Sample records for waste control specialists

  1. EPA's Review of DOE's Inventory Tracking for TRU Wastes at Waste Control Specialists

    EPA Pesticide Factsheets

    On April 9, 2014, EPA's Waste Isolation Pilot Plant (WIPP) waste characterization team visited Waste Control Specialists (WCS) to determine whether DOE was meeting EPA's waste inventory tracking requirements at 40 CFR 194.24(c)(4).

  2. Radioactive waste handling and disposal at King Faisal Specialist Hospital and Research Centre.

    PubMed

    Al-Haj, Abdalla N; Lobriguito, Aida M; Al Anazi, Ibrahim

    2012-08-01

    King Faisal Specialist Hospital & Research Centre (KFSHRC) is the largest specialized medical center in Saudi Arabia. It performs highly specialized diagnostic imaging procedures with the use of various radionuclides required by sophisticated dual imaging systems. As a leading institution in cancer research, KFSHRC uses both long-lived and short-lived radionuclides. KFSHRC established the first cyclotron facility in the Middle East, which solved the in-house high demand for radionuclides and the difficulty in importing them. As both user and producer of high standard radiopharmaceuticals, KFSHRC generates large volumes of low and high level radioactive wastes. An old and small radioactive facility that was used for storage of radioactive waste was replaced with a bigger warehouse provided with facilities that will reduce radiation exposure of the staff, members of the public, and of the environment in the framework of "as low as reasonably achievable." The experiences and the effectiveness of the radiation protection program on handling and storage of radioactive wastes are presented.

  3. Air traffic control specialist performance measurement database.

    DOT National Transportation Integrated Search

    1999-06-01

    The Air Traffic Control Specialist (ATCS) Performance Measurement Database is a compilation of performance measures and : measurement techniques that researchers have used. It may be applicable to other human factor research related to air traffic co...

  4. Surveying air traffic control specialist perception of scheduling regulations

    NASA Astrophysics Data System (ADS)

    Thompson, Darrius E.

    While there have been several studies conducted on air traffic controller fatigue, there is a lack of research on the subject since the scheduling policy changes that took place in 2012. The effectiveness of these changes has yet to be measured. The goal of this study was to investigate air traffic control specialist views towards the number of hours scheduled between shifts, changes in perception since 2012 regulation changes, and external factors that impact fatigue. A total of 54 FAA air traffic control specialist completed an online questionnaire. The results from the survey showed that the majority of respondents felt the 2012 regulation changes were not sufficient to address fatigue issues, and work with some amount sleep deprivation. The factors that appeared to have the most significant effect on fatigue included facility level, age group, availability of recuperative breaks, and children under 18 in the home.

  5. Air traffic control specialist visual scanning II : task load, visual noise, and intrusions into controlled airspace.

    DOT National Transportation Integrated Search

    1999-12-01

    The Federal Aviation Administration (FAA) started an Air Traffic Control Specialist (ATCS) information-scanning program a number : of years ago. The goal is to learn about how controllers use information displays and develop techniques for reducing a...

  6. Environmental Support Specialist, Blocks VI & VII, 17-7. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This military-developed text contains the final section of a four-part course to train environmental support specialists. Covered in the individual course blocks are maintenance of water and waste processing system components (external corrosion control, cathodic protection, drive equipment, pipelines and valves, meters and recorders, chemical…

  7. 78 FR 41993 - Transport Handling Specialists, Inc.-Continuance in Control Exemption-RSL Railroad, LLC

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

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

  8. Manpower Requirements for Air Traffic Control and Flight Service Specialists in Indiana.

    ERIC Educational Resources Information Center

    Purdue Univ., Lafayette, IN. Office of Manpower Studies.

    As of January 1, 1968 the Federal Aviation Administration (FAA) of the United States Department of Transportation employed 6,963 controllers in airport towers, 7,617 controllers in Air Route Traffic Control Centers, and 4,459 flight service specialists at airport locations. Projected needs are as follows: (1) Controllers in airport towers:…

  9. Validity of clinical color vision tests for air traffic control specialists.

    DOT National Transportation Integrated Search

    1992-10-01

    An experiment on the relationship between aeromedical color vision screening test performance and performance on color-dependent tasks of Air Traffic Control Specialists was replicated to expand the data base supporting the job-related validity of th...

  10. Human factors for air traffic control specialists: a user's manual for your brain.

    DOT National Transportation Integrated Search

    1999-11-01

    This document presents the findings of human factors research and other information useful to air traffic control specialists in a succinct and easy-to-read format. Topics include: controller-pilot voice communications, memory, fatigue, and the effec...

  11. Human factors for air traffic control specialists : a user's manual for your brain

    DOT National Transportation Integrated Search

    1999-11-01

    This document presents the findings of human factors research and other information useful to air traffic control specialists in a succinct and easy-to-read format. Topics include: controller-pilot voice communications, memory, fatigue and the effect...

  12. Toward the development of a new selection battery for air traffic control specialists.

    DOT National Transportation Integrated Search

    1979-09-01

    In an effort to update and refine the selection battery for air traffic controllers, five experimental tests measuring aptitudes and skills considered important in air traffic work were administered to newly selected Air Traffic Control Specialist (A...

