Understanding Research Gaps and Priorities for Improving Behavioral Counseling Interventions: Lessons Learned From the U.S. Preventive Services Task Force.

PubMed

Kurth, Ann E; Miller, Therese L; Woo, Meghan; Davidson, Karina W

2015-09-01

Behavioral counseling interventions can address significant causes of preventable morbidity and mortality. However, despite a growing evidence base for behavioral counseling interventions, there remain significant research gaps that limit translating the evidence into clinical practice. Using U.S. Preventive Services Task Force (USPSTF) examples, we address how researchers and funders can move the research portfolio forward to achieve better application of behavioral counseling interventions to address substantial health burdens in the U.S. This paper describes the types of gaps that the USPSTF encounters across its behavioral counseling intervention topics and provides suggestions for opportunities to address these gaps to enhance the evidence base for primary care-based behavioral counseling recommendations. To accomplish this, we draw from both the USPSTF experience and issues identified by researchers and clinicians during the USPSTF-sponsored Behavioral Counseling Intervention Forum. We also discuss the dilemma posed by having "insufficient" evidence with which to make a behavioral counseling intervention-related recommendation, and describe two case examples (screening for alcohol misuse in adolescence and screening for child maltreatment), detailing the research gaps that remain. Recommendations are outlined for researchers, funders, and practice implementers to improve behavioral counseling intervention research and application. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement.

PubMed

Moyer, Virginia A

2014-03-04

Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for lung cancer. The USPSTF reviewed the evidence on the efficacy of low-dose computed tomography, chest radiography, and sputum cytologic evaluation for lung cancer screening in asymptomatic persons who are at average or high risk for lung cancer (current or former smokers) and the benefits and harms of these screening tests and of surgical resection of early-stage non-small cell lung cancer. The USPSTF also commissioned modeling studies to provide information about the optimum age at which to begin and end screening, the optimum screening interval, and the relative benefits and harms of different screening strategies. This recommendation applies to asymptomatic adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. The USPSTF recommends annual screening for lung cancer with low-dose computed tomography in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation).

Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. preventive services task force recommendation statement.

PubMed

Moyer, Virginia A

2013-08-06

Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening and behavioral counseling interventions in primary care to reduce alcohol misuse. The USPSTF reviewed new evidence on the effectiveness of screening for alcohol misuse for improving health outcomes, the accuracy of various screening approaches, the effectiveness of various behavioral counseling interventions for improving intermediate or long-term health outcomes, the harms of screening and behavioral counseling interventions, and influences from the health care system that promote or detract from effective screening and counseling interventions for alcohol misuse. These recommendations apply to adolescents aged 12 to 17 years and adults aged 18 years or older. These recommendations do not apply to persons who are actively seeking evaluation or treatment of alcohol misuse. The USPSTF recommends that clinicians screen adults aged 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse. (Grade B recommendation)The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening and behavioral counseling interventions in primary care settings to reduce alcohol misuse in adolescents. (I statement)

Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Pignone, Michael; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2018-04-24

Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, 28.7% of community-dwelling adults 65 years or older reported falling, resulting in 29 million falls (37.5% of which needed medical treatment or restricted activity for a day or longer) and an estimated 33 000 deaths in 2015. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the prevention of falls in community-dwelling older adults. The USPSTF reviewed the evidence on the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling older adults 65 years or older who are not known to have osteoporosis or vitamin D deficiency. The USPSTF found adequate evidence that exercise interventions have a moderate benefit in preventing falls in older adults at increased risk for falls and that multifactorial interventions have a small benefit. The USPSTF found adequate evidence that vitamin D supplementation has no benefit in preventing falls in older adults. The USPSTF found adequate evidence to bound the harms of exercise and multifactorial interventions as no greater than small. The USPSTF found adequate evidence that the overall harms of vitamin D supplementation are small to moderate. The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation) The USPSTF recommends against vitamin D supplementation to prevent falls in community-dwelling adults 65 years or older. (D recommendation) These recommendations apply to community-dwelling adults who are not known to have osteoporosis or vitamin D deficiency.

Menopausal hormone therapy for primary prevention: why the USPSTF is wrong.

PubMed

Langer, R D; Simon, J A; Pines, A; Lobo, R A; Hodis, H N; Pickar, J H; Archer, D F; Sarrel, P M; Utian, W H

2017-10-01

The US Preventive Services Task Force (USPSTF) Draft Recommendation statement on Menopausal Hormone Therapy: Primary Prevention for Chronic Diseases, released in May 2017, perpetuates a major disconnect between the primary population affected, women within roughly 10 years of menopause, and the data cited. Furthermore, major elements of the evidence relied upon have been misinterpreted or misstated, particularly in regard to coronary heart disease and breast cancer, for which there is no statistically significant evidence of harm. As currently drafted, the recommendations reiterate the USPSTF statements of 2012, 2005 and 2002, and will perpetuate egregious harm to the public health. In an attempt to avoid that outcome and to facilitate a return to rational discourse regarding menopausal hormone therapy, an ad hoc group of experts in menopausal health submitted this comprehensive response to the USPSTF.

VDRL test

MedlinePlus

... having blood drawn are slight, but may include: Excessive bleeding Fainting or feeling lightheaded Hematoma (blood accumulating ... Saunders; 2015:chap 239. US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, Grossman DC, et al. ...

Obstetrician-gynecologists' knowledge and opinions about the United States Preventive Services Task Force (USPSTF) committee, the Women's Health Amendment, and the Affordable Care Act: national study after the release of the USPSTF 2009 Breast Cancer Screening Recommendation Statement.

PubMed

Anderson, Britta L; Urban, Renata R; Pearlman, Mark; Schulkin, Jay

2014-02-01

Investigate the knowledge and opinions of obstetrician and gynecologists (ob-gyns) regarding the USPSTF committee and statement, and to assess their reactions to healthcare legislation. A national cross-sectional survey study of ob-gyns was conducted six months after a controversial USPSTF recommendation statement was released in November 2009. Ob-gyns' opinions about the Women's Health Amendment (WHA) and the Affordable Care Act (ACA) were also assessed. A total of 54% of ob-gyns knew that the USPSTF recommendations do not represent the position of the U.S. government and 40% knew that the USPSTF is not comprised of federal employees. A majority (60%) thought that the USPSTF was influenced by potential costs more than guidelines should be. When examining ob-gyns opinions about new national health policies, 88% support the mammography coverage provided by the WHA but support for the ACA varied. This study provides a snapshot of ob-gyns' knowledge and opinions about the USPSTF and breast cancer screening guidelines at a controversial point in time. Our findings are a unique contribution to larger efforts to understand health and political policy as the culture of medicine continues to evolve. Copyright © 2013 Elsevier Inc. All rights reserved.

An approach to addressing subpopulation considerations in systematic reviews: the experience of reviewers supporting the U.S. Preventive Services Task Force.

PubMed

Whitlock, Evelyn P; Eder, Michelle; Thompson, Jamie H; Jonas, Daniel E; Evans, Corinne V; Guirguis-Blake, Janelle M; Lin, Jennifer S

2017-03-02

Guideline developers and other users of systematic reviews need information about whether a medical or preventive intervention is likely to benefit or harm some patients more (or less) than the average in order to make clinical practice recommendations tailored to these populations. However, guidance is lacking on how to include patient subpopulation considerations into the systematic reviews upon which guidelines are often based. In this article, we describe methods developed to consistently consider the evidence for relevant subpopulations in systematic reviews conducted to support primary care clinical preventive service recommendations made by the U.S. Preventive Services Task Force (USPSTF). Our approach is grounded in our experience conducting systematic reviews for the USPSTF and informed by a review of existing guidance on subgroup analysis and subpopulation issues. We developed and refined our approach based on feedback from the Subpopulation Workgroup of the USPSTF and pilot testing on reviews being conducted for the USPSTF. This paper provides processes and tools for incorporating evidence-based identification of important sources of potential heterogeneity of intervention effects into all phases of systematic reviews. Key components of our proposed approach include targeted literature searches and key informant interviews to identify the most important subpopulations a priori during topic scoping, a framework for assessing the credibility of subgroup analyses reported in studies, and structured investigation of sources of heterogeneity of intervention effects. Further testing and evaluation are necessary to refine this proposed approach and demonstrate its utility to the producers and users of systematic reviews beyond the context of the USPSTF. Gaps in the evidence on important subpopulations identified by routinely applying this process in systematic reviews will also inform future research needs.

Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement.

PubMed

Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2017-04-25

Preeclampsia affects approximately 4% of pregnancies in the United States. It is the second leading cause of maternal mortality worldwide and may lead to serious maternal complications, including stroke, eclampsia, and organ failure. Adverse perinatal outcomes for the fetus and newborn include intrauterine growth restriction, low birth weight, and stillbirth. Many of the complications associated with preeclampsia lead to early induction of labor or cesarean delivery and subsequent preterm birth. Preeclampsia is more prevalent among African American women than among white women. Differences in prevalence may be, in part, due to African American women being disproportionally affected by risk factors for preeclampsia. African American women also have case fatality rates related to preeclampsia 3 times higher than rates among white women. Inequalities in access to adequate prenatal care may contribute to poor outcomes associated with preeclampsia in African American women. To update the 1996 US Preventive Services Task Force (USPSTF) recommendation on screening for preeclampsia. The USPSTF reviewed the evidence on the accuracy of screening and diagnostic tests for preeclampsia, the potential benefits and harms of screening for preeclampsia, the effectiveness of risk prediction tools, and the benefits and harms of treatment of screen-detected preeclampsia. Given the evidence that treatment can reduce maternal and perinatal morbidity and mortality, and the well-established accuracy of blood pressure measurements, the USPSTF found adequate evidence that screening for preeclampsia results in a substantial benefit for the mother and infant. In addition, there is adequate evidence to bound the harms of screening for and treatment of preeclampsia as no greater than small. Therefore, the USPSTF concludes with moderate certainty that there is a substantial net benefit of screening for preeclampsia in pregnant women. The USPSTF recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy. (B recommendation).

Behavioral Counseling to Prevent Skin Cancer: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2018-03-20

Skin cancer is the most common type of cancer in the United States. Although invasive melanoma accounts for only 2% of all skin cancer cases, it is responsible for 80% of skin cancer deaths. Basal and squamous cell carcinoma, the 2 predominant types of nonmelanoma skin cancer, represent the vast majority of skin cancer cases. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on behavioral counseling for the primary prevention of skin cancer and the 2009 recommendation on screening for skin cancer with skin self-examination. The USPSTF reviewed the evidence on whether counseling patients about sun protection reduces intermediate outcomes (eg, sunburn or precursor skin lesions) or skin cancer; the link between counseling and behavior change, the link between behavior change and skin cancer incidence, and the harms of counseling or changes in sun protection behavior; and the link between counseling patients to perform skin self-examination and skin cancer outcomes, as well as the harms of skin self-examination. The USPSTF determined that behavioral counseling interventions are of moderate benefit in increasing sun protection behaviors in children, adolescents, and young adults with fair skin types. The USPSTF found adequate evidence that behavioral counseling interventions result in a small increase in sun protection behaviors in adults older than 24 years with fair skin types. The USPSTF found inadequate evidence on the benefits and harms of counseling adults about skin self-examination to prevent skin cancer. The USPSTF recommends counseling young adults, adolescents, children, and parents of young children about minimizing exposure to UV radiation for persons aged 6 months to 24 years with fair skin types to reduce their risk of skin cancer. (B recommendation) The USPSTF recommends that clinicians selectively offer counseling to adults older than 24 years with fair skin types about minimizing their exposure to UV radiation to reduce risk of skin cancer. Existing evidence indicates that the net benefit of counseling all adults older than 24 years is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the presence of risk factors for skin cancer. (C recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of counseling adults about skin self-examination to prevent skin cancer. (I statement).

Collaborative Modeling: Experience of the U.S. Preventive Services Task Force.

PubMed

Petitti, Diana B; Lin, Jennifer S; Owens, Douglas K; Croswell, Jennifer M; Feuer, Eric J

2018-01-01

Models can be valuable tools to address uncertainty, trade-offs, and preferences when trying to understand the effects of interventions. Availability of results from two or more independently developed models that examine the same question (comparative modeling) allows systematic exploration of differences between models and the effect of these differences on model findings. Guideline groups sometimes commission comparative modeling to support their recommendation process. In this commissioned collaborative modeling, modelers work with the people who are developing a recommendation or policy not only to define the questions to be addressed but ideally, work side-by-side with each other and with systematic reviewers to standardize selected inputs and incorporate selected common assumptions. This paper describes the use of commissioned collaborative modeling by the U.S. Preventive Services Task Force (USPSTF), highlighting the general challenges and opportunities encountered and specific challenges for some topics. It delineates other approaches to use modeling to support evidence-based recommendations and the many strengths of collaborative modeling compared with other approaches. Unlike systematic reviews prepared for the USPSTF, the commissioned collaborative modeling reports used by the USPSTF in making recommendations about screening have not been required to follow a common format, sometimes making it challenging to understand key model features. This paper presents a checklist developed to critically appraise commissioned collaborative modeling reports about cancer screening topics prepared for the USPSTF. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

78 FR 23261 - Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-18

... during conference calls and via email discussions. Member duties include prioritizing topics, designing... their expertise in methodological issues such as meta-analysis, analytic modeling or clinical...

77 FR 18823 - Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... without primary health care clinical experience may be selected based on their expertise in methodological... calls and via email discussions. Member duties include prioritizing topics, designing research plans...

Comparison of Recommended Eligibility for Primary Prevention Statin Therapy Based on the US Preventive Services Task Force Recommendations vs the ACC/AHA Guidelines.

PubMed

Pagidipati, Neha J; Navar, Ann Marie; Mulder, Hillary; Sniderman, Allan D; Peterson, Eric D; Pencina, Michael J

2017-04-18

There are important differences among guideline recommendations for using statin therapy in primary prevention. New recommendations from the US Preventive Services Task Force (USPSTF) emphasize therapy based on the presence of 1 or more cardiovascular disease (CVD) risk factors and a 10-year global CVD risk of 10% or greater. To determine the difference in eligibility for primary prevention statin treatment among US adults, assuming full application of USPSTF recommendations compared with the American College of Cardiology/American Heart Association (ACC/AHA) guidelines. National Health and Nutrition Examination Survey (NHANES) data (2009-2014) were used to assess statin eligibility under the 2016 USPSTF recommendations vs the 2013 ACC/AHA cholesterol guidelines among a nationally representative sample of 3416 US adults aged 40 to 75 years with fasting lipid data and triglyceride levels of 400 mg/dL or less, without prior CVD. The 2016 USPSTF recommendations vs 2013 ACC/AHA guidelines. Eligibility for primary prevention statin therapy. Among the US primary prevention population represented by 3416 individuals in NHANES, the median weighted age was 53 years (interquartile range, 46-61), and 53% (95% CI, 52%-55%) were women. Along with the 21.5% (95% CI, 19.3%-23.7%) of patients who reported currently taking lipid-lowering medication, full implementation of the USPSTF recommendations would be associated with initiation of statin therapy in an additional 15.8% (95% CI, 14.0%-17.5%) of patients, compared with an additional 24.3% (95% CI, 22.3%-26.3%) of patients who would be recommended for statin initiation under full implementation of the 2013 ACC/AHA guidelines. Among the 8.9% of individuals in the primary prevention population who would be recommended for statins by ACC/AHA guidelines but not by USPSTF recommendations, 55% would be adults aged 40 to 59 years with a mean 30-year cardiovascular risk greater than 30%, and 28% would have diabetes. In this sample of US adults from 2009-2014, adherence to the 2016 USPSTF recommendations for statin therapy, compared with the 2013 ACC/AHA guidelines, could lead to a lower number of individuals recommended for primary prevention statin therapy, including many younger adults with high mean long-term CVD risk.

Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement.

PubMed

Siu, Albert L

2016-02-16

Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for breast cancer. The USPSTF reviewed the evidence on the following: effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced breast cancer and treatment-related morbidity; harms of breast cancer screening; test performance characteristics of digital breast tomosynthesis as a primary screening strategy; and adjunctive screening in women with increased breast density. In addition, the USPSTF reviewed comparative decision models on optimal starting and stopping ages and intervals for screening mammography; how breast density, breast cancer risk, and comorbidity level affect the balance of benefit and harms of screening mammography; and the number of radiation-induced breast cancer cases and deaths associated with different screening mammography strategies over the course of a woman's lifetime. This recommendation applies to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. (B recommendation) The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. (C recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging (MRI), DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).

Vision Screening in Children Aged 6 Months to 5 Years: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2017-09-05

One of the most important causes of vision abnormalities in children is amblyopia (also known as "lazy eye"). Amblyopia is an alteration in the visual neural pathway in a child's developing brain that can lead to permanent vision loss in the affected eye. Among children younger than 6 years, 1% to 6% have amblyopia or its risk factors (strabismus, anisometropia, or both). Early identification of vision abnormalities could prevent the development of amblyopia. Studies show that screening rates among children vary by race/ethnicity and family income. Data based on parent reports from 2009-2010 indicated identical screening rates among black non-Hispanic children and white non-Hispanic children (80.7%); however, Hispanic children were less likely than non-Hispanic children to report vision screening (69.8%). Children whose families earned 200% or more above the federal poverty level were more likely to report vision screening than families with lower incomes. To update the 2011 US Preventive Services Task Force (USPSTF) recommendation on screening for amblyopia and its risk factors in children. The USPSTF reviewed the evidence on the accuracy of vision screening tests and the benefits and harms of vision screening and treatment. Surgical interventions were considered to be out of scope for this review. Treatment of amblyopia is associated with moderate improvements in visual acuity in children aged 3 to 5 years, which are likely to result in permanent improvements in vision throughout life. The USPSTF concluded that the benefits are moderate because untreated amblyopia results in permanent, uncorrectable vision loss, and the benefits of screening and treatment potentially can be experienced over a child's lifetime. The USPSTF found adequate evidence to bound the potential harms of treatment (ie, higher false-positive rates in low-prevalence populations) as small. Therefore, the USPSTF concluded with moderate certainty that the overall net benefit is moderate for children aged 3 to 5 years. The USPSTF recommends vision screening at least once in all children aged 3 to 5 years to detect amblyopia or its risk factors. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of vision screening in children younger than 3 years. (I statement).

Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2017-12-12

Menopause occurs at a median age of 51.3 years, and the average US woman who reaches menopause is expected to live another 30 years. The prevalence and incidence of most chronic conditions, such as coronary heart disease, dementia, stroke, fractures, and breast cancer, increase with age; however, the excess risk for these conditions that can be attributed to menopause alone is uncertain. Since the publication of findings from the Women's Health Initiative that hormone therapy use is associated with serious adverse health effects in postmenopausal women, use of menopausal hormone therapy has declined. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the use of menopausal hormone therapy for the primary prevention of chronic conditions. The USPSTF reviewed the evidence on the benefits and harms of systemic (ie, oral or transdermal) hormone therapy for the prevention of chronic conditions in postmenopausal women and whether outcomes vary among women in different subgroups or by timing of intervention after menopause. The review did not address hormone therapy for preventing or treating menopausal symptoms. Although the use of hormone therapy to prevent chronic conditions in postmenopausal women is associated with some benefits, there are also well-documented harms. The USPSTF determined that the magnitude of both the benefits and the harms of hormone therapy in postmenopausal women is small to moderate. Therefore, the USPSTF concluded with moderate certainty that combined estrogen and progestin has no net benefit for the primary prevention of chronic conditions for most postmenopausal women with an intact uterus and that estrogen alone has no net benefit for the primary prevention of chronic conditions for most postmenopausal women who have had a hysterectomy. The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal women. (D recommendation) The USPSTF recommends against the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal women who have had a hysterectomy. (D recommendation).

Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2018-04-17

Because of the aging population, osteoporotic fractures are an increasingly important cause of morbidity and mortality in the United States. Approximately 2 million osteoporotic fractures occurred in the United States in 2005, and annual incidence is projected to increase to more than 3 million fractures by 2025. Within 1 year of experiencing a hip fracture, many patients are unable to walk independently, more than half require assistance with activities of daily living, and 20% to 30% of patients will die. To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on vitamin D supplementation, with or without calcium, to prevent fractures. The USPSTF reviewed the evidence on vitamin D, calcium, and combined supplementation for the primary prevention of fractures in community-dwelling adults (defined as not living in a nursing home or other institutional care setting). The review excluded studies conducted in populations with a known disorder related to bone metabolism (eg, osteoporosis or vitamin D deficiency), taking medications known to be associated with osteoporosis (eg, long-term steroids), or with a previous fracture. The USPSTF found inadequate evidence to estimate the benefits of vitamin D, calcium, or combined supplementation to prevent fractures in community-dwelling men and premenopausal women. The USPSTF found adequate evidence that daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of calcium has no benefit for the primary prevention of fractures in community-dwelling, postmenopausal women. The USPSTF found inadequate evidence to estimate the benefits of doses greater than 400 IU of vitamin D or greater than 1000 mg of calcium to prevent fractures in community-dwelling postmenopausal women. The USPSTF found adequate evidence that supplementation with vitamin D and calcium increases the incidence of kidney stones. The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of vitamin D and calcium supplementation, alone or combined, for the primary prevention of fractures in community-dwelling, asymptomatic men and premenopausal women. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of daily supplementation with doses greater than 400 IU of vitamin D and greater than 1000 mg of calcium for the primary prevention of fractures in community-dwelling, postmenopausal women. (I statement) The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of calcium for the primary prevention of fractures in community-dwelling, postmenopausal women. (D recommendation) These recommendations do not apply to persons with a history of osteoporotic fractures, increased risk for falls, or a diagnosis of osteoporosis or vitamin D deficiency.

Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.

PubMed

Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Gillman, Matthew W; Harper, Diane M; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Owens, Douglas K; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Siu, Albert L

2016-06-21

Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years. To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer. The USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality; the harms of these screening tests; and the test performance characteristics of these tests for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer. The USPSTF also commissioned a comparative modeling study to provide information on optimal starting and stopping ages and screening intervals across the different available screening methods. The USPSTF concludes with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit. Multiple screening strategies are available to choose from, with different levels of evidence to support their effectiveness, as well as unique advantages and limitations, although there are no empirical data to demonstrate that any of the reviewed strategies provide a greater net benefit. Screening for colorectal cancer is a substantially underused preventive health strategy in the United States. The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation). The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient's overall health and prior screening history (C recommendation).

Impact of United States Preventive Services Task Force Recommendations on Utilization of Prostate-specific Antigen Screening in Medicare Beneficiaries.

PubMed

Khairnar, Rahul; Mishra, Mark V; Onukwugha, Eberechukwu

2018-02-16

Previous studies assessing the impact of United States Preventive Services Task Force (USPSTF) recommendations on utilization of prostate-specific antigen (PSA) screening have not investigated longer-term impacts of 2008 recommendations nor have they investigated the impact of 2012 recommendations in the Medicare population. This study aimed to evaluate change in utilization of PSA screening, post-2008 and 2012 USPSTF recommendations, and assessed trends and determinants of receipt of PSA screening in the Medicare population. This retrospective study of male Medicare beneficiaries utilized Medicare Current Beneficiary Survey data and linked administrative claims from 2006 to 2013. Beneficiaries aged ≥65 years, with continuous enrollment in parts A and B for each year they were surveyed were included in the study. Beneficiaries with self-reported/claims-based diagnosis of prostate cancer were excluded. The primary outcome was receipt of PSA screening. Other measures included age groups (65 to 74 and ≥75), time periods (pre-2008/post-2008 and 2012 recommendations), and sociodemographic variables. The study cohort consisted of 11,028 beneficiaries, who were predominantly white (87.56%), married (69.25%), and unemployed (84.4%); 52.21% beneficiaries were aged ≥75. Declining utilization trends for PSA screening were observed in men aged ≥75 after 2008 recommendations and in both age groups after 2012 recommendations. The odds of receiving PSA screening declined by 17% in men aged ≥75 after 2008 recommendations and by 29% in men aged ≥65 after 2012 recommendations. The 2008 and 2012 USPSTF recommendations against PSA screening were associated with declines in utilization of PSA screening during the study period. USPSTF recommendations play a significant role in affecting utilization patterns of health services.

Risk-based lung cancer screening may prevent more deaths than current U.S. guidelines

Cancer.gov

A study from the National Cancer Institute (NCI) offers new evidence that individualized lung cancer risk-based screening may be more effective at preventing lung cancer deaths than current U.S. Preventive Services Task Force (USPSTF) screening criteria.

CE: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States.

PubMed

Parmer, John; Allen, Leeanna; Walton, Wanda

2017-08-01

: Nurses play a critical role in the diagnosis and treatment of tuberculosis and in the prevention of tuberculosis transmission through infection control practices. To eliminate tuberculosis in the United States, however, an expanded approach to testing and treating people with latent tuberculosis infection must be implemented. Recently, the U.S. Preventive Services Task Force (USPSTF) issued a new recommendation statement on latent tuberculosis infection testing that expands nurses' opportunities to identify at-risk populations for tuberculosis prevention. In combination with newer testing methodologies and shorter treatment regimens, implementation of the USPSTF recommendation has the potential to remove previously existing barriers to screening and treatment of both patients and health care providers. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents preventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF recommendation's applicability to public health and primary care practice in the United States.

Decrease in Prostate Cancer Testing Following the US Preventive Services Task Force (USPSTF) Recommendations.

PubMed

Li, Jun; Berkowitz, Zahava; Hall, Ingrid J

2015-01-01

To assess changes of prostate-specific antigen (PSA) testing following recent US Preventive Services Task Force (USPSTF) prostate cancer screening recommendations using 2005 to 2013 National Health Interview Survey data. We calculated the percentage of PSA testing among men ≥40 years by age group and age-adjusted race for each survey year. Differences between years were assessed with linear contrasts after combining all years' data. The overall percentage of PSA testing was highest in 2008 and decreased significantly in 2013. Compared with 2008, each age group had significantly lower screening percentages in 2013, especially men ≥75 years old (-14.0% points; P < .001). Both men aged 50 to 74 and men aged ≥75 had significantly lower percentages in 2013 than in 2010. For white and black men, the PSA testing percentages were highest in 2008 and decreased significantly in 2013. Only white men had a significantly lower percentage in 2013 than in 2010. Significant declines in PSA testing from 2008 to 2013 in men ≥75 years old may reflect the impact of the 2008 USPSTF recommendations. While the cause of the decreases in PSA testing between 2010 and 2013 among men aged 50 to 74 years old and white men is unknown, the decreases may suggest the early effects of the 2012 recommendations. © Copyright 2015 by the American Board of Family Medicine.

Impact of the United States Preventive Services Task Force 'D' recommendation on prostate cancer screening and staging.

PubMed

Eapen, Renu S; Herlemann, Annika; Washington, Samuel L; Cooperberg, Matthew R

2017-05-01

In 2012, the United States Preventive Services Task Force (USPSTF) issued a grade 'D' recommendation against the use of routine prostate-specific antigen (PSA)-based screening for any men. This recommendation reflects critical misinterpretations of the available evidence base regarding benefits and harms of PSA screening and has influenced the nationwide landscape of prostate cancer screening, diagnosis, and treatment. Following the USPSTF recommendation, a substantial decline in PSA screening was noted for all age groups. Similarly, overall rates of prostate biopsy and prostate cancer incidence have significantly decreased with a shift toward higher grade and stage disease upon diagnosis. Concurrently, the incidence of metastatic prostate cancer has significantly risen in the United States. These trends are concerning particularly for the younger men with occult high-grade disease who are expected to benefit the most from early detection and definitive prostate cancer treatment. These emerging trends in PSA screening and prostate cancer incidence following the USPSTF recommendation may have significant public health implications. Due to the long natural history of the disease, a long-term follow-up is needed to provide a better understanding on the implications of such recommendations on disease progression and mortality rates in prostate cancer patients. The future of US screening policy should reflect a targeted 'smarter' screening strategy rather than dichotomizing the decision between 'screen all' or 'screen none'.

A randomized controlled trial of a commercially available weight loss program

USDA-ARS?s Scientific Manuscript database

The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians refer obese adults for intensive, multi-component behavioral counseling, yet most obese Americans choose a self-help approach to lose weight. The current study examined weight loss between a community-based, intensive behavi...

75 FR 69094 - Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... final recommendation documents, and participating in workgroups on specific topics or methods. A... literature and in the methods of evidence review; 2. Understanding and experience in the application of... based on their expertise in methodological issues such as medical decisionmaking, clinical epidemiology...

Preventive health services implemented by family physicians in Portugal—a cross-sectional study based on two clinical scenarios

PubMed Central

Martins, Carlos; Azevedo, Luís Filipe; Santos, Cristina; Sá, Luísa; Santos, Paulo; Couto, Maria; Pereira, Altamiro; Hespanhol, Alberto

2014-01-01

Objectives To assess whether Portuguese family physicians perform preventive health services in accordance with scientific evidence, based on the recommendations of the United States Preventive Services Task Force (USPSTF). Design Cross-sectional study. Setting Primary healthcare, Portuguese National Health Service. Participants 255 Portuguese family physicians selected by a stratified cluster sampling design were invited to participate in a computer-assisted telephone survey. Outcomes Prevalence of compliance with USPSTF recommendations for screening, given a male and female clinical scenario and a set of proposed medical interventions, including frequency of the intervention and performance in their own daily practice. Results A response rate of 95.7% was obtained (n=244). 98–100% of family physicians answered according to the USPSTF recommendations in most interventions. In the male scenario, the lowest concordance was observed in the evaluation of prostate-specific antigen with 37% of family physicians answering according to the USPSTF recommendations. In the female scenario, the lowest concordance was for cholesterol testing with 2% of family physicians complying. Family physicians younger than 50 years had significantly better compliance scores than older ones (mean 77% vs 72%; p<0.001). Conclusions We found a high degree of agreement with USPSTF recommendations among Portuguese family physicians. However, we also found results suggesting excessive use of some medical interventions, raising concerns related to possible harm associated with overdiagnosis and overtreatment. PMID:24861550

Prevalence and healthcare actions of women in a large health system with a family history meeting the 2005 USPSTF recommendation for BRCA genetic counseling referral.

PubMed

Bellcross, Cecelia A; Leadbetter, Steven; Alford, Sharon Hensley; Peipins, Lucy A

2013-04-01

In 2005, the United States Preventive Services Task Force (USPSTF) released guidelines which outlined specific family history patterns associated with an increased risk for BRCA1/2 mutations, and recommended at-risk individuals be referred for genetic counseling and evaluation for BRCA testing. The purpose of this study was to assess the prevalence of individuals with a USPSTF increased-risk family history pattern, the frequency with which specific patterns were met, and resulting healthcare actions among women from the Henry Ford Health System. As part of a study evaluating ovarian cancer risk perception and screening, 2,524 randomly selected participants completed a detailed interview (response rate 76%) from an initial eligible cohort of 16,720 women. Approximately 6% of participants had a family history fulfilling one or more of the USPSTF patterns. Although 90% of these women had shared their family history with their provider, less than 20% had been referred for genetic counseling and only 8% had undergone genetic testing. Caucasian women with higher income and education levels were more likely to receive referrals. Among the 95 participants in the total study cohort who reported BRCA testing, 78% did not have a family history that met one of the USPSTF patterns. These results suggest a higher prevalence of women with an increased-risk family history than originally predicted by the USPSTF, and lack of provider recognition and referral for genetic services. Improvements in healthcare infrastructure and clinician education will be required to realize population level benefits from BRCA genetic counseling and testing.

State-by-state Variation in Prostate-specific Antigen Screening Trends Following the 2011 United States Preventive Services Task Force Panel Update.

PubMed

Vetterlein, Malte W; Dalela, Deepansh; Sammon, Jesse D; Karabon, Patrick; Sood, Akshay; Jindal, Tarun; Meyer, Christian P; Löppenberg, Björn; Sun, Maxine; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas

2018-02-01

To evaluate state-by-state trends in prostate-specific antigen (PSA) screening prevalence after the 2011 United States Preventive Services Task Force (USPSTF) recommendation against this practice. We included 222,475 men who responded to the Behavioral Risk Factor Surveillance System 2012 and 2014 surveys, corresponding to early and late post-USPSTF populations. Logistic regression was used to identify predictors of PSA screening and to calculate the adjusted and weighted state-by-state PSA screening prevalence and respective relative percent changes between 2012 and 2014. To account for unmeasured factors, the correlation between changes in PSA screening over time and changes in screening for colorectal and breast cancer were assessed. All analyses were conducted in 2016. Overall, 38.9% (95% confidence interval [CI] = 38.6%-39.2%) reported receiving PSA screening in 2012 vs 35.8% (95% CI = 35.1%-36.2%) in 2014. State of residence, age, race, education, income, insurance, access to care, marital status, and smoking status were independent predictors of PSA screening in both years (all P <.001). In adjusted analyses, the nationwide PSA screening prevalence decreased by a relative 8.5% (95% CI = 6.4%-10.5%; P <.001) between 2012 and 2014. There was a vast state-by-state heterogeneity, ranging from a relative 26.6% decrease in Vermont to 10.2% increase in Hawaii. Overall, 81.5% and 84.0% of the observed changes were not accompanied by matching changes in respective colorectal and breast cancer screening utilization, for which there were no updates in USPSTF recommendations. There is a significant state-by-state variation in PSA screening trends following the 2011 USPSTF recommendation. Further research is needed to elucidate the reasons for this heterogeneity in screening behavior among the states. Copyright © 2017 Elsevier Inc. All rights reserved.

The Effect of Primary Care Physician Knowledge of Lung Cancer Screening Guidelines on Perceptions and Utilization of Low-Dose Computed Tomography.

PubMed

Raz, Dan J; Wu, Geena X; Consunji, Martin; Nelson, Rebecca A; Kim, Heeyoung; Sun, Can-Lan; Sun, Virginia; Kim, Jae Y

2018-01-01

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is recommended by the U.S. Preventive Services Task Force (USPSTF) in high-risk patients, but a minority of eligible people are screened. It is not clear whether knowledge of USPSTF recommendations among primary care physicians (PCP) affects utilization of LDCT. A randomly selected sample of 1384 PCPs in Los Angeles County was surveyed between January and October 2015, using surveys sent by mail, fax, and e-mail. The response rate was 18% (n = 250). Training background, years in practice, practice type, and respondent demographics were collected. We analyzed results based on the response to a question on whether the USPSTF recommends the use of LDCT to screen high-risk individuals for lung cancer. A total of 117 (47%) PCPs responded that the USPSTF recommends LDCT for LCS. Of PCPs who were aware of USPSTF recommendations, 97% responded that CT was effective at reducing lung cancer mortality among individuals meeting eligibility criteria, compared with 90% who were unaware of guidelines (P = .02). A larger proportion of PCPs aware of guidelines ordered LDCT (71% vs. 38%, P < .001) and initiated a discussion on screening (86% vs. 62%, P < .001). Both groups of PCPs reported similar perceptions of barriers to screening, such as insurance coverage, risks of LCS, and cost to society. Practice size, training background, and years in practice did not affect knowledge of guidelines. Awareness of USPSTF recommendations for LDCT is associated with increased utilization of LDCT for screening. Educational interventions for PCPs may improve adherence with LCS recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

Change in Breast Cancer Screening Intervals Since the 2009 USPSTF Guideline.

PubMed

Wernli, Karen J; Arao, Robert F; Hubbard, Rebecca A; Sprague, Brian L; Alford-Teaster, Jennifer; Haas, Jennifer S; Henderson, Louise; Hill, Deidre; Lee, Christoph I; Tosteson, Anna N A; Onega, Tracy

2017-08-01

In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended biennial mammography for women aged 50-74 years and shared decision-making for women aged 40-49 years for breast cancer screening. We evaluated changes in mammography screening interval after the 2009 recommendations. We conducted a prospective cohort study of women aged 40-74 years who received 821,052 screening mammograms between 2006 and 2012 using data from the Breast Cancer Surveillance Consortium. We compared changes in screening intervals and stratified intervals based on whether the mammogram at the end of the interval occurred before or after the 2009 recommendation. Differences in mean interval length by woman-level characteristics were compared using linear regression. The mean interval (in months) minimally decreased after the 2009 USPSTF recommendations. Among women aged 40-49 years, the mean interval decreased from 17.2 months to 17.1 months (difference -0.16%, 95% confidence interval [CI] -0.30 to -0.01). Similar small reductions were seen for most age groups. The largest change in interval length in the post-USPSTF period was declines among women with a first-degree family history of breast cancer (difference -0.68%, 95% CI -0.82 to -0.54) or a 5-year breast cancer risk ≥2.5% (difference -0.58%, 95% CI -0.73 to -0.44). The 2009 USPSTF recommendation did not lengthen the average mammography interval among women routinely participating in mammography screening. Future studies should evaluate whether breast cancer screening intervals lengthen toward biennial intervals following new national 2016 breast cancer screening recommendations, particularly among women less than 50 years of age.

Primary care physicians' utilization of type 2 diabetes screening guidelines and referrals to behavioral interventions: a survey-linked retrospective study.

PubMed

Mehta, Sandhya; Mocarski, Michelle; Wisniewski, Tami; Gillespie, Karin; Narayan, K M Venkat; Lang, Kathleen

2017-01-01

To assess primary care physicians' (PCPs) knowledge of type 2 diabetes screening guidelines (American Diabetes Association (ADA) and 2008 US Preventive Services Task Force (USPSTF)), the alignment between their self-reported adherence and actual practice, and how often PCPs recommended diabetes prevention and self-management education programs (DPP/DSME). An online survey of PCPs to understand knowledge and adherence toward use of USPSTF/ADA guidelines and recommendation of DPP/DSME. Patient data from electronic medical records (EMRs) for each PCP were used to identify rates of screening in eligible patients as per guidelines and the two sources were compared to assess concordance. Of 305 surveyed physicians, 38% reported use of both guidelines (33% use ADA only, 25% USPSTF only). Approximately one-third of physicians who reported use of USPSTF/ADA guidelines had non-concordant EMR data. Similarly, while most PCPs reported they are 'very likely' to screen patients with risk factors listed in guidelines, for each criterion at least one-fourth (24%) of PCPs survey responses were non-concordant with EMRs. PCPs reported they provide referral to DPP and DSME on average to 45% and 67% of their newly diagnosed patients with pre-diabetes and diabetes, respectively. Findings show disconnect between PCPs' perceptions of adherence to screening guidelines and actual practice, and highlight limited referrals to DPP/DSME programs. More research is needed to understand barriers to guideline consistent screening and uptake of DPP/DSME, particularly in light of recent policy changes such as the linking USPSTF criteria to reimbursement and expected Medicare DPP reimbursement in 2018.

The Effect of the 2009 USPSTF breast cancer screening recommendations on breast cancer in Michigan: A longitudinal study.

PubMed

Caughran, Jamie; Braun, Tom M; Breslin, Tara M; Smith, Daniel R; Kreinbrink, Jennifer L; Parish, Grace K; Davis, Alan T; Bacon-Baguley, Teresa A; Silver, Samuel M; Henry, Norah L

2018-05-21

In 2009, the revised United States Preventive Services Task Force (USPSTF) guidelines recommended against routine screening mammography for women age 40-49 years and against teaching self-breast examinations (SBE). The aim of this study was to analyze whether breast cancer method of presentation changed following the 2009 USPSTF screening recommendations in a large Michigan cohort. Data were collected on women with newly diagnosed stage 0-III breast cancer participating in the Michigan Breast Oncology Quality Initiative (MiBOQI) registry at 25 statewide institutions from 2006 to 2015. Data included method of detection, cancer stage, treatment type, and patient demographics. In all, 30 008 women with breast cancer detected via mammogram or palpation with an average age of 60.1 years were included. 38% of invasive cancers were identified by palpation. Presentation with palpable findings decreased slightly over time, from 34.6% in 2006 to 28.9% in 2015 (P < .001). Over the 9-year period, there was no statistically significant change in rate of palpation-detected tumors for women age <50 years or ≥50 years (P = .27, .30, respectively). Younger women were more likely to present with palpable tumors compared to older women in a statewide registry. This rate did not increase following publication of the 2009 USPSTF breast cancer screening recommendations. © 2018 Wiley Periodicals, Inc.

Screening for Cardiovascular Disease Risk With Electrocardiography: US Preventive Services Task Force Recommendation Statement.

PubMed

Curry, Susan J; Krist, Alex H; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Kubik, Martha; Landefeld, C Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen; Wong, John B

2018-06-12

Cardiovascular disease (CVD), which encompasses atherosclerotic conditions such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease, is the most common cause of death among adults in the United States. Treatment to prevent CVD events by modifying risk factors is currently informed by CVD risk assessment with tools such as the Framingham Risk Score or the Pooled Cohort Equations, which stratify individual risk to inform treatment decisions. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on screening for coronary heart disease with electrocardiography (ECG). The USPSTF reviewed the evidence on whether screening with resting or exercise ECG improves health outcomes compared with the use of traditional CVD risk assessment alone in asymptomatic adults. For asymptomatic adults at low risk of CVD events (individuals with a 10-year CVD event risk less than 10%), it is very unlikely that the information from resting or exercise ECG (beyond that obtained with conventional CVD risk factors) will result in a change in the patient's risk category as assessed by the Framingham Risk Score or Pooled Cohort Equations that would lead to a change in treatment and ultimately improve health outcomes. Possible harms are associated with screening with resting or exercise ECG, specifically the potential adverse effects of subsequent invasive testing. For asymptomatic adults at intermediate or high risk of CVD events, there is insufficient evidence to determine the extent to which information from resting or exercise ECG adds to current CVD risk assessment models and whether information from the ECG results in a change in risk management and ultimately reduces CVD events. As with low-risk adults, possible harms are associated with screening with resting or exercise ECG in asymptomatic adults at intermediate or high risk of CVD events. The USPSTF recommends against screening with resting or exercise ECG to prevent CVD events in asymptomatic adults at low risk of CVD events. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG to prevent CVD events in asymptomatic adults at intermediate or high risk of CVD events. (I statement).

Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Bibbins-Domingo, Kirsten; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2017-06-20

Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes. Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom). To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older. The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF concluded with moderate certainty that screening for obesity in children and adolescents 6 years and older is of moderate net benefit. The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation).

Impact of statin guidelines on statin utilization and costs in an employer-based primary care clinic.

PubMed

Gurgle, Holly E; Schauerhamer, Marisa B; Rodriguez, Simón A; McAdam-Marx, Carrie

2017-12-01

The purpose of this study was to describe statin utilization and costs in an employer-based patient cohort by comparing actual practice and assumed adoption of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) or 2016 US Preventive Services Task Force (USPSTF) statin recommendations versus the guidelines described in 2001 (and supplemented in 2004) in the Third Report of the National Cholesterol Education Program's Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATPIII). Descriptive cohort analysis included patients treated in an employer-based primary care clinic between January 2012 and April 2014. ATPIII, ACC/AHA, and USPSTF recommendations were retrospectively applied at the patient level based on lipid levels and statin prescribing data collected from a health risk assessment and electronic health record. Actual statin prescribing was compared with prescribing predicted by guideline recommendations. Costs for each strategy were estimated using employer pharmacy claims data. The study included 555 patients, of whom 112 (20.2%) were treated with a statin at baseline. ATPIII and ACC/AHA recommended statin use in 284 (51.2%) and 279 (50.3%) patients, respectively. Within the subgroup of 479 primary prevention patients, ACC/AHA recommended statin use in 203 (42.4%) versus USPSTF, which recommended statin use in 91 (19.0%). The 90-day cost per patient was similar to baseline with implementation of ATPIII or ACC/AHA recommendations, excluding use of brand name-only high-intensity statins, and costs could be reduced slightly with implementation of USPSTF guidelines. Despite differences in ATPIII, ACC/AHA, and USPSTF guidelines, application of any of these statin recommendations would result in optimized statin utilization and fairly neutral effects on cost in this real-world employer-based population.

Assessing Screening Policies for Childhood Obesity

PubMed Central

Wein, Lawrence M.; Yang, Yan; Goldhaber-Fiebert, Jeremy D.

2014-01-01

To address growing concerns over childhood obesity, the United States Preventive Services Task Force (USPSTF) recently recommended that children undergo obesity screening beginning at age 6 [1]. An Expert Committee recommends starting at age 2 [2]. Analysis is needed to assess these recommendations and investigate whether there are better alternatives. We model the age- and sex-specific population-wide distribution of body mass index (BMI) through age 18 using National Longitudinal Survey of Youth data [3]. The impact of treatment on BMI is estimated using the targeted systematic review performed to aid the USPSTF [4]. The prevalence of hypertension and diabetes at age 40 are estimated from the Panel Study of Income Dynamics [5]. We fix the screening interval at 2 years, and derive the age- and sex-dependent BMI thresholds that minimize adult disease prevalence, subject to referring a specified percentage of children for treatment yearly. We compare this optimal biennial policy to biennial versions of the USPSTF and Expert Committee recommendations. Compared to the USPSTF recommendation, the optimal policy reduces adult disease prevalence by 3% in relative terms (the absolute reductions are < 1%) at the same treatment referral rate, or achieves the same disease prevalence at a 28% reduction in treatment referral rate. If compared to the Expert Committee recommendation, the reductions change to 6% and 40%, respectively. The optimal policy treats mostly 16 year olds and few children under age 14. Our results suggest that adult disease is minimized by focusing childhood obesity screening and treatment on older adolescents. PMID:22240724

Enhancing the Evidence for Behavioral Counseling

PubMed Central

Alcántara, Carmela; Klesges, Lisa M.; Resnicow, Ken; Stone, Amy; Davidson, Karina W.

2015-01-01

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care–focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)—a multidisciplinary scientific organization committed to improving population health through behavior change—we review the USPSTF mandate and current recommendations for behavioral counseling interventions, and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care–focused behavioral counseling interventions. This perspective highlights five areas for further development, including: (1) behavioral counseling–focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care–based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice. PMID:26296553

Screening and Prevention Measures for Melanoma: Is There a Survival Advantage?

PubMed Central

Chen, Suephy C.; Swetter, Susan M.

2012-01-01

Controversy has emerged over the past decades regarding the value and impact of melanoma screening to detect early stage disease for improved prognosis. Those questioning the benefits of prevention efforts base their arguments on the absence of prospective, randomized studies demonstrating decreased melanoma mortality to justify the cost associated with screening and educational campaigns. For those in favor of melanoma screening, the lack of proven survival benefit is not a justification to abandon this approach, but rather a reflection of the lack of resources necessary to conduct a long-term trial. In 2009, the US Preventive Services Task Force (USPSTF)report did not recommend routine primary care screening for the general population given the absence of evidence. However, since the USPSTF report, a series of new studies are available, which support the potential benefit of screening and have the potential to significantly impact current policies regarding skin cancer screening, particularly for melanoma. PMID:22907282

Registry-based Study of Trends in Breast Cancer Screening Mammography before and after the 2009 U.S. Preventive Services Task Force Recommendations

PubMed Central

Bolton, Kenyon C.; Mace, John L.; Herschorn, Sally D.; James, Ted A.; Vacek, Pamela M.; Weaver, Donald L.; Geller, Berta M.

2014-01-01

Purpose To determine whether the 2009 U.S. Preventive Services Task Force (USPSTF) guidelines for breast cancer mammography screening were followed by changes in screening utilization in the state of Vermont. Materials and Methods This retrospective study was HIPAA compliant and approved by the institutional review board, with waiver of informed consent. Trends in screening mammography utilization during 1997–2011 were examined among approximately 150 000 women aged 40 years and older in the state of Vermont using statewide mammography registry data. Results The percentage of Vermont women aged 40 years and older screened in the past year declined from 45.3% in 2009% to 41.6% in 2011 (an absolute decrease of −3.7 percentage points; 95% confidence interval [CI]: −3.3, −4.1). The largest decline in utilization was among women aged 40–49 years (−4.8 percentage points; 95% CI: −4.1, −5.4), although substantial declines were also observed among women aged 50–74 years (−3.0 percentage points; 95% CI: −2.6, −3.5) and women aged 75 years and older (−3.1 percentage points; 95% CI: −2.3, −4.0). The percentage of women aged 50–74 years screened within the past 2 years declined by −3.4 percentage points (95% CI: −3.0, −3.9) from 65.4% in 2009 to 61.9% in 2011. Conclusion After years of increasing screening mammography utilization in Vermont, there was a decline in screening, which coincided with the release of the 2009 USPSTF recommendations. The age-specific patterns in utilization were generally consistent with the USPSTF recommendations, although there was also evidence that the percentage of women aged 50–74 years screened in the past 2 years declined since 2009. © RSNA, 2013 PMID:24072778

Enhancing the Evidence for Behavioral Counseling: A Perspective From the Society of Behavioral Medicine.

PubMed

Alcántara, Carmela; Klesges, Lisa M; Resnicow, Ken; Stone, Amy; Davidson, Karina W

2015-09-01

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care-focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)--a multidisciplinary scientific organization committed to improving population health through behavior change--we review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions. This perspective highlights five areas for further development, including (1) behavioral counseling-focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care-based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Evaluating the role of public health in implementation of genomics-related recommendations: a case study of hereditary cancers using the CDC Science Impact Framework.

PubMed

Green, Ridgely Fisk; Ari, Mary; Kolor, Katherine; Dotson, W David; Bowen, Scott; Habarta, Nancy; Rodriguez, Juan L; Richardson, Lisa C; Khoury, Muin J

2018-06-15

Public health plays an important role in ensuring access to interventions that can prevent disease, including the implementation of evidence-based genomic recommendations. We used the Centers for Disease Control and Prevention (CDC) Science Impact Framework to trace the impact of public health activities and partnerships on the implementation of the 2009 Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Lynch Syndrome screening recommendation and the 2005 and 2013 United States Preventive Services Task Force (USPSTF) BRCA1 and BRCA2 testing recommendations.The EGAPP and USPSTF recommendations have each been cited by >300 peer-reviewed publications. CDC funds selected states to build capacity to integrate these recommendations into public health programs, through education, policy, surveillance, and partnerships. Most state cancer control plans include genomics-related goals, objectives, or strategies. Since the EGAPP recommendation, major public and private payers now provide coverage for Lynch Syndrome screening for all newly diagnosed colorectal cancers. National guidelines and initiatives, including Healthy People 2020, included similar recommendations and cited the EGAPP and USPSTF recommendations. However, disparities in implementation based on race, ethnicity, and rural residence remain challenges. Public health achievements in promoting the evidence-based use of genomics for the prevention of hereditary cancers can inform future applications of genomics in public health.

Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Bibbins-Domingo, Kirsten; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Ebell, Mark; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, C Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Siu, Albert L; Tseng, Chien-Wen

2018-05-08

In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of dying of prostate cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostate cancer have an increased risk of prostate cancer compared with other men. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on prostate-specific antigen (PSA)-based screening for prostate cancer. The USPSTF reviewed the evidence on the benefits and harms of PSA-based screening for prostate cancer and subsequent treatment of screen-detected prostate cancer. The USPSTF also commissioned a review of existing decision analysis models and the overdiagnosis rate of PSA-based screening. The reviews also examined the benefits and harms of PSA-based screening in patient subpopulations at higher risk of prostate cancer, including older men, African American men, and men with a family history of prostate cancer. Adequate evidence from randomized clinical trials shows that PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened. Screening programs may also prevent approximately 3 cases of metastatic prostate cancer per 1000 men screened. Potential harms of screening include frequent false-positive results and psychological harms. Harms of prostate cancer treatment include erectile dysfunction, urinary incontinence, and bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence, and 2 in 3 men will experience long-term erectile dysfunction. Adequate evidence shows that the harms of screening in men older than 70 years are at least moderate and greater than in younger men because of increased risk of false-positive results, diagnostic harms from biopsies, and harms from treatment. The USPSTF concludes with moderate certainty that the net benefit of PSA-based screening for prostate cancer in men aged 55 to 69 years is small for some men. How each man weighs specific benefits and harms will determine whether the overall net benefit is small. The USPSTF concludes with moderate certainty that the potential benefits of PSA-based screening for prostate cancer in men 70 years and older do not outweigh the expected harms. For men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one and should include discussion of the potential benefits and harms of screening with their clinician. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs. Clinicians should not screen men who do not express a preference for screening. (C recommendation) The USPSTF recommends against PSA-based screening for prostate cancer in men 70 years and older. (D recommendation).

The impact of overdiagnosis on the selection of efficient lung cancer screening strategies.

PubMed

Han, Summer S; Ten Haaf, Kevin; Hazelton, William D; Munshi, Vidit N; Jeon, Jihyoun; Erdogan, Saadet A; Johanson, Colden; McMahon, Pamela M; Meza, Rafael; Kong, Chung Yin; Feuer, Eric J; de Koning, Harry J; Plevritis, Sylvia K

2017-06-01

The U.S. Preventive Services Task Force (USPSTF) recently updated their national lung screening guidelines and recommended low-dose computed tomography (LDCT) for lung cancer (LC) screening through age 80. However, the risk of overdiagnosis among older populations is a concern. Using four comparative models from the Cancer Intervention and Surveillance Modeling Network, we evaluate the overdiagnosis of the screening program recommended by USPSTF in the U.S. 1950 birth cohort. We estimate the number of LC deaths averted by screening (D) per overdiagnosed case (O), yielding the ratio D/O, to quantify the trade-off between the harms and benefits of LDCT. We analyze 576 hypothetical screening strategies that vary by age, smoking, and screening frequency and evaluate efficient screening strategies that maximize the D/O ratio and other metrics including D and life-years gained (LYG) per overdiagnosed case. The estimated D/O ratio for the USPSTF screening program is 2.85 (model range: 1.5-4.5) in the 1950 birth cohort, implying LDCT can prevent ∼3 LC deaths per overdiagnosed case. This D/O ratio increases by 22% when the program stops screening at an earlier age 75 instead of 80. Efficiency frontier analysis shows that while the most efficient screening strategies that maximize the mortality reduction (D) irrespective of overdiagnosis screen through age 80, screening strategies that stop at age 75 versus 80 produce greater efficiency in increasing life-years gained per overdiagnosed case. Given the risk of overdiagnosis with LC screening, the stopping age of screening merits further consideration when balancing benefits and harms. © 2017 UICC.

Change in Mammography Use Following the Revised Guidelines from the U.S. Preventive Services Task Force.

PubMed

Lee, Jeannette Y; Malak, Sharp F; Klimberg, Vicki Suzanne; Henry-Tillman, Ronda; Kadlubar, Susan

2017-03-01

The U.S. Preventive Services Task Force (USPSTF) recommended screening mammography every 1-2 years for women 40 years and older in 2002, and changed its recommendations in 2009 to no routine screening for women between 40 and 49 years of age; and biennial screening for women between 50 and 74 years of age. This study evaluates the change in mammographic use after the issuance of the revised recommendations. Women who participated in a cross-sectional study of breast cancer risk factors from 2007 to 2013 were asked if they had received a mammogram in the preceding 2 years. All 3442 study participants who enrolled in the study after January 1, 2011 were matched by race, age, and educational level with women enrolled between 2007 and 2010. The proportions of women who stated they had received a mammogram in the past 2 years were compared between the two groups. One fourth of the participants were African American and 39% were 40-49 years of age. Among white women, significant decreases in recent mammogram use from 2007-2010 to 2011-2013 were detected for women 40-49 years of age (-10.3%, p < 0.001) and 50-74 years of age (-8.8%, p < 0.001). Among African-American women, the change in recent mammogram use was not statistically significant for women 40-49 years of age (-2.7%, p = 0.440) or 50-74 years of age (-2.2%, p = 0.398). Following the change in the USPSTF guidelines, mammography use among white women declined; however, no change was observed among African-American women. © 2016 Wiley Periodicals, Inc.

Testing and referral patterns in the years surrounding the US Preventive Services Task Force recommendation against prostate-specific antigen screening.

PubMed

Hutchinson, Ryan; Akhtar, Abdulhadi; Haridas, Justin; Bhat, Deepa; Roehrborn, Claus; Lotan, Yair

2016-12-15

Since the US Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA) screening, there have been conflicting reports regarding the impact on the behavior of providers. This study analyzed real-world data on PSA ordering and referral practices in the years surrounding the recommendation. A whole-institution sample of entered PSA orders and urology referrals was obtained from the electronic medical record. The study was performed at a tertiary referral center with a catchment in the southern United States. PSA examinations were defined as screening when they were ordered by providers with appointments in internal medicine, family medicine, or general internal medicine. Linear and quadratic regression analyses were performed, and joinpoint regression was used to assess for trend inflection points. Between January 2010 and July 2015, there were 275,784 unique ambulatory visits for men. There were 63,722 raw PSA orders, and 54,684 were evaluable. Primary care providers ordered 17,315 PSA tests and 858 urology referrals. The number of PSA tests per ambulatory visit, the number of referrals per ambulatory visit, the age at the time of the urology referral, and the proportion of PSA tests performed outside the recommended age range did not significantly change. The PSA value at the time of referral increased significantly (P = .022). Joinpoint analysis revealed no joinpoints in the analysis of total PSA orders, screening PSA tests, or examinations per 100 visits. In the years surrounding the USPSTF recommendation, PSA behavior did not change significantly. Patients were referred at progressively higher average PSA levels. The implications for prostate cancer outcomes from these trends warrant further research into provider variables associated with actual PSA utilization. Cancer 2016;122:3785-3793. © 2016 American Cancer Society. © 2016 American Cancer Society.

The Immediate Impact of the 2009 USPSTF Screening Guideline Change on Physician Recommendation of a Screening Mammogram: Findings from a National Ambulatory and Medical Care Survey-Based Study.

PubMed

Rajan, Suja S; Suryavanshi, Manasi S; Karanth, Siddharth; Lairson, David R

2017-04-01

Regular screening is considered the most effective method to reduce the mortality and morbidity associated with breast cancer. Nevertheless, contradictory evidence about screening mammograms has led to periodic changes and considerable variations among different screening guidelines. This study is the first to examine the immediate impact of the 2009 US Preventive Services Task Force (USPSTF) guideline modification on physician recommendation of mammograms. The study included visits by women aged 40 years and older without prior breast cancer from the National Ambulatory and Medical Care Survey 2008-2010. Bivariate and multiple logistic regressions were used to determine the factors associated with mammography recommendation. Approximately 29,395 visits were included and mammography was recommended during 1350 visits; 50-64-year-old women had 72% higher odds, and 65-74-year-old women had twice the odds of getting a mammogram recommendation compared with 40-49-year-old women in 2009. However, there was no difference in recommendation by age groups in 2008 and 2010. Obstetricians and gynecologists did not modify their recommendation behavior in 2009, unlike all other specialists who reduced their recommendation for 40-49-year-old women in 2009. Other characteristics associated with mammogram recommendations were certain patient comorbidities, physician specialty and primary care physician status, health maintenance organization status of the clinic, and certain visit characteristics. This study demonstrated a temporary effect of the USPSTF screening guideline change on mammogram recommendation. However, in light of conflicting recommendations by different guidelines, the physicians erred toward the more rigorous guidelines and did not permanently reduce their mammogram recommendation for women aged 40-49 years.

Receipt of Glucose Testing and Performance of Two US Diabetes Screening Guidelines, 2007–2012

PubMed Central

Bullard, Kai McKeever; Ali, Mohammed K.; Imperatore, Giuseppina; Geiss, Linda S.; Saydah, Sharon H.; Albu, Jeanine B.; Cowie, Catherine C.; Sohler, Nancy; Albright, Ann; Gregg, Edward W.

2015-01-01

Background Screening guidelines are used to help identify prediabetes and diabetes before implementing evidence-based prevention and treatment interventions. We examined screening practices benchmarking against two US guidelines, and the capacity of each guideline to identify dysglycemia. Methods Using 2007–2012 National Health and Nutrition Examination Surveys, we analyzed nationally-representative, cross-sectional data from 5,813 fasting non-pregnant adults aged ≥20 years without self-reported diabetes. We examined proportions of adults eligible for diagnostic glucose testing and those who self-reported receiving testing in the past three years, as recommended by the American Diabetes Association (ADA) and the US Preventive Services Task Force (USPSTF-2008) guidelines. For each screening guideline, we also assessed sensitivity, specificity, and positive (PPV) and negative predictive values in identifying dysglycemia (defined as fasting plasma glucose ≥100 mg/dl or hemoglobin A1c ≥5.7%). Results In 2007–2012, 73.0% and 23.7% of US adults without diagnosed diabetes met ADA and USPSTF-2008 criteria for screening, respectively; and 91.5% had at least one major risk factor for diabetes. Of those ADA- or USPSTF-eligible adults, about 51% reported being tested within the past three years. Eligible individuals not tested were more likely to be lower educated, poorer, uninsured, or have no usual place of care compared to tested eligible adults. Among adults with ≥1 major risk factor, 45.7% reported being tested, and dysglycemia yields (i.e., PPV) ranged from 45.8% (high-risk ethnicity) to 72.6% (self-reported prediabetes). ADA criteria and having any risk factor were more sensitive than the USPSTF-2008 guideline (88.8–97.7% vs. 31.0%) but less specific (13.5–39.7% vs. 82.1%) in recommending glucose testing, resulting in lower PPVs (47.7–54.4% vs. 58.4%). Conclusion Diverging recommendations and variable performance of different guidelines may be impeding national diabetes prevention and treatment efforts. Efforts to align screening recommendations may result in earlier identification of adults at high risk for prediabetes and diabetes. PMID:25928306

The effect of the USPSTF PSA screening recommendation on prostate cancer incidence patterns in the USA

PubMed Central

Fleshner, Katherine; Carlsson, Sigrid V.; Roobol, Monique J.

2017-01-01

Guidelines conflict regarding recommendations for prostate-specific antigen (PSA) screening for early detection of prostate cancer. The United States Preventive Services Task Force (USPSTF) assigned a grade of D (recommending against screening) for men 75 and older in 2008 and for men of all ages in 2012. We reviewed temporal trends in rates of screening before and after the 2012 recommendation based on a literature search for studies published between 2011/01/01–2016/10/03 on PSA utilization patterns, changes in prostate cancer incidence and biopsy patterns, and how the recommendation has shaped physician and patient attitudes about PSA screening and subsequent ordering of other screening tests. Rates of PSA screening decreased by 3–10 percentage points among all age groups and within most U.S. geographic regions. Rates of prostate biopsy and prostate cancer incidence have declined in unison, with a notable shift towards higher grade, stage and risk upon detection. Despite the recommendation, some physicians reported ongoing willingness to screen appropriately selected men, and men largely reported intending to continue to ask for the PSA test. In the coming years, we expect to have a better picture of whether these decreased rates of screening will impact prostate cancer metastasis and mortality. PMID:27995937

Periodic Screening Pelvic Examination: Evidence Report and Systematic Review for the US Preventive Services Task Force.

PubMed

Guirguis-Blake, Janelle M; Henderson, Jillian T; Perdue, Leslie A

2017-03-07

Recent changes in the periodicity of cervical cancer screening have led to questions about the role of screening pelvic examinations among asymptomatic women. To systematically review literature on health benefits, accuracy, and harms of the screening pelvic examination for gynecologic conditions for the US Preventive Services Task Force (USPSTF). MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials for relevant English-language studies published through January 13, 2016, with surveillance through August 3, 2016. Two reviewers independently screened abstracts and studies. The search yielded 8678 unique citations; 316 full-text articles were reviewed, and 9 studies including 27 630 patients met inclusion criteria. Two reviewers rated study quality using USPSTF criteria. Morbidity; mortality; diagnostic accuracy for any gynecologic cancer or condition except cervical cancer, gonorrhea, and chlamydia, which are covered by other USPSTF screening recommendations; harms (false-positive rates, false-negative rates, surgery rates). No trials examined the effectiveness of the pelvic examination in reducing all-cause mortality, reducing cancer- and disease-specific morbidity and mortality, or improving quality of life. Eight studies reported accuracy for the screening pelvic examination: ovarian cancer (4 studies; n = 26 432), bacterial vaginosis (2 studies; n = 930), trichomoniasis (1 study; n = 779), and genital herpes (1 study; n = 779). In the 4 ovarian cancer screening studies, low prevalence of ovarian cancer consistently resulted in low positive predictive values (PPVs) and false-positive rates, with a lack of precision in accuracy estimates (sensitivity range, 0%-100%; specificity range, 91%-99%; PPV range, 0%-3.6%; negative predictive value [NPV] range, ≥99%). Each diagnostic accuracy study for bacterial vaginosis, trichomoniasis, and genital herpes was performed in a high-prevalence population with substantial proportions of symptomatic patients and reported accuracy characteristics for individual physical examination findings (bacterial vaginosis, homogeneous discharge: sensitivity range, 69%-79%; specificity range, 54%-97%; PPV range, 52%-95%; NPV range, 79%-80%; herpes simplex virus, vulvar ulcerations: sensitivity, 20%; specificity, 98%; PPV, 88%; NPV, 57%; trichomoniasis, colpitis macularis: sensitivity, 2%; specificity, 100%; PPV, 100%; NPV, 85%). Surgery rates resulting from an abnormal screening pelvic examination for ovarian cancer ranged from 5% to 36% at 1 year, with the largest study reporting an 11% surgery rate and 1% complication rate within 1 year of a screening pelvic examination with abnormal findings. No direct evidence was identified for overall benefits and harms of the pelvic examination as a 1-time or periodic screening test. Limited evidence was identified regarding the diagnostic accuracy and harms of routine screening pelvic examinations in asymptomatic primary care populations.

Adherence to cervical cancer screening guidelines for U.S. women aged 25-64: data from the 2005 Health Information National Trends Survey (HINTS).

PubMed

Nelson, Wendy; Moser, Richard P; Gaffey, Allison; Waldron, William

2009-11-01

Although it is widely accepted that Papanicolaou (Pap) screening can reduce cervical cancer mortality, many women still do not maintain regular cervical cancer screenings. To describe the prevalence of cervical cancer screening and the demographic, behavioral, psychological, and cancer-related knowledge factors associated with adherence to U.S. Preventive Services Task Force (USPSTF) cervical cancer screening guidelines among women in the United States. Data for women aged 25-64 were obtained from the National Cancer Institute's (NCI) 2005 Health Information National Trends Survey (HINTS). Women were considered adherent to screening guidelines if they had two consecutive, on-schedule screenings and planned to have another within the next 3 years. The sample comprised 2070 women. Ninety-eight percent of women reported ever having a Pap smear, 90% reported having had a recent Pap smear (within 3 years), and 84% were adherent to USPSTF screening guidelines. Maintaining regular cervical cancer screening was significantly associated with having health insurance, normal body mass index (BMI), smoking status (nonsmoker), mood (absence of a mood disturbance), and being knowledgeable about cervical cancer screening and human papillomavirus (HPV) infection. Based on the observation that women who were current smokers, obese, or experiencing a substantial degree of psychological distress were significantly less likely to adhere to recommended screening guidelines, we suggest that healthcare providers pay particular attention to the screening needs of these more vulnerable women.

Physician Attitudes Toward Adult Vaccines and Other Preventive Practices, United States, 2012.

PubMed

Hurley, Laura P; Bridges, Carolyn B; Harpaz, Rafael; Allison, Mandy A; O' Leary, Sean T; Crane, Lori A; Brtnikova, Michaela; Stokley, Shannon; Beaty, Brenda L; Jimenez-Zambrano, Andrea; Kempe, Allison

2016-01-01

We described the following among U.S. primary care physicians: (1) perceived importance of vaccines recommended by the Advisory Committee on Immunization Practices relative to U.S. Preventive Services Task Force (USPSTF) preventive services, (2) attitudes toward the U.S. adult immunization schedule, and (3) awareness and use of Medicare preventive service visits. We conducted an Internet and mail survey from March to June 2012 among national networks of general internists and family physicians. We received responses from 352 of 445 (79%) general internists and 255 of 409 (62%) family physicians. For a 67-year-old hypothetical patient, 540/606 (89%, 95% confidence interval [CI] 87, 92) of physicians ranked seasonal influenza vaccine and 487/607 (80%, 95% CI 77, 83) ranked pneumococcal vaccine as very important, whereas 381/604 (63%, 95% CI 59, 67) ranked Tdap/Td vaccine and 288/607 (47%, 95% CI 43, 51) ranked herpes zoster vaccine as very important (p<0.001). All Grade A USPSTF recommendations were considered more important than Tdap/Td and herpes zoster vaccines. For the hypothetical patient aged 30 years, the number and percentage of physicians who reported that the Tdap/Td vaccine (377/604; 62%, 95% CI 59, 66) is very important was greater than the number and percentage who reported that the seasonal influenza vaccine (263/605; 43%, 95% CI 40, 47) is very important (p<0.001), and all Grade A and Grade B USPSTF recommendations were more often reported as very important than was any vaccine. A total of 172 of 587 physicians (29%) found aspects of the adult immunization schedule confusing. Among physicians aware of "Welcome to Medicare" and annual wellness visits, 492/514 (96%, 95% CI 94, 97) and 329/496 (66%, 95% CI 62, 70), respectively, reported having conducted fewer than 10 such visits in the previous month. Despite lack of prioritization of vaccines by ACIP, physicians are prioritizing some vaccines over others and ranking some vaccines below other preventive services. These attitudes and confusion about the immunization schedule may result in missed opportunities for vaccination. Medicare preventive visits are not being used widely despite offering a venue for delivery of preventive services, including vaccinations.

Development and validation of risk models to select ever-smokers for CT lung-cancer screening

PubMed Central

Katki, Hormuzd A.; Kovalchik, Stephanie A.; Berg, Christine D.; Cheung, Li C.; Chaturvedi, Anil K.

2016-01-01

Importance The US Preventive Services Task Force (USPSTF) recommends computed-tomography (CT) lung-cancer screening for ever-smokers ages 55-80 years who smoked at least 30 pack-years with no more than 15 years since quitting. However, selecting ever-smokers for screening using individualized lung-cancer risk calculations may be more effective and efficient than current USPSTF recommendations. Objective Comparison of modeled outcomes from risk-based CT lung-screening strategies versus USPSTF recommendations. Design/Setting/Participants Empirical risk models for lung-cancer incidence and death in the absence of CT screening using data on ever-smokers from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO; 1993-2009) control group. Covariates included age, education, sex, race, smoking intensity/duration/quit-years, Body Mass Index, family history of lung-cancer, and self-reported emphysema. Model validation in the chest radiography groups of the PLCO and the National Lung Screening Trial (NLST; 2002-2009), with additional validation of the death model in the National Health Interview Survey (NHIS; 1997-2001), a representative sample of the US. Models applied to US ever-smokers ages 50-80 (NHIS 2010-2012) to estimate outcomes of risk-based selection for CT lung-screening, assuming screening for all ever-smokers yields the percent changes in lung-cancer detection and death observed in the NLST. Exposure Annual CT lung-screening for 3 years. Main Outcomes and Measures Model validity: calibration (number of model-predicted cases divided by number of observed cases (Estimated/Observed)) and discrimination (Area-Under-Curve (AUC)). Modeled screening outcomes: estimated number of screen-avertable lung-cancer deaths, estimated screening effectiveness (number needed to screen (NNS) to prevent 1 lung-cancer death). Results Lung-cancer incidence and death risk models were well-calibrated in PLCO and NLST. The lung-cancer death model calibrated and discriminated well for US ever-smokers ages 50-80 (NHIS 1997-2001: Estimated/Observed=0.94, 95%CI=0.84-1.05; AUC=0.78, 95%CI=0.76-0.80). Under USPSTF recommendations, the models estimated 9.0 million US ever-smokers would qualify for lung-cancer screening and 46,488 (95%CI=43,924-49,053) lung-cancer deaths were estimated as screen-avertable over 5 years (estimated NNS=194, 95%CI=187-201). In contrast, risk-based selection screening the same number of ever-smokers (9.0 million) at highest 5-year lung-cancer risk (≥1.9%), was estimated to avert 20% more deaths (55,717; 95%CI=53,033-58,400) and was estimated to reduce the estimated NNS by 17% (NNS=162, 95%CI=157-166). Conclusions and Relevance Among a cohort of US ever-smokers age 50-80 years, application of a risk-based model for CT screening for lung cancer compared with a model based on USPSTF recommendations was estimated to be associated with a greater number of lung-cancer deaths prevented over 5 years along with a lower NNS to prevent 1 lung-cancer death. PMID:27179989

Development and Validation of Risk Models to Select Ever-Smokers for CT Lung Cancer Screening.

PubMed

Katki, Hormuzd A; Kovalchik, Stephanie A; Berg, Christine D; Cheung, Li C; Chaturvedi, Anil K

2016-06-07

The US Preventive Services Task Force (USPSTF) recommends computed tomography (CT) lung cancer screening for ever-smokers aged 55 to 80 years who have smoked at least 30 pack-years with no more than 15 years since quitting. However, selecting ever-smokers for screening using individualized lung cancer risk calculations may be more effective and efficient than current USPSTF recommendations. Comparison of modeled outcomes from risk-based CT lung-screening strategies vs USPSTF recommendations. Empirical risk models for lung cancer incidence and death in the absence of CT screening using data on ever-smokers from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO; 1993-2009) control group. Covariates included age; education; sex; race; smoking intensity, duration, and quit-years; body mass index; family history of lung cancer; and self-reported emphysema. Model validation in the chest radiography groups of the PLCO and the National Lung Screening Trial (NLST; 2002-2009), with additional validation of the death model in the National Health Interview Survey (NHIS; 1997-2001), a representative sample of the United States. Models were applied to US ever-smokers aged 50 to 80 years (NHIS 2010-2012) to estimate outcomes of risk-based selection for CT lung screening, assuming screening for all ever-smokers, yield the percent changes in lung cancer detection and death observed in the NLST. Annual CT lung screening for 3 years beginning at age 50 years. For model validity: calibration (number of model-predicted cases divided by number of observed cases [estimated/observed]) and discrimination (area under curve [AUC]). For modeled screening outcomes: estimated number of screen-avertable lung cancer deaths and estimated screening effectiveness (number needed to screen [NNS] to prevent 1 lung cancer death). Lung cancer incidence and death risk models were well calibrated in PLCO and NLST. The lung cancer death model calibrated and discriminated well for US ever-smokers aged 50 to 80 years (NHIS 1997-2001: estimated/observed = 0.94 [95%CI, 0.84-1.05]; AUC, 0.78 [95%CI, 0.76-0.80]). Under USPSTF recommendations, the models estimated 9.0 million US ever-smokers would qualify for lung cancer screening and 46,488 (95% CI, 43,924-49,053) lung cancer deaths were estimated as screen-avertable over 5 years (estimated NNS, 194 [95% CI, 187-201]). In contrast, risk-based selection screening of the same number of ever-smokers (9.0 million) at highest 5-year lung cancer risk (≥1.9%) was estimated to avert 20% more deaths (55,717 [95% CI, 53,033-58,400]) and was estimated to reduce the estimated NNS by 17% (NNS, 162 [95% CI, 157-166]). Among a cohort of US ever-smokers aged 50 to 80 years, application of a risk-based model for CT screening for lung cancer compared with a model based on USPSTF recommendations was estimated to be associated with a greater number of lung cancer deaths prevented over 5 years, along with a lower NNS to prevent 1 lung cancer death.

Knowledge of and Attitudes Toward Evidence-Based Guidelines for and Against Clinical Preventive Services: Results from a National Survey.

PubMed

Lantz, Paula M; Evans, W Douglas; Mead, Holly; Alvarez, Carmen; Stewart, Lisa

2016-03-01

Both the underuse and overuse of clinical preventive services relative to evidence-based guidelines are a public health concern. Informed consumers are an important foundation of many components of the Affordable Care Act, including coverage mandates for proven clinical preventive services recommended by the US Preventive Services Task Force. Across sociodemographic groups, however, knowledge of and positive attitudes toward evidence-based guidelines for preventive care are extremely low. Given the demonstrated low levels of consumers' knowledge of and trust in guidelines, coupled with their strong preference for involvement in preventive care decisions, better education and decision-making support for evidence-based preventive services are greatly needed. Both the underuse and overuse of clinical preventive services are a serious public health problem. The goal of our study was to produce population-based national data that could assist in the design of communication strategies to increase knowledge of and positive attitudes toward evidence-based guidelines for clinical preventive services (including the US Preventive Services Task Force, USPSTF) and to reduce uncertainty among patients when guidelines change or are controversial. In late 2013 we implemented an Internet-based survey of a nationally representative sample of 2,529 adults via KnowledgePanel, a probability-based survey panel of approximately 60,000 adults, statistically representative of the US noninstitutionalized population. African Americans, Hispanics, and those with less than a high school education were oversampled. We then conducted descriptive statistics and multivariable logistic regression analysis to identify the prevalence of and sociodemographic characteristics associated with key knowledge and attitudinal variables. While 36.4% of adults reported knowing that the Affordable Care Act requires insurance companies to cover proven preventive services without cost sharing, only 7.7% had heard of the USPSTF. Approximately 1 in 3 (32.6%) reported trusting that a government task force would make fair guidelines for preventive services, and 38.2% believed that the government uses guidelines to ration health care. Most of the respondents endorsed the notion that research/scientific evidence and expert medical opinion are important for the creation of guidelines and that clinicians should follow guidelines based on evidence. But when presented with patient vignettes in which a physician made a guideline-based recommendation against a cancer-screening test, less than 10% believed that this recommendation alone, without further dialogue and/or the patient's own research, was sufficient to make such a decision. Given these demonstrated low levels of knowledge and mistrust regarding guidelines, coupled with a strong preference for shared decision making, better consumer education and decision supports for evidence-based guidelines for clinical preventive services are greatly needed. © 2016 Milbank Memorial Fund.

Cancer Screening Test Use - United States, 2015.

PubMed

White, Arica; Thompson, Trevor D; White, Mary C; Sabatino, Susan A; de Moor, Janet; Doria-Rose, Paul V; Geiger, Ann M; Richardson, Lisa C

2017-03-03

Healthy People 2020 (HP2020) includes objectives to increase screening for breast, cervical, and colorectal cancer (1) as recommended by the U.S. Preventive Services Task Force (USPSTF).* Progress toward meeting these objectives is monitored by measuring cancer screening test use against national targets using data from the National Health Interview Survey (NHIS) (1). Analysis of 2015 NHIS data indicated that screening test use remains substantially below HP2020 targets for selected cancer screening tests. Although colorectal cancer screening test use increased from 2000 to 2015, no improvements in test use were observed for breast and cervical cancer screening. Disparities exist in screening test use by race/ethnicity, socioeconomic status, and health care access indicators. Increased measures to implement evidence-based interventions and conduct targeted outreach are needed if the HP2020 targets for cancer screening are to be achieved and the disparities in screening test use are to be reduced.

Medicaid Primary Care Physician Fees and the Use of Preventive Services among Medicaid Enrollees

PubMed Central

Atherly, Adam; Mortensen, Karoline

2014-01-01

Objective The Patient Protection and Affordable Care Act (ACA) increases Medicaid physician fees for preventive care up to Medicare rates for 2013 and 2014. The purpose of this paper was to model the relationship between Medicaid preventive care payment rates and the use of U.S. Preventive Services Task Force (USPSTF)–recommended preventive care use among Medicaid enrollees. Data Sources/Study Session We used data from the 2003 and 2008 Medical Expenditure Panel Survey (MEPS), a national probability sample of the U.S. civilian, noninstitutionalized population, linked to Kaiser state Medicaid benefits data, including the state Medicaid-to-Medicare physician fee ratio in 2003 and 2008. Study Design Probit models were used to estimate the probability that eligible individuals received one of five USPSF-recommended preventive services. A difference-in-difference model was used to separate out the effect of changes in the Medicaid payment rate and other factors. Data Collection/Extraction Methods Data were linked using state identifiers. Principal Findings Although Medicaid enrollees had a lower rate of use of the five preventive services in univariate analysis, neither Medicaid enrollment nor changes in Medicaid payment rates had statistically significant effects on meeting screening recommendations for the five screenings. The results were robust to a number of different sensitivity tests. Individual and state characteristics were significant. Conclusions Our results suggest that although temporary changes in primary care provider payments for preventive services for Medicaid enrollees may have other desirable effects, they are unlikely to substantially increase the use of these selected USPSTF-recommended preventive care services among Medicaid enrollees. PMID:24628495

Value of lifestyle intervention to prevent diabetes and sequelae.

PubMed

Dall, Timothy M; Storm, Michael V; Semilla, April P; Wintfeld, Neil; O'Grady, Michael; Narayan, K M Venkat

2015-03-01

The Community Preventive Services Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes, as evidence continues to show that intensive lifestyle interventions are effective for overweight individuals with prediabetes. To illustrate the potential clinical and economic benefits of treating prediabetes with lifestyle intervention to prevent or delay onset of type 2 diabetes and sequelae. This 2014 analysis used a Markov model to simulate disease onset, medical expenditures, economic outcomes, mortality, and quality of life for a nationally representative sample with prediabetes from the 2003-2010 National Health and Nutrition Examination Survey. Modeled scenarios used 10-year follow-up results from the lifestyle arm of the Diabetes Prevention Program and Outcomes Study versus simulated natural history of disease. Over 10 years, estimated average cumulative gross economic benefits of treating patients who met diabetes screening criteria recommended by the ADA ($26,800) or USPSTF ($24,700) exceeded average benefits from treating the entire prediabetes population ($17,800). Estimated cumulative, gross medical savings for these three populations averaged $10,400, $11,200, and $6,300, respectively. Published estimates suggest that opportunistic screening for prediabetes is inexpensive, and lifestyle intervention similar to the Diabetes Prevention Program can be achieved for ≤$2,300 over 10 years. Lifestyle intervention among people with prediabetes produces long-term societal benefits that exceed anticipated intervention costs, especially among prediabetes patients that meet the ADA and USPSTF screening guidelines. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Comparing the Maryland Comprehensive Cancer Control Plan With Federal Cancer Prevention and Control Recommendations.

PubMed

Fowler, Stephanie L; Platz, Elizabeth A; Diener-West, Marie; Hokenmaier, Sarah; Truss, Meredith; Lewis, Courtney; Kanarek, Norma F

2015-10-01

Since the introduction of the Affordable Care Act (ACA) in 2012, 11 million more Americans now have access to preventive services via health care coverage. Several prevention-related recommendations issued by the US Preventive Services Task Force (USPSTF), Centers for Disease Control and Prevention (CDC), and Advisory Committee on Immunization Practices (ACIP) are covered under the ACA. State cancer plans often provide prevention strategies, but whether these strategies correspond to federal evidence-based recommendations is unclear. The objective of this article is to assess whether federal evidence-based recommendations, including those covered under the ACA, are included in the Maryland Comprehensive Cancer Control Plan (MCCCP). A total of 19 federal recommendations pertaining to cancer prevention and control were identified. Inclusion of federal cancer-related recommendations by USPSTF, CDC, and ACIP in the MCCCP's goals, objectives, and strategies was examined. Nine of the federal recommendations were issued after the MCCCP's publication. MCCCP recommendations corresponded completely with 4 federal recommendations and corresponded only partially with 3. Reasons for partial correspondence included specification of less restrictive at-risk populations or different intervention implementers. Three federal recommendations were not mentioned in the MCCCP's goals, objectives, and strategies. Many cancer-related federal recommendations were released after the MCCCP's publication and therefore do not appear in the most current version. We recommend that the results of this analysis be considered in the update of the MCCCP. Our findings underscore the need for a periodic scan for changes to federal recommendations and for adjusting state policies and programs to correspond with federal recommendations, as appropriate for Marylanders.

Impact of Prostate-specific Antigen (PSA) Screening Trials and Revised PSA Screening Guidelines on Rates of Prostate Biopsy and Postbiopsy Complications.

PubMed

Gershman, Boris; Van Houten, Holly K; Herrin, Jeph; Moreira, Daniel M; Kim, Simon P; Shah, Nilay D; Karnes, R Jeffrey

2017-01-01

Prostate biopsy and postbiopsy complications represent important risks of prostate-specific antigen (PSA) screening. Although landmark randomized trials and updated guidelines have challenged routine PSA screening, it is unclear whether these publications have affected rates of biopsy or postbiopsy complications. To evaluate whether publication of the 2008 and 2012 US Preventive Services Task Force (USPSTF) recommendations, the 2009 European Randomized Study of Screening for Prostate Cancer and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or the 2013 American Urological Association (AUA) guidelines was associated with changes in rates of biopsy or postbiopsy complications, and to identify predictors of postbiopsy complications. This quasiexperimental study used administrative claims of 5279315 commercially insured US men aged ≥40 yr from 2005 to 2014, of whom 104584 underwent biopsy. Publications on PSA screening. Interrupted time-series analysis was used to evaluate the association of publications with rates of biopsy and 30-d complications. Logistic regression was performed to identify predictors of complications. From 2005 to 2014, biopsy rates fell 33% from 64.1 to 42.8 per 100000 person-months, with immediate reductions following the 2008 USPSTF recommendations (-10.1; 95% confidence interval [CI], -17.1 to -3.0; p<0.001), 2012 USPSTF recommendations (-13.8; 95% CI, -21.0 to -6.7; p<0 .001), and 2013 AUA guidelines (-8.8; 95% CI, -16.7 to -0.92; p=0.03). Concurrently, complication rates decreased 10% from 8.7 to 7.8 per 100000 person-months, with a reduction following the 2012 USPSTF recommendations (-2.5; 95% CI, -4.5 to -0.45; p=0.02). However, the proportion of men undergoing biopsy who experienced complications increased from 14% to 18%, driven by nonsepsis infectious complications (p<0.001). Predictors of complications included prior fluoroquinolone use (odds ratio [OR]: 1.27; 95% CI, 1.22-1.32; p<0.001), anticoagulant use (OR: 1.14; 95% CI, 1.04-1.25; p=0.004), and age ≥70 yr (OR: 1.25; 95% CI, 1.15-1.36; p<0.001). Limitations included the retrospective design. Although there has been an absolute reduction in rates of biopsy and 30-d complications, the relative morbidity of biopsy continues to increase. These observations suggest a need to reduce the morbidity of biopsy. Absolute rates of biopsy and postbiopsy complications have decreased following landmark publications about prostate-specific antigen screening; however, the relative morbidity of biopsy continues to increase. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Underutilization of aspirin for primary prevention of cardiovascular disease among HIV-infected patients.

PubMed

Burkholder, Greer A; Tamhane, Ashutosh R; Salinas, Jorge L; Mugavero, Michael J; Raper, James L; Westfall, Andrew O; Saag, Michael S; Willig, James H

2012-12-01

Individuals infected with human immunodeficiency virus (HIV) are at increased risk for cardiovascular disease (CVD) events compared with uninfected persons. However, little is known about HIV provider practices regarding aspirin (ASA) for primary prevention of CVD. A cross-sectional study was conducted among patients attending the University of Alabama at Birmingham 1917 HIV Clinic during 2010 to determine the proportion receiving ASA for primary prevention of CVD and identify factors associated with ASA prescription. Ten-year risk for CVD events was calculated for men aged 45-79 and women aged 55-79. The 2009 US Preventive Services Task Force (USPSTF) guidelines were used to determine those qualifying for primary CVD prevention. Among 397 patients who qualified to receive ASA (mean age, 52.2 years, 94% male, 36% African American), only 66 (17%) were prescribed ASA. In multivariable logistic regression analysis, diabetes mellitus (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.28-5.27), hyperlipidemia (OR, 3.42; 95% CI, 1.55-7.56), and current smoking (OR, 1.87; 95% CI, 1.03-3.41) were significantly associated with ASA prescription. Odds of ASA prescription more than doubled for each additional CVD-related comorbidity present among hypertension, diabetes, hyperlipidemia, and smoking (OR, 2.13, 95% CI, 1.51-2.99). In this HIV-infected cohort, fewer than 1 in 5 patients in need received ASA for primary CVD prevention. Escalating likelihood of ASA prescription with increasing CVD-related comorbidity count suggests that providers may be influenced more by co-occurrence of these diagnoses than by USPSTF guidelines. In the absence of HIV-specific guidelines, interventions to improve HIV provider awareness of and adherence to existing general population guidelines on CVD risk reduction are needed.

Comparing the Maryland Comprehensive Cancer Control Plan With Federal Cancer Prevention and Control Recommendations

PubMed Central

Platz, Elizabeth A.; Diener-West, Marie; Hokenmaier, Sarah; Truss, Meredith; Lewis, Courtney; Kanarek, Norma F.

2015-01-01

Introduction Since the introduction of the Affordable Care Act (ACA) in 2012, 11 million more Americans now have access to preventive services via health care coverage. Several prevention-related recommendations issued by the US Preventive Services Task Force (USPSTF), Centers for Disease Control and Prevention (CDC), and Advisory Committee on Immunization Practices (ACIP) are covered under the ACA. State cancer plans often provide prevention strategies, but whether these strategies correspond to federal evidence-based recommendations is unclear. The objective of this article is to assess whether federal evidence-based recommendations, including those covered under the ACA, are included in the Maryland Comprehensive Cancer Control Plan (MCCCP). Methods A total of 19 federal recommendations pertaining to cancer prevention and control were identified. Inclusion of federal cancer-related recommendations by USPSTF, CDC, and ACIP in the MCCCP’s goals, objectives, and strategies was examined. Results Nine of the federal recommendations were issued after the MCCCP’s publication. MCCCP recommendations corresponded completely with 4 federal recommendations and corresponded only partially with 3. Reasons for partial correspondence included specification of less restrictive at-risk populations or different intervention implementers. Three federal recommendations were not mentioned in the MCCCP’s goals, objectives, and strategies. Conclusion Many cancer-related federal recommendations were released after the MCCCP’s publication and therefore do not appear in the most current version. We recommend that the results of this analysis be considered in the update of the MCCCP. Our findings underscore the need for a periodic scan for changes to federal recommendations and for adjusting state policies and programs to correspond with federal recommendations, as appropriate for Marylanders. PMID:26425867

Impact of USPSTF recommendations for aspirin for prevention of recurrent preeclampsia.

PubMed

Tolcher, Mary Catherine; Chu, Derrick M; Hollier, Lisa M; Mastrobattista, Joan M; Racusin, Diana A; Ramin, Susan M; Sangi-Haghpeykar, Haleh; Aagaard, Kjersti M

2017-09-01

The US Preventive Services Task Force recommends low-dose aspirin for the prevention of preeclampsia among women at high risk for primary occurrence or recurrence of disease. Recommendations for the use of aspirin for preeclampsia prevention were issued by the US Preventive Services Task Force in September 2014. The objective of the study was to evaluate the incidence of recurrent preeclampsia in our cohort before and after the US Preventive Services Task Force recommendation for aspirin for preeclampsia prevention. This was a retrospective cohort study designed to evaluate the rates of recurrent preeclampsia among women with a history of preeclampsia. We utilized a 2-hospital, single academic institution database from August 2011 through June 2016. We excluded multiple gestations and included only the first delivery for women with multiple deliveries during the study period. The cohort of women with a history of preeclampsia were divided into 2 groups, before and after the release of the US Preventive Services Task Force 2014 recommendations. Potential confounders were accounted for in multivariate analyses, and relative risk and adjusted relative risk were calculated. A total of 17,256 deliveries occurred during the study period. A total of 417 women had a documented history of prior preeclampsia: 284 women before and 133 women after the US Preventive Services Task Force recommendation. Comparing the before and after groups, the proportion of Hispanic women in the after group was lower and the method of payment differed between the groups (P <.0001). The prevalence of type 1 diabetes was increased in the after period, but overall rates of pregestational diabetes were similar (6.3% before vs 5.3% after [P > .05]). Risk factors for recurrent preeclampsia included maternal age >35 years (relative risk, 1.83; 95% confidence interval, 1.34-2.48), Medicaid insurance (relative risk, 2.08; 95% confidence interval, 1.15-3.78), type 2 diabetes (relative risk, 2.13; 95% confidence interval, 1.37-3.33), and chronic hypertension (relative risk, 1.96; 95% confidence interval, 1.44-2.66). The risk of recurrent preeclampsia was decreased by 30% in the after group (adjusted relative risk, 0.70; 95% confidence interval, 0.52-0.95). Rates of recurrent preeclampsia among women with a history of preeclampsia decreased by 30% after release of the US Preventive Services Task Force recommendation for aspirin for preeclampsia prevention. Future prospective studies should include direct measures of aspirin compliance, gestational age at initiation, and explore the influence of race and ethnicity on the efficacy of this primary prevention. Copyright © 2017 Elsevier Inc. All rights reserved.

Underutilization of Aspirin for Primary Prevention of Cardiovascular Disease Among HIV-Infected Patients

PubMed Central

Burkholder, Greer A.; Tamhane, Ashutosh R.; Salinas, Jorge L.; Mugavero, Michael J.; Raper, James L.; Westfall, Andrew O.; Saag, Michael S.; Willig, James H.

2012-01-01

Background. Individuals infected with human immunodeficiency virus (HIV) are at increased risk for cardiovascular disease (CVD) events compared with uninfected persons. However, little is known about HIV provider practices regarding aspirin (ASA) for primary prevention of CVD. Methods. A cross-sectional study was conducted among patients attending the University of Alabama at Birmingham 1917 HIV Clinic during 2010 to determine the proportion receiving ASA for primary prevention of CVD and identify factors associated with ASA prescription. Ten-year risk for CVD events was calculated for men aged 45–79 and women aged 55–79. The 2009 US Preventive Services Task Force (USPSTF) guidelines were used to determine those qualifying for primary CVD prevention. Results. Among 397 patients who qualified to receive ASA (mean age, 52.2 years, 94% male, 36% African American), only 66 (17%) were prescribed ASA. In multivariable logistic regression analysis, diabetes mellitus (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.28–5.27), hyperlipidemia (OR, 3.42; 95% CI, 1.55–7.56), and current smoking (OR, 1.87; 95% CI, 1.03–3.41) were significantly associated with ASA prescription. Odds of ASA prescription more than doubled for each additional CVD-related comorbidity present among hypertension, diabetes, hyperlipidemia, and smoking (OR, 2.13, 95% CI, 1.51–2.99). Conclusions. In this HIV-infected cohort, fewer than 1 in 5 patients in need received ASA for primary CVD prevention. Escalating likelihood of ASA prescription with increasing CVD-related comorbidity count suggests that providers may be influenced more by co-occurrence of these diagnoses than by USPSTF guidelines. In the absence of HIV-specific guidelines, interventions to improve HIV provider awareness of and adherence to existing general population guidelines on CVD risk reduction are needed. PMID:22942209

Seroprevalence of HCV and HIV Infections by Year of Birth in Spain: Impact of US CDC and USPSTF Recommendations for HCV and HIV Testing

PubMed Central

Meijide, Héctor; Cañizares, Angelina; Castro-Iglesias, Ángeles; Delgado, Manuel; Pértega, Sonia; Pedreira, José; Bou, Germán; Poveda, Eva

2014-01-01

Background The US Centers for Disease Control and Prevention (CDC) recently add the advice of one-time testing of HCV infection in persons born during 1945–1965. Moreover, the US Preventive Services Task Force (USPSTF) newly recommended one-time HIV testing for persons aged 15–65. Herein, we evaluate the potential impact of these recommendations in a reference medical area of Spain. Methods All assays results entries for HCV and HIV serological markers ordered at a reference lab from primary care and specialized physicians between 2008 and 2012 were recorded in a medical area which covers 501,526 citizens in Northern Spain. The year of birth were also documented. Results A total of 108,159 anti-HCV-Ab results were generated during the study period. The global rate of anti-HCV-Ab+ was 7.7% (95% CI: 7.6%–7.9%), being more prevalent in men than women (8.6% vs. 4.5%). By year of birth, the highest prevalence was found in persons born between 1955 and 1970. HCV genotype 1 was the most prevalent (59.7%) followed by genotype 3 (22.7%). Regard HIV infection, among 65,279 anti-HIV results generated the prevalence of anti-HIV+ was 1.1% (95% CI: 1.0%–1.2%), being more frequent in men (2% vs 0.5%). The years of birth with highest rates of HIV infection exactly match with those for HCV infection. Conclusions The highest rates of HCV and HIV infections are found between 1960 and 1965. Different historical and social circumstances such as the huge intravenous drug use epidemic in the eighties in Spain, might explain it. Therefore, each country needs to determine its own HCV and HIV seroprevalences by year of birth to establish the proper recommendations for the screening of both infections. PMID:25436642

Primary Care Physicians' Support of Shared Decision Making for Different Cancer Screening Decisions.

PubMed

Elston Lafata, Jennifer; Brown, Richard F; Pignone, Michael P; Ratliff, Scott; Shay, L Aubree

2017-01-01

Despite its widespread advocacy, shared decision making (SDM) is not routinely used for cancer screening. To better understand the implementation barriers, we describe primary care physicians' (PCPs') support for SDM across diverse cancer screening contexts. Surveys were mailed to a random sample of USA-based PCPs. Using multivariable logistic regression analyses, we tested for associations of PCPs' support of SDM with the US Preventive Service Task Force (USPSTF) assigned recommendation grade, assessed whether the decision pertained to not screening older patients, and the PCPs' autonomous v. controlled motivation-orientation for using SDM. PCPs (n = 278) were, on average, aged 52 years, 38% female, and 69% white. Of these, 79% endorsed discussing screening benefits as very important to SDM; 64% for discussing risks; and 31% for agreeing with patient's opinion. PCPs were most likely to rate SDM as very important for colorectal cancer screening in adults aged 50-75 years (69%), and least likely for colorectal cancer screening in adults aged >85 years (34%). Regression results indicated the importance of PCPs' having autonomous or self-determined reasons for engaging in SDM (e.g., believing in the benefits of SDM) (OR = 2.29, 95% CI, 1.87 to 2.79). PCPs' support for SDM varied by USPSTF recommendation grade (overall contrast, X 2 = 14.7; P = 0.0054), with support greatest for A-Grade recommendations. Support for SDM was lower in contexts where decisions pertained to not screening older patients (OR = 0.45, 95% CI, 0.35 to 0.56). It is unknown whether PCPs' perceptions of the importance of SDM behaviors differs with specific screening decisions or the potential limited ability to generalize findings. Our results highlight the need to document SDM benefits and consider the specific contextual challenges, such as the level of uncertainty or whether evidence supports recommending/not recommending screening, when implementing SDM across an array of cancer screening contexts. © The Author(s) 2016.

Preventing dental caries in children <5 years: systematic review updating USPSTF recommendation.

PubMed

Chou, Roger; Cantor, Amy; Zakher, Bernadette; Mitchell, Jennifer Priest; Pappas, Miranda

2013-08-01

Screening and preventive interventions by primary care providers could improve outcomes related to early childhood caries. The objective of this study was to update the 2004 US Preventive Services Task Force systematic review on prevention of caries in children younger than 5 years of age. Searching Medline and the Cochrane Library (through March 2013) and reference lists, we included trials and controlled observational studies on the effectiveness and harms of screening and treatments. One author extracted study characteristics and results, which were checked for accuracy by a second author. Two authors independently assessed study quality. No study evaluated effects of screening by primary care providers on clinical outcomes. One good-quality cohort study found pediatrician examination associated with a sensitivity of 0.76 for identifying a child with cavities. No new trials evaluated oral fluoride supplementation. Three new randomized trials were consistent with previous studies in finding fluoride varnish more effective than no varnish (reduction in caries increment 18% to 59%). Three trials of xylitol were inconclusive regarding effects on caries. New observational studies were consistent with previous evidence showing an association between early childhood fluoride use and enamel fluorosis. Evidence on the accuracy of risk prediction instruments in primary care settings is not available. There is no direct evidence that screening by primary care clinicians reduces early childhood caries. Evidence previously reviewed by the US Preventive Services Task Force found oral fluoride supplementation effective at reducing caries incidence, and new evidence supports the effectiveness of fluoride varnish in higher-risk children.

Lipid Screening in Childhood and Adolescence for Detection of Multifactorial Dyslipidemia: Evidence Report and Systematic Review for the US Preventive Services Task Force.

PubMed

Lozano, Paula; Henrikson, Nora B; Morrison, Caitlin C; Dunn, John; Nguyen, Matt; Blasi, Paula R; Whitlock, Evelyn P

2016-08-09

Multifactorial dyslipidemia, characterized by elevated total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C), is associated with dyslipidemia and markers of atherosclerosis in young adulthood. Screening for dyslipidemia in childhood could delay or reduce cardiovascular events in adulthood. To systematically review the evidence on benefits and harms of screening adolescents and children for multifactorial dyslipidemia for the US Preventive Services Task Force (USPSTF). MEDLINE, Cochrane Central Register of Controlled Trials, and PubMed were searched for studies published between January 1, 2005, and June 2, 2015; studies included in a previous USPSTF evidence report and reference lists of relevant studies and ongoing trials were also searched. Surveillance was conducted through April 9, 2016. Fair- and good-quality studies in English with participants 0 to 20 years of age. Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized. Outcomes included dyslipidemia (TC≥200 mg/dL or LDL-C≥130 mg/dL) and atherosclerosis in childhood; myocardial infarction and ischemic stroke in adulthood; diagnostic yield (number of confirmed cases per children screened); and harms of screening or treatment. Simulated diagnostic yield was calculated as initial screening yield × positive predictive value from a study with confirmatory testing. Screening of children for multifactorial dyslipidemia has not been evaluated in randomized clinical trials. Based on 1 observational study (n = 6500) and nationally representative prevalence estimates, the simulated diagnostic yield of screening for elevated TC varies between 4.8% and 12.3% (higher in obese children [12.3%] and at the ages when TC naturally peaks-7.2% at age 9-11 years and 7.2% at age 16-19 years). One good-quality randomized clinical trial (n = 663) found a modest effect of intensive dietary counseling for a low-fat, low-cholesterol diet on lipid levels at 1 year in children aged 8 to 10 years with mild to moderate dyslipidemia; mean between-group difference in TC change from baseline was -6.1 mg/dL (95% CI, -9.1 to -3.2 mg/dL; P < .001). Between-group differences dissipated by year 5. The intervention did not adversely affect nutritional status, growth, or development over the 18-year study period. One observational study (n = 9245) found that TC concentration at age 12 to 39 years was not associated with death before age 55 years. The diagnostic yield of lipid screening varies by age and body mass index. No direct evidence was identified for benefits or harms of childhood screening or treatment on outcomes in adulthood. Intensive dietary interventions may be safe, with modest short-term benefit of uncertain clinical significance.

An update of the appraisal of the accuracy and utility of cervical discography in chronic neck pain.

PubMed

Onyewu, Obi; Manchikanti, Laxmaiah; Falco, Frank J E; Singh, Vijay; Geffert, Stephanie; Helm, Standiford; Cohen, Steven P; Hirsch, Joshua A

2012-01-01

Chronic neck pain represents a significant public health problem. Despite high prevalence rates, there is a lack of consensus regarding the causes or treatments for this condition. Based on controlled evaluations, the cervical intervertebral discs, facet joints, and atlantoaxial joints have all been implicated as pain generators. Cervical provocation discography, which includes disc stimulation and morphological evaluation, is occasionally used to distinguish a painful disc from other potential sources of pain. Yet in the absence of validation and controlled outcome studies, the procedure remains mired in controversy. A systematic review of the diagnostic accuracy of cervical discography. To systematically evaluate and update the diagnostic accuracy of cervical discography. The available literature on cervical discography was reviewed. Methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. However, studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF).Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to June 2012, and manual searches of the bibliographies of known primary and review articles. A total of 41 manuscripts were considered for accuracy and utility of cervical discography in chronic neck pain. There were 23 studies evaluating accuracy of discography. There were 3 studies meeting inclusion criteria for assessing the accuracy and prevalence of discography, with a prevalence of 16% to 53%. Based on modified Agency for Healthcare Research and Quality (AHRQ) accuracy evaluation and United States Preventive Services Task Force (USPSTF) level of evidence criteria, this systematic review indicates the strength of evidence is limited for the diagnostic accuracy of cervical discography. Limitations include a paucity of literature, poor methodological quality, and very few studies performed utilizing International Association for the Study of Pain (IASP) criteria. There is limited evidence for the diagnostic accuracy of cervical discography. Nevertheless, in the absence of any other means to establish a relationship between pathology and symptoms, cervical provocation discography may be an important evaluation tool in certain contexts to identify a subset of patients with chronic neck pain secondary to intervertebral disc disorders. Based on the current systematic review, cervical provocation discography performed according to the IASP criteria with control disc(s), and a minimum provoked pain intensity of 7 of 10, or at least 70% reproduction of worst pain (i.e. worst spontaneous pain of 7 = 7 x 70% = 5), may be a useful tool for evaluating chronic pain and cervical disc abnormalities in a small proportion of patients.

Screening for Major Depressive Disorder in Children and Adolescents: A Systematic Review for the U.S. Preventive Services Task Force.

PubMed

Forman-Hoffman, Valerie; McClure, Emily; McKeeman, Joni; Wood, Charles T; Middleton, Jennifer Cook; Skinner, Asheley C; Perrin, Eliana M; Viswanathan, Meera

2016-03-01

Major depressive disorder (MDD) is common among children and adolescents and is associated with functional impairment and suicide. To update the 2009 U.S. Preventive Services Task Force (USPSTF) systematic review on screening for and treatment of MDD in children and adolescents in primary care settings. Several electronic searches (May 2007 to February 2015) and searches of reference lists of published literature. Trials and recent systematic reviews of treatment, test-retest studies of screening, and trials and large cohort studies for harms. Data were abstracted by 1 investigator and checked by another; 2 investigators independently assessed study quality. Limited evidence from 5 studies showed that such tools as the Beck Depression Inventory and Patient Health Questionnaire for Adolescents had reasonable accuracy for identifying MDD among adolescents in primary care settings. Six trials evaluated treatment. Several individual fair- and good-quality studies of fluoxetine, combined fluoxetine and cognitive behavioral therapy, escitalopram, and collaborative care demonstrated benefits of treatment among adolescents, with no associated harms. The review included only English-language studies, narrow inclusion criteria focused only on MDD, high thresholds for quality, potential publication bias, limited data on harms, and sparse evidence on long-term outcomes of screening and treatment among children younger than 12 years. No evidence was found of a direct link between screening children and adolescents for MDD in primary care or similar settings and depression or other health-related outcomes. Evidence showed that some screening tools are accurate and some treatments are beneficial among adolescents (but not younger children), with no evidence of associated harms. Agency for Healthcare Research and Quality.

Improving secondary prevention screening in clinical encounters using mhealth among prelicensure master's entry clinical nursing students.

PubMed

FitzGerald, Leah Z; Rorie, Anne; Salem, Benissa E

2015-04-01

To determine the feasibility and acceptability of a mHealth application among nursing students for health promotion and secondary prevention health recommendations for hospitalized adult patients. A pretest-posttest design with a convenience sample of 169 prelicensure master's entry clinical nursing students in a large urban public university. Survey questions assessed intention to use, perceived usefulness, perceived ease of use, subjective norm, voluntariness, clinical area relevance, output quality, and result demonstrability of the United States Preventive Services Task Force (USPSTF) evidence-based practice guidelines via the mHealth application. Descriptive statistics and frequencies were used to explore sociodemographics; paired t-tests were used to evaluate pre- and posttest differences. Pre- and posttest significant differences (p < .01) were found between intention to use, perceived usefulness, subjective norm, voluntariness, image, clinical relevance, result demonstrability, and output quality (p < .02). Ease use of a mHealth application was not significantly different. These findings highlight the need to integrate evidence-based practice tools using mHealth technology among prelicensure master's entry clinical nursing students in order to engage and foster translational learning and improve dissemination of secondary prevention screening guidelines among hospitalized patients. © 2015 Sigma Theta Tau International.

Society of Behavioral Medicine supports implementation of high quality lung cancer screening in high-risk populations.

PubMed

Watson, Karriem S; Blok, Amanda C; Buscemi, Joanna; Molina, Yamile; Fitzgibbon, Marian; Simon, Melissa A; Williams, Lance; Matthews, Kameron; Studts, Jamie L; Lillie, Sarah E; Ostroff, Jamie S; Carter-Harris, Lisa; Winn, Robert A

2016-12-01

The Society of Behavioral Medicine (SBM) supports the United States Preventive Services Task Force (USPSTF) recommendation of low-dose computed tomography (LDCT) screening of the chest for eligible populations to reduce lung cancer mortality. Consistent with efforts to translate research findings into real-world settings, SBM encourages health-care providers and health-care systems to (1) integrate evidence-based tobacco treatment as an essential component of LDCT-based lung cancer screening, (2) examine the structural barriers that may impact screening uptake, and (3) incorporate shared decision-making as a clinical platform to facilitate consultations and engagement with individuals at high risk for lung cancer about the potential benefits and harms associated with participation in a lung cancer screening program. We advise policy makers and legislators to support screening in high-risk populations by continuing to (1) expand access to high quality LDCT-based screening among underserved high-risk populations, (2) enhance cost-effectiveness by integrating evidence-based tobacco treatments into screening in high-risk populations, and (3) increase funding for research that explores implementation science and increased public awareness and access of diverse populations to participate in clinical and translational research.

Applying Sparse Machine Learning Methods to Twitter: Analysis of the 2012 Change in Pap Smear Guidelines. A Sequential Mixed-Methods Study.

PubMed

Lyles, Courtney Rees; Godbehere, Andrew; Le, Gem; El Ghaoui, Laurent; Sarkar, Urmimala

2016-06-10

It is difficult to synthesize the vast amount of textual data available from social media websites. Capturing real-world discussions via social media could provide insights into individuals' opinions and the decision-making process. We conducted a sequential mixed methods study to determine the utility of sparse machine learning techniques in summarizing Twitter dialogues. We chose a narrowly defined topic for this approach: cervical cancer discussions over a 6-month time period surrounding a change in Pap smear screening guidelines. We applied statistical methodologies, known as sparse machine learning algorithms, to summarize Twitter messages about cervical cancer before and after the 2012 change in Pap smear screening guidelines by the US Preventive Services Task Force (USPSTF). All messages containing the search terms "cervical cancer," "Pap smear," and "Pap test" were analyzed during: (1) January 1-March 13, 2012, and (2) March 14-June 30, 2012. Topic modeling was used to discern the most common topics from each time period, and determine the singular value criterion for each topic. The results were then qualitatively coded from top 10 relevant topics to determine the efficiency of clustering method in grouping distinct ideas, and how the discussion differed before vs. after the change in guidelines . This machine learning method was effective in grouping the relevant discussion topics about cervical cancer during the respective time periods (~20% overall irrelevant content in both time periods). Qualitative analysis determined that a significant portion of the top discussion topics in the second time period directly reflected the USPSTF guideline change (eg, "New Screening Guidelines for Cervical Cancer"), and many topics in both time periods were addressing basic screening promotion and education (eg, "It is Cervical Cancer Awareness Month! Click the link to see where you can receive a free or low cost Pap test.") It was demonstrated that machine learning tools can be useful in cervical cancer prevention and screening discussions on Twitter. This method allowed us to prove that there is publicly available significant information about cervical cancer screening on social media sites. Moreover, we observed a direct impact of the guideline change within the Twitter messages.

Screening for Adolescent Idiopathic Scoliosis: Evidence Report and Systematic Review for the US Preventive Services Task Force.

PubMed

Dunn, John; Henrikson, Nora B; Morrison, Caitlin C; Blasi, Paula R; Nguyen, Matt; Lin, Jennifer S

2018-01-09

Adolescent idiopathic scoliosis (AIS), a spinal curvature of 10° or more, is the most common form of scoliosis, with a prevalence of 1% to 3%. Curves progress in approximately two-thirds of patients with AIS before skeletal maturity, and large curves (>50°) may be associated with adverse health outcomes. To systematically review evidence on benefits and harms of AIS screening for the US Preventive Services Task Force (USPSTF). Cochrane Central Register of Controlled Trials, MEDLINE, ERIC, PubMed, CINAHL, and relevant systematic reviews were searched for studies published from January 1966 to October 20, 2016; studies included in a previous USPSTF report were also reviewed. Surveillance was conducted through July 24, 2017. Fair- and good-quality studies that evaluated the accuracy of screening children and adolescents aged 10 to 18 years for AIS, the benefits of AIS treatment, the harms of AIS screening or treatment, or long-term health outcomes. Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized. Health outcomes and spinal curvature in adolescence and adulthood, accuracy of screening for AIS, any harm of AIS screening or treatment. Fourteen studies (N = 448 276) in 26 articles were included. Accuracy of AIS screening was highest (93.8% sensitivity; 99.2% specificity) in a cohort study of a clinic-based program using forward bend test, scoliometer, and Moiré topography screening (n = 306 082); accuracy was lower in cohort studies of 6 programs using fewer modalities (n = 141 161). Four controlled studies (n = 587) found evidence for benefit of bracing on curve progression compared with controls. A randomized clinical trial and a nonrandomized trial of exercise treatment (N = 184) found favorable reductions in Cobb angle of 0.67° to 4.9° in the intervention group compared with increases of 1.38° to 2.8° in the control group. Two cohort studies (n = 339) on long-term outcomes found that braced participants reported more negative treatment experience and body appearance compared with surgically treated or untreated participants. A study that combined a randomized clinical trial and cohort design (n = 242) reported harms of bracing, which included skin problems on the trunk and nonback body pains. There was no evidence on the effect of AIS screening on adult health outcomes. Screening can detect AIS. Bracing and possibly exercise treatment can interrupt or slow progression of curvature in adolescence. However, there is little or no evidence on long-term outcomes for AIS treated in adolescence, the association between curvature at skeletal maturity and adult health outcomes, the harms of AIS screening or treatment, or the effect of AIS screening on adult health outcomes.

Tobacco Harms, Nicotine Pharmacology, and Pharmacologic Tobacco Cessation Interventions for Women.

PubMed

Baraona, L Kim; Lovelace, Dawn; Daniels, Julie L; McDaniel, Linda

2017-05-01

Firsthand and secondhand tobacco use is linked to a multitude of harmful illnesses, adverse perinatal outcomes, and death. Cessation attempts among women may be hampered by their unique biologic response to nicotine. Current research has revealed epigenetic changes from intrauterine nicotine exposure that have intergenerational consequences. Multiple studies have demonstrated the efficacy of various pharmacologic tobacco cessation interventions in conjunction with behavioral counseling. Based on this evidence, the US Preventative Services Task Force (USPSTF) 2015 guideline recommends pharmacologic therapy for all nonpregnant persons who smoke in addition to behavioral counseling. The effectiveness of pharmacologic treatments among pregnant women is less clear, with far fewer studies evaluating potential benefits and harms. While exposure to pharmacologic therapies raises concerns for fetal safety, these potential risks must be weighed against those of continued tobacco use, which guarantees fetal exposure to nicotine. First-line tobacco cessation medications include nicotine replacement therapy (NRT), bupropion, and varenicline. Second-line medications include nortriptyline and clonidine. Pharmacokinetics, effectiveness, regimens, and safety profiles for nonpregnant, pregnant, and lactating women are reviewed. Alternative tobacco cessation options and potential new pharmacologic tobacco cessation agents are discussed. Initiating brief interventions, using the 5A's and 5R's model is described. © 2017 by the American College of Nurse-Midwives.

Applying Sparse Machine Learning Methods to Twitter: Analysis of the 2012 Change in Pap Smear Guidelines. A Sequential Mixed-Methods Study

PubMed Central

Godbehere, Andrew; Le, Gem; El Ghaoui, Laurent; Sarkar, Urmimala

2016-01-01

Background It is difficult to synthesize the vast amount of textual data available from social media websites. Capturing real-world discussions via social media could provide insights into individuals’ opinions and the decision-making process. Objective We conducted a sequential mixed methods study to determine the utility of sparse machine learning techniques in summarizing Twitter dialogues. We chose a narrowly defined topic for this approach: cervical cancer discussions over a 6-month time period surrounding a change in Pap smear screening guidelines. Methods We applied statistical methodologies, known as sparse machine learning algorithms, to summarize Twitter messages about cervical cancer before and after the 2012 change in Pap smear screening guidelines by the US Preventive Services Task Force (USPSTF). All messages containing the search terms “cervical cancer,” “Pap smear,” and “Pap test” were analyzed during: (1) January 1–March 13, 2012, and (2) March 14–June 30, 2012. Topic modeling was used to discern the most common topics from each time period, and determine the singular value criterion for each topic. The results were then qualitatively coded from top 10 relevant topics to determine the efficiency of clustering method in grouping distinct ideas, and how the discussion differed before vs. after the change in guidelines . Results This machine learning method was effective in grouping the relevant discussion topics about cervical cancer during the respective time periods (~20% overall irrelevant content in both time periods). Qualitative analysis determined that a significant portion of the top discussion topics in the second time period directly reflected the USPSTF guideline change (eg, “New Screening Guidelines for Cervical Cancer”), and many topics in both time periods were addressing basic screening promotion and education (eg, “It is Cervical Cancer Awareness Month! Click the link to see where you can receive a free or low cost Pap test.”) Conclusions It was demonstrated that machine learning tools can be useful in cervical cancer prevention and screening discussions on Twitter. This method allowed us to prove that there is publicly available significant information about cervical cancer screening on social media sites. Moreover, we observed a direct impact of the guideline change within the Twitter messages. PMID:27288093

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

Kruger, R.

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Undermore » the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.« less

WE-B-207-00: CT Lung Cancer Screening Part 1

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

NONE

2015-06-15

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Undermore » the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.« less

WE-B-207-02: CT Lung Cancer Screening and the Medical Physicist: A Dosimetry Summary of CT Participants in the National Lung Cancer Screening Trial (NLST)

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

Lee, C.

2015-06-15

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Undermore » the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.« less

Testicular self-examination and testicular cancer: a cost-utility analysis.

PubMed

Aberger, Michael; Wilson, Bradley; Holzbeierlein, Jeffrey M; Griebling, Tomas L; Nangia, Ajay K

2014-12-01

The United States Preventive Services Task Force (USPSTF) has recommended against testicular self-examinations (TSE) or clinical examination for testicular cancer screening. However, in this recommendation there was no consideration of the significant fiscal cost of treating advanced disease versus evaluation of benign disease. In this study, a cost-utility validation for TSE was performed. The cost of treatment for an advanced-stage testicular tumor (both seminomatous and nonseminomatous) was compared to the cost of six other scenarios involving the clinical assessment of a testicular mass felt during self-examination (four benign and two early-stage malignant). Medicare reimbursements were used as an estimate for a national cost standard. The total treatment cost for an advanced-stage seminoma ($48,877) or nonseminoma ($51,592) equaled the cost of 313-330 benign office visits ($156); 180-190 office visits with scrotal ultrasound ($272); 79-83 office visits with serial scrotal ultrasounds and labs ($621); 6-7 office visits resulting in radical inguinal orchiectomy for benign pathology ($7,686) or 2-3 office visits resulting in treatment and surveillance of an early-stage testicular cancer ($17,283: seminoma, $26,190: nonseminoma). A large number of clinical evaluations based on the TSE for benign disease can be made compared to the cost of one missed advanced-stage tumor. An average of 2.4 to 1 cost benefit ratio was demonstrated for early detected testicular cancer versus advanced-stage disease. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Co-occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines.

PubMed

Capone, George T; Chicoine, Brian; Bulova, Peter; Stephens, Mary; Hart, Sarah; Crissman, Blythe; Videlefsky, Andrea; Myers, Katherine; Roizen, Nancy; Esbensen, Anna; Peterson, Moya; Santoro, Stephanie; Woodward, Jason; Martin, Barry; Smith, David

2018-01-01

Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. The United States Preventive Service Task Force (USPSTF) has developed criteria for prioritizing conditions of public health importance with the potential for providing screening recommendations to improve clinical care. The quality of existing evidence needed to inform clinical guidelines has not been previously reviewed. Using the National Library of Medicine (NLM) database PubMed, we first identified 18 peer reviewed articles that addressed co-occurring medical conditions in adults with DS. Those conditions discussed in over half of the articles were prioritized for further review. Second, we performed detailed literature searches on these specific conditions. To inform the search strategy and review process a series of key questions were formulated a priori. The quality of available evidence was then graded and knowledge gaps were identified. The number of participating adults and the design of clinical studies varied by condition and were often inadequate for answering all of our key questions. We provide data on thyroid disease, cervical spine disease, hearing impairment, overweight-obesity, sleep apnea, congenital heart disease, and osteopenia-osteoporosis. Minimal evidence demonstrates massive gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The development of evidence-based clinical guidance will require an expanded clinical knowledge-base in order to move forward. © 2017 Wiley Periodicals, Inc.

Genetic Counseling and Evaluation for BRCA1/2 Testing

MedlinePlus

... counseling. If you do not have a personal history of breast or ovarian cancer BRCA genetic counseling, ... the USPSTF recommendation. If you have a personal history of ovarian cancer Genetic counseling and testing is ...

Physician and patient gender concordance and the delivery of comprehensive clinical preventive services.

PubMed

Flocke, Susan A; Gilchrist, Valerie

2005-05-01

Understanding the role of patient- and physician-gender on delivery of preventive services has important implications for identifying strategies to increase preventive service delivery. We attempt to overcome methodological limitations of previous studies in examining the association of the patient-physician gender interaction on the delivery of preventive screening, counseling, and immunization services. In this cross-sectional study, research nurses directly observed 3256 consecutive adult patient visits to 138 family physicians. Delivery of gender neutral US Preventive Services Task Force (USPSTF) recommended screening, health behavior counseling, and immunization services was assessed by direct observation and medical record review. Multilevel regression analyses were used to test the interaction effect of physician and patient gender with preventive service delivery, controlling for patient age, insurance type, number of office visits in the past 2 years and physician age. The interaction effect of physician and patient gender was not significantly associated with delivery of gender neutral screening, counseling, or immunizations. Patients of female physicians were more up-to-date on counseling services (P < 0.01) and immunizations (P < 0.05) than patients of male physicians. Male patients, independent of physician gender, were more up-to-date on counseling and immunizations (P < 0.01). Physician-patient gender concordance is not associated with delivery of more preventive services. Rather, female physicians provide more counseling and immunization services to all of their patients. Previous research showing higher rates of gender-specific screening achieved by women physicians may have been an indication of an overall greater prevention orientation among women physicians rather than a specific benefit of gender concordance.

The influence of PSA autoantibodies in prostate cancer patients: a prospective clinical study-II.

PubMed

Nakajima, Kosei; Heilbrun, Lance K; Smith, Daryn; Hogan, Victor; Raz, Avraham; Heath, Elisabeth

2017-03-14

The U.S. Preventive Services Task Force (USPSTF) has recommended against PSA-based screening for prostate cancer due to potential possibilities of false-results. Since no alternative test is available to replace it, we have initiated a trial with the purpose of establishing whether Galectin-3 (Gal-3) serum level and/or the patients' immune response to PSA and Gal-3 antigens could complement the PSA test as diagnostic tools for prostate cancer patients. A blind, prospective, single institution, pilot study was conducted. A total of 95 men were recruited and classified into 5 different groups: healthy controls (Group1), newly diagnosed patients (Group2), no recurrence after local therapy (Group3), rising PSA after local therapy (Group4), and metastatic patients (Group5). The primary endpoints were the levels of serum PSA, PSA autoantibodies (AAPSA), Gal-3, and Gal-3 autoantibodies (AAGal-3). Data were analyzed by Spearman's rank correlation (rho) and least squares linear regression modeling. The expression levels of PSA, AAPSA, Gal-3, and AAGal-3 were determined in both healthy controls and prostate cancer patients. Negative correlations were observed between PSA and AAPSA levels among all 95 men combined (rho = -0.321, P = 0.0021; fitted slope -0.288, P = 0.0048), and in metastatic patients (rho = -0.472, P = 0.0413; fitted slope -1.145, P = 0.0061). We suggest an association between PSA and AAPSA, whereby the AAPSA may alter PSA levels. It provides a novel outlook for prostate cancer diagnosis, and should serve as a basis for an all-inclusive diagnostic trial centering on patients with metastasis.

Comparison of Alcohol Use Disorder Screens During College Athlete Pre-Participation Evaluations.

PubMed

Majka, Erek; Graves, Travis; Diaz, Vanessa A; Player, Marty S; Dickerson, Lori M; Gavin, Jennifer K; Wessell, Andrea

2016-05-01

The US Preventive Services Task Force (USPSTF) recommends screening adults for alcohol misuse, a challenge among young adults who may not have regular primary care. The pre-participation evaluation (PPE) provides an opportunity for screening, but traditional screening tools require extra time in an already busy visit. The objective of this study was to compare the 10-item Alcohol Use Disorders Identification Test (AUDIT) with a single-question alcohol misuse screen in a population of college-aged athletes. This cross-sectional study was performed during an athletic PPE clinic at a college in the Southeastern United States among athletes ages 18 years and older. Written AUDIT and single-question screen "How many times in the past year have you had X or more drinks in a day?" (five for men, four for women) asked orally were administered to each participant. Sensitivity, specificity, and positive and negative predictive values for the single-question screen were compared to AUDIT. A total of 225 athletes were screened; 60% were female; 29% screened positive by AUDIT; 59% positive by single-question instrument. Males were more likely to screen positive by both methods. Compared to the AUDIT, the brief single-question screen had 92% sensitivity for alcohol misuse and 55% specificity. The negative predictive value of the single-question screen was 95% compared to AUDIT. A single-question screen for alcohol misuse in college-aged athletes had a high sensitivity and negative predictive value compared to the more extensive AUDIT screen. Ease of administration of this screening tool is ideal for use within the pre-participation physical among college-aged athletes who may not seek regular medical care.

Pairing Smoking-Cessation Services With Lung Cancer Screening: A Clinical Guideline From the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco

PubMed Central

Fucito, Lisa M.; Czabafy, Sharon; Hendricks, Peter S.; Kotsen, Chris; Richardson, Donna; Toll, Benjamin A.

2016-01-01

Smoking cessation is crucial for reducing cancer risk and premature mortality. The US Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening with low-dose computed tomography (LDCT), and the Center for Medicare and Medicaid Services recently approved lung screening as a benefit for patients ages 55 to 77 years who have a 30 pack-year history. The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed the guideline described in this commentary based on an illustrative literature review to present the evidence for smoking-cessation health benefits in this high-risk group and to provide clinical recommendations for integrating evidence-based smoking-cessation treatment with lung cancer screening. Unfortunately, extant data on lung cancer screening participants were scarce at the time this guideline was written. However, in this review, the authors summarize the sufficient evidence on the benefits of smoking cessation and the efficacy of smoking-cessation interventions for smokers ages 55 to 77 years to provide smoking-cessation interventions for smokers who seek lung cancer screening. It is concluded that smokers who present for lung cancer screening should be encouraged to quit smoking at each visit. Access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results, and motivation to quit should not be a necessary precondition for treatment. Follow-up contacts to support smoking-cessation efforts should be arranged for smokers. Evidence-based behavioral strategies should be used at each visit to motivate smokers who are unwilling to try quitting/reducing smoking or to try evidence-based treatments that may lead to eventual cessation. PMID:26916412

An Analysis of Mass Screening Strategies Using a Mathematical Model: Comparison of Breast Cancer Screening in Japan and the United States

PubMed Central

Tsunematsu, Miwako; Kakehashi, Masayuki

2015-01-01

Background Although the United States Preventive Services Task Force (USPSTF) downgraded their recommendation for breast cancer screening for women aged 40–49 years in 2009, Japanese women in their 40s have been encouraged to attend breast cancer screenings since 2004. The aim of this study is to examine whether these different mass-screening strategies are justifiable by the different situations of these countries and to provide evidence for suitable judgment. Methods Performance of screening strategies (annual/biennial intervals; initiating/terminating ages) was evaluated using a mathematical model based on the natural history of breast cancer and the transition between its stages. Benefits (reduced number of deaths and extended average life expectancy) and harm (false-positives) associated with these strategies were calculated. Results Additional average life expectancy by including women in their 40s as participants were 13 days (26%) and 25 days (22%) in Japan and the United States, respectively, under the biennial screening condition; however, the respective increases in numbers of false-positive cases were 65% and 53% in Japan and the United States. Moreover, the number of screenings needed to detect one diagnosis or to avert one death was smaller when participants were limited to women of age 50 or over than when women in their 40s were included. The validity of including women in their 40s in Japan could not be determined without specifying the weight of harms compared to benefits. Conclusions Whether screening of women in their 40s in Japan is justifiable must be carefully determined based the quantitative balance of benefits and harms. PMID:25483105

A longitudinal assessment of adherence to breast and cervical cancer screening recommendations among women with and without intellectual disability.

PubMed

Xu, Xinling; McDermott, Suzanne W; Mann, Joshua R; Hardin, James W; Deroche, Chelsea B; Carroll, Dianna D; Courtney-Long, Elizabeth A

2017-07-01

Each year in the United States, about 4000 deaths are attributed to cervical cancer, and over 40,000 deaths are attributed to breast cancer (U.S. Cancer Statistics Working Group, 2015). The purpose of this study was to identify predictors of full, partial, and no screening for breast and cervical cancer among women with and without intellectual disability (ID) who are within the age group for screening recommended by the U.S. Preventive Service Task Force (USPSTF), while accounting for changes in recommendations over the study period. Women with ID and an age matched comparison group of women without ID were identified using merged South Carolina Medicaid and Medicare files from 2000 to 2010. The sample consisted of 9406 and 16,806 women for mammography screening and Papanicolaou (Pap) testing adherence, respectively. We estimated multinomial logistic regression models and determined that women with ID were significantly less likely than women without ID to be fully adherent compared to no screening with mammography recommendations (adjusted odds ratio [AOR]: 0.63, 95% confidence interval [CI] 0.55-0.72), and Pap testing recommendations (AOR: 0.17, 95% CI 0.16-0.19). For the 70% of women with ID for whom we had residential information, those who lived in a group home, medical facility, or supervised community living setting were more likely to be fully adherent with both preventive services than those living alone or with family members. For both outcomes, women residing in a supervised nonmedical community living setting had the highest odds of full adherence, adjusting for other covariates. Copyright © 2017 Elsevier Inc. All rights reserved.

American Association for Clinical Chemistry

MedlinePlus

... did not need additional cardiac testing. Read the study LAB TESTS ONLINE USPSTF Updates Draft Recommendations on Cervical Cancer ... to follow colleagues and receive updates when they post in a forum, as well as enhanced email and messaging tools. Search ... AACC Programs and Partners Lab Tests Online Harmonization.net Commission on Accreditation in Clinical ...

Hand digit control in children: motor overflow in multi-finger pressing force vector space during maximum voluntary force production.

PubMed

Shim, Jae Kun; Karol, Sohit; Hsu, Jeffrey; de Oliveira, Marcio Alves

2008-04-01

The aim of this study was to investigate the contralateral motor overflow in children during single-finger and multi-finger maximum force production tasks. Forty-five right handed children, 5-11 years of age produced maximum isometric pressing force in flexion or extension with single fingers or all four fingers of their right hand. The forces produced by individual fingers of the right and left hands were recorded and analyzed in four-dimensional finger force vector space. The results showed that increases in task (right) hand finger forces were linearly associated with non-task (left) hand finger forces. The ratio of the non-task hand finger force magnitude to the corresponding task hand finger force magnitude, termed motor overflow magnitude (MOM), was greater in extension than flexion. The index finger flexion task showed the smallest MOM values. The similarity between the directions of task hand and non-task hand finger force vectors in four-dimensional finger force vector space, termed motor overflow direction (MOD), was the greatest for index and smallest for little finger tasks. MOM of a four-finger task was greater than the sum of MOMs of single-finger tasks, and this phenomenon was termed motor overflow surplus. Contrary to previous studies, no single-finger or four-finger tasks showed significant changes of MOM or MOD with the age of children. We conclude that the contralateral motor overflow in children during finger maximum force production tasks is dependent upon the task fingers and the magnitude and direction of task finger forces.

75 FR 45606 - Interagency Ocean Policy Task Force-Final Recommendations of the Interagency Ocean Policy Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... COUNCIL ON ENVIRONMENTAL QUALITY Interagency Ocean Policy Task Force--Final Recommendations of the Interagency Ocean Policy Task Force AGENCY: Council on Environmental Quality. ACTION: Notice of Availability, Interagency Ocean Policy Task Force's [[Page 45607

76 FR 60863 - Aquatic Nuisance Species Task Force Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-30

...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species Task Force (ANS Task Force). The ANS Task Force's purpose is to develop and implement a program for U.S. waters to prevent...

78 FR 29378 - Aquatic Nuisance Species Task Force; Public Teleconference/Webinar

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

...-FF09F14000-134] Aquatic Nuisance Species Task Force; Public Teleconference/ Webinar AGENCY: Fish and Wildlife... teleconference/webinar of the Aquatic Nuisance Species Task Force (ANS Task Force). The ANS Task Force's purpose... aquatic nuisance species; to monitor, control, and study such species; and to disseminate related...

Keepin' On: Five Years Down the Road to Better Schools. Reports of the Task Force on Improving Kentucky's Schools and the Task Force on Restructuring Time and Learning.

ERIC Educational Resources Information Center

Prichard Committee for Academic Excellence, Lexington, KY.

This report contains the findings of two task forces established during 1994 by the Prichard Committee for Academic Excellence: (1) the Task Force on Improving Kentucky Schools; and (2) the Task Force on Restructuring Time and Learning. The task forces, comprised of parents and business members of the Prichard Committee, examined key elements of…

Screening for Excessive Alcohol Use and Brief Counseling of Adults - 17 States and the District of Columbia, 2014.

PubMed

McKnight-Eily, Lela R; Okoro, Catherine A; Mejia, Roberto; Denny, Clark H; Higgins-Biddle, John; Hungerford, Dan; Kanny, Dafna; Sniezek, Joseph E

2017-03-31

Excessive and/or risky alcohol use* resulted in $249 billion in economic costs in 2010 (1) and >88,000 deaths in the United States every year from 2006 to 2010 (2). It is associated with birth defects and disabilities (e.g., fetal alcohol spectrum disorders [FASDs]), increases in chronic diseases (e.g., heart disease and breast cancer), and injuries and violence (e.g., motor vehicle crashes, suicide, and homicide). † Since 2004, the U.S. Preventive Services Task Force (USPSTF) has recommended alcohol misuse screening and brief counseling (also known as alcohol screening and brief intervention or ASBI) for adults aged ≥18 years (3). § Among adults, ASBI reduces episodes of binge-level consumption, reduces weekly alcohol consumption, and increases compliance with recommended drinking limits in those who have an intervention in comparison to those who do not (3). A recent study suggested that health care providers rarely talk with patients about alcohol use (4). To estimate the prevalence of U.S. adults who reported receiving elements of ASBI, CDC analyzed 2014 Behavioral Risk Factor Surveillance System (BRFSS) data from 17 states ¶ and the District of Columbia (DC). Weighted crude and age-standardized overall and state-level prevalence estimates were calculated by selected drinking patterns and demographic characteristics. Overall, 77.7% of adults (age-standardized estimate) reported being asked about alcohol use by a health professional in person or on a form during a checkup, but only 32.9% reported being asked about binge-level alcohol consumption (3). Among binge drinkers, only 37.2% reported being asked about alcohol use and advised about the harms of drinking too much, and only 18.1% reported being asked about alcohol use and advised to reduce or quit drinking. Widespread implementation of ASBI and other evidence-based interventions could help reduce excessive alcohol use in adults and related harms.

Lung Nodule Detection via Deep Reinforcement Learning.

PubMed

Ali, Issa; Hart, Gregory R; Gunabushanam, Gowthaman; Liang, Ying; Muhammad, Wazir; Nartowt, Bradley; Kane, Michael; Ma, Xiaomei; Deng, Jun

2018-01-01

Lung cancer is the most common cause of cancer-related death globally. As a preventive measure, the United States Preventive Services Task Force (USPSTF) recommends annual screening of high risk individuals with low-dose computed tomography (CT). The resulting volume of CT scans from millions of people will pose a significant challenge for radiologists to interpret. To fill this gap, computer-aided detection (CAD) algorithms may prove to be the most promising solution. A crucial first step in the analysis of lung cancer screening results using CAD is the detection of pulmonary nodules, which may represent early-stage lung cancer. The objective of this work is to develop and validate a reinforcement learning model based on deep artificial neural networks for early detection of lung nodules in thoracic CT images. Inspired by the AlphaGo system, our deep learning algorithm takes a raw CT image as input and views it as a collection of states, and output a classification of whether a nodule is present or not. The dataset used to train our model is the LIDC/IDRI database hosted by the lung nodule analysis (LUNA) challenge. In total, there are 888 CT scans with annotations based on agreement from at least three out of four radiologists. As a result, there are 590 individuals having one or more nodules, and 298 having none. Our training results yielded an overall accuracy of 99.1% [sensitivity 99.2%, specificity 99.1%, positive predictive value (PPV) 99.1%, negative predictive value (NPV) 99.2%]. In our test, the results yielded an overall accuracy of 64.4% (sensitivity 58.9%, specificity 55.3%, PPV 54.2%, and NPV 60.0%). These early results show promise in solving the major issue of false positives in CT screening of lung nodules, and may help to save unnecessary follow-up tests and expenditures.

Lung Nodule Detection via Deep Reinforcement Learning

PubMed Central

Ali, Issa; Hart, Gregory R.; Gunabushanam, Gowthaman; Liang, Ying; Muhammad, Wazir; Nartowt, Bradley; Kane, Michael; Ma, Xiaomei; Deng, Jun

2018-01-01

Lung cancer is the most common cause of cancer-related death globally. As a preventive measure, the United States Preventive Services Task Force (USPSTF) recommends annual screening of high risk individuals with low-dose computed tomography (CT). The resulting volume of CT scans from millions of people will pose a significant challenge for radiologists to interpret. To fill this gap, computer-aided detection (CAD) algorithms may prove to be the most promising solution. A crucial first step in the analysis of lung cancer screening results using CAD is the detection of pulmonary nodules, which may represent early-stage lung cancer. The objective of this work is to develop and validate a reinforcement learning model based on deep artificial neural networks for early detection of lung nodules in thoracic CT images. Inspired by the AlphaGo system, our deep learning algorithm takes a raw CT image as input and views it as a collection of states, and output a classification of whether a nodule is present or not. The dataset used to train our model is the LIDC/IDRI database hosted by the lung nodule analysis (LUNA) challenge. In total, there are 888 CT scans with annotations based on agreement from at least three out of four radiologists. As a result, there are 590 individuals having one or more nodules, and 298 having none. Our training results yielded an overall accuracy of 99.1% [sensitivity 99.2%, specificity 99.1%, positive predictive value (PPV) 99.1%, negative predictive value (NPV) 99.2%]. In our test, the results yielded an overall accuracy of 64.4% (sensitivity 58.9%, specificity 55.3%, PPV 54.2%, and NPV 60.0%). These early results show promise in solving the major issue of false positives in CT screening of lung nodules, and may help to save unnecessary follow-up tests and expenditures. PMID:29713615

Grip force and force sharing in two different manipulation tasks with bottles.

PubMed

Cepriá-Bernal, Javier; Pérez-González, Antonio; Mora, Marta C; Sancho-Bru, Joaquín L

2017-07-01

Grip force and force sharing during two activities of daily living were analysed experimentally in 10 right-handed subjects. Four different bottles, filled to two different levels, were manipulated for two tasks: transporting and pouring. Each test subject's hand was instrumented with eight thin wearable force sensors. The grip force and force sharing were significantly different for each bottle model. Increasing the filling level resulted in an increase in grip force, but the ratio of grip force to load force was higher for lighter loads. The task influenced the force sharing but not the mean grip force. The contributions of the thumb and ring finger were higher in the pouring task, whereas the contributions of the palm and the index finger were higher in the transport task. Mean force sharing among fingers was 30% for index, 29% for middle, 22% for ring and 19% for little finger. Practitioner Summary: We analysed grip force and force sharing in two manipulation tasks with bottles: transporting and pouring. The objective was to understand the effects of the bottle features, filling level and task on the contribution of different areas of the hand to the grip force. Force sharing was different for each task and the bottles features affected to both grip force and force sharing.

PRN 94-9: Announcing the Formation of Two Industry-Wide Task Forces: Agricultural Reentry Task Force and Outdoor Residential Exposure Task Force

EPA Pesticide Factsheets

This Notice announces two industry-wide Task Forces being formed in response to generic exposure data requirements. It contains EPA's policy on a registrant's options for, and responsibilities when joining Task Force as a way to satisfy data requirements.

78 FR 60306 - Aquatic Nuisance Species Task Force Meeting

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...-FF09F14000-134] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior... the Aquatic Nuisance Species (ANS) Task Force. The ANS Task Force's purpose is to develop and... Task Force will meet from 8 a.m. to 4:30 p.m. on Wednesday, November 6, through Thursday, November 7...

77 FR 61019 - Aquatic Nuisance Species Task Force Meeting

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2012-10-05

..., Cost Center: FF09F14000, Fund: 134] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and... Aquatic Nuisance Species (ANS) Task Force. The ANS Task Force's purpose is to develop and implement a.... DATES: The ANS Task Force will meet from 8:30 a.m. to 5:00 p.m. Wednesday November 14, and from 8:30 a.m...

Task specific grip force control in writer's cramp.

PubMed

Schneider, A S; Fürholzer, W; Marquardt, C; Hermsdörfer, J

2014-04-01

Writer's cramp is defined as a task specific focal dystonia generating hypertonic muscle co-contractions during handwriting resulting in impaired writing performance and exaggerated finger force. However, little is known about the generalisation of grip force across tasks others than writing. The aim of the study was to directly compare regulation of grip forces during handwriting with force regulation in other fine-motor tasks in patients and control subjects. Handwriting, lifting and cyclic movements of a grasped object were investigated in 21 patients and 14 controls. The applied forces were registered in all three tasks and compared between groups and tasks. In addition, task-specific measures of fine-motor skill were assessed. As expected, patients generated exaggerated forces during handwriting compared to control subjects. However there were no statistically significant group differences during lifting and cyclic movements. The control group revealed a generalisation of grip forces across manual tasks whereas in patients there was no such correlation. We conclude that increased finger forces during handwriting are a task-specific phenomenon that does not necessarily generalise to other fine-motor tasks. Force control of patients with writer's cramp in handwriting and other fine-motor tasks is characterised by individualised control strategies. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

76 FR 22685 - Interagency Management Task Force Public Meeting

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2011-04-22

... Force Public Meeting AGENCY: Office of Energy Efficiency and Renewable Energy, Department of Energy (DOE... meetings of the Interagency Energy Management Task Force (Task Force) in 2011. FEMP intends to hold recurring public meetings of the Task Force. Interested parties can check http://www.femp.energy.gov/news...

75 FR 20578 - Federal Advisory Committee; Defense Health Board (DHB); Department of Defense Task Force on the...

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... (DHB); Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Forces... announces a meeting of the Department of Defense Task Force on the Prevention of Suicide by Members of the... Secretary, Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Forces, One...

75 FR 21603 - Renewal of Department of Defense Federal Advisory Committee; Missouri River (North Dakota) Task...

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...-6128. SUPPLEMENTARY INFORMATION: The Task Force is a non-discretionary Federal advisory committee and... Committee; Missouri River (North Dakota) Task Force AGENCY: Department of Defense (DoD). ACTION: Renewal of... Missouri River (North Dakota) Task Force (hereafter referred to as the Task Force). FOR FURTHER INFORMATION...

Force fluctuations while pressing and moving against high- and low-friction touch screen surfaces.

PubMed

Joshi, Mukta N; Keenan, Kevin G

2016-07-01

The purpose of this study was to identify the influence of a high- and low-friction surface on the ability to maintain a steady downward force during an index finger pressing and moving task. Fifteen right-handed subjects (24-48 years) performed a static force pressing task and a hybrid pressing and moving task on the surface of an iPad mini while holding a steady 2-N force on high- and low-friction surfaces. Variability of force was quantified as the standard deviation (SD) of normal force (F z) and shear force (F xy) across friction conditions and tasks. The SD of F z was 227 % greater during the hybrid task as compared to the static task (p < .001) and was 19 % greater for the high- versus low-friction condition (p = .033). There were positive correlations between SD of F z and F xy during the hybrid force/motion tasks on the high- and low-friction conditions (r (2) = 0.5 and 0.86, respectively), suggesting significant associations between normal and shear forces for this hybrid task. The correlation between the SD of F z for static and hybrid tasks was r (2) = 0.44, indicating that the common practice of examining the control of static tasks may not sufficiently explain performance during hybrid tasks, at least for the young subjects tested in the current study. As activities of daily living frequently require hybrid force/motion tasks (e.g., writing, doing the dishes, and cleaning counters), the results of this study emphasize the need to study motor performance during hybrid tasks in addition to static force tasks.

U.S. Northern Command > Newsroom > Fact Sheets

Science.gov Websites

Operations Command, North U.S. Marine Forces Northern Command U.S. Fleet Forces Command Air Forces Northern U.S. Army North Joint Task Force North Joint Task Force Civil Support Joint Task Force Alaska Joint

Proximal arm kinematics affect grip force-load force coordination

PubMed Central

Vermillion, Billy C.; Lum, Peter S.

2015-01-01

During object manipulation, grip force is coordinated with load force, which is primarily determined by object kinematics. Proximal arm kinematics may affect grip force control, as proximal segment motion could affect control of distal hand muscles via biomechanical and/or neural pathways. The aim of this study was to investigate the impact of proximal kinematics on grip force modulation during object manipulation. Fifteen subjects performed three vertical lifting tasks that involved distinct proximal kinematics (elbow/shoulder), but resulted in similar end-point (hand) trajectories. While temporal coordination of grip and load forces remained similar across the tasks, proximal kinematics significantly affected the grip force-to-load force ratio (P = 0.042), intrinsic finger muscle activation (P = 0.045), and flexor-extensor ratio (P < 0.001). Biomechanical coupling between extrinsic hand muscles and the elbow joint cannot fully explain the observed changes, as task-related changes in intrinsic hand muscle activation were greater than in extrinsic hand muscles. Rather, between-task variation in grip force (highest during task 3) appears to contrast to that in shoulder joint velocity/acceleration (lowest during task 3). These results suggest that complex neural coupling between the distal and proximal upper extremity musculature may affect grip force control during movements, also indicated by task-related changes in intermuscular coherence of muscle pairs, including intrinsic finger muscles. Furthermore, examination of the fingertip force showed that the human motor system may attempt to reduce variability in task-relevant motor output (grip force-to-load force ratio), while allowing larger fluctuations in output less relevant to task goal (shear force-to-grip force ratio). PMID:26289460

78 FR 23970 - Interagency Task Force on Veterans Small Business Development

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... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting. SUMMARY: This document corrects the SBA's Interagency Task Force on Veterans Small Business Developments...

32 CFR 700.1053 - Commander of a task force.

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2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Commander of a task force. 700.1053 Section 700... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any other naval commander, may detail in command of a task force, or other task command, any eligible...

75 FR 76422 - Meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

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... DEPARTMENT OF DEFENSE Office of the Secretary Meeting of the Department of Defense Task Force on... Forces (Subsequently Referred to as the Task Force) AGENCY: Department of Defense. ACTION: Notice... forthcoming meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

75 FR 62611 - Interagency Task Force on Veterans Small Business Development

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... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

75 FR 76744 - National Disaster Housing Task Force

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...] National Disaster Housing Task Force AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of Meeting. SUMMARY: The National Disaster Housing Task Force (NDHTF) will meet by teleconference on December...: Mitchell Wyllins, National Disaster Housing Task Force, 500 C Street, SW., (Room 428), Washington, DC 20472...

77 FR 41472 - Interagency Task Force on Veterans Small Business Development

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... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

76 FR 8393 - Interagency Task Force on Veterans Small Business Development

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2011-02-14

... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

75 FR 62438 - Interagency Task Force on Veterans Small Business Development Meeting

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2010-10-08

... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development Meeting AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force... first public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting...

Face and Construct Validity of a Novel Virtual Reality-Based Bimanual Laparoscopic Force-Skills Trainer With Haptics Feedback.

PubMed

Prasad, Raghu; Muniyandi, Manivannan; Manoharan, Govindan; Chandramohan, Servarayan M

2018-05-01

The purpose of this study was to examine the face and construct validity of a custom-developed bimanual laparoscopic force-skills trainer with haptics feedback. The study also examined the effect of handedness on fundamental and complex tasks. Residents (n = 25) and surgeons (n = 25) performed virtual reality-based bimanual fundamental and complex tasks. Tool-tissue reaction forces were summed, recorded, and analysed. Seven different force-based measures and a 1-time measure were used as metrics. Subsequently, participants filled out face validity and demographic questionnaires. Residents and surgeons were positive on the design, workspace, and usefulness of the simulator. Construct validity results showed significant differences between residents and experts during the execution of fundamental and complex tasks. In both tasks, residents applied large forces with higher coefficient of variation and force jerks (P < .001). Experts, with their dominant hand, applied lower forces in complex tasks and higher forces in fundamental tasks (P < .001). The coefficients of force variation (CoV) of residents and experts were higher in complex tasks (P < .001). Strong correlations were observed between CoV and task time for fundamental (r = 0.70) and complex tasks (r = 0.85). Range of smoothness of force was higher for the non-dominant hand in both fundamental and complex tasks. The simulator was able to differentiate the force-skills of residents and surgeons, and objectively evaluate the effects of handedness on laparoscopic force-skills. Competency-based laparoscopic skills assessment curriculum should be updated to meet the requirements of bimanual force-based training.

Childhood Obesity Task Forces Established by State Legislatures, 2001-2010

PubMed Central

Kim, Sonia A.; Sherry, Bettylou; Blanck, Heidi M.

2013-01-01

Introduction States and communities are considering policy and environmental strategies, including enacting legislation, to reduce and prevent childhood obesity. One legislative approach has been to create task forces to understand key issues and develop a course of action. The goal of this study was to describe state-level, childhood obesity task forces in the United States created by legislation from 2001 through 2010. Methods We used the Center for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity database to identify state-level childhood obesity task forces created through legislation from 2001 through 2010. Results We identified 21 states that had enacted legislation creating childhood obesity task forces of which 6 had created more than one task force. Most task forces were charged with both gathering and reviewing information and making recommendations for obesity-prevention actions in the state. Most legislation required that task forces include representation from the state legislature, state agencies, community organizations, and community members. Conclusion Evaluation of the effectiveness of obesity-prevention task forces and the primary components that contribute to their success may help to determine the advantages of the use of such strategies in obesity prevention. PMID:23987250

2015 International PV Quality Assurance Task Force (PVQAT) Workshop |

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Photovoltaic Research | NREL International PV Quality Assurance Task Force (PVQAT) Workshop 2015 International PV Quality Assurance Task Force (PVQAT) Workshop Wednesday, February 25, 2015 Chairs : Tony Sample and Masaaki Yamamichi The 2015 International PV Quality Assurance Task Force (PVQAT

78 FR 27969 - Meeting of the Community Preventive Services Task Force (Task Force)

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2013-05-13

... discussed: Matters to be discussed: cancer prevention and control, cardiovascular disease prevention and... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention...

77 FR 56845 - Meeting of the Community Preventive Services Task Force (Task Force)

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...: Matters to be discussed: Tobacco, oral health and cardiovascular disease. Meeting Accessibility: This... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention...

78 FR 59939 - Meeting of the Community Preventive Services Task Force (Task Force)

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.... Matters to be discussed: Cancer prevention and control, cardiovascular disease prevention and control... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention...

78 FR 7849 - Interagency Task Force on Veterans Small Business Development

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... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

76 FR 54258 - Request for Comments-Fiscal Oversight Task Force Report and Recommendations

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... LEGAL SERVICES CORPORATION Request for Comments--Fiscal Oversight Task Force Report and... Fiscal Oversight Task Force, which reviewed and made recommendations regarding how LSC conducts fiscal... territories. By Resolution adopted on July 21, 2010, the Board established the Fiscal Oversight Task Force...

78 FR 70087 - Interagency Task Force on Veterans Small Business Development

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... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

78 FR 45996 - Interagency Task Force on Veterans Small Business Development

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... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

78 FR 21492 - Interagency Task Force on Veterans Small Business Development

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... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

77 FR 41165 - Notice of Meeting of the Agricultural Air Quality Task Force

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... Agricultural Air Quality Task Force AGENCY: Natural Resources Conservation Service, USDA. ACTION: Notice of meeting. SUMMARY: The Department of Agriculture (USDA), Agricultural Air Quality Task Force (AAQTF) will.../Concerns Discussion Continued discussion of goals for Task Force Anaerobic Digester Technologies Odor...

Update in women's health.

PubMed

Ganschow, Pamela S; Jacobs, Elizabeth A; Mackinnon, Jennifer; Charney, Pamela

2009-06-01

The aim of this clinical update is to summarize articles and guidelines published in the last year with the potential to change current clinical practice as it relates to women's health. We used two independent search strategies to identify articles relevant to women's health published between March 1, 2007 and February 29, 2008. First, we reviewed the Cochrane Database of Systematic Reviews and journal indices from the ACP Journal Club, Annals of Internal Medicine, Archives of Internal Medicine, British Medical Journal, Circulation, Diabetes, JAMA, JGIM, Journal of Women's Health, Lancet, NEJM, Obstetrics and Gynecology, and Women's Health Journal Watch. Second, we performed a MEDLINE search using the medical subject heading term "sex factors." The authors, who all have clinical and/or research experience in the area of women's health, reviewed all article titles, abstracts, and, when indicated, full publications. We excluded articles related to obstetrical aspects of women's health focusing on those relevant to general internists. We had two acceptance criteria, scientific rigor and potential to impact women's health. We also identified new and/or updated women's health guidelines released during the same time period. We identified over 250 publications with potential relevance to women's health. Forty-six articles were selected for presentation as part of the Clinical Update, and nine were selected for a more detailed discussion in this paper. Evidence-based women's health guidelines are listed in Table 1. Table 1 Important Women's Health Guidelines in 2007-2008: New or Updated Topic Issuing organization Updated recommendations and comments Mammography screening in women 40-4917 ACP Individualized risk assessment and informed decision making should be used to guide decisions about mammography screening in this age group. To aid in the risk assessment, a discussion of the risk factors, which if present in a woman in her 40s increases her risk to above that of an average 50-year-old woman, is provided in the guidelines. In addition, available risk prediction models, such as the NIH Web site calculator (http://www.cancer.gov/bcrisktool/) can also be used to estimate quantitative breast cancer risk. This model was updated in 2008 with race-specific data for calculating risk in African-American women.18 The harms and benefits of mammography should be discussed and incorporated along with a woman's preferences and breast cancer risk profile into the decision on when to begin screening. If a woman decides to forgo mammography, the decision should be readdressed every 1 to 2 years. STD screening guidelines19 USPSTF and CDC Routine screening for this infection is now recommended for ALL sexually active women age 24 and under, based on the recent high prevalence estimates for chlamydia It is not recommended for women (pregnant or nonpregnant) age 25 and older, unless they are at increased risk for infection. STD treatment guidelines20 CDC Flouroquinolones are NO longer recommended for treatment of N. gonorrhea, due to increasing resistance (as high as 15% of isolates in 2006). For uncomplicated infections, treatment of gonorrhea should be initiated with ceftriaxone 125 mg IM or cefixime 400 mg PO and co-treatment for chlamydia infection (unless ruled out with testing). Recent estimates demonstrate that almost 50% of persons with gonorrhea have concomitant chlamydia infection21. STD = sexually transmitted disease, NIH = National Institutes of Health, ACP = American College of Physicians, USPSTF = United States Prevention Services Task Force, CDC = Centers for Disease Control.

Community hoarding task forces: a comparative case study of five task forces in the United States.

PubMed

Bratiotis, Christiana

2013-05-01

During the past decade, many community task forces have formed to address hoarding problems that come to public attention. Such task forces provide a societal-level intervention to assist people with the most severe cases of hoarding, who do not voluntarily seek or want help for their hoarding behaviour. This qualitative study of five U.S. hoarding task forces included sites selected for their diversity of purpose, approaches to hoarding intervention and community geography, composition and resources. Data were collected during the period of September 2007-March 2008. The case study methodology used multiple forms of data, including semi-structured interviews, analysis of documents, small group interviews and investigator observation. This study captured the perspectives of public and private sector service providers such as mental health, housing, social service, public health agencies and community enforcement organisations (fire, police, legal, animal control) to examine how task forces organise and operate and the emerging practice and policy changes. Study findings suggest that structural factors (e.g. leadership, purpose, funding and membership) impact hoarding task force viability, that participation on a task force influences practice and policy decisions about hoarding, and that social work can expand its role in task force leadership. Task forces may be a mechanism for improving community policies about hoarding and mechanisms for addressing other social problems across multiple sectors. © 2012 Blackwell Publishing Ltd.

75 FR 32186 - Task Force on Community Preventive Services

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... by space available. Purpose: The mission of the Task Force is to develop and publish the Guide to... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Task Force on Community Preventive Services Name: Task Force on Community Preventive Services meeting. Times and Dates: 8...

78 FR 2996 - Meeting of the Community Preventive Services Task Force (Task Force)

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... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the Community Preventive Services Task Force (Task Force) AGENCY: Centers for Disease Control and Prevention... for Disease Control and Prevention (CDC) announces the next meeting of the Community Preventive...

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75 FR 70764 - Small Business Information Security Task Force

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7 CFR 1900.6 - Chair, Loan Resolution Task Force.

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... 7 Agriculture 12 2010-01-01 2010-01-01 false Chair, Loan Resolution Task Force. 1900.6 Section... AGRICULTURE PROGRAM REGULATIONS GENERAL Delegations of Authority § 1900.6 Chair, Loan Resolution Task Force. The Chair, Loan Resolution Task Force is delegated the following authorities, to be exercised until...

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Gulf Coast Ecosystem Restoration Task Force Meeting and Public Listening

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Data Media & News Publications Press Releases Story Archive Home Gulf Coast Ecosystem Restoration Task Force Meeting and Public Listening Session Gulf Coast Ecosystem Restoration Task Force Meeting and Title: Gulf Coast Ecosystem Restoration Task Force Meeting and Public Listening SessionDescription: The

Task Force II: Energy and Its Socioeconomic Impacts

ERIC Educational Resources Information Center

Appalachia, 1977

1977-01-01

Summarizing the Task Force Issues Paper presented at the Appalachian Conference on Balanced Growth and Economic Development (1977), this article presents selected comments by Task Force participants, and Task Force recommendations re: a national severence tax on extraction of nonrenewable energy resources; socioeconomic costs of nuclear energy; a…

Patient-provider discussions about lung cancer screening pre- and post-guidelines: Health Information National Trends Survey (HINTS).

PubMed

Carter-Harris, Lisa; Tan, Andy S L; Salloum, Ramzi G; Young-Wolff, Kelly C

2016-11-01

In 2013, the USPSTF issued a Grade B recommendation that long-term current and former smokers receive lung cancer screening. Shared decision-making is important for individuals considering screening, and patient-provider discussions an essential component of the process. We examined prevalence and predictors of lung cancer screening discussions pre- and post-USPSTF guidelines. Data were obtained from two cycles of the Health Information National Trends Survey (2012; 2014). The analyzed sample comprised screening-eligible current and former smokers with no personal history of lung cancer (n=746 in 2012; n=795 in 2014). Descriptive and multiple logistic regression analyses were conducted; patient-reported discussion about lung cancer screening with provider was the outcome of interest. Contrary to expectations, patient-provider discussions about lung cancer screening were more prevalent pre-guideline, but overall patient-provider discussions were low in both years (17% in 2012; 10% in 2014). Current smokers were more likely to have had a discussion than former smokers. Significant predictors of patient-provider discussions included family history of cancer and having healthcare coverage. The prevalence of patient-provider discussions about lung cancer screening is suboptimal. There is a critical need for patient and provider education about shared decision-making and its importance in cancer screening decisions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Unintentional force changes in cyclical tasks performed by an abundant system: Empirical observations and a dynamical model.

PubMed

Reschechtko, Sasha; Hasanbarani, Fariba; Akulin, Vladimir M; Latash, Mark L

2017-05-14

The study explored unintentional force changes elicited by removing visual feedback during cyclical, two-finger isometric force production tasks. Subjects performed two types of tasks at 1Hz, paced by an auditory metronome. One - Force task - required cyclical changes in total force while maintaining the sharing, defined as relative contribution of a finger to total force. The other task - Share task - required cyclical changes in sharing while keeping total force unchanged. Each trial started under full visual feedback on both force and sharing; subsequently, feedback on the variable that was instructed to stay constant was frozen, and finally feedback on the other variable was also removed. In both tasks, turning off visual feedback on total force elicited a drop in the mid-point of the force cycle and an increase in the peak-to-peak force amplitude. Turning off visual feedback on sharing led to a drift of mean share toward 50:50 across both tasks. Without visual feedback there was consistent deviation of the two force time series from the in-phase pattern (typical of the Force task) and from the out-of-phase pattern (typical of the Share task). This finding is in contrast to most earlier studies that demonstrated only two stable patterns, in-phase and out-of-phase. We interpret the results as consequences of drifts of parameters in a dynamical system leading in particular to drifts in the referent finger coordinates toward their actual coordinates. The relative phase desynchronization is caused by the right-left differences in the hypothesized drift processes, consistent with the dynamic dominance hypothesis. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Unintentional force changes in cyclical tasks performed by an abundant system: Empirical observations and a dynamical model

PubMed Central

Reschechtko, Sasha; Hasanbarani, Fariba; Akulin, Vladimir M.; Latash, Mark L.

2017-01-01

The study explored unintentional force changes elicited by removing visual feedback during cyclical, two-finger isometric force production tasks. Subjects performed two types of tasks at 1 Hz, paced by an auditory metronome. One – Force task – required cyclical changes in total force while maintaining the sharing, defined as relative contribution of a finger to total force. The other task – Share task – required cyclical changes in sharing while keeping total force unchanged. Each trial started under full visual feedback on both force and sharing; subsequently, feedback on the variable that was instructed to stay constant was frozen, and finally feedback on the other variable was also removed. In both tasks, turning off visual feedback on total force elicited a drop in the mid-point of the force cycle and an increase in the peak-to-peak force amplitude. Turning off visual feedback on sharing led to a drift of mean share toward 50:50 across both tasks. Without visual feedback there was consistent deviation of the two force time series from the in-phase pattern (typical of the Force task) and from the out-of-phase pattern (typical of the Share task). This finding is in contrast to most earlier studies that demonstrated only two stable patterns, in-phase and out-of-phase. We interpret the results as consequences of drifts of parameters in a dynamical system leading in particular to drifts in the referent finger coordinates toward their actual coordinates. The relative phase desynchronization is caused by the right-left differences in the hypothesized drift processes, consistent with the dynamic dominance hypothesis. PMID:28344070

77 FR 4584 - Sunshine Act Meetings; National Science Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-30

... of a National Academy of Sciences/National Research Council study CPP Task Force on Unsolicited Mid... and December 13 meeting minutes Discussion of the MS Task Force draft report CSB Task Force on Data... Task Force Closing Remarks From the Chairman Committee on Audit and Oversight (A&O) Open Session: 4-4...

Academic Standards Task Force Report.

ERIC Educational Resources Information Center

Burnham, Peter F.

The product of a year-long research process undertaken by a Task Force on Academic Standards at Tompkins Cortland Community College (TCCC) in 1980-81, this report provides background to the deliberations of the Task Force and a presentation of their position on academic standards at TCCC. The report establishes the Task Force's commitments to…

75 FR 61175 - Aquatic Nuisance Species Task Force Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species (ANS) Task Force. The.... DATES: The ANS Task Force will meet from 8 a.m. to 5 p.m. on Wednesday, November 3 through Thursday...

18 CFR 701.58 - Task forces.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Task forces. 701.58... Headquarters Organization § 701.58 Task forces. The Director with Council concurrence or the Council may establish task forces from time to time to aid in the preparation of issues for presentation to the Council...

3 CFR - White House Task Force on Middle-Class Working Families

Code of Federal Regulations, 2010 CFR

2010-01-01

... 3 The President 1 2010-01-01 2010-01-01 false White House Task Force on Middle-Class Working... Task Force on Middle-Class Working Families Memorandum for the Heads of Executive Departments and... times. To these ends, I hereby direct the following: Section 1. White House Task Force on Middle-Class...

77 FR 441 - Measurement and Control of Combustible Gas Generation and Dispersal

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

... Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report... Fukushima Task Force Report: ``[t]he task force recommends, as part of the longer term review, that the NRC... additional information is revealed through further study of the Fukushima Dai-ichi accident.'' The Commission...

76 FR 58165 - Petitions for Rulemaking Submitted by the Natural Resources Defense Council, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

...-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report... the Fukushima Task Force Report for the purpose of providing the Commission with fully-informed... recommendations from the Fukushima Task Force Report, and is not providing a separate opportunity for public...

76 FR 76189 - Notice of Public Hearing-Fiscal Oversight Task Force Report & Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... period; and (3) reactions to those comments submitted by Task Force members. DATES: Monday, December 12... Report, the public comments previously submitted, and reactions to those comments from several Task Force members. The public comments and a summary of Task Force members' reactions may be viewed online at http...

Solar Energy Task Force Report: Technical Training Guidelines.

ERIC Educational Resources Information Center

O'Connor, Kevin

This task force report offers guidelines and information for the development of vocational education programs oriented to the commercial application of solar energy in water and space heating. After Section I introduces the Solar Energy Task Force and its activities, Section II outlines the task force's objectives and raises several issues and…

The effect of bracing availability on one-hand isometric force exertion capability.

PubMed

Jones, Monica L H; Reed, Matthew P; Chaffin, Don B

2013-01-01

Environmental obstructions that workers encounter can kinematically limit the postures that they can achieve. However, such obstructions can also provide an opportunity for additional support by bracing with the hand, thigh or other body part. The reaction forces on bracing surfaces, which are in addition to those acting at the feet and task hand, are hypothesised to improve force exertion capability, and become required inputs to biomechanical analysis of tasks with bracing. The effects of kinematic constraints and associated bracing opportunities on isometric hand force were quantified in a laboratory study of 22 men and women. Analyses of one-hand maximal push, pull and lift tasks demonstrated that bracing surfaces available at the thighs and non-task hand enabled participants to exert an average of 43% more force at the task hand. Task hand force direction deviated significantly from the nominal direction for exertions performed with bracing at both medium and low task hand locations. This study quantifies the effect of bracing on kinematically constrained force exertions. Knowledge that appropriate bracing surfaces can substantially increase hand force is critical to the evaluation of task-oriented strength capability. Force estimates may also involve large off-axis components, which have clear implications for ergonomic analyses of manual tasks.

Performance drifts in two-finger cyclical force production tasks performed by one and two actors.

PubMed

Hasanbarani, Fariba; Reschechtko, Sasha; Latash, Mark L

2018-03-01

We explored changes in the cyclical two-finger force performance task caused by turning visual feedback off performed either by the index and middle fingers of the dominant hand or by two index fingers of two persons. Based on an earlier study, we expected drifts in finger force amplitude and midpoint without a drift in relative phase. The subjects performed two rhythmical tasks at 1 Hz while paced by an auditory metronome. One of the tasks required cyclical changes in total force magnitude without changes in the sharing of the force between the two fingers. The other task required cyclical changes in the force sharing without changing total force magnitude. Subjects were provided with visual feedback, which showed total force magnitude and force sharing via cursor motion along the vertical and horizontal axes, respectively. Further, visual feedback was turned off, first on the variable that was not required to change and then on both variables. Turning visual feedback off led to a mean force drift toward lower magnitudes while force amplitude increased. There was a consistent drift in the relative phase in the one-hand task with the index finger leading the middle finger. No consistent relative phase drift was seen in the two-person tasks. The shape of the force cycle changed without visual feedback reflected in the lower similarity to a perfect cosine shape and in the higher time spent at lower force magnitudes. The data confirm findings of earlier studies regarding force amplitude and midpoint changes, but falsify predictions of an earlier proposed model with respect to the relative phase changes. We discuss factors that could contribute to the observed relative phase drift in the one-hand tasks including the leader-follower pattern generalized for two-effector tasks performed by one person.

76 FR 52318 - U.S. Coral Reef Task Force Public Meeting and Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration U.S. Coral Reef Task Force... of the U.S. Coral Reef Task Force. The meeting will be held in Ft. Lauderdale, Florida. This meeting, the 26th bi-annual meeting of the U.S. Coral Reef Task Force, provides a forum for coordinated...

76 FR 7579 - U.S. Coral Reef Task Force Public Meeting and Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-10

.... Coral Reef Task Force Public Meeting and Public Comment AGENCY: Fish and Wildlife Service, Interior... Service (Service), announce a public business meeting of the U.S. Coral Reef Task Force (USCRTF) [email protected] ); or Liza Johnson, U.S. Coral Reef Task Force Department of the Interior Liaison, U.S...

76 FR 15334 - Aquatic Nuisance Species Task Force Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-21

...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species (ANS) Task Force. The.... DATES: The ANS Task Force will meet from 8 a.m. to 5 p.m. on Wednesday, May 4; and Thursday May 5; and...

Force Control Characteristics for Generation and Relaxation in the Lower Limb.

PubMed

Ohtaka, Chiaki; Fujiwara, Motoko

2018-05-29

We investigated the characteristics for force generation and relaxation using graded isometric contractions of the knee extensors. Participants performed the following tasks as quickly and accurately as possible. For the force generation task, force was increased from 0% to 20%, 40% and 60% of the maximal voluntary force (MVF). For the force relaxation task, force was decreased from 60% to 40%, 20% and 0%. The following parameters of the recorded force were calculated: error, time, and rate of force development. The error was consistently greater for force relaxation than generation. Reaction and adjustment times were independent of the tasks. The control strategy was markedly different for force relaxation and generation, this tendency was particularly evident for the lower limb compared to the upper limb.

Consolidated fuel reprossing program: The implications of force reflection for teleoperation in space

NASA Technical Reports Server (NTRS)

Draper, John V.; Herndon, Joseph N.; Moore, Wendy E.

1987-01-01

Previous research on teleoperator force feedback is reviewed and results of a testing program which assessed the impact of force reflection on teleoperator task performance are reported. Force relection is a type of force feedback in which the forces acting on the remote portion of the teleoperator are displayed to the operator by back-driving the master controller. The testing program compared three force reflection levels: 4 to 1 (four units of force on the slave produce one unit of force at the master controller), 1 to 1, and infinity to 1 (no force reflection). Time required to complete tasks, rate of occurrence of errors, the maximum force applied to tasks components, and variability in forces applied to components during completion of representative remote handling tasks were used as dependent variables. Operators exhibited lower error rates, lower peak forces, and more consistent application of forces using force relection than they did without it. These data support the hypothesis that force reflection provides useful information for teleoperator users. The earlier literature and the results of the experiment are discussed in terms of their implications for space based teleoperator systems. The discussion described the impact of force reflection on task completion performance and task strategies, as suggested by the literature. It is important to understand the trade-offs involved in using telerobotic systems with and without force reflection.

Dynamical signatures of isometric force control as a function of age, expertise, and task constraints.

PubMed

Vieluf, Solveig; Sleimen-Malkoun, Rita; Voelcker-Rehage, Claudia; Jirsa, Viktor; Reuter, Eva-Maria; Godde, Ben; Temprado, Jean-Jacques; Huys, Raoul

2017-07-01

From the conceptual and methodological framework of the dynamical systems approach, force control results from complex interactions of various subsystems yielding observable behavioral fluctuations, which comprise both deterministic (predictable) and stochastic (noise-like) dynamical components. Here, we investigated these components contributing to the observed variability in force control in groups of participants differing in age and expertise level. To this aim, young (18-25 yr) as well as late middle-aged (55-65 yr) novices and experts (precision mechanics) performed a force maintenance and a force modulation task. Results showed that whereas the amplitude of force variability did not differ across groups in the maintenance tasks, in the modulation task it was higher for late middle-aged novices than for experts and higher for both these groups than for young participants. Within both tasks and for all groups, stochastic fluctuations were lowest where the deterministic influence was smallest. However, although all groups showed similar dynamics underlying force control in the maintenance task, a group effect was found for deterministic and stochastic fluctuations in the modulation task. The latter findings imply that both components were involved in the observed group differences in the variability of force fluctuations in the modulation task. These findings suggest that between groups the general characteristics of the dynamics do not differ in either task and that force control is more affected by age than by expertise. However, expertise seems to counteract some of the age effects. NEW & NOTEWORTHY Stochastic and deterministic dynamical components contribute to force production. Dynamical signatures differ between force maintenance and cyclic force modulation tasks but hardly between age and expertise groups. Differences in both stochastic and deterministic components are associated with group differences in behavioral variability, and observed behavioral variability is more strongly task dependent than person dependent. Copyright © 2017 the American Physiological Society.

Crafting a Balanced System of Assessment in Wisconsin. Recommendations of the Next Generation Assessment Task Force

ERIC Educational Resources Information Center

Wisconsin Department of Public Instruction, 2009

2009-01-01

The Next Generation Assessment Task Force was convened to formulate Wisconsin's path forward. Task force members listened to leaders from business and technology sectors as well as leaders from PK-12 and higher education. This summary shares the process, definitions, assumptions, and recommendations of the task force. This paper aims to use these…

75 FR 47624 - U.S. Coral Reef Task Force Public Meeting and Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service U.S. Coral Reef Task Force Public Meeting and... (Service), announce a public meeting of the U.S. Coral Reef Task Force (USCRTF) and a request for written.... Coral Reef Task Force Department of the Interior Liaison, U.S. Department of the Interior, MS-3530-MIB...

75 FR 15457 - Aquatic Nuisance Species Task Force Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

...] Aquatic Nuisance Species Task Force Meeting AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: This notice announces a meeting of the Aquatic Nuisance Species (ANS) Task Force. The.... DATES: The ANS Task Force will meet from 8 a.m. to 5 p.m. on Wednesday, May 5, and from 8 a.m. to 5 p.m...

77 FR 23667 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-20

... CONTACT: Mail Delivery service through Recovering Warrior Task Force, Hoffman Building II, 200 Stovall St... Review of Non- Medical Case Management. 9:30-9:45 a.m. Break. 9:45-10:45 a.m. Task Force Recommendation... Task Force through the contact information in FOR FURTHER INFORMATION CONTACT, and this individual will...

Forest biomass as an energy source

Treesearch

P.E. Laks; R.W. Hemingway; A. Conner

1979-01-01

The Task Force on Forest Biomass as an Energy Source was chartered by the Society of American Foresters on September 26, 1977, and took its present form following an amendment to the charter on October 5, 1977. It built upon the findings of two previous task forces, the Task Force on Energy and Forest Resources and the Task Force for Evaluation of the CORRIM Report (...

Past, Current, and Future Incidence Rates and Burden of Metastatic Prostate Cancer in the United States.

PubMed

Kelly, Scott P; Anderson, William F; Rosenberg, Philip S; Cook, Michael B

2017-11-18

Metastatic prostate cancer (PCA) remains a highly lethal malignancy in the USA. As prostate-specific antigen testing declines nationally, detailed assessment of current age- and race-specific incidence trends and quantitative forecasts are needed. To evaluate the current trends of metastatic PCA by age and race, and forecast the number of new cases (annual burden) and future trends. We derived incidence data for men aged ≥45 yr who were diagnosed with metastatic PCA from the population-based Surveillance, Epidemiology, and End Results registries. We examined the current trends of metastatic PCA from 2004 to 2014, and forecast the annual burden and incidence rates by age and race for 2015-2025, using age-period-cohort models and population projections. We also examined alternative forecasts (2012-2025) using trends prior to the revised screening guidelines issued in 2012. Metastatic PCA, steadily declining from 2004 to 2007 by 1.45%/yr, began to increase by 0.58%/yr after 2008, which accelerated to 2.74%/yr following the 2012 United States Preventive Services Task Force recommendations-a pattern that was magnified among men aged ≤69 yr and white men. Forecasts project the incidence to increase by 1.03%/yr through 2025, with men aged 45-54 yr (2.29%/yr) and 55-69 yr (1.53%/yr) increasing more rapidly. Meanwhile, the annual burden is expected to increase 42% by 2025. Our forecasts estimated an additional 15 891 metastatic cases from 2015 to 2025 compared with alternative forecasts using trends prior to 2012. The recent uptick in metastatic PCA rates has resulted in forecasts that project increasing rates through 2025, particularly among men aged ≤69 yr. Moreover, racial disparities are expected to persist and the annual burden will increase considerably. The impact of the prior and current PCA screening recommendations on metastatic PCA rates requires continued examination. In this report, we assessed how the incidence of metastatic prostate cancer has changed over recent years, and forecast future incidence trends and the number of new cases expected each year. We found that the incidence of metastatic prostate cancer has been increasing more rapidly since 2012, resulting in a rise in both future incidence and the number of new cases by 2025. Future incidence rates and the number of new cases were reduced in alternative forecasts using data prior to the 2012 United States Preventive Services Task Force (USPSTF) recommendations against prostate-specific antigen (PSA) testing for prostate cancer. There is a need for additional research that examines whether national declines in PSA testing contributed to increases in rates of metastatic disease. The incidence of metastatic disease in black men is still expected to occur at considerably higher rates compared with that in white men. Published by Elsevier B.V.

Control of force during rapid visuomotor force-matching tasks can be described by discrete time PID control algorithms.

PubMed

Dideriksen, Jakob Lund; Feeney, Daniel F; Almuklass, Awad M; Enoka, Roger M

2017-08-01

Force trajectories during isometric force-matching tasks involving isometric contractions vary substantially across individuals. In this study, we investigated if this variability can be explained by discrete time proportional, integral, derivative (PID) control algorithms with varying model parameters. To this end, we analyzed the pinch force trajectories of 24 subjects performing two rapid force-matching tasks with visual feedback. Both tasks involved isometric contractions to a target force of 10% maximal voluntary contraction. One task involved a single action (pinch) and the other required a double action (concurrent pinch and wrist extension). 50,000 force trajectories were simulated with a computational neuromuscular model whose input was determined by a PID controller with different PID gains and frequencies at which the controller adjusted muscle commands. The goal was to find the best match between each experimental force trajectory and all simulated trajectories. It was possible to identify one realization of the PID controller that matched the experimental force produced during each task for most subjects (average index of similarity: 0.87 ± 0.12; 1 = perfect similarity). The similarities for both tasks were significantly greater than that would be expected by chance (single action: p = 0.01; double action: p = 0.04). Furthermore, the identified control frequencies in the simulated PID controller with the greatest similarities decreased as task difficulty increased (single action: 4.0 ± 1.8 Hz; double action: 3.1 ± 1.3 Hz). Overall, the results indicate that discrete time PID controllers are realistic models for the neural control of force in rapid force-matching tasks involving isometric contractions.

Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease.

PubMed

Huang, Cheng-Ya; Chen, Yu-An; Hwang, Ing-Shiou; Wu, Ruey-Meei

2018-03-31

To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). University research laboratory. Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. Not applicable. Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Interagency Task Forces: The Right Tools for the Job

DTIC Science & Technology

2011-01-01

shortcomings. This analysis discusses four organizational reform models and recommends the interagency task force ( IATF ) as the preferred structure...model.64 Still others recommend creating and deploying ad hoc IATFs for crisis operations. These interagency task forces would be task- organized to...forces assigned for planning, exercises, and mission execution.65 A 2005 article in Policy Review recommended developing IATFs as needed for specific

Vocational Evaluation and Work Adjustment Bulletin; Vol. 8, Special Edition: Vocational Evaluation Project Final Report Part 2.

ERIC Educational Resources Information Center

Vocational Evaluation and Work Adjustment Association, Washington, DC.

Part 2 of the three-part Vocational Evaluation Project final report contains brief summaries of the seven task force report which comprise the final report and two such task force reports. The report of task force 5, Standards for Vocational Evaluation, describes the task force's effort to study the standards for accreditation presently used by…

Comparing the Values Hierarchy of the Kentucky Department of Education's Character/Values Task Force. Comparing a Character/Values Task Force to a National Sample.

ERIC Educational Resources Information Center

Butler, Fonda P.

In March 1989, the Kentucky Department of Education assembled a task force to make recommendations regarding the issue of teaching values and character in public schools in Kentucky. The 23-member task force represented educators, parents, the legislature, state and local school boards, law enforcement agencies, higher education, Catholic…

Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities. Executive Summary

DTIC Science & Technology

2017-03-21

March 2017 Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities OFFICE OF THE UNDER SECRETARY OF...the Department of Defense. The DSB Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities completed its formal...Ensuring the Resilience of National Space Capabilities | i DSB Task Force on Defense Strategies for Ensuring the

Communicating with New and Existing Markets. A Task Force of Howard Community College's 1998-1999 Commission on the Future.

ERIC Educational Resources Information Center

Howard Community Coll., Columbia, MD.

This is a report from a task force formed by Howard Community College (Maryland) to examine existing and future markets. The task force also explored ways to use marketing strategies to attract potential customers to the college. The task force recommends that the college use its strengths to attract customers, such as its commitment to open…

Report of the Defense Science Board Task Force on Quality of Life.

DTIC Science & Technology

1995-10-15

The Quality of Life Task Force is deeply grateful to those distinguished Americans who served as Counselors to the Task Force. Although they did not... Quality of Life issues to the readiness and well being of our Armed Forces. Their willingness to offer suggestions and advice on topics within their...respective expertise was most helpful The recommendations of the Report are those of the Quality of Life Task Force; and Counselors may, or may not, concur in whole or in part with them.

Screening for Hepatitis C Infections in Adults

MedlinePlus

Understanding Task Force Recommendations Screening for Hepatitis C Virus Infection in Adults The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Hepatitis C ...

78 FR 10127 - Request for Nominations to the Agricultural Air Quality Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... Conservation Service Request for Nominations to the Agricultural Air Quality Task Force AGENCY: Natural... Nominations to the Agricultural Air Quality Task Force. SUMMARY: The Secretary of Agriculture invites... Force (AAQTF) which was established by the Federal Agriculture Improvement and Reform Act of 1996 to...

Science and Sandy: Lessons Learned

NASA Astrophysics Data System (ADS)

Werner, K.

2013-12-01

Following Hurricane Sandy's impact on the mid-Atlantic region, President Obama established a Task Force to '...ensure that the Federal Government continues to provide appropriate resources to support affected State, local, and tribal communities to improve the region's resilience, health, and prosperity by building for the future.' The author was detailed from NOAA to the Task Force between January and June 2013. As the Task Force and others began to take stock of the region's needs and develop plans to address them, many diverse approaches emerged from different areas of expertise including: infrastructure, management and construction, housing, public health, and others. Decision making in this environment was complex with many interests and variables to consider and balance. Although often relevant, science and technical expertise was not always at the forefront of this process. This talk describes the author's experience with the Sandy Task Force focusing on organizing scientific expertise to support the work of the Task Force. This includes a description of federal activity supporting Sandy recovery efforts, the role of the Task Force, and lessons learned from developing a science support function within the Task Force.

Force related hemodynamic responses during execution and imagery of a hand grip task: A functional near infrared spectroscopy study.

PubMed

Wriessnegger, Selina C; Kirchmeyr, Daniela; Bauernfeind, Günther; Müller-Putz, Gernot R

2017-10-01

We examined force related hemodynamic changes during the performance of a motor execution (ME) and motor imagery (MI) task by means of multichannel functional near infrared spectroscopy (fNIRS). The hemodynamic responses of fourteen healthy participants were measured while they performed a hand grip execution or imagery task with low and high grip forces. We found an overall higher increase of [oxy-Hb] concentration changes during ME for both grip forces but with a delayed peak maximum for the lower grip force. During the MI task with lower grip force, the [oxy-Hb] level increases are stronger compared to the MI with higher grip force. The facilitation in performing MI with higher grip strength might thus indicate less inhibition of the actual motor act which could also explain the later increase onset of [oxy-Hb] in the ME task with the lower grip force. Our results suggest that execution and imagery of a hand grip task with high and low grip forces, leads to different cortical activation patterns. Since impaired control of grip forces during object manipulation in particular is one aspect of fine motor control deficits after stroke, our study will contribute to future rehabilitation programs enhancing patient's grip force control. Copyright © 2017 Elsevier Inc. All rights reserved.

78 FR 28580 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces AGENCY: Office... Defense announces the following Federal Advisory Committee meeting of the Department of Defense Task Force...

77 FR 68744 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Federal... Committee meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

75 FR 59698 - Federal Advisory Committee; Department of Defense Task Force on the Care, Management, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

.... SUPPLEMENTARY INFORMATION: The Task Force is a non-discretionary Federal advisory committee established to (a... for wounded, ill, and injured members of the Armed Forces; ii. Medical case management; iii. Non... Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Member of...

PRN 2009-1: Establishment of Antimicrobial Exposure Assessment Task Force II

EPA Pesticide Factsheets

This PR notice announces the establishment of the Antimicrobial Exposure Assessment Task Force II, an industry-wide task force to develop mixer, loader, applicator and post-application exposure data for antimicrobial pesticides used in various settings.

Practice and Age-Related Loss of Adaptability in Sensorimotor Performance

PubMed Central

Sosnoff, Jacob J.; Voudrie, Stefani J.

2009-01-01

The purpose of the present investigation was to examine whether the ability to adapt to task constraints is influenced by short-term practice in older adults. Young (18–29 years old) and old (65–75 years old) adults produced force output to a constant force target and a 1-Hz sinusoidal force target by way of the index finger flexion. Participants completed each task 5 times per session for 5 concurrent sessions. The amount and structure of force variability was calculated using linear and nonlinear analyses. As expected, there was a decrease in the magnitude of variability (coefficient of variation) in both tasks and task-related change in the structure of force variability (approximate entropy) with training across groups. The authors found older adults to have a greater amount of variability than their younger counterparts in both tasks. Older adults also demonstrated an increase in the structure of force output in the constant task but a decrease in structure in the sinusoidal task. Age differences in the adaptability to task constraints persisted throughout practice. The authors propose that older adults' ability to adapt sensorimotor output to task demands is not a result of lack of familiarity with the task but that it is, instead, characteristic of the aging process. PMID:19201684

Tibiofemoral contact forces during walking, running and sidestepping.

PubMed

Saxby, David J; Modenese, Luca; Bryant, Adam L; Gerus, Pauline; Killen, Bryce; Fortin, Karine; Wrigley, Tim V; Bennell, Kim L; Cicuttini, Flavia M; Lloyd, David G

2016-09-01

We explored the tibiofemoral contact forces and the relative contributions of muscles and external loads to those contact forces during various gait tasks. Second, we assessed the relationships between external gait measures and contact forces. A calibrated electromyography-driven neuromusculoskeletal model estimated the tibiofemoral contact forces during walking (1.44±0.22ms(-1)), running (4.38±0.42ms(-1)) and sidestepping (3.58±0.50ms(-1)) in healthy adults (n=60, 27.3±5.4years, 1.75±0.11m, and 69.8±14.0kg). Contact forces increased from walking (∼1-2.8 BW) to running (∼3-8 BW), sidestepping had largest maximum total (8.47±1.57 BW) and lateral contact forces (4.3±1.05 BW), while running had largest maximum medial contact forces (5.1±0.95 BW). Relative muscle contributions increased across gait tasks (up to 80-90% of medial contact forces), and peaked during running for lateral contact forces (∼90%). Knee adduction moment (KAM) had weak relationships with tibiofemoral contact forces (all R(2)<0.36) and the relationships were gait task-specific. Step-wise regression of multiple external gait measures strengthened relationships (0.20

Benchmarking CIN3+ risk as the basis for incorporating HPV and Pap cotesting into cervical screening and management guidelines

PubMed Central

Katki, Hormuzd A.; Schiffman, Mark; Castle, Philip E.; Fetterman, Barbara; Poitras, Nancy E.; Lorey, Thomas; Cheung, Li C.; Raine-Bennett, Tina R.; Gage, Julia C.; Kinney, Walter K.

2013-01-01

Objective In 2012, the United States Preventive Services Task Force (USPSTF) and a consensus of 25 organizations endorsed concurrent cytology and HPV testing (“cotesting”) for cervical cancer screening. Past screening and management guidelines were implicitly based on risks defined by Pap-alone, without consideration of HPV test results. To promote management that is consistent with accepted practice, new guidelines incorporating cotesting should aim to achieve equal management of women at equal risk of cervical intraepithelial neoplasia grade 3 and cancer (CIN3+). Methods We estimated cumulative 5-year risks of CIN3+ for 965,360 women aged 30–64 undergoing cotesting at Kaiser Permanente Northern California 2003–2010. We calculated the implicit risk thresholds for Pap-alone and applied them for new management guidance on HPV and Pap cotesting, citing 2 examples: HPV-positive/ASC-US and HPV-negative/Pap-negative. We call this guidance process “benchmarking”. Results LSIL, for which immediate colposcopy is prescribed, carries 5-year CIN3+ risk of 5.2%, suggesting that test results with similar risks should be managed with colposcopy. Similarly, ASC-US (2.6% risk) is managed with 6–12 month follow-up and Pap-negative (0.26% risk) is managed with 3-year follow-up. The 5-year CIN3+ risk for women with HPV-positive/ASC-US was 6.8% (95%CI 6.2% to 7.6%). This is greater than the 5.2% risk implicitly leading to referral to colposcopy, consistent with current management recommendations that HPV-positive/ASC-US should be referred for immediate colposcopy. The 5-year CIN3+ risk for women with HPV-negative/Pap-negative was 0.08% (95%CI 0.07% to 0.09%), far below the 0.26% implicitly required for a 3-year return and justifying a longer (e.g., 5-year) return. Conclusions Using the principle of “equal management of equal risks,” benchmarking to implicit risk thresholds based on Pap-alone can be used to achieve safe and consistent incorporation of cotesting. PMID:23519302

Comprehensive review of neurophysiologic basis and diagnostic interventions in managing chronic spinal pain.

PubMed

Manchikanti, Laxmaiah; Boswell, Mark V; Singh, Vijay; Derby, Richard; Fellows, Bert; Falco, Frank J E; Datta, Sukdeb; Smith, Howard S; Hirsch, Joshua A

2009-01-01

Understanding the neurophysiological basis of chronic spinal pain and diagnostic interventional techniques is crucial in the proper diagnosis and management of chronic spinal pain. Central to the understanding of the structural basis of chronic spinal pain is the provision of physical diagnosis and validation of patient symptomatology. It has been shown that history, physical examination, imaging, and nerve conduction studies in non-radicular or discogenic pain are unable to diagnose the precise cause in 85% of the patients. In contrast, controlled diagnostic blocks have been shown to determine the cause of pain in as many as 85% of the patients. To provide evidence-based clinical practice guidelines for diagnostic interventional techniques. Best evidence synthesis. Strength of evidence was assessed by the U.S. Preventive Services Task Force (USPSTF) criteria utilizing 5 levels of evidence ranging from Level I to III with 3 subcategories in Level II. Diagnostic criteria established by systematic reviews were utilized with controlled diagnostic blocks. Diagnostic criteria included at least 80% pain relief with controlled local anesthetic blocks with the ability to perform multiple maneuvers which were painful prior to the diagnostic blocks for facet joint and sacroiliac joint blocks, whereas for provocation discography, the criteria included concordant pain upon stimulation of the target disc with 2 adjacent discs producing no pain at all. The indicated level of evidence for diagnostic lumbar, cervical, and thoracic facet joint nerve blocks is Level I or II-1. The indicated evidence is Level II-2 for lumbar and cervical discography, whereas it is Level II-3 for thoracic provocation discography. The evidence for diagnostic sacroiliac joint nerve blocks is Level II-2. Level of evidence for selective nerve root blocks for diagnostic purposes is Level II-3. Limitations of this guideline preparation include a continued paucity of literature and conflicts in preparation of systematic reviews and guidelines. These guidelines include the evaluation of evidence for diagnostic interventional procedures in managing chronic spinal pain and recommendations. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines also do not represent a "standard of care."

Fitts' Law in the Control of Isometric Grip Force With Naturalistic Targets.

PubMed

Thumser, Zachary C; Slifkin, Andrew B; Beckler, Dylan T; Marasco, Paul D

2018-01-01

Fitts' law models the relationship between amplitude, precision, and speed of rapid movements. It is widely used to quantify performance in pointing tasks, study human-computer interaction, and generally to understand perceptual-motor information processes, including research to model performance in isometric force production tasks. Applying Fitts' law to an isometric grip force task would allow for quantifying grasp performance in rehabilitative medicine and may aid research on prosthetic control and design. We examined whether Fitts' law would hold when participants attempted to accurately produce their intended force output while grasping a manipulandum when presented with images of various everyday objects (we termed this the implicit task). Although our main interest was the implicit task, to benchmark it and establish validity, we examined performance against a more standard visual feedback condition via a digital force-feedback meter on a video monitor (explicit task). Next, we progressed from visual force feedback with force meter targets to the same targets without visual force feedback (operating largely on feedforward control with tactile feedback). This provided an opportunity to see if Fitts' law would hold without vision, and allowed us to progress toward the more naturalistic implicit task (which does not include visual feedback). Finally, we changed the nature of the targets from requiring explicit force values presented as arrows on a force-feedback meter (explicit targets) to the more naturalistic and intuitive target forces implied by images of objects (implicit targets). With visual force feedback the relation between task difficulty and the time to produce the target grip force was predicted by Fitts' law (average r 2 = 0.82). Without vision, average grip force scaled accurately although force variability was insensitive to the target presented. In contrast, images of everyday objects generated more reliable grip forces without the visualized force meter. In sum, population means were well-described by Fitts' law for explicit targets with vision ( r 2 = 0.96) and implicit targets ( r 2 = 0.89), but not as well-described for explicit targets without vision ( r 2 = 0.54). Implicit targets should provide a realistic see-object-squeeze-object test using Fitts' law to quantify the relative speed-accuracy relationship of any given grasper.

A guide for statewide impaired-driving task forces.

DOT National Transportation Integrated Search

2009-09-01

The purpose of the guide is to assist State officials and other stakeholders who are interested in establishing an : Impaired-Driving Statewide Task Force or who are exploring ways to improve their current Task Force. The guide : addresses issues suc...

PRN 2007-3: The Agricultural Handlers Exposure Task Force, L.L.C

EPA Pesticide Factsheets

This PR Notice discusses the Agricultural Handlers Exposure Task Force, an industry-wide task force formed to develop mixer, loader, and applicator exposure data for pesticides used in agricultural settings. It includes contacts for more information.

78 FR 7415 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... Committee meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

78 FR 66902 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

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2013-11-07

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... Federal Advisory Committee meeting of the Department of Defense Task Force on the Care, Management, and...

77 FR 31337 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

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2012-05-25

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and...

76 FR 38118 - Meeting of the Department of Defense Task Force on the Care, Management, and Transition of...

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2011-06-29

... DEPARTMENT OF DEFENSE Office of the Secretary Meeting of the Department of Defense Task Force on... Forces AGENCY: Department of Defense. ACTION: Meeting notice. SUMMARY: Under the provisions of the... that the following Federal Advisory Committee meeting of the Department of Defense Task Force on the...

78 FR 38015 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-25

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Notice of... of the Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

Load type influences motor unit recruitment in biceps brachii during a sustained contraction.

PubMed

Baudry, Stéphane; Rudroff, Thorsten; Pierpoint, Lauren A; Enoka, Roger M

2009-09-01

Twenty subjects participated in four experiments designed to compare time to task failure and motor-unit recruitment threshold during contractions sustained at 15% of maximum as the elbow flexor muscles either supported an inertial load (position task) or exerted an equivalent constant torque against a rigid restraint (force task). Subcutaneous branched bipolar electrodes were used to record single motor unit activity from the biceps brachii muscle during ramp contractions performed before and at 50 and 90% of the time to failure for the position task during both fatiguing contractions. The time to task failure was briefer for the position task than for the force task (P=0.0002). Thirty and 29 motor units were isolated during the force and position tasks, respectively. The recruitment threshold declined by 48 and 30% (P=0.0001) during the position task for motor units with an initial recruitment threshold below and above the target force, respectively, whereas no significant change in recruitment threshold was observed during the force task. Changes in recruitment threshold were associated with a decrease in the mean discharge rate (-16%), an increase in discharge rate variability (+40%), and a prolongation of the first two interspike intervals (+29 and +13%). These data indicate that there were faster changes in motor unit recruitment and rate coding during the position task than the force task despite a similar net muscle torque during both tasks. Moreover, the results suggest that the differential synaptic input observed during the position task influences most of the motor unit pool.

Task- and time-dependent modulation of Ia presynaptic inhibition during fatiguing contractions performed by humans

PubMed Central

Maerz, Adam H.; Gould, Jeffrey R.; Enoka, Roger M.

2011-01-01

Presynaptic modulation of Ia afferents converging onto the motor neuron pool of the extensor carpi radialis (ECR) was compared during contractions (20% of maximal force) sustained to failure as subjects controlled either the angular position of the wrist while supporting an inertial load (position task) or exerted an equivalent force against a rigid restraint (force task). Test Hoffmann (H) reflexes were evoked in the ECR by stimulating the radial nerve above the elbow. Conditioned H reflexes were obtained by stimulating either the median nerve above the elbow or at the wrist (palmar branch) to assess presynaptic inhibition of homonymous (D1 inhibition) and heteronymous Ia afferents (heteronymous Ia facilitation), respectively. The position task was briefer than the force task (P = 0.001), although the maximal voluntary force and electromyograph for ECR declined similarly at failure for both tasks. Changes in the amplitude of the conditioned H reflex were positively correlated between the two conditioning methods (P = 0.02) and differed between the two tasks (P < 0.05). The amplitude of the conditioned H reflex during the position task first increased (129 ± 20.5% of the initial value, P < 0.001) before returning to its initial value (P = 0.22), whereas it increased progressively during the force task to reach 122 ± 17.4% of the initial value at failure (P < 0.001). Moreover, changes in conditioned H reflexes were associated with the time to task failure and force fluctuations. The results suggest a task- and time-dependent modulation of presynaptic inhibition of Ia afferents during fatiguing contractions. PMID:21543747

77 FR 6786 - U.S. Coral Reef Task Force Public Meeting and Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration U.S. Coral Reef Task Force... of the U.S. Coral Reef Task Force. The meeting will be held in Washington, DC This meeting, the 27th [[Page 6787

First Responder Refresher: National Standard Curriculum (Instructor Course Guide)

DOT National Transportation Integrated Search

1997-07-08

This white paper provides a brief overview of the report titled "ITS Focus Task Force on System Architecture Report", dated May 1997. The report was prepared by a special task force of the United Kingdoms ITS Focus organization. This task force wa...

Repairing the Breach. Key Ways To Support Family Life, Reclaim Our Streets, and Rebuild Civil Society in America's Communities. Report of the National Task Force on African-American Men and Boys.

ERIC Educational Resources Information Center

Austin, Bobby William, Ed.

This report of the National Task Force on African-American Men and Boys is the beginning of an approach to repair society's breaches and restore the streets to safety. The Task Force, headed by Andrew J. Young and established in 1994, conceived its mission as one of reclamation. The Task Force made 61 specific recommendations, and three general…

Bidirectional transfer between joint and individual actions in a task of discrete force production.

PubMed

Masumoto, Junya; Inui, Nobuyuki

2017-07-01

The present study examined bidirectional learning transfer between joint and individual actions involving discrete isometric force production with the right index finger. To examine the effects of practice of joint action on performance of the individual action, participants performed a pre-test (individual condition), practice blocks (joint condition), and a post-test (individual condition) (IJI task). To examine the effects of practice of the individual action on performance during the joint action, the participants performed a pre-test (joint condition), practice blocks (individual condition), and a post-test (joint condition) (JIJ task). Whereas one participant made pressing movements with a target peak force of 10% maximum voluntary contraction (MVC) in the individual condition, two participants produced the target force of the sum of 10% MVC produced by each of them in the joint condition. In both the IJI and JIJ tasks, absolute errors and standard deviations of peak force were smaller post-test than pre-test, indicating bidirectional transfer between individual and joint conditions for force accuracy and variability. Although the negative correlation between forces produced by two participants (complementary force production) became stronger with practice blocks in the IJI task, there was no difference between the pre- and post-tests for the negative correlation in the JIJ task. In the JIJ task, the decrease in force accuracy and variability during the individual action did not facilitate complementary force production during the joint action. This indicates that practice performed by two people is essential for complementary force production in joint action.

77 FR 55218 - Homeland Security Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... childhood arrivals program. The HSAC will also receive a report from the Sustainability and Efficiency Task Force, review and discuss the task forces' report, and formulate recommendations for the Department. The.... HSAC conference call details and the Sustainability and Efficiency Task Force report will be provided...

Task force on deterrence of air piracy : final report.

DOT National Transportation Integrated Search

1978-11-01

In February 1969, as the frequency of hijacking of U.S. air carrier aircraft was rising to an all-time high, the Federal Aviation Administration established a multi-disciplinary Task Force on Deterrence of Air Piracy. The work of the Task Force in de...

75 FR 16577 - Gulf War Veterans' Illnesses Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

77 FR 18307 - Gulf War Veterans' Illnesses Task Force Report

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force Report AGENCY: Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Secretary Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive...

78 FR 28292 - Gulf War Veterans' Illnesses Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary, Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

76 FR 65321 - Gulf War Veterans' Illnesses Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary, Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

78 FR 63208 - UPDATE-Meeting of the Community Preventive Services Task Force (Task Force)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

..., and issues recommendations. These recommendations provide evidence-based options from which decision makers in communities, companies, health departments, health plans and healthcare systems, non..., available resources, and constraints of their constituents. The Task Force's recommendations, along with the...

An introductory handbook for state task forces to combat drunk driving.

DOT National Transportation Integrated Search

1983-01-01

In June 1982 Governor Robb created a task force to identify and assess efforts under way in Virginia to address the problem of drunken driving and to make recommendations. This booklet was prepared to assist the task force in its deliberations.

Forced Aerobic Exercise Preceding Task Practice Improves Motor Recovery Poststroke.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Dey, Tanujit; Alberts, Jay L

To understand how two types of aerobic exercise affect upper-extremity motor recovery post-stroke. Our aims were to (1) evaluate the feasibility of having people who had a stroke complete an aerobic exercise intervention and (2) determine whether forced or voluntary exercise differentially facilitates upper-extremity recovery when paired with task practice. Seventeen participants with chronic stroke completed twenty-four 90-min sessions over 8 wk. Aerobic exercise was immediately followed by task practice. Participants were randomized to forced or voluntary aerobic exercise groups or to task practice only. Improvement on the Fugl-Meyer Assessment exceeded the minimal clinically important difference: 12.3, 4.8, and 4.4 for the forced exercise, voluntary exercise, and repetitive task practice-only groups, respectively. Only the forced exercise group exhibited a statistically significant improvement. People with chronic stroke can safely complete intensive aerobic exercise. Forced aerobic exercise may be optimal in facilitating motor recovery associated with task practice. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Response to Vogelstein: How the 2012 AAP Task Force on circumcision went wrong.

PubMed

Van Howe, Robert S

2018-01-01

Vogelstein cautions medical organizations against jumping into the fray of controversial issues, yet proffers the 2012 American Academy of Pediatrics' Task Force policy position on infant male circumcision as 'an appropriate use of position-statements.' Only a scratch below the surface of this policy statement uncovers the Task Force's failure to consider Vogelstein's many caveats. The Task Force supported the cultural practice by putting undeserved emphasis on questionable scientific data, while ignoring or underplaying the importance of valid contrary scientific data. Without any effort to quantitatively assess the risk/benefit balance, the Task Force concluded the benefits of circumcision outweighed the risks, while acknowledging that the incidence of risks was unknown. This Task Force differed from other Academy policy-forming panels by ignoring the Academy's standard quality measures and by not appointing members with extensive research experience, extensive publications, or recognized expertise directly related to this topic. Despite nearly 100 publications available at the time addressing the substantial ethical issues associated with infant male circumcision, the Task Force chose to ignore the ethical controversy. They merely stated, with minimal justification, the opinion of one of the Task Force members that the practice of infant male circumcision is morally permissible. The release of the report has fostered an explosion of academic discussion on the ethics of infant male circumcision with a number of national medical organizations now decrying the practice as a human rights violation. © 2017 John Wiley & Sons Ltd.

Task analysis of Air Force pharmacy practice.

PubMed

Bartholomew, A; Sawyer, W T; Coats, L

1995-01-15

The frequency with which United States Air Force pharmacists perform specific professional tasks and the pharmacists' views as to the importance of those tasks were studied. A questionnaire was prepared that asked recipients to rate each of 36 tasks selected as representing the spectrum of practice activities. There were four categories of tasks: managerial tasks, dispensing tasks, drug information tasks, and patient care tasks. Recipients rated the tasks with respect to frequency of performance and importance on separate 6-point scales. The questionnaire was mailed in May 1991 to the 225 pharmacists then serving in the Air Force worldwide. Of the 225 questionnaires, 150 usable questionnaires were returned (response rate, 67%). All the tasks in the survey were performed by at least one Air Force pharmacy officer, although the frequency of task performance varied. In particular, the frequency of many patient care tasks was low. All the tasks were perceived to have some importance, but drug information tasks were rated as being significantly more important than tasks in the other categories; patient care tasks were rated lowest in importance. The results varied with the respondents' demographic characteristics. Pharmacy officers with more years of service, more senior positions, higher rank, or an advanced degree in a field other than pharmacy tended to give responses that diverged from those of the population. A 1991 survey showed an awareness among Air Force pharmacists of the need to orient practice around patient care; however, they were not spending substantial time on patient care and tended to view it as less important than more traditional pharmacy tasks.

Grip force control in individuals with multiple sclerosis.

PubMed

Iyengar, Veena; Santos, Marcio J; Ko, Michael; Aruin, Alexander S

2009-10-01

Appropriate regulation of grip force is essential in performance of various activities of daily living such as drinking, eating, buttoning a shirt, and so on. The extent to which individuals with multiple sclerosis (MS) are able to regulate grip forces while performing elements of the activities of daily living is largely unknown. . To investigate how individuals with MS control grip force during performance of functional tasks. . This study evaluated the grip force control in selected individuals with MS (n = 9) and healthy control subjects (n = 9) while they performed the task of lifting and placing an instrumented object on a shelf and the task of lifting the object and bringing it close to the mouth to mimic drinking. The grip forces, object acceleration, force ratio, and time lag were recorded and analyzed. . The individuals with MS used significantly larger peak grip force and force ratio than control subjects while performing both tasks and for both hands. In addition, the time lag between the peaks of grip and load forces was significantly longer in individuals with MS. . The application of excessive grip force could predispose individuals with MS to additional fatigue and musculoskeletal overuse trauma. Rehabilitation protocols for the MS population may need to account for increased levels of grip force applied during the performance of functional tasks.

76 FR 52932 - Notice of Meeting of the Agricultural Air Quality Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service Notice of Meeting of the Agricultural Air Quality Task Force AGENCY: Natural Resources Conservation Service (NRCS). ACTION: Notice of meeting. SUMMARY: The Agricultural Air Quality Task Force (AAQTF) will meet to continue discussions on...

Using grasping tasks to evaluate hand force coordination in children with hemiplegic cerebral palsy.

PubMed

Mackenzie, Samuel J; Getchell, Nancy; Modlesky, Christopher M; Miller, Freeman; Jaric, Slobodan

2009-08-01

Mackenzie SJ, Getchell N, Modlesky CM, Miller F, Jaric S. Using grasping tasks to evaluate hand force coordination in children with hemiplegic cerebral palsy. To assess force coordination in children with hemiplegic cerebral palsy (CP) using a device that allows for testing both unimanual and bimanual manipulation tasks performed under static and dynamic conditions. Nonequivalent groups design. University research laboratory for motor control. Six children with hemiplegic CP (age, mean +/- SD, 11.6+/-1.8 y) and 6 typically developing controls (11.6+/-1.6 y). Not applicable. Children performed simple lifting and force-matching static ramp tasks by way of both unimanual and bimanual pulling using a device that measures grip force (force acting perpendicularly at the digits-device contact area) and load force (tangential force). Main outcome measures were grip/load force ratios (grip force scaling) and correlation coefficients (force coupling). CP subjects showed significantly higher grip/load force ratios (P<.05) and slightly lower correlation coefficients than the control group, with more pronounced differences for most tasks when using their involved hand. For subjects with CP, switching from unimanual to bimanual conditions did not bring changes in scaling or coupling for the involved hand (P>.05). Compared with healthy children, the impaired hand function in the hemiplegic CP pediatric population could be reflected in excessive grip force that is also decoupled from ongoing changes in load force. Therefore, the bimanual grip load device used in this study could provide a sensitive measure of grip force coordination in CP, although nonmotor deficits should be taken into account when asking children to perform more complex tasks.

77 FR 3241 - Intent To Hold North Dakota Task Force Meeting as Established by the Missouri River Protection...

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2012-01-23

... duties of the Task Force are to prepare and approve a plan for the use of the funds made available under... of the Task Force are to prepare and approve a plan for the use of the funds made available under... Force Meeting as Established by the Missouri River Protection and Improvement Act of 2000 (Title VII...

75 FR 33838 - NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting

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2010-06-15

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (10-065)] NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration announces a meeting of the Ad-Hoc Task Force on...

75 FR 15742 - NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting

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2010-03-30

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: (10-035)] NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration announces a meeting of the Ad-Hoc Task Force on...

Honeywell's Working Parents Task Force. Final Report and Recommendations.

ERIC Educational Resources Information Center

Honeywell, Inc., Minneapolis, Minn.

This publication provides a summary of the Honeywell Working Parent Task Force's recommendations on how to solve problems experienced by working parents. The Task Force consisted of three committees: the Employment Practices Committee (EPC); the Parent Education Committee (PEC); and the Child Care Facilities Committee (CCFC). After examining a…

77 FR 71471 - Interagency Task Force on Veterans Small Business Development; Notice of Meeting

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2012-11-30

... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development; Notice of Meeting AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency... agenda for its public meeting of the Interagency Task Force on Veterans Small Business Development. The...

75 FR 34439 - Defense Science Board Task Force on Nuclear Treaty Monitoring and Verification

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2010-06-17

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Science Board Task Force on Nuclear Treaty... meetings. SUMMARY: The Defense Science Board Task Force on Nuclear Treaty Monitoring and Verification will... Applications International Corporation, 4001 North Fairfax Drive, Suite 300, Arlington, VA. FOR FURTHER...

76 FR 70913 - Retrospective Review Under Executive Order 13579

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2011-11-16

... Fukushima Task Force Report. DATES: November 16, 2011. ADDRESSES: You can access publicly available... Enhancing Reactor Safety in the 21st Century: The Near-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report, ML111861807), was issued. The Commission has...

76 FR 55394 - Meeting of the Task Force on Community Preventive Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the...), Department of Health and Human Services (HHS). ACTION: Notice of meeting. SUMMARY: The Centers for Disease... (Task Force). The Task Force--an independent, nonfederal body of nationally known leaders in public...

76 FR 4115 - Meeting of the Task Force on Community Preventive Services

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2011-01-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the...), Department of Health and Human Services (HHS). ACTION: Notice of meeting. SUMMARY: The Centers for Disease... (Task Force). The Task Force--an independent, nonfederal body of nationally known leaders in public...

75 FR 63846 - Meeting of the Task Force on Community Preventive Services

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2010-10-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Meeting of the...), Department of Health and Human Services (HHS). ACTION: Notice of meeting. SUMMARY: The Centers for Disease... (Task Force). The Task Force is an independent, nonfederal body of nationally known leaders in public...

75 FR 48929 - Notice of Meeting of the Agricultural Air Quality Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... Agricultural Air Quality Task Force AGENCY: Natural Resources Conservation Service (NRCS), United States... Triangle Park, North Carolina 27711; (919) 541-5400. The Agricultural Air Quality Task Force (AAQTF) will meet to continue discussions on air quality issues relating to agriculture. Additionally, the Livestock...

NASA replanning efforts continue

NASA Astrophysics Data System (ADS)

Katzoff, Judith A.

A task force of the National Aeronautics and Space Administration (NASA) is producing new launch schedules for NASA's three remaining space shuttle orbiters, possibly supplemented by expendable launch vehicles. In the wake of the explosion of the space shuttle Challenger on January 28, 1986, the task force is assuming a delay of 12-18 months before resumption of shuttle flights.NASA's Headquarters Replanning Task Force, which meets daily, is separate from the agency's Data and Design Analysis Task Force, which collects and analyzes information about the accident for the use of the investigative commission appointed by President Ronald Reagan.

Report of NASA Lunar Energy Enterprise Case Study Task Force

NASA Technical Reports Server (NTRS)

Kearney, John J.

1989-01-01

The Lunar Energy Enterprise Case Study Task Force was asked to determine the economic viability and commercial potential of mining and extracting He-3 from the lunar soil, and transporting the material to Earth for use in a power-generating fusion reactor. Two other space energy projects, the Space Power Station (SPS) and the Lunar Power Station (LPS), were also reviewed because of several interrelated aspects of these projects. The specific findings of the Task Force are presented. Appendices contain related papers generated by individual Task Force Members.

14th International Congress on Antiphospholipid Antibodies Task Force Report on Catastrophic Antiphospholipid Syndrome.

PubMed

Cervera, Ricard; Rodríguez-Pintó, Ignasi; Colafrancesco, Serena; Conti, Fabrizio; Valesini, Guido; Rosário, Cristina; Agmon-Levin, Nancy; Shoenfeld, Yehuda; Ferrão, Claudia; Faria, Raquel; Vasconcelos, Carlos; Signorelli, Flavio; Espinosa, Gerard

2014-07-01

The 'Task Force on Catastrophic Antiphospholipid Syndrome (CAPS)' was developed on the occasion of the 14th International Congress on Antiphospholipid Antibodies. The objectives of this Task Force were to assess the current knowledge on pathogenesis, clinical and laboratory features, diagnosis and classification, precipitating factors and treatment of this condition in order to address recommendations for future research. This article summarizes the studies analyzed by the Task Force, its recommendations and the future research agenda. Copyright © 2014 Elsevier B.V. All rights reserved.

Fitts’ Law in the Control of Isometric Grip Force With Naturalistic Targets

PubMed Central

Thumser, Zachary C.; Slifkin, Andrew B.; Beckler, Dylan T.; Marasco, Paul D.

2018-01-01

Fitts’ law models the relationship between amplitude, precision, and speed of rapid movements. It is widely used to quantify performance in pointing tasks, study human-computer interaction, and generally to understand perceptual-motor information processes, including research to model performance in isometric force production tasks. Applying Fitts’ law to an isometric grip force task would allow for quantifying grasp performance in rehabilitative medicine and may aid research on prosthetic control and design. We examined whether Fitts’ law would hold when participants attempted to accurately produce their intended force output while grasping a manipulandum when presented with images of various everyday objects (we termed this the implicit task). Although our main interest was the implicit task, to benchmark it and establish validity, we examined performance against a more standard visual feedback condition via a digital force-feedback meter on a video monitor (explicit task). Next, we progressed from visual force feedback with force meter targets to the same targets without visual force feedback (operating largely on feedforward control with tactile feedback). This provided an opportunity to see if Fitts’ law would hold without vision, and allowed us to progress toward the more naturalistic implicit task (which does not include visual feedback). Finally, we changed the nature of the targets from requiring explicit force values presented as arrows on a force-feedback meter (explicit targets) to the more naturalistic and intuitive target forces implied by images of objects (implicit targets). With visual force feedback the relation between task difficulty and the time to produce the target grip force was predicted by Fitts’ law (average r2 = 0.82). Without vision, average grip force scaled accurately although force variability was insensitive to the target presented. In contrast, images of everyday objects generated more reliable grip forces without the visualized force meter. In sum, population means were well-described by Fitts’ law for explicit targets with vision (r2 = 0.96) and implicit targets (r2 = 0.89), but not as well-described for explicit targets without vision (r2 = 0.54). Implicit targets should provide a realistic see-object-squeeze-object test using Fitts’ law to quantify the relative speed-accuracy relationship of any given grasper. PMID:29773999

Covert face recognition in congenital prosopagnosia: a group study.

PubMed

Rivolta, Davide; Palermo, Romina; Schmalzl, Laura; Coltheart, Max

2012-03-01

Even though people with congenital prosopagnosia (CP) never develop a normal ability to "overtly" recognize faces, some individuals show indices of "covert" (or implicit) face recognition. The aim of this study was to demonstrate covert face recognition in CP when participants could not overtly recognize the faces. Eleven people with CP completed three tasks assessing their overt face recognition ability, and three tasks assessing their "covert" face recognition: a Forced choice familiarity task, a Forced choice cued task, and a Priming task. Evidence of covert recognition was observed with the Forced choice familiarity task, but not the Priming task. In addition, we propose that the Forced choice cued task does not measure covert processing as such, but instead "provoked-overt" recognition. Our study clearly shows that people with CP demonstrate covert recognition for faces that they cannot overtly recognize, and that behavioural tasks vary in their sensitivity to detect covert recognition in CP. Copyright © 2011 Elsevier Srl. All rights reserved.

Report of the Fermilab ILC Citizens' Task Force

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

None

Fermi National Accelerator Laboratory convened the ILC Citizens' Task Force to provide guidance and advice to the laboratory to ensure that community concerns and ideas are included in all public aspects of planning and design for a proposed future accelerator, the International Linear Collider. In this report, the members of the Task Force describe the process they used to gather and analyze information on all aspects of the proposed accelerator and its potential location at Fermilab in northern Illinois. They present the conclusions and recommendations they reached as a result of the learning process and their subsequent discussions and deliberations.more » While the Task Force was charged to provide guidance on the ILC, it became clear during the process that the high cost of the proposed accelerator made a near-term start for the project at Fermilab unlikely. Nevertheless, based on a year of extensive learning and dialogue, the Task Force developed a series of recommendations for Fermilab to consider as the laboratory develops all successor projects to the Tevatron. The Task Force recognizes that bringing a next-generation particle physics project to Fermilab will require both a large international effort and the support of the local community. While the Task Force developed its recommendations in response to the parameters of a future ILC, the principles they set forth apply directly to any large project that may be conceived at Fermilab, or at other laboratories, in the future. With this report, the Task Force fulfills its task of guiding Fermilab from the perspective of the local community on how to move forward with a large-scale project while building positive relationships with surrounding communities. The report summarizes the benefits, concerns and potential impacts of bringing a large-scale scientific project to northern Illinois.« less

Status Report on Activities of the Systems Assessment Task Force, OECD-NEA Expert Group on Accident Tolerant Fuels for LWRs

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

Bragg-Sitton, Shannon Michelle

The Organization for Economic Cooperation and Development /Nuclear Energy Agency (OECD/NEA) Nuclear Science Committee approved the formation of an Expert Group on Accident Tolerant Fuel (ATF) for LWRs (EGATFL) in 2014. Chaired by Kemal Pasamehmetoglu, INL Associate Laboratory Director for Nuclear Science and Technology, the mandate for the EGATFL defines work under three task forces: (1) Systems Assessment, (2) Cladding and Core Materials, and (3) Fuel Concepts. Scope for the Systems Assessment task force includes definition of evaluation metrics for ATF, technology readiness level definition, definition of illustrative scenarios for ATF evaluation, parametric studies, and selection of system codes. Themore » Cladding and Core Materials and Fuel Concepts task forces will identify gaps and needs for modeling and experimental demonstration; define key properties of interest; identify the data necessary to perform concept evaluation under normal conditions and illustrative scenarios; identify available infrastructure (internationally) to support experimental needs; and make recommendations on priorities. Where possible, considering proprietary and other export restrictions (e.g., International Traffic in Arms Regulations), the Expert Group will facilitate the sharing of data and lessons learned across the international group membership. The Systems Assessment Task Force is chaired by Shannon Bragg-Sitton (INL), while the Cladding Task Force will be chaired by a representative from France (Marie Moatti, Electricite de France [EdF]) and the Fuels Task Force will be chaired by a representative from Japan (Masaki Kurata, Japan Atomic Energy Agency [JAEA]). This report provides an overview of the Systems Assessment Task Force charter and status of work accomplishment.« less

Weighing the Anti-Ischemic Benefits and Bleeding Risks from Aspirin Therapy: a Rational Approach.

PubMed

Dugani, Sagar; Ames, Jeffrey M; Manson, JoAnn E; Mora, Samia

2018-02-21

The role of aspirin in secondary cardiovascular prevention is well understood; however, the role in primary prevention is less clear, and requires careful balancing of potential benefits with risks. Here, we summarize the evidence base on the benefits and risks of aspirin therapy, discuss clinical practice guidelines and decision support tools to assist in initiating aspirin therapy, and highlight ongoing trials that may clarify the role of aspirin in cardiovascular disease prevention. In 2016, the USPSTF released guidelines on the use of aspirin for primary prevention. Based on 11 trials (n = 118,445), aspirin significantly reduced all-cause mortality and nonfatal myocardial infarction, and in 7 trials that evaluated aspirin ≤ 100 mg/day, there was significant reduction in nonfatal stroke. The USPSTF recommends individualized use of aspirin based on factors including age, 10-year atherosclerotic cardiovascular disease risk score, and bleeding risk. Several ongoing trials are evaluating the role of aspirin in primary prevention, secondary prevention, and in combination therapy for atrial fibrillation. Evidence-based approaches to aspirin use should consider the anti-ischemic benefits and bleeding risks from aspirin. In this era of precision medicine, tools that provide the personalized benefit to risk assessment, such as the freely available clinical decision support tool (Aspirin-Guide), can be easily incorporated into the electronic health record and facilitate more informed decisions about initiating aspirin therapy for primary prevention. Aspirin has a complex matrix of benefits and risks, and its use in primary prevention requires individualized decision-making. Results from ongoing trials may guide healthcare providers in identifying appropriate candidates for aspirin therapy.

Increased reaction times and reduced response preparation already starts at middle age

PubMed Central

Wolkorte, Ria; Kamphuis, Janine; Zijdewind, Inge

2014-01-01

Generalized slowing characterizes aging and there is some evidence to suggest that this slowing already starts at midlife. This study aims to assess reaction time changes while performing a concurrent low-force and high-force motor task in young and middle-aged subjects. The high-force motor task is designed to induce muscle fatigue and thereby progressively increase the attentional demands. Twenty-five young (20–30 years, 12 males) and 16 middle-aged (35–55 years, 9 males) adults performed an auditory two-choice reaction time task (CRT) with and without a concurrent low- or high-force motor task. The CRT required subjects to respond to two different stimuli that occurred with a probability of 70 or 30%. The motor task consisted of index finger abduction, at either 10% (10%-dual-task) or 30% (30%-dual-task) of maximal voluntary force. Cognitive task performance was measured as percentage of correct responses and reaction times. Middle-aged subjects responded slower on the frequent but more accurately on the infrequent stimuli of CRT than young subjects. Both young and middle-aged subjects showed increased errors and reaction times while performing under dual-task conditions and both outcome measures increased further under fatiguing conditions. Only under 30%-dual-task demands, an age-effect on dual-task performance was present. Both single- and dual-task conditions showed that already at mid-life response preparation is seriously declined and that subjects implement different strategies to perform a CRT task. PMID:24808862

TASK FORCE REPORT ON ASSESSMENT AND EVALUATION.

ERIC Educational Resources Information Center

MORRIS, ROBERT

THE TASK FORCE ON ASSESSMENT AND EVALUATION HAS BEEN CHARGED TO RECOMMEND THE MOST EFFECTIVE MEANS FOR ASSESSING AND EVALUATING THE SHORT-TERM ACTIVITIES AND THE LONG-TERM ACHIEVEMENTS OF ACTION FOR BOSTON COMMUNITY DEVELOPMENT. THE GENERAL OBJECTIVES OF THE TASK FORCE ARE--THE ANALYSIS OF DATA RELEVANT FOR EVALUATING DAY-BY-DAY DECISION-MAKING,…

Inter-Association Task Force Report on Image.

ERIC Educational Resources Information Center

Special Libraries Association, Washington, DC.

In 1988, the Board of Directors of the Special Libraries Association provided funding to a task force to gather data which would determine how certain segments of society perceive librarians, how librarians view themselves and their colleagues, and to provide recommendations for addressing the issue of image. The task force project consisted of…

Report of the Social Studies Task Force.

ERIC Educational Resources Information Center

Gathman, John; And Others

In 1982 the Colorado Board of Education directed the State Board of Education to organize task forces to address a variety of state educational needs. This report, presented by the Social Studies Task Force, explains the group's purposes and concerns, provides a social studies definition, and outlines the Colorado grades K-12 social studies…

Human Health Effects, Task Force Assessment, Preliminary Report.

ERIC Educational Resources Information Center

Aronow, Wilbert S.; And Others

Presented in this preliminary report is one of seven assessments conducted by a special task force of Project Clean Air, the Human Health Effects Task Force. The reports summarize assessments of the state of knowledge on various air pollution problems, particularly in California, and make tentative recommendations as to what the University of…

Report of the Task Force on School Health.

ERIC Educational Resources Information Center

Maryland State Dept. of Health and Mental Hygiene, Baltimore.

The 1990 Report of the Task Force on School Health examines the current status of Maryland's school health programs and proposes 16 recommendations designed to implement a comprehensive school health (CSH) program to meet the needs of all students. The report describes the Task Force, which was appointed in 1989. After presenting a background on…

A Status Report from the Task Force on Marketing Research.

ERIC Educational Resources Information Center

Keim, William A.; And Others

Concerned with changes in enrollment and credit hour patterns, the chancellor of the Kansas City Metropolitan Community Colleges (MCC) created a special Task Force to consider recommendations for marketing strategies for the 1978-79 academic year. The Task Force reviewed regional and district demography, area population trends and density, age and…

Task Force on Education Funding Equity, Accountability, and Partnerships. Final Report.

ERIC Educational Resources Information Center

Maryland State Dept. of Legislative Services, Annapolis.

In 1997, Maryland formed the Task Force on Education Funding Equity, Accountability, and Partnerships. The group made a comprehensive review of education funding and programs in grades K-12 to ensure that students throughout Maryland have an equal opportunity for academic success. The task force's final report features the membership roster, the…

75 FR 43943 - Defense Science Board; Task Force on Nuclear Treaty Monitoring and Verification

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Science Board; Task Force on Nuclear Treaty... meetings. SUMMARY: The Defense Science Board Task Force on Nuclear Treaty Monitoring and Verification will... held September 13-14, and 25-26, 2010. ADDRESSES: The meetings will be held at Science Applications...

76 FR 69296 - Proposed Models for Plant-Specific Adoption of Technical Specifications Task Force Traveler TSTF...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... Adoption of Technical Specifications Task Force Traveler TSTF-500, Revision 2, ``DC Electrical Rewrite... Technical Specifications Task Force (TSTF) Traveler TSTF-500, Revision 2, ``DC Electrical Rewrite--Update to... Reactor Systems Engineer, Technical Specifications Branch, Mail Stop: O-7 C2A, Division of Inspection and...

28 CFR 16.105 - Exemption of Foreign Terrorist Tracking Task Force System.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exemption of Foreign Terrorist Tracking Task Force System. 16.105 Section 16.105 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR... of Foreign Terrorist Tracking Task Force System. (a) The following system of records is exempt from 5...

26 CFR 54.9815-2713T - Coverage of preventive health services (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

... the current recommendations of the United States Preventive Services Task Force with respect to the... States Preventive Services Task Force with respect to the individual. The provider bills the plan for an... A or B in the current recommendations of the United States Preventive Services Task Force with...

National Task Force on Student Aid Problems. Final Report.

ERIC Educational Resources Information Center

1975

This document presents a full discussion of the activities, findings, and recommendations of the National Task Force on Student Aid Problems. The task force was a voluntary association of concerned and interested agencies and organizations. Its only standing came from the support of those directly concerned with student aid problems. By design and…

Task Force on Education Funding Equity, Accountability, and Partnerships. Preliminary Report.

ERIC Educational Resources Information Center

Maryland State Dept. of Legislative Services, Annapolis.

In 1997, Maryland formed the Task Force on Education Funding Equity, Accountability, and Partnerships to ensure that students throughout Maryland have an equal opportunity for academic success. The Task Force's preliminary report features a comprehensive review of education funding and programs in grades K-12. The report presents membership and…

78 FR 44034 - Petition for Rulemaking Submitted by the Natural Resources Defense Council, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

... the Fukushima Dai-ichi Accident,'' (Fukushima Task Force Report, ADAMS Accession No. ML111861807..., pages 43-46, of the Fukushima Task Force Report, which discusses the enhancement of spent fuel pool... Commission was still in the process of reviewing the Fukushima Task Force Report, and the NRC did not...

Initial Report of the Task Force on Cultural Competence Education in the Health Sciences

ERIC Educational Resources Information Center

New Mexico Higher Education Department, 2007

2007-01-01

This report summarizes the findings and recommendations of the Task Force on Cultural Competence Education and represents the distillation of the Task Force's efforts to fulfill its legislative charge. The report is intended to facilitate a statewide conversation about the health services provided to New Mexico's multicultural citizenry. It…

75 FR 30002 - Federal Advisory Committee; Defense Task Force on Sexual Assault in the Military Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... DEPARTMENT OF DEFENSE Office of the Secretary Federal Advisory Committee; Defense Task Force on Sexual Assault in the Military Services AGENCY: Department of Defense (DoD). ACTION: Termination of... Department of Defense gives notice that it is terminating the Defense Task Force on Sexual Assault in the...

Convergence, Competition, Cooperation: The Report of the Governor's Blue Ribbon Telecommunications Infrastructure Task Force. Volume One.

ERIC Educational Resources Information Center

Wisconsin Governor's Office, Madison.

This report by the Blue Ribbon Task Force on Wisconsin's Telecommunications Infrastructure considers infrastructure to be the common network that connects individual residences, businesses, and agencies, rather than the individual systems and equipment themselves. The task force recognizes that advances in telecommunications technologies and…

The Washington State Task Force on Student Transportation Safety. Final Report.

ERIC Educational Resources Information Center

Washington State Legislature, Olympia.

Findings of a study conducted by the Washington State Task Force on Student Transportation Safety are presented in this report. The data-collection process involved four phases: meetings with experts in student transportation and pedestrian safety; public meetings, informational work sessions, and tours of problems areas; task force meetings; and…

Youth Employment. Final Recommendations of the State Superintendent's Task Force.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison.

This report contains the final recommendations of the task force on youth employment for the state of Wisconsin. The task force was specifically charged with studying issues related to working teenagers, reviewing existing laws and regulations on child labor, and developing recommendations to ensure that when teenagers work, their jobs do not…

78 FR 10636 - Task Force on Research on Violence Against American Indian and Alaska Native Women; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

... DEPARTMENT OF JUSTICE Task Force on Research on Violence Against American Indian and Alaska Native Women; Meeting AGENCY: Office on Violence Against Women, United States Department of Justice. ACTION... public meeting of the Task Force on Research on Violence Against American Indian and Alaska Native Women...

32 CFR 700.1053 - Commander of a task force.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Commander of a task force. 700.1053 Section 700.1053 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any...

32 CFR 700.1053 - Commander of a task force.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Commander of a task force. 700.1053 Section 700.1053 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any...

32 CFR 700.1053 - Commander of a task force.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Commander of a task force. 700.1053 Section 700.1053 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any...

77 FR 59627 - Homeland Security Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-28

... purpose of reviewing and deliberating on recommendations by the HSAC's Cyber Skills Task Force. DATES: The.... The HSAC will meet to review and deliberate on the Cyber Skills Task Force report of findings and... details and the Cyber Skills Task Force report will be provided to interested members of the public at the...

Report of the Task Force on Declining Enrollment. Third Revision.

ERIC Educational Resources Information Center

Highline Public Schools, Seattle, WA.

The purpose of this task force was to study the program, facilities, and alternatives of the Highline School District as they relate to enrollment decline. Specifically, the task force was to establish criteria for identifying facilities where changes should be considered; identify and prioritize alternatives for use of excess classroom space; and…

77 FR 1913 - Notice of Meeting of the Agricultural Air Quality Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... Conservation Service Notice of Meeting of the Agricultural Air Quality Task Force AGENCY: Natural Resources...), Agricultural Air Quality Task Force (AAQTF) will meet to continue discussions on critical air quality issues... relationship between agricultural production and air quality. The meeting is open to the public, and a draft...

Status Report on Activities of the Systems Assessment Task Force, OECD-NEA Expert Group on Accident Tolerant Fuels for LWRs

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

Bragg-Sitton, Shannon Michelle

The Organization for Economic Cooperation and Development /Nuclear Energy Agency (OECD/NEA) Nuclear Science Committee approved the formation of an Expert Group on Accident Tolerant Fuel (ATF) for LWRs (EGATFL) in 2014. Chaired by Kemal Pasamehmetoglu, INL Associate Laboratory Director for Nuclear Science and Technology, the mandate for the EGATFL defines work under three task forces: (1) Systems Assessment, (2) Cladding and Core Materials, and (3) Fuel Concepts. Scope for the Systems Assessment task force (TF1) includes definition of evaluation metrics for ATF, technology readiness level definition, definition of illustrative scenarios for ATF evaluation, and identification of fuel performance and systemmore » codes applicable to ATF evaluation. The Cladding and Core Materials (TF2) and Fuel Concepts (TF3) task forces will identify gaps and needs for modeling and experimental demonstration; define key properties of interest; identify the data necessary to perform concept evaluation under normal conditions and illustrative scenarios; identify available infrastructure (internationally) to support experimental needs; and make recommendations on priorities. Where possible, considering proprietary and other export restrictions (e.g., International Traffic in Arms Regulations), the Expert Group will facilitate the sharing of data and lessons learned across the international group membership. The Systems Assessment task force is chaired by Shannon Bragg-Sitton (Idaho National Laboratory [INL], U.S.), the Cladding Task Force is chaired by Marie Moatti (Electricite de France [EdF], France), and the Fuels Task Force is chaired by a Masaki Kurata (Japan Atomic Energy Agency [JAEA], Japan). The original Expert Group mandate was established for June 2014 to June 2016. In April 2016 the Expert Group voted to extend the mandate one additional year to June 2017 in order to complete the task force deliverables; this request was subsequently approved by the Nuclear Science Committee. This report provides an update on the status Systems Assessment Task Force activities.« less

Fifth Report of the NASA Advisory Council Task Force on the Shuttle-Mir Rendezvous and Docking Missions

NASA Technical Reports Server (NTRS)

1995-01-01

The NASA Advisory Council Task Force on the Shuttle-Mir rendezvous and docking missions examine a number of specific issues related to the Shuttle-Mir program. Three teams composed of Task Force members and technical advisors were formed to address the follow issues: preliminary results from STS-71 and the status of preparations for STS-74; NASA's presence in Russia; and NASA's automated data processing and telecommunications (ADP/T) infrastructure in Russia. The three review team reports have been included in the fifth report of the Task Force.

Enhanced Training by a Systemic Governance of Force Capabilities, Tasks, and Processes

DTIC Science & Technology

2013-06-01

18th ICCRTS “C2 in Underdeveloped, Degraded and Denied Operational Environments” Enhanced Training by a Systemic Governance of Force Capabilities...TITLE AND SUBTITLE Enhanced Training by a Systemic Governance of Force Capabilities, Tasks, and Processes 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...assess, evaluate and accredit the Swedish forces. This paper presents a Systemic Governance of Capabilities, Tasks, and Processes applied to the

Evaluation of pliers' grip spans in the maximum gripping task and sub-maximum cutting task.

PubMed

Kim, Dae-Min; Kong, Yong-Ku

2016-12-01

A total of 25 males participated to investigate the effects of the grip spans of pliers on the total grip force, individual finger forces and muscle activities in the maximum gripping task and wire-cutting tasks. In the maximum gripping task, results showed that the 50-mm grip span had significantly higher total grip strength than the other grip spans. In the cutting task, the 50-mm grip span also showed significantly higher grip strength than the 65-mm and 80-mm grip spans, whereas the muscle activities showed a higher value at 80-mm grip span. The ratios of cutting force to maximum grip strength were also investigated. Ratios of 30.3%, 31.3% and 41.3% were obtained by grip spans of 50-mm, 65-mm, and 80-mm, respectively. Thus, the 50-mm grip span for pliers might be recommended to provide maximum exertion in gripping tasks, as well as lower maximum-cutting force ratios in the cutting tasks.

U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.

PubMed

Salloum, Ramzi G; Kohler, Racquel E; Jensen, Gail A; Sheridan, Stacey L; Carpenter, William R; Biddle, Andrea K

2014-03-01

Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. We identified female Medicare beneficiaries aged 66-80 years and used bivariate probit regression to examine the receipt of breast (mammogram) and cervical (Pap test) cancer screening reflecting changes in the Task Force recommendations. We analyzed 9,760 Medicare Current Beneficiary Survey responses from 2001 to 2007. More than two-thirds reported receiving a mammogram and more than one-third a Pap test in the previous 2 years. Lack of recommendation was given as a reason for not getting screened among the majority (51% for mammogram and 75% for Pap). After controlling for beneficiary-level socioeconomic characteristics and access to care factors, we did not observe a significant change in breast and cervical cancer screening patterns following the changes in Task Force recommendations. Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.

Deficits in inhibitory force control in young adults with ADHD.

PubMed

Neely, Kristina A; Wang, Peiyuan; Chennavasin, Amanda P; Samimy, Shaadee; Tucker, Jacqueline; Merida, Andrea; Perez-Edgar, Koraly; Huang-Pollock, Cynthia

2017-05-01

Poor inhibitory control is a well-established cognitive correlate of adults with ADHD. However, the simple reaction time (RT) task used in a majority of studies records performance errors only via the presence or absence of a single key press. This all-or-nothing response makes it impossible to capture subtle differences in underlying processes that shape performance. Subsequently, all-or-nothing tasks may underestimate the prevalence of executive function deficits in ADHD. The current study measured inhibitory control using a standard Go/No-Go RT task and a more sensitive continuous grip force task among adults with (N=51, 22 female) and without (N=51, 29 female) ADHD. Compared to adults without ADHD, adults with ADHD made more failed inhibits in the classic Go/No-Go paradigm and produced greater and more variable force during motor inhibition. The amount of force produced on failed inhibits was a stronger predictor of ADHD-related symptoms than the number of commissions in the standard RT task. Adults with ADHD did not differ from those without ADHD on the mean force and variability of force produced in Go trials. These findings suggest that the use of a precise and continuous motor task, such as the force task used here, provides additional information about the nature of inhibitory motor control in adults with ADHD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Estimation of lumbar spinal loading and trunk muscle forces during asymmetric lifting tasks: application of whole-body musculoskeletal modelling in OpenSim.

PubMed

Kim, Hyun-Kyung; Zhang, Yanxin

2017-04-01

Large spinal compressive force combined with axial torsional shear force during asymmetric lifting tasks is highly associated with lower back injury (LBI). The aim of this study was to estimate lumbar spinal loading and muscle forces during symmetric lifting (SL) and asymmetric lifting (AL) tasks using a whole-body musculoskeletal modelling approach. Thirteen healthy males lifted loads of 7 and 12 kg under two lifting conditions (SL and AL). Kinematic data and ground reaction force data were collected and then processed by a whole-body musculoskeletal model. The results show AL produced a significantly higher peak lateral shear force as well as greater peak force of psoas major, quadratus lumborum, multifidus, iliocostalis lumborum pars lumborum, longissimus thoracis pars lumborum and external oblique than SL. The greater lateral shear forces combined with higher muscle force and asymmetrical muscle contractions may have the biomechanical mechanism responsible for the increased risk of LBI during AL. Practitioner Summary: Estimating lumbar spinal loading and muscle forces during free-dynamic asymmetric lifting tasks with a whole-body musculoskeletal modelling in OpenSim is the core value of this research. The results show that certain muscle groups are fundamentally responsible for asymmetric movement, thereby producing high lumbar spinal loading and muscle forces, which may increase risks of LBI during asymmetric lifting tasks.

Finger Interdependence: Linking the Kinetic and Kinematic Variables

PubMed Central

Kim, Sun Wook; Shim, Jae Kun; Zatsiorsky, Vladimir M.; Latash, Mark L.

2008-01-01

We studied the dependence between voluntary motion of a finger and pressing forces produced by the tips of other fingers of the hand. Subjects moved one of the fingers (task finger) of the right hand trying to follow a cyclic, ramp-like flexion-extension template at different frequencies. The other fingers (slave fingers) were restricted from moving; their flexion forces were recorded and analyzed. Index finger motion caused the smallest force production by the slave fingers. Larger forces were produced by the neighbors of the task finger; these forces showed strong modulation over the range of motion of the task finger. The enslaved forces were higher during the flexion phase of the movement cycle as compared to the extension phase. The index of enslaving expressed in N/rad was higher when the task finger moved through the more flexed postures. The dependence of enslaving on both range and direction of task finger motion poses problems for methods of analysis of finger coordination based on an assumption of universal matrices of finger inter-dependence. PMID:18255182

Report of the MLA Task Force on Evaluating Scholarship for Tenure and Promotion

ERIC Educational Resources Information Center

Modern Language Association, 2007

2007-01-01

In 2004 the Executive Council of the Modern Language Association of America (MLA) created a task force to examine current standards and emerging trends in publication requirements for tenure and promotion in English and foreign language departments in the United States. To fulfill its charge, the task force reviewed numerous studies, reports, and…

Short-Circuiting the Bureaucracy: Policy Origins in Education.

ERIC Educational Resources Information Center

Graham, Hugh Davis

The Great Society's secret task forces created by Lyndon Johnson, particularly in the case-study area of federal education policy, show the use and misuse of the task force device. Modern use of it began with John F. Kennedy. Although he used the task force device effectively sometimes, he did not use it effectively in his educational programs in…

77 FR 39724 - U.S. Coral Reef Task Force Public Meeting and Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

...-DS61200000] U.S. Coral Reef Task Force Public Meeting and Public Comment AGENCY: Fish and Wildlife Service... Wildlife Service (Service), announce a public meeting of the U.S. Coral Reef Task Force (USCRTF) and a... strengthen U.S. government actions to better preserve and protect coral reef ecosystems. The Departments of...

Idaho Rural Education Task Force. Public School Information. Legislative Report, 2008

ERIC Educational Resources Information Center

Idaho State Department of Education, 2008

2008-01-01

The Idaho Rural Education Task Force was formed in July 2007 with the goal of proposing and examining solutions to challenges facing rural schools. The task force's work this year has focused on three areas: recruitment and retention of highly qualified teachers, funding shortages related to insurance costs and staff allowances, and the technology…

Lifelong Learning NCES Task Force: Final Report, Volume I. Working Paper Series.

ERIC Educational Resources Information Center

Binkley, Marilyn; Hudson, Lisa; Knepper, Paula; Kolstad, Andy; Stowe, Peter; Wirt, John

In September 1998, the National Center for Education Statistics (NCES) established a 1-year task force to review the NCES's role concerning lifelong learning. The eight-member task force established a working definition of lifelong learning ("a process or system through which individuals are able and willing to learn at all stages of life,…

Million Hearts 2022: Understanding the Links between Environmental Pollutant Exposure and Cardiovascular and Cerebrovascular Events - Justus-Warren Heart Disease and Stroke Prevention Task Force

EPA Science Inventory

The webinar was requested by the Justus-Warren Heart Disease and Stroke Prevention Task Force. From their website, “The task force was established in 1995 in North Carolina to provide statewide leadership for the prevention and management of cardiovascular disease. Meetings are...

History and background of the California Oak Mortality Task Force (COMTF)

Treesearch

Mark R. Stanley

2006-01-01

The California Oak Mortality Task Force was formed in August 2000 as a consensus group to address the impacts caused by Phytophthora ramorum. It is over 1000 strong with over 80 agencies, universities, public, and private groups currently involved. The Task Force has been a tremendous success and may serve as model for other similar efforts.

77 FR 17534 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

... Association (``SIFMA'') formed the MMI Blue-Sky Task Force (``Task Force'') to address systemic and unique... processing. The Task Force, along other money market industry members,\\8\\ determined that DTC's current MMI... amount or proceeds after the 3 p.m. E.T. deadline for RTP instructions.\\9\\ Accordingly, DTC is proposing...

"Rekindle and Recapture the Love": Establishing System-Wide Indicators of Progress in Community Engagement and Economic Development

ERIC Educational Resources Information Center

Janke, Emily M.

2014-01-01

In May 2012, University of North Carolina (UNC) President Tom Ross simultaneously commissioned two task forces to develop indicators that all UNC campuses could use to measure "progress in community engagement and economic development." The charge to the Community Engagement Task Force and the Economic Development Task Force was to…

77 FR 16483 - Petition for Rulemaking Submitted by the Natural Resources Defense Council, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

... Enhancing Reactor Safety in the 21st Century: The Near-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report, ADAMS Accession No. ML111861807), dated July 12..., of the Fukushima Task Force Report, regarding the enhancement of the ability of nuclear power plants...

San Juan College Task Force on Innovation 1995 Report.

ERIC Educational Resources Information Center

Moore, Nelle

In fall 1994, San Juan College, in New Mexico, established the Task Force on Innovation to examine changes in the paradigm of education and how those changes might affect the college. The Task Force determined that the primary driver of change in education was technology, and specifically the increasing number of means and ease of access to…

Report of the Task Force on Continuing Education and Non-Credit Instruction.

ERIC Educational Resources Information Center

Ernest, Richard J.; And Others

The Task Force on Continuing Education and Non-Credit Instruction was appointed to develop specific strategies for expanding lifelong learning and non-credit instruction in the Virginia community colleges. The task force reviewed a report on the state funding of non-credit instruction; wrote to the community college coordinating offices in 17…

ACHP | News

Science.gov Websites

Search skip specific nav links Home arrow News arrow June 27, 2012 ACHP Rightsizing Task Force to Meet in Cleveland The ACHP's Rightsizing Task Force will be making a visit to Cleveland, Ohio, June 25-26 for a tour and a listening session and open meeting. The task force will host a public meeting on June 26 at

Responding to Violence and Abuse: Educating Minnesota Professionals for the Future. A Report of the Statewide Task Forces.

ERIC Educational Resources Information Center

Minnesota Higher Education Center against Violence and Abuse, St. Paul.

In response to a 1993 Minnesota crime bill, four task forces reviewed violence education in professional higher education programs and made recommendations for legislation and law enforcement. The four task forces--in Law, Health Services, Human Services, and Education--made several critical recommendations that applied across professions:…

National Library of Education Advisory Task Force. Briefing Book.

ERIC Educational Resources Information Center

National Library of Education (ED/OERI), Washington, DC.

This briefing book with appendices was prepared for the initial meetings of the National Library of Education Advisory Task Force (NLE/ATF), in March 1996. An agenda for this meeting is included in the briefing book. The first section, "Governing Authorities for NLE and the Advisory Task Force," contains a copy of Public Law 103-227,…

Attainment and retention of force moderation following laparoscopic resection training with visual force feedback.

PubMed

Hernandez, Rafael; Onar-Thomas, Arzu; Travascio, Francesco; Asfour, Shihab

2017-11-01

Laparoscopic training with visual force feedback can lead to immediate improvements in force moderation. However, the long-term retention of this kind of learning and its potential decay are yet unclear. A laparoscopic resection task and force sensing apparatus were designed to assess the benefits of visual force feedback training. Twenty-two male university students with no previous experience in laparoscopy underwent relevant FLS proficiency training. Participants were randomly assigned to either a control or treatment group. Both groups trained on the task for 2 weeks as follows: initial baseline, sixteen training trials, and post-test immediately after. The treatment group had visual force feedback during training, whereas the control group did not. Participants then performed four weekly test trials to assess long-term retention of training. Outcomes recorded were maximum pulling and pushing forces, completion time, and rated task difficulty. Extreme maximum pulling force values were tapered throughout both the training and retention periods. Average maximum pushing forces were significantly lowered towards the end of training and during retention period. No significant decay of applied force learning was found during the 4-week retention period. Completion time and rated task difficulty were higher during training, but results indicate that the difference eventually fades during the retention period. Significant differences in aptitude across participants were found. Visual force feedback training improves on certain aspects of force moderation in a laparoscopic resection task. Results suggest that with enough training there is no significant decay of learning within the first month of the retention period. It is essential to account for differences in aptitude between individuals in this type of longitudinal research. This study shows how an inexpensive force measuring system can be used with an FLS Trainer System after some retrofitting. Surgical instructors can develop their own tasks and adjust force feedback levels accordingly.

A teleoperation training simulator with visual and kinesthetic force virtual reality

NASA Technical Reports Server (NTRS)

Kim, Won S.; Schenker, Paul

1992-01-01

A force-reflecting teleoperation training simulator with a high-fidelity real-time graphics display has been developed for operator training. A novel feature of this simulator is that it enables the operator to feel contact forces and torques through a force-reflecting controller during the execution of the simulated peg-in-hole task, providing the operator with the feel of visual and kinesthetic force virtual reality. A peg-in-hole task is used in our simulated teleoperation trainer as a generic teleoperation task. A quasi-static analysis of a two-dimensional peg-in-hole task model has been extended to a three-dimensional model analysis to compute contact forces and torques for a virtual realization of kinesthetic force feedback. The simulator allows the user to specify force reflection gains and stiffness (compliance) values of the manipulator hand for both the three translational and the three rotational axes in Cartesian space. Three viewing modes are provided for graphics display: single view, two split views, and stereoscopic view.

Improving child and adolescent psychiatry education for medical students: an inter-organizational collaborative action plan.

PubMed

Fox, Geraldine S; Stock, Saundra; Briscoe, Gregory W; Beck, Gary L; Horton, Rita; Hunt, Jeffrey I; Liu, Howard Y; Partner Rutter, Ashley; Sexson, Sandra; Schlozman, Steven C; Stubbe, Dorothy E; Stuber, Margaret L

2012-11-01

A new Child and Adolescent Psychiatry in Medical Education (CAPME) Task Force, sponsored by the Association for Directors of Medical Student Education in Psychiatry (ADMSEP), has created an inter-organizational partnership between child and adolescent psychiatry (CAP) educators and medical student educators in psychiatry. This paper outlines the task force design and strategic plan to address the long-standing dearth of CAP training for medical students. The CAPME ADMSEP Task Force, formed in 2010, identified common challenges to teaching CAP among ADMSEP's CAPME Task Force members, utilizing focus-group discussions and a needs-assessment survey. The Task Force was organized into five major sections, with inter-organizational action plans to address identified areas of need, such as portable modules and development of benchmark CAP competencies. The authors predict that all new physicians, regardless of specialty, will be better trained in CAP. Increased exposure may also improve recruitment into this underserved area.

Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma.

PubMed

Wells, Samuel A; Asa, Sylvia L; Dralle, Henning; Elisei, Rossella; Evans, Douglas B; Gagel, Robert F; Lee, Nancy; Machens, Andreas; Moley, Jeffrey F; Pacini, Furio; Raue, Friedhelm; Frank-Raue, Karin; Robinson, Bruce; Rosenthal, M Sara; Santoro, Massimo; Schlumberger, Martin; Shah, Manisha; Waguespack, Steven G

2015-06-01

The American Thyroid Association appointed a Task Force of experts to revise the original Medullary Thyroid Carcinoma: Management Guidelines of the American Thyroid Association. The Task Force identified relevant articles using a systematic PubMed search, supplemented with additional published materials, and then created evidence-based recommendations, which were set in categories using criteria adapted from the United States Preventive Services Task Force Agency for Healthcare Research and Quality. The original guidelines provided abundant source material and an excellent organizational structure that served as the basis for the current revised document. The revised guidelines are focused primarily on the diagnosis and treatment of patients with sporadic medullary thyroid carcinoma (MTC) and hereditary MTC. The Task Force developed 67 evidence-based recommendations to assist clinicians in the care of patients with MTC. The Task Force considers the recommendations to represent current, rational, and optimal medical practice.

Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma

PubMed Central

Asa, Sylvia L.; Dralle, Henning; Elisei, Rossella; Evans, Douglas B.; Gagel, Robert F.; Lee, Nancy; Machens, Andreas; Moley, Jeffrey F.; Pacini, Furio; Raue, Friedhelm; Frank-Raue, Karin; Robinson, Bruce; Rosenthal, M. Sara; Santoro, Massimo; Schlumberger, Martin; Shah, Manisha; Waguespack, Steven G.

2015-01-01

Introduction: The American Thyroid Association appointed a Task Force of experts to revise the original Medullary Thyroid Carcinoma: Management Guidelines of the American Thyroid Association. Methods: The Task Force identified relevant articles using a systematic PubMed search, supplemented with additional published materials, and then created evidence-based recommendations, which were set in categories using criteria adapted from the United States Preventive Services Task Force Agency for Healthcare Research and Quality. The original guidelines provided abundant source material and an excellent organizational structure that served as the basis for the current revised document. Results: The revised guidelines are focused primarily on the diagnosis and treatment of patients with sporadic medullary thyroid carcinoma (MTC) and hereditary MTC. Conclusions: The Task Force developed 67 evidence-based recommendations to assist clinicians in the care of patients with MTC. The Task Force considers the recommendations to represent current, rational, and optimal medical practice. PMID:25810047

International confederation for cleft lip and palate and related craniofacial anomalies task force report: holistic outcomes.

PubMed

Broder, Hillary L

2014-11-01

Objective : This paper describes the process and outcomes of the 2013 American Cleft Palate-Craniofacial Association task force on Holistic Outcomes. The goals and membership of the task force are presented. Methods : Using internet communication, the group introduced themselves, shared ideas and information related to holistic assessment and implementation of using a validated holistic measure, the Child Oral Health Impact Profile (COHIP) at participating international sites. Results : Data from the sites were analyzed using descriptive statistics. Administration of the COHIP was successful. It varied from self-completion as well as verbal presentation due to language differences and a function of the short time period to complete collection. Additionally qualitative comments were reported by the task force site directors. Conclusions : Future directions for holistic assessment and communication among task force members and sites were discussed at the Congress and are presented in this report.

NASA's Big Data Task Force

NASA Astrophysics Data System (ADS)

Holmes, C. P.; Kinter, J. L.; Beebe, R. F.; Feigelson, E.; Hurlburt, N. E.; Mentzel, C.; Smith, G.; Tino, C.; Walker, R. J.

2017-12-01

Two years ago NASA established the Ad Hoc Big Data Task Force (BDTF - https://science.nasa.gov/science-committee/subcommittees/big-data-task-force), an advisory working group with the NASA Advisory Council system. The scope of the Task Force included all NASA Big Data programs, projects, missions, and activities. The Task Force focused on such topics as exploring the existing and planned evolution of NASA's science data cyber-infrastructure that supports broad access to data repositories for NASA Science Mission Directorate missions; best practices within NASA, other Federal agencies, private industry and research institutions; and Federal initiatives related to big data and data access. The BDTF has completed its two-year term and produced several recommendations plus four white papers for NASA's Science Mission Directorate. This presentation will discuss the activities and results of the TF including summaries of key points from its focused study topics. The paper serves as an introduction to the papers following in this ESSI session.

A Model for Steering with Haptic-Force Guidance

NASA Astrophysics Data System (ADS)

Yang, Xing-Dong; Irani, Pourang; Boulanger, Pierre; Bischof, Walter F.

Trajectory-based tasks are common in many applications and have been widely studied. Recently, researchers have shown that even very simple tasks, such as selecting items from cascading menus, can benefit from haptic-force guidance. Haptic guidance is also of significant value in many applications such as medical training, handwriting learning, and in applications requiring precise manipulations. There are, however, only very few guiding principles for selecting parameters that are best suited for proper force guiding. In this paper, we present a model, derived from the steering law that relates movement time to the essential components of a tunneling task in the presence of haptic-force guidance. Results of an experiment show that our model is highly accurate for predicting performance times in force-enhanced tunneling tasks.

Results of telerobotic hand controller study using force information and rate control

NASA Technical Reports Server (NTRS)

Willshire, Kelli F.; Harrison, F. W.; Hogge, Edward F.; Williams, Robert L.; Soloway, Donald

1992-01-01

To increase quantified information about the effectiveness and subjective workload of force information relayed through manipulator input control devices, a space related task was performed by eight subjects with kinesthetic force feedback and/or local force accommodation through three different input control devices (i.e., hand controllers) operating in rate control mode. Task completion time, manipulator work, and subjective responses were measured. Results indicated a difference among the hand controllers. For the Honeywell six degree-of-freedom hand controller, the overall task completion times were shortest, the amount of work exerted was the least, and was the most preferred by test subjects. Neither force accommodation with or without reflection resulted in shorter task completion times or reduced work although those conditions were better than no force information for some aspects. Comparisons of results from previous studies are discussed.

Problems and research issues associated with the hybrid control of force and displacement

NASA Technical Reports Server (NTRS)

Paul, R. P.

1987-01-01

The hybrid control of force and position is basic to the science of robotics but is only poorly understood. Before much progress can be made in robotics, this problem needs to be solved in a robust manner. However, the use of hybrid control implies the existence of a model of the environment, not an exact model (as the function of hybrid control is to accommodate these errors), but a model appropriate for planning and reasoning. The monitored forces in position control are interpreted in terms of a model of the task as are the monitored displacements in force control. The reaction forces of the task of writing are far different from those of hammering. The programming of actions in such a modeled world becomes more complicated and systems of task level programming need to be developed. Sensor based robotics, of which force sensing is the most basic, implies an entirely new level of technology. Indeed, robot force sensors, no matter how compliant they may be, must be protected from accidental collisions. This implies other sensors to monitor task execution and again the use of a world model. This new level of technology is the task level, in which task actions are specified, not the actions of individual sensors and manipulators.

Identification of Occupational Areas for Indiana's Future. Final Report of the Technology Forecasting Task Force.

ERIC Educational Resources Information Center

Indiana State Commission on Vocational and Technical Education, Indianapolis.

A task force representing the Indiana private sector was convened for two purposes: to (1) identify the impact of technology on required worker skills, the labor market, and the vocational education, training, and employment system; and (2) identify occupational areas that should be future growth areas for the state. Task force members reviewed…

Task Force for Expanding Credit and Noncredit Courses for Students with Intellectual and Development Disabilities. Final Report

ERIC Educational Resources Information Center

Maryland Higher Education Commission, 2016

2016-01-01

The Task Force to Study the Impact of Expanding Credit and Noncredit Courses for Students with Intellectual and Developmental Disabilities was formed in July 2013. Chapter 392, Acts of 2013, (House Bill 813) established the Task Force to Study the Impact of Expanding Credit and Noncredit Courses for Students with Intellectual and Developmental…

Arizona Community Colleges: Report of the Task Force on Community College Enrollment Growth Planning.

ERIC Educational Resources Information Center

Arizona State Board of Directors for Community Colleges, Phoenix.

The Task Force on Enrollment Growth Planning (TFEGP), authorized in 1992 by the State Board of Directors for Community Colleges (SBDCC) of Arizona, includes representatives from each community college as well as staff from SBDCC office. The Task Force was created to prepare enrollment growth estimates for community colleges through the year 2010;…

The Educational, Fiscal, and Access Implications of the Fall Academic Calendar. The Report of the Academic Calendar Task Force.

ERIC Educational Resources Information Center

Armstrong, William B.

In 1991, California's San Diego Community College District (SDCCD) formed a task force to investigate the effects of adopting academic calendars that end either before or after the winter holidays. To gather information, the task force performed a grade distribution analysis among district college students to determine the impact of fall semester…

Report of the Task Force to Explore Feasibility of a Three-Year Baccalaureate Program. Established March 1, 1972.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee.

Presented in this document are the results of a Task Force study in Florida that explored the feasibility of a baccalaureate degree program that can be completed in 3 academic years. The Task Force addressed itself to the issues surrounding time-shortened degrees: acceleration; locksteps; relevancy of educational objectives to individual and…

Report of the Task Force on the Status of Women at the University of California, Davis.

ERIC Educational Resources Information Center

Fisher, Kathleen M.

The charge given to the Task Force on the Status of Women at the University of California, Davis, was to determine the employment opportunities for women on the Davis campus. The Task Force addressed itself primarily to 4 major employment categories: non-academic staff, academic staff, faculty, and administration, with lesser consideration given…

A Report by the Governor's Task Force on Vocational and Technical Education.

ERIC Educational Resources Information Center

Governor's Task Force on Vocational and Technical Education, Columbus, OH.

On July 19, 1968, a Task Force on Vocational and Technical Education was created by the governor of Ohio to develop proposals for organization, financing, and legislation. Some major problems to which the Task Force gave attention were: (1) the serious gap between the need for and the availability of vocational and technical education, (2) the…

76 FR 70067 - Taxpayers and Ratepayers United, et al.; Environmental Impacts of Severe Reactor and Spent Fuel...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-10

... environmental issues raised in the Fukushima Task Force Report. The NRC is not instituting a public comment... Reactor Safety in the 21st Century: The Near-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident'' (Fukushima Task Force Report, ADAMS Accession No. ML111861807), dated July 12, 2011, as...

77 FR 30560 - Proposed Generic Communication; Generic Letter on Seismic Risk Evaluations for Operating Reactors

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

... the Fukushima Near-Term Task Force Recommendations 2.1 and 2.3. The request for information letters... addressing the Fukushima Near-Term Task Force Recommendations 2.1 and 2.3. The memorandum is available... Fukushima Near-Term Task Force Recommendations 2.1 and 2.3 (ADAMS Accession Number ML12056A046), as...

The APA Task Force on Statistical Inference (TFSI) Report as a Framework for Teaching and Evaluating Students' Understandings of Study Validity.

ERIC Educational Resources Information Center

Thompson, Bruce

Web-based statistical instruction, like all statistical instruction, ought to focus on teaching the essence of the research endeavor: the exercise of reflective judgment. Using the framework of the recent report of the American Psychological Association (APA) Task Force on Statistical Inference (Wilkinson and the APA Task Force on Statistical…

Building Bridges to the Information Superhighway: Annual Report of the Disabilities Issues Task Force, Federal Communications Commission (March 1995--April 1996).

ERIC Educational Resources Information Center

Federal Communications Commission, Washington, DC.

This report describes activities and accomplishments of the Federal Communications Commission's Disabilities Issues Task Force on disabilities issues from March 1995 through April 1996, its first year. Introductory material includes a message from the chairman of the Commission and a statement of the Task Force's purpose, which is to address…

U. S. Atlantic Fleet, Task Force 85. Operation Plan Number 3-44

DTIC Science & Technology

1944-07-27

Potential Targets in Sectors of Responsibility Gril /8thPhib/Al6-3 Serial: 0031(P) DEAN/14- Potential Targets in Se_otors t of Respon- sibility...tags accompany the remains, ANNEX QUEEN MEDICAL PLAN - Page 6 of 8 GrIl /8thPhib/Al6-3 WESTERN NAVAL TASK FORCE, Serial: 0037(P) TASK FORCE EIGHTY-FIVE

Credentialing Educational Accomplishment. Report and Recommendations of the Task Force on Educational Credit and Credentials.

ERIC Educational Resources Information Center

Miller, Jerry W., Ed.; Mills, Olive, Ed.

The Task Force on Educational Credit and Credentials of the American Council on Education undertook a two-year study to determine how postsecondary education's system for awarding credit and credentials can be changed or its adequacy improved to meet today's educational and social needs. This book sets forth the Task Force's report and…

Tomorrow. The Report of the Task Force for the Study of Chemistry Education in the United States.

ERIC Educational Resources Information Center

American Chemical Society, Washington, DC.

An American Chemical Society (ACS) task force was charged to examine the state of chemistry education in the United States and to make recommendations in light of its findings. This document presents the task force's report and 39 major (and also secondary) recommendations. These recommendations, with accompanying discussions, focus on: (1)…

Enslaving in a serial chain: interactions between grip force and hand force in isometric tasks.

PubMed

Paclet, Florent; Ambike, Satyajit; Zatsiorsky, Vladimir M; Latash, Mark L

2014-03-01

This study was motivated by the double action of extrinsic hand muscles that produce grip force and also contribute to wrist torque. We explored interactions between grip force and wrist torque in isometric force production tasks. In particular, we tested a hypothesis that an intentional change in one of the two kinetic variables would produce an unintentional change in the other (enslaving). When young healthy subjects produced accurate changes in the grip force, only minor effects on the force produced by the hand (by wrist flexion/extension action) were observed. In contrast, a change in the hand force produced consistent changes in grip force in the same direction. The magnitude of such unintentional grip force change was stronger for intentional hand force decrease as compared to hand force increase. These effects increased with the magnitude of the initial grip force. When the subjects were asked to produce accurate total force computed as the sum of the hand and grip forces, strong negative covariation between the two forces was seen across trials interpreted as a synergy stabilizing the total force. An index of this synergy was higher in the space of "modes," hypothetical signals to the two effectors that could be changed by the controller one at a time. We interpret the complex enslaving effects (positive force covariation) as conditioned by typical everyday tasks. The presence of synergic effects (negative, task-specific force covariation) can be naturally interpreted within the referent configuration hypothesis.

Enslaving in a serial chain: Interactions between grip force and hand force in isometric tasks

PubMed Central

Paclet, Florent; Ambike, Satyajit; Zatsiorsky, Vladimir M.; Latash, Mark L.

2014-01-01

This study was motivated by the double action of extrinsic hand muscles that produce grip force and also contribute to wrist torque. We explored interactions between grip force and wrist torque in isometric force production tasks. In particular, we tested a hypothesis that an intentional change in one of the two kinetic variables would produce an unintentional change in the other (enslaving). When young healthy subjects produced accurate changes in the grip force, only minor effects on the force produced by the hand (by wrist flexion/extension action) were observed. In contrast, a change in the hand force produced consistent changes in grip force in the same direction. The magnitude of such unintentional grip force change was stronger for intentional hand force decrease as compared to hand force increase. These effects increased with the magnitude of the initial grip force. When the subjects were asked to produce accurate total force computed as the sum of the hand and grip forces, strong negative co-variation between the two forces was seen across trials interpreted as a synergy stabilizing the total force. An index of this synergy was higher in the space of “modes”, hypothetical signals to the two effectors that could be changed by the controller one at a time. We interpret the complex enslaving effects (positive force co-variation) as conditioned by typical everyday tasks. The presence of synergic effects (negative, task-specific force co-variation) can be naturally interpreted within the referent configuration hypothesis. PMID:24309747

The interaction of force and repetition on musculoskeletal and neural tissue responses and sensorimotor behavior in a rat model of work-related musculoskeletal disorders

PubMed Central

2013-01-01

Background We examined the relationship of musculoskeletal risk factors underlying force and repetition on tissue responses in an operant rat model of repetitive reaching and pulling, and if force x repetition interactions were present, indicative of a fatigue failure process. We examined exposure-dependent changes in biochemical, morphological and sensorimotor responses occurring with repeated performance of a handle-pulling task for 12 weeks at one of four repetition and force levels: 1) low repetition with low force, 2) high repetition with low force, 3) low repetition with high force, and 4) high repetition with high force (HRHF). Methods Rats underwent initial training for 4–6 weeks, and then performed one of the tasks for 12 weeks, 2 hours/day, 3 days/week. Reflexive grip strength and sensitivity to touch were assayed as functional outcomes. Flexor digitorum muscles and tendons, forelimb bones, and serum were assayed using ELISA for indicators of inflammation, tissue stress and repair, and bone turnover. Histomorphometry was used to assay macrophage infiltration of tissues, spinal cord substance P changes, and tissue adaptative or degradative changes. MicroCT was used to assay bones for changes in bone quality. Results Several force x repetition interactions were observed for: muscle IL-1alpha and bone IL-1beta; serum TNFalpha, IL-1alpha, and IL-1beta; muscle HSP72, a tissue stress and repair protein; histomorphological evidence of tendon and cartilage degradation; serum biomarkers of bone degradation (CTXI) and bone formation (osteocalcin); and morphological evidence of bone adaptation versus resorption. In most cases, performance of the HRHF task induced the greatest tissue degenerative changes, while performance of moderate level tasks induced bone adaptation and a suggestion of muscle adaptation. Both high force tasks induced median nerve macrophage infiltration, spinal cord sensitization (increased substance P), grip strength declines and forepaw mechanical allodynia by task week 12. Conclusions Although not consistent in all tissues, we found several significant interactions between the critical musculoskeletal risk factors of force and repetition, consistent with a fatigue failure process in musculoskeletal tissues. Prolonged performance of HRHF tasks exhibited significantly increased risk for musculoskeletal disorders, while performance of moderate level tasks exhibited adaptation to task demands. PMID:24156755

The interaction of force and repetition on musculoskeletal and neural tissue responses and sensorimotor behavior in a rat model of work-related musculoskeletal disorders.

PubMed

Barbe, Mary F; Gallagher, Sean; Massicotte, Vicky S; Tytell, Michael; Popoff, Steven N; Barr-Gillespie, Ann E

2013-10-25

We examined the relationship of musculoskeletal risk factors underlying force and repetition on tissue responses in an operant rat model of repetitive reaching and pulling, and if force x repetition interactions were present, indicative of a fatigue failure process. We examined exposure-dependent changes in biochemical, morphological and sensorimotor responses occurring with repeated performance of a handle-pulling task for 12 weeks at one of four repetition and force levels: 1) low repetition with low force, 2) high repetition with low force, 3) low repetition with high force, and 4) high repetition with high force (HRHF). Rats underwent initial training for 4-6 weeks, and then performed one of the tasks for 12 weeks, 2 hours/day, 3 days/week. Reflexive grip strength and sensitivity to touch were assayed as functional outcomes. Flexor digitorum muscles and tendons, forelimb bones, and serum were assayed using ELISA for indicators of inflammation, tissue stress and repair, and bone turnover. Histomorphometry was used to assay macrophage infiltration of tissues, spinal cord substance P changes, and tissue adaptative or degradative changes. MicroCT was used to assay bones for changes in bone quality. Several force x repetition interactions were observed for: muscle IL-1alpha and bone IL-1beta; serum TNFalpha, IL-1alpha, and IL-1beta; muscle HSP72, a tissue stress and repair protein; histomorphological evidence of tendon and cartilage degradation; serum biomarkers of bone degradation (CTXI) and bone formation (osteocalcin); and morphological evidence of bone adaptation versus resorption. In most cases, performance of the HRHF task induced the greatest tissue degenerative changes, while performance of moderate level tasks induced bone adaptation and a suggestion of muscle adaptation. Both high force tasks induced median nerve macrophage infiltration, spinal cord sensitization (increased substance P), grip strength declines and forepaw mechanical allodynia by task week 12. Although not consistent in all tissues, we found several significant interactions between the critical musculoskeletal risk factors of force and repetition, consistent with a fatigue failure process in musculoskeletal tissues. Prolonged performance of HRHF tasks exhibited significantly increased risk for musculoskeletal disorders, while performance of moderate level tasks exhibited adaptation to task demands.

Learning to combine high variability with high precision: lack of transfer to a different task.

PubMed

Wu, Yen-Hsun; Truglio, Thomas S; Zatsiorsky, Vladimir M; Latash, Mark L

2015-01-01

The authors studied effects of practicing a 4-finger accurate force production task on multifinger coordination quantified within the uncontrolled manifold hypothesis. During practice, task instability was modified by changing visual feedback gain based on accuracy of performance. The authors also explored the retention of these effects, and their transfer to a prehensile task. Subjects practiced the force production task for 2 days. After the practice, total force variability decreased and performance became more accurate. In contrast, variance of finger forces showed a tendency to increase during the first practice session while in the space of finger modes (hypothetical commands to fingers) the increase was under the significance level. These effects were retained for 2 weeks. No transfer of these effects to the prehensile task was seen, suggesting high specificity of coordination changes. The retention of practice effects without transfer to a different task suggests that further studies on a more practical method of improving coordination are needed.

Task Analysis in Optical & Contact Lens Dispensing. Dispensing Opticians.

ERIC Educational Resources Information Center

Hrushowy, Eugene; Stanley, Dale

A task force of opticians and educators in British Columbia was assembled to determine the knowledge and skills required of dispensing opticians and contact lens specialists. The ideas generated by the task force were analyzed and distilled into the standardized tasks listed in this document, using Krathwohl's taxonomy. The document contains 36…

Maximal force and tremor changes across the menstrual cycle.

PubMed

Tenan, Matthew S; Hackney, Anthony C; Griffin, Lisa

2016-01-01

Sex hormones have profound effects on the nervous system in vitro and in vivo. The present study examines the effect of the menstrual cycle on maximal isometric force (MVC) and tremor during an endurance task. Nine eumenorrheic females participated in five study visits across their menstrual cycle. In each menstrual phase, an MVC and an endurance task to failure were performed. Tremor across the endurance task was quantified as the coefficient of variation in force and was assessed in absolute time and relative percent time to task failure. MVC decreases 23% from ovulation to the mid luteal phase of the menstrual cycle. In absolute time, the mid luteal phase has the highest initial tremor, though the early follicular phase has substantially higher tremor than other phases after 150 s of task performance. In relative time, the mid luteal phase has the highest level of tremor throughout the endurance task. Both MVC and tremor during an endurance task are modified by the menstrual cycle. Performance of tasks and sports which require high force and steadiness to exhaustion may be decreased in the mid luteal phase compared to other menstrual phases.

75 FR 4051 - Defense Health Board; DoD Task Force on the Prevention of Suicide by Members of the Armed Forces...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... Prevention of Suicide by Members of the Armed Forces; Meeting AGENCY: Department of Defense (DoD). ACTION... of Suicide by Members of the Armed Forces (hereafter, Task Force) will meet on February 11, 2010, to gather information pertaining to suicide and suicide prevention programs for members of the Armed...

Neural Correlates of Task Cost for Stance Control with an Additional Motor Task: Phase-Locked Electroencephalogram Responses

PubMed Central

Hwang, Ing-Shiou; Huang, Cheng-Ya

2016-01-01

With appropriate reallocation of central resources, the ability to maintain an erect posture is not necessarily degraded by a concurrent motor task. This study investigated the neural control of a particular postural-suprapostural procedure involving brain mechanisms to solve crosstalk between posture and motor subtasks. Participants completed a single posture task and a dual-task while concurrently conducting force-matching and maintaining a tilted stabilometer stance at a target angle. Stabilometer movements and event-related potentials (ERPs) were recorded. The added force-matching task increased the irregularity of postural response rather than the size of postural response prior to force-matching. In addition, the added force-matching task during stabilometer stance led to marked topographic ERP modulation, with greater P2 positivity in the frontal and sensorimotor-parietal areas of the N1-P2 transitional phase and in the sensorimotor-parietal area of the late P2 phase. The time-frequency distribution of the ERP primary principal component revealed that the dual-task condition manifested more pronounced delta (1–4 Hz) and beta (13–35 Hz) synchronizations but suppressed theta activity (4–8 Hz) before force-matching. The dual-task condition also manifested coherent fronto-parietal delta activity in the P2 period. In addition to a decrease in postural regularity, this study reveals spatio-temporal and temporal-spectral reorganizations of ERPs in the fronto-sensorimotor-parietal network due to the added suprapostural motor task. For a particular set of postural-suprapostural task, the behavior and neural data suggest a facilitatory role of autonomous postural response and central resource expansion with increasing interregional interactions for task-shift and planning the motor-suprapostural task. PMID:27010634

Task Force on the Role of General Education in Associate Science Degree Programs. Final Report and Recommendations.

ERIC Educational Resources Information Center

Weyers, Lori; Langerman, Philip

In 1989-90, the General Education Task Force of the Wisconsin Technical College System (WTCS) was convened to determine the role of the general education curriculum in the attainment of skills that enhance the likelihood of success among technical college graduates in their careers, homes and communities. The Task Force consisted of at least one…

Guidelines for Cognitive Behavioral Training within Doctoral Psychology Programs in the United States: Report of the Inter-Organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education

ERIC Educational Resources Information Center

Klepac, Robert K.; Ronan, George F.; Andrasik, Frank; Arnold, Kevin D.; Belar, Cynthia D.; Berry, Sharon L.; Christofff, Karen A.; Craighead, Linda W.; Dougher, Michael J.; Dowd, E. Thomas; Herbert, James D.; McFarr, Lynn M.; Rizvi, Shireen L.; Sauer, Eric M.; Strauman, Timothy J.

2012-01-01

The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a yearlong series of…

Homelessness: The New Hampshire Response. The Final Report and Recommendations of the New Hampshire Task Force on Homelessness.

ERIC Educational Resources Information Center

New Hampshire State Div. of Mental Health and Developmental Services, Concord.

This report presents results and recommendations of a two-year study and information-gathering effort by the New Hampshire Task Force on Homelessness, in compliance with the charge of the State legislature. The report is comprised of five sections. Section 1, "Introduction," presents an overview of the Task Force and a report on the…

Funds for the Future. Report of the Twentieth Century Fund Task Force on College and University Endowment Policy.

ERIC Educational Resources Information Center

Williamson, J. Peter

The Task Force on College and University Endowment Policy examines endowment policy in a broad context. They feel that it is important to preserve private colleges and universities and develop a sense of mission about how best to pursue this objective. The Task Force reviews policy issues faced by managers of endowment funds for institutions of…

Conference-EC-US Task Force Joint US-EU Workshop on Metabolomics and Environmental Biotechnology

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

PI: Lily Y. Young

2009-06-04

Since 1990, the EC-US Task Force on Biotechnology Research has been coordinating transatlantic efforts to guide and exploit the ongoing revolution in biotechnology and the life sciences. The Task Force was established in June 1990 by the European Commission and the White House Office of Science and Technology Policy. The Task Force has acted as an effective forum for discussion, coordination, and development of new ideas for the last 18 years. Task Force members are European Commission and US Government science and technology administrators who meet annually to enhance communication across the Atlantic, and to encourage collaborative research. Through sponsoringmore » workshops, and other activities, the Task Force also brings together scientific leaders and early career researchers from both sides of the Atlantic to forecast research challenges and opportunities and to promote better links between researchers. Over the years, by keeping a focus on the future of science, the Task Force has played a key role in establishing a diverse range of emerging scientific fields, including biodiversity research, neuroinformatics, genomics, nanobiotechnology, neonatal immunology, transkingdom molecular biology, biologically-based fuels, and environmental biotechnology. The EC-US Task Force has sponsored a number of Working Groups on topics of mutual transatlantic interest. The idea to create a Working Group on Environmental Biotechnology research was discussed in the Task Force meeting of October 1993. The EC-US Working Group on Environmental Biotechnology set as its mission 'To train the next generation of leaders in environmental biotechnology in the United States and the European Union to work collaboratively across the Atlantic.' Since 1995, the Working Group supported three kinds of activities, all of which focus one early career scientists: (1) Workshops on the use of molecular methods and genomics in environmental biotechnology; (2) Short courses with theoretical, laboratory and field elements; and (3) Short term exchange fellowships. The short term exchange fellowships were created to enable young scientists to develop collaborations with colleagues across the Atlantic and to learn a new skill or expertise in the area of environmental biotechnology.« less

The synergic control of multi-finger force production: Stability of explicit and implicit task components

PubMed Central

Reschechtko, Sasha; Zatsiorsky, Vladimir M.; Latash, Mark L.

2016-01-01

Manipulating objects with the hands requires the accurate production of resultant forces including shear forces; effective control of these shear forces also requires the production of internal forces normal to the surface of the object(s) being manipulated. In the present study, we investigated multi-finger synergies stabilizing shear and normal components of force, as well as drifts in both components of force, during isometric pressing tasks requiring a specific magnitude of shear force production. We hypothesized that shear and normal forces would evolve similarly in time, and also show similar stability properties as assessed by the decomposition of inter-trial variance within the uncontrolled manifold hypothesis. Healthy subjects were required to accurately produce total shear and total normal forces with four fingers of the hand during a steady-state force task (with and without visual feedback) and a self-paced force pulse task. The two force components showed similar time profiles during both shear force pulse production and unintentional drift induced by turning the visual feedback off. Only the explicitly instructed components of force, however, were stabilized with multi-finger synergies. No force-stabilizing synergies and no anticipatory synergy adjustments were seen for the normal force in shear force production trials. These unexpected qualitative differences in the control of the two force components – which are produced by some of the same muscles and show high degree of temporal coupling – are interpreted within the theory of control with referent coordinates for salient variables. These observations suggest the existence of two classes of neural variables: one that translates into shifts of referent coordinates and defines changes in magnitude of salient variables, and the other controlling gains in back-coupling loops that define stability of the salient variables. Only the former are shared between the explicit and implicit task components. PMID:27601252

Force-stabilizing synergies in motor tasks involving two actors

PubMed Central

Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M.; Latash, Mark L.

2015-01-01

We investigated the ability of two persons to produce force-stabilizing synergies in accurate multi-finger force production tasks under visual feedback on the total force only. The subjects produced a time profile of total force (the sum of two hand forces in one-person tasks and the sum of two subject forces in two-person tasks) consisting of a ramp-up, steady-state, and ramp-down segments; the steady-state segment was interrupted in the middle by a quick force pulse. Analyses of the structure of inter-trial finger force variance, motor equivalence, anticipatory synergy adjustments (ASAs), and the unintentional drift of the sharing pattern were performed. The two-person performance was characterized by a dramatically higher amount of inter-trial variance that did not affect total force, higher finger force deviations that did not affect total force (motor equivalent deviations), shorter ASAs, and larger drift of the sharing pattern. The rate of sharing pattern drift correlated with the initial disparity between the forces produced by the two persons (or two hands). The drift accelerated following the quick force pulse. Our observations show that sensory information on the task-specific performance variable is sufficient for the organization of performance-stabilizing synergies. They suggest, however, that two actors are less likely to follow a single optimization criterion as compared to a single performer. The presence of ASAs in the two-person condition might reflect fidgeting by one or both of the subjects. We discuss the characteristics of the drift in the sharing pattern as reflections of different characteristic times of motion within the sub-spaces that affect and do not affect salient performance variables. PMID:26105756

Force-stabilizing synergies in motor tasks involving two actors.

PubMed

Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M; Latash, Mark L

2015-10-01

We investigated the ability of two persons to produce force-stabilizing synergies in accurate multi-finger force production tasks under visual feedback on the total force only. The subjects produced a time profile of total force (the sum of two hand forces in one-person tasks and the sum of two subject forces in two-person tasks) consisting of a ramp-up, steady-state, and ramp-down segments; the steady-state segment was interrupted in the middle by a quick force pulse. Analyses of the structure of inter-trial finger force variance, motor equivalence, anticipatory synergy adjustments (ASAs), and the unintentional drift of the sharing pattern were performed. The two-person performance was characterized by a dramatically higher amount of inter-trial variance that did not affect total force, higher finger force deviations that did not affect total force (motor equivalent deviations), shorter ASAs, and larger drift of the sharing pattern. The rate of sharing pattern drift correlated with the initial disparity between the forces produced by the two persons (or two hands). The drift accelerated following the quick force pulse. Our observations show that sensory information on the task-specific performance variable is sufficient for the organization of performance-stabilizing synergies. They suggest, however, that two actors are less likely to follow a single optimization criterion as compared to a single performer. The presence of ASAs in the two-person condition might reflect fidgeting by one or both of the subjects. We discuss the characteristics of the drift in the sharing pattern as reflections of different characteristic times of motion within the subspaces that affect and do not affect salient performance variables.

The Role of Direct and Visual Force Feedback in Suturing Using a 7-DOF Dual-Arm Teleoperated System.

PubMed

Talasaz, Ali; Trejos, Ana Luisa; Patel, Rajni V

2017-01-01

The lack of haptic feedback in robotics-assisted surgery can result in tissue damage or accidental tool-tissue hits. This paper focuses on exploring the effect of haptic feedback via direct force reflection and visual presentation of force magnitudes on performance during suturing in robotics-assisted minimally invasive surgery (RAMIS). For this purpose, a haptics-enabled dual-arm master-slave teleoperation system capable of measuring tool-tissue interaction forces in all seven Degrees-of-Freedom (DOFs) was used. Two suturing tasks, tissue puncturing and knot-tightening, were chosen to assess user skills when suturing on phantom tissue. Sixteen subjects participated in the trials and their performance was evaluated from various points of view: force consistency, number of accidental hits with tissue, amount of tissue damage, quality of the suture knot, and the time required to accomplish the task. According to the results, visual force feedback was not very useful during the tissue puncturing task as different users needed different amounts of force depending on the penetration of the needle into the tissue. Direct force feedback, however, was more useful for this task to apply less force and to minimize the amount of damage to the tissue. Statistical results also reveal that both visual and direct force feedback were required for effective knot tightening: direct force feedback could reduce the number of accidental hits with the tissue and also the amount of tissue damage, while visual force feedback could help to securely tighten the suture knots and maintain force consistency among different trials/users. These results provide evidence of the importance of 7-DOF force reflection when performing complex tasks in a RAMIS setting.

Age-related differences in postural adjustments in connection with different tasks involving weight transfer while standing.

PubMed

Jonsson, Erika; Henriksson, Marketta; Hirschfeld, Helga

2007-10-01

Weight transfer designed to change the area of the supportive base during the performance of three different motor tasks (one-leg stance, tandem stance and gait initiation) was examined both in healthy, physically active elderly people and younger adults. The former two tasks are balance tests used clinically. Our hypothesis was that the elderly subjects would demonstrate age-related changes in their postural adjustments that could be detected by analysis of the ground reaction forces. While 24 healthy elderly adults (65-77 years of age) and 26 younger adults (24-40 years of age) performed these three tasks, the ground reaction forces were recorded from two force plates. Prior to the onset of all three tasks, the elderly placed significantly more weight on the leg that was to provide support (the stance leg), than did the younger individuals. The analyses revealed two distinct phases of weight transfer, i.e., an initial thrust and a subsequent unloading phase. The elderly individuals exhibited a significantly longer unloading phase, as well as a higher frequency of peaks of vertical and lateral forces during this phase. Moreover, the maximal force rate during this phase was achieved at an earlier time point by the elderly. However, both groups generated forces of similar magnitudes and force rates. In conclusion, our findings indicate the presence of age-related differences in the temporal phasing of the ground reaction forces in all three of these tasks involving weight transfer, whereas the magnitude and rates of change of these forces are independent of age.

Haptic force-feedback devices for the office computer: performance and musculoskeletal loading issues.

PubMed

Dennerlein, J T; Yang, M C

2001-01-01

Pointing devices, essential input tools for the graphical user interface (GUI) of desktop computers, require precise motor control and dexterity to use. Haptic force-feedback devices provide the human operator with tactile cues, adding the sense of touch to existing visual and auditory interfaces. However, the performance enhancements, comfort, and possible musculoskeletal loading of using a force-feedback device in an office environment are unknown. Hypothesizing that the time to perform a task and the self-reported pain and discomfort of the task improve with the addition of force feedback, 26 people ranging in age from 22 to 44 years performed a point-and-click task 540 times with and without an attractive force field surrounding the desired target. The point-and-click movements were approximately 25% faster with the addition of force feedback (paired t-tests, p < 0.001). Perceived user discomfort and pain, as measured through a questionnaire, were also smaller with the addition of force feedback (p < 0.001). However, this difference decreased as additional distracting force fields were added to the task environment, simulating a more realistic work situation. These results suggest that for a given task, use of a force-feedback device improves performance, and potentially reduces musculoskeletal loading during mouse use. Actual or potential applications of this research include human-computer interface design, specifically that of the pointing device extensively used for the graphical user interface.

Performance evaluation of a six-axis generalized force-reflecting teleoperator

NASA Technical Reports Server (NTRS)

Hannaford, B.; Wood, L.; Guggisberg, B.; Mcaffee, D.; Zak, H.

1989-01-01

Work in real-time distributed computation and control has culminated in a prototype force-reflecting telemanipulation system having a dissimilar master (cable-driven, force-reflecting hand controller) and a slave (PUMA 560 robot with custom controller), an extremely high sampling rate (1000 Hz), and a low loop computation delay (5 msec). In a series of experiments with this system and five trained test operators covering over 100 hours of teleoperation, performance was measured in a series of generic and application-driven tasks with and without force feedback, and with control shared between teleoperation and local sensor referenced control. Measurements defining task performance included 100-Hz recording of six-axis force/torque information from the slave manipulator wrist, task completion time, and visual observation of predefined task errors. The task consisted of high precision peg-in-hole insertion, electrical connectors, velcro attach-de-attach, and a twist-lock multi-pin connector. Each task was repeated three times under several operating conditions: normal bilateral telemanipulation, forward position control without force feedback, and shared control. In shared control, orientation was locally servo controlled to comply with applied torques, while translation was under operator control. All performance measures improved as capability was added along a spectrum of capabilities ranging from pure position control through force-reflecting teleoperation and shared control. Performance was optimal for the bare-handed operator.

Altered visual strategies and attention are related to increased force fluctuations during a pinch grip task in older adults.

PubMed

Keenan, Kevin G; Huddleston, Wendy E; Ernest, Bradley E

2017-11-01

The purpose of the study was to determine the visual strategies used by older adults during a pinch grip task and to assess the relations between visual strategy, deficits in attention, and increased force fluctuations in older adults. Eye movements of 23 older adults (>65 yr) were monitored during a low-force pinch grip task while subjects viewed three common visual feedback displays. Performance on the Grooved Pegboard test and an attention task (which required no concurrent hand movements) was also measured. Visual strategies varied across subjects and depended on the type of visual feedback provided to the subjects. First, while viewing a high-gain compensatory feedback display (horizontal bar moving up and down with force), 9 of 23 older subjects adopted a strategy of performing saccades during the task, which resulted in 2.5 times greater force fluctuations in those that exhibited saccades compared with those who maintained fixation near the target line. Second, during pursuit feedback displays (force trace moving left to right across screen and up and down with force), all subjects exhibited multiple saccades, and increased force fluctuations were associated ( r s = 0.6; P = 0.002) with fewer saccades during the pursuit task. Also, decreased low-frequency (<4 Hz) force fluctuations and Grooved Pegboard times were significantly related ( P = 0.033 and P = 0.005, respectively) with higher (i.e., better) attention z scores. Comparison of these results with our previously published results in young subjects indicates that saccadic eye movements and attention are related to force control in older adults. NEW & NOTEWORTHY The significant contributions of the study are the addition of eye movement data and an attention task to explain differences in hand motor control across different visual displays in older adults. Older participants used different visual strategies across varying feedback displays, and saccadic eye movements were related with motor performance. In addition, those older individuals with deficits in attention had impaired motor performance on two different hand motor control tasks, including the Grooved Pegboard test. Copyright © 2017 the American Physiological Society.

The Oklahoma Attorney General's Task Force report on the State of End-of-Life Health Care, 2005.

PubMed

Edmondson, W A Drew

2005-05-01

This article includes the recommendations submitted by the 15 members of the Oklahoma Attorney General's Task Force in their Report on the State of End-of-Life Health Care. The task force was created on April 21, 2004, and their report was accepted by Attorney General W.A. Drew Edmondson at a press conference April 11, 2005. It has been forwarded to members of the Oklahoma Legislature, relevant state agencies and organizations with an invitation to join with members of the task force to continue efforts to improve end-of-life care for Oklahomans. Copies of the report are available upon request to the Office of Attorney General.

Impaired Inhibitory Force Feedback in Fixed Dystonia.

PubMed

Mugge, Winfred; Schouten, Alfred C; van Hilten, Jacobus J; van der Helm, Frans C T

2016-04-01

Complex regional pain syndrome (CRPS) is a multifactorial disorder associated with an aberrant host response to tissue injury. About 25% of CRPS patients suffer poorly understood involuntary sustained muscle contractions associated with dysfunctional reflexes that result in abnormal postures (fixed dystonia). A recent modeling study simulated fixed dystonia (FD) caused by aberrant force feedback. The current study aims to validate this hypothesis by experimentally recording the modulation of reflexive force feedback in patients with FD. CRPS patients with and without FD, patients with FD but without CRPS, as well as healthy controls participated in the experiment. Three task instructions and three perturbation characteristics were used to evoke a wide range of responses to force perturbations. During position tasks ("maintain posture"), healthy subjects as well as patients resisted the perturbations, becoming more stiff than when being relaxed (i.e., the relax task). Healthy subjects and CRPS patients without FD were both more compliant during force tasks ("maintain force") than during relax tasks, meaning they actively gave way to the imposed forces. Remarkably, the patients with FD failed to do so. A neuromuscular model was fitted to the experimental data to separate the distinct contributions of position, velocity and force feedback, as well as co-contraction to the motor behavior. The neuromuscular modeling indicated that inhibitory force feedback is deregulated in patients with FD, for both CRPS and non-CRPS patients. From previously published simulation results and the present experimental study, it is concluded that aberrant force feedback plays a role in fixed dystonia.

Effect of loudness on reaction time and response force in different motor tasks.

PubMed

Jaśkowski, Piotr; Włodarczyk, Dariusz

2005-12-01

Van der Molen and Keuss, in 1979 and 1981, showed that paradoxically long reaction times occur with extremely strong auditory stimuli when the task is difficult, e.g., choice-by-location or Simon paradigm. It was argued that this paradoxical behavior of RT is due to active inhibition of an arousal-dependent bypassing mechanism to prevent false responses. As the peak force, i.e., maximal force exerted by participants on a response key, is considered to be related to immediate arousal, we predicted that for extremely loud stimuli and for difficult tasks, lengthening of RT should be associated with reduction of peak force. Moreover, these effects should be enhanced when emphasis is on accuracy rather than speed. Although the relation between RT and intensity depended on task difficulty, no increase in RT was found for the loudest tones. Moreover, peak force increased monotonically with loudness, showing no tendency to be suppressed for loudest tones and difficult tasks.

Corporate funding and conflicts of interest: a primer for psychologists.

PubMed

Pachter, Wendy S; Fox, Ronald E; Zimbardo, Philip; Antonuccio, David O

2007-12-01

A presidential task force on external funding was established by the American Psychological Association (APA) in 2003 to review APA policies, procedures, and practices regarding the acceptance of funding and support from private corporations for educational and training programs; continuing education offerings; research projects; publications; advertising; scientific and professional meetings and conferences; and consulting, practice, and advocacy relationships. This article, based on the Executive Summary of the APA Task Force on External Funding Final Report, presents the findings and unanimous recommendations of the task force in the areas of association income, annual convention, research and journals, continuing education, education, practice, and conflicts of interest and ethics. The task force concluded that it is important for both APA and individual psychologists to become familiar with the challenges that corporate funding can pose to their integrity. The nature and extent of those challenges led the task force to recommend that APA develop explicit policies, educational materials, and continuing education programs to preserve the independence of psychological science, practice, and education. (Copyright) 2007 APA.

Early childhood: breastfeeding, "solving the problem of childhood obesity within a generation," an excerpt from the White House Task Force on Childhood Obesity: report to the President, May 2010.

PubMed

2010-10-01

On February 9, 2010, the same day the First Lady launched the Let's Move! campaign, President Obama created a new interagency White House Task Force on Childhood Obesity, charged with creating and implementing a comprehensive action plan to end the childhood obesity epidemic. The resulting action plan was developed by experts from across the federal government, with substantial public input, and released on May 11. The first chapter of the task force report discusses strategies for getting children a healthy start on life, including supporting breastfeeding. Here is an excerpt from the discussion of breastfeeding that appears in the report. The full text of the task force report can be found at www.letsmove.gov . —Martha Coven, JD Special Assistant to the President for Mobility and Opportunity White House Domestic Policy Council Lead Staff, White House Task Force on Childhood Obesity.

Improving the Agility of the NATO Response Force (NRF)

DTIC Science & Technology

2010-04-01

the MCCE and the MIH helicopter task force. As 168 Hauser and Kernic eds., 140-141. 169 NATO...agility through unified efforts. Initiatives such as the MIH helicopter task force and the Movement Coordination Centre Europe (MCCE) are positive

Toward a State of Esteem. The Final Report of the California Task Force to Promote Self-esteem and Personal and Social Responsibility.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

This document contains the final report of a California Task Force created to promote self-esteem and personal responsibility. It begins with an executive summary listing key principles of the task force and providing recommendations and discussions in each of six major areas upon which the report focuses. The next section presents the task…

7 CFR Exhibit D to Subpart B of... - Fact Sheet-The Federal Interagency Task Force on Food and Shelter for the Homeless

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Fact Sheet-The Federal Interagency Task Force on Food... (CONTINUED) PROPERTY MANAGEMENT Management of Property Exhibit D to Subpart B of Part 1955—Fact Sheet—The Federal Interagency Task Force on Food and Shelter for the Homeless Editorial Note: Exhibit D is not...

Proceedings: The Conference of the University/Urban Schools National Task Force: What Works in Urban Schools (3rd, San Francisco, CA, July 9-10, 1982).

ERIC Educational Resources Information Center

Bossone, Richard M., Ed.

Proceedings of the University/Urban Schools Task Force conference on what works in urban schools are summarized in this report. The future direction of the Task Force, articulated by conference participants, is described as a move toward the conceptualization and design of programs to teach thinking skills versus programs that mainly teach subject…

Report and Recommendations of the British Columbia Teacher's Federation's (BCTF) Task Force on First Nations Education to the Annual General Meeting (January 1999). (Revised Annotated Version).

ERIC Educational Resources Information Center

British Columbia Teachers' Federation, Vancouver.

In 1998, the British Columbia Teachers' Federation (BCTF) appointed an eight-member task force to investigate the effectiveness of the education system for First Nations students. The task force report and recommendations are intended to serve several groups of Aboriginal students: First Nations students, with or without status under Canada's…

Last Best Chance 2004: Educating Young Adolescents in the 21st Century. Middle Grades Task Force Report. Fall 2004

ERIC Educational Resources Information Center

North Carolina State Department of Education, 2004

2004-01-01

This study is a follow up to the Last Best Chance report published in 1989. A task force of 29 education leaders was challenged to help chart the course for middle level education in North Carolina. While examining middle level education (ages 11 through 14), task force members continuously asked, "What should it look like in order for all…

SUNY 2000. College Expectations: The Report of the SUNY Task Force on College Entry-Level Knowledge and Skills.

ERIC Educational Resources Information Center

State Univ. of New York, Albany. Office of the Chancellor.

This document reports on the work of a task force charged with formulating recommendations on the kind of preparation an incoming student should have to assure successful entry to and completion of the freshman year of study at the State University of New York (SUNY). In addition, the task force was asked to specify what program of study and forms…

Defense Science Board Task Force Report on Cyber Defense Management

DTIC Science & Technology

2016-09-01

manage cyber security is often a verymanual and labor intensive process. When a crisis hits, DoD responses range from highly automatedand instrumented...DSB Task Force Report on Cyber Defense Management September 2016 (U) This page intentionally blank REPORT OF THE DEFENSE SCIENCE BOARD STUDY ON Cyber ...DEFENSE FOR ACQUISITION, TECHNOLOGY & LOGISTICS SUBJECT: Final Report of the Defense Science Board (DSB) Task Force on Cyber Defense Management I am

Flow Control and Design Assessment for Drainage System at McMurdo Station, Antarctica

DTIC Science & Technology

2014-11-24

Council BMP Best Management Practice CASQUA California Storm Water Quality Task Force CRREL Cold Regions Research and Engineering Laboratory DS...ponds The California Storm Water Quality Task Force (CASQUA 1993) defines a sediment basin as “a pond created by excavation or constructing an em...British Standards Institution. California Storm Water Quality Task Force (CASQUA). 1993. ESC41: Check Dams. In Stormwater Best Management Practices

The Report to the United States Office of Education of the National Task Forces on Instructional Strategies in Schools with High Concentrations of Low-Income Pupils.

ERIC Educational Resources Information Center

Optimum Computer Systems, Inc., Washington, DC.

This paper presents the reports of the National Task Forces on Urban, Rural, Migrant, Native American and Bilingual/Bicultural Education. The Task Forces were asked to pinpoint strategies for instructional and programmatic improvement in these areas. The focus of inquiry was on reading and mathematics instruction. Attention was also paid to…

The effect of ankle bracing on knee kinetics and kinematics during volleyball-specific tasks.

PubMed

West, T; Ng, L; Campbell, A

2014-12-01

The purpose of this study was to examine the effects of ankle bracing on knee kinetics and kinematics during volleyball tasks. Fifteen healthy, elite, female volleyball players performed a series of straight-line and lateral volleyball tasks with no brace and when wearing an ankle brace. A 14-camera Vicon motion analysis system and AMTI force plate were used to capture the kinetic and kinematic data. Knee range of motion, peak knee anterior-posterior and medial-lateral shear forces, and peak ground reaction forces that occurred between initial contact with the force plate and toe off were compared using paired sample t-tests between the braced and non-braced conditions (P < 0.05). The results revealed no significant effect of bracing on knee kinematics or ground reaction forces during any task or on knee kinetics during the straight-line movement volleyball tasks. However, ankle bracing was demonstrated to reduce knee lateral shear forces during all of the lateral movement volleyball tasks. Wearing the Active Ankle T2 brace will not impact knee joint range of motion and may in fact reduce shear loading to the knee joint in volleyball players. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Developing a Community-Wide Initiative to Address Childhood Adversity and Toxic Stress: A Case Study of The Philadelphia ACE Task Force.

PubMed

Pachter, Lee M; Lieberman, Leslie; Bloom, Sandra L; Fein, Joel A

The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. The task force has been successful in developing a research agenda and conducting research on ACEs in the urban context, and has identified foci of local activity in the areas of professional training and workforce development, community education, and local practical interventions around adversity, trauma, and resiliency. In this article we also address the lessons learned over the first 5 years of the task force's existence and offers recommendations for future efforts to build a local community-based ACEs collaborative. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Proceedings of the Seminar on the DoD Computer Security Initiative Program (3rd), National Bureau of Standards, Gaithersburg, Maryland, November 18-20, 1980.

DTIC Science & Technology

1980-01-01

TECHNIQUES IMPROVING RAPIDLY C-7 INDUSTRY THRUSTS IN 70s DRIVING FORCE : IMPROVE PRODUCT QUALITY * EASE MAINTENANCE, MODIFICATION IMPROVE PERFORMANCE...together a task force to make recommendations on what we should be doing about computer secur- ity. Other members of the task force came from both our...of the marketing task force mostly echoed and endorsed the user’s report. Both reports were issued in March of 1973. Notice that DoD 5200.28 had just

Stability of multifinger action in different state spaces

PubMed Central

Reschechtko, Sasha; Zatsiorsky, Vladimir M.

2014-01-01

We investigated stability of action by a multifinger system with three methods: analysis of intertrial variance, application of transient perturbations, and analysis of the system's motion in different state spaces. The “inverse piano” device was used to apply transient (lifting-and-lowering) perturbations to individual fingers during single- and two-finger accurate force production tasks. In each trial, the perturbation was applied either to a finger explicitly involved in the task or one that was not. We hypothesized that, in one-finger tasks, task-specific stability would be observed in the redundant space of finger forces but not in the nonredundant space of finger modes (commands to explicitly involved fingers). In two-finger tasks, we expected that perturbations applied to a nontask finger would not contribute to task-specific stability in mode space. In contrast to our expectations, analyses in both force and mode spaces showed lower stability in directions that did not change total force output compared with directions that did cause changes in total force. In addition, the transient perturbations led to a significant increase in the enslaving index. We consider these results within a theoretical scheme of control with referent body configurations organized hierarchically, using multiple few-to-many mappings organized in a synergic way. The observed volatility of enslaving, greater equifinality of total force compared with elemental variables, and large magnitude of motor equivalent motion in both force and mode spaces provide support for the concept of task-specific stability of performance and the existence of multiple neural loops, which ensure this stability. PMID:25253478

Stability of multifinger action in different state spaces.

PubMed

Reschechtko, Sasha; Zatsiorsky, Vladimir M; Latash, Mark L

2014-12-15

We investigated stability of action by a multifinger system with three methods: analysis of intertrial variance, application of transient perturbations, and analysis of the system's motion in different state spaces. The "inverse piano" device was used to apply transient (lifting-and-lowering) perturbations to individual fingers during single- and two-finger accurate force production tasks. In each trial, the perturbation was applied either to a finger explicitly involved in the task or one that was not. We hypothesized that, in one-finger tasks, task-specific stability would be observed in the redundant space of finger forces but not in the nonredundant space of finger modes (commands to explicitly involved fingers). In two-finger tasks, we expected that perturbations applied to a nontask finger would not contribute to task-specific stability in mode space. In contrast to our expectations, analyses in both force and mode spaces showed lower stability in directions that did not change total force output compared with directions that did cause changes in total force. In addition, the transient perturbations led to a significant increase in the enslaving index. We consider these results within a theoretical scheme of control with referent body configurations organized hierarchically, using multiple few-to-many mappings organized in a synergic way. The observed volatility of enslaving, greater equifinality of total force compared with elemental variables, and large magnitude of motor equivalent motion in both force and mode spaces provide support for the concept of task-specific stability of performance and the existence of multiple neural loops, which ensure this stability. Copyright © 2014 the American Physiological Society.

Ecological Relevance Determines Task Priority in Older Adults' Multitasking.

PubMed

Doumas, Michail; Krampe, Ralf Th

2015-05-01

Multitasking is a challenging aspect of human behavior, especially if the concurrently performed tasks are different in nature. Several studies demonstrated pronounced performance decrements (dual-task costs) in older adults for combinations of cognitive and motor tasks. However, patterns of costs among component tasks differed across studies and reasons for participants' resource allocation strategies remained elusive. We investigated young and older adults' multitasking of a working memory task and two sensorimotor tasks, one with low (finger force control) and one with high ecological relevance (postural control). The tasks were performed in single-, dual-, and triple-task contexts. Working memory accuracy was reduced in dual-task contexts with either sensorimotor task and deteriorated further under triple-task conditions. Postural and force performance deteriorated with age and task difficulty in dual-task contexts. However, in the triple-task context with its maximum resource demands, older adults prioritized postural control over both force control and memory. Our results identify ecological relevance as the key factor in older adults' multitasking. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Multifunctional Battalion Task Force Training: Slovenian Armed Forces Battalion Training Cycle

DTIC Science & Technology

2016-06-10

MULTIFUNCTIONAL BATTALION TASK FORCE TRAINING: SLOVENIAN ARMED FORCES BATTALION TRAINING CYCLE A thesis presented to...Forces Battalion Training Cycle 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Major Ales Avsec 5d...Bn TF) training cycle . It focuses on how the SAF is conducting the infantry and multifunctional Bn TF training. In particular, it deals with mission

Transforming American Education: Reducing the Risk to the Nation. A Report to the Secretary of Education, United States Department of Education, by The National Task Force on Educational Technology.

ERIC Educational Resources Information Center

Ridley, William J.; Hull, McAllister H., Jr.

Designed to assist educational decision-makers at the school and district level, this report summarizes the work of the National Task Force on Educational Technology, which was formed in the fall of 1984 to investigate the potential of appropriately integrated technology for improving learning in American schools. The task force used six primary…

GAO's Views on the Default Task Force's Recommendations for Reducing Default Costs in the Guaranteed Student Loan Program. Testimony before the Subcommittee on Postsecondary Education, Committee on Education and Labor, House of Representatives.

ERIC Educational Resources Information Center

Gainer, William J.

This General Accounting Office (GAO) testimony before the Subcommittee on Postsecondary Education, Committee on Education and Labor, House of Representatives, concerns the findings of the task force that addressed the increasing costs of student loan defaults. The task force report is considered, generally, to provide additional incentives and…

Appalachia: Rural Women and the Economics of Hunger. Hearing before the Domestic Task Force of the Select Committee on Hunger. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Hunger.

The Domestic Task Force of the House Select Committee on Hunger met to hear testimony on women and hunger in Appalachia and on food assistance programs and legislation, including H.R. 2100, the 1985 farm bill. Introductory remarks by task force members outline the bill's food assistance provisions, which include increased funding for food stamp…

A Real Alternative: The Final Report and Recommendations of the Community National Field Task Force on the Improvement and Reform of American Education.

ERIC Educational Resources Information Center

Office of Education (DHEW), Washington, DC.

This report is one of six to be released by as many task forces on educational improvement and reform. The main body of this report consists of five sections: (a) an introduction, which briefly describes the work of the task force; (b) a description of the alternative of community participation in education; (c) recommendations; (d) access to…

Staff Report on the Guaranteed Student Loan Program, Belmont Task Force Recommendations. Prepared for the Subcommittee on Postsecondary Education of the Committee on Education and Labor.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and Labor.

Recommendations of the Belmont Task Force concerning the problem of student loan defaults are offered to the U.S. House of Representatives. The task force concludes that the purpose of the Guaranteed Student Loan (GSL) program has changed significantly in the last decade. While originally established as a loan of convenience for middle-income…

DESIGNING PHARMACEUTICAL TRIALS FOR SARCOPENIA IN FRAIL OLDER ADULTS: EU/US TASK FORCE RECOMMENDATIONS

PubMed Central

VELLAS, B.; PAHOR, M.; MANINI, T.; ROOKS, D.; GURALNIK, J.M.; MORLEY, J.; STUDENSKI, S.; EVANS, W.; ASBRAND, C.; FARIELLO, R.; PEREIRA, S.; ROLLAND, Y.; VAN KAN, G. ABELLAN; CESARI, M.; CHUMLEA, WM.C.; FIELDING, R.

2014-01-01

An international task force of academic and industry leaders in sarcopenia research met on December 5, 2012 in Orlando, Florida to develop guidelines for designing and executing randomized clinical trials of sarcopenia treatments. The Task Force reviewed results from previous trials in related disease areas to extract lessons relevant to future sarcopenia trials, including practical issues regarding the design and conduct of trials in elderly populations, the definition of appropriate target populations, and the selection of screening tools, outcome measures, and biomarkers. They discussed regulatory issues, the challenges posed by trials of different types of interventions, and the need for standardization and harmonization. The Task Force concluded with recommendations for advancing the field toward better clinical trials. PMID:23933872

Task Force on Teacher Education in Physics: Findings and Recommendations

NASA Astrophysics Data System (ADS)

Otero, Valerie

2010-03-01

In response to the national crisis in science education, including low performance in high school physical science and a critical shortage of highly qualified physics teachers, a National Task Force was convened to investigate the state of physics education in the United States. The Task Force spent one year collecting data from over 900 universities and conducting site visits at 13 universities that were identified as ``high producers'' of physics teachers. The final report of the Task Force will be published early in 2010 and will highlight the findings and recommendations that resulted from the study. In this presentation, the main findings and recommendations will be presented along with selected case studies that illustrate exemplary practices in physics and education departments.

Muscle function in glenohumeral joint stability during lifting task.

PubMed

Blache, Yoann; Begon, Mickaël; Michaud, Benjamin; Desmoulins, Landry; Allard, Paul; Dal Maso, Fabien

2017-01-01

Ensuring glenohumeral stability during repetitive lifting tasks is a key factor to reduce the risk of shoulder injuries. Nevertheless, the literature reveals some lack concerning the assessment of the muscles that ensure glenohumeral stability during specific lifting tasks. Therefore, the purpose of this study was to assess the stabilization function of shoulder muscles during a lifting task. Kinematics and muscle electromyograms (n = 9) were recorded from 13 healthy adults during a bi-manual lifting task performed from the hip to the shoulder level. A generic upper-limb OpenSim model was implemented to simulate glenohumeral stability and instability by performing static optimizations with and without glenohumeral stability constraints. This procedure enabled to compute the level of shoulder muscle activity and forces in the two conditions. Without the stability constraint, the simulated movement was unstable during 74%±16% of the time. The force of the supraspinatus was significantly increased of 107% (p<0.002) when the glenohumeral stability constraint was implemented. The increased supraspinatus force led to greater compressive force (p<0.001) and smaller shear force (p<0.001), which contributed to improved glenohumeral stability. It was concluded that the supraspinatus may be the main contributor to glenohumeral stability during lifting task.

Muscle function in glenohumeral joint stability during lifting task

PubMed Central

Begon, Mickaël; Michaud, Benjamin; Desmoulins, Landry; Allard, Paul

2017-01-01

Ensuring glenohumeral stability during repetitive lifting tasks is a key factor to reduce the risk of shoulder injuries. Nevertheless, the literature reveals some lack concerning the assessment of the muscles that ensure glenohumeral stability during specific lifting tasks. Therefore, the purpose of this study was to assess the stabilization function of shoulder muscles during a lifting task. Kinematics and muscle electromyograms (n = 9) were recorded from 13 healthy adults during a bi-manual lifting task performed from the hip to the shoulder level. A generic upper-limb OpenSim model was implemented to simulate glenohumeral stability and instability by performing static optimizations with and without glenohumeral stability constraints. This procedure enabled to compute the level of shoulder muscle activity and forces in the two conditions. Without the stability constraint, the simulated movement was unstable during 74%±16% of the time. The force of the supraspinatus was significantly increased of 107% (p<0.002) when the glenohumeral stability constraint was implemented. The increased supraspinatus force led to greater compressive force (p<0.001) and smaller shear force (p<0.001), which contributed to improved glenohumeral stability. It was concluded that the supraspinatus may be the main contributor to glenohumeral stability during lifting task. PMID:29244838

Effects of Type and Strength of Force Feedback on Movement Time in a Target Selection Task

NASA Technical Reports Server (NTRS)

Rorie, Robert Conrad; Vu, Kim-Phuong L.; Marayong, Panadda; Robles, Jose; Strybel, Thomas Z.; Battiste, Vernol

2013-01-01

Future cockpits will likely include new onboard technologies, such as cockpit displays of traffic information, to help support future flight deck roles and responsibilities. These new technologies may benefit from multimodal feedback to aid pilot information processing. The current study investigated the effects of multiple levels of force feedback on operator performance in an aviation task. Participants were presented with two different types of force feedback (gravitational and spring force feedback) for a discrete targeting task, with multiple levels of gain examined for each force feedback type. Approach time and time in target were recorded. Results suggested that the two highest levels of gravitational force significantly reduced approach times relative to the lowest level of gravitational force. Spring force level only affected time in target. Implications of these findings for the design of future cockpit displays will be discussed.

Impaired force control in writer's cramp showing a bilateral deficit in sensorimotor integration.

PubMed

Bleton, Jean-Pierre; Teremetz, Maxime; Vidailhet, Marie; Mesure, Serge; Maier, Marc A; Lindberg, Påvel G

2014-01-01

Abnormal cortical processing of sensory inputs has been found bilaterally in writer's cramp (WC). This study tested the hypothesis that patients with WC have an impaired ability to adjust grip forces according to visual and somatosensory cues in both hands. A unimanual visuomotor force-tracking task and a bimanual sense of effort force-matching task were performed by WC patients and healthy controls. In visuomotor tracking, WC patients showed increased error, greater variability, and longer release duration than controls. In the force-matching task, patients underestimated, whereas controls overestimated, the force applied in the other hand. Visuomotor tracking and force matching were equally impaired in both the symptomatic and nonsymptomatic hand in WC patients. This study provides evidence of bilaterally impaired grip-force control in WC, when using visual or sense of effort cues. This suggests a generalized subclinical deficit in sensorimotor integration in WC. Copyright © 2013 Movement Disorder Society.

An evaluation of nursing tasks.

PubMed

Baptiste, Andrea

2011-01-01

Functional capacity evaluations have been criticized as being too general in theory and not being accurate enough to determine what tasks an employee can perform. This paper will describe results of a descriptive study that was conducted in a laboratory setting to objectively determine the physical demands of patient transfer tasks performed by nurses. Fifty three tasks were analyzed and broken down into sub-tasks to quantify the peak force required to perform each sub-task in order to determine which tasks pose healthcare workers at highest risk of injury. Dissecting the transfer task into segments allows us to see which part of the task requires high forces on the part of the caregiver. The task can then be modified to eliminate the risk of injury to the caregiver. This modification can be accomplished by using healthcare technology, such as floor based or overhead lifts, friction reducing devices, sit to stand lifts, properly designed slings, and motorized beds/trolleys. Technological solutions are available for some of these high risk tasks and should be implemented where applicable to reduce the force demand and eliminate or reduce the risk of injury to healthcare workers in nursing.

Effects of load position and force direction on back muscle loading in one-wheeled wheelbarrow tasks.

PubMed

Chen, Su-Huang; Lee, Yung-Hui; Lin, Chiuhsiang Joe

2015-01-01

Various parameters related to pushing/pulling tasks have been examined yet the effects of changing the load position in one-wheeled wheelbarrow task has not been examined. To explore the effects of load position and force direction on muscle activity during wheelbarrow tasks. Nine participants were recruited to take part in the experiment. Each participant performed 18 trials consisting of 2 force directions (push and pull) and 9 load positions. The dependent variables were EMG of erector spinae and gripping force. ANOVA was used to identify significant differences between force direction and load position in EMG and gripping force data. Results showed that peak EMG was lowest for the left and right erector spinae when the load was positioned farther from the participant. Peak EMG of the bilateral erector spinae increased when the weight was near the participant and on the ipsilateral hand. Based on the EMG results, we suggest that loads be arranged in the anterior part of the bin in order to reduce muscle activity on the spine during the wheelbarrow task. This finding also provides some directions in the improvement and ergonomic redesign of the one-wheeled wheelbarrow.

Reciprocity-based experimental determination of dynamic forces and moments: A feasibility study

NASA Technical Reports Server (NTRS)

Ver, Istvan L.; Howe, Michael S.

1994-01-01

BBN Systems and Technologies has been tasked by the Georgia Tech Research Center to carry Task Assignment No. 7 for the NASA Langley Research Center to explore the feasibility of 'In-Situ Experimental Evaluation of the Source Strength of Complex Vibration Sources Utilizing Reciprocity.' The task was carried out under NASA Contract No. NAS1-19061. In flight it is not feasible to connect the vibration sources to their mounting points on the fuselage through force gauges to measure dynamic forces and moments directly. However, it is possible to measure the interior sound field or vibration response caused by these structureborne sound sources at many locations and invoke principle of reciprocity to predict the dynamic forces and moments. The work carried out in the framework of Task 7 was directed to explore the feasibility of reciprocity-based measurements of vibration forces and moments.

Age-related differences in finger force control are characterized by reduced force production.

PubMed

Vieluf, Solveig; Godde, Ben; Reuter, Eva-Maria; Voelcker-Rehage, Claudia

2013-01-01

It has been repeatedly shown that precise finger force control declines with age. The tasks and evaluation parameters used to reveal age-related differences vary between studies. In order to examine effects of task characteristics, young adults (18-25 years) and late middle-aged adults (55-65 years) performed precision grip tasks with varying speed and force requirements. Different outcome variables were used to evaluate age-related differences. Age-related differences were confirmed for performance accuracy (TWR) and variability (relative root mean square error, rRMSE). The task characteristics, however, influenced accuracy and variability in both age groups: Force modulation performance at higher speed was poorer than at lower speed and at fixed force levels than at force levels adjusted to the individual maximum forces. This effect tended to be stronger for older participants for the rRMSE. A curve fit confirmed the age-related differences for both spatial force tracking parameters (amplitude and intercept) and for one temporal parameter (phase shift), but not for the temporal parameter frequency. Additionally, matching the timing parameters of the sine wave seemed to be more important than matching the spatial parameters in both young adults and late middle-aged adults. However, the effect was stronger for the group of late middle-aged, even though maximum voluntary contraction was not significantly different between groups. Our data indicate that changes in the processing of fine motor control tasks with increasing age are caused by difficulties of late middle-aged adults to produce a predefined amount of force in a short time.

Purchasing oncology services. Kerr L. White Institute/American Cancer Society Task Force on Purchasing Oncology Services.

PubMed

Cangialose, C B; Blair, A E; Borchardt, J S; Ades, T B; Bennett, C L; Dickersin, K; Gesme, D H; Henderson, I C; McGinnis, L S; Mooney, K; Mortenson, L E; Sperduto, P; Winkenwerder, W; Ballard, D J

2000-06-15

A multidisciplinary panel representing various stakeholders in the health care delivery and oncology services marketplace was convened to develop specific criteria for healthcare purchasers to consider when evaluating the structures and processes of health plans. These rank ordered criteria also can be used by oncologic service providers and health plan designers as a yardstick for the services they offer. A multidisciplinary 31-member Task Force was assembled by the Kerr L. White Institute and the American Cancer Society in March 1997. Task Force members were selected for their ability to offer expert insight as purchasers, suppliers, policymakers, consumers, or stakeholders in the health care marketplace. A preference-weighted majority voting rule was used to identify the three most important recommendations of the 10 that were generated through a modified Delphi technique. To test the practicality of the top three recommendations, leaders of large managed care organizations (MCOs) were surveyed; the results of this survey then were compared with the results of the Task Force survey. The three most important recommendations from the Task Force were that health plans provide access to: 1) comprehensive cancer care, 2) preventive and screening services, and 3) second opinions and treatment options supported by scientific evidence. The difference between the responses of the Task Force and the MCOs was that MCOs placed the highest importance on evidence-based decision-making, with their next three rankings coinciding with those identified by the Task Force. The value of these summary recommendations will be realized through their use by both purchasers and suppliers to influence the structure and content of the delivery of oncologic services.

Preventing skin cancer: findings of the Task Force on Community Preventive Services On reducing Exposure to Ultraviolet Light.

PubMed

Saraiya, Mona; Glanz, Karen; Briss, Peter; Nichols, Phyllis; White, Cornelia; Das, Debjani

2003-10-17

Rates of skin cancer, the most common cancer in the United States, are increasing. The most preventable risk factor for skin cancer is unprotected ultraviolet (UV) exposure. Seeking to identify effective approaches to reducing the incidence of skin cancer by improving individual and community efforts to reduce unprotected UV exposure, the Task Force on Community Preventive Services conducted systematic reviews of community interventions to reduce exposure to ultraviolet light and increase protective behaviors. The Task Force found sufficient evidence to recommend two interventions that are based on improvements in sun protective or "covering-up" behavior (wearing protective clothing including long-sleeved clothing or hats): educational and policy approaches in two settings--primary schools and recreational or tourism sites. They found insufficient evidence to determine the effectiveness of a range of other population-based interventions and recommended additional research in these areas: educational and policy approaches in child care centers, secondary schools and colleges, recreational or tourism sites for children, and workplaces; interventions conducted in health-care settings and targeted to both providers and children's parents or caregivers; media campaigns alone; and community wide multicomponent interventions. This report also presents additional information regarding the recommended community interventions, briefly describes how the reviews were conducted, provides resources for further information, and provides information that can help in applying the interventions locally. The U.S. Preventive Services Task Force conducted a systematic review of counseling by primary care clinicians to prevent skin cancer (CDC. Counseling to prevent skin cancer: recommendation and rationale of the U.S. Preventive Services Task Force. MMWR 2003;52[No. RR-15]:13-17), which is also included in this issue, the first jointly released findings from the Task Force on Community Preventive Services and the U.S. Preventive Services Task Force.

Measurement of Forces and Moments Transmitted to the Residual Limb

DTIC Science & Technology

2009-08-01

prosthesis alignment, socket pressure, gait, force and moment sensors 16. SECURITY CLASSIFICATION OF: U 17. LIMITATION OF ABSTRACT 18. NUMBER... prosthesis to measure the forces and moments at the base of the socket and to use these measurements to estimate the forces transmitted to the residual limb...BODY – EACH TASK IN STATEMENT OF WORK Task 1. To instrument a transtibial prosthesis with a tri-axial transducer to measure the forces and

The Composite Strain Index (COSI) and Cumulative Strain Index (CUSI): methodologies for quantifying biomechanical stressors for complex tasks and job rotation using the Revised Strain Index.

PubMed

Garg, Arun; Moore, J Steven; Kapellusch, Jay M

2017-08-01

The Composite Strain Index (COSI) quantifies biomechanical stressors for complex tasks consisting of exertions at different force levels and/or with different exertion times. The Cumulative Strain Index (CUSI) further integrates biomechanical stressors from different tasks to quantify exposure for the entire work shift. The paper provides methodologies to compute COSI and CUSI along with examples. Complex task simulation produced 169,214 distinct tasks. Use of average, time-weighted average (TWA) and peak force and COSI classified 66.9, 28.2, 100 and 38.9% of tasks as hazardous, respectively. For job rotation the simulation produced 10,920 distinct jobs. TWA COSI, peak task COSI and CUSI classified 36.5, 78.1 and 66.6% jobs as hazardous, respectively. The results suggest that the TWA approach systematically underestimates the biomechanical stressors and peak approach overestimates biomechanical stressors, both at the task and job level. It is believed that the COSI and CUSI partially address these underestimations and overestimations of biomechanical stressors. Practitioner Summary: COSI quantifies exposure when applied hand force and/or duration of that force changes during a task cycle. CUSI integrates physical exposures from job rotation. These should be valuable tools for designing and analysing tasks and job rotation to determine risk of musculoskeletal injuries.

75 FR 43565 - NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: (10-084)] NASA Advisory Council; Ad-Hoc Task Force on Planetary Defense; Meeting AGENCY: National Aeronautics and Space Administration. ACTION... amended, the National Aeronautics and Space Administration announces a two-part meeting of the Ad-Hoc Task...

76 FR 72404 - Pesticides: Availability of Pesticide Registration Notice Regarding the Non-Dietary Exposure Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... Pesticide Registration Notice Regarding the Non-Dietary Exposure Task Force AGENCY: Environmental Protection... Registration Notice (PR Notice) regarding the data development efforts of the Non-Dietary Exposure Task Force... participate. FOR FURTHER INFORMATION CONTACT: Richard P. Dumas, Pesticide Re- evaluation Division (7508P...

Report of the Defense Science Board Task Force on Globalization and Security.

DTIC Science & Technology

1999-12-01

adversaries, such as North Korea’s progress in ballistic missiles. The leveling effect of globalization is a thread that runs through the Task Force...globalization are manifold. Increased use of the commercial sector cannot be separated from the effects of globalization. Nor is increased DoD reliance...enhance dramatically DSB Task Force on Globalization and Security DoD’s organizational efficiency and effectiveness . This could allow DoD to cut

Applicability of Performance Assessment Tools to Marine Corps Air Ground Task Force C4 System of Systems Performance Assessment

DTIC Science & Technology

2010-09-01

application of existing assessment tools that may be applicable to Marine Air Ground Task Force (MAGTF) Command, Control, Communications and...of existing assessment tools that may be applicable to Marine Air Ground Task Force (MAGTF) Command, Control, Communications and Computers (C4...assessment tools and analysis concepts that may be extended to the Marine Corps’ C4 System of Systems assessment methodology as a means to obtain a

Training and Familiarization with the Battle Command Sustainment Support System

DTIC Science & Technology

2010-06-11

for Task Force Bastone and SDDC” by Mitch Chandran (Translog, Fall 2005) focuses on the initial use of the BCS3 by the Surface Deployment and...the Heartbeat of ITV for Task Force Bastone and SDDC,” Journal of Military Transportation Management (Fall 2005): 13. 49Ibid. 50Ibid. 51Colonel...Mitch. “BCS3 Becomes the Heartbeat of ITV for Task Force Bastone and SDDC.” Journal of Military Transportation Management (Fall 2005). Department

Power system restoration - A task force report

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

Adibi, M.; Clelland, P.; Fink, L.

1986-01-01

The IEEE PES System Operation Subcommittee has established the Power System Restoration Task Force to: review operating practices, conduct a literature search, prepare relevant glossaries and bibliographies, and promote information exchange through technical papers. This is the first report of the Task Force. The problem of bulk power system restoration following a complete or partial collapse is practically as old as the electric utility industry itself. Many electric utilities have developed over the years system restoration schemes that meet the needs of their particular systems. These plans provide a great deal of insight into how the restorative process is viewedmore » by operating and planning personnel and what concerns and constraints any plan must operate under. The body of the report consists of notes prepared by members of the Task Force. It should not be interred that a complete reporting on Power System Restoration is undertaken here. The intent is to report upon work of the Task Force to date. The report also reviews several different restoration plans and shows their common concerns and constraints.« less

The AAPT Advanced Laboratory Task Force Report

NASA Astrophysics Data System (ADS)

Dunham, Jeffrey

2008-04-01

In late 2005, the American Association of Physics Teachers (AAPT) assembled a seven-member Advanced Laboratory Task Force^ to recommend ways that AAPT could increase the degree and effectiveness of its interactions with physics teachers of upper-division physics laboratories, with the ultimate goal of improving the teaching of advanced laboratories. The task force completed its work during the first half of 2006 and its recommendations were presented to the AAPT Executive Committee in July 2006. This talk will present the recommendations of the task force and actions taken by AAPT in response to them. The curricular goals of the advanced laboratory course at various institutions will also be discussed. The talk will conclude with an appeal to the APS membership to support ongoing efforts to revitalize advanced laboratory course instruction. ^Members of the Advanced Laboratory Task Force: Van Bistrow, University of Chicago; Bob DeSerio, University of Florida; Jeff Dunham, Middlebury College (Chair); Elizabeth George, Wittenburg University; Daryl Preston, California State University, East Bay; Patricia Sparks, Harvey Mudd College; Gerald Taylor, James Madison University; and David Van Baak, Calvin College.

Report of the Special Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care.

PubMed

Anderson, R J; Milburn, L T

1990-04-01

Texas not-for-profit hospitals recently received intense scrutiny regarding their involvement in charity-related contributions when Texas Attorney General Jim Mattox formed the Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care. This article details the task force's recommendations concerning charity care obligations of Texas not-for-profit hospitals. Setting the stage for these recommendations was a broad definition of charitable services that included costs for delivering services to indigents and for providing community services to fulfill the hospital's charitable, religious, educational, research, or eleemosynary purposes. The task force unanimously agreed that a mandated level of charity care was incongruent with the hospitals' individual missions and specific community needs, but they supported the formation of standard accounting procedures for charitable services and the voluntary submission of their mission statements to the attorney general of Texas. While the hospitals' role in providing charitable services is very important, the task force emphasized that the overall need for adequate financing and reimbursement of health care is a societal problem that needs specific state and federal actions.

Evaluation of knee joint forces during kneeling work with different kneepads.

PubMed

Xu, Hang; Jampala, Sree; Bloswick, Donald; Zhao, Jie; Merryweather, Andrew

2017-01-01

The main purpose of this study is to determine knee joint forces resulting from kneeling work with and without kneepads to quantify how different kneepads redistribute force. Eleven healthy males simulated a tile setting task to different locations during six kneepad states (five different kneepad types and without kneepad). Peak and average forces on the anatomical landmarks of both knees were obtained by custom force sensors. The results revealed that kneepad design can significantly modify the forces on the knee joint through redistribution. The Professional Gel design was preferred among the five tested kneepads which was confirmed with both force measurements and participants' responses. The extreme reaching locations induced significantly higher joint forces on left knee or right knee depending on task. The conclusion of this study is that a properly selected kneepad for specific tasks and a more neutral working posture can modify the force distribution on the knees and likely decrease the risk of knee disorders from kneeling work. Copyright © 2016 Elsevier Ltd. All rights reserved.

Improving posture-motor dual-task with a supraposture-focus strategy in young and elderly adults

PubMed Central

Yu, Shu-Han

2017-01-01

In a postural-suprapostural task, appropriate prioritization is necessary to achieve task goals and maintain postural stability. A “posture-first” principle is typically favored by elderly people in order to secure stance stability, but this comes at the cost of reduced suprapostural performance. Using a postural-suprapostural task with a motor suprapostural goal, this study investigated differences between young and older adults in dual-task cost across varying task prioritization paradigms. Eighteen healthy young (mean age: 24.8 ± 5.2 years) and 18 older (mean age: 68.8 ± 3.7 years) adults executed a designated force-matching task from a stabilometer board using either a stabilometer stance (posture-focus strategy) or force-matching (supraposture-focus strategy) as the primary task. The dual-task effect (DTE: % change in dual-task condition; positive value: dual-task benefit, negative value: dual-task cost) of force-matching error and reaction time (RT), posture error, and approximate entropy (ApEn) of stabilometer movement were measured. When using the supraposture-focus strategy, young adults exhibited larger DTE values in each behavioral parameter than when using the posture-focus strategy. The older adults using the supraposture-focus strategy also attained larger DTE values for posture error, stabilometer movement ApEn, and force-matching error than when using the posture-focus strategy. These results suggest that the supraposture-focus strategy exerted an increased dual-task benefit for posture-motor dual-tasking in both healthy young and elderly adults. The present findings imply that the older adults should make use of the supraposture-focus strategy for fall prevention during dual-task execution. PMID:28151943

Improving posture-motor dual-task with a supraposture-focus strategy in young and elderly adults.

PubMed

Yu, Shu-Han; Huang, Cheng-Ya

2017-01-01

In a postural-suprapostural task, appropriate prioritization is necessary to achieve task goals and maintain postural stability. A "posture-first" principle is typically favored by elderly people in order to secure stance stability, but this comes at the cost of reduced suprapostural performance. Using a postural-suprapostural task with a motor suprapostural goal, this study investigated differences between young and older adults in dual-task cost across varying task prioritization paradigms. Eighteen healthy young (mean age: 24.8 ± 5.2 years) and 18 older (mean age: 68.8 ± 3.7 years) adults executed a designated force-matching task from a stabilometer board using either a stabilometer stance (posture-focus strategy) or force-matching (supraposture-focus strategy) as the primary task. The dual-task effect (DTE: % change in dual-task condition; positive value: dual-task benefit, negative value: dual-task cost) of force-matching error and reaction time (RT), posture error, and approximate entropy (ApEn) of stabilometer movement were measured. When using the supraposture-focus strategy, young adults exhibited larger DTE values in each behavioral parameter than when using the posture-focus strategy. The older adults using the supraposture-focus strategy also attained larger DTE values for posture error, stabilometer movement ApEn, and force-matching error than when using the posture-focus strategy. These results suggest that the supraposture-focus strategy exerted an increased dual-task benefit for posture-motor dual-tasking in both healthy young and elderly adults. The present findings imply that the older adults should make use of the supraposture-focus strategy for fall prevention during dual-task execution.

A systematic evaluation of prevalence and diagnostic accuracy of sacroiliac joint interventions.

PubMed

Simopoulos, Thomas T; Manchikanti, Laxmaiah; Singh, Vijay; Gupta, Sanjeeva; Hameed, Haroon; Diwan, Sudhir; Cohen, Steven P

2012-01-01

The contributions of the sacroiliac joint to low back and lower extremity pain have been a subject of considerable debate and research. It is generally accepted that 10% to 25% of patients with persistent mechanical low back pain below L5 have pain secondary to sacroiliac joint pathology. However, no single historical, physical exam, or radiological feature can definitively establish a diagnosis of sacroiliac joint pain. Based on present knowledge, a proper diagnosis can only be made using controlled diagnostic blocks. The diagnosis and treatment of sacroiliac joint pain continue to be characterized by wide variability and a paucity of the literature. To evaluate the accuracy of diagnostic sacroiliac joint interventions. A systematic review of diagnostic sacroiliac joint interventions. Methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, or poor based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. In this evaluation we utilized controlled local anesthetic blocks using at least 50% pain relief as the reference standard. The evidence is good for the diagnosis of sacroiliac joint pain utilizing controlled comparative local anesthetic blocks. The prevalence of sacroiliac joint pain is estimated to range between 10% and 62% based on the setting; however, the majority of analyzed studies suggest a point prevalence of around 25%, with a false-positive rate for uncontrolled blocks of approximately 20%. The evidence for provocative testing to diagnose sacroiliac joint pain was fair. The evidence for the diagnostic accuracy of imaging is limited. The limitations of this systematic review include a paucity of literature, variations in technique, and variable criterion standards for the diagnosis of sacroiliac joint pain. Based on this systematic review, the evidence for the diagnostic accuracy of sacroiliac joint injections is good, the evidence for provocation maneuvers is fair, and evidence for imaging is limited.

75 FR 12493 - Task Force on Childhood Obesity: Request for Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-16

... Force on Childhood Obesity: Request for Information AGENCY: U.S. Department of Agriculture, U.S.... SUMMARY: Across the country, childhood obesity has reached epidemic rates. On February 9, 2010, President Obama signed a Presidential Memo establishing a Task Force on Childhood Obesity that directs Federal...

America’s Army: The Strength of the Nation. 2010 Army Posture Statement

DTIC Science & Technology

2010-02-19

Task Force ARFORGEN Army Force Generation AFRICOM Africa Command AMAP Army Medical Action Plan AMC Army Material Command APS Army Prepositioned Stocks ...Facilities EBCT Evaluation Brigade Combat Team EOD Explosive Ordnance Disposal ES2 Every Soldier a Sensor ETF Enterprise Task Force FCS Future Combat

Pharmacy faculty workplace issues: findings from the 2009-2010 COD-COF Joint Task Force on Faculty Workforce.

PubMed

Desselle, Shane P; Peirce, Gretchen L; Crabtree, Brian L; Acosta, Daniel; Early, Johnnie L; Kishi, Donald T; Nobles-Knight, Dolores; Webster, Andrew A

2011-05-10

Many factors contribute to the vitality of an individual faculty member, a department, and an entire academic organization. Some of the relationships among these factors are well understood, but many questions remain unanswered. The Joint Task Force on Faculty Workforce examined the literature on faculty workforce issues, including the work of previous task forces charged by the American Association of Colleges of Pharmacy (AACP). We identified and focused on 4 unique but interrelated concepts: organizational culture/climate, role of the department chair, faculty recruitment and retention, and mentoring. Among all 4 resides the need to consider issues of intergenerational, intercultural, and gender dynamics. This paper reports the findings of the task force and proffers specific recommendations to AACP and to colleges and schools of pharmacy.

Interpersonal synergies: static prehension tasks performed by two actors.

PubMed

Solnik, Stanislaw; Reschechtko, Sasha; Wu, Yen-Hsun; Zatsiorsky, Vladimir M; Latash, Mark L

2016-08-01

We investigated multidigit synergies stabilizing components of the resultant force vector during joint performance of a static prehension task by two persons as compared to similar tasks performed by a single person using both hands. Subjects transferred the instrumented handle from the right hand to the left hand (one-person condition) or passed that handle to another person (two-person condition) while keeping the handle's position and orientation stationary. Only three digits were involved per hand, the thumb, the index finger, and the middle finger; the forces and moments produced by the digits were measured by six-component sensors. We estimated the performance-stabilizing synergies within the uncontrolled manifold framework by quantifying the intertrial variance structure of digit forces and moments. The analysis was performed at three levels: between hands, between virtual finger and virtual thumb (imagined digits producing the same mechanical variables as the corresponding actual digits combined) produced by the two hands (in both interpersonal and intrapersonal conditions), and between the thumb and virtual finger for one hand only. Additionally, we performed correlation and phase synchronization analyses of resultant tangential forces and internal normal forces. Overall, the one-person conditions were characterized by higher amount of intertrial variance that did not affect resultant normal force components, higher internal components of normal forces, and stronger synchronization of the normal forces generated by the hands. Our observations suggest that in two-person tasks, when participants try to achieve a common mechanical outcome, the performance-stabilizing synergies depend on non-visual information exchange, possibly via the haptic and proprioceptive systems. Therefore, synergies quantified in tasks using visual feedback only may not be generalizable to more natural tasks.

Visual search in a forced-choice paradigm

NASA Technical Reports Server (NTRS)

Holmgren, J. E.

1974-01-01

The processing of visual information was investigated in the context of two visual search tasks. The first was a forced-choice task in which one of two alternative letters appeared in a visual display of from one to five letters. The second task included trials on which neither of the two alternatives was present in the display. Search rates were estimated from the slopes of best linear fits to response latencies plotted as a function of the number of items in the visual display. These rates were found to be much slower than those estimated in yes-no search tasks. This result was interpreted as indicating that the processes underlying visual search in yes-no and forced-choice tasks are not the same.

Improving training of laparoscopic tissue manipulation skills using various visual force feedback types.

PubMed

Smit, Daan; Spruit, Edward; Dankelman, Jenny; Tuijthof, Gabrielle; Hamming, Jaap; Horeman, Tim

2017-01-01

Visual force feedback allows trainees to learn laparoscopic tissue manipulation skills. The aim of this experimental study was to find the most efficient visual force feedback method to acquire these skills. Retention and transfer validity to an untrained task were assessed. Medical students without prior experience in laparoscopy were randomized in three groups: Constant Force Feedback (CFF) (N = 17), Bandwidth Force Feedback (BFF) (N = 16) and Fade-in Force Feedback (N = 18). All participants performed a pretest, training, post-test and follow-up test. The study involved two dissimilar tissue manipulation tasks, one for training and one to assess transferability. Participants performed six trials of the training task. A force platform was used to record several force parameters. A paired-sample t test showed overall lower force parameter outcomes in the post-test compared to the pretest (p < .001). A week later, the force parameter outcomes were still significantly lower than found in the pretest (p < .005). Participants also performed the transfer task in the post-test (p < .02) and follow-up (p < .05) test with lower force parameter outcomes compared to the pretest. A one-way MANOVA indicated that in the post-test the CFF group applied 50 % less Mean Absolute Nonzero Force (p = .005) than the BFF group. All visual force feedback methods showed to be effective in decreasing tissue manipulation force as no major differences were found between groups in the post and follow-up trials. The BFF method is preferred for it respects individual progress and minimizes distraction.

Objective Assessment of Laparoscopic Force and Psychomotor Skills in a Novel Virtual Reality-Based Haptic Simulator.

PubMed

Prasad, M S Raghu; Manivannan, Muniyandi; Manoharan, Govindan; Chandramohan, S M

2016-01-01

Most of the commercially available virtual reality-based laparoscopic simulators do not effectively evaluate combined psychomotor and force-based laparoscopic skills. Consequently, the lack of training on these critical skills leads to intraoperative errors. To assess the effectiveness of the novel virtual reality-based simulator, this study analyzed the combined psychomotor (i.e., motion or movement) and force skills of residents and expert surgeons. The study also examined the effectiveness of real-time visual force feedback and tool motion during training. Bimanual fundamental (i.e., probing, pulling, sweeping, grasping, and twisting) and complex tasks (i.e., tissue dissection) were evaluated. In both tasks, visual feedback on applied force and tool motion were provided. The skills of the participants while performing the early tasks were assessed with and without visual feedback. Participants performed 5 repetitions of fundamental and complex tasks. Reaction force and instrument acceleration were used as metrics. Surgical Gastroenterology, Government Stanley Medical College and Hospital; Institute of Surgical Gastroenterology, Madras Medical College and Rajiv Gandhi Government General Hospital. Residents (N = 25; postgraduates and surgeons with <2 years of laparoscopic surgery) and expert surgeons (N = 25; surgeons with >4 and ≤10 years of laparoscopic surgery). Residents applied large forces compared with expert surgeons and performed abrupt tool movements (p < 0.001). However, visual + haptic feedback improved the performance of residents (p < 0.001). In complex tasks, visual + haptic feedback did not influence the applied force of expert surgeons, but influenced their tool motion (p < 0.001). Furthermore, in complex tissue sweeping task, expert surgeons applied more force, but were within the tissue damage limits. In both groups, exertion of large forces and abrupt tool motion were observed during grasping, probing or pulling, and tissue sweeping maneuvers (p < 0.001). Modern day curriculum-based training should evaluate the skills of residents with robust force and psychomotor-based exercises for proficient laparoscopy. Visual feedback on force and motion during training has the potential to enhance the learning curve of residents. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

WWC Review of the Report "Meeting the Challenge of Combating Chronic Absenteeism: Impact of the NYC Mayor's Interagency Task Force on Chronic Absenteeism and School Attendance and Its Implications for Other Cities." What Works Clearinghouse Single Study Review

ERIC Educational Resources Information Center

What Works Clearinghouse, 2014

2014-01-01

The 2013 study, "Meeting the Challenge of Combating Chronic Absenteeism: Impact of the NYC Mayor's Interagency Task Force on Chronic Absenteeism and School Attendance and Its Implications for Other Cities", examined the impact of the strategies developed by an interagency task force in New York City to combat chronic absenteeism in…

Report of the Defense Science Board Task Force on Tactical Battlefield Communications,

DTIC Science & Technology

2000-02-01

Communications, in and Intelligence (ASD/C3I); and LTG John Woodward, J6. The Task Force comprised fourteen experts from government, industry, and academe. The...O’Berry (USAF-Retired) Col Bobby Smart (USAF) Professor Stewart Personick Mr. Mark Rich Mr. Peter D. Steensma DSB Staff Assistant Mr. John ...were: The Honorable Dr. Jacques Gansler, USD/AT&L, the Honorable Art Money, ASD/C3I and LTG John Woodward, JCS-J6. The Task Force membership (Figure

Report of the Defense Science Board Task Force on Trends and Implications of Climate Change on National and International Security

DTIC Science & Technology

2011-10-01

Propulsion Laboratory Dr. Diane Evans Jet Propulsion Laboratory CAPT Tim Gallaudet US Navy Task Force on Climate Change Mr. David Goldwyn State...Ashley Moran Strauss Center, University of Texas, Austin DOD’s (Minerva) Climate Change and African Political Stability Project CAPT Timothy ... Gallaudet Office of the Oceanographer of the Navy Navy’s Climate Change Task Force Dr. Sherri Goodman, Dr. Ralph Espach and Mr. Peter MacKenzie CNA

Hispanic Youth--Dropout Prevention. Report of the Task Force on the Participation of Hispanic Students in Vocational Education Programs = La Joventud Hispana. Reporte del Grupo Especial. La Investigacion de la Participacion de los Estudiantes Hispanos en la Educacion Relativa a la Vocacion.

ERIC Educational Resources Information Center

Idaho State Dept. of Education, Boise. Div. of Vocational Education.

An Idaho task force of Hispanic Americans, industry representatives, and education leaders studied the reasons Hispanic students were not enrolling in and completing vocational education programs. The task force sponsored a series of community meetings to identify reasons and solutions. Approximately 40-60 parents, students, and other interested…

National Task Force on a Uniform Measurement Unit for the Recognition of Continuing Education: Working Papers; and The Continuing Education Unit: A Uniform Unit of Measure for Non-Credit Continuing Education Programs (An Interim Statement of the National Task Force).

ERIC Educational Resources Information Center

National Univ. Extension Association, Washington, DC.

In 1968, a national planning conference, under the joint sponsorship of 34 organizations responsing to continuing education needs, created the National Task Force to determine the feasibility of a uniform unit of measurement and develop a proposal for field testing the concept. Stressing that continuing education units should supplement, not…

Overview of the Machine-Tool Task Force

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

Sutton, G.P.

1981-06-08

The Machine Tool Task Force, (MTTF) surveyed the state of the art of machine tool technology for material removal for two and one-half years. This overview gives a brief summary of the approach, specific subjects covered, principal conclusions and some of the key recommendations aimed at improving the technology and advancing the productivity of machine tools. The Task Force consisted of 123 experts from the US and other countries. Their findings are documented in a five-volume report, Technology of Machine Tools.

Effects of Visual Feedback and Memory on Unintentional Drifts in Performance During Finger Pressing Tasks

PubMed Central

Solnik, Stanislaw; Qiao, Mu; Latash, Mark L.

2017-01-01

This study tested two hypotheses on the nature of unintentional force drifts elicited by removing visual feedback during accurate force production tasks. The role of working memory (memory hypothesis) was explored in tasks with continuous force production, intermittent force production, and rest intervals over the same time interval. The assumption of unintentional drifts in referent coordinate for the fingertips was tested using manipulations of visual feedback: Young healthy subjects performed accurate steady-state force production tasks by pressing with the two index fingers on individual force sensors with visual feedback on the total force, sharing ratio, both, or none. Predictions based on the memory hypothesis have been falsified. In particular, we observed consistent force drifts to lower force values during continuous force production trials only. No force drift or drifts to higher forces were observed during intermittent force production trials and following rest intervals. The hypotheses based on the idea of drifts in referent finger coordinates have been confirmed. In particular, we observed superposition of two drift processes: A drift of total force to lower magnitudes and a drift of the sharing ratio to 50:50. When visual feedback on total force only was provided, the two finger forces showed drifts in opposite directions. We interpret the findings as evidence for the control of motor actions with changes in referent coordinates for participating effectors. Unintentional drifts in performance are viewed as natural relaxation processes in the involved systems; their typical time reflects stability in the direction of the drift. The magnitude of the drift was higher in the right (dominant) hand, which is consistent with the dynamic dominance hypothesis. PMID:28168396

Cortical activity predicts good variation in human motor output.

PubMed

Babikian, Sarine; Kanso, Eva; Kutch, Jason J

2017-04-01

Human movement patterns have been shown to be particularly variable if many combinations of activity in different muscles all achieve the same task goal (i.e., are goal-equivalent). The nervous system appears to automatically vary its output among goal-equivalent combinations of muscle activity to minimize muscle fatigue or distribute tissue loading, but the neural mechanism of this "good" variation is unknown. Here we use a bimanual finger task, electroencephalography (EEG), and machine learning to determine if cortical signals can predict goal-equivalent variation in finger force output. 18 healthy participants applied left and right index finger forces to repeatedly perform a task that involved matching a total (sum of right and left) finger force. As in previous studies, we observed significantly more variability in goal-equivalent muscle activity across task repetitions compared to variability in muscle activity that would not achieve the goal: participants achieved the task in some repetitions with more right finger force and less left finger force (right > left) and in other repetitions with less right finger force and more left finger force (left > right). We found that EEG signals from the 500 milliseconds (ms) prior to each task repetition could make a significant prediction of which repetitions would have right > left and which would have left > right. We also found that cortical maps of sites contributing to the prediction contain both motor and pre-motor representation in the appropriate hemisphere. Thus, goal-equivalent variation in motor output may be implemented at a cortical level.

Bilingual Advantage in Attentional Control: Evidence from the Forced-Attention Dichotic Listening Paradigm

ERIC Educational Resources Information Center

Soveri, Anna; Laine, Matti; Hamalainen, Heikki; Hugdahl, Kenneth

2011-01-01

It has been claimed that due to their experience in controlling two languages, bilinguals exceed monolinguals in certain executive functions, especially inhibition of task-irrelevant stimuli. Here we investigated the effects of bilingualism on an executive phonological task, namely the forced-attention dichotic listening task with syllabic…

Task-level testing of the JPL-OMV smart end effector

NASA Technical Reports Server (NTRS)

Hannaford, B.

1987-01-01

An intelligent end effector previously developed at JPL has been tested in over 21 hours of experimental teleoperation. The end effector provides local control of gripper clamping force and a 6-degree-of-freedom, wrist mounted force torque sensor. Resolved forces and torques were displayed to the test subjects, and the effect of this information on their performance of simulated satellite servicing tasks was assessed. The experienced subjects accomplished the tasks with lower levels of Remote Manipulator System (RMS) forces than intermediate and naive subjects, but the force levels were apparently uncorrelated with the presence or absence of the display. This negative finding was attributed to the lack of a suitable control mode in the manipulator control system.

Grasp Assist Device with Automatic Mode Control Logic

NASA Technical Reports Server (NTRS)

Laske, Evan (Inventor); Davis, Donald R. (Inventor); Ihrke, Chris A. (Inventor)

2018-01-01

A system includes a glove, sensors, actuator assemblies, and controller. The sensors include load sensors which measure an actual grasping force and attitude sensors which determine a glove attitude. The actuator assembly provides a grasp assist force to the glove. Respective locations of work cells in the work environment and permitted work tasks for each work cell are programmed into the controller. The controller detects the glove location and attitude. A work task is selected by the controller for the location. The controller calculates a required grasp assist force using measured actual grasping forces from the load sensors. The required grasp assist force is applied via the glove using the actuator assembly to thereby assist the operator in performing the identified work task.

Analysis of the pen pressure and grip force signal during basic drawing tasks: The timing and speed changes impact drawing characteristics.

PubMed

Gatouillat, Arthur; Dumortier, Antoine; Perera, Subashan; Badr, Youakim; Gehin, Claudine; Sejdić, Ervin

2017-08-01

Writing is a complex fine and trained motor skill, involving complex biomechanical and cognitive processes. In this paper, we propose the study of writing kinetics using three angles: the pen-tip normal force, the total grip force signal and eventually writing quality assessment. In order to collect writing kinetics data, we designed a sensor collecting these characteristics simultaneously. Ten healthy right-handed adults were recruited and were asked to perform four tasks: first, they were instructed to draw circles at a speed they considered comfortable; they then were instructed to draw circles at a speed they regarded as fast; afterwards, they repeated the comfortable task compelled to follow the rhythm of a metronome; and eventually they performed the fast task under the same timing constraints. Statistical differences between the tasks were computed, and while pen-tip normal force and total grip force signal were not impacted by the changes introduced in each task, writing quality features were affected by both the speed changes and timing constraint changes. This verifies the already-studied speed-accuracy trade-off and suggest the existence of a timing constraints-accuracy trade-off. Copyright © 2017 Elsevier Ltd. All rights reserved.

Study of modeling and evaluation of remote manipulation tasks with force feedback

NASA Technical Reports Server (NTRS)

Hill, J. W.

1979-01-01

The use of time and motion study methods to evaluate force feedback in remote manipulation tasks are described. Several systems of time measurement derived for industrial workers were studied and adapted for manipulator use. A task board incorporating a set of basic motions was designed and built. Results obtained from two subjects in three manipulation situations for each are reported: a force-reflective manipulator, a unilateral manipulator, and the unaided human hand. The results indicate that: (1) a time-and-motion study techniques are applicable to manipulation; and that (2) force feedback facilitates some motions (notably fitting), but not others (such as positioning).

Infrastructure Task Force National Environmental Policy Act Requirements - February 2011

EPA Pesticide Factsheets

This document summarizes in a matrix format the federal regulations requirements and guidance for complying with the National Environmental Policy Act for the Infrastructure Task Force federal partner agencies.

PRN 2000-7: Non-Dietary Exposure Task Force

EPA Pesticide Factsheets

This PR Notice announces an industry-wide task force to jointly develop residential indoor exposure data for pesticides containing one or more of the active ingredients synthetic pyrethroids, pyrethrum and synergists.

Report of the Task Force on Human Rights.

ERIC Educational Resources Information Center

National Education Association, Washington, DC.

The NEA Task Force was instructed to "recommend to the Executive Committee a structure and program for the coordination and expansion of the human rights activities of the NEA and of the departments, divisions, commissions, and committees." Their recommendations and a discussion of the forces in American society that make them necessary comprise…

Force-Sensing Enhanced Simulation Environment (ForSense) for laparoscopic surgery training and assessment.

PubMed

Cundy, Thomas P; Thangaraj, Evelyn; Rafii-Tari, Hedyeh; Payne, Christopher J; Azzie, Georges; Sodergren, Mikael H; Yang, Guang-Zhong; Darzi, Ara

2015-04-01

Excessive or inappropriate tissue interaction force during laparoscopic surgery is a recognized contributor to surgical error, especially for robotic surgery. Measurement of force at the tool-tissue interface is, therefore, a clinically relevant skill assessment variable that may improve effectiveness of surgical simulation. Popular box trainer simulators lack the necessary technology to measure force. The aim of this study was to develop a force sensing unit that may be integrated easily with existing box trainer simulators and to (1) validate multiple force variables as objective measurements of laparoscopic skill, and (2) determine concurrent validity of a revised scoring metric. A base plate unit sensitized to a force transducer was retrofitted to a box trainer. Participants of 3 different levels of operative experience performed 5 repetitions of a peg transfer and suture task. Multiple outcome variables of force were assessed as well as a revised scoring metric that incorporated a penalty for force error. Mean, maximum, and overall magnitudes of force were significantly different among the 3 levels of experience, as well as force error. Experts were found to exert the least force and fastest task completion times, and vice versa for novices. Overall magnitude of force was the variable most correlated with experience level and task completion time. The revised scoring metric had similar predictive strength for experience level compared with the standard scoring metric. Current box trainer simulators can be adapted for enhanced objective measurements of skill involving force sensing. These outcomes are significantly influenced by level of expertise and are relevant to operative safety in laparoscopic surgery. Conventional proficiency standards that focus predominantly on task completion time may be integrated with force-based outcomes to be more accurately reflective of skill quality. Copyright © 2015 Elsevier Inc. All rights reserved.

Dynamic stability requirements during gait and standing exergames on the wii fit® system in the elderly

PubMed Central

2012-01-01

Background In rehabilitation, training intensity is usually adapted to optimize the trained system to attain better performance (overload principle). However, in balance rehabilitation, the level of intensity required during training exercises to optimize improvement in balance has rarely been studied, probably due to the difficulty in quantifying the stability level during these exercises. The goal of the present study was to test whether the stabilizing/destabilizing forces model could be used to analyze how stability is challenged during several exergames, that are more and more used in balance rehabilitation, and a dynamic functional task, such as gait. Methods Seven healthy older adults were evaluated with three-dimensional motion analysis during gait at natural and fast speed, and during three balance exergames (50/50 Challenge, Ski Slalom and Soccer). Mean and extreme values for stabilizing force, destabilizing force and the ratio of the two forces (stability index) were computed from kinematic and kinetic data to determine the mean and least level of dynamic, postural and overall balance stability, respectively. Results Mean postural stability was lower (lower mean destabilizing force) during the 50/50 Challenge game than during all the other tasks, but peak postural instability moments were less challenging during this game than during any of the other tasks, as shown by the minimum destabilizing force values. Dynamic stability was progressively more challenged (higher mean and maximum stabilizing force) from the 50/50 Challenge to the Soccer and Slalom games, to the natural gait speed task and to the fast gait speed task, increasing the overall stability difficulty (mean and minimum stability index) in the same manner. Conclusions The stabilizing/destabilizing forces model can be used to rate the level of balance requirements during different tasks such as gait or exergames. The results of our study showed that postural stability did not differ much between the evaluated tasks (except for the 50/50 Challenge), compared to dynamic stability, which was significantly less challenged during the games than during the functional tasks. Games with greater centre of mass displacements and changes in the base of support are likely to stimulate balance control enough to see improvements in balance during dynamic functional tasks, and could be tested in pathological populations with the approach used here. PMID:22607025

Force of Choice: Optimizing Theater Special Operations Commands to Achieve Synchronized Effects

DTIC Science & Technology

2012-12-01

GCC Geographic Combatant Command GFM Global Force Management GSN Global SOF Network (aka EGSN) IA Interagency IATF Interagency Task Force...and through African partners.75 SOCOM NCR was chosen because it is a primary outgrowth of the SOCOM Interagency Task Force ( IATF ), and the...result, SOCOM established the IATF and Special Operations Support Teams (SOST). While the IATF remained at SOCOM Headquarters at MacDill AFB, the

Practice and transfer of the frequency structures of continuous isometric force.

PubMed

King, Adam C; Newell, Karl M

2014-04-01

The present study examined the learning, retention and transfer of task outcome and the frequency-dependent properties of isometric force output dynamics. During practice participants produced isometric force to a moderately irregular target pattern either under a constant or variable presentation. Immediate and delayed retention tests examined the persistence of practice-induced changes of force output dynamics and transfer tests investigated performance to novel (low and high) irregular target patterns. The results showed that both constant and variable practice conditions exhibited similar reductions in task error but that the frequency-dependent properties were differentially modified across the entire bandwidth (0-12Hz) of force output dynamics as a function of practice. Task outcome exhibited persistent properties on the delayed retention test whereas the retention of faster time scales processes (i.e., 4-12Hz) of force output was mediated as a function of frequency structure. The structure of the force frequency components during early practice and following a rest interval was characterized by an enhanced emphasis on the slow time scales related to perceptual-motor feedback. The findings support the proposition that there are different time scales of learning at the levels of task outcome and the adaptive frequency bandwidths of force output dynamics. Copyright © 2014 Elsevier B.V. All rights reserved.

ACHP | Archeology Task Force

Science.gov Websites

Task Force ACHP adopts new Policy Statement Regarding Treatment of Burial Sites, Human Remains, and Treatment of Human Remains and Grave Goods;" A new human remains policy statement was adopted in

USLCSG Task Force

Science.gov Websites

Unites States Linear Collider Steering Group dot dot dot dot What's New! June 2003 Meeting Welcome to the USLCSG Task Force at the Stanford Linear Accelerator Center [Enter] dot dot SLAC Page Owners

Task Force on Innovation in Dental Hygiene Curricula.

ERIC Educational Resources Information Center

Bader, James; And Others

1989-01-01

The background, origins, functions, and recommendations of the American Association of Dental Schools' task force investigating improvement of access to dental hygiene training programs and of curriculum and program design are presented. (MSE)

Pharmacy Faculty Workplace Issues: Findings From the 2009-2010 COD-COF Joint Task Force on Faculty Workforce

PubMed Central

Peirce, Gretchen L.; Crabtree, Brian L.; Acosta, Daniel; Early, Johnnie L.; Kishi, Donald T.; Nobles-Knight, Dolores; Webster, Andrew A.

2011-01-01

Many factors contribute to the vitality of an individual faculty member, a department, and an entire academic organization. Some of the relationships among these factors are well understood, but many questions remain unanswered. The Joint Task Force on Faculty Workforce examined the literature on faculty workforce issues, including the work of previous task forces charged by the American Association of Colleges of Pharmacy (AACP). We identified and focused on 4 unique but interrelated concepts: organizational culture/climate, role of the department chair, faculty recruitment and retention, and mentoring. Among all 4 resides the need to consider issues of intergenerational, intercultural, and gender dynamics. This paper reports the findings of the task force and proffers specific recommendations to AACP and to colleges and schools of pharmacy. PMID:21769139

Report of the Task Force on SSC Magnet System Test Site

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

NONE

1984-10-01

The Task Force on SSC Magnet Systems test Site was appointed by Maury Tigner, Director of the SSC, Phase 1 in August 1984. In brief, the charge asked the Task Force to make a critical evaluation of potential test sites for a major SSC magnet System Test Facility (STF) with regard to: (1) availability of the needed space, utilities, staff and other requirements on the desired time scale; and (2) the cost of preparing the sites for the tests and for operating the facilities during the test period. The charge further suggests that, by virtue of existing facilities and availabilitymore » of experienced staff, BNL and FNAL are the two best candidate sites and that is therefore appears appropriate to restrict the considerations of the Task Force to these sites. During the subsequent deliberations of the Task Force, no new facts were revealed that altered the assumptions of the charge in this regard. The charge does not ask for a specific site recommendation for the STF. Indeed, an agreement on such a recommendation would be difficult to achieve considering the composition of the Task Force, wherein a large fraction of the membership is drawn from the two contending laboratories. Instead, we have attempted to describe the purpose of the facility, outline a productive test program, list the major facilities required, carefully review the laboratories` responses to the facility requirements, and make objective comparisons of the specific features and capabilities offered.« less

AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training.

PubMed

Harkness, Beth A; Allison, Jerry D; Clements, Jessica B; Coffey, Charles W; Fahey, Frederic H; Gress, Dustin A; Kinahan, Paul E; Nickoloff, Edward L; Mawlawi, Osama R; MacDougall, Robert D; Pizzutiello, Robert J

2015-09-08

The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear  medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics  Training. The mission of this task force was to assemble a representative group of stakeholders to:• Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years,• Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and• Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission.

AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training

PubMed Central

Allison, Jerry D.; Clements, Jessica B.; Coffey, Charles W.; Fahey, Frederic H.; Gress, Dustin A.; Kinahan, Paul E.; Nickoloff, Edward L.; Mawlawi, Osama R.; MacDougall, Robert D.; Pizzuitello, Robert J.

2015-01-01

The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics Training. The mission of this task force was to assemble a representative group of stakeholders to: Estimate the demand for board‐certified nuclear medicine physicists in the next 5–10 years,Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, andIdentify approaches that may be considered to facilitate the training of nuclear medicine physicists. As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face‐to‐face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission. PACS number: 01.40.G‐ PMID:26699325

Visual force feedback in laparoscopic training.

PubMed

Horeman, Tim; Rodrigues, Sharon P; van den Dobbelsteen, John J; Jansen, Frank-Willem; Dankelman, Jenny

2012-01-01

To improve endoscopic surgical skills, an increasing number of surgical residents practice on box or virtual reality (VR) trainers. Current training is focused mainly on hand-eye coordination. Training methods that focus on applying the right amount of force are not yet available. The aim of this project is to develop a low-cost training system that measures the interaction force between tissue and instruments and displays a visual representation of the applied forces inside the camera image. This visual representation continuously informs the subject about the magnitude and the direction of applied forces. To show the potential of the developed training system, a pilot study was conducted in which six novices performed a needle-driving task in a box trainer with visual feedback of the force, and six novices performed the same task without visual feedback of the force. All subjects performed the training task five times and were subsequently tested in a post-test without visual feedback. The subjects who received visual feedback during training exerted on average 1.3 N (STD 0.6 N) to drive the needle through the tissue during the post-test. This value was considerably higher for the group that received no feedback (2.6 N, STD 0.9 N). The maximum interaction force during the post-test was noticeably lower for the feedback group (4.1 N, STD 1.1 N) compared with that of the control group (8.0 N, STD 3.3 N). The force-sensing training system provides us with the unique possibility to objectively assess tissue-handling skills in a laboratory setting. The real-time visualization of applied forces during training may facilitate acquisition of tissue-handling skills in complex laparoscopic tasks and could stimulate proficiency gain curves of trainees. However, larger randomized trials that also include other tasks are necessary to determine whether training with visual feedback about forces reduces the interaction force during laparoscopic surgery.

Recruitment of faster motor units is associated with greater rates of fascicle strain and rapid changes in muscle force during locomotion

PubMed Central

Lee, Sabrina S. M.; de Boef Miara, Maria; Arnold, Allison S.; Biewener, Andrew A.; Wakeling, James M.

2013-01-01

SUMMARY Animals modulate the power output needed for different locomotor tasks by changing muscle forces and fascicle strain rates. To generate the necessary forces, appropriate motor units must be recruited. Faster motor units have faster activation–deactivation rates than slower motor units, and they contract at higher strain rates; therefore, recruitment of faster motor units may be advantageous for tasks that involve rapid movements or high rates of work. This study identified motor unit recruitment patterns in the gastrocnemii muscles of goats and examined whether faster motor units are recruited when locomotor speed is increased. The study also examined whether locomotor tasks that elicit faster (or slower) motor units are associated with increased (or decreased) in vivo tendon forces, force rise and relaxation rates, fascicle strains and/or strain rates. Electromyography (EMG), sonomicrometry and muscle-tendon force data were collected from the lateral and medial gastrocnemius muscles of goats during level walking, trotting and galloping and during inclined walking and trotting. EMG signals were analyzed using wavelet and principal component analyses to quantify changes in the EMG frequency spectra across the different locomotor conditions. Fascicle strain and strain rate were calculated from the sonomicrometric data, and force rise and relaxation rates were determined from the tendon force data. The results of this study showed that faster motor units were recruited as goats increased their locomotor speeds from level walking to galloping. Slow inclined walking elicited EMG intensities similar to those of fast level galloping but different EMG frequency spectra, indicating that recruitment of the different motor unit types depended, in part, on characteristics of the task. For the locomotor tasks and muscles analyzed here, recruitment patterns were generally associated with in vivo fascicle strain rates, EMG intensity and tendon force. Together, these data provide new evidence that changes in motor unit recruitment have an underlying mechanical basis, at least for certain locomotor tasks. PMID:22972893

Recruitment of faster motor units is associated with greater rates of fascicle strain and rapid changes in muscle force during locomotion.

PubMed

Lee, Sabrina S M; de Boef Miara, Maria; Arnold, Allison S; Biewener, Andrew A; Wakeling, James M

2013-01-15

Animals modulate the power output needed for different locomotor tasks by changing muscle forces and fascicle strain rates. To generate the necessary forces, appropriate motor units must be recruited. Faster motor units have faster activation-deactivation rates than slower motor units, and they contract at higher strain rates; therefore, recruitment of faster motor units may be advantageous for tasks that involve rapid movements or high rates of work. This study identified motor unit recruitment patterns in the gastrocnemii muscles of goats and examined whether faster motor units are recruited when locomotor speed is increased. The study also examined whether locomotor tasks that elicit faster (or slower) motor units are associated with increased (or decreased) in vivo tendon forces, force rise and relaxation rates, fascicle strains and/or strain rates. Electromyography (EMG), sonomicrometry and muscle-tendon force data were collected from the lateral and medial gastrocnemius muscles of goats during level walking, trotting and galloping and during inclined walking and trotting. EMG signals were analyzed using wavelet and principal component analyses to quantify changes in the EMG frequency spectra across the different locomotor conditions. Fascicle strain and strain rate were calculated from the sonomicrometric data, and force rise and relaxation rates were determined from the tendon force data. The results of this study showed that faster motor units were recruited as goats increased their locomotor speeds from level walking to galloping. Slow inclined walking elicited EMG intensities similar to those of fast level galloping but different EMG frequency spectra, indicating that recruitment of the different motor unit types depended, in part, on characteristics of the task. For the locomotor tasks and muscles analyzed here, recruitment patterns were generally associated with in vivo fascicle strain rates, EMG intensity and tendon force. Together, these data provide new evidence that changes in motor unit recruitment have an underlying mechanical basis, at least for certain locomotor tasks.

Depth of processing in the stroop task: evidence from a novel forced-reading condition.

PubMed

Eidels, Ami; Ryan, Kathryn; Williams, Paul; Algom, Daniel

2014-01-01

The presence of the Stroop effect betrays the fact that the carrier words were read in the face of instructions to ignore them and to respond to the target ink colors. In this study, we probed the nature of this involuntary reading by comparing color performance with that in a new forced-reading Stroop task in which responding is strictly contingent on reading each and every word. We found larger Stroop effects in the forced-reading task than in the classic Stroop task and concluded that words are processed to a shallower level in the Stroop task than they are in routine voluntary reading. The results show that the two modes of word processing differ in systematic ways and are conductive to qualitatively different representations. These results can pose a challenge to the strongly automatic view of word reading in the Stroop task.

Interchangeable end effector tools utilized on the PFMA

NASA Technical Reports Server (NTRS)

Cody, Joe; Carroll, John; Crow, George; Gierow, Paul; Littles, Jay; Maness, Michael; Morrison, Jim

1992-01-01

An instrumented task board, used for measuring forces applied by the Protoflight Manipulator Arm (PFMA) to the task board, was fabricated and delivered to Marshall Space Flight Center. SRS Technologies phased out the existing IBM compatible data acquisition system, used with a instrumented task board, and integrated the force measuring electronic hardware in with the Macintosh II data acquisition system. The purpose of this change was to acquire all data with the same time tag, allowing easier and more accurate data reduction in addition to real-time graphics. A three-dimensional optical position sensing system for determining the location of the PFMA's end effect or in reference to the center of the instrumented task board was also designed and delivered under. An improved task board was fabricated which included an improved instrumented beam design. The modified design of the task board improved the force/torque measurement system by increasing the sensitivity, reliability, load range and ease of maintenance. A calibration panel for the optical position system was also designed and fabricated. The calibration method developed for the position sensors enhanced the performance of the sensors as well as simplified the installation and calibration procedures required. The modifications made under this effort expanded the capabilities of the task board system. The system developed determines the arm's position relative to the task board and measures the signals to the joints resulting from the operator's control signals in addition to the task board forces. The software and hardware required to calculate and record the position of the PFMA during the performance of tasks with the instrumented task board were defined, designed and delivered to MSFC. PFMA joint input signals can be measured from a breakout box to evaluate the sensitivity or response of the arm operation to control commands. The data processing system provides the capability for post processing of time-history graphics and plots of the PFMA positions, the operator's actions, and the PFMA servo reactions in addition to realtime force and position sensor data presentation.

Interchangeable end effector tools utilized on the PFMA

NASA Astrophysics Data System (ADS)

Cody, Joe; Carroll, John; Crow, George; Gierow, Paul; Littles, Jay; Maness, Michael; Morrison, Jim

1992-02-01

An instrumented task board, used for measuring forces applied by the Protoflight Manipulator Arm (PFMA) to the task board, was fabricated and delivered to Marshall Space Flight Center. SRS Technologies phased out the existing IBM compatible data acquisition system, used with a instrumented task board, and integrated the force measuring electronic hardware in with the Macintosh II data acquisition system. The purpose of this change was to acquire all data with the same time tag, allowing easier and more accurate data reduction in addition to real-time graphics. A three-dimensional optical position sensing system for determining the location of the PFMA's end effect or in reference to the center of the instrumented task board was also designed and delivered under. An improved task board was fabricated which included an improved instrumented beam design. The modified design of the task board improved the force/torque measurement system by increasing the sensitivity, reliability, load range and ease of maintenance. A calibration panel for the optical position system was also designed and fabricated. The calibration method developed for the position sensors enhanced the performance of the sensors as well as simplified the installation and calibration procedures required. The modifications made under this effort expanded the capabilities of the task board system. The system developed determines the arm's position relative to the task board and measures the signals to the joints resulting from the operator's control signals in addition to the task board forces. The software and hardware required to calculate and record the position of the PFMA during the performance of tasks with the instrumented task board were defined, designed and delivered to MSFC. PFMA joint input signals can be measured from a breakout box to evaluate the sensitivity or response of the arm operation to control commands. The data processing system provides the capability for post processing of time-history graphics and plots of the PFMA positions, the operator's actions, and the PFMA servo reactions in addition to realtime force and position sensor data presentation.

Assessing Tuition- and Debt-Free Higher Education. NASFAA Task Force Report

ERIC Educational Resources Information Center

National Association of Student Financial Aid Administrators, 2017

2017-01-01

The Assessing Tuition- and Debt-Free Higher Education Task Force was convened in July 2016. Charged by the National Association of Student Financial Aid Administrators's (NASFAA's) Board of Directors with evaluating the existing landscape of state and local promise programs with a focus on scaling such models to the national level, the task force…

Association of Academic Physiatrists Women's Task Force Report.

PubMed

Silver, Julie K; Cuccurullo, Sara; Ambrose, Anne Felicia; Bhatnagar, Saurabha; Bosques, Glendaliz; Fleming, Talya K; Frontera, Walter R; Karimi, Danielle Perret; Oh-Park, Mooyeon; Sowa, Gwendolyn; Visco, Christopher; Weiss, Lyn; Knowlton, Tiffany

2018-04-30

The Association of Academic Physiatrists (AAP) convened a women's task force in 2016, and the members agreed on a list of metrics that would permit retrospective data review pertaining to the representation and inclusion of women physicians in the society. Examples of categories examined included leadership positions (i.e., board membership, board presidents, committee membership, committee chairs, and resident fellow physician chairs), conference presentations (i.e., annual meeting session proposals, annual meeting faculty, annual meeting plenary speakers) and recognition awards (i.e., recognition award nominations and recipients). The findings highlight areas in which the AAP has been successful in supporting gender equity and other areas in which women physiatrists have been underrepresented. The task force worked with the Board of Trustees to construct an action plan; asking the respective committees to address areas of underrepresentation. A volunteer from each committee was deemed a 'diversity steward' and going forward will work directly with the task force as a liaison to document an action plan and collect data. The board plans to transparently report progress to members and other stakeholders, and the task force aims to publish a follow-up report within the next five years.

Association for Theatre in Higher Education Task Force on Distribution Chair's Report.

ERIC Educational Resources Information Center

Whitmore, Jon

1989-01-01

Presents recommendations of the Association for Theatre in Higher Education Task Force, addressing the issue of faculty workload. Suggests several questions to form the basis for discussions on this issue. (MM)

78 FR 57161 - Meeting of the Community Preventive Services Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-17

..., and policies that increase healthy longevity, save lives and dollars and improve Americans' quality of life. During this meeting, the Task Force will consider the findings of systematic reviews on existing...

Ohio Lake Erie Commission Homepage

Science.gov Websites

view the Lake Erie Protection & Restoration Plan 2016. Phosphorus Task Force Click here to see the Ohio Lake Erie Phosphorus Task Force II Final Report 2013. About the Lake Erie Commission The role of

Report of the Governor's Blue Ribbon Transportation Task Force

DOT National Transportation Integrated Search

1982-12-01

Governor Ray appointed the Blue Ribbon Transportation Task Force to provide guidance concerning specific steps that can be taken to: achieve maximum efficiency in the utilization of transportation resources; preserve essential transportation services...

Freedom of Information Act: FOIA Task Force Report

EPA Pesticide Factsheets

FOIA Task Force review of any significant weaknesses, and recommendation for improvements of efficiency and effectiveness of the agency's FOIA operations to ensure that information is provided to the Amercian public in a timely fashion.

Screening for and Management of Obesity in Adults

MedlinePlus

... Task Force Recommendations Screening for and Management of Obesity in Adults The U.S. Preventive Services Task Force ( ... final recommendation on Screening for and Management of Obesity in Adults . This recommendation is for adults ages ...

1999 Florida Freight Stakeholders Task Force Report

DOT National Transportation Integrated Search

1999-11-01

The Florida Freight Stakeholders Task Force was organized in 1998 as a result of the Governor's Transportation Summit to address two principal objectives: (1) to identify, prioritize and recommend freight transportation projects for fast track fundin...

Timing at peak force may be the hidden target controlled in continuation and synchronization tapping.

PubMed

Du, Yue; Clark, Jane E; Whitall, Jill

2017-05-01

Timing control, such as producing movements at a given rate or synchronizing movements to an external event, has been studied through a finger-tapping task where timing is measured at the initial contact between finger and tapping surface or the point when a key is pressed. However, the point of peak force is after the time registered at the tapping surface and thus is a less obvious but still an important event during finger tapping. Here, we compared the time at initial contact with the time at peak force as participants tapped their finger on a force sensor at a given rate after the metronome was turned off (continuation task) or in synchrony with the metronome (sensorimotor synchronization task). We found that, in the continuation task, timing was comparably accurate between initial contact and peak force. These two timing events also exhibited similar trial-by-trial statistical dependence (i.e., lag-one autocorrelation). However, the central clock variability was lower at the peak force than the initial contact. In the synchronization task, timing control at peak force appeared to be less variable and more accurate than that at initial contact. In addition to lower central clock variability, the mean SE magnitude at peak force (SEP) was around zero while SE at initial contact (SEC) was negative. Although SEC and SEP demonstrated the same trial-by-trial statistical dependence, we found that participants adjusted the time of tapping to correct SEP, but not SEC, toward zero. These results suggest that timing at peak force is a meaningful target of timing control, particularly in synchronization tapping. This result may explain the fact that SE at initial contact is typically negative as widely observed in the preexisting literature.

GeoVision Exploration Task Force Report

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

Doughty, Christine; Dobson, Patrick F.; Wall, Anna

The GeoVision study effort included ground-breaking, detailed research on current and future market conditions and geothermal technologies in order to forecast and quantify the electric and non-electric deployment potentials under a range of scenarios, in addition to their impacts on the Nation’s jobs, economy and environment. Coordinated by the U.S. Department of Energy’s (DOE’s) Geothermal Technologies Office (GTO), the GeoVision study development relied on the collection, modeling, and analysis of robust datasets through seven national laboratory partners, which were organized into eight technical Task Force groups. The purpose of this report is to provide a central repository for the researchmore » conducted by the Exploration Task Force. The Exploration Task Force consists of four individuals representing three national laboratories: Patrick Dobson (task lead) and Christine Doughty of Lawrence Berkeley National Laboratory, Anna Wall of National Renewable Energy Laboratory, Travis McLing of Idaho National Laboratory, and Chester Weiss of Sandia National Laboratories. As part of the GeoVision analysis, our team conducted extensive scientific and financial analyses on a number of topics related to current and future geothermal exploration methods. The GeoVision Exploration Task Force complements the drilling and resource technology investigations conducted as part of the Reservoir Maintenance and Development Task Force. The Exploration Task Force however has focused primarily on early stage R&D technologies in exploration and confirmation drilling, along with an evaluation of geothermal financing challenges and assumptions, and innovative “blue-sky” technologies. This research was used to develop geothermal resource supply curves (through the use of GETEM) for use in the ReEDS capacity expansion modeling that determines geothermal technology deployment potential. It also catalogues and explores the large array of early-stage R&D technologies with the potential to dramatically reduce exploration and geothermal development costs, forming the basis of the GeoVision Technology Improvement (TI) scenario. These modeling topics are covered in detail in Potential to Penetration task force report. Most of the research contained herein has been published in peer-reviewed papers or conference proceedings and are cited and referenced accordingly. The sections that follow provide a central repository for all of the research findings of the Exploration and Confirmation Task Force. In summary, it provides a comprehensive discussion of Engineered Geothermal Systems (EGS) and associated technology challenges, the risks and costs of conducting geothermal exploration, a review of existing government efforts to date in advancing early-stage R&D in both exploration and EGS technologies, as well as a discussion of promising and innovative technologies and implementation of blue-sky concepts that could significantly reduce costs, lower risks, and shorten the time needed to explore and develop geothermal resources of all types.« less

The development of contact force construction in the dynamic-contact task of cycling [corrected].

PubMed

Brown, Nicholas A T; Jensen, Jody L

2003-01-01

Purposeful movement requires that an individual produce appropriate joint torques to accelerate segments, and when environmental contact is involved, to develop task-appropriate contact forces. Developmental research has been confined largely to the mastery of unconstrained movement skills (pointing, kicking). The purpose of this study was to study the developmental progression that characterizes the interaction of muscular and non-muscular forces in tasks constrained by contact with the environment. Seven younger children (YC, 6-8 years), 7 older children (OC, 9-11 years) and 7 adults (AD) pedaled an ergometer (80 rpm) at an anthropometrically scaled cycling power. Resultant forces measured at the pedal's surface were decomposed into muscle, inertia and gravity components. Muscle pedal forces were further examined in terms of the underlying lower extremity joint torques and kinematic weights that constitute the muscular component of the pedal force. Data showed children applied muscle forces to the pedal in a significantly different manner compared to adults, and that this was due to the children's lower segmental mass and inertia. The children adjusted the contribution of the proximal joint muscle torques to compensate for reduced contributions to the resultant pedal force by gravitational and inertial components. These data show that smaller segmental mass and inertia limit younger children's ability to construct the dynamic-contact task of cycling in an adult-like form. On the basis of these results, however, the children's response was not "immature". Rather, the results show a task-appropriate adaptation to lower segmental mass and inertia. Copyright 2002 Elsevier Science Ltd.

77 FR 4787 - Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

..., Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces; Amended... of the Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded... edition of the Federal Register (77 FR 3454) is amended to reflect changes in the meeting times and agenda...

The Lower Extremity Biomechanics of Single- and Double-Leg Stop-Jump Tasks

PubMed Central

2011-01-01

The anterior cruciate ligament (ACL) injury is a common occurrence in sports requiring stop-jump tasks. Single- and double-leg stop-jump techniques are frequently executed in sports. The higher risk of ACL injury in single-leg drop landing task compared to a double-leg drop landing task has been identified. However the injury bias between single- and double-leg landing techniques has not been investigated for stop-jump tasks. The purpose of this study was to determine the differences between single- and double-leg stop-jump tasks in knee kinetics that were influenced by the lower extremity kinematics during the landing phase. Ground reaction force, lower extremity kinematics, and knee kinetics data during the landing phase were obtained from 10 subjects performing single- and double-leg stop-jump tasks, using motion-capture system and force palates. Greater peak posterior and vertical ground reaction forces, and peak proximal tibia anterior and lateral shear forces (p < 0.05) during landing phase were observed of single-leg stop-jump. Single-leg stop-jump exhibited smaller hip and knee flexion angle, and knee flexion angular velocity at initial foot contact with the ground (p < 0.05). We found smaller peak hip and knee flexion angles (p < 0.05) during the landing phase of single-leg stop-jump. These results indicate that single-leg landing may have higher ACL injury risk than double-leg landing in stop-jump tasks that may be influenced by the lower extremity kinematics during the landing phase. Key points Non-contact ACL injuries are more likely to occur during the single-leg stop-jump task than during the double-leg stop-jump task. Single-leg stop-jump exhibited greater peak proximal tibia anterior and lateral shear forces, and peak posterior and vertical ground reaction forces during the landing phase than the double-leg stop-jump task. Single-leg stop-jump exhibited smaller hip flexion angle, knee flexion angle, and knee flexion angular velocity at initial foot contact with the ground. Single-leg stop-jump exhibited greater peak knee extension and valgus moment during the landing phase than the double-leg stop-jump task. Single-leg stop-jump extended the hip joint at initial foot contact with the ground. PMID:24149308

Force and Directional Force Modulation Effects on Accuracy and Variability in Low-Level Pinch Force Tracking.

PubMed

Park, Sangsoo; Spirduso, Waneen; Eakin, Tim; Abraham, Lawrence

2018-01-01

The authors investigated how varying the required low-level forces and the direction of force change affect accuracy and variability of force production in a cyclic isometric pinch force tracking task. Eighteen healthy right-handed adult volunteers performed the tracking task over 3 different force ranges. Root mean square error and coefficient of variation were higher at lower force levels and during minimum reversals compared with maximum reversals. Overall, the thumb showed greater root mean square error and coefficient of variation scores than did the index finger during maximum reversals, but not during minimum reversals. The observed impaired performance during minimum reversals might originate from history-dependent mechanisms of force production and highly coupled 2-digit performance.

Force Reconnaissance: A Key Enabler in the Marine Air Ground Task Force and Beyond

DTIC Science & Technology

2012-03-13

round Task Force Advance Force Operations, Deep Reconnaissance, Military Free Fall (MFF), Marine Combatar t Diver ( MCD ), Joint Terminal Attack...Marine Division. These early years focused on developing the doctrine and insertion skills became legendary in the crucible of South East Asia , and...potential for regional powers to threaten critical U.S. interests. Areas of particular concern in the QDR are the Middle East and Asia .41 The United

Real time relationship between individual finger force and grip exertion on distal phalanges in linear force following tasks.

PubMed

Luo, Shi-Jian; Shu, Ge; Gong, Yan

2018-05-01

Individual finger force (FF) in a grip task is a vital concern in rehabilitation engineering and precise control of manipulators because disorders in any of the fingers will affect the stability or accuracy of the grip force (GF). To understand the functions of each finger in a dynamic grip exertion task, a GF following experiment with four individual fingers without thumb was designed. This study obtained four individual FFs from the distal phalanges with a cylindrical handle in dynamic GF following tasks. Ten healthy male subjects with similar hand sizes participated in the four-finger linear GF following tasks at different submaximal voluntary contraction (SMVC) levels. The total GF, individual FF, finger force contribution, and following error were subsequently calculated and analyzed. The statistics indicated the following: 1) the accuracy and stability of GF at low %MVC were significantly higher than those at high SMVC; 2) at low SMVC, the ability of the fingers to increase the GF was better than the ability to reduce it, but it was contrary at high SMVC; 3) when the target wave (TW) was changing, all four fingers strongly participated in the force exertion, but the participation of the little finger decreased significantly when TW remained stable; 4) the index finger and ring finger had a complementary relationship and played a vital role in the adjustment and control of GF. The middle finger and little finger had a minor influence on the force control and adjustment. In conclusion, each of the fingers had different functions in a GF following task. These findings can be used in the assessment of finger injury rehabilitation and for algorithms of precise control. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fast-adapting mechanoreceptors are important for force control in precision grip but not for sensorimotor memory.

PubMed

Park, Susanna B; Davare, Marco; Falla, Marika; Kennedy, William R; Selim, Mona M; Wendelschafer-Crabb, Gwen; Koltzenburg, Martin

2016-06-01

Sensory feedback from cutaneous mechanoreceptors in the fingertips is important in effective object manipulation, allowing appropriate scaling of grip and load forces during precision grip. However, the role of mechanoreceptor subtypes in these tasks remains incompletely understood. To address this issue, psychophysical tasks that may specifically assess function of type I fast-adapting (FAI) and slowly adapting (SAI) mechanoreceptors were used with object manipulation experiments to examine the regulation of grip force control in an experimental model of graded reduction in tactile sensitivity (healthy volunteers wearing 2 layers of latex gloves). With gloves, tactile sensitivity decreased significantly from 1.9 ± 0.4 to 12.3 ± 2.2 μm in the Bumps task assessing function of FAI afferents but not in a grating orientation task assessing SAI afferents (1.6 ± 0.1 to 1.8 ± 0.2 mm). Six axis force/torque sensors measured peak grip (PGF) and load (PLF) forces generated by the fingertips during a grip-lift task. With gloves there was a significant increase of PGF (14 ± 6%), PLF (17 ± 5%), and grip and load force rates (26 ± 8%, 20 ± 8%). A variable-weight series task was used to examine sensorimotor memory. There was a 20% increase in PGF when the lift of a light object was preceded by a heavy relative to a light object. This relationship was not significantly altered when lifting with gloves, suggesting that the addition of gloves did not change sensorimotor memory effects. We conclude that FAI fibers may be important for the online force scaling but not for the buildup of a sensorimotor memory. Copyright © 2016 the American Physiological Society.

Third Report of the Task Force on the Shuttle-Mir Rendezvous and Docking Missions

NASA Technical Reports Server (NTRS)

1994-01-01

In May 1994, the Task Force on the Shuttle-Mir Rendezvous and Docking Missions was established by the NASA Advisory Council. Its purpose is to review Phase 1 (Shuttle-Mir) planning, training, operations, rendezvous and docking, and management and to provide interim reports containing specific recommendations to the Advisory Council. Phase 1 represents the building block to create the experience and technical expertise for an International Space Station. The Phase 1 program brings together the United States and Russia in a major cooperative and contractual program that takes advantage of both countries' capabilities. The content of the Phase 1 program consists of the following elements as defined by the Phase 1 Program Management Plan, dated October 6, 1994: Shuttle-Mir rendezvous and docking missions; astronaut long duration presence on Mir Requirements for Mir support of Phase 1 when astronauts are not on board; outfitting Spektr and Priroda modules with NASA science, research, and risk mitigation equipment Related ground support requirements of NASA and the Russian Space Agency (RSA) to support Phase 1 Integrated NASA and RSA launch schedules and manifests The first meeting of the Task Force was held at the Johnson Space Center (JSC) on May 24 and 25, 1994 with a preliminary report submitted to the NASA Advisory Council on June 6, 1994. The second meeting of the Task Force was held at JSC on July 12 and 13, 1994 and a detailed report containing a series of specific recommendations was submitted on July 29, 1994. This report reflects the results of the third Task Force meeting which was held at JSC on 11 and 12 October, 1994. The briefings presented at that meeting reviewed NASA's response to the Task Force recommendations made to date and provided background data and current status on several critical areas which the Task Force had not addressed in its previous reports.

Report of AAPT Task Force on Teaching Responsibility for Four Year Colleges.

ERIC Educational Resources Information Center

Fuller, Richard M.

1979-01-01

Describes the purpose of establishing the task force on teaching responsibilities, and outlines the recommended guidelines which called for clear definitions of conditions and components necessary for high quality physics programs. (GA)

Space station operations task force summary report

NASA Technical Reports Server (NTRS)

1987-01-01

A companion to the Space Stations Operation Task Force Panels' Reports, this document summarizes all space station program goals, operations, and the characteristics of the expected user community. Strategies for operation and recommendations for implementation are included.

Algorithms for the diagnosis and treatment of restless legs syndrome in primary care

PubMed Central

2011-01-01

Background Restless legs syndrome (RLS) is a neurological disorder with a lifetime prevalence of 3-10%. in European studies. However, the diagnosis of RLS in primary care remains low and mistreatment is common. Methods The current article reports on the considerations of RLS diagnosis and management that were made during a European Restless Legs Syndrome Study Group (EURLSSG)-sponsored task force consisting of experts and primary care practioners. The task force sought to develop a better understanding of barriers to diagnosis in primary care practice and overcome these barriers with diagnostic and treatment algorithms. Results The barriers to diagnosis identified by the task force include the presentation of symptoms, the language used to describe them, the actual term "restless legs syndrome" and difficulties in the differential diagnosis of RLS. Conclusion The EURLSSG task force reached a consensus and agreed on the diagnostic and treatment algorithms published here. PMID:21352569

Modeling good research practices--overview: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force-1.

PubMed

Caro, J Jaime; Briggs, Andrew H; Siebert, Uwe; Kuntz, Karen M

2012-01-01

Models-mathematical frameworks that facilitate estimation of the consequences of health care decisions-have become essential tools for health technology assessment. Evolution of the methods since the first ISPOR modeling task force reported in 2003 has led to a new task force, jointly convened with the Society for Medical Decision Making, and this series of seven papers presents the updated recommendations for best practices in conceptualizing models; implementing state-transition approaches, discrete event simulations, or dynamic transmission models; dealing with uncertainty; and validating and reporting models transparently. This overview introduces the work of the task force, provides all the recommendations, and discusses some quandaries that require further elucidation. The audience for these papers includes those who build models, stakeholders who utilize their results, and, indeed, anyone concerned with the use of models to support decision making.

Data Driven, Force Based Interaction for Quadrotors

NASA Astrophysics Data System (ADS)

McKinnon, Christopher D.

Quadrotors are small and agile, and are becoming more capable for their compact size. They are expected perform a wide variety of tasks including inspection, physical interaction, and formation flight. In all of these tasks, the quadrotors can come into close proximity with infrastructure or other quadrotors, and may experience significant external forces and torques. Reacting properly in each case is essential to completing the task safely and effectively. In this thesis, we develop an algorithm, based on the Unscented Kalman Filter, to estimate such forces and torques without making assumptions about the source of the forces and torques. We then show in experiment how the proposed estimation algorithm can be used in conjunction with controls and machine learning to choose the appropriate actions in a wide variety of tasks including detecting downwash, tracking the wind induced by a fan, and detecting proximity to the wall.

Combined Diet and Physical Activity Promotion Programs for Prevention of Diabetes: Community Preventive Services Task Force Recommendation Statement.

PubMed

Pronk, Nicolaas P; Remington, Patrick L

2015-09-15

Community Preventive Services Task Force recommendation on the use of combined diet and physical activity promotion programs to reduce progression to type 2 diabetes in persons at increased risk. The Task Force commissioned an evidence review that assessed the benefits and harms of programs to promote and support individual improvements in diet, exercise, and weight and supervised a review on the economic efficiency of these programs in clinical trial, primary care, and primary care-referable settings. Adolescents and adults at increased risk for progression to type 2 diabetes. The Task Force recommends the use of combined diet and physical activity promotion programs by health care systems, communities, and other implementers to provide counseling and support to clients identified as being at increased risk for type 2 diabetes. Economic evidence indicates that these programs are cost-effective.

Effect of visual feedback on brain activation during motor tasks: an FMRI study.

PubMed

Noble, Jeremy W; Eng, Janice J; Boyd, Lara A

2013-07-01

This study examined the effect of visual feedback and force level on the neural mechanisms responsible for the performance of a motor task. We used a voxel-wise fMRI approach to determine the effect of visual feedback (with and without) during a grip force task at 35% and 70% of maximum voluntary contraction. Two areas (contralateral rostral premotor cortex and putamen) displayed an interaction between force and feedback conditions. When the main effect of feedback condition was analyzed, higher activation when visual feedback was available was found in 22 of the 24 active brain areas, while the two other regions (contralateral lingual gyrus and ipsilateral precuneus) showed greater levels of activity when no visual feedback was available. The results suggest that there is a potentially confounding influence of visual feedback on brain activation during a motor task, and for some regions, this is dependent on the level of force applied.

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

Nakicenovic, Nebojsa; Kammen, Daniel; Jewell, Jessica

The UN Secretary General established the Sustainable Energy for All initiative in order to guide and support efforts to achieve universal access to modern energy, rapidly increase energy efficiency, and expand the use of renewable energies. Task forces were formed involving prominent energy leaders and experts from business, government, academia and civil society worldwide. The goal of the Task Forces is to inform the implementation of the initiative by identifying challenges and opportunities for achieving its objectives. This report contains the findings of Task Force Two which is dedicated energy efficiency and renewable energy objectives. The report shows that doublingmore » the rate of energy efficiency improvements and doubling the share of energy from renewable sources by 2030 is challenging but feasible if sufficient actions are implemented. Strong and well-informed government policies as well as extensive private investment should focus on the high impact areas identified by the task force.« less

Project LASER: Learning about science, engineering, and research

NASA Technical Reports Server (NTRS)

1990-01-01

The number of American students entering science and engineering careers and their ranking in comparison with other countries is on the decline. This decline has alarmed Congress which, in 1987, established a Task Force on Women, Minorities, and the Handicapped in Science and Technology to define the problem and find solutions. If left unchanged, the task force has warned that the prospects for maintaining an advanced industrial society will diminish. NASA is supportive of the six goals outlined by the task force, which are paraphrase herein, and is carefully assessing its education programs to identify those offering the greatest potential for achieving the task force objectives with a reasonable range of resources. A major initiative is under way on behalf of NASA at its Marshall Space Flight Center, where highly effective features of several NASA education programs along with innovations are being integrated into a comprehensive pilot program. This program, dubbed Project LASER, is discussed.

Developments of new force reflecting control schemes and an application to a teleoperation training simulator

NASA Technical Reports Server (NTRS)

Kim, Won S.

1992-01-01

Two schemes of force reflecting control, position-error based force reflection and low-pass-filtered force reflection, both combined with shared compliance control, were developed for dissimilar master-slave arms. These schemes enabled high force reflection gains, which were not possible with a conventional scheme when the slave arm was much stiffer than the master arm. The experimental results with a peg-in-hole task indicated that the newly force reflecting control schemes combined with compliance control resulted in best task performances. As a related application, a simulated force reflection/shared compliance control teleoperation trainer was developed that provided the operator with the feel of kinesthetic force virtual reality.

Coherence and interlimb force control: Effects of visual gain.

PubMed

Kang, Nyeonju; Cauraugh, James H

2018-03-06

Neural coupling across hemispheres and homologous muscles often appears during bimanual motor control. Force coupling in a specific frequency domain may indicate specific bimanual force coordination patterns. This study investigated coherence on pairs of bimanual isometric index finger force while manipulating visual gain and task asymmetry conditions. We used two visual gain conditions (low and high gain = 8 and 512 pixels/N), and created task asymmetry by manipulating coefficient ratios imposed on the left and right index finger forces (0.4:1.6; 1:1; 1.6:0.4, respectively). Unequal coefficient ratios required different contributions from each hand to the bimanual force task resulting in force asymmetry. Fourteen healthy young adults performed bimanual isometric force control at 20% of their maximal level of the summed force of both fingers. We quantified peak coherence and relative phase angle between hands at 0-4, 4-8, and 8-12 Hz, and estimated a signal-to-noise ratio of bimanual forces. The findings revealed higher peak coherence and relative phase angle at 0-4 Hz than at 4-8 and 8-12 Hz for both visual gain conditions. Further, peak coherence and relative phase angle values at 0-4 Hz were larger at the high gain than at the low gain. At the high gain, higher peak coherence at 0-4 Hz collapsed across task asymmetry conditions significantly predicted greater signal-to-noise ratio. These findings indicate that a greater level of visual information facilitates bimanual force coupling at a specific frequency range related to sensorimotor processing. Copyright © 2018 Elsevier B.V. All rights reserved.

Grip Force Control Is Dependent on Task Constraints in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Law, Sui-Heung; Lo, Sing Kai; Chow, Susanna; Cheing, Gladys L.Y.

2011-01-01

Excessive grip force (GF) is often found in children with developmental coordination disorder (DCD). However, their GF control may vary when task constraints are imposed upon their motor performance. This study aimed to investigate how their GF control changes in response to task demands, and to examine their tactile sensitivity. Twenty-one…

Strengthening malaria prevention and control: integrating West African militaries' malaria control efforts. The inaugural meeting of the West African Malaria Task Force, April 24-26, 2013, Accra, Ghana.

PubMed

McCollum, Jeffrey T; Hanna, Refaat; Halbach, Alaina C; Cummings, James F

2015-01-01

From April 24 to 26, 2013, the Armed Forces Health Surveillance Center and the U.S. Africa Command cosponsored the inaugural meeting of the West Africa Malaria Task Force in Accra, Ghana. The meeting's purpose was to identify common challenges, explore regional and transcontinental collaborations, and to share knowledge about best practices in the fight against malaria in West Africa. Military representatives from Benin, Burkina Faso, Ghana, Liberia, Niger, Nigeria, Senegal, and Togo participated in the Task Force; various U.S. Government agencies were also represented, including the Department of Defense, the Centers for Disease Control and Prevention, and the Agency for International Development. African nation participants presented brief overviews of their military's malaria prevention and control measures, surveillance programs, diagnostic capabilities, and treatment regimens emphasizing gaps within existing programs. Representatives from U.S. agencies discussed activities and capabilities relevant for the region, challenges and lessons learned regarding malaria, and highlighted opportunities for enhanced partnerships to counter malaria in West Africa. This article summarizes the major conclusions of the Task Force meeting, identifies relevant focus areas for future Task Force activities, and outlines opportunities for further inclusion of West African militaries to improve regional malaria surveillance and control efforts. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

An Increase in Postural Load Facilitates an Anterior Shift of Processing Resources to Frontal Executive Function in a Postural-Suprapostural Task

PubMed Central

Huang, Cheng-Ya; Chang, Gwo-Ching; Tsai, Yi-Ying; Hwang, Ing-Shiou

2016-01-01

Increase in postural-demand resources does not necessarily degrade a concurrent motor task, according to the adaptive resource-sharing hypothesis of postural-suprapostural dual-tasking. This study investigated how brain networks are organized to optimize a suprapostural motor task when the postural load increases and shifts postural control into a less automatic process. Fourteen volunteers executed a designated force-matching task from a level surface (a relative automatic process in posture) and from a stabilometer board while maintaining balance at a target angle (a relatively controlled process in posture). Task performance of the postural and suprapostural tasks, synchronization likelihood (SL) of scalp EEG, and graph-theoretical metrics were assessed. Behavioral results showed that the accuracy and reaction time of force-matching from a stabilometer board were not affected, despite a significant increase in postural sway. However, force-matching in the stabilometer condition showed greater local and global efficiencies of the brain networks than force-matching in the level-surface condition. Force-matching from a stabilometer board was also associated with greater frontal cluster coefficients, greater mean SL of the frontal and sensorimotor areas, and smaller mean SL of the parietal-occipital cortex than force-matching from a level surface. The contrast of supra-threshold links in the upper alpha and beta bands between the two stance conditions validated load-induced facilitation of inter-regional connections between the frontal and sensorimotor areas, but that contrast also indicated connection suppression between the right frontal-temporal and the parietal-occipital areas for the stabilometer stance condition. In conclusion, an increase in stance difficulty alters the neurocognitive processes in executing a postural-suprapostural task. Suprapostural performance is not degraded by increase in postural load, due to (1) increased effectiveness of information transfer, (2) an anterior shift of processing resources toward frontal executive function, and (3) cortical dissociation of control hubs in the parietal-occipital cortex for neural economy. PMID:27594830

Remarks of Governor Ted Schwinden to the International Conference of the Council of Educational Facility Planners (64th, Edmonton, Alberta, October 3, 1987.

ERIC Educational Resources Information Center

Montana State Office of the Governor, Helena.

This speech summarizes the recommendations of seven National Governors' Association task forces represented in "Time for Results: The Governors' 1991 Report on Education," highlighting the physical facilities group's concerns. The Task Force on Teaching confronted work force quantity and quality issues and recommended strategies for…

U.S. Army Medical Contingent to Task Force Forager Pacific Partnership 2015: Lessons and Best Practices

DTIC Science & Technology

2016-07-01

CONTINGENT-PACIFIC PARTNERSHIP 2015 Foreword Global health engagements conducted in...medical task force of health -care experts with medical equipment and supplies to conduct health engagements in four host nations, including the...at Pearl Harbor, HI, 15 medical personnel from the Australian and New Zealand defense forces; a civilian medical planner from Project HOPE ( Health

Public Service through the State Government Workforce: Meeting the Challenge of Change. Executive Summary.

ERIC Educational Resources Information Center

State Univ. of New York, Albany. Nelson A. Rockefeller Inst. of Government.

This report summarizes the findings of a New York State task force that studied the public work force of the state with a focus on preparing these workers for the future. Discussion of the task force was organized along four major topics of concern: recruiting, retention, and compensation; management style; education, training, and retraining; and…

Access management implementation in Kentucky technical support document and status report.

DOT National Transportation Integrated Search

2008-05-01

This report describes the efforts of the Kentucky Transportation Cabinet's Access Management implementation Task Force. The task force was established in May 2004 and was charged with the responsibility of reviewing and refining the recommendations i...

Force illusions and drifts observed during muscle vibration.

PubMed

Reschechtko, Sasha; Cuadra, Cristian; Latash, Mark L

2018-01-01

We explored predictions of a scheme that views position and force perception as a result of measuring proprioceptive signals within a reference frame set by ongoing efferent process. In particular, this hypothesis predicts force illusions caused by muscle vibration and mediated via changes in both afferent and efferent components of kinesthesia. Healthy subjects performed accurate steady force production tasks by pressing with the four fingers of one hand (the task hand) on individual force sensors with and without visual feedback. At various times during the trials, subjects matched the perceived force using the other hand. High-frequency vibration was applied to one or both of the forearms (over the hand and finger extensors). Without visual feedback, subjects showed a drop in the task hand force, which was significantly smaller under the vibration of that forearm. Force production by the matching hand was consistently higher than that of the task hand. Vibrating one of the forearms affected the matching hand in a manner consistent with the perception of higher magnitude of force produced by the vibrated hand. The findings were consistent between the dominant and nondominant hands. The effects of vibration on both force drift and force mismatching suggest that vibration led to shifts in both signals from proprioceptors and the efferent component of perception, the referent coordinate and/or coactivation command. The observations fit the hypothesis on combined perception of kinematic-kinetic variables with little specificity of different groups of peripheral receptors that all contribute to perception of forces and coordinates. NEW & NOTEWORTHY We show that vibration of hand/finger extensors produces consistent errors in finger force perception. Without visual feedback, finger force drifted to lower values without a drift in the matching force produced by the other hand; hand extensor vibration led to smaller finger force drift. The findings fit the scheme with combined perception of kinematic-kinetic variables and suggest that vibration leads to consistent shifts of the referent coordinate and, possibly, of coactivation command to the effector.

An instrumented glove for grasp specification in virtual-reality-based point-and-direct telerobotics.

PubMed

Yun, M H; Cannon, D; Freivalds, A; Thomas, G

1997-10-01

Hand posture and force, which define aspects of the way an object is grasped, are features of robotic manipulation. A means for specifying these grasping "flavors" has been developed that uses an instrumented glove equipped with joint and force sensors. The new grasp specification system will be used at the Pennsylvania State University (Penn State) in a Virtual Reality based Point-and-Direct (VR-PAD) robotics implementation. Here, an operator gives directives to a robot in the same natural way that human may direct another. Phrases such as "put that there" cause the robot to define a grasping strategy and motion strategy to complete the task on its own. In the VR-PAD concept, pointing is done using virtual tools such that an operator can appear to graphically grasp real items in live video. Rather than requiring full duplication of forces and kinesthetic movement throughout a task as is required in manual telemanipulation, hand posture and force are now specified only once. The grasp parameters then become object flavors. The robot maintains the specified force and hand posture flavors for an object throughout the task in handling the real workpiece or item of interest. In the Computer integrated Manufacturing (CIM) Laboratory at Penn State, hand posture and force data were collected for manipulating bricks and other items that require varying amounts of force at multiple pressure points. The feasibility of measuring desired grasp characteristics was demonstrated for a modified Cyberglove impregnated with Force-Sensitive Resistor (FSR) (pressure sensors in the fingertips. A joint/force model relating the parameters of finger articulation and pressure to various lifting tasks was validated for the instrumented "wired" glove. Operators using such a modified glove may ultimately be able to configure robot grasping tasks in environments involving hazardous waste remediation, flexible manufacturing, space operations and other flexible robotics applications. In each case, the VR-PAD approach will finesse the computational and delay problems of real-time multiple-degree-of-freedom force feedback telemanipulation.

Taxonomy based analysis of force exchanges during object grasping and manipulation

PubMed Central

Martin-Brevet, Sandra; Jarrassé, Nathanaël; Burdet, Etienne

2017-01-01

The flexibility of the human hand in object manipulation is essential for daily life activities, but remains relatively little explored with quantitative methods. On the one hand, recent taxonomies describe qualitatively the classes of hand postures for object grasping and manipulation. On the other hand, the quantitative analysis of hand function has been generally restricted to precision grip (with thumb and index opposition) during lifting tasks. The aim of the present study is to fill the gap between these two kinds of descriptions, by investigating quantitatively the forces exerted by the hand on an instrumented object in a set of representative manipulation tasks. The object was a parallelepiped object able to measure the force exerted on the six faces and its acceleration. The grasping force was estimated from the lateral force and the unloading force from the bottom force. The protocol included eleven tasks with complementary constraints inspired by recent taxonomies: four tasks corresponding to lifting and holding the object with different grasp configurations, and seven to manipulating the object (rotation around each of its axis and translation). The grasping and unloading forces and object rotations were measured during the five phases of the actions: unloading, lifting, holding or manipulation, preparation to deposit, and deposit. The results confirm the tight regulation between grasping and unloading forces during lifting, and extend this to the deposit phase. In addition, they provide a precise description of the regulation of force exchanges during various manipulation tasks spanning representative actions of daily life. The timing of manipulation showed both sequential and overlapping organization of the different sub-actions, and micro-errors could be detected. This phenomenological study confirms the feasibility of using an instrumented object to investigate complex manipulative behavior in humans. This protocol will be used in the future to investigate upper-limb dexterity in patients with sensory-motor impairments. PMID:28562617

Validity Of The Nintendo Wii Balance Board To Assess Weight Bearing Asymmetry During Sit-To-Stand And Return-To-Sit Task

PubMed Central

Abujaber, Sumayeh; Gillispie, Gregory; Marmon, Adam; Zeni, Joseph

2015-01-01

Weight bearing asymmetry is common in patients with unilateral lower limb musculoskeletal pathologies. The Nintendo Wii Balance Board (WBB) has been suggested as a low-cost and widely-available tool to measure weight bearing asymmetry in a clinical environment; however no study has evaluated the validity of this tool during dynamic tasks. Therefore, the purpose of this study was to determine the concurrent validity of force measurements acquired from the WBB as compared to laboratory force plates. Thirty-five individuals before, or within 1 year of total joint arthroplasty performed a sit-to-stand and return-to-sit task in two conditions. First, subjects performed the task with both feet placed on a single WBB. Second, the task was repeated with each foot placed on an individual laboratory force plate. Peak vertical ground reaction force (VGRF) under each foot and the inter-limb symmetry ratio were calculated. Validity was examined using Intraclass Correlation Coefficients (ICC), regression analysis, 95% limits of agreement and Bland-Altman plots. Force plates and the WBB exhibited excellent agreement for all outcome measurements (ICC =0.83–0.99). Bland-Altman plots showed no obvious relationship between the difference and the mean for the peak VGRF, but there was a consistent trend in which VGRF on the unaffected side was lower and VGRF on the affected side was higher when using the WBB. However, these consistent biases can be adjusted for by utilizing regression equations that estimate the force plate values based on the WBB force. The WBB may serve as a valid, suitable, and low-cost alternative to expensive, laboratory force plates for measuring weight bearing asymmetry in clinical settings. PMID:25715680

Validity of the Nintendo Wii Balance Board to assess weight bearing asymmetry during sit-to-stand and return-to-sit task.

PubMed

Abujaber, Sumayeh; Gillispie, Gregory; Marmon, Adam; Zeni, Joseph

2015-02-01

Weight bearing asymmetry is common in patients with unilateral lower limb musculoskeletal pathologies. The Nintendo Wii Balance Board (WBB) has been suggested as a low-cost and widely-available tool to measure weight bearing asymmetry in a clinical environment; however no study has evaluated the validity of this tool during dynamic tasks. Therefore, the purpose of this study was to determine the concurrent validity of force measurements acquired from the WBB as compared to laboratory force plates. Thirty-five individuals before, or within 1 year of total joint arthroplasty performed a sit-to-stand and return-to-sit task in two conditions. First, subjects performed the task with both feet placed on a single WBB. Second, the task was repeated with each foot placed on an individual laboratory force plate. Peak vertical ground reaction force (VGRF) under each foot and the inter-limb symmetry ratio were calculated. Validity was examined using Intraclass Correlation Coefficients (ICC), regression analysis, 95% limits of agreement and Bland-Altman plots. Force plates and the WBB exhibited excellent agreement for all outcome measurements (ICC=0.83-0.99). Bland-Altman plots showed no obvious relationship between the difference and the mean for the peak VGRF, but there was a consistent trend in which VGRF on the unaffected side was lower and VGRF on the affected side was higher when using the WBB. However, these consistent biases can be adjusted for by utilizing regression equations that estimate the force plate values based on the WBB force. The WBB may serve as a valid, suitable, and low-cost alternative to expensive, laboratory force plates for measuring weight bearing asymmetry in clinical settings. Copyright © 2015 Elsevier B.V. All rights reserved.

Tera-node Network Technology (Task 3) Scalable Personal Telecommunications

DTIC Science & Technology

2000-03-14

Simulation results of this work may be found in http://north.east.isi.edu/spt/ audio.html. 6. Internet Research Task Force Reliable Multicast...Adaptation, 4. Multimedia Proxy Caching, 5. Experiments with the Rate Adaptation Protocol (RAP) 6. Providing leadership and innovation to the Internet ... Research Task Force (IRTF) Reliable Multicast Research Group (RMRG) 1. End-to-end Architecture for Quality-adaptive Streaming Applications over the

Real-time augmented feedback benefits robotic laparoscopic training.

PubMed

Judkins, Timothy N; Oleynikov, Dmitry; Stergiou, Nick

2006-01-01

Robotic laparoscopic surgery has revolutionized minimally invasive surgery for treatment of abdominal pathologies. However, current training techniques rely on subjective evaluation. There is a lack of research on the type of tasks that should be used for training. Robotic surgical systems also do not currently have the ability to provide feedback to the surgeon regarding success of performing tasks. We trained medical students on three laparoscopic tasks and provided real-time feedback of performance during training. We found that real-time feedback can benefit training if the feedback provides information that is not available through other means (grip force). Subjects that received grip force feedback applied less force when the feedback was removed. Other forms of feedback (speed and relative phase) did not aid or impede training. Secondly, a relatively short training period (10 trials for each task) significantly improved most objective measures of performance. We also showed that robotic surgical performance can be quantitatively measured and evaluated. Providing grip force feedback can make the surgeon more aware of the forces being applied to delicate tissue during surgery.

Agricultural Drainage Management Systems Task Force (ADMSTF)

USDA-ARS?s Scientific Manuscript database

The Agricultural Drainage Management Systems (ADMS) Task Force was initiated during a Charter meeting in the fall of 2002 by dedicated professional employees of Federal, State, and Local Government Agencies and Universities. The Agricultural Drainage Management (ADM) Coalition was established in 200...

Reducing the Gap of Pain: A Strategy for Optimizing Federal Resource Availability in Response to Major Incidents

DTIC Science & Technology

2007-03-01

TM Transportation Means TX- TF1 Texas Task Force 1; a US&R team UPS United Parcel Service, Inc.; a major commercial cargo carrier US&R Urban...Pennsylvania Urban Search and Rescue (US&R) Task Force One (PA- TF1 ) were pre-deployed to the area in advance of the storm. In a moving report of their...4 it would be a good idea to add swiftwater/flood rescue components to all of the US&R Task Forces.” Lt. Douglas Bair, a PA- TF1 rescue squad

Screening for asymptomatic bacteriuria in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement.

PubMed

2008-07-01

Reaffirmation of the 2004 U.S. Preventive Services Task Force recommendation statement about screening for asymptomatic bacteriuria in adults. The U.S. Preventive Services Task Force did a targeted literature search for evidence on the benefits and harms of screening for asymptomatic bacteriuria in pregnant women, nonpregnant women, and men. Screen for asymptomatic bacteriuria with urine culture in pregnant women at 12 to 16 weeks' gestation or at the first prenatal visit, if later. (Grade A recommendation.) Do not screen for asymptomatic bacteriuria in men and nonpregnant women. (Grade D recommendation.).

Standards of Evidence for Behavioral Counseling Recommendations.

PubMed

McNellis, Robert J; Ory, Marcia G; Lin, Jennifer S; O'Connor, Elizabeth A

2015-09-01

Behavioral counseling interventions to promote healthy behaviors can significantly reduce leading causes of disease and death. Recommendations for delivery of these interventions in primary care have been and continue to be an important part of the U.S. Preventive Services Task Force's portfolio of clinical preventive services recommendations. However, primary and secondary research on the effectiveness of behavioral counseling interventions can be more complex than recommendations for screening or use of preventive medications. The nature of behavior change and interventions to promote it can lead to unique challenges. This paper summarizes and expands upon an extensive discussion held at the U.S. Preventive Services Task Force's Expert Forum on behavioral counseling interventions held in November 2013. The paper describes the foundational challenges for using behavioral outcomes as evidence to support a Task Force recommendation. The paper discusses research design and reporting characteristics needed by behavioral counseling intervention researchers in order for their research to contribute to the evidentiary basis of a Task Force recommendation. Finally, the paper identifies critical issues that need to be considered by the Task Force and other stakeholders to maintain confidence and credibility in the standards of evidence for behavioral counseling recommendations. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Behavioral Counseling Interventions Expert Forum: Overview and Primer on U.S. Preventive Services Task Force Methods.

PubMed

Curry, Susan J; Whitlock, Evelyn P

2015-09-01

The importance of behavioral counseling as a clinical preventive service derives from the social and economic burden of preventable disease in the U.S., the central role behavioral risk factors play as leading causes of premature morbidity and mortality, and the promise of the healthcare visit as a teachable moment for behavioral counseling support. In November 2013, the U.S. Preventive Services Task Force convened an expert forum on behavioral counseling interventions. The forum brought together NIH, CDC, and Agency for Healthcare Research and Quality leaders, leading behavioral counseling researchers, and members of the U.S. Preventive Services Task Force to discuss issues related to optimizing evidence-based behavioral counseling recommendations. This paper provides an overview of the methods used by the Task Force to develop counseling recommendations. Special focus is on the development and evaluation of evidence from systematic reviews. Assessment of the net benefit of a behavioral counseling intervention, based on the evidence review, determines the recommendation statement and accompanying letter grade. A recent Task Force recommendation on screening and behavioral counseling interventions in primary care to reduce alcohol misuse provides a brief example. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations

PubMed Central

Kumar, Ashish; Acharya, Subrat K.; Singh, Shivaram P.; Saraswat, Vivek A.; Arora, Anil; Duseja, Ajay; Goenka, Mahesh K.; Jain, Deepali; Kar, Premashish; Kumar, Manoj; Kumaran, Vinay; Mohandas, Kunisshery M.; Panda, Dipanjan; Paul, Shashi B.; Ramachandran, Jeyamani; Ramesh, Hariharan; Rao, Padaki N.; Shah, Samir R.; Sharma, Hanish; Thandassery, Ragesh B.

2014-01-01

Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality and healthcare expenditure in patients with chronic liver disease. There are no consensus guidelines on diagnosis and management of HCC in India. The Indian National Association for Study of the Liver (INASL) set up a Task-Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis and management of HCC, relevant to disease patterns and clinical practices in India. The Task-Force first identified various contentious issues on various aspects of HCC and these issues were allotted to individual members of the Task-Force who reviewed them in detail. The Task-Force used the Oxford Center for Evidence Based Medicine—Levels of Evidence of 2009 for developing an evidence-based approach. A 2-day round table discussion was held on 9th and 10th February, 2013 at Puri, Odisha, to discuss, debate, and finalize the consensus statements. The members of the Task-Force reviewed and discussed the existing literature at this meeting and formulated the INASL consensus statements for each of the issues. We present here the INASL consensus guidelines (The Puri Recommendations) on prevention, diagnosis and management of HCC in India. PMID:25755608

The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations.

PubMed

Kumar, Ashish; Acharya, Subrat K; Singh, Shivaram P; Saraswat, Vivek A; Arora, Anil; Duseja, Ajay; Goenka, Mahesh K; Jain, Deepali; Kar, Premashish; Kumar, Manoj; Kumaran, Vinay; Mohandas, Kunisshery M; Panda, Dipanjan; Paul, Shashi B; Ramachandran, Jeyamani; Ramesh, Hariharan; Rao, Padaki N; Shah, Samir R; Sharma, Hanish; Thandassery, Ragesh B

2014-08-01

Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality and healthcare expenditure in patients with chronic liver disease. There are no consensus guidelines on diagnosis and management of HCC in India. The Indian National Association for Study of the Liver (INASL) set up a Task-Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis and management of HCC, relevant to disease patterns and clinical practices in India. The Task-Force first identified various contentious issues on various aspects of HCC and these issues were allotted to individual members of the Task-Force who reviewed them in detail. The Task-Force used the Oxford Center for Evidence Based Medicine-Levels of Evidence of 2009 for developing an evidence-based approach. A 2-day round table discussion was held on 9th and 10th February, 2013 at Puri, Odisha, to discuss, debate, and finalize the consensus statements. The members of the Task-Force reviewed and discussed the existing literature at this meeting and formulated the INASL consensus statements for each of the issues. We present here the INASL consensus guidelines (The Puri Recommendations) on prevention, diagnosis and management of HCC in India.

Bimanual Force Variability and Chronic Stroke: Asymmetrical Hand Control

PubMed Central

Kang, Nyeonju; Cauraugh, James H.

2014-01-01

The purpose of this study was to investigate force variability generated by both the paretic and non-paretic hands during bimanual force control. Nine chronic stroke individuals and nine age-matched individuals with no stroke history performed a force control task with both hands simultaneously. The task involved extending the wrist and fingers at 5%, 25%, and 50% of maximum voluntary contraction. Bimanual and unimanual force variability during bimanual force control was determined by calculating the coefficient of variation. Analyses revealed two main findings: (a) greater bimanual force variability in the stroke group than the control group and (b) increased force variability by the paretic hands during bimanual force control in comparison to the non-paretic hands at the 5% and 25% force production conditions. A primary conclusion is that post stroke bimanual force variability is asymmetrical between hands. PMID:25000185

Effects of prolonged vibration to vastus intermedius muscle on force steadiness of knee extensor muscles during isometric force-matching task.

PubMed

Saito, Akira; Ando, Ryosuke; Akima, Hiroshi

2016-12-01

Afferent inputs from Ia fibers in muscle spindles are essential for the control of force and prolonged vibration has been applied to muscle-tendon units to manipulate the synaptic input from Ia afferents onto α-motor neurons. The vastus intermedius (VI) reportedly provides the highest contribution to the low-level knee extension torque among the individual synergists of quadriceps femoris (QF). The purpose of the present study was to examine the effect of prolonged vibration to the VI on force steadiness of the QF. Nine healthy men (25.1±4.3years) performed submaximal force-matching task of isometric knee extension for 15s before and after mechanical vibration to the superficial region of VI for 30min. Target forces were 2.5%, 10%, and 30% of maximal voluntary contraction (MVC), and force steadiness was determined by the coefficient of variation (CV) of force. After the prolonged VI vibration, the CV of force at 2.5%MVC was significantly increased, but CVs at 10% and 30%MVCs were not significantly changed. The present study concluded that application of prolonged vibration to the VI increased force fluctuations of the QF during a very low-level force-matching task. Copyright © 2016 Elsevier Ltd. All rights reserved.

An involuntary stereotypical grasp tendency pervades voluntary dynamic multifinger manipulation

PubMed Central

Rácz, Kornelius; Brown, Daniel

2012-01-01

We used a novel apparatus with three hinged finger pads to characterize collaborative multifinger interactions during dynamic manipulation requiring individuated control of fingertip motions and forces. Subjects placed the thumb, index, and middle fingertips on each hinged finger pad and held it—unsupported—with constant total grasp force while voluntarily oscillating the thumb's pad. This task combines the need to 1) hold the object against gravity while 2) dynamically reconfiguring the grasp. Fingertip force variability in this combined motion and force task exhibited strong synchrony among normal (i.e., grasp) forces. Mechanical analysis and simulation show that such synchronous variability is unnecessary and cannot be explained solely by signal-dependent noise. Surprisingly, such variability also pervaded control tasks requiring different individuated fingertip motions and forces, but not tasks without finger individuation such as static grasp. These results critically extend notions of finger force variability by exposing and quantifying a pervasive challenge to dynamic multifinger manipulation: the need for the neural controller to carefully and continuously overlay individuated finger actions over mechanically unnecessary synchronous interactions. This is compatible with—and may explain—the phenomenology of strong coupling of hand muscles when this delicate balance is not yet developed, as in early childhood, or when disrupted, as in brain injury. We conclude that the control of healthy multifinger dynamic manipulation has barely enough neuromechanical degrees of freedom to meet the multiple demands of ecological tasks and critically depends on the continuous inhibition of synchronous grasp tendencies, which we speculate may be of vestigial evolutionary origin. PMID:22956798

Vibrotactile grasping force and hand aperture feedback for myoelectric forearm prosthesis users.

PubMed

Witteveen, Heidi J B; Rietman, Hans S; Veltink, Peter H

2015-06-01

User feedback about grasping force and hand aperture is very important in object handling with myoelectric forearm prostheses but is lacking in current prostheses. Vibrotactile feedback increases the performance of healthy subjects in virtual grasping tasks, but no extensive validation on potential users has been performed. Investigate the performance of upper-limb loss subjects in grasping tasks with vibrotactile stimulation, providing hand aperture, and grasping force feedback. Cross-over trial. A total of 10 subjects with upper-limb loss performed virtual grasping tasks while perceiving vibrotactile feedback. Hand aperture feedback was provided through an array of coin motors and grasping force feedback through a single miniature stimulator or an array of coin motors. Objects with varying sizes and weights had to be grasped by a virtual hand. Percentages correctly applied hand apertures and correct grasping force levels were all higher for the vibrotactile feedback condition compared to the no-feedback condition. With visual feedback, the results were always better compared to the vibrotactile feedback condition. Task durations were comparable for all feedback conditions. Vibrotactile grasping force and hand aperture feedback improves grasping performance of subjects with upper-limb loss. However, it should be investigated whether this is of additional value in daily-life tasks. This study is a first step toward the implementation of sensory vibrotactile feedback for users of myoelectric forearm prostheses. Grasping force feedback is crucial for optimal object handling, and hand aperture feedback is essential for reduction of required visual attention. Grasping performance with feedback is evaluated for the potential users. © The International Society for Prosthetics and Orthotics 2014.

Predictive and Reactive Grip Force Responses to Rapid Load Increases in People With Multiple Sclerosis.

PubMed

Allgöwer, Kathrin; Kern, Claudia; Hermsdörfer, Joachim

2017-03-01

To determine the effects of multiple sclerosis (MS) on predictive and reactive grip force control in a catching task and on clinical tests of hand function. Case-control study with matched-pairs control group. University prevention and rehabilitation center. Participants (N=30) consisted of people with multiple sclerosis (PwMS) (n=15) and healthy controls (n=15), matched for sex, age, and hand dominance. Not applicable. Performance on the Expanded Disability Status Scale (EDSS), Nine-Hole Peg Test (9-HPT), Jebsen-Taylor Hand Function Test (JTHFT), and 2-point discrimination (2PD) was evaluated. To analyze grip force control, blindfolded subjects held a receptacle equipped with grip force and acceleration sensors in their hand. In a catching task, a weight was dropped from (1) the experimenter's hand unexpectedly into the receptacle (reactive force control); and (2) from the subject's opposite hand (predictive force control). Grip forces and time lags were analyzed. PwMS (mean EDSS ± SD, 4.2±1.86) had impairments in the 9-HPT and JTHFT (P<.001). The 2PD did not differ significantly between PwMS and controls. During reactive force control (catching task 1), PwMS showed significantly higher grip forces immediately after impact (P<.05), and a significant prolongation of the time from grip force increase until reaching the peak of grip force (P<.001). PwMS and controls did not differ during predictive force control (catching task 2; P>.1). Exaggerated grip force responses and alterations of timing after an unpredictable perturbation, combined with preserved grip force control during predictable conditions, is a characteristic pattern of fine motor control deficits in MS. Measures of reactive grip force responses may be used to complement neurologic assessments. Further studies exploring the usefulness of these measures should be performed in a broader community of PwMS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Exploring physical exposures and identifying high-risk work tasks within the floor layer trade

PubMed Central

McGaha, Jamie; Miller, Kim; Descatha, Alexis; Welch, Laurie; Buchholz, Bryan; Evanoff, Bradley; Dale, Ann Marie

2014-01-01

Introduction Floor layers have high rates of musculoskeletal disorders yet few studies have examined their work exposures. This study used observational methods to describe physical exposures within floor laying tasks. Methods We analyzed 45 videos from 32 floor layers using Multimedia-Video Task Analysis software to determine the time in task, forces, postures, and repetitive hand movements for installation of four common flooring materials. We used the WISHA checklists to define exposure thresholds. Results Most workers (91%) met the caution threshold for one or more exposures. Workers showed high exposures in multiple body parts with variability in exposures across tasks and for different materials. Prolonged exposures were seen for kneeling, poor neck and low back postures, and intermittent but frequent hand grip forces. Conclusions Floor layers experience prolonged awkward postures and high force physical exposures in multiple body parts, which probably contribute to their high rates of musculoskeletal disorders. PMID:24274895

Tactical Medical Training for Police Officers: Lessons from U.S. Special Forces

DTIC Science & Technology

2012-12-01

time is reliable, dangers inherent in law enforcement combined with police officers working locations is often problematic . In tactical situations, a...technique. Eight people were arrested in August 2012 and indicted on sex trafficking charges for allegedly forcing teenage girls into prostitution ...Six of the people detained were arrested by the Inland Child Exploitation/ Prostitution Task Force. The Inland Child Exploitation/ Prostitution Task