination therapies, etc. Systems biology, a new science of the 21st century, becomes practically available and resembles TCM in many aspects such as study method and design, and is current key component technologies that serves as the major driving force for translation of the personalized medicine revolution of TCM principles into practice, will advance personalized therapy principles into healthcare management tools for individuals and populations. Such system approach concepts are transforming principles of TCM to modern therapeutic approaches, enable a predictive and preventive medicine and will lead to personalized medicine. To realise the full potential of personalized TCM, we describe the current status of principles and practice of TCM integrated with systems biology platform. Some characteristic examples are presented to highlight the application of this platform to personalized TCM research and development as well as some of the necessary milestones for moving TCM into mainstream health care. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Grading Nemesis: An Historical Overview and a Current Look at Pass/Fail Grading.

ERIC Educational Resources Information Center

Weller, L. David

1983-01-01

A brief history of grading practices at American colleges and universities is given, along with results of a survey of the current uses of pass/fail grading. The pass/fail system is widely used for a limited number of elective courses. Its adoption peaked during the mid-1970s. (PP)

Over-injection and self-oscillations in an electron vacuum diode

NASA Astrophysics Data System (ADS)

Leopold, J. G.; Siman-Tov, M.; Goldman, A.; Krasik, Ya. E.

2017-07-01

We demonstrate a practical means by which one can inject more than the space-charge limiting current into a vacuum diode. This over-injection causes self-oscillations of the space-charge resulting in an electron beam current modulation at a fixed frequency, a reaction of the system to the Coulomb repulsive forces due to charge accumulation.

Academic-Practice Partnerships: The Interdependence Between Leadership and Followership.

PubMed

Everett, Linda Q

2016-04-01

In this article, there is a discussion focused on three contemporary nursing topics: leadership, followership, and academic-practice partnerships. These comments are framed within the context of the current healthcare system transformation. There is a focus on why each of these topics is relevant to the nursing profession in leading change and advancing health. Finally, there is a description about the interdependence of leadership and followership and the significance these hold for the interdependence between nursing education and nursing practice. © The Author(s) 2016.

Online Faculty Development and Assessment System (OFDAS)

ERIC Educational Resources Information Center

Villar, Luis M.; Alegre, Olga M.

2006-01-01

The rapid growth of online learning has led to the development of faculty inservice evaluation models focused on quality improvement of degree programs. Based on current "best practices" of student online assessment, the Online Faculty Development and Assessment System (OFDAS), created at the Canary Islands, was designed to serve the…

77 FR 33000 - Solicitation for a Cooperative Agreement: Resources for NIC's Web Site on Data Collection and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-04

... examples of policy and procedure governing information management; information on effective practices in developing or acquiring automated information management systems; and an overview of current information... agencies do not have staff dedicated to data collection and analysis, information system management, or...

Policy, Systems, and Environmental Change in the Mississippi Delta: Considerations for Evaluation Design

ERIC Educational Resources Information Center

Kegler, Michelle C.; Honeycutt, Sally; Davis, Melvin; Dauria, Emily; Berg, Carla; Dove, Cassandra; Gamble, Abigail; Hawkins, Jackie

2015-01-01

Community-level policy, systems, and environmental (PSE) change strategies may offer an economical and sustainable approach to chronic disease prevention. The rapidly growing number of untested but promising PSE strategies currently underway offers an exciting opportunity to establish practice-based evidence for this approach. This article…

Regenerating an Arsenic Removal Iron-Based Adsorptive Media System, Part 1: The Regeneration Process

EPA Science Inventory

Adsorptive media technology is a frequently used method of removing arsenic by small water systems because of its simplicity and efficiency. Current practice is to replace the media when it no longer reduces arsenic below the USEPA drinking water maximum contaminant level (MCL) ...

Development of uniform sections for pavement management system inventory and application : interim report.

DOT National Transportation Integrated Search

2007-12-01

This report summarizes the findings of the first phase of LTRC research project 04-2P, which is sponsored by LADOTD. The project is assessing the current status and the state-of-the-practice of the LADOTD pavement management system (PMS). Results of ...

The Use of Documentation in a Participatory System of Evaluation

ERIC Educational Resources Information Center

Picchio, Mariacristina; Di Giandomenico, Isabella; Musatti, Tullia

2014-01-01

Pedagogical documentation is a practice currently used in Italian early childhood education and care (ECEC) services to make visible children's learning processes in ECEC, to promote parents' participation and to support professionals' reflexive competences. These functions of pedagogical documentation have been enhanced within a system of…

Technical Communications in OSS Content Management Systems: An Academic Institutional Case Study

ERIC Educational Resources Information Center

Cripps, Michael J.

2011-01-01

Single sourcing through a content management system (CMS) is altering technical communication practices in many organizations, including institutions of higher education. Open source software (OSS) solutions are currently among the most popular content management platforms adopted by colleges and universities in the United States and abroad. The…

76 FR 77477 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... borrowers, as all businesses, need accounting systems for their own internal use as well as external use. Such records are maintained as part of normal business practices. Without systems, no records would... information unless it displays a currently valid OMB control number. Rural Utilities Service Title: Accounting...

THE OCCURRENCE OF CONTAMINANT ACCUMULATION IN LEAD PIPE SCALES FROM DOMESTIC DRINKING WATER DISTRIBUTION SYSTEMS

EPA Science Inventory

Previous work has shown that contaminants, such as Al, As and Ra, can accumulate in drinking water distribution system solids. The release of accumulated contaminants back into the water supply could result in elevated levels at consumers’ taps, and current monitoring practices d...

HRD Issues in Asia.

ERIC Educational Resources Information Center

1998

This document contains four papers from a symposium on human resource development (HRD) issues in Asia. "The Japanese Human Resource Development System" (Kiyoe Harada) provides a comprehensive model of the Japanese HRD system based on the current state of the art, including management practices and issues and trends in Japanese HRD.…

The male reproductive system - An overview of common problems.

PubMed

Wijesinha, Sanjiva; Piterman, Leon; Kirby, Catherine N

2013-05-01

Many male reproductive system problems could be perceived as being embarrassing, which may be one of the reasons that they are often not identified in general practice. This article provides an overview of some common problems affecting the male reproductive system, and outlines current treatment options. Erectile dysfunction, premature ejaculation, loss of libido, testicular cancer and prostate disease may cause embarrassment to the patient and, occasionally, the general practitioner. We describe how patients affected by these conditions may present to general practice, and discuss the reasons why they may not present. We also discuss how GPs can overcome difficulties in identifying and dealing with their male patients suffering from male reproductive system issues.

Public Health Information Systems: Priorities and Practices for Successful Deployments.

PubMed

Pearce, Martin

2016-01-01

A fast paced workshop designed for senior public health decision makers and clinical leaders implementing information systems to support delivery of public health programs. The tutorial will introduce public health information systems and provide best practices for implementing solutions related to immunization, communicable disease case management and outbreak management. Using a combination of formats, the tutorial will: • Highlight key functionality of public health information systems. • Review global crises currently exposing gaps and deficiencies in public health information. • Examine governance, planning, and implementation priorities. • Highlight considerations supporting implementations nationally and in special populations. • Provide real, actionable lessons learned to take away and apply in the real world.

Ocular static and dynamic light scattering: a noninvasive diagnostic tool for eye research and clinical practice

NASA Technical Reports Server (NTRS)

Ansari, Rafat R.

2004-01-01

The noninvasive techniques of static and dynamic light scattering are emerging as valuable diagnostic tools for the early detection of ocular and systemic diseases. These include corneal abnormalities, pigmentary dispersion syndrome, glaucoma, cataract, diabetic vitreopathy, and possibly macular degeneration. Systemic conditions such as diabetes and possibly Alzheimer's disease can potentially be detected early via ocular tissues. The current state of development of these techniques for application to ophthalmic research and ultimately clinical practice is reviewed. (c) 2004 Society of Photo-Optical Instrumentation Engineers.

Solutions for medical databases optimal exploitation.

PubMed

Branescu, I; Purcarea, V L; Dobrescu, R

2014-03-15

The paper discusses the methods to apply OLAP techniques for multidimensional databases that leverage the existing, performance-enhancing technique, known as practical pre-aggregation, by making this technique relevant to a much wider range of medical applications, as a logistic support to the data warehousing techniques. The transformations have practically low computational complexity and they may be implemented using standard relational database technology. The paper also describes how to integrate the transformed hierarchies in current OLAP systems, transparently to the user and proposes a flexible, "multimodel" federated system for extending OLAP querying to external object databases.

openSE: a Systems Engineering Framework Particularly Suited to Particle Accelerator Studies and Development Projects

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

Bonnal, P.; Féral, B.; Kershaw, K.

Particle accelerator projects share many characteristics with industrial projects. However, experience has shown that best practice of industrial project management is not always well suited to particle accelerator projects. Major differences include the number and complexity of technologies involved, the importance of collaborative work, development phases that can last more than a decade, and the importance of telerobotics and remote handling to address future preventive and corrective maintenance requirements due to induced radioactivity, to cite just a few. The openSE framework it is a systems engineering and project management framework specifically designed for scientific facilities’ systems and equipment studies andmore » development projects. Best practices in project management, in systems and requirements engineering, in telerobotics and remote handling and in radiation safety management were used as sources of inspiration, together with analysis of current practices surveyed at CERN, GSI and ESS.« less

[Diagnosis and venom specific immunotherapy (VIT) in allergic children in Poland--how much the current practice follows the international guidelines?].

PubMed

Cichocka-Jarosz, Ewa; Brzyski, Piotr; Lis, Grzegorz; Jedynak-Wasowicz, Urszula; Pietrzyk, Jacek Józef; Lange, Joanna; Małaczyńska, Teresa; Kraluk, Barbara; Swiebocka, Ewa; Breborowicz, Anna; Kycler, Zdzisława; Pietraszek-Mamcarz, Jolanta; Poszwiński, Adam; Gaszczyk, Grzegorz

2010-01-01

Insect venom allergy requires a high level approach adequate to allergy intensity. In case of severe IgE-mediated sting reactions, in children older than five years, venom immunotherapy is a treatment of choice. Identification of current practices applied to venom allergic children in Poland and their adherence to the international guidelines. Questionnaire survey concerning diagnostic and treatment rules was carried out in 8 centres of pediatric allergology, based on a similar audit conducted in the United Kingdom [Diwakar L. et al. Clin Exp Allergy 2008, 38: 1651]. In 5 centres both RAST and SPT tests were used as the first line of investigation. Subsequently 6 centres performed IDT. In three centres baseline serum tryptase levels were estimated. In case of sensitization to both bee and wasp venom in a child with the history of severe systemic reaction, but uncertain culprit insect, specific venom immunotherapy with both venoms was practised by 2 centres. In systemic reaction and not-detectable IgE in 6 centres child was followed-up in 6-12 months. Antihistamine premedication concerned all children in 7 centres. Six-week interval between booster doses was applied in half of centres. A target dose equal 100 mcg was used in 7 centres. Similarly all centres practiced 3-5 five year period of VIT. In Poland current practice with venom allergic children was conducted in congruence with most of the recommendations.

Review article: practical current issues in perioperative patient safety.

PubMed

Eichhorn, John H

2013-02-01

This brief review provides an overview and, importantly, a context perspective of relevant current practical issues in perioperative patient safety. The dramatic improvement in anesthesia patient safety over the last 30 years was not initiated by electronic monitors but, rather, largely by a set of behaviours known as "safety monitoring" that were then made decidedly more effective by extending the human senses through electronic monitoring, for example, capnography and pulse oximetry. In the highly developed world, this current success is threatened by complacency and production pressure. In some areas of the developing/underdeveloped world, the challenge is implementing the components of anesthesia practice that will bring safety improvements to parallel the overall current success, for instance, applying the World Federation of Societies of Anaesthesiologists (WFSA) "International Standards for A Safe Practice of Anaesthesia". Generally, expanding the current success in safety involves many practical issues. System issues involve research, effective reporting mechanisms and analysis/broadcasting of results, perioperative communication (including "speaking up to power"), and checklists. Monitoring issues involve enforcing existing published monitoring standards and also recognizing the risk of danger to the patient from hypoventilation during procedural sedation and from postoperative intravenous pain medications. Issues of clinical care include medication errors in the operating room, cerebral hypoperfusion (especially in the head-up position), dangers of airway management, postoperative residual weakness from muscle relaxants, operating room fires, and risks specific in obstetric anesthesia. Recognition of the issues outlined here and empowerment of all anesthesia professionals, from the most senior professors and administrators to the newest practitioners, should help maintain, solidify, and expand the improvements in anesthesia and perioperative patient safety.

Congestion Management Systems: Review of Current Practices.

DOT National Transportation Integrated Search

2004-10-31

National parks roads and parkways integrate highway engineering and landscape architecture in their designs to provide access to recreational areas, and to provide scenic recreational travel opportunities. Typically the engineering challenge is to bu...

High-precision GPS vehicle tracking to improve safety.

DOT National Transportation Integrated Search

2016-09-01

Commercial Global Positioning System (GPS) devices are being used in transportation for applications : including vehicle navigation, traffic monitoring, and tracking commercial and public transit vehicles. The : current state-of-practice technology i...

The Sun/Earth System and Space Weather

NASA Technical Reports Server (NTRS)

Poland, Arthur I.; Fox, Nicola; Lucid, Shannon

2003-01-01

Solar variability and solar activity are now seen as significant drivers with respect to the Earth and human technology systems. Observations over the last 10 years have significantly advanced our understanding of causes and effects in the Sun/Earth system. On a practical level the interactions between the Sun and Earth dictate how we build our systems in space (communications satellites, GPS, etc), and some of our ground systems (power grids). This talk will be about the Sun/Earth system: how it changes with time, its magnetic interactions, flares, the solar wind, and how the Sun effects human systems. Data will be presented from some current spacecraft which show, for example, how we are able to currently give warnings to the scientific community, the Government and industry about space storms and how this data has improved our physical understanding of processes on the Sun and in the magnetosphere. The scientific advances provided by our current spacecraft has led to a new program in NASA to develop a 'Space Weather' system called 'Living With a Star'. The current plan for the 'Living With a Star' program will also be presented.

Supervision--growing and building a sustainable general practice supervisor system.

PubMed

Thomson, Jennifer S; Anderson, Katrina J; Mara, Paul R; Stevenson, Alexander D

2011-06-06

This article explores various models and ideas for future sustainable general practice vocational training supervision in Australia. The general practitioner supervisor in the clinical practice setting is currently central to training the future general practice workforce. Finding ways to recruit, retain and motivate both new and experienced GP teachers is discussed, as is the creation of career paths for such teachers. Some of the newer methods of practice-based teaching are considered for further development, including vertically integrated teaching, e-learning, wave consulting and teaching on the run, teaching teams and remote teaching. Approaches to supporting and resourcing teaching and the required infrastructure are also considered. Further research into sustaining the practice-based general practice supervision model will be required.

78 FR 64735 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

...The Food and Drug Administration (FDA) is proposing regulations for domestic and foreign facilities that are required to register under the Federal Food, Drug, and Cosmetic Act (the FD&C Act) to establish requirements for current good manufacturing practice in manufacturing, processing, packing, and holding of animal food. FDA also is proposing regulations to require that certain facilities establish and implement hazard analysis and risk-based preventive controls for food for animals. FDA is taking this action to provide greater assurance that animal food is safe and will not cause illness or injury to animals or humans and is intended to build an animal food safety system for the future that makes modern, science and risk-based preventive controls the norm across all sectors of the animal food system.

Evaluation of LOINC for Representing Constitutional Cytogenetic Test Result Reports

PubMed Central

Heras, Yan Z.; Mitchell, Joyce A.; Williams, Marc S.; Brothman, Arthur R.; Huff, Stanley M.

2009-01-01

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future. PMID:20351857

Evaluation of LOINC for representing constitutional cytogenetic test result reports.

PubMed

Heras, Yan Z; Mitchell, Joyce A; Williams, Marc S; Brothman, Arthur R; Huff, Stanley M

2009-11-14

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future.

NASA's Current Earth Science Program

NASA Technical Reports Server (NTRS)

Charles, Leslie Bermann

1998-01-01

NASA's Earth science program is a scientific endeavor whose goal is to provide long-term understanding of the Earth as an integrated system of land, water, air and life. A highly developed scientific knowledge of the Earth system is necessary to understand how the environment affects humanity, and how humanity may be affecting the environment. The remote sensing technologies used to gather the global environmental data used in such research also have numerous practical applications. Current applications of remote sensing data demonstrate their practical benefits in areas such as the monitoring of crop conditions and yields, natural disasters and forest fires; hazardous waste clean up; and tracking of vector-borne diseases. The long-term availability of environmental data is essential for the continuity of important research and applications efforts. NASA's Earth observation program has undergone many changes in the recent past.

Payment models to support population health management.

PubMed

Huerta, Timothy R; Hefner, Jennifer L; McAlearney, Ann Scheck

2014-01-01

To survey the policy-driven financial controls currently being used to drive physician change in the care of populations. This paper offers a review of current health care payment models and discusses the impact of each on the potential success of PHM initiatives. We present the benefits of a multi-part model, combining visit-based fee-for-service reimbursement with a monthly "care coordination payment" and a performance-based payment system. A multi-part model removes volume-based incentives and promotes efficiency. However, it is predicated on a pay-for-performance framework that requires standardized measurement. Application of this model is limited due to the current lack of standardized measurement of quality goals that are linked to payment incentives. Financial models dictated by health system payers are inextricably linked to the organization and management of health care. There is a need for better measurements and realistic targets as part of a comprehensive system of measurement assessment that focuses on practice redesign, with the goal of standardizing measurement of the structure and process of redesign. Payment reform is a necessary component of an accurate measure of the associations between practice transformation and outcomes important to both patients and society.

How current Clinical Practice Guidelines for low back pain reflect Traditional Medicine in East Asian Countries: a systematic review of Clinical Practice Guidelines and systematic reviews.

PubMed

Cho, Hyun-Woo; Hwang, Eui-Hyoung; Lim, Byungmook; Heo, Kwang-Ho; Liu, Jian-Ping; Tsutani, Kiichiro; Lee, Myeong Soo; Shin, Byung-Cheul

2014-01-01

The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM) interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs) and evidence from current systematic reviews and meta-analyses (SR-MAs) and to analyze the impact of this gap on present CPGs. We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54%) mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure). However, the CPGs did not recommend acupuncture (or acupressure). Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (sub)acute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (sub)acute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.

An Assessment of Regional Water Resources and Agricultural Sustainability in the Mississippi River Alluvial Aquifer System of Mississippi and Arkansas Under Current and Future Climate

NASA Astrophysics Data System (ADS)

Rigby, J.; Reba, M.

2011-12-01

The Lower Mississippi River Alluvial Plain is a highly productive agricultural region for rice, soy beans, and cotton that depends heavily on irrigation. Development of the Mississippi River Alluvial Aquifer (MRAA), one of the more prolific agricultural aquifers in the country, has traditionally been the primary source for irrigation in the region yielding over 1,100 Mgal/day to irrigation wells. Increasingly, the realities of changing climate and rapidly declining water tables have highlighted the necessity for new water management practices. Tail-water recovery and reuse is a rapidly expanding practice due in part to the efforts and cost-sharing of the NRCS, but regional studies of the potential for such practices to alleviate groundwater mining under current and future climate are lacking. While regional studies of aquifer geology have long been available, including assessments of regional groundwater flow, much about the aquifer is still not well understood including controls on recharge rates, a crucial component of water management design. We review the trends in regional availability of surface and groundwater resources, their current status, and the effects of recent changes in management practices on groundwater decline in Mississippi and Arkansas. Global and regional climate projections are used to assess scenarios of sustainable aquifer use under current land use and management along with the potential for more widely practiced surface water capture and reuse to alleviate groundwater decline. Finally, we highlight crucial knowledge gaps and challenges associated with the development of water management practices for sustainable agricultural use in the region.

A novel concept of fault current limiter based on saturable core in high voltage DC transmission system

NASA Astrophysics Data System (ADS)

Yuan, Jiaxin; Zhou, Hang; Gan, Pengcheng; Zhong, Yongheng; Gao, Yanhui; Muramatsu, Kazuhiro; Du, Zhiye; Chen, Baichao

2018-05-01

To develop mechanical circuit breaker in high voltage direct current (HVDC) system, a fault current limiter is required. Traditional method to limit DC fault current is to use superconducting technology or power electronic devices, which is quite difficult to be brought to practical use under high voltage circumstances. In this paper, a novel concept of high voltage DC transmission system fault current limiter (DCSFCL) based on saturable core was proposed. In the DCSFCL, the permanent magnets (PM) are added on both up and down side of the core to generate reverse magnetic flux that offset the magnetic flux generated by DC current and make the DC winding present a variable inductance to the DC system. In normal state, DCSFCL works as a smoothing reactor and its inductance is within the scope of the design requirements. When a fault occurs, the inductance of DCSFCL rises immediately and limits the steepness of the fault current. Magnetic field simulations were carried out, showing that compared with conventional smoothing reactor, DCSFCL can decrease the high steepness of DC fault current by 17% in less than 10ms, which verifies the feasibility and effectiveness of this method.

Examining Teacher Perceptions of the Relationship between Evaluation Policy and Teacher Practice in a North Carolina School System

ERIC Educational Resources Information Center

Frasier, Amanda Marie Slaten

2017-01-01

Examining the justification for current evaluation policy reveals that such policy rests on two assumptions related to the impact on the work of teachers: (1) evaluations are necessary because teachers need to be rated, sanctioned, or rewarded in order to be motivated to improve their practice; and (2) evaluations yield information that is useful…

How To Make a Curriculum: The 1987 Guidelines for Curriculum Development in the Norwegian High School--A New Paradigma in Curriculum Development Practice?

ERIC Educational Resources Information Center

Gundem, Bjorg B.

This paper relates to a research project on the history and current practice of curriculum administration in Norway. An elaboration is provided on the changing high school system and the growing impact of curriculum scholarship on curriculum development. The discussion revolves around three objectives: (1) to determine if the newly formulated set…

Teaching Science in Diverse Settings: Marginalized Discourses and Classroom Practice. Counterpoints: Studies in the Postmodern Theory of Education.

ERIC Educational Resources Information Center

Barton, Angela Calabrese, Ed.; Osborne, Margery D., Ed.

The essays in this book draw from current debates concerning schooling and the need for liberatory education; the social construction of science and identity; and systems of race, class, and gender oppression and domination. These works aim to pose such questions as: (1) How can we shape practice and curriculum to address the needs of diverse…

Understanding Providers' Interaction with Graphical User Interface Pertaining to Clinical Document Usage in an Electronic Health Record System

ERIC Educational Resources Information Center

Rizvi, Rubina Fatima

2017-01-01

Despite high Electronic Health Record (EHR) system adoption rates by hospital and office-based practices, many users remain highly dissatisfied with the current state of EHRs. Sub-optimal EHR usability as a result of insufficient incorporation of User-Centered Design (UCD) approach during System Development Life Cycle process (SDLC) is considered…

Clinical Consultation Systems: Designing for the Physician as Computer User

PubMed Central

Shortliffe, Edward H.

1981-01-01

The barriers to successful implementation of consultation systems for physicians have been frequently discussed. Our research has been directed at the development of computer techniques that will heighten the acceptance of high performance decision making tools. We discuss two current projects at Stanford Medical School that address both practical and theoretical issues in the design and construction of clinically useful systems.

Russian Universities: (Lessons of the Past and Tasks of the Future)

ERIC Educational Resources Information Center

Dubin, B. V.

2008-01-01

The system of higher education in Russia remains isolated from the world system of education in terms of its pedagogical standards and practices and in terms of current views of the postmodern individual and society. The system in Russia is not oriented toward providing students with a good specialty that enjoys public recognition and is also well…

A Sociopolitical Eclipse: The Surrendering of Two Super Systems to Promote Equity in U.S. Education

ERIC Educational Resources Information Center

Bass, Lisa

2015-01-01

In this analysis, I argue that inequitable social and educational policies and practices hinder equity in the U.S. educational system. I challenge and critique the status quo, and the nation's current efforts toward educational equity. I then propose a radical shift in educational policy--a surrendering of social and political systems for the…

Risk Modeling of Interdependent Complex Systems of Systems: Theory and Practice.

PubMed

Haimes, Yacov Y

2018-01-01

The emergence of the complexity characterizing our systems of systems (SoS) requires a reevaluation of the way we model, assess, manage, communicate, and analyze the risk thereto. Current models for risk analysis of emergent complex SoS are insufficient because too often they rely on the same risk functions and models used for single systems. These models commonly fail to incorporate the complexity derived from the networks of interdependencies and interconnectedness (I-I) characterizing SoS. There is a need to reevaluate currently practiced risk analysis to respond to this reality by examining, and thus comprehending, what makes emergent SoS complex. The key to evaluating the risk to SoS lies in understanding the genesis of characterizing I-I of systems manifested through shared states and other essential entities within and among the systems that constitute SoS. The term "essential entities" includes shared decisions, resources, functions, policies, decisionmakers, stakeholders, organizational setups, and others. This undertaking can be accomplished by building on state-space theory, which is fundamental to systems engineering and process control. This article presents a theoretical and analytical framework for modeling the risk to SoS with two case studies performed with the MITRE Corporation and demonstrates the pivotal contributions made by shared states and other essential entities to modeling and analysis of the risk to complex SoS. A third case study highlights the multifarious representations of SoS, which require harmonizing the risk analysis process currently applied to single systems when applied to complex SoS. © 2017 Society for Risk Analysis.

Practical aspects of the use of three-phase alternating current electric machines in electricity storage system

NASA Astrophysics Data System (ADS)

Ciucur, Violeta

2015-02-01

Of three-phase alternating current electric machines, it brings into question which of them is more advantageous to be used in electrical energy storage system by pumping water. The two major categories among which are given dispute are synchronous and the asynchronous machine. To consider the synchronous machine with permanent magnet configuration because it brings advantages compared with conventional synchronous machine, first by removing the necessary additional excitation winding. From the point of view of loss of the two types of machines, the optimal adjustment of the magnetic flux density is obtained to minimize the copper loss by hysteresis and eddy currents.

Assessing diabetes practices in clinical settings: precursor to building community partnerships around disease management.

PubMed

Prochaska, John D; Mier, Nelda; Bolin, Jane N; Hora, Kerrie L; Clark, Heather R; Ory, Marcia G

2009-12-01

Many recommended best practices exist for clinical and community diabetes management and prevention. However, in many cases, these recommendations are not being fully utilized. It is useful to gain a sense of currently utilized and needed practices when beginning a partnership building effort to ameliorate such practice problems. The purpose of this study was to assess current practices in clinical settings within the Brazos Valley in preparation for beginning a community-based participatory research project on improving diabetes prevention and management in this region. Fifty-seven physicians with admission privileges to a regional health system were faxed a survey related to current diabetes patient loads, knowledge and implementation of diabetes-related best practices, and related topics. Both qualitative and quantitative examination of the data was conducted. Fifteen percent of responding providers indicated they implemented diabetes prevention best practices, with significant differences between primary-care physicians and specialists. Respondents indicated a need for educational and counseling resources, as well as an increased health-care workforce in the region. The utilization of a faxed-based survey proved an effective means for assessing baseline data as well as serving as a catalyst for further discussion around coalition development. Results indicated a strong need for both clinical and community-based services regarding diabetes prevention and management, and provided information and insight to begin focused community dialogue around diabetes prevention and management needs across the region. Other sites seeking to begin similar projects may benefit from a similar process.

Net Metering Policy Development and Distributed Solar Generation in Minnesota: Overview of Trends in Nationwide Policy Development and Implications of Increasing the Eligible System Size Cap

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

Doris, E.; Busche, S.; Hockett, S.

2009-12-01

The goal of the Minnesota net metering policy is to give the maximum possible encouragement to distributed generation assets, especially solar electric systems (MN 2008). However, according to a published set of best practices (NNEC 2008) that prioritize the maximum development of solar markets within states, the Minnesota policy does not incorporate many of the important best practices that may help other states transform their solar energy markets and increase the amount of grid-connected distributed solar generation assets. Reasons cited include the low system size limit of 40kW (the best practices document recommends a 2 MW limit) and a lackmore » of language protecting generators from additional utility fees. This study was conducted to compare Minnesota's policies to national best practices. It provides an overview of the current Minnesota policy in the context of these best practices and other jurisdictions' net metering policies, as well as a qualitative assessment of the impacts of raising the system size cap within the policy based on the experiences of other states.« less

Leadership development practices and hospital financial outcomes.

PubMed

Crowe, Daniel; Garman, Andrew N; Li, Chien-Ching; Helton, Jeff; Anderson, Matthew M; Butler, Peter

2017-08-01

Affordable Care Act legislation is requiring leaders in US health systems to adapt to new and very different approaches to improving operating performance. Research from other industries suggests leadership development can be a helpful component of organizational change strategies; however, there is currently very little healthcare-specific research available to guide design and deployment. The goal of this exploratory study is to examine potential relationships between specific leadership development practices and health system financial outcomes. Results from the National Center for Healthcare Leadership survey of leadership development practices were correlated with hospital and health system financial performance data from the 2013 Medicare Cost Reports. A general linear regression model, controlling for payer mix, case-mix index, and bed size, was used to assess possible relationships between leadership practices and three financial performance metrics: operating margin, days cash on hand, and debt to capitalization. Statistically significant associations were found between hospital-level operating margins and 5 of the 11 leadership practices as well as the composite score. Relationships at the health system level, however, were not statistically significant. Results provide preliminary evidence of an association between hospital financial performance and investments made in developing their leaders.

Data collection and information presentation for optimal decision making by clinical managers--the Autocontrol Project.

PubMed Central

Grant, A. M.; Richard, Y.; Deland, E.; Després, N.; de Lorenzi, F.; Dagenais, A.; Buteau, M.

1997-01-01

The Autocontrol methodology has been developed in order to support the optimisation of decision-making and the use of resources in the context of a clinical unit. The theoretical basis relates to quality assurance and information systems and is influenced by management and cognitive research in the health domain. The methodology uses population rather than individual decision making and because of its dynamic feedback design promises to have rapid and profound effect on practice. Most importantly the health care professional is the principle user of the Autocontrol system. In this methodology we distinguish three types of evidence necessary for practice change: practice based or internal evidence, best evidence derived from the literature or external evidence concerning the practice in question, and process based evidence on how to optimise the process of practice change. The software used by the system is of the executive decision support type which facilitates interrogation of large databases. The Autocontrol system is designed to interrogate the data of the patient medical record however the latter often lacks data on concomitant resource use and this must be supplemented. This paper reviews the Autocontrol methodology and gives examples from current studies. PMID:9357733

Data collection and information presentation for optimal decision making by clinical managers--the Autocontrol Project.

PubMed

Grant, A M; Richard, Y; Deland, E; Després, N; de Lorenzi, F; Dagenais, A; Buteau, M

1997-01-01

The Autocontrol methodology has been developed in order to support the optimisation of decision-making and the use of resources in the context of a clinical unit. The theoretical basis relates to quality assurance and information systems and is influenced by management and cognitive research in the health domain. The methodology uses population rather than individual decision making and because of its dynamic feedback design promises to have rapid and profound effect on practice. Most importantly the health care professional is the principle user of the Autocontrol system. In this methodology we distinguish three types of evidence necessary for practice change: practice based or internal evidence, best evidence derived from the literature or external evidence concerning the practice in question, and process based evidence on how to optimise the process of practice change. The software used by the system is of the executive decision support type which facilitates interrogation of large databases. The Autocontrol system is designed to interrogate the data of the patient medical record however the latter often lacks data on concomitant resource use and this must be supplemented. This paper reviews the Autocontrol methodology and gives examples from current studies.

Promoting healing and restoring trust: policy recommendations for improving behavioral health care for American Indian/Alaska Native adolescents.

PubMed

Goodkind, Jessica R; Ross-Toledo, Kimberly; John, Susie; Hall, Janie Lee; Ross, Lucille; Freeland, Lance; Coletta, Ernest; Becenti-Fundark, Twila; Poola, Charlene; Begay-Roanhorse, Regina; Lee, Christopher

2010-12-01

American Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15-24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: (1) high levels of violence and trauma exposure and traumatic loss, (2) past and current oppression, racism, and discrimination, (3) underfunded systems of care, (4) disregard for effective indigenous practices in service provision, policy, and funding, (5) overreliance on evidence-based practices, (6) lack of cultural competence among systems of care and providers, and (7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed.

PROMOTING HEALING AND RESTORING TRUST:POLICY RECOMMENDATIONS FOR IMPROVING BEHAVIORAL HEALTH CARE FOR AMERICAN INDIAN/ALASKA NATIVE ADOLESCENTS

PubMed Central

Goodkind, Jessica R.; Ross-Toledo, Kimberly; John, Susie; Hall, Janie Lee; Ross, Lucille; Freeland, Lance; Coletta, Ernest; Becenti-Fundark, Twila; Poola, Charlene; Begay-Roanhorse, Regina; Lee, Christopher

2011-01-01

American Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15 to 24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: 1) high levels of violence and trauma exposure and traumatic loss, 2) past and current oppression, racism, and discrimination, 3) underfunded systems of care, 4) disregard for effective indigenous practices in service provision, policy, and funding, 5) overreliance on evidence-based practices, 6) lack of cultural competence among systems of care and providers, and 7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed. PMID:20857331

Using Coaching as a Professional Development Modality to Train Teachers in the Use of Evidence-Based Practices for Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Hollins, Samantha Marsh

2013-01-01

Professional development for teachers currently working in the classroom is an important focus of educational programs and school systems. Continuous professional development is especially important for special education teachers to maintain current information related to strategies and supports that are effective in educating students with…

Too Anxious to Speak? The Implications of Current Research into Selective Mutism for Educational Psychology Practice

ERIC Educational Resources Information Center

Cleave, Hayley

2009-01-01

Selective Mutism is a low incidence disorder but has considerable impact on the school system when it occurs. Over the last decade several research articles have been published which have challenged the understanding of the aetiology of Selective Mutism. Current perceptions about the aetiology of Selective Mutism are considered in order to inform…

School Evaluation: Current Practices in OECD Countries and a Literature Review. OECD Education Working Papers, No. 42

ERIC Educational Resources Information Center

Faubert, Violaine

2009-01-01

This paper examines the current academic and policy literatures concerning school evaluation in primary and secondary education within the OECD countries. First, it provides a typology of the existing systems of school evaluation across the OECD. It encompasses the diverse criteria and instruments commonly used to carry out schools evaluation, as…

Systems-based practice in graduate medical education: systems thinking as the missing foundational construct.

PubMed

Colbert, Colleen Y; Ogden, Paul E; Ownby, Allison R; Bowe, Constance

2011-04-01

Since 2001, residencies have struggled with teaching and assessing systems-based practice (SBP). One major obstacle may be that the competency alone is not sufficient to support assessment. We believe the foundational construct underlying SBP is systems thinking, absent from the current Accreditation Council for Graduate Medical Education competency language. Systems thinking is defined as the ability to analyze systems as a whole. The purpose of this article is to describe psychometric issues that constrain assessment of SBP and elucidate the role of systems thinking in teaching and assessing SBP. Residency programs should incorporate systems thinking models into their curricula. Trainees should be taught to understand systems at an abstract level, in order to analyze their own healthcare systems, and participate in quality and patient safety activities. We suggest that a developmental trajectory for systems thinking be developed, similar to the model described by Dreyfus and Dreyfus.

Animal Health and Welfare Issues Facing Organic Production Systems

PubMed Central

Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

2013-01-01

Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

30 CFR 75.902-4 - Attachment of ground conductors and ground check wires to equipment frames; use of separate...

Code of Federal Regulations, 2014 CFR

2014-07-01

... SAFETY STANDARDS-UNDERGROUND COAL MINES Underground Low- and Medium-Voltage Alternating Current Circuits... from resistance grounded systems separate connections shall be used when practicable. ...

30 CFR 75.902-4 - Attachment of ground conductors and ground check wires to equipment frames; use of separate...

Code of Federal Regulations, 2013 CFR

2013-07-01

... SAFETY STANDARDS-UNDERGROUND COAL MINES Underground Low- and Medium-Voltage Alternating Current Circuits... from resistance grounded systems separate connections shall be used when practicable. ...

30 CFR 75.902-4 - Attachment of ground conductors and ground check wires to equipment frames; use of separate...

Code of Federal Regulations, 2012 CFR

2012-07-01

... SAFETY STANDARDS-UNDERGROUND COAL MINES Underground Low- and Medium-Voltage Alternating Current Circuits... from resistance grounded systems separate connections shall be used when practicable. ...

Survey of transit bus maintenance programs in Virginia.

DOT National Transportation Integrated Search

1981-01-01

Transit bus maintenance practices as used by thirteen small and medium-sized transit systems in Virginia were cataloged. Different approaches to maintenance were investigated and the current condition of transit bus maintenance was determined. Factor...

Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

PubMed Central

Martinez, Johanna; Phillips, Erica; Fein, Oliver

2013-01-01

Purpose The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP) and its evaluation process. Methods To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1) knowledge gain; (2) course ratings; and (3) qualitative feedback. Results On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion The course, entitled Perspectives on the Changing Healthcare System (POCHS) and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum. PMID:24001523

BOA: Asbestos pipe-insulation removal robot system, Phase 2. Topical report, January--June 1995

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

Schempf, H.; Bares, J.E.

This report explored the regulatory impact and cost-benefit of a robotic thermal asbestos pipe-insulation removal system over the current manual abatement work practice. The authors are currently in the second phase of a two-phase program to develop a robotic asbestos abatement system, comprised of a ground-based support system (including vacuum, fluid delivery, computing/electronics/power, and other subsystems) and several on-pipe removal units, each sized to handle pipes within a given diameter range. The intent of this study was to (i) aid in developing design and operational criteria for the overall system to maximize cost-efficiency, and (ii) to determine the commercial potentialmore » of a robotic pipe-insulation abatement system.« less

A National Satellite-Based System for Providing Continuing Education to Engineers.

ERIC Educational Resources Information Center

Georgia Inst. of Tech., Atlanta.

This document proposes, and indicates initial reaction to, a multi-point satellite-based delivery system which will permit expansion of current programs and services of the Association for Media-based Continuing Education for Engineers, Inc. (AMCEE) consortium to a much larger aggregated audience of practicing engineers throughout the country. It…

Learning to Click: An Evaluation of the Personal Response System Clicker Technology in Introductory Marketing Courses

ERIC Educational Resources Information Center

Williamson Sprague, Elaine; Dahl, Darren W.

2010-01-01

The incorporation of personal response system (PRS) clickers into teaching pedagogy has created implications for teaching practice and student satisfaction. Using a current undergraduate business student population, the authors measure student attitudes and preferences and identify student performance outcomes relating to the use of PRS clickers.…

Managing Courses Defining Learning: What Faculty, Students, and Administrators Want

ERIC Educational Resources Information Center

Jafari, Ali; McGee, Patricia; Carmean, Colleen

2006-01-01

The use of Learning/Course Management Systems (L/CMSs) has exploded in higher education. Recently, these authors served as editors for a book, "Course Management Systems for Learning," which explored current L/CMS design and usage by documenting best practices, research, standards, and implementations. Although the final section of the book…

Improving fumigation efficiency by increasing drip-tape number and using low permeability film in raised-bed production systems

USDA-ARS?s Scientific Manuscript database

Drip fumigation is commonly used for controlling soilborne pests in raised-bed strawberry production systems in California. However, the high emission loss and poor pest control indicate that the current fumigation practice with two drip tapes and polyethylene film (PE) covering need to be improved....

Learning Documentations in VET Systems: An Analysis of Current Swiss Practices

ERIC Educational Resources Information Center

Caruso, Valentina; Cattaneo, Alberto; Gurtner, Jean-Luc

2016-01-01

Swiss vocational education and training (VET) is defined as a dual-track system where apprentices weekly alternate between vocational school and a (real) workplace. At the workplace, they have to keep a learning documentation throughout their training, in which they are expected to regularly document their professional development. The actual use…

Potential means of cost reduction in grade crossing automatic gate systems. volume II : improved gate arm concepts for railroad/highway grade crossings gate systems

DOT National Transportation Integrated Search

1977-02-28

This report, Volume II of a two-volume study, examines the potential for reduction of the cost of installing and maintaining automatic gates at railroad-highway grade crossings. It includes a review of current practices, equipment, and standards; con...

Adapting Accountability Systems to the Limitations of Educational Measurement

ERIC Educational Resources Information Center

Kane, Michael

2015-01-01

Michael Kane writes in this article that he is in more or less complete agreement with Professor Koretz's characterization of the problem outlined in the paper published in this issue of "Measurement." Kane agrees that current testing practices are not adequate for test-based accountability (TBA) systems, but he writes that he is far…

Potential means of cost reduction in grade crossing automatic gate systems. volume I : overview and low cost railroad/highway grade crossing gate systems

DOT National Transportation Integrated Search

1977-02-28

This report, Volume I of a two-volume study, examines the potential for reduction of the cost of installing and maintaining automatic gates at railroad-highway grade crossings. It comprises a general overview; a review of current practices, equipment...

Research Capacity for Local Innovation: The Case of Conservation Agriculture in Ethiopia, Malawi and Mozambique

ERIC Educational Resources Information Center

Brown, Brendan; Nuberg, Ian; Llewellyn, Rick

2018-01-01

Purpose: The limited uptake of improved agricultural practices in Africa raise questions on the functionality of current agricultural research systems. Our purpose is to explore the capacity for local innovation within the research systems of Ethiopia, Malawi and Mozambique. Design/Methodology/Approach: Using Conservation Agriculture (CA) as a…

Evolution of the Systems Engineering Education Development (SEED) Program at NASA Goddard Space Flight Center

NASA Technical Reports Server (NTRS)

Bagg, Thomas C., III; Brumfield, Mark D.; Jamison, Donald E.; Granata, Raymond L.; Casey, Carolyn A.; Heller, Stuart

2003-01-01

The Systems Engineering Education Development (SEED) Program at NASA Goddard Space Flight Center develops systems engineers from existing discipline engineers. The program has evolved significantly since the report to INCOSE in 2003. This paper describes the SEED Program as it is now, outlines the changes over the last year, discusses current status and results, and shows the value of human systems and leadership skills for practicing systems engineers.

Will integrated surveillance systems for vectors and vector-borne diseases be the future of controlling vector-borne diseases? A practical example from China.

PubMed

Wu, Y; Ling, F; Hou, J; Guo, S; Wang, J; Gong, Z

2016-07-01

Vector-borne diseases are one of the world's major public health threats and annually responsible for 30-50% of deaths reported to the national notifiable disease system in China. To control vector-borne diseases, a unified, effective and economic surveillance system is urgently needed; all of the current surveillance systems in China waste resources and/or information. Here, we review some current surveillance systems and present a concept for an integrated surveillance system combining existing vector and vector-borne disease monitoring systems. The integrated surveillance system has been tested in pilot programmes in China and led to a 21·6% cost saving in rodent-borne disease surveillance. We share some experiences gained from these programmes.

Integrating Systems Thinking Into Nursing Education.

PubMed

Phillips, Janet M; Stalter, Ann M

2016-09-01

A critical need exists for nursing leadership in current complex health care settings. Systems thinking can be incorporated into nursing education at all levels by using evidence-based principles in education. Teaching tips are provided using a systems awareness model to guide nurse educators in the assessment and integration of systems thinking and engaging learners in interprofessional education and practice. J Contin Educ Nurs. 2016;47(9):395-397. Copyright 2016, SLACK Incorporated.

View from the top: CEO perspectives on executive development and succession planning practices in healthcare organizations.

PubMed

Groves, Kevin S

2006-01-01

Many healthcare professionals question whether the industry's hospitals and multi-site systems are implementing the necessary executive development and succession planning systems to ensure that high potential managers are prepared and aptly selected to assume key executive roles. Survey data, case studies, and cross-industry comparisons suggest that healthcare organizations may face a leadership crisis as the current generation of chief executive officers (CEOs) nears retirement while traditional means of developing the leadership pipeline, including middle-management positions and graduate programs requiring formal residencies, continue to dissipate. Given the daunting challenges that accompany the healthcare industry's quest to identify, develop, and retain leadership talent, this article provides best practice findings from a qualitative study of 13 healthcare organizations with a record of exemplary executive development and succession planning practices. CEOs from six single-site hospitals, six healthcare systems, and one medical group were interviewed to identify industry best practices so that healthcare practitioners and educators may utilize the findings to enhance the industry's leadership capacity.

Climate change mitigation and adaptation in the land use sector: from complementarity to synergy.

PubMed

Duguma, Lalisa A; Minang, Peter A; van Noordwijk, Meine

2014-09-01

Currently, mitigation and adaptation measures are handled separately, due to differences in priorities for the measures and segregated planning and implementation policies at international and national levels. There is a growing argument that synergistic approaches to adaptation and mitigation could bring substantial benefits at multiple scales in the land use sector. Nonetheless, efforts to implement synergies between adaptation and mitigation measures are rare due to the weak conceptual framing of the approach and constraining policy issues. In this paper, we explore the attributes of synergy and the necessary enabling conditions and discuss, as an example, experience with the Ngitili system in Tanzania that serves both adaptation and mitigation functions. An in-depth look into the current practices suggests that more emphasis is laid on complementarity-i.e., mitigation projects providing adaptation co-benefits and vice versa rather than on synergy. Unlike complementarity, synergy should emphasize functionally sustainable landscape systems in which adaptation and mitigation are optimized as part of multiple functions. We argue that the current practice of seeking co-benefits (complementarity) is a necessary but insufficient step toward addressing synergy. Moving forward from complementarity will require a paradigm shift from current compartmentalization between mitigation and adaptation to systems thinking at landscape scale. However, enabling policy, institutional, and investment conditions need to be developed at global, national, and local levels to achieve synergistic goals.

Quench Detection and Protection of an HTS Coil

NASA Astrophysics Data System (ADS)

Sheehan, Evan; Pfotenhauer, John; Miller, Franklin; Christianson, Owen

2017-12-01

A pulsed, modular HTS magnet for energy storage applications was constructed and tested. Charge and discharge pulses were accomplished in about 1 second. A recuperative cryogenic cooling system supplies 42 to 80 Kelvin helium gas to the magnet. A practical solution to overvoltage and overcurrent protection has been implemented digitally using LabVIEW. Voltages as little as 46 μV greater than the expected value trigger the protection system, which stops the pulse profile and begins an immediate current ramp down to zero over 1 second. The protection system has displayed its effectiveness in HTS transition detection and damage prevention. Experimentation has demonstrated that current pulses on the order of seconds with amplitudes of up to 110 Amps can be achieved for extended periods. Higher currents produce joint heating in excess of the available cooling from the existing cryogenic system.

AAC services for multilingual populations: South African service provider perspectives.

PubMed

Tönsing, Kerstin M; van Niekerk, Karin; Schlünz, Georg I; Wilken, Ilana

In South Africa, many persons in need of augmentative and alternative communication (AAC) come from multilingual backgrounds. There is as yet a limited evidence base (locally and internationally) for the provision of AAC services to multilingual populations. The perspectives of service providers can assist in gaining an understanding of current practices and the factors that influence these. The study aimed to obtain the perspectives of AAC service providers about practices in providing AAC systems and AAC intervention to clients from multilingual backgrounds. Fifteen AAC service providers were purposefully chosen to participate in one of three focus groups - two face-to-face and one online focus group. Data from the face-to-face focus groups was transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data. Four overarching themes were identified, namely (a) current practices, (b) factors influencing current practices, (c) service provides' orientation towards different language options in AAC intervention, and (d) needs and desired developments regarding AAC technology. This paper reports on the first three themes. Service providers reported their practices to range from a focus on L1 exclusively, L2 exclusively, to a multilingual (sequential or simultaneous) approach. The South African language context, family language preferences and choices, service provider skill and knowledge, as well as AAC technology were identified as factors influencing their practices. Although many viewed access to multiple languages through AAC as positive, they also expressed concerns and reservations about providing multilingual AAC services. Although service providers in general saw the need to give clients from multilingual backgrounds access to multiple languages using AAC, this did not always translate into multilingual AAC practices. Both extrinsic factors (e.g. the lack of appropriate AAC devices, software and apps giving access to non-English languages) and intrinsic factors (service providers' language competency and their beliefs about the cognitive demands of multilingual AAC systems) influenced their practices and choices. Appropriate AAC service delivery to multilingual populations in South Africa would require not only appropriate AAC technology developments, but also research evidence to establish the efficacy of multilingual AAC interventions for clients with a variety of characteristics. Copyright © 2018 Elsevier Inc. All rights reserved.

Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient?

PubMed

Vogt, Henrik; Ulvestad, Elling; Eriksen, Thor Eirik; Getz, Linn

2014-12-01

The practicing doctor, and most obviously the primary care clinician who encounters the full complexity of patients, faces several fundamental but intrinsically related theoretical and practical challenges - strongly actualized by so-called medically unexplained symptoms (MUS) and multi-morbidity. Systems medicine, which is the emerging application of systems biology to medicine and a merger of molecular biomedicine, systems theory and mathematical modelling, has recently been proposed as a primary care-centered strategy for medicine that promises to meet these challenges. Significantly, it has been proposed to do so in a way that at first glance may seem compatible with humanistic medicine. More specifically, it is promoted as an integrative, holistic, personalized and patient-centered approach. In this article, we ask whether and to what extent systems medicine can provide a comprehensive conceptual account of and approach to the patient and the root causes of health problems that can be reconciled with the concept of the patient as a person, which is an essential theoretical element in humanistic medicine. We answer this question through a comparative analysis of the theories of primary care doctor Eric Cassell and systems biologist Denis Noble. We argue that, although systems biological concepts, notably Noble's theory of biological relativity and downward causation, are highly relevant for understanding human beings and health problems, they are nevertheless insufficient in fully bridging the gap to humanistic medicine. Systems biologists are currently unable to conceptualize living wholes, and seem unable to account for meaning, value and symbolic interaction, which are central concepts in humanistic medicine, as constraints on human health. Accordingly, systems medicine as currently envisioned cannot be said to be integrative, holistic, personalized or patient-centered in a humanistic medical sense. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

How changes to the Medicare Benefits Schedule could improve the practice of cardiology and save taxpayer money.

PubMed

Harper, Richard W; Nasis, Arthur; Sundararajan, Vijaya

2015-09-21

Rising health care costs above inflation are placing serious strains on the sustainability of the Australian Medicare system in its current structure. The Medicare Benefits Schedule (MBS), which lists rebates payable to patients for private medical services provided on a fee-for-service basis, is the cornerstone of the Australian health care system. Introduced in the 1980s, the MBS has changed little despite major advances in the evidence base for the practice of cardiology. We outline how we believe sensible changes to the MBS listings for four cardiac services--invasive coronary angiography, computed tomography coronary angiography, stress testing and percutaneous coronary intervention--would improve the clinical practice of cardiology and save substantial amounts of taxpayer money.

The medical practice as business organization.

PubMed

Bender, A D; Aaronson, W E; Krasnick, C J; Bender, J G

1996-03-01

Medical practices historically have not been examined in terms of their organizational structures and of the appropriateness of their structures for survival as business entities. In this paper, we propose a model for the typical medical practice and discuss its fit with current organizational theory. It is apparent that the medical practice organization does not fit with the demands of a rapidly changing and complex environment. To survive and grow, the medical practice organization must align itself with others that have an interest and stake in the health care system, develop teamwork among physicians, bridge the gap between physicians and others in the organization, and recognize that the work done in the organization depends on other components of the organization.

Effective Literacy and English Language Instruction for English Learners in the Elementary Grades. IES Practice Guide. NCEE 2007-4011

ERIC Educational Resources Information Center

Gersten, Russell; Baker, Scott K.; Shanahan, Timothy; Linan-Thompson, Sylvia; Collins, Penny; Scarcella, Robin

2007-01-01

This Practice Guide is the first in a series of the Institute of Education Sciences (IES) guides in education that are developed by a panel of experts. The guides are intended to bring the best available evidence and expertise to bear on the types of systemic challenges that cannot currently be addressed by single intervention or programs. This…

Preparing the Future Dental Hygiene Workforce: Knowledge, Skills, and Reform.

PubMed

Fried, Jacquelyn L; Maxey, Hannah L; Battani, Kathryn; Gurenlian, JoAnn R; Byrd, Tammi O; Brunick, Ann

2017-09-01

With the health care delivery system in transition, the way in which oral health care services are delivered in 2040 will inevitably change. To achieve the aims of reduced cost, improved access, and higher quality and to advance population wellness, oral health care will likely become a more integrated part of medical care. An integrated primary care system would better meet the needs of an increasingly diverse and aging U.S. population with uneven access to health care services. By 2040, trends suggest that a smaller proportion of dental hygienists will work in traditional solo dental offices; many more will practice with multidisciplinary health care teams in large-group dental and medical practices and in a variety of non-traditional community settings. This integration will require changes in how dental hygienists are educated. To shape the skill sets, clinical judgment, and knowledge of future practitioners, current dental hygiene curricula must be reexamined, redirected, and enhanced. This article examines some of the factors that are likely to shape the future of dental hygiene practice, considers the strengths and weaknesses of current curricula, and proposes educational changes to prepare dental hygienists for practice in 2040. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Flying Lessons for Clinicians: Developing System 2 Practice.

PubMed

Gregoire, Jerome N; Alfes, Celeste M; Reimer, Andrew P; Terhaar, Mary F

There is a long history of adopting lessons learned from aviation to improve health care practice. Two of the major practices that have successfully transferred include using a checklist and simulation. Training and simulation technology is currently underdeveloped for nurses and health care providers entering critical care transport. This article describes a pedagogical approach adopted from aviation to develop a new simulation platform and program of research to develop the science of critical care transport nursing education. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

System-Level Shared Governance Structures and Processes in Healthcare Systems With Magnet®-Designated Hospitals: A Descriptive Study.

PubMed

Underwood, Carlisa M; Hayne, Arlene N

The purpose was to identify and describe structures and processes of best practices for system-level shared governance in healthcare systems. Currently, more than 64.6% of US community hospitals are part of a system. System chief nurse executives (SCNEs) are challenged to establish leadership structures and processes that effectively and efficiently disseminate best practices for patients and staff across complex organizations, geographically dispersed locations, and populations. Eleven US healthcare SCNEs from the American Nurses Credentialing Center's repository of Magnet®-designated facilities participated in a 35-multiquestion interview based on Kanter's Theory of Organizational Empowerment. Most SCNEs reported the presence of more than 50% of the empowerment structures and processes in system-level shared governance. Despite the difficulties and complexities of growing health systems, SCNEs have replicated empowerment characteristics of hospital shared governance structures and processes at the system level.

77 FR 26734 - Notice of Intent To Extend a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... American Samoa, Guam, Micronesia, Northern Marianas, Puerto Rico, and the Virgin Islands. The objectives of... practices; (2) youth group participants; and (3) staff. NEERS consists of separate software sub-systems for...

An evaluation of IDOT's current underdrain systems

DOT National Transportation Integrated Search

1995-12-01

The use of pavement underdrains became common practice in Illinois following the issuance of a Department underdrain policy in December 1970. Since that time, a variety of materials have been incorporated as underdrains. As these materials evolved, I...

eXascale PRogramming Environment and System Software (XPRESS)

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

Chapman, Barbara; Gabriel, Edgar

Exascale systems, with a thousand times the compute capacity of today’s leading edge petascale computers, are expected to emerge during the next decade. Their software systems will need to facilitate the exploitation of exceptional amounts of concurrency in applications, and ensure that jobs continue to run despite the occurrence of system failures and other kinds of hard and soft errors. Adapting computations at runtime to cope with changes in the execution environment, as well as to improve power and performance characteristics, is likely to become the norm. As a result, considerable innovation is required to develop system support to meetmore » the needs of future computing platforms. The XPRESS project aims to develop and prototype a revolutionary software system for extreme-­scale computing for both exascale and strong­scaled problems. The XPRESS collaborative research project will advance the state-­of-­the-­art in high performance computing and enable exascale computing for current and future DOE mission-­critical applications and supporting systems. The goals of the XPRESS research project are to: A. enable exascale performance capability for DOE applications, both current and future, B. develop and deliver a practical computing system software X-­stack, OpenX, for future practical DOE exascale computing systems, and C. provide programming methods and environments for effective means of expressing application and system software for portable exascale system execution.« less

Update on wide- and ultra-widefield retinal imaging

PubMed Central

Shoughy, Samir S; Arevalo, J Fernando; Kozak, Igor

2015-01-01

The peripheral retina is the site of pathology in many ocular diseases and ultra-widefield (UWF) imaging is one of the new technologies available to ophthalmologists to manage some of these diseases. Currently, there are several imaging systems used in practice for the purpose of diagnostic, monitoring disease progression or response to therapy, and telemedicine. These include modalities for both adults and pediatric patients. The current systems are capable of producing wide- and UWF color fundus photographs, fluorescein and indocyanine green angiograms, and autofluorescence images. Using this technology, important clinical observations have been made in diseases such as diabetic retinopathy, uveitides, retinal vascular occlusions and tumors, intraocular tumors, retinopathy of prematurity, and age-related macular degeneration. Widefield imaging offers excellent postoperative documentation of retinal detachment surgery. New applications will soon be available to integrate this technology into large volume routine clinical practice. PMID:26458474

Particle sedimentation in curved tubes: A 3D simulation and optimization for treatment of vestibular vertigo

NASA Astrophysics Data System (ADS)

White, Brian; Squires, Todd M.; Hain, Timothy C.; Stone, Howard A.

2003-11-01

Benign paroxysmal positional vertigo (BPPV) is a mechanical disorder of the vestibular system where micron-size crystals abnormally drift into the semicircular canals of the inner ear that sense angular motion of the head. Sedimentation of these crystals causes sensation of motion after true head motion has stopped: vertigo results. The usual clinical treatment is through a series of head maneuvers designed to move the particles into a less sensitive region of the canal system. We present a three-dimensional model to simulate treatment of BPPV by determining the complete hydrodynamic motion of the particles through the course of a therapeutic maneuver while using a realistic representation of the actual geometry. Analyses of clinical maneuvers show the parameter range for which they are effective, and indicate inefficiencies in current practice. In addition, an optimization process determines the most effective head maneuver, which significantly differs from those currently in practice.

Memory characteristics of ring-shaped ceramic superconductors

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

Takeoka, A.; Hasunuma, M.; Sakaiya, S.

1989-03-01

For the practical application of ceramic superconductors, the authors investigated the residual magnetic field characteristics of ring-shaped ceramic superconductors in a Y-Ba-Cu-O system with high Tc. The residual magnetic field of a ring with asymmetric current paths, supplied by external currents, appeared when one of the branch currents was above the critical current. The residual magnetic field saturated when both brach currents exceeded the critical current of the ring and showed hysteresis-like characteristics. The saturated magnetic field is subject to the critical current of the ring. A superconducting ring with asymmetric current paths suggests a simple and quite new persistent-currentmore » type memory device.« less

Performance management in healthcare: a critical analysis.

PubMed

Hewko, Sarah J; Cummings, Greta G

2016-01-01

Purpose - The purpose of this paper is to explore the underlying theoretical assumptions and implications of current micro-level performance management and evaluation (PME) practices, specifically within health-care organizations. PME encompasses all activities that are designed and conducted to align employee outputs with organizational goals. Design/methodology/approach - PME, in the context of healthcare, is analyzed through the lens of critical theory. Specifically, Habermas' theory of communicative action is used to highlight some of the questions that arise in looking critically at PME. To provide a richer definition of key theoretical concepts, the authors conducted a preliminary, exploratory hermeneutic semantic analysis of the key words "performance" and "management" and of the term "performance management". Findings - Analysis reveals that existing micro-level PME systems in health-care organizations have the potential to create a workforce that is compliant, dependent, technically oriented and passive, and to support health-care systems in which inequalities and power imbalances are perpetually reinforced. Practical implications - At a time when the health-care system is under increasing pressure to provide high-quality, affordable services with fewer resources, it may be wise to investigate new sector-specific ways of evaluating and managing performance. Originality/value - In this paper, written for health-care leaders and health human resource specialists, the theoretical assumptions and implications of current PME practices within health-care organizations are explored. It is hoped that readers will be inspired to support innovative PME practices within their organizations that encourage peak performance among health-care professionals.

Providing Individually Tailored Academic and Behavioral Support Services for Youth in the Juvenile Justice and Child Welfare Systems. Practice Guide

ERIC Educational Resources Information Center

Gonsoulin, S.; Darwin, M. J.; Read, N. W.

2012-01-01

Youth who are involved with the juvenile justice and child welfare systems face many challenges and barriers to academic and vocational success. Regardless of the reasons for their involvement, youth in these systems are "disproportionately children and youth of color who currently have, or have experienced, a host of risk factors that are…

Vacuum pumps and systems: A review of current practice

NASA Technical Reports Server (NTRS)

Giles, Stuart

1986-01-01

A review of the fundamental characteristics of the many types of vacuum pumps and vacuum pumping systems is given. The optimum pumping range, relative cost, performance limitations, maintenance problems, system operating costs and similar subjects are discussed. Experiences from the thin film deposition, chemical processing, material handling, food processing and other industries, as well as space simulation are used to support conclusions and recommendations.

Development of a health care systems curriculum.

PubMed

Pruitt, Zachary; Mhaskar, Rahul; Kane, Bryan G; Barraco, Robert D; DeWaay, Deborah J; Rosenau, Alex M; Bresnan, Kristin A; Greenberg, Marna Rayl

2017-01-01

There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution. This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created to assess student health system competence. Student evaluation of course curriculum design, delivery, and assessment was provided through web-based surveys. To meet competency standards for system-based practice, a health systems curriculum was developed and delivered across 4 years of medical school training. Each of the health system lectures and problem-based learning activities are described herein. The majority of first and second year medical students stated they gained working knowledge of health systems by engaging in these sessions. The majority of the 2016 graduating students (88.24%) felt that the course content, overall, prepared them for their career. A health systems curriculum in undergraduate medical education using a problem-based learning approach is feasible. The majority of students learning health systems curriculum through this format reported being prepared to improve individual patient care and optimize the health system's value (better care and health for lower cost).

Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

PubMed

Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

2015-04-01

The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Drug product distribution systems and departmental operations.

PubMed

Hynniman, C E

1991-10-01

Technologies affecting institutional pharmacy practice and the operation of pharmacy departments are reviewed, future developments are outlined, and implications of these developments for pharmacy education are proposed. Computer technology, especially as applied to areas such as artificial intelligence, online information databases, electronic bulletin boards, hospital information systems, and point-of-care systems, will have a strong impact on pharmacy practice and management in the 1990s. Other areas in which growth is likely to be active include bar-code technology, robotics, and automated drug dispensing. The applications of these technologies are described, with particular attention placed on the effects of increased automation on the drug-dispensing function. Technological advances may effect marked reductions in dispensing and medication errors; questions concerning the cost-effectiveness of these new systems remain to be answered. These advances also create new opportunities for clinical involvement by pharmacists; however, a fundamental understanding of computer systems is essential. Current practitioners can benefit from attending seminars, participating in users' groups, and keeping current with the computer literature. Many students now acquire the needed skills in computer laboratories and in the classroom. Technological advances will offer the opportunity for pharmacists to expand their clinical role.

[Centralized immunization schedules and regional equity of access: an audit among Apulian healthcare workers].

PubMed

Tafuri, S; Martinelli, D; Caputi, G; Fortunato, F; Germinario, C; Prato, R

2009-01-01

The reform of the Vth Title of the Italian Constitution has given the Regions autonomous power over planning of their immunization programme and immunization calendar. This amendment has federalized Italy's vaccination system and, is justified by epidemiological evidence however casts doubt on its provision of equal rights to health care. The objective of this current study is to gain insight into the opinion of vaccine services officers in the Apulia region on federal immunization and the regional immunization programme. Research was conducted using an anonymous standardized questionnaire to which 302 vaccines services staff responded. 67.4% of respondents believe that the current federal vaccination programme should be maintained, whilst 20.2% believe that the current system should be eradicated and 12.4% believe it should be phased out gradually. The current apulian vaccination calendar provides free and active immunizations for all newborns for the pneumococcal, meningitis C, chickenpox and hepatitis A vaccines. The interviewees believe that the vaccinations provided in the regional immunization programme are very important (average importance out of 10 = 6.1/7). The positive response to the regional vaccination plan given by the health officers explains, at least in part, the conservative attitude tewards federal vaccination plans. It cannot be excluded that sacrificing regional autonomy over vaccination programmes might be considered by the vaccination officers as being responsible for the abandonment of the Region's long established immunization practices. The success of these practices is evident in the case of the Region's Hepatitis A immunization programme where the active provision of this vaccine has drastically reduced the endemicity of the illness in Apulia. These experiences of good practice should be adequately considered in before opting to phase out the current immunisation programme.

78 FR 3646 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

...The Food and Drug Administration (FDA) is proposing to amend its regulation for Current Good Manufacturing Practice In Manufacturing, Packing, or Holding Human Food (CGMPs) to modernize it and to add requirements for domestic and foreign facilities that are required to register under the Federal Food, Drug, and Cosmetic Act (the FD&C Act) to establish and implement hazard analysis and risk- based preventive controls for human food. FDA also is proposing to revise certain definitions in FDA's current regulation for Registration of Food Facilities to clarify the scope of the exemption from registration requirements provided by the FD&C Act for ``farms.'' FDA is taking this action as part of its announced initiative to revisit the CGMPs since they were last revised in 1986 and to implement new statutory provisions in the FD&C Act. The proposed rule is intended to build a food safety system for the future that makes modern, science-, and risk-based preventive controls the norm across all sectors of the food system.

[Oxidative stress. Should it be measured in the diabetic patient?].

PubMed

Villa-Caballero, L; Nava-Ocampo, A A; Frati-Munari, A C; Ponce-Monter, H

2000-01-01

Oxidative stress has been defined as a loss of counterbalance between free radical or reactive oxygen species production and the antioxidant systems, with negative effects on carbohydrates, lipids, and proteins. It is also involved in the progression of different chronic diseases and apoptosis. Diabetes mellitus is associated to a high oxidative stress level through different biochemical pathways, i.e. protein glycosylation, glucose auto-oxidation, and the polyol pathway, mainly induced by hyperglycemia. Oxidative stress could also be involved in the pathogenesis of atherosclerotic lesions and other chronic diabetic complications. Measurement of oxidative stress could be useful to investigate its role in the initiation and development processes of chronic diabetic complications and also to evaluate preventive actions, including antioxidative therapy. Different attempts have been made to obtain a practical, accurate, specific, and sensitive method to evaluate oxidative stress in clinical practice. However, this ideal method is not currently available to date and the usefulness of the current methods needs to be confirmed in daily practice. We suggest quantifying oxidated and reduced glutation (GSSG/GSH) and the thiobarbituric reactive substances (TBARS) with currently alternatives. Currently available alternative methods while we await better options.

Solutions for medical databases optimal exploitation

PubMed Central

Branescu, I; Purcarea, VL; Dobrescu, R

2014-01-01

The paper discusses the methods to apply OLAP techniques for multidimensional databases that leverage the existing, performance-enhancing technique, known as practical pre-aggregation, by making this technique relevant to a much wider range of medical applications, as a logistic support to the data warehousing techniques. The transformations have practically low computational complexity and they may be implemented using standard relational database technology. The paper also describes how to integrate the transformed hierarchies in current OLAP systems, transparently to the user and proposes a flexible, “multimodel" federated system for extending OLAP querying to external object databases. PMID:24653769

Reframing the Australian nurse teacher competencies: do they reflect the 'REAL' world of nurse teacher practice?

PubMed

Guy, Jacqui; Taylor, Christine; Roden, Janet; Blundell, Jennifer; Tolhurst, Gerda

2011-04-01

The Australian nurse teacher competencies were introduced in 1996; however, the researchers perceived that changes to the health care system and a nursing workforce shortage may have affected nurse teacher roles over the past decade. This study aimed to explore perceptions of nurse teachers on the applicability of the current Australian nurse teacher competencies to practice, and modify the nurse teacher competencies to better reflect current practice. Methodology utilized mixed methods, and data collection was via focus groups, telephone interviews, and survey data. Results revealed that participants were mostly positive about the original competency statements, although there were some variations between items. Themes that emerged from the qualitative data were: changing trends in health care; preparation for teaching; understanding of the competencies, contextual influences on education role; nurse teachers as change agents, and resource management. Conclusions were that the Australian nurse teacher competencies (1996) were reflective of the current generic roles of nurse teachers however some of the competencies needed reframing to meet the current needs of nurse teachers. However, changes needed to be made in areas such as reducing complex language, inclusion of technology, and cultural competencies. Nurse teachers were supportive of the research because they valued the teacher competencies for reflection on their practice and the development of portfolios, job descriptions and performance appraisals. Copyright © 2010. Published by Elsevier Ltd.

Strengthening health professions regulation in Cambodia: a rapid assessment.

PubMed

Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

2016-03-10

This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and overlap between governance and regulatory arrangements for the five regulated professions. There is considerable scope for reform to the current regulatory system to better align the system to Cambodia's: Current needs and circumstances; Health system strategic priorities; and International obligations. Cambodia is also well placed to base its reformed regulatory system on recent developments of "smart regulatory practices" for health professionals.

Partnering with patients to promote holistic diabetes management: changing paradigms.

PubMed

Lorenzo, Lenora

2013-07-01

To provide a review of best practice for clinical management of diabetes mellitus (DM) for nurse practitioners (NPs) and accelerate incorporation of key findings into current practice. A search was conducted in Pub Med, Ovid, CINAHL, and Cochrane's Database of Systematic Reviews. There are many challenges for DM care identified in the current health system. There is a great need to change care paradigms to engage patients in partnership for enhanced management and self-management in DM. A review of the best practice evidence revealed numerous models of care, strategies, and tools available to enhance diabetes care and promote health and well-being. The primary focus of this article is to engage NP clinicians to incorporate new strategies to augment management and improve clinical outcomes. Incorporation of best practice for DM management may accelerate the paradigm shift to more patient-focused care. Engaged, informed, and activated patients along with clinicians working in partnerships may enhance clinical outcomes. ©2013 The Author ©2013 American Association of Nurse Practitioners.

Contemporary management of pericardial effusion: practical aspects for clinical practice.

PubMed

Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo

2017-03-01

A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.

Financing a College Education: How It Works, How It's Changing. American Council on Education/Oryx Press Series on Higher Education.

ERIC Educational Resources Information Center

King, Jacqueline E., Ed.

This collection of 15 essays by policy analysts and higher education specialists examines student financial aid, how policy and practice have changed, how student costs at U.S. colleges and universities are currently being met, and why and how enhancements to current programs would make the system more equitable. Following an introduction by D.…

21 CFR 110.5 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria and...

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

PubMed

Rosa, William

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

Soil organic carbon sequestration in cotton production systems of the southeastern United States: a review.

PubMed

Causarano, H J; Franzluebbers, A J; Reeves, D W; Shaw, J N

2006-01-01

Past agricultural management practices have contributed to the loss of soil organic carbon (SOC) and emission of greenhouse gases (e.g., carbon dioxide and nitrous oxide). Fortunately, however, conservation-oriented agricultural management systems can be, and have been, developed to sequester SOC, improve soil quality, and increase crop productivity. Our objectives were to (i) review literature related to SOC sequestration in cotton (Gossypium hirsutum L.) production systems, (ii) recommend best management practices to sequester SOC, and (iii) outline the current political scenario and future probabilities for cotton producers to benefit from SOC sequestration. From a review of 20 studies in the region, SOC increased with no tillage compared with conventional tillage by 0.48 +/- 0.56 Mg C ha(-1) yr(-1) (H(0): no change, p < 0.001). More diverse rotations of cotton with high-residue-producing crops such as corn (Zea mays L.) and small grains would sequester greater quantities of SOC than continuous cotton. No-tillage cropping with a cover crop sequestered 0.67 +/- 0.63 Mg C ha(-1) yr(-1), while that of no-tillage cropping without a cover crop sequestered 0.34 +/- 47 Mg C ha(-1) yr(-1) (mean comparison, p = 0.04). Current government incentive programs recommend agricultural practices that would contribute to SOC sequestration. Participation in the Conservation Security Program could lead to government payments of up to Dollars 20 ha(-1). Current open-market trading of C credits would appear to yield less than Dollars 3 ha(-1), although prices would greatly increase should a government policy to limit greenhouse gas emissions be mandated.

Adaptive Systems Engineering: A Medical Paradigm for Practicing Systems Engineering

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

R. Douglas Hamelin; Ron D. Klingler; Christopher Dieckmann

2011-06-01

From its inception in the defense and aerospace industries, SE has applied holistic, interdisciplinary tools and work-process to improve the design and management of 'large, complex engineering projects.' The traditional scope of engineering in general embraces the design, development, production, and operation of physical systems, and SE, as originally conceived, falls within that scope. While this 'traditional' view has expanded over the years to embrace wider, more holistic applications, much of the literature and training currently available is still directed almost entirely at addressing the large, complex, NASA and defense-sized systems wherein the 'ideal' practice of SE provides the cradle-to-gravemore » foundation for system development and deployment. Under such scenarios, systems engineers are viewed as an integral part of the system and project life-cycle from conception to decommissioning. In far less 'ideal' applications, SE principles are equally applicable to a growing number of complex systems and projects that need to be 'rescued' from overwhelming challenges that threaten imminent failure. The medical profession provides a unique analogy for this latter concept and offers a useful paradigm for tailoring our 'practice' of SE to address the unexpected dynamics of applying SE in the real world. In short, we can be much more effective as systems engineers as we change some of the paradigms under which we teach and 'practice' SE.« less

Design and fabrication of a four-man capacity urine wick evaporator system

NASA Technical Reports Server (NTRS)

1979-01-01

The integrated system was tested to determine the performance characteristics and limitations of the dual catalyst concept. The primary objective of the dual catalyst concept is to remove ammonia and other noxious substances in the gas phase and thereby eliminate the need for and current practice of chemically or electrochemically pretreating urine prior to distillation.

Better informed in clinical practice - a brief overview of dental informatics.

PubMed

Reynolds, P A; Harper, J; Dunne, S

2008-03-22

Uptake of dental informatics has been hampered by technical and user issues. Innovative systems have been developed, but usability issues have affected many. Advances in technology and artificial intelligence are now producing clinically useful systems, although issues still remain with adapting computer interfaces to the dental practice working environment. A dental electronic health record has become a priority in many countries, including the UK. However, experience shows that any dental electronic health record (EHR) system cannot be subordinate to, or a subset of, a medical record. Such a future dental EHR is likely to incorporate integrated care pathways. Future best dental practice will increasingly depend on computer-based support tools, although disagreement remains about the effectiveness of current support tools. Over the longer term, future dental informatics tools will incorporate dynamic, online evidence-based medicine (EBM) tools, and promise more adaptive, patient-focused and efficient dental care with educational advantages in training.

Enhancing adult learning in clinical supervision.

PubMed

Goldman, Stuart

2011-01-01

For decades, across almost every training site, clinical supervision has been considered "central to the development of skills" in psychiatry. The crucial supervisor/supervisee relationship has been described extensively in the literature, most often framed as a clinical apprenticeship of the novice to the master craftsman. This approach fails to directly incorporate adult-learning theory (ALT), despite a clear literature supporting its superiority. In this article, the author describes the basic principles of ALT, reviewing the limitations of current supervisory practice from the ALT perspective. He then describes system insights gleaned from elements of the manufacturing process and integrates them into a model that enhances ALT-informed approaches to clinical supervision that can be utilized in all settings. Although there are clear benefits of ALT and the proposed "pull" manufacturing management-informed approaches to supervision, there are several anticipated areas of likely resistance: the issues of time for the collaborative goal-setting, monitoring progress, and revising the educational plan. Much of this is already a factor in the current, labor-intensive patterns of individual supervision, and, in practice, even the formal monthly review has, in almost all cases, taken appreciably less than half of a supervisory hour. Any possible increases in time or effort would be more than compensated for by the inherent efficiency of resident-specific teaching and learning. Current supervisory practices can be revised to include principles of ALT and "pull" manufacturing systems that can enhance resident education.

Industrial Energy Efficiency Practices in Indonesia: Lesson Learned from Astra Green Energy (AGen) Award

NASA Astrophysics Data System (ADS)

Telaga, A. S.; Hartanto, I. D.

2017-03-01

Many countries have used award system to promote energy efficiency practices in industry. The award system has been found to have significant impact to increase energy conservation and sustainability adoption in companies. Astra International (AI) as a holding company of more than 200 companies also organised Astra green energy (AGen) award to all affiliated companies (AFFCO) in Astra group. The event has been used to share energy efficiency best practices among AFFCO in Astra group. AFFCOs of Astra International are among the biggest and the leader in their industrial sectors Therefore, analyses from AFFO’s energy efficiency case studies represents current practices in Indonesia industrial sectors. Analyses are divided into industry, building, and renewable energy. The results from analyses found that AFFCOs already aware of energy conservation and have implemented projects to promote energy efficiency. However, the AFFCOs do not optimally use monitoring data for energy reduction.

Medical examiner/death investigator training requirements in state medical examiner systems.

PubMed

Prahlow, J A; Lantz, P E

1995-01-01

Comprehensive and properly performed investigation of suspicious, unusual, unnatural, and various natural deaths is necessary to maintain the health, safety, and well-being of society as a whole. Adequate investigation requires the combined efforts and cooperation of law-enforcement and other public-service agencies, medical professionals, and those within the forensic community. As such, the "death investigator" plays a crucial role in the investigation process. These front-line investigators, whether they be coroners, medical examiners, physicians, other medical professionals, or lay-people, are required to make important decisions which have far-reaching consequences on how death investigation cases proceed. Death investigation practices vary greatly among medico-legal jurisdictions. A recent publication has categorized state death investigation systems by type of system. In an attempt to better delineate death investigation practices with specific regard to investigators' training and continuing education requirements, we surveyed the 20 systems categorized as state medical examiner systems and the five states with combined state medical examiner and county coroner/medical examiner systems. We present our findings and make recommendations which address the attributes and deficiencies of current death investigation practices.

21 CFR 225.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act...

21 CFR 210.1 - Status of current good manufacturing practice regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice regulations...

21 CFR 226.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115, inclusive...

The Future of Pork Production in the World: Towards Sustainable, Welfare-Positive Systems.

PubMed

McGlone, John J

2013-05-15

Among land animals, more pork is eaten in the world than any other meat. The earth holds about one billion pigs who deliver over 100 mmt of pork to people for consumption. Systems of pork production changed from a forest-based to pasture-based to dirt lots and finally into specially-designed buildings. The world pork industry is variable and complex not just in production methods but in economics and cultural value. A systematic analysis of pork industry sustainability was performed. Sustainable production methods are considered at three levels using three examples in this paper: production system, penning system and for a production practice. A sustainability matrix was provided for each example. In a comparison of indoor vs. outdoor systems, the food safety/zoonoses concerns make current outdoor systems unsustainable. The choice of keeping pregnant sows in group pens or individual crates is complex in that the outcome of a sustainability assessment leads to the conclusion that group penning is more sustainable in the EU and certain USA states, but the individual crate is currently more sustainable in other USA states, Asia and Latin America. A comparison of conventional physical castration with immunological castration shows that the less-common immunological castration method is more sustainable (for a number of reasons). This paper provides a method to assess the sustainability of production systems and practices that take into account the best available science, human perception and culture, animal welfare, the environment, food safety, worker health and safety, and economics (including the cost of production and solving world hunger). This tool can be used in countries and regions where the table values of a sustainability matrix change based on local conditions. The sustainability matrix can be used to assess current systems and predict improved systems of the future.

Applications of geographic information systems (GIS) for transportation and climate change

DOT National Transportation Integrated Search

2011-08-31

This report describes the current practice and application of GIS technologies for integrating climate change into the transportation decision-making process. It examines how select state, regional, and local agencies are using GIS to analyze, mitiga...

Menus and mnemonics in airway facilities.

DOT National Transportation Integrated Search

2003-04-01

This study examines the use of menus and mnemonics in current Airway Facilities (AF) systems and compares them to human factors : guidelines and best practices. Researchers from the William J. Hughes Technical Center traveled to AF field sites and co...

GREEN KIT: A MODULAR, VARIABLE APPLICATION SYSTEM FOR SUSTAINABLE COOLING

EPA Science Inventory

Definition of technical challenge to sustainability One of the challenges to sustainability is to build shelters that provide human comfort (people) using limited resources (prosperity) and minimum environment impact (planet). Current practices in building ...

The case for living kidney sales: rationale, objections and concerns.

PubMed

Matas, Arthur J

2004-12-01

Currently, potential kidney transplant candidates are dying on the waiting list. One potential solution would be a regulated system of living kidney sales (with safeguards to protect the vendor). Potential objections and practical concerns are discussed.

Development of a precast bridge deck overhang system

DOT National Transportation Integrated Search

2011-02-01

Prestressed-precast panels are commonly used at interior beams for bridge decks in Texas. The use of these panels can provide ease : of construction, sufficient capacity, and good economy for the construction of bridge decks in Texas. Current practic...

Guidelines for traffic signal energy back\\0x2010up systems : final report.

DOT National Transportation Integrated Search

2009-07-01

Power outages affect traffic signalized intersections, leading to potentially serious problems. Current practices of responding to power failures are very basic, ranging from do nothing to installing portable generators. The purpose of this res...

North America Wound, Ostomy, and Continence and Enterostomal Therapy Nurses Current Ostomy Care Practice Related to Peristomal Skin Issues.

PubMed

Colwell, Janice C; McNichol, Laurie; Boarini, Joy

The purpose of this study was to describe the practice of 796 ostomy nurses in North America in 2014 related to peristomal skin issues. Descriptive study. Participants were 796 wound, ostomy, and continence (WOC) and enterostomal therapy (ET) nurses currently practicing in the United States or Canada and caring for patients with ostomies. The collection of data occurred in conjunction with an educational program on peristomal skin complications and practice issues and solicited the participant's perception on the incidence and frequency of peristomal skin issues as well as on practice patterns. Participants attended an educational program. They were also asked to anonymously respond to multiple-choice questions on ostomy care management via an audience response system followed by discussion of each item and their responses. This descriptive study reports on the answers to the questions as well as the pertinent discussion points. Participants estimated that approximately 77.70% of their patients developed peristomal skin issues. The most commonly encountered problem was irritant contact dermatitis (peristomal moisture-associated skin damage). Contributing factors were inappropriate use of a pouching system owing to lack of follow-up after hospital discharge. Reported interventions for the prevention and management of peristomal skin issues included preoperative stoma site marking, use of a convex pouching system, and barrier rings. However, subsequent discussion revealed that the frequency of use of these products varied considerably. Participants identified shortened hospital stays, absence of preoperative stoma marking, and limited outpatient follow-up as contributing to development of peristomal skin problems. WOC and ET nurses estimate that more than three-quarters of persons living with an ostomy develop peristomal skin problems. Multiple interventions for managing these problems were identified, but some variability in management approaches emerged.

Practices and risks associated with operation of tie-down lashings in the vehicle transport industry.

PubMed

Fraysse, François; Milanese, Steven; Thewlis, Dominic

2016-12-01

Load restraint systems in automobile transport utilise tie-down lashings placed over the car's tyres, which are tensioned manually by the operator using a ratchet assembly. This process has been identified as a significant manual handling injury risk. The aim of this study was to gain insight on the current practices associated with tie-down lashings operation, and identify the gaps between current and optimal practice. We approached this with qualitative and quantitative assessments and one numerical simulation to establish: (i) insight into the factors involved in ratcheting; (ii) the required tension to hold the car on the trailer; and (iii) the tension achieved by drivers in practice and associated joint loads. We identified that the method recommended to the drivers was not used in practice. Drivers instead tensioned the straps to the maximum of their capability, leading to over-tensioning and mechanical overload at the shoulder and elbow. We identified the postures and strategies that resulted in the lowest loads on the upper body during ratcheting (using both hands and performing the task with their full body). This research marks the first step towards the development of a training programme aiming at changing practice to reduce injury risks associated with the operation of tie-down lashings in the automobile transport industry. Practitioner Summary: The study investigated current practice associated with the operation of tie-down lashings through qualitative (interviews) and quantitative (biomechanical analysis) methods. Operators tended to systematically over-tension the lashings and consequently overexert, increasing injury risks.

Advanced Technologies to Improve Closure of Life Support Systems

NASA Technical Reports Server (NTRS)

Barta, Daniel J.

2016-01-01

As NASA looks beyond the International Space Station toward long-duration, deep space missions away from Earth, the current practice of supplying consumables and spares will not be practical nor affordable. New approaches are sought for life support and habitation systems that will reduce dependency on Earth and increase mission sustainability. To reduce launch mass, further closure of Environmental Control and Life Support Systems (ECLSS) beyond the current capability of the ISS will be required. Areas of particular interest include achieving higher degrees of recycling within Atmosphere Revitalization, Water Recovery and Waste Management Systems. NASA is currently investigating advanced carbon dioxide reduction processes that surpass the level of oxygen recovery available from the Sabatier Carbon Dioxide Reduction Assembly (CRA) on the ISS. Candidate technologies will potentially improve the recovery of oxygen from about 50% (for the CRA) to as much as 100% for technologies who's end product is solid carbon. Improving the efficiency of water recycling and recovery can be achieved by the addition of advanced technologies to recover water from brines and solid wastes. Bioregenerative technologies may be utilized for water reclaimation and also for the production of food. Use of higher plants will simultaneously benefit atmosphere revitalization and water recovery through photosynthesis and transpiration. The level at which bioregenerative technologies are utilized will depend on their comparative requirements for spacecraft resources including mass, power, volume, heat rejection, crew time and reliability. Planetary protection requirements will need to be considered for missions to other solar system bodies.

Current good manufacturing practice in manufacturing, processing, packing, or holding of drugs; revision of certain labeling controls--FDA. Final rule.

PubMed

1993-08-03

The Food and Drug Administration (FDA) is amending the current good manufacturing practice (CGMP) regulations for human and veterinary drug products to revise certain labeling control provisions. Specifically, the final rule defines the term "gang-printed labeling," specifies conditions for the use of gang-printed or cut labeling, exempts manufacturers that employ automated 100-percent labeling inspection systems from CGMP labeling reconciliation requirements, and requires manufacturers to identify filled drug product containers that are set aside and held in an unlabeled condition for future labeling operations. These changes are intended to reduce the frequency of drug product mislabeling and associated drug product recalls.

New clinical practice guidelines on the classification, evaluation and management of childhood interstitial lung disease in infants: what do they mean?

PubMed

Wambach, Jennifer A; Young, Lisa R

2014-12-01

The American Thoracic Society (ATS) recently published a clinical practice guideline regarding the classification, evaluation, and management of childhood interstitial lung disease in infancy (chILD). As disease entities among infants with ILD are often distinct from forms seen in older children and adults, the guideline encourages an age-based classification system and focuses on the diagnostic approach to neonates and infants <2 years of age. The guideline reviews current evidence and recommendations for the evaluation, relevant genetic studies, and management of symptomatic infants. Here, we summarize the ATS guideline, highlight the major concepts, and discuss future strategies aimed at addressing current gaps in knowledge.

Identifying poor performance among doctors in NHS organizations.

PubMed

Locke, Rachel; Scallan, Samantha; Leach, Camilla; Rickenbach, Mark

2013-10-01

To account for the means by which poor performance among career doctors is identified by National Health Service organizations, whether the tools are considered effective and how these processes may be strengthened in the light of revalidation and the requirement for doctors to demonstrate their fitness to practice. This study sought to look beyond the 'doctor as individual'; as well as considering the typical approaches to managing the practice of an individual, the systems within which the doctor is working were reviewed, as these are also relevant to standards of performance. A qualitative review was undertaken consisting of a literature review of current practice, a policy review of current documentation from 15 trusts in one deanery locality, and 14 semi-structured interviews with respondents with an overview of processes in use. The framework for the analysis of the data considered tools at three levels: individual, team and organizational. Tools are, in the main, reactive--with an individual focus. They rely on colleagues and others to speak out, so their effectiveness is hindered by a reluctance to do so. Tools can lack an evidence base for their use, and there is limited linking of data across contexts and tools. There is more work to be done in evaluating current tools and developing stronger processes. Linkage between data sources needs to be improved and proactive tools at the organizational level need further development to help with the early identification of performance issues. This would also assist in balancing a wider systems approach with a current over emphasis on individual doctors. © 2012 John Wiley & Sons Ltd.

Information systems: the key to evidence-based health practice.

PubMed Central

Rodrigues, R. J.

2000-01-01

Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

International short-term medical missions: a systematic review of recommended practices.

PubMed

Roche, Stephanie D; Ketheeswaran, Pavinarmatha; Wirtz, Veronika J

2017-01-01

To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient countries' existing health systems. Systematic review of PubMed-indexed articles on STMMs and their bibliographies using preferred reporting items for systematic reviews and meta-analyses guidelines. Recommendations were organized using the World Health Organization Health Systems Framework. In 92 publications, 67 % offered at least one recommendation that would link STMMs to the recipient country's health system. Among these recommendations, most focused on service delivery and few on health financing and governance. There is a lack of consensus around a proper standard of care, patient selection, and trip duration. Comprehensive global standards are needed for STMM work to ensure that services are beneficial both to patients and to the broader healthcare systems of recipient countries. By providing an overview of the current recommendations and important gaps where practice recommendations are needed, this study can provide relevant input into the development of global standards for STMMs.

Rail Brake System Using a Linear Induction Motor for Dynamic Braking

NASA Astrophysics Data System (ADS)

Sakamoto, Yasuaki; Kashiwagi, Takayuki; Tanaka, Minoru; Hasegawa, Hitoshi; Sasakawa, Takashi; Fujii, Nobuo

One type of braking system for railway vehicles is the eddy current brake. Because this type of brake has the problem of rail heating, it has not been used for practical applications in Japan. Therefore, we proposed the use of a linear induction motor (LIM) for dynamic braking in eddy current brake systems. The LIM reduces rail heating and uses an inverter for self excitation. In this paper, we estimated the performance of an LIM from experimental results of a fundamental test machine and confirmed that the LIM generates an approximately constant braking force under constant current excitation. At relatively low frequencies, this braking force remains unaffected by frequency changes. The reduction ratio of rail heating is also approximately proportional to the frequency. We also confirmed that dynamic braking resulting in no electrical output can be used for drive control of the LIM. These characteristics are convenient for the realization of the LIM rail brake system.

Critical carbon input to maintain current soil organic carbon stocks in global wheat systems

PubMed Central

Wang, Guocheng; Luo, Zhongkui; Han, Pengfei; Chen, Huansheng; Xu, Jingjing

2016-01-01

Soil organic carbon (SOC) dynamics in croplands is a crucial component of global carbon (C) cycle. Depending on local environmental conditions and management practices, typical C input is generally required to reduce or reverse C loss in agricultural soils. No studies have quantified the critical C input for maintaining SOC at global scale with high resolution. Such information will provide a baseline map for assessing soil C dynamics under potential changes in management practices and climate, and thus enable development of management strategies to reduce C footprint from farm to regional scales. We used the soil C model RothC to simulate the critical C input rates needed to maintain existing soil C level at 0.1° × 0.1° resolution in global wheat systems. On average, the critical C input was estimated to be 2.0 Mg C ha−1 yr−1, with large spatial variability depending on local soil and climatic conditions. Higher C inputs are required in wheat system of central United States and western Europe, mainly due to the higher current soil C stocks present in these regions. The critical C input could be effectively estimated using a summary model driven by current SOC level, mean annual temperature, precipitation, and soil clay content. PMID:26759192

Dissemination 2.0: closing the gap between knowledge and practice with new media and marketing.

PubMed

Bernhardt, Jay M; Mays, Darren; Kreuter, Matthew W

2011-01-01

Despite substantial investments in public health and clinical research at the national level, and significant advancements in these areas of science, few evidence-based programs and services are rapidly implemented in health care or public health practice as a result of failures of dissemination. A significant gap in current processes to disseminate and implement effective programs relates to the lack of systems and infrastructure to facilitate distribution of scientific research products to potential end users, including clinicians and other practitioners. In this article, the authors assert that Web 2.0 technologies can be leveraged to enhance dissemination efforts and increase the implementation of evidence-based programs and services in everyday practice. The authors describe the research-to-practice delivery process and highlight gaps in the supply chain necessary to translate research findings into evidence-based practice. The authors critically evaluate the 4 most prominent strategies currently used to promote dissemination and implementation of research evidence in practice, and they detail how each can be improved by leveraging Web 2.0 technologies to enhance dissemination of research evidence. Last, the authors provide examples and suggestions for capitalizing on Web 2.0 technologies to enhance dissemination efforts and ensure that evidence-based research products reach intended end users and are implemented in clinical practice.

The future of pharmacy practice research - Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA.

PubMed

Babar, Zaheer-Ud-Din; Scahill, Shane; Nagaria, Raveena Amee; Curley, Louise E

2018-01-11

Healthcare is under significant pressure with the explosion of long term conditions, shift in worldwide demographics and is evolving through advances in technology. Aligned with this is the changing role of pharmacy from the traditional dispenser of medicines to having (in addition) a more advanced clinical role. This study aimed to understand what the pharmacy practice research agenda might look like from the viewpoint of pharmacy academics and practitioners across five high-income countries. Qualitative methods were used, and thirty one-hour interviews were undertaken with practitioners and academics from five economically advanced countries. These nations have comparable socio-economic status but differing health systems and include; Australia, Canada, New Zealand, United Kingdom and United States of America. Six key informants were chosen from each country, three academics and three community pharmacists. A general inductive analysis was undertaken to analyse the most common and recurring themes. These themes of research were based around current community pharmacy practice issues and the enablers to changing the profession. Specific areas pharmacy practice could be more involved with included long term health conditions. Some community pharmacists also believed that research into the impact of professional standards and policy change would be beneficial. The findings of this research suggest that current pharmacy practice research methods are sufficient, but need to be used more effectively. Participants identified a wide range of issues within community pharmacy practice. Academics largely focused on how research can be utilised in the community and how to implement findings to ensure sustainability of pharmacy practice research. Issues that community pharmacists would like to research are related to the current practice model, such as allocating time to provide patient-focused services in addition to managing a business. Copyright © 2018 Elsevier Inc. All rights reserved.

The Dynamics of Community Health Care Consolidation: Acquisition of Physician Practices

PubMed Central

Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H

2014-01-01

Context Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. Methods We used key informant interviews, supplemented by document analysis. Findings The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. Conclusions In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. PMID:25199899

The dynamics of community health care consolidation: acquisition of physician practices.

PubMed

Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H

2014-09-01

Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. We used key informant interviews, supplemented by document analysis. The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. © 2014 Milbank Memorial Fund.

Perceptions of Indonesian general practitioners in maintaining standards of medical practice at a time of health reform.

PubMed

Syah, Nur A; Roberts, Chris; Jones, Alison; Trevena, Lyndal; Kumar, Koshila

2015-10-01

There is little research on how GPs experience the demands of maintaining standards of medical practice in developing countries and what strategies might improve their capability to provide high-quality primary health care (PHC). This study aims to explore the underlying factors, which shape GPs' experience within the Indonesian PHC system and impact on their experience of professional practice. A grounded theory approach was applied using semi-structured interviews of 25 purposively selected GPs in West Sumatra, Indonesia. The interviews were analysed inductively through an iterative process of the interplay between empirical data, emerging analysis and theory development. Three major health care systems attribute shaped GPs' experiences of professional practice, including (i) a restricted concept of the PHC system, (ii) lack of regulation of private primary care practice conducted by GPs, midwives, nurses and specialists and (iii) low coverage and inappropriate policy of the health insurance system. The findings indicate that a major revision of current health care system is required with a focus on promoting the concept of PHC services to the population, redefining the role of the GP to deliver recognised best practice within available resources, changing the way GPs are remunerated by the public health system and the health insurance industry, policing of the regulations related to the scope of practice of other health care professionals, particularly midwives and nurses, and regulation of prescribing. GPs can be the champions of the PHC service that Indonesia needs, but it requires sustained systematic change. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

National continuous surveys on internal quality control for HbA1c in 306 clinical laboratories of China from 2012 to 2016: Continual improvement.

PubMed

Li, Tingting; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-09-01

This study aimed to evaluate whether the quality performance of clinical laboratories in China has been greatly improved and whether Internal Quality Control (IQC) practice of HbA1c has also been changed since National Center for Clinical Laboratories (NCCL) of China organized laboratories to report IQC data for HbA1c in 2012. Internal Quality Control information of 306 External Quality Assessment (EQA) participant laboratories which kept reporting IQC data in February from 2012 to 2016 were collected by Web-based EQA system. Then percentages of laboratories meeting four different imprecision specifications for current coefficient of variations (CVs) of HbA1c measurements were calculated. Finally, we comprehensively analyzed analytical systems and IQC practice of HbA1c measurements. The current CVs of HbA1c tests have decreased significantly from 2012 to 2016. And percentages of laboratories meeting four imprecision specifications for CVs all showed the increasing tendency year by year. As for analytical system, 52.1% (159/306) laboratories changed their systems with the change in principle of assay. And many laboratories began to use cation exchange high-performance liquid chromatography (CE-HPLC) instead of Immunoturbidimetry, because CE-HPLC owed a lower intra-laboratory CVs. The data of IQC practice, such as IQC rules and frequency, also showed significant variability among years with overall tendency of meeting requirements. The imprecision performance of HbA1c tests has been improved in these 5 years with the change in IQC practice, but it is still disappointing in China. Therefore, laboratories should actively find existing problems and take action to promote performance of HbA1c measurements. © 2016 Wiley Periodicals, Inc.

21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION TOMOGRAPHY DRUGS (Eff. 12-12-2011) General Provisions § 212.2 What is current good manufacturing practice for...

21 CFR 1271.150 - Current good tissue practice requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part set...

Educating for the 21st-Century Health Care System: An Interdependent Framework of Basic, Clinical, and Systems Sciences.

PubMed

Gonzalo, Jed D; Haidet, Paul; Papp, Klara K; Wolpaw, Daniel R; Moser, Eileen; Wittenstein, Robin D; Wolpaw, Terry

2017-01-01

In the face of a fragmented and poorly performing health care delivery system, medical education in the United States is poised for disruption. Despite broad-based recommendations to better align physician training with societal needs, adaptive change has been slow. Traditionally, medical education has focused on the basic and clinical sciences, largely removed from the newer systems sciences such as population health, policy, financing, health care delivery, and teamwork. In this article, authors examine the current state of medical education with respect to systems sciences and propose a new framework for educating physicians in adapting to and practicing in systems-based environments. Specifically, the authors propose an educational shift from a two-pillar framework to a three-pillar framework where basic, clinical, and systems sciences are interdependent. In this new three-pillar framework, students not only learn the interconnectivity in the basic, clinical, and systems sciences but also uncover relevance and meaning in their education through authentic, value-added, and patient-centered roles as navigators within the health care system. Authors describe the Systems Navigation Curriculum, currently implemented for all students at the Penn State College of Medicine, as an example of this three-pillar educational model. Simple adjustments, such as including occasional systems topics in medical curriculum, will not foster graduates prepared to practice in the 21st-century health care system. Adequate preparation requires an explicit focus on the systems sciences as a vital and equal component of physician education.

[Environmental damage assessment: international regulations and revelation to China].

PubMed

Zhang, Hong-zhen; Cao, Dong; Yu, Fang; Wang, Jin-nan; Qi, Ji; Jia, Qian; Zhang, Tian-zhu; Luo, Yong-ming

2013-05-01

As the whole society gradually realizes the scarcity of nature resources and environmental value, countries all over the world have evolved and improved the system of environmental damage assessment through the practices of pollution prevention and ecological environmental protection. On one hand, in the research prospective, the practices of environmental damage assessment brought new challenges to environmental law, environmental economics, environmental science, environmental engineering, etc. On the other hand, they constantly promoted and developed relevant laws and regulations, techniques, working mechanism, and guidelines on procedure in practice. On the hasis of comparison and analysis of international practices and experiences from US, EU, and Japan, etc., this article identified relevant concepts, content, and scope of environmental damage assessment, and presented its scientific positioning and development direction. At present, both theory and practice of environmental damage assessment in China are in their infancy period. Considering current environmental situation and socioeconomic development features of China, learning international practices and experiences and raising the orientation of environmental damage assessment have great meaning in exploring the suitable environmental damage assessment system.

The medicalization of addiction treatment professionals.

PubMed

Roy, A Kenison; Miller, Michael M

2012-01-01

In a previous article, the authors described the changes initiated by recent health care legislation, and how those changes might affect the practice of medicine and the delivery of addiction services. This article reviews the same changes with respect to how they have the potential to change the practice activities of addiction physicians, addiction therapists, addiction counselors and addiction nurses, as well as the activities of administrators and service delivery financial personnel. Developments in delivery systems and the impact of those developments on professionals who work in addiction treatment are considered; current problems, potential solutions, and opportunities for clinicians under health reform are addressed. The goals envisioned for health system reform and the potential for realization of those goals via changes in addiction service delivery design and clinical practice are discussed.

Issues Facing Pharmacy Leaders in 2015: Suggestions for Pharmacy Strategic Planning

PubMed Central

Weber, Robert J.

2015-01-01

Issues facing pharmacy leaders in 2015 include practice model growth and the role of pharmacy students, clinical privileging of health-system pharmacists and provider status, medication error prevention, and specialty pharmacy services. The goal of this article is to provide practical approaches to 4 issues facing pharmacy leaders in 2015 to help them focus their department’s goals. This article will address (1) advances in the pharmacy practice model initiative and the role of pharmacy students, (2) the current thinking of pharmacists being granted clinical privileges in health systems, (3) updates on preventing harmful medication errors, and (4) the growth of specialty pharmacy services. The sample template of a strategic plan may be used by a pharmacy department in 2015 in an effort to continue developing patient-centered pharmacy services. PMID:25717212

Systems thinking perspectives applied to healthcare transition for youth with disabilities: a paradigm shift for practice, policy and research.

PubMed

Hamdani, Y; Jetha, A; Norman, C

2011-11-01

Healthcare transition (HCT) for youth with disabilities is a complex phenomenon influenced by multiple interacting factors, including health, personal and environmental factors. Current research on the transition to adulthood for disabled youth has primarily focused on identifying these multilevel factors to guide the development of interventions to improve the HCT process. However, little is known about how this complex array of factors interacts and contributes to successful HCT. Systems thinking provides a theoretically informed perspective that accounts for complexity and can contribute to enhanced understanding of the interactions among HCT factors. The objective of this paper is to introduce general concepts of systems thinking as applied to HCT practice and research. Several systems thinking concepts and principles are introduced and a discussion of HCT as a complex system is provided. Systems dynamics methodology is described as one systems method for conceptualizing HCT. A preliminary systems dynamics model is presented to facilitate discourse on the application of systems thinking principles to HCT practice, policy and research. An understanding of the complex interactions and patterns of relationships in HCT can assist health policy makers and practitioners in determining key areas of intervention, the impact of these interventions on the system and the potential intended and unintended consequences of change. This paper provides initial examination of applying systems thinking to inform future research and practice on HCT. © 2011 Blackwell Publishing Ltd.

Canadian community pharmacists' use of digital health technologies in practice.

PubMed

Leung, Valerie; Tharmalingam, Sukirtha; Cooper, Janet; Charlebois, Maureen

2016-01-01

In 2010, a pan-Canadian study on the current state and benefits of provincial drug information systems (DIS) found that substantial benefits were being realized and that pharmacists perceived DIS to be a valuable tool in the evolving models of pharmacy practice. To understand changes in digital health and the impact on practice since that time, a survey of community pharmacists in Canada was conducted. In 2014, Canada Health Infoway (Infoway) and the Canadian Pharmacists Association (CPhA) invited community pharmacists to participate in a Web-based survey to understand their use and perceived benefits of digital health in practice. The survey was open from April 15 to May 12, 2014. Of the 447 survey responses, almost all used some form of digital health in practice. Those with access to DIS and provincial laboratory information systems (LIS) reported increased productivity and better quality of care. Those without access to these systems would overwhelmingly like access. There have been significant advances in digital health and community pharmacy practice over the past several years. In addition to digital health benefits in the areas of productivity and quality of care, pharmacists are also experiencing substantial benefits in areas related to recently expanded scope of practice activities such as ordering lab tests. Community pharmacists frequently use digital health in practice and recognize the benefits of these technologies. Digital health is, and will continue to be, a key enabler for practice transformation and improved quality of care. Can Pharm J (Ott) 2016;149:xx-xx.

Design of General-purpose Industrial signal acquisition system in a large scientific device

NASA Astrophysics Data System (ADS)

Ren, Bin; Yang, Lei

2018-02-01

In order to measure the industrial signal of a large scientific device experiment, a set of industrial data general-purpose acquisition system has been designed. It can collect 4~20mA current signal and 0~10V voltage signal. Through the practical experiments, it shows that the system is flexible, reliable, convenient and economical, and the system has characters of high definition and strong anti-interference ability. Thus, the system fully meets the design requirements..

Future Combat System Spinout 1 Technical Field Test - Establishing and Implementing Models and Simulations System of Systems Verification, Validation and Accreditation Practices, Methodologies and Procedures

DTIC Science & Technology

2009-11-24

assisted by the Brigade Combat Team (BCT) Modernization effort, the use of Models and Simulations ( M &S) becomes more crucial in supporting major...in 2008 via a slice of the Current Force (CF) BCT structure. To ensure realistic operational context, a M &S System-of- Systems (SoS) level...messages, and constructive representation of platforms, vehicles, and terrain. The M &S federation also provided test control, data collection, and live

Fatigue risk management in aviation maintenance : current best practices and potential future countermeasures.

DOT National Transportation Integrated Search

2011-06-01

The unregulated hours and frequent night work characteristic of maintenance can produce significant levels of : employee fatigue, with a resultant risk of maintenance error. Fatigue Risk Management Systems (FRMS) are : widely used to manage fatigue a...

Can Research in the Human Sciences Become More Relevant to Practice?

ERIC Educational Resources Information Center

Howard, George S.

1985-01-01

Reviews the scientist practitioner model in counseling and examines problems associated with it. Discusses insights of general systems theory and Rychlak's insights into deficiencies in the current model of psychological research, and presents a revised model. (JAC)

Augmentative Communication Services in the Schools.

ERIC Educational Resources Information Center

Blackstone, Sarah W.

1989-01-01

The article considers current issues concerning service delivery systems and practices concerning augmentative and alternative communication (AAC) services in U.S. schools. Concerns in AAC program development are noted and service delivery models (center-based, community-based, or collaborative) are compared. (DB)

Educational Organization for the Future

ERIC Educational Resources Information Center

Cote, Ron Roy

1977-01-01

Five basic components of the emerging educational system--forecasts and assessment, program planning, alternative environments, electronics and socialization, and differentiated faculty--summarize both current trends in educational practice and the implications for schools provided by analysts of the radically different society America is…

Ideas in Practice: Studies in Atmospheric Pollution For Science Teachers

ERIC Educational Resources Information Center

Rowe, Donald R.

1974-01-01

Describes the content and structure of an enviromental course offered by the Department of Engineering Technology at Western Kentucky University. The course focuses on atmospheric pollution and is designed for science teachers currently teaching in the school system. (JR)

Long-term pavement performance information management system : pavement performance database user reference guide

DOT National Transportation Integrated Search

1995-02-01

This paper (1) summarizes the most relevant current experience and practice regarding permits (provisions, administrative requirements) and highway use pricing mechanisms (use taxes, permit fees, tolls) of importance for truck size and weight (TS&W) ...

Art Education in the Union of Soviet Socialist Republics

ERIC Educational Resources Information Center

Yusov, Boris

1978-01-01

Describes different systems of art education for different student populations, professional art training, historical changes in art education, art education research, aesthetic education, and art education as it is currently practiced in the Union of Soviet Socialist Republics. (RK)

Lateral support systems and underpinning, volume III : construction methods.

DOT National Transportation Integrated Search

1976-04-01

This report provides current information and design guidelines on cut-and-cover tunneling for practicing engineers. The main emphasis is on the geotechnical aspects of engineering. Included in this volume is a state-of-the-art summary of displacement...

Methodologies for Evaluating Environmental Benefits of Intelligent Transportation Systems

DOT National Transportation Integrated Search

2001-05-01

This report provides an overview of the current state of practice in evaluation of air quality impacts and also in emissions modeling. This report also describes the recent developments in emissions modeling. The air quality impacts of various ITS st...

21 CFR 211.48 - Plumbing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.48 Plumbing. (a) Potable water shall be supplied under continuous positive pressure in a plumbing system free of defects that could contribute contamination to any drug product. Potable water shall meet the...

21 CFR 211.48 - Plumbing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.48 Plumbing. (a) Potable water shall be supplied under continuous positive pressure in a plumbing system free of defects that could contribute contamination to any drug product. Potable water shall meet the...

21 CFR 211.48 - Plumbing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.48 Plumbing. (a) Potable water shall be supplied under continuous positive pressure in a plumbing system free of defects that could contribute contamination to any drug product. Potable water shall meet the...

21 CFR 211.48 - Plumbing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.48 Plumbing. (a) Potable water shall be supplied under continuous positive pressure in a plumbing system free of defects that could contribute contamination to any drug product. Potable water shall meet the...

Lateral support systems and underpinning, volume II : design fundamentals.

DOT National Transportation Integrated Search

1976-04-01

This report provides current information and design guidelines on cut-and-cover : tunneling for practicing engineers. The main emphasis is on the geotechnical : aspects of engineering. Included in this volume is a state-of-the-art summary of : displa...

Lateral Support Systems And Underpinning. Volume II. Design Fundamentals

DOT National Transportation Integrated Search

1976-04-01

This report provides current information and design guidelines on cut-and-cover tunneling for practicing engineers. The main emphasis is on the geotechnical aspects of engineering. Included in this volume is a state-of-the-art summary of displacement...

Healthcare improvement as planned system change or complex responsive processes? a longitudinal case study in general practice

PubMed Central

2013-01-01

Background Interest in how to implement evidence-based practices into routine health care has never been greater. Primary care faces challenges in managing the increasing burden of chronic disease in an ageing population. Reliable prescriptions for translating knowledge into practice, however, remain elusive, despite intense research and publication activity. This study seeks to explore this dilemma in general practice by challenging the current way of thinking about healthcare improvement and asking what can be learned by looking at change through a complexity lens. Methods This paper reports the local level of an embedded case study of organisational change for better chronic illness care over more than a decade. We used interviews, document review and direct observation to explore how improved chronic illness care developed in one practice. This formed a critical case to compare, using pattern matching logic, to the common prescription for local implementation of best evidence and a rival explanation drawn from complexity sciences interpreted through modern sociology and psychology. Results The practice changed continuously over more than a decade to deliver better chronic illness care in line with research findings and policy initiatives – re-designing care processes, developing community linkages, supporting patient self-management, using guidelines and clinical information systems, and integrating nurses into the practice team. None of these improvements was designed and implemented according to an explicit plan in response to a documented gap in chronic disease care. The process that led to high quality chronic illness care exhibited clear complexity elements of co-evolution, non-linearity, self-organisation, emergence and edge of chaos dynamics in a network of agents and relationships where a stable yet evolving way of organizing emerged from local level communicative interaction, power relating and values based choices. Conclusions The current discourse of implementation science as planned system change did not match organisational reality in this critical case of improvement in general practice. Complexity concepts translated in human terms as complex responsive processes of relating fit the pattern of change more accurately. They do not provide just another fashionable blueprint for change but inform how researchers, policymakers and providers participate in improving healthcare. PMID:23617833

OVERVIEW, PRACTICAL TIPS AND POTENTIAL PITFALLS OF USING AUTOMATIC EXPOSURE CONTROL IN CT: SIEMENS CARE DOSE 4D.

PubMed

Söderberg, Marcus

2016-06-01

Today, computed tomography (CT) systems routinely use automatic exposure control (AEC), which modulates the tube current. However, for optimal use, there are several aspects of an AEC system that need to be considered. The purpose of this study was to provide an overview of the Siemens CARE Dose 4D AEC system, discuss practical tips and demonstrate potential pitfalls. Two adult anthropomorphic phantoms were examined using two different Siemens CT systems. When optimising the CT radiation dose and image quality, the projection angle of the localiser, patient centring, protocol selection, scanning direction and the use of protective devices requires special attention. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Efficiency of the strong satisfiability checking procedure for reactive system specifications

NASA Astrophysics Data System (ADS)

Shimakawa, Masaya; Hagihara, Shigeki; Yonezaki, Naoki

2018-04-01

Reactive systems are those that interact with their environment. To develop reactive systems without defects, it is important to describe behavior specifications in a formal language, such as linear temporal logic, and to verify the specification. Specifically, it is important to check whether specifications satisfy the property called realizability. In previous studies, we have proposed the concept of strong satisfiability as a necessary condition for realizability. Although this property of reactive system specifications is a necessary condition, many practical unrealizable specifications are also strongly unsatisfiable. Moreover, we have previously shown the theoretical complexity of the strong satisfiability problem. In the current study, we investigate the practical efficiency of the strong satisfiability checking procedure and demonstrate that strong satisfiability can be checked more efficiently than realizability.

A Global Assessment on Climate Research Engaging Indigenous Knowledge Systems and Recommendations for Quality Standards of Research Practice in Indigenous Communities

NASA Astrophysics Data System (ADS)

Davíd-Chavez, D. M.; Gavin, M. C.

2017-12-01

Indigenous communities worldwide have maintained their own knowledge systems for millennia informed through careful observation of dynamics of environmental changes. Withstanding centuries of challenges to their rights to maintain and practice these knowledge systems, Indigenous peoples continually speak to a need for quality standards for research in their communities. Although, international and Indigenous peoples' working groups emphasize Indigenous knowledge systems and the communities who hold them as critical resources for understanding and adapting to climate change, there has yet to be a comprehensive, evidence based analysis into how diverse knowledge systems are integrated in scientific studies. Do current research practices challenge or support Indigenous communities in their efforts to maintain and appropriately apply their knowledge systems? This study addresses this question using a systematic literature review and meta-analysis assessing levels of Indigenous community participation and decision-making in all stages of the research process (initiation, design, implementation, analysis, dissemination). Assessment is based on reported quality indicators such as: outputs that serve the community, ethical guidelines in practice (free, prior, and informed consent and intellectual property rights), and community access to findings. These indicators serve to identify patterns between levels of community participation and quality standards in practice. Meta-analysis indicates most climate studies practice an extractive model in which Indigenous knowledge systems are co-opted with minimal participation or decision-making authority from communities who hold them. Few studies report outputs that directly serve Indigenous communities, ethical guidelines in practice, or community access to findings. Studies reporting the most quality indicators were initiated in mutual agreement between Indigenous communities and outside researchers or by communities themselves. This study also draws from the researcher's experiences as an Indigenous scientist and includes recommendations for quality research practice. This global assessment provides an evidence base to inform our understanding of broader impacts related to research design.

School Readiness and Pedagogies of Competence and Performance: Theorising the Troubled Relationship between Early Years and Early Years Policy

ERIC Educational Resources Information Center

Neaum, Sally

2016-01-01

School readiness is currently a strong focus for education policy in England. However, understanding what it means to be ready for school, and how this is reflected in policy and enacted in practice, are sites of contention. This paper explores the genesis of the current disparity in understandings in the context of the English education system. A…

Acute asthma severity identification of expert system flow in emergency department

NASA Astrophysics Data System (ADS)

Sharif, Nurul Atikah Mohd; Ahmad, Norazura; Ahmad, Nazihah; Desa, Wan Laailatul Hanim Mat

2017-11-01

Integration of computerized system in healthcare management help in smoothening the documentation of patient records, highly accesses of knowledge and clinical practices guideline, and advice on decision making. Exploit the advancement of artificial intelligent such as fuzzy logic and rule-based reasoning may improve the management of emergency department in terms of uncertainty condition and medical practices adherence towards clinical guideline. This paper presenting details of the emergency department flow for acute asthma severity identification with the embedding of acute asthma severity identification expert system (AASIES). Currently, AASIES is still in preliminary stage of system validation. However, the implementation of AASIES in asthma bay management is hope can reduce the usage of paper for manual documentation and be a pioneer for the development of a more complex decision support system to smoothen the ED management and more systematic.

Transition of Care in Adolescents With Cerebral Palsy: A Survey of Current Practices.

PubMed

Bolger, Ashlee; Vargus-Adams, Jilda; McMahon, Mary

2017-03-01

Transition of care from pediatric to adult health care providers for youth with special needs (including cerebral palsy [CP]) is of current interest because these individuals are now living well into adulthood. Studies have attempted to identify barriers to transition, ideal timing for transition of care, and key elements for successful transition programs. These studies often encompass a wide range of diagnoses, and results cannot be fully applied to those with CP. To identify and describe current transition-of-care (TOC) practices and beliefs among physician providers of adolescents with CP in multidisciplinary CP clinics. Descriptive survey. Multidisciplinary CP clinics in the United States. Physician leaders in the aforementioned CP clinics. Respondents completed an electronic survey. Responses were deidentified and reported in aggregate by the use of descriptive statistics. Electronic survey addressing 3 domains: demographics of clinics, current opinions/practices related to TOC processes, and perceived barriers to successful TOC. Fifteen surveys were sent with 11 returned (response rate = 73%). TOC practices varied among clinics surveyed. Fifty-five percent of clinics had a structured transition program, but only one transitioned 100% of their patients to adult providers by 22 years of age. Only one clinic had an absolute upper age limit for seeing patients, and 36% of clinics accepted new patients older than 21 years. No respondent was "completely satisfied" with their transition process, and only one respondent was "moderately satisfied." The majority of respondents felt the ideal care setting for adults with CP was a comprehensive, multidisciplinary adult-focused clinic in an adult hospital/clinic with primarily adult providers. They noted the top 3 perceived barriers to successful TOC were limited adult providers willing to accept CP patients, concern about the level of care in the adult health care system, and lack of financial resources. Current TOC practices vary considerably among multidisciplinary pediatric CP clinics and are not satisfactory to individual physician providers within these clinics. Respondents desired a multidisciplinary clinic in an adult care setting with adult providers; however, the top 3 perceived barriers involved the adult health care system, making it difficult for pediatric providers to develop effective TOC programs. Not applicable. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Implications of Dual Practice among Health Workers: A Systematic Review

PubMed Central

MOGHRI, Javad; RASHIDIAN, Arash; ARAB, Mohammad; AKBARI SARI, Ali

2017-01-01

Background: Mixed health care systems to work simultaneously on both public and private facilities, is common today. This phenomenon referred to as dual practice (DP), has potential implications for access, quality, cost and equity of health services. This paper aimed to review systematically studies that assess the implications of DP among health workers. Methods: MEDLINE, EMBASE, and The Cochrane library were searched for obtaining published literature between Feb 1990 and May 2014. Google and Google Scholars, organizational websites, and reference lists of relevant papers searched to get grey literature. Only studies concentrated on consequences and impacts of DP among health professionals and conducted using “randomized controlled trials”, “non-randomized controlled trials”, “controlled before and after studies”, or “interrupted time series” were eligible for inclusion. Results: From 3242 records, we focused on 19 studies, which aimed to assess effects and impacts of dual practice. After that, the current understanding of DP positive and negative implications was categorized and discussed based on two perspectives. Conclusion: There has been a propensity to over-reliance on theoretical methods in predicting the implications of this phenomenon. Almost all of the mentioned implications are based on theoretical predictions undermined in the broader literature. Furthermore, assessing the current literature showed positive and negative impacts of DP on different parts of the health system and various dimensions of service delivery. These implications are contexted specific and may vary from system to system. PMID:28451549

Development of an "Alert Framework" Based on the Practices in the Medical Front.

PubMed

Sakata, Takuya; Araki, Kenji; Yamazaki, Tomoyoshi; Kawano, Koichi; Maeda, Minoru; Kushima, Muneo; Araki, Sanae

2018-05-09

At the University of Miyazaki Hospital (UMH), we have accumulated and semantically structured a vast amount of medical information since the activation of the electronic health record system approximately 10 years ago. With this medical information, we have decided to develop an alert system for aiding in medical treatment. The purpose of this investigation is to not only to integrate an alert framework into the electronic heath record system, but also to formulate a modeling method of this knowledge. A trial alert framework was developed for the staff in various occupational categories at the UMH. Based on findings of subsequent interviews, a more detailed and upgraded alert framework was constructed, resulting in the final model. Based on our current findings, an alert framework was developed with four major items. Based on the analysis of the medical practices from the trial model, it has been concluded that there are four major risk patterns that trigger the alert. Furthermore, the current alert framework contains detailed definitions which are easily substituted into the database, leading to easy implementation of the electronic health records.

Microengineering of magnetic bearings and actuators

NASA Astrophysics Data System (ADS)

Ghantasala, Muralihar K.; Qin, LiJiang; Sood, Dinesh K.; Zmood, Ronald B.

2000-06-01

Microengineering has evolved in the last decade as a subject of its own with the current research encompassing every possible area of devices from electromagnetic to optical and bio-micro electromechanical systems (MEMS). The primary advantage of the micro system technology is its small size, potential to produce high volume and low cost devices. However, the major impediments in the successful realization of many micro devices in practice are the reliability, packaging and integration with the existing microelectronics technology. Microengineering of actuators has recently grown tremendously due to its possible applicability to a wide range of devices of practical importance and the availability of a choice of materials. Selection of materials has been one of the important aspects of the design and fabrication of many micro system and actuators. This paper discusses the issues related to the selection of materials and subsequently their effect on the performance of the actuator. These will be discussed taking micro magnetic actuators and bearings, in particular, as examples. Fabrication and processing strategies and performance evaluation methods adopted will be described. Current status of the technology and projected futuristic applications in this area will be reviewed.

Classification of diabetic foot ulcers.

PubMed

Game, Frances

2016-01-01

It is known that the relative importance of factors involved in the development of diabetic foot problems can vary in both their presence and severity between patients and lesions. This may be one of the reasons why outcomes seem to vary centre to centre and why some treatments may seem more effective in some people than others. There is a need therefore to classify and describe lesions of the foot in patients with diabetes in a manner that is agreed across all communities but is simple to use in clinical practice. No single system is currently in widespread use, although a number have been published. Not all are well validated outside the system from which they were derived, and it has not always been made clear the clinical purposes to which such classifications should be put to use, whether that be for research, clinical description in routine clinical care or audit. Here the currently published classification systems, their validation in clinical practice, whether they were designed for research, audit or clinical care, and the strengths and weaknesses of each are explored. Copyright © 2016 John Wiley & Sons, Ltd.

The Importance of Play in Early Childhood Education: A Critical Perspective on Current Policies and Practices in Germany and Hong Kong

ERIC Educational Resources Information Center

Faas, Stefan; Wu, Shu-chen; Geiger, Steffen

2017-01-01

In order to reflect international reform movements in a system- and culture-comparative perspective, the following article investigates the early childhood education systems in Germany and in Hong Kong, with reference to the respective social and educational roots, pedagogical development lines, and basic educational approaches. In addition,…

Developing a Self-Report-Based Sequential Analysis Method for Educational Technology Systems: A Process-Based Usability Evaluation

ERIC Educational Resources Information Center

Lin, Yi-Chun; Hsieh, Ya-Hui; Hou, Huei-Tse

2015-01-01

The development of a usability evaluation method for educational systems or applications, called the self-report-based sequential analysis, is described herein. The method aims to extend the current practice by proposing self-report-based sequential analysis as a new usability method, which integrates the advantages of self-report in survey…

76 FR 52042 - Auriga Laboratories, Inc., Curon Medical, Inc., Goldstate Corp., OneWorld Systems, Inc., and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-19

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Auriga Laboratories, Inc., Curon Medical, Inc., Goldstate Corp., OneWorld Systems, Inc., and PracticeXpert, Inc.; Order of Suspension of Trading August 17, 2011. It appears to the Securities and Exchange Commission that there is a lack of current and accurate information concerning the...

A Blueprint for Human Resource Development in the Third Decade of the Ontario Colleges of Applied Arts and Technology: Executive Summary.

ERIC Educational Resources Information Center

Giroux, Roy F.

In 1987, a review of Ontario's community college system was initiated to assess the system's present human resource development practices and plan future directions. A field-based study was conducted to identify and assess current human resource development efforts, identify areas for improvement, and suggest possible future directions. Through…

The Role of Research in the Policy and Practice of Quality Teacher Education: An International Review

ERIC Educational Resources Information Center

Tatto, Maria Teresa

2015-01-01

The stated goal of current education reform is the redesign of education systems in pursuit of quality. Systems that consistently "come out on top" have excited much interest in uncovering the features that have contributed to their success; notably among these is the preparation of future teachers. Research on teacher education quality…

Reconstructing Iraq

DTIC Science & Technology

2004-09-02

ICG Middle East Report N°30, 2 September 2004 Page 16 and institutions to counter monopolistic practices harmful to both investors and consumers ...204 A senior Ministry of Trade official described large-scale corruption in the food and consumer goods rationing system at all 198 ICG...procurement of items for the ration system also provides fertile ground for current corruption. Black markets thrive on goods whose prices are kept

The Placer Media Management System or Using the Computer in the Small Film Library.

ERIC Educational Resources Information Center

Luckey, Jacqueline

In describing this media management system, which currently serves 84 public schools (K-12) in four rural counties east of Sacramento, this report suggests that the computer is a practical solution for film libraries trying to keep pace with increased use while not reducing their expenditures for purchasing and repairing film stock. The major…

Towards Introducing a Geocoding Information System for Greenland

NASA Astrophysics Data System (ADS)

Siksnans, J.; Pirupshvarre, Hans R.; Lind, M.; Mioc, D.; Anton, F.

2011-08-01

Currently, addressing practices in Greenland do not support geocoding. Addressing points on a map by geographic coordinates is vital for emergency services such as police and ambulance for avoiding ambiguities in finding incident locations (Government of Greenland, 2010) Therefore, it is necessary to investigate the current addressing practices in Greenland. Asiaq (Asiaq, 2011) is a public enterprise of the Government of Greenland which holds three separate databases regards addressing and place references: - list of locality names (towns, villages, farms), - technical base maps (including road center lines not connected with names, and buildings), - the NIN registry (The Land Use Register of Greenland - holds information on the land allotments and buildings in Greenland). The main problem is that these data sets are not interconnected, thus making it impossible to address a point in a map with geographic coordinates in a standardized way. The possible solutions suffer from the fact that Greenland has a scattered habitation pattern and the generalization of the address assignment schema is a difficult task. A schema would be developed according to the characteristics of the settlement pattern, e.g. cities, remote locations and place names. The aim is to propose an ontology for a common postal address system for Greenland. The main part of the research is dedicated to the current system and user requirement engineering. This allowed us to design a conceptual database model which corresponds to the user requirements, and implement a small scale prototype. Furthermore, our research includes resemblance findings in Danish and Greenland's addressing practices, data dictionary for establishing Greenland addressing system's logical model and enhanced entity relationship diagram. This initial prototype of the Greenland addressing system could be used to evaluate and build the full architecture of the addressing information system for Greenland. Using software engineering methods the implementation can be done according to the developed data model and initial database prototype. Development of the Greenland addressing system using a modern GIS and database technology would ease the work and improve the quality of public services such as: postal delivery, emergency response, customer/business relationship management, administration of land, utility planning and maintenance and public statistical data analysis.

Defining the methodological challenges and opportunities for an effective science of sociotechnical systems and safety.

PubMed

Waterson, Patrick; Robertson, Michelle M; Cooke, Nancy J; Militello, Laura; Roth, Emilie; Stanton, Neville A

2015-01-01

An important part of the application of sociotechnical systems theory (STS) is the development of methods, tools and techniques to assess human factors and ergonomics workplace requirements. We focus in this paper on describing and evaluating current STS methods for workplace safety, as well as outlining a set of six case studies covering the application of these methods to a range of safety contexts. We also describe an evaluation of the methods in terms of ratings of their ability to address a set of theoretical and practical questions (e.g. the degree to which methods capture static/dynamic aspects of tasks and interactions between system levels). The outcomes from the evaluation highlight a set of gaps relating to the coverage and applicability of current methods for STS and safety (e.g. coverage of external influences on system functioning; method usability). The final sections of the paper describe a set of future challenges, as well as some practical suggestions for tackling these. We provide an up-to-date review of STS methods, a set of case studies illustrating their use and an evaluation of their strengths and weaknesses. The paper concludes with a 'roadmap' for future work.

Primary Health Care as a Foundation for Strengthening Health Systems in Low- and Middle-Income Countries.

PubMed

Bitton, Asaf; Ratcliffe, Hannah L; Veillard, Jeremy H; Kress, Daniel H; Barkley, Shannon; Kimball, Meredith; Secci, Federica; Wong, Ethan; Basu, Lopa; Taylor, Chelsea; Bayona, Jaime; Wang, Hong; Lagomarsino, Gina; Hirschhorn, Lisa R

2017-05-01

Primary health care (PHC) has been recognized as a core component of effective health systems since the early part of the twentieth century. However, despite notable progress, there remains a large gap between what individuals and communities need, and the quality and effectiveness of care delivered. The Primary Health Care Performance Initiative (PHCPI) was established by an international consortium to catalyze improvements in PHC delivery and outcomes in low- and middle-income countries through better measurement and sharing of effective models and practices. PHCPI has developed a framework to illustrate the relationship between key financing, workforce, and supply inputs, and core primary health care functions of first-contact accessibility, comprehensiveness, coordination, continuity, and person-centeredness. The framework provides guidance for more effective assessment of current strengths and gaps in PHC delivery through a core set of 25 key indicators ("Vital Signs"). Emerging best practices that foster high-performing PHC system development are being codified and shared around low- and high-income countries. These measurement and improvement approaches provide countries and implementers with tools to assess the current state of their PHC delivery system and to identify where cross-country learning can accelerate improvements in PHC quality and effectiveness.

Defending Against Advanced Persistent Threats Using Game-Theory.

PubMed

Rass, Stefan; König, Sandra; Schauer, Stefan

2017-01-01

Advanced persistent threats (APT) combine a variety of different attack forms ranging from social engineering to technical exploits. The diversity and usual stealthiness of APT turns them into a central problem of contemporary practical system security, since information on attacks, the current system status or the attacker's incentives is often vague, uncertain and in many cases even unavailable. Game theory is a natural approach to model the conflict between the attacker and the defender, and this work investigates a generalized class of matrix games as a risk mitigation tool for an advanced persistent threat (APT) defense. Unlike standard game and decision theory, our model is tailored to capture and handle the full uncertainty that is immanent to APTs, such as disagreement among qualitative expert risk assessments, unknown adversarial incentives and uncertainty about the current system state (in terms of how deeply the attacker may have penetrated into the system's protective shells already). Practically, game-theoretic APT models can be derived straightforwardly from topological vulnerability analysis, together with risk assessments as they are done in common risk management standards like the ISO 31000 family. Theoretically, these models come with different properties than classical game theoretic models, whose technical solution presented in this work may be of independent interest.

Variability in Accreditation Council for Graduate Medical Education Resident Case Log System practices among orthopaedic surgery residents.

PubMed

Salazar, Dane; Schiff, Adam; Mitchell, Erika; Hopkinson, William

2014-02-05

The Accreditation Council for Graduate Medical Education (ACGME) Resident Case Log System is designed to be a reflection of residents' operative volume and an objective measure of their surgical experience. All operative procedures and manipulations in the operating room, Emergency Department, and outpatient clinic are to be logged into the Resident Case Log System. Discrepancies in the log volumes between residents and residency programs often prompt scrutiny. However, it remains unclear if such disparities truly represent differences in operative experiences or if they are reflections of inconsistent logging practices. The purpose of this study was to investigate individual recording practices among orthopaedic surgery residents prior to August 1, 2011. Orthopaedic surgery residents received a questionnaire on case log practices that was distributed through the Council of Orthopaedic Residency Directors list server. Respondents were asked to respond anonymously about recording practices in different clinical settings as well as types of cases routinely logged. Hypothetical scenarios of common orthopaedic procedures were presented to investigate the differences in the Current Procedural Terminology codes utilized. Two hundred and ninety-eight orthopaedic surgery residents completed the questionnaire; 37% were fifth-year residents, 22% were fourth-year residents, 18% were third-year residents, 15% were second-year residents, and 8% were first-year residents. Fifty-six percent of respondents reported routinely logging procedures performed in the Emergency Department or urgent care setting. Twenty-two percent of participants routinely logged procedures in the clinic or outpatient setting, 20% logged joint injections, and only 13% logged casts or splints applied in the office setting. There was substantial variability in the Current Procedural Terminology codes selected for the seven clinical scenarios. There has been a lack of standardization in case-logging practices among orthopaedic surgery residents prior to August 1, 2011. ACGME case log data prior to this date may not be a reliable measure of residents' procedural experience.

Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

PubMed

Stucki, Gerold; Zampolini, Mauro; Juocevicius, Alvydas; Negrini, Stefano; Christodoulou, Nicolas

2017-04-01

Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

Evaluating an online pharmaceutical education system for pharmacy interns in critical care settings.

PubMed

Yeh, Yu-Ting; Chen, Hsiang-Yin; Cheng, Kuei-Ju; Hou, Ssu-An; Yen, Yu-Hsuan; Liu, Chien-Tsai

2014-02-01

Incorporating electronic learning (eLearning) system into professional experimental programs such as pharmacy internships is a challenge. However, none of the current systems can fully support the unique needs of clinical pharmacy internship. In this study we enhanced a commercial eLearning system for clinical pharmacy internship (The Clinical Pharmacy Internship eLearning System, CPIES). The KAP questionnaire was used to evaluate the performance of group A with the traditional teaching model and group B with the CPIES teaching model. The CPIES teaching model showed significant improvement in interns' knowledge and practice (p = 0.002 and 0.031, respectively). The traditional teaching model only demonstrated significant improvement in practice (p = 0.011). Moreover, professionalism, such as attitudes on cooperating with other health professionals, is developed by learning from a good mentor. The on-line teaching and traditional teaching methods should undoubtedly be blended in a complete teaching model in order to improve learners' professional knowledge, facilitate correct attitude, and influence good practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Medical Education and Health Care Delivery: A Call to Better Align Goals and Purposes.

PubMed

Sklar, David P; Hemmer, Paul A; Durning, Steven J

2018-03-01

The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models.The authors describe the potential of medical education to augment payment incentives to make changes in clinical practice and the importance of aligning the purpose and goals of medical education with those of the health care delivery system. The authors discuss how curricular and assessment changes and faculty development can align medical education with the transformative trends in the health care delivery system. They also explain how the theory of situated cognition offers a shared conceptual framework that could help address the misalignment of education and clinical care. They provide examples of how quality improvement, health care innovation, population care management, and payment alignment could create bridges for joining health care delivery and medical education to meet the health care reform goals of a high-performing health care delivery system while controlling health care spending. Finally, the authors illustrate how current payment incentives such as bundled payments, value-based purchasing, and population-based payments can work synergistically with medical education to provide high-value care.

Barriers faced by expanded practice dental hygienists in Oregon.

PubMed

Coplen, Amy E; Bell, Kathryn P

2015-04-01

Oregon allows dental hygienists to provide services without the supervision of a dentist if they hold an expanded practice permit (EPP). This study surveyed practicing and non-practicing EPP holders with the purpose of assessing perceived barriers to practicing independently and better educating students to begin independent practice upon graduation. A survey was developed, approved by the institutional review board and pilot tested with current Expanded Practice Dental Hygienists (EPDHs). A list of EPDHs was obtained from the Oregon State Dental Board, and 181 surveys were mailed in November 2011. The response rate was 39% (n=71). Data from this study indicate a large number of new EPP holders, with 62% (n=41) holding their permit for 3 years or less, but only 41% (n=29) of respondents are actually providing care in a setting requiring an EPP. Responding practicing EPDHs reported barriers including: challenges with insurance reimbursement, lack of knowledge/acceptance, equipment cost/maintenance, difficulty obtaining a collaborative agreement/cooperating facility, advertising and inability to make a living wage. Responding non-practicing EPDHs reported barriers including: currently working in another setting, lack of business knowledge, time, start-up cost, inability to make a living wage, lack of opportunity, reimbursement difficulties and lack of experience. Perceived barriers to practicing independently differ between those practicing utilizing their EPP and those not practicing. Ways to eliminate barriers for both practicing and non-practicing EPDHs should be explored. There is potential to reduce the barriers to independent practice through curricular changes, public health partnerships among EPDHs, and new health care systems that specifically address barriers found through this study. Copyright © 2015 The American Dental Hygienists’ Association.

"I'm running my depression:" Self-management of depression in neoliberal Australia.

PubMed

Brijnath, Bianca; Antoniades, Josefine

2016-03-01

The current study examines how the neoliberal imperative to self-manage has been taken up by patients, focusing specifically on Indian-Australians and Anglo-Australians living with depression in Australia. We use Nikolas Rose's work on governmentality and neoliberalism to theorise our study and begin by explicating the links between self-management, neoliberalism and the Australian mental health system. Using qualitative methods, comprising 58 in-depth interviews, conducted between May 2012 and May 2013, we argue that participants practices of self-management included reduced use of healthcare services, self-medication and self-labour. Such practices occurred over time, informed by unsatisfactory interactions with the health system, participants confidence in their own agency, and capacity to craft therapeutic strategies. We argue that as patients absorbed and enacted neoliberal norms, a disconnect was created between the policy rhetoric of self-management, its operationalisation in the health system and patient understandings and practices of self-management. Such a disconnect, in turn, fosters conditions for risky health practices and poor health outcomes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families

PubMed Central

Shah, Prakesh S.; McDonald, Sarah D.; Barrett, Jon; Synnes, Anne; Robson, Kate; Foster, Jonathan; Pasquier, Jean-Charles; Joseph, K.S.; Piedboeuf, Bruno; Lacaze-Masmonteil, Thierry; O'Brien, Karel; Shivananda, Sandesh; Chaillet, Nils; Pechlivanoglou, Petros

2018-01-01

Background: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. Methods: Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems. Three broad clusters of projects will be undertaken. Cluster 1 will focus on quality-improvement efforts that use the Evidence-based Practice for Improving Quality method to evaluate information from the CPTBN database and review the current literature, then identify potentially better health care practices and implement identified strategies. Cluster 2 will assess the impact of current practices and practice changes in maternal, perinatal and neonatal care on maternal, neonatal and neurodevelopmental outcomes. Cluster 3 will evaluate the effect of preterm birth on babies, their families and the health care system by integrating CPTBN data, parent feedback, and national and provincial database information in order to identify areas where more parental support is needed, and also generate robust estimates of resource use, cost and cost-effectiveness around preterm neonatal care. Interpretation: These collaborative efforts will create a flexible, transdisciplinary, evaluable and informative research and quality-improvement platform that supports programs, projects and partnerships focused on improving outcomes of preterm neonates. PMID:29348260

Career satisfaction among general surgeons in Canada: a qualitative study of enablers and barriers to improve recruitment and retention in general surgery.

PubMed

Ahmed, Najma; Conn, Lesley Gotlib; Chiu, Mary; Korabi, Bochra; Qureshi, Adnan; Nathens, Avery B; Kitto, Simon

2012-11-01

To understand what influences career satisfaction among general surgeons in urban and rural areas in Canada in order to improve recruitment and retention in general surgery. Semistructured interviews were conducted with 32 general surgeons in 2010 who were members of the Canadian Association of General Surgeons and who currently practice in either an urban or rural area. Interviews explored factors contributing to career satisfaction, as well as suggestions for preventive, screening, or management strategies to support general surgery practice. Findings revealed that both urban and rural general surgeons experienced the most satisfaction from their ability to resolve patient problems quickly and effectively, enhancing their sense of the meaningfulness of their clinical practice. The supportive relationships with colleagues, trainees, and patients was also cited as a key source of career satisfaction. Conversely, insufficient access to resources and a perceived disconnect between hospital administration and clinical practice priorities were raised as key "systems-level" problems. As a result, many participants felt alienated from their work by these systems-level barriers that were perceived to hinder the provision of high-quality patient care. Career satisfaction among both urban and rural general surgeons was influenced positively by the social aspects of their work, such as patient and colleague relationships, as well as a perception of an increasing amount of control and autonomy over their professional commitments. The modern general surgeon values a balance between professional obligations and personal time that may be difficult to achieve given the current system constraints.

Perceived determinants of cardiovascular risk management in primary care: disconnections between patient behaviours, practice organisation and healthcare system.

PubMed

Huntink, E; Wensing, M; Klomp, M A; van Lieshout, J

2015-12-15

Although conditions for high quality cardiovascular risk management in primary care in the Netherlands are favourable, there still remains a gap between practice guideline recommendations and practice. The aim of the current study was to identify determinants of cardiovascular primary care in the Netherlands. We performed a qualitative study, using semi-structured interviews with healthcare professionals and patients with established cardiovascular diseases or at high cardiovascular risk. A framework analysis was used to cluster the determinants into seven domains: 1) guideline factors, 2) individual healthcare professional factors, 3) patient factors, 4) professional interaction, 5) incentives and recourses, 6) mandate, authority and accountability, and 7) social, political and legal factors. Twelve healthcare professionals and 16 patients were interviewed. Healthcare professionals and patients mentioned a variety of factors concerning all seven domains. Determinants of practice according to the health care professionals were related to communication between healthcare professionals, patients' lack of knowledge and self-management, time management, market mechanisms in the Dutch healthcare system and motivational interviewing skills of healthcare professionals. Patients mentioned determinants related to their knowledge of risk factors for cardiovascular diseases, medication adherence and self-management as key determinants. A key finding is the mismatch between healthcare professionals' and patients' views on patient's knowledge and self-management. Perceived determinants of cardiovascular risk management were mainly related to patient behaviors and (but only for health professionals) to the healthcare system. Though health care professionals and patients agree upon the importance of patients' knowledge and self-management, their judgment of the current state of knowledge and self-management is entirely different.

Development of a health care systems curriculum

PubMed Central

Pruitt, Zachary; Mhaskar, Rahul; Kane, Bryan G; Barraco, Robert D; DeWaay, Deborah J; Rosenau, Alex M; Bresnan, Kristin A; Greenberg, Marna Rayl

2017-01-01

Background There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution. Methods This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created to assess student health system competence. Student evaluation of course curriculum design, delivery, and assessment was provided through web-based surveys. Results To meet competency standards for system-based practice, a health systems curriculum was developed and delivered across 4 years of medical school training. Each of the health system lectures and problem-based learning activities are described herein. The majority of first and second year medical students stated they gained working knowledge of health systems by engaging in these sessions. The majority of the 2016 graduating students (88.24%) felt that the course content, overall, prepared them for their career. Conclusion A health systems curriculum in undergraduate medical education using a problem-based learning approach is feasible. The majority of students learning health systems curriculum through this format reported being prepared to improve individual patient care and optimize the health system’s value (better care and health for lower cost). PMID:29138614

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

Makarov, Yuri V.; Du, Pengwei; Etingov, Pavel V.

This planning reference book is a document reflecting a Western Electricity Coordination Council (WECC) effort to put together multiple sources of information and provide a clear, systemic, comprehensive outline of the problems, both existing and anticipated; their impacts on the system; currently used and proposed solutions by the industry and research community; planning practices; new technologies, equipment, and standards; and expected future trends. This living (periodically updated) document could help WECC and other practicing engineers, especially the younger generation of engineers joining the workforce, to get familiar with a large variety of information related to the integration of variable resourcesmore » into the WECC system, bypassing in part the need for time-consuming information gathering and learning processes from more experienced engineers or from the literature.« less

Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals.

PubMed

Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting

2017-01-01

With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.

Modernized build and test infrastructure for control software at ESO: highly flexible building, testing, and automatic quality practices for telescope control software

NASA Astrophysics Data System (ADS)

Pellegrin, F.; Jeram, B.; Haucke, J.; Feyrin, S.

2016-07-01

The paper describes the introduction of a new automatized build and test infrastructure, based on the open-source software Jenkins1, into the ESO Very Large Telescope control software to replace the preexisting in-house solution. A brief introduction to software quality practices is given, a description of the previous solution, the limitations of it and new upcoming requirements. Modifications required to adapt the new system are described, how these were implemented to current software and the results obtained. An overview on how the new system may be used in future projects is also presented.

System hazards in managing laboratory test requests and results in primary care: medical protection database analysis and conceptual model.

PubMed

Bowie, Paul; Price, Julie; Hepworth, Neil; Dinwoodie, Mark; McKay, John

2015-11-27

To analyse a medical protection organisation's database to identify hazards related to general practice systems for ordering laboratory tests, managing test results and communicating test result outcomes to patients. To integrate these data with other published evidence sources to inform design of a systems-based conceptual model of related hazards. A retrospective database analysis. General practices in the UK and Ireland. 778 UK and Ireland general practices participating in a medical protection organisation's clinical risk self-assessment (CRSA) programme from January 2008 to December 2014. Proportion of practices with system risks; categorisation of identified hazards; most frequently occurring hazards; development of a conceptual model of hazards; and potential impacts on health, well-being and organisational performance. CRSA visits were undertaken to 778 UK and Ireland general practices of which a range of systems hazards were recorded across the laboratory test ordering and results management systems in 647 practices (83.2%). A total of 45 discrete hazard categories were identified with a mean of 3.6 per practice (SD=1.94). The most frequently occurring hazard was the inadequate process for matching test requests and results received (n=350, 54.1%). Of the 1604 instances where hazards were recorded, the most frequent was at the 'postanalytical test stage' (n=702, 43.8%), followed closely by 'communication outcomes issues' (n=628, 39.1%). Based on arguably the largest data set currently available on the subject matter, our study findings shed new light on the scale and nature of hazards related to test results handling systems, which can inform future efforts to research and improve the design and reliability of these systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Health insurance dentists' subjective perceptions of quality when implementing quality management in practice - results from a nationwide survey].

PubMed

Kettler, Nele; Chenot, Regine; Jordan, A Rainer

2015-01-01

Statutory health insurance dentists working in private practice have a duty to maintain and improve the quality of dental care. An individual practice's approach to quality management (QM) can be made to reflect the practice's philosophy on quality and standards and can be adapted to the specific requirements of the practice setting they are meant to serve. This study set out to collect data on the subjective perceptions of quality that exist among German dentists, and to canvass their views on the process and benefits of implementing QM systems. In doing so, this study aimed to identify the incentives and obstacles that currently exist in relation to the implementation and further development of practice-based QM systems. As part of a nationally representative cross-sectional study, a random sample of 2,084 dentists was asked to complete a questionnaire on perceptions of quality and QM. The response rate was 40.3 % (n=838). The study's primary end point was defined as the surveyed dentists' interpretative description of quality. The study's secondary end point was defined as the dentists' subjective evaluations of the benefits of QM in the day-to-day management of their own practices. Responses to open-ended questions were analysed using content analysis, while quantitative questions were analysed using descriptive univariate analysis. When analysing respondents' subjective perceptions of quality (primary end point), the following dimensions were revealed as highly significant: patient (mentioned by 31.4 % of the responders), quality of treatment (29.5 %) and staff (14.8 %). As far as the benefits of QM in the day-to-day management of the respondent's own practices (secondary end point) were concerned, these appeared to be linked to the ease of implementation of the organizational tools offered by QM systems: managing emergencies, team meetings and procedural check lists were ranked as "can be implemented to a reasonable degree" and "can be fully implemented" by 82.3 %, 80.2 % and 79.9 % of respondents, respectively. There appeared to be a disconnect between the respondents' subjective perceptions of quality and the benefits of QM as part of day-to-day practice management, with QM systems failing to reflect the respondents' subjective views on quality. The perceptions of QM among German statutory health insurance dentists are generally positive but marked by a disconnect between aspects of quality currently measured by QM systems and the dentists' views on what is required in order to assess quality standards in relation to the dimensions "patient", "quality of treatment" and "staff". A targeted review of the tools offered by QM systems may lead to improved ease of implementation. If QM is to form an integral part of clinical practice, all future developments need to consider the dentists' subjective perceptions of quality and their attitudes towards QM. Copyright © 2015. Published by Elsevier GmbH.

Extra-bodily DNA sampling by the police.

PubMed

Gans, Jeremy

2013-12-01

Forensic investigators have statutory powers to take DNA samples directly from suspects' bodies in certain circumstances but sometimes the powers fall short, legally or practically Police may then look for samples that have become separated from their suspects for one reason or another. No jurisdiction currently bars or even regulates this practice, which is instead loosely governed by laws on property, consent and evidence. This article argues that this lack of regulation undermines the entire system of forensic procedure laws.

[A review on urban metabolism research based on physical space entities for environmental management].

PubMed

Liu, Ye; Liu, Dan

2015-07-01

Urban metabolism is a basic theory for coping with global environmental problems, which is coherent with the aims of national environmental management. This paper analyzed the concept of urban metabolism, and pointed out the meaning for urban metabolism in physical space entities; reviewed the current methods for urban metabolism and its merits and shortages; analyzed the system boundaries, connotation, and methodologies; and summarized the advances on urban meta-bolism practices in physical space entities. At last, we made conclusions that there were shortages, including conception system, basic theory system, and interdisciplinary integrated theory system in current urban metabolism research, and the current cases studied in urban metabolism were limited and not suitable to the harmony development between society, economy, and environment. In the future, we need to strengthen comparison between different case studies from different countries, develop the prior modes of typical urban metabolism research, identify the mechanism for urban ecosystem, and strengthen the spatial decision support system of environmental management taking urban spatial entity spaces as units.

Education, practical training and professional development for public health practitioners: a scoping review of the literature and insights for sustainable food system capacity-building.

PubMed

Wegener, Jessica; Fong, Debbie; Rocha, Cecilia

2018-06-01

Noting the upstream positioning of sustainable food systems (SFS) to multiple global crises, the present review described examples of emerging and promising practices to support SFS-oriented education, practical training (PT) and continuing professional development (CPD) among trainees and public health practitioners (PHP). A secondary objective was to compile the evidence into practical considerations for educators, supervising practitioners and professional associations. A scoping review of the literature published between 2007 and 2017 was conducted in May 2017 using four databases: CINAHL, MEDLINE, Scopus and HSSA, along with bibliography hand-searching and expert consultation. Articles were screened for relevance and specificity by independent raters. Nineteen articles were included for analysis. Two-thirds of the articles related to dietitians and public health nutritionists. Emerging practices included curriculum-based considerations, incorporation of 'sustainability' within professional competencies and self-reflection related to SFS. Descriptions of SFS-related education, PT and CPD practices appeared largely in the literature from developed countries. Articles converged on the need for ecosystems, food systems and sustainability considerations within and across practice to support current and future practitioners. There is growing interest in SFS but guidance to support educators and preceptors is lacking. Updates to dietary guidelines to reflect issues of sustainability are a timely prompt to examine the education, training and development needs of trainees and PHP. Practical examples of emerging practices can empower PHP to promote SFS in all areas of practice. More research is needed to address identified gaps in the literature and to improve SFS-specific education, PT and CPD.

JP8 Reformation for Combat Vehicles

DTIC Science & Technology

2007-08-07

phase (fuel), and a gas phase (hydrogen) at elevated pressures. • Trickle - bed configuration is difficult to model and scale down—not practical for...gases output from HDS reactor are used to fuel the reformer. Current Technology Status: •Integrated desulfurization/reforming system successfully

Development of a precast bridge deck overhang system for the rock creek bridge.

DOT National Transportation Integrated Search

2008-12-01

Precast, prestressed panels are commonly used at interior beams for bridges in Texas. The use of these : panels provides ease of construction, sufficient capacity, and good economy for the construction of : bridges in Texas. Current practice for the ...

Development of Uniform Sections for PMS Inventory and Application.

DOT National Transportation Integrated Search

2007-12-01

This report summarizes the findings of the first phase of LTRC research project 04-2P, which is sponsored by LADOTD. : The project is assessing the current status and the state-of-the-practice of the LADOTD pavement management system : (PMS). Results...

A landscape vision for integrating industrial crops into biofuel systems

USDA-ARS?s Scientific Manuscript database

Achieving energy independence and security through domestic production of renewable biofuels is feasible but will require a different landscape than we have with current agricultural practices. Integrating industrial crops such as Canola, Camelina, or Cuphea could offer many opportunities to enhance...

78 FR 64482 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... for the administration of and a record of academic performance of current, former, and nominated... performance of the functions of the agency, including whether the information shall have practical utility; (b... collection instruments, please write to the Center Director, Student Information System, Performance and...

Studying Innovation Technologies in Modern Education

ERIC Educational Resources Information Center

Stukalenko, Nina M.; Zhakhina, Bariya B.; Kukubaeva, Asiya K.; Smagulova, Nurgul K.; Kazhibaeva, Gulden K.

2016-01-01

In modern society, innovation technologies expand to almost every field of human activity, including such wide field as education. Due to integrating innovation technologies into the educational process practice, this phenomenon gained special significance within improvement and modernization of the established educational system. Currently, the…

21 CFR 868.6225 - Nose clip.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ANESTHESIOLOGY DEVICES Miscellaneous § 868.6225 Nose clip. (a) Identification. A nose clip is a device intended to close a patient's external nares (nostrils) during diagnostic or therapeutic procedures. (b... from the current good manufacturing practice requirements of the quality system regulation in part 820...

Rivaroxaban real-world evidence: Validating safety and effectiveness in clinical practice.

PubMed

Beyer-Westendorf, Jan; Camm, A John; Coleman, Craig I; Tamayo, Sally

2016-09-28

Randomised controlled trials (RCTs) are considered the gold standard of clinical research as they use rigorous methodologies, detailed protocols, pre-specified statistical analyses and well-defined patient cohorts. However, RCTs do not take into account the complexity of real-world clinical decision-making. To tackle this, real-world data are being increasingly used to evaluate the long-term safety and effectiveness of a given therapy in routine clinical practice and in patients who may not be represented in RCTs, addressing key clinical questions that may remain. Real-world evidence plays a substantial role in supporting the use of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in clinical practice. By providing data on patient profiles and the use of anticoagulation therapies in routine clinical practice, real-world evidence expands the current awareness of NOACs, helping to ensure that clinicians are well-informed on their use to implement patient-tailored clinical decisions. There are various issues with current anticoagulation strategies, including under- or overtreatment and frequent monitoring with VKAs. Real-world studies have demonstrated that NOAC use is increasing (Dresden NOAC registry and Global Anticoagulant Registry in the FIELD-AF [GARFIELD-AF]), as well as reaffirming the safety and effectiveness of rivaroxaban previously observed in RCTs (XArelto on preveNtion of sTroke and non-central nervoUS system systemic embolism in patients with non-valvular atrial fibrillation [XANTUS] and IMS Disease Analyzer). This article will describe the latest updates in real-world evidence across a variety of methodologies, such as non-interventional studies (NIS), registries and database analyses studies. It is anticipated that these studies will provide valuable clinical insights into the management of thromboembolism, and enhance the current knowledge on anticoagulant use and outcomes for patients.

Education of Pharmacists in Canada

PubMed Central

Ensom, Mary H.H.

2008-01-01

In Canada, the education of pharmacists is built upon a foundation of strong, research-intensive publicly funded universities and a universal health-care system that balances government and private financing for prescription medications. The evolution of pharmacy education and practice in Canada has laid the foundation for a variety of emerging trends related to expanded roles for pharmacists, increasing interprofessional collaboration for patient-centered care, and emergence of pharmacy technicians as a soon-to-be regulated professional group in parts of the country. Current challenges include the need to better integrate internationally educated pharmacists within the domestic workforce and tools to ensure continuous professional development and maintenance of competency of practitioners. Academic pharmacy is currently debating how best to manage the need to enhance the pharmacy curriculum to meet current and future skills needs, and whether a doctor of pharmacy (PharmD) degree ought to become the standard entry-to-practice qualification for pharmacists in Canada. PMID:19325948

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

PubMed Central

Teoh, M; Clark, C H; Wood, K; Whitaker, S; Nisbet, A

2011-01-01

Volumetric modulated arc therapy (VMAT) is a novel radiation technique, which can achieve highly conformal dose distributions with improved target volume coverage and sparing of normal tissues compared with conventional radiotherapy techniques. VMAT also has the potential to offer additional advantages, such as reduced treatment delivery time compared with conventional static field intensity modulated radiotherapy (IMRT). The clinical worldwide use of VMAT is increasing significantly. Currently the majority of published data on VMAT are limited to planning and feasibility studies, although there is emerging clinical outcome data in several tumour sites. This article aims to discuss the current use of VMAT techniques in practice and review the available data from planning and clinical outcome studies in various tumour sites including prostate, pelvis (lower gastrointestinal, gynaecological), head and neck, thoracic, central nervous system, breast and other tumour sites. PMID:22011829

Application of SAE ARP4754A to Flight Critical Systems

NASA Technical Reports Server (NTRS)

Peterson, Eric M.

2015-01-01

This report documents applications of ARP4754A to the development of modern computer-based (i.e., digital electronics, software and network-based) aircraft systems. This study is to offer insight and provide educational value relative to the guidelines in ARP4754A and provide an assessment of the current state-of-the- practice within industry and regulatory bodies relative to development assurance for complex and safety-critical computer-based aircraft systems.

The Role of Education in a System of Care: Effectively Serving Children with Emotional or Behavioral Disorders. Systems of Care: Promising Practices in Children's Mental Health 1998 Series. Volume III.

ERIC Educational Resources Information Center

Woodruff, Darren W.; Osher, David; Hoffman, Catherine C.; Gruner, Allison; King, Mark A.; Snow, Stephanie T.; McIntire, Jonathan C.

This is the third volume in a series of monographs from the Comprehensive Community Mental Health Service for Children and Their Families Program, which currently supports 41 comprehensive system of care sites to meet the needs of children with serious emotional disturbances (SED). This volume explores sites that are overcoming obstacles to…

Research and design of logistical information system based on SOA

NASA Astrophysics Data System (ADS)

Zhang, Bo

2013-03-01

Through the study on the existing logistics information systems and SOA technology, based on the current situation of enterprise logistics management and business features, this paper puts forward a SOA-based logistics system design program. This program is made in the WCF framework, with the combination of SOA and the actual characteristics of logistics enterprises, is simple to realize, easy to operate, and has strong expansion characteristic, therefore has high practical value.

The reliability-quality relationship for quality systems and quality risk management.

PubMed

Claycamp, H Gregg; Rahaman, Faiad; Urban, Jason M

2012-01-01

Engineering reliability typically refers to the probability that a system, or any of its components, will perform a required function for a stated period of time and under specified operating conditions. As such, reliability is inextricably linked with time-dependent quality concepts, such as maintaining a state of control and predicting the chances of losses from failures for quality risk management. Two popular current good manufacturing practice (cGMP) and quality risk management tools, failure mode and effects analysis (FMEA) and root cause analysis (RCA) are examples of engineering reliability evaluations that link reliability with quality and risk. Current concepts in pharmaceutical quality and quality management systems call for more predictive systems for maintaining quality; yet, the current pharmaceutical manufacturing literature and guidelines are curiously silent on engineering quality. This commentary discusses the meaning of engineering reliability while linking the concept to quality systems and quality risk management. The essay also discusses the difference between engineering reliability and statistical (assay) reliability. The assurance of quality in a pharmaceutical product is no longer measured only "after the fact" of manufacturing. Rather, concepts of quality systems and quality risk management call for designing quality assurance into all stages of the pharmaceutical product life cycle. Interestingly, most assays for quality are essentially static and inform product quality over the life cycle only by being repeated over time. Engineering process reliability is the fundamental concept that is meant to anticipate quality failures over the life cycle of the product. Reliability is a well-developed theory and practice for other types of manufactured products and manufacturing processes. Thus, it is well known to be an appropriate index of manufactured product quality. This essay discusses the meaning of reliability and its linkages with quality systems and quality risk management.

Fuzzy logic based on-line fault detection and classification in transmission line.

PubMed

Adhikari, Shuma; Sinha, Nidul; Dorendrajit, Thingam

2016-01-01

This study presents fuzzy logic based online fault detection and classification of transmission line using Programmable Automation and Control technology based National Instrument Compact Reconfigurable i/o (CRIO) devices. The LabVIEW software combined with CRIO can perform real time data acquisition of transmission line. When fault occurs in the system current waveforms are distorted due to transients and their pattern changes according to the type of fault in the system. The three phase alternating current, zero sequence and positive sequence current data generated by LabVIEW through CRIO-9067 are processed directly for relaying. The result shows that proposed technique is capable of right tripping action and classification of type of fault at high speed therefore can be employed in practical application.

Study of the zinc-silver oxide battery system

NASA Technical Reports Server (NTRS)

Nanis, L.

1973-01-01

Theoretical and experimental models for the evaluation of current distribution in flooded, porous electrodes are discussed. An approximation for the local current distribution function was derived for conditions of a linear overpotential, a uniform concentration, and a very conductive matrix. By considering the porous electrode to be an analog of chemical catalyst structures, a dimensionless performance parameter was derived from the approximated current distribution function. In this manner the electrode behavior was characterized in terms of an electrochemical Thiele parameter and an effectiveness factor. It was shown that the electrochemical engineering approach makes possible the organizations of theoretical descriptions and of practical experience in the form of dimensionless parameters, such as the electrochemical Thiele parameters, and hence provides useful information for the design of new electrochemical systems.

Management system to a photovoltaic panel based on the measurement of short-circuit currents

NASA Astrophysics Data System (ADS)

Dordescu, M.

2016-12-01

This article is devoted to fundamental issues arising from operation in terms of increased energy efficiency for photovoltaic panel (PV). By measuring the current from functioning cage determine the current value prescribed amount corresponding to maximum power point results obtained by requiring proof of pregnancy with this method are the maximum energy possible, thus justifying the usefulness of this process very simple and inexpensive to implement in practice. The proposed adjustment method is much simpler and more economical than conventional methods that rely on measuring power cut.

Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production.

PubMed

Farr, Michelle; Banks, Jonathan; Edwards, Hannah B; Northstone, Kate; Bernard, Elly; Salisbury, Chris; Horwood, Jeremy

2018-03-19

To examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved. Mixed-method evaluation of a primary care e-consultation system. Primary care practices in South West England. Qualitative interviews with 23 practice staff in six practices. Patient survey data for 756 e-consultations from 36 practices, with free-text survey comments from 512 patients, were analysed thematically. Anonymised patients' records were abstracted for 485 e-consultations from eight practices, including consultation types and outcomes. Descriptive statistics were used to analyse quantitative data. Analysis of implementation and the usage of the e-consultation system were informed by: (1) normalisation process theory, (2) a framework that illustrates how e-consultations were co-produced and (3) patients' and staff touchpoints. We found different expectations between patients and staff on how to use e-consultations 'appropriately'. While some patients used the system to try and save time for themselves and their general practitioners (GPs), some used e-consultations when they could not get a timely face-to-face appointment. Most e-consultations resulted in either follow-on phone (32%) or face-to-face appointments (38%) and GPs felt that this duplicated their workload. Patient satisfaction of the system was high, but a minority were dissatisfied with practice communication about their e-consultation. Where both patients and staff interact with technology, it is in effect 'co-implemented'. How patients used e-consultations impacted on practice staff's experiences and appraisal of the system. Overall, the e-consultation system studied could improve access for some patients, but in its current form, it was not perceived by practices as creating sufficient efficiencies to warrant financial investment. We illustrate how this e-consultation system and its implementation can be improved, through mapping the co-production of e-consultations through touchpoints. © 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.