  13. Air traffic control specialist decision making and strategic planning : a field survey

    DOT National Transportation Integrated Search

    2001-03-01

    This study investigated Air Traffic Control Specialists' perspective regarding decision making and planning and related cognitive processes such as learning, memory, and situation awareness. The results of 100 semi-structured interviews indicated tha...

  14. Waste management in space: a NASA symposium. Special issue

    NASA Technical Reports Server (NTRS)

    Wydeven, T. (Principal Investigator)

    1991-01-01

    This special issue contains papers from the NASA Symposium on Waste Processing for Advanced Life Support, which was held at NASA Ames Research Center on September 11-13, 1990. Specialists in waste management from academia, government, and industry convened to exchange ideas and advise NASA in developing effective methods for waste management in a Controlled Ecological Life Support System (CELSS). Innovative and well-established methods were presented to assist in developing and managing wastes in closed systems for future long-duration space missions, especially missions to Mars.

  15. Specialist Bibliographic Databases

    PubMed Central

    2016-01-01

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

  16. Specialist Bibliographic Databases.

    PubMed

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

    2016-05-01

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

  17. Environmental Support Specialist, Block V, 17-6. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This military-developed text contains the third section of a four-part course to train environmental support specialists. Covered in the individual sections are field sanitation, classes and sources of waste, composition and characteristics of sewage, principles of sewage treatment, primary waste treatment, secondary waste treatment, tertiary…

  18. Studies of poststrike air traffic control specialist trainees. II., Selection and screening programs.

    DOT National Transportation Integrated Search

    1988-07-01

    Specific contributions of aviation psychologists to the selection and Academy training of FAA air traffic control specialists are presented in an historical context. Research results which formed the basis for the written aptitude selection tests, Th...

  19. Collaboration Between Environmental Water Chemistry Students and Hazardous Waste Treatment Specialists on the University of Colorado-Boulder Campus

    NASA Astrophysics Data System (ADS)

    Dittrich, T. M.

    2012-12-01

    The University of Colorado-Boulder is one of a few universities in the country that has a licensed Treatment, Storage, and Disposal Facility (TSDF) for hazardous waste on campus. This facility, located on the bottom floor of the Environmental Health and Safety (EH&S) building, allows CU to more economically treat hazardous waste by enabling treatment specialists on staff to safely collect and organize the hazardous waste generated on campus. Hazardous waste is anything that contains a regulated chemical or compound and most chemicals used in engineering labs (e.g., acids, solvents, metal solutions) fall into this category. The EH&S staff is able to treat close almost 33% of the waste from campus and the rest is packed for off-site treatment at various places all over the country for disposal (e.g., Sauget, IL, Port Aurthor, TX). The CU-Boulder campus produced over 50 tons of hazardous waste in 2010 costing over $300,000 in off-campus expenses. The EH&S staff assigns one of over 50 codes to the waste which will determine if the waste can be treated on campus of must be shipped off campus to be disposed of. If the waste can be treated on campus, it will undergo one of three processes: 1) neutralization, 2) UV-ozone oxidation, or 3) ion exchange. If the waste is acidic but contains no heavy metals, the acid is neutralized with sodium hydroxide (a base) and can be disposed "down the drain" to the Boulder Wastewater Treatment Plant. If the waste contains organic compounds and no metals, a UV-ozone oxidation system is used to break down the organic compounds. Silver from photography wastewater can be removed using ion exchange columns. Undergraduate and graduate students worked with the hazardous waste treatment facility at the Environmental Health and Safety (EH&S) building on the CU-Boulder campus during the fall of 2011 and fall of 2012. Early in the semester, students receive a tour of the three batch treatment processes the facility is equipped with. Later in the

  20. Differences in quality standards when prescribing nutritional support: Differences between specialist and non-specialist physicians.

    PubMed

    Morán López, Jesús Manuel; Piedra León, María; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio

    2016-01-01

    Adequate nutritional support includes many different aspects, but poor understanding of clinical nutrition by health care professionales often results in an inadequate prescription. A study was conducted to compare enteral and parenteral nutritional support plans prescribed by specialist and non-specialist physicians. Non-specialist physicians recorded anthropometric data from only 13.3% of patients, and none of them performed nutritional assessments. Protein amounts provided by non-specialist physicians were lower than estimated based on ESPEN (10.29g of nitrogen vs 14.62; P<.001). Differences were not statistically significant in the specialist group (14.88g of nitrogen; P=.072). Calorie and glutamine provision and laboratory controls prescribed by specialists were significantly closer to those recommended by clinical guidelines. Nutritional support prescribed by specialists in endocrinology and nutrition at San Pedro de Alcántara Hospital was closer to clinical practice guideline standards and of higher quality as compared to that prescribed by non-specialists. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  1. Evaluation of an alternative method for hiring air traffic control specialists with prior military experience.

    DOT National Transportation Integrated Search

    1992-01-01

    This study was conducted to assess an FAA program to hire former military air traffic control specialists to enter ATC field training directly without first attending the Academy screening program. Selection of military controllers was based on meeti...

  2. Validation of the Federal Aviation Administration Air Traffic Control Specialist Pre-Training Screen.

    DOT National Transportation Integrated Search

    1994-02-01

    Two formal validation studies of the Air Traffic Control Specialist Pre Training Screen (ATCS/PTS), a 5 day computer administered test battery, are described. The ATCS/PTS was designed to replace the 9 week US Federal Aviation Administration (FAA) Ac...

  3. Corrosion Control Specialist Career Ladder AFSC 53530, 53550, 53570, and 53690

    DTIC Science & Technology

    1975-03-01

    AD-AO08 189 CORROSION CONTROL SPECIALIST CAREER LADDER AFSC 53530, 53550, 53570, AND 53690 Air Force Occupational Measurement Center Lackland Air... Force Base, Texas 1 March 1975 I DISTRIBUTED BY: National Technical Information Service U. S. DEPARTMENT OF COMMERCE *I 11 5091 OCCUPATIONAL SURVEY...DISCUSSION OF BACKGROUJND INFORMATION --------------------------- xxvi 01L< R PREFACE This report presents the results cf detailed Air Force

  4. Assessing Prior Experience in the Selection of Air Traffic Control Specialists

    DTIC Science & Technology

    2013-04-01

    Crosstabulation --------------------------B1 APPENDIX C: IFR Operations Experience • Academy Training Performance Crosstabulation ---------C1 APPENDIX...Control Specialist (ATCS) rating? (n=9,333) BQ35 – Do you have prior Instrument Flight Rules ( IFR ) operations experience? (n = 9,349) 2. Hold or...not have a prior ATCS rating. Do you have prior IFR (Instrument Flight Rules) Operations experience? Of the 9,349 respondents to this question

  5. A facility specialist model for improving retention of nursing home staff: results from a randomized, controlled study.

    PubMed

    Pillemer, Karl; Meador, Rhoda; Henderson, Charles; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie

    2008-07-01

    This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and Connecticut and randomly assigned to treatment and control conditions. Staff outcomes were measured through certified nursing assistant interviews, and turnover rates were measured over the course of the year. In the intervention condition, a staff member was selected to be the facility retention specialist, who would advocate for and implement programs to improve staff retention and commitment throughout the facility. Retention specialists received an intensive 3-day training in retention leadership and in a number of evidence-based retention programs. Ongoing support was provided throughout the project. Treatment facilities experienced significant declines in turnover rates compared to control facilities. As predicted, we found positive effects on certified nursing assistant assessments of the quality of retention efforts and of care provided in the facility; we did not find effects for job satisfaction or stress. The study provides evidence for the effectiveness of the retention specialist model. Findings from a detailed process evaluation suggest modifications of the program that may increase program effects.

  6. [The fiscal position of medical specialists].

    PubMed

    Stevens, S; Moors, M

    2013-01-01

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

  7. Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations.

    PubMed

    Orozco-Beltran, D; Pan, C; Svendsen, A L; Faerch, L; Caputo, S

    2016-03-01

    To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. Study of Once-Daily Levemir (SOLVE(™) ) is an international, 24-week, observational study of insulin initiation in people with type 2 diabetes. A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) -1.2 ± 1.4% (-13.1 ± 15.3 mmol/mol) and -1.3 ± 1.6% (-14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [-0.04%, 95% confidence interval (CI) -0.09 to -0.01 (-0.4 mmol/mol, 95% CI -1.0-0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06-0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64-0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation. © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

  8. STS-35 payload specialists perform balancing act on OV-102's middeck

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Aided by the microgravity environment aboard Columbia, Orbiter Vehicle (OV) 102, STS-35 Payload Specialist Ronald A. Parise balances Payload Specialist Samuel T. Durrance on his index finger in front of the middeck starboard wall. Durrance is wearing a blood pressure cuff and is holding a beverage container and food package during the microgravity performance. The waste management compartment (WMC), side hatch, and orbiter galley are seen behind the two crewmembers. Durrance's feet are at the forward lockers.

  9. Parts Specialist.

    ERIC Educational Resources Information Center

    Fuqua, Lou; Fuqua, Debbie

    Designed to address the skills that an auto parts specialist must master in order to be effective in the market place, this manual consists of 13 units of instruction. Covered in the units are orientation; human relations; communications; safety; parts and systems identification; stocking, shipping, and receiving; inventory control; cataloging and…

  10. Poor glycemic control as a reason for referral of diabetes patients to specialists in Israel

    PubMed Central

    Fogelman, Yacov; Karkabi, Khaled; Goldfracht, Margalit

    2016-01-01

    Aims/introduction Family physicians face the dilemma of when to refer patients with diabetes to specialists. This study examined attitudes of family physicians to referring patients with poor glucose control to diabetes specialists. Materials and methods At continuous medical education courses, family physicians were asked to respond anonymously, as to whether they generally manage the diabetes of their patients, and specifically those with poor glycemic control (HbA1c>9.0%). Results Of 470 respondents, 426 (90%) reported that they generally manage their patients’ diabetes; 202 (43%) reported that they manage the diabetes of patients with HbA1c>9.0%. Board certification in family medicine and affiliation to a health maintenance organization, but not sex, age, years of professional experience, or the proportion of patients with diabetes at their clinics, were associated with referral practices. Conclusions Family medicine residency and organizational support appear to promote treatment by family physicians of patients with poorly controlled diabetes in the primary care setting. PMID:27124172

  11. A formative evaluation of the collegiate training initiative--air traffic control specialist (CTI-ATCS) program.

    DOT National Transportation Integrated Search

    1996-02-01

    This report describes the initial formative evaluation of the Federal Aviation Administration (FAA) College Training Initiative - Air Traffic Control Specialist (CTI-ATCS) Program. The purpose of the CTI-ATCS program is to test "the concept that non-...

  12. Relationships of anxiety scores to academy and field training performance of air traffic control specialists.

    DOT National Transportation Integrated Search

    1989-05-01

    State-trait anxiety scores were used prior to the 1981 strike of air traffic control specialists (ATCSs) to estimate perceived levels of job stress in field studies of this occupational group. The present study assessed the relationship between anxie...

  13. Stress, anxiety, and the air traffic control specialist : some conclusions from a decade of research.

    DOT National Transportation Integrated Search

    1980-09-01

    This paper summarizes a decade of research evaluating possible stress effects of work on Air Traffic Control Specialists (ATCSs).Studies were conducted at a variety of large and small air traffic facilities. A visit of several days to each facility w...

  14. Development, validation, and fairness of a biographical data questionnaire for the air traffic control specialist occupation.

    DOT National Transportation Integrated Search

    2012-12-01

    Development and validation of a biographical data (biodata) instrument for selection into the Air Traffic : Control Specialist occupation is described. Bootstrapping was used to estimate correlations between item : responses to the Applicant Ba...

  15. Relationships of Type A behavior with biographical characteristics and training performance of air traffic control specialists.

    DOT National Transportation Integrated Search

    1994-07-01

    While there has been a considerable amount of research concerning the relationships between various cognitive measures and the selection and subsequent performance of Air Traffic Control Specialists (ATCSs), data concerning the potential importance o...

  16. Heating Systems Specialist.

    ERIC Educational Resources Information Center

    Air Force Training Command, Sheppard AFB, TX.

    This instructional package is intended for use in training Air Force personnel enrolled in a program for apprentice heating systems specialists. Training includes instruction in fundamentals and pipefitting; basic electricity; controls, troubleshooting, and oil burners; solid and gas fuel burners and warm air distribution systems; hot water…

  17. Controlling changes - lessons learned from waste management facilities

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

    Johnson, B.M.; Koplow, A.S.; Stoll, F.E.

    This paper discusses lessons learned about change control at the Waste Reduction Operations Complex (WROC) and Waste Experimental Reduction Facility (WERF) of the Idaho National Engineering Laboratory (INEL). WROC and WERF have developed and implemented change control and an as-built drawing process and have identified structures, systems, and components (SSCS) for configuration management. The operations have also formed an Independent Review Committee to minimize costs and resources associated with changing documents. WROC and WERF perform waste management activities at the INEL. WROC activities include storage, treatment, and disposal of hazardous and mixed waste. WERF provides volume reduction of solid low-levelmore » waste through compaction, incineration, and sizing operations. WROC and WERF`s efforts aim to improve change control processes that have worked inefficiently in the past.« less

  18. Controls for Burning Solid Wastes

    ERIC Educational Resources Information Center

    Toro, Richard F.; Weinstein, Norman J.

    1975-01-01

    Modern thermal solid waste processing systems are becoming more complex, incorporating features that require instrumentation and control systems to a degree greater than that previously required just for proper combustion control. With the advent of complex, sophisticated, thermal processing systems, TV monitoring and computer control should…

  19. The relationships between chronological age, length of experience, and job performance ratings of air route traffic control specialists.

    DOT National Transportation Integrated Search

    1967-06-01

    The survey-type study of several hundred journeymen radar control specialists of four Air Route Traffic Control Centers was conducted in order to determine the extent to which job performance might be associative with chronological age and length of ...

  20. Incremental Validity of Biographical Data in the Prediction of En Route Air Traffic Control Specialist Technical Skills

    DOT National Transportation Integrated Search

    2012-07-01

    Previous research demonstrated that an empirically-keyed, response-option scored biographical data (biodata) : scale predicted supervisory ratings of air traffic control specialist (ATCS) job performance (Dean & Broach, : 2011). This research f...

  1. Association between the 2012 Health and Social Care Act and specialist visits and hospitalisations in England: A controlled interrupted time series analysis.

    PubMed

    Lopez Bernal, James A; Lu, Christine Y; Gasparrini, Antonio; Cummins, Steven; Wharam, J Frank; Soumerai, Steven B

    2017-11-01

    The 2012 Health and Social Care Act (HSCA) in England led to among the largest healthcare reforms in the history of the National Health Service (NHS). It gave control of £67 billion of the NHS budget for secondary care to general practitioner (GP) led Clinical Commissioning Groups (CCGs). An expected outcome was that patient care would shift away from expensive hospital and specialist settings, towards less expensive community-based models. However, there is little evidence for the effectiveness of this approach. In this study, we aimed to assess the association between the NHS reforms and hospital admissions and outpatient specialist visits. We conducted a controlled interrupted time series analysis to examine rates of outpatient specialist visits and inpatient hospitalisations before and after the implementation of the HSCA. We used national routine hospital administrative data (Hospital Episode Statistics) on all NHS outpatient specialist visits and inpatient hospital admissions in England between 2007 and 2015 (with a mean of 26.8 million new outpatient visits and 14.9 million inpatient admissions per year). As a control series, we used equivalent data on hospital attendances in Scotland. Primary outcomes were: total, elective, and emergency hospitalisations, and total and GP-referred specialist visits. Both countries had stable trends in all outcomes at baseline. In England, after the policy, there was a 1.1% (95% CI 0.7%-1.5%; p < 0.001) increase in total specialist visits per quarter and a 1.6% increase in GP-referred specialist visits (95% CI 1.2%-2.0%; p < 0.001) per quarter, equivalent to 12.7% (647,000 over the 5,105,000 expected) and 19.1% (507,000 over the 2,658,000 expected) more visits per quarter by the end of 2015, respectively. In Scotland, there was no change in specialist visits. Neither country experienced a change in trends in hospitalisations: change in slope for total, elective, and emergency hospitalisations were -0.2% (95% CI -0

  2. Noise control of waste water pipes

    NASA Astrophysics Data System (ADS)

    Lilly, Jerry

    2005-09-01

    Noise radiated by waste water pipes is a major concern in multifamily housing projects. While the most common solution to this problem is to use cast-iron pipes in lieu of plastic pipes, this may not be sufficient in high-end applications. It should also be noted that many (if not most) multifamily housing projects in the U.S.A. are constructed with plastic waste piping. This paper discusses some of the measures that developers are currently using to control noise from both plastic and cast-iron waste pipes. In addition, results of limited noise measurements of transient water flow in plastic and cast-iron waste pipes will be presented.

  3. Three studies of biographical factors associated with success in air traffic control specialist screening/training at the FAA Academy.

    DOT National Transportation Integrated Search

    1983-04-01

    The current Air Traffic Control Specialist (ATCS) selection procedure requires that all applicants pass the Office of Personnel Management (OPM) air traffic control aptitude test. In addition to the test scores, applicants may also receive points for...

  4. Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

    PubMed Central

    Weiland, Anne; Blankenstein, Annette H.; Van Saase, Jan L. C. M.; Van der Molen, Henk T.; Jacobs, Mariël E.; Abels, Dineke C.; Köse, Nedim; Van Dulmen, Sandra; Vernhout, René M.; Arends, Lidia R.

    2015-01-01

    Background Patients with medically unexplained physical symptoms (MUPS) are prevalent 25–50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don’t feel understood. We developed an evidence-based communication training, aimed to improve specialists’ interviewing, information-giving and planning skills in MUPS consultations, and tested its effectiveness. Methods The intervention group in this multi-center randomized controlled trial received a 14-hour training program to which experiential learning and feedback were essential. Using techniques from Cognitive Behavioral Therapy, they were stimulated to seek interrelating factors (symptoms, cognitions, emotions, behavior, and social environment) that reinforced a patient’s symptoms. They were taught to explain MUPS understandably, reassure patients effectively and avoid unnecessary diagnostic testing. Before and after the intervention training, specialists videotaped a total of six consultations with different MUPS patients. These were evaluated to assess doctors’ MUPS-focused communicating skills using an adapted version of the Four Habit Coding Scheme on five-point Likert scales. Participants evaluated the training by self-report on three-point Likert scales. Doctors in the control group received training after completion of the study. Results 123 doctors (40% specialists, 60% residents) and 478 MUPS patients from 11 specialties were included; 98 doctors completed the study (80%) and 449 videotaped consultations were assessed. Trained doctors interviewed patients more effectively than untrained ones (p < 0.001), summarized information in a more patient-centered way (p = 0.001), and better explained MUPS and the role of perpetuating factors (p < 0.05). No effects on planning skills were found. On a 3-point scale the training was evaluated with 2.79. Conclusion MUPS-focused communication

  5. Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists.

    PubMed

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

    2018-05-22

    Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work

  6. Comparing specialist medical care with specialist medical care plus the Lightning Process for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised controlled trial (SMILE Trial).

    PubMed

    Crawley, Esther; Mills, Nicola; Hollingworth, Will; Deans, Zuzana; Sterne, Jonathan A; Donovan, Jenny L; Beasant, Lucy; Montgomery, Alan

    2013-12-26

    Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a relatively common and potentially serious condition with a limited evidence base for treatment. Specialist treatment for paediatric CFS/ME uses interventions recommended by National Institute for Health and Clinical Excellence (NICE) including cognitive behavioural therapy, graded exercise therapy and activity management. The Lightning Process (LP) is a trademarked intervention derived from osteopathy, life-coaching and neuro-linguistic programming, delivered over three consecutive days as group sessions. Although over 250 children with CFS/ME attend LP courses each year, there are no reported studies on the effectiveness or cost-effectiveness. This pragmatic randomised controlled trial is set within a specialist paediatric CFS/ME service in the south west of England. Children and young people with CFS/ME (n = 80 to 112), aged 12 to 18 years old will be randomised to specialist medical care (SMC) or SMC plus the LP. The primary outcome will be physical function (SF-36 physical function short form) and fatigue (Chalder Fatigue Scale). This study will tell us whether adding the LP to SMC is effective and cost-effective compared to SMC alone. This study will also provide detailed information on the implementation of the LP and SMC. Current Controlled Trials ISRCTN81456207 (31 July 2012).

  7. Association between the 2012 Health and Social Care Act and specialist visits and hospitalisations in England: A controlled interrupted time series analysis

    PubMed Central

    Lu, Christine Y.; Wharham, J. Frank; Soumerai, Steven B.

    2017-01-01

    Background The 2012 Health and Social Care Act (HSCA) in England led to among the largest healthcare reforms in the history of the National Health Service (NHS). It gave control of £67 billion of the NHS budget for secondary care to general practitioner (GP) led Clinical Commissioning Groups (CCGs). An expected outcome was that patient care would shift away from expensive hospital and specialist settings, towards less expensive community-based models. However, there is little evidence for the effectiveness of this approach. In this study, we aimed to assess the association between the NHS reforms and hospital admissions and outpatient specialist visits. Methods and findings We conducted a controlled interrupted time series analysis to examine rates of outpatient specialist visits and inpatient hospitalisations before and after the implementation of the HSCA. We used national routine hospital administrative data (Hospital Episode Statistics) on all NHS outpatient specialist visits and inpatient hospital admissions in England between 2007 and 2015 (with a mean of 26.8 million new outpatient visits and 14.9 million inpatient admissions per year). As a control series, we used equivalent data on hospital attendances in Scotland. Primary outcomes were: total, elective, and emergency hospitalisations, and total and GP-referred specialist visits. Both countries had stable trends in all outcomes at baseline. In England, after the policy, there was a 1.1% (95% CI 0.7%–1.5%; p < 0.001) increase in total specialist visits per quarter and a 1.6% increase in GP-referred specialist visits (95% CI 1.2%–2.0%; p < 0.001) per quarter, equivalent to 12.7% (647,000 over the 5,105,000 expected) and 19.1% (507,000 over the 2,658,000 expected) more visits per quarter by the end of 2015, respectively. In Scotland, there was no change in specialist visits. Neither country experienced a change in trends in hospitalisations: change in slope for total, elective, and emergency

  8. Evaluation of functional color vision requirements and current color vision screening tests for air traffic control specialists.

    DOT National Transportation Integrated Search

    1990-08-01

    An experiment was conducted to evaluate the relation of type and degree of color vision deficiency and aeromedical color vision screening test scores to performance of color-dependent tasks of Air Traffic Control Specialists. The subjects included 37...

  9. Problems in air traffic management. VII., Job training performance of air traffic control specialists - measurement, structure, and prediction.

    DOT National Transportation Integrated Search

    1965-07-01

    A statistical study of training- and job-performance measures of several hundred Air Traffic Control Specialists (ATCS) representing Enroute, Terminal, and Flight Service Station specialties revealed that training-performance measures reflected: : 1....

  10. Compact, closed-loop controlled waste incinerator

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

    Schadow, K.C.; Seeker, W.R.

    1999-07-01

    Technologies for solid and liquid waste destruction in compact incinerators are being developed in collaboration between industry, universities, and a Government laboratory. This paper reviews progress on one technology, namely active combustion control to achieve efficient and controlled afterburning of air-starved reaction products. This technology which uses synchronized waste gas injection into acoustically stabilized air vortices was transitioned to a simplified afterburner design and practical operational conditions. The full-scale, simplified afterburner, which achieved CO and NO{sub x} emissions of about 30 ppm with a residence time of less than 50 msec, was integrated with a commercially available marine incinerator tomore » increase throughput and reduce emissions. Closed-loop active control with diode laser sensors and novel control strategies was demonstrated on a sub-scale afterburner.« less

  11. Library Media Specialists: Premier Information Specialists for the Information Age

    ERIC Educational Resources Information Center

    Neuman, Delia

    2011-01-01

    The information age has given library media specialists an unprecedented opportunity to play a leading role in helping teachers, administrators, and especially students access and use information intelligently. As the school's premier information specialist; the library media specialist has a unique role to play in helping everyone in the school…

  12. Ophthalmic requirements and considerations for the en route air traffic control specialist : an ergonomic analysis of the visual work environment.

    DOT National Transportation Integrated Search

    1996-04-01

    The Federal Air Surgeon requested continued investigation of visual disorders and vision corrective devices as to their relevance to the medical certification of airmen and controllers. The en route Air Traffic Control Specialist (ATCS) works with a ...

  13. The selection of air traffic control specialists. I., History and review of contributions by the Civil Aeromedical Institute.

    DOT National Transportation Integrated Search

    1980-06-01

    For two decades the FAA Civil Aeromedical Institute (CAMI) has engaged in active research programs exploring most aspects of the problems of effectively selecting air traffic control specialists (ATCSs) for the FAA. The results of those efforts have ...

  14. Mission Specialist (MS) Ride on middeck

    NASA Image and Video Library

    1992-06-24

    STS007-02-020 (21 June 1983) --- Astronaut Sally K. Ride, STS-7 mission specialist, STS-7 mission specialist, stands in the mid deck of the orbiting Space Shuttle Challenger near one of the experiment with which she has devoted a great deal of time. The continuous flow electrophoresis system (CFES) experiment, about the size of a household refrigerator, stands nearby. One of her fellow crewmembers moves partially out of frame in the background. The tube on her face is part of a communications system linking Dr. Ride to ground controllers in Houston.

  15. Plumbing Specialist II & III, 3-22. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    These military-developed curriculum materials consist of a course description, course chart, plan of instruction, lesson plans, study guides, and workbooks for use in training plumbing specialists II and III. Covered in the course blocks are building waste systems and exterior and interior supply systems. Course block II, on building waste…

  16. "Control-alt-delete": rebooting solutions for the E-waste problem.

    PubMed

    Li, Jinhui; Zeng, Xianlai; Chen, Mengjun; Ogunseitan, Oladele A; Stevels, Ab

    2015-06-16

    A number of efforts have been launched to solve the global electronic waste (e-waste) problem. The efficiency of e-waste recycling is subject to variable national legislation, technical capacity, consumer participation, and even detoxification. E-waste management activities result in procedural irregularities and risk disparities across national boundaries. We review these variables to reveal opportunities for research and policy to reduce the risks from accumulating e-waste and ineffective recycling. Full regulation and consumer participation should be controlled and reinforced to improve local e-waste system. Aiming at standardizing best practice, we alter and identify modular recycling process and infrastructure in eco-industrial parks that will be expectantly effective in countries and regions to handle the similar e-waste stream. Toxicity can be deleted through material substitution and detoxification during the life cycle of electronics. Based on the idea of "Control-Alt-Delete", four patterns of the way forward for global e-waste recycling are proposed to meet a variety of local situations.

  17. A Facility Specialist Model for Improving Retention of Nursing Home Staff: Results from a Randomized, Controlled Study

    ERIC Educational Resources Information Center

    Pillemer, Karl; Meador, Rhoda; Henderson, Charles, Jr.; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie

    2008-01-01

    Purpose: This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. Design and Methods: We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and…

  18. Validity of the air traffic control specialist nonradar screen as a predictor of performance in radar based ATC training.

    DOT National Transportation Integrated Search

    1994-04-01

    Between January 1986 and March 1992, the Federal Aviation Administration's 42-day Nonradar Screen was used to identify Air Traffic Control Specialist (ATCS) candidates with the highest potential to succeed in the rigorous ATCS field training program....

  19. An Investigation of the Relationship Between Chronological Age and Indicators of Job Performance for Incumbent Air Traffic Control Specialists

    DOT National Transportation Integrated Search

    1999-06-01

    Over the last few decades, researchers have consistently found a negative relationship between the age of air traffic control specialists (ATCSs) and both training success and ratings of job performance. As more ATCSs reach retirement age and the Fed...

  20. Environmental control and waste management system design concept

    NASA Technical Reports Server (NTRS)

    Gandy, A. R.

    1974-01-01

    Passive device contains both solid and liquid animal waste matter for extended period without being cleaned and without contaminating animal. Constant airflow dries solid waste and evaporates liquid matter. Technique will maintain controlled atmospheric conditions and cage cleanliness during periods of 6 months to 1 year.

  1. Environmental Medicine Specialist (AFSC 90850).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This five-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for environmental medical specialists. Covered in the individual volumes are (1) control of communicable diseases (principles of epidemiology and biology; food, waterborne, airborne, and sexually transmitted diseases; medical zoology;…

  2. Some effects of 8- vs 10-hour work schedules on the test performance/alertness of air traffic control specialists.

    DOT National Transportation Integrated Search

    1995-12-01

    A 10-hour, 4-day rotating shift schedule worked by some Air Traffic Control Specialists (ATCSs) was compared to the more traditional 8-hour, 2-2-1 rapidly rotating schedule. Measures of performance and alertness were obtained from a group of 52 ATCSs...

  3. A multicentre non-blinded randomised controlled trial to assess the impact of regular early specialist symptom control treatment on quality of life in malignant mesothelioma (RESPECT-MESO): study protocol for a randomised controlled trial.

    PubMed

    Gunatilake, Samal; Brims, Fraser J H; Fogg, Carole; Lawrie, Iain; Maskell, Nick; Forbes, Karen; Rahman, Najib; Morris, Steve; Ogollah, Reuben; Gerry, Stephen; Peake, Mick; Darlison, Liz; Chauhan, Anoop J

    2014-09-19

    Malignant pleural mesothelioma is an incurable cancer caused by exposure to asbestos. The United Kingdom has the highest death rate from mesothelioma in the world and this figure is increasing. Median survival is 8 to 12 months, and most patients have symptoms at diagnosis. The fittest patients may be offered chemotherapy with palliative intent. For patients not fit for systemic anticancer treatment, best supportive care remains the mainstay of management. A study from the United States examining advanced lung cancer showed that early specialist palliative care input improved patient health related quality of life and depression symptoms 12 weeks after diagnosis. While mesothelioma and advanced lung cancer share many symptoms and have a poor prognosis, oncology and palliative care services in the United Kingdom, and many other countries, vary considerably compared to the United States. The aim of this trial is to assess whether regular early symptom control treatment provided by palliative care specialists can improve health related quality of life in patients newly diagnosed with mesothelioma. This multicentre study is an non-blinded, randomised controlled, parallel group trial. A total of 174 patients with a new diagnosis of malignant pleural mesothelioma will be minimised with a random element in a 1:1 ratio to receive either 4 weekly regular early specialist symptom control care, or standard care. The primary outcome is health related quality of life for patients at 12 weeks. Secondary outcomes include health related quality of life for patients at 24 weeks, carer health related quality of life at 12 and 24 weeks, patient and carer mood at 12 and 24 weeks, overall survival and analysis of healthcare utilisation and cost. Current practice in the United Kingdom is to involve specialist palliative care towards the final weeks or months of a life-limiting illness. This study aims to investigate whether early, regular specialist care input can result in significant

  4. Identifying Core Competencies of Infection Control Nurse Specialists in Hong Kong.

    PubMed

    Chan, Wai Fong; Bond, Trevor G; Adamson, Bob; Chow, Meyrick

    2016-01-01

    To confirm a core competency scale for Hong Kong infection control nurses at the advanced nursing practice level from the core competency items proposed in a previous phase of this study. This would serve as the foundation of competency assurance in Hong Kong hospitals. A cross-sectional survey design was used. All public and private hospitals in Hong Kong. All infection control nurses in hospitals of Hong Kong. The 83-item proposed core competency list established in an earlier study was transformed into a questionnaire and sent to 112 infection control nurses in 48 hospitals in Hong Kong. They were asked to rate the importance of each infection prevention and control item using Likert-style response categories. Data were analyzed using the Rasch model. The response rate of 81.25% was achieved. Seven items were removed from the proposed core competency list, leaving a scale of 76 items that fit the measurement requirements of the unidimensional Rasch model. Essential core competency items of advanced practice for infection control nurses in Hong Kong were identified based on the measurement criteria of the Rasch model. Several items of the scale that reflect local Hong Kong contextual characteristics are distinguished from the overseas standards. This local-specific competency list could serve as the foundation for education and for certification of infection control nurse specialists in Hong Kong. Rasch measurement is an appropriate analytical tool for identifying core competencies of advanced practice nurses in other specialties and in other locations in a manner that incorporates practitioner judgment and expertise.

  5. Improving cancer patients' pain: the impact of the hospital specialist palliative care team.

    PubMed

    Jack, B; Hillier, V; Williams, A; Oldham, J

    2006-12-01

    Pain is reported to occur in the majority of patients with advanced cancer and is one of the main reasons for referral to a hospital specialist palliative care team. Yet despite this, there is a paucity of research into the impact the hospital specialist palliative care team has on pain control in patients. A non-equivalent control group design using a quota sample investigated 100 cancer patients who had been admitted to hospital for symptom control. Fifty patients received specialist hospital palliative care team intervention compared with 50 patients receiving traditional care. Outcome was assessed using the Palliative Care Assessment (PACA) tool on three occasions. There was no difference between the groups on the initial assessment and the results indicated that all cancer patients admitted to hospital had a significant improvement in their pain control. However, the patients who had the additional input of the palliative care team demonstrated a statistically significant greater improvement than the control group (P<0.001). Potential explanations are made for the results including the enhanced knowledge and skills of the hospital specialist palliative care team.

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

    PubMed

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

    2017-06-01

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

  7. A Comparison of Selected Supervisory Skills of Content Specialist and Non-Content Specialist University Supervisors

    ERIC Educational Resources Information Center

    Hunt, Kevin; Mitchell, Murray; Maina, Michael; Griffin, Lisa

    2015-01-01

    The purpose of this study was to describe and contrast selected approaches to the supervision of student teachers between Content Specialist and Non-Content Specialist university supervisors. Content Specialist supervisors were identified as trained university supervisors with a background in physical education. Non-Content Specialist supervisors…

  8. Differential prediction of FAA Academy performance on the basis of gender and written air traffic control specialist aptitude test scores.

    DOT National Transportation Integrated Search

    1996-04-01

    The technical fairness of the written air traffic control specialist (ATCS) aptitude test battery was investigated within the framework of the Uniform Guidelines on Employee Selection Procedures (29 CFR 1607). First, the adverse impact of using a com...

  9. The selection of air traffic control specialists : two studies demonstrating methods to insure an accurate validity coefficient for selection devices.

    DOT National Transportation Integrated Search

    1979-03-01

    There are several conditions that can influence the calculation of the statistical validity of a test battery such as that used to selected Air Traffic Control Specialists. Two conditions of prime importance to statistical validity are recruitment pr...

  10. Improved Sweetpotato Whitefly and Potato Psyllid Control in Tomato by Combining the Mirid Dicyphus hesperus (Heteroptera: Miridae) With Specialist Parasitic Wasps.

    PubMed

    Calvo, F J; Torres-Ruiz, A; Velázquez-González, J; Rodríguez-Leyva, E; Lomeli-Flores, J R

    2018-04-02

    Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae) and Bactericera cockerelli Sulcer (Hemiptera: Psyllidae) are important pests in tomato, and the mirid Dicyphus hesperus Knight (Heteroptera: Miridae) has been shown as an effective predator of both pests. Although the predator was able to suppress populations of both pests, the remaining levels could still exceed tolerable levels. Thus, we here hypothesized whether the combination of D. hesperus with the specialist parasitoids Eretmocerus eremicus Rose y Zolnerowich (Hymenoptera: Aphelinidae) (whitefly) and Tamarixia triozae (Burks) (Hymenoptera: Eulophidae) (psyllid) would result in better pest control on a greenhouse scale. For that, we conducted a trial in which we compared the results against B. tabaci and B. cockerelli in greenhouses treated with D. hesperus alone or the predator in combination with the specialist parasitoids. The results showed that the predator was able to establish and suppress B. tabaci and B. cockerelli in tomato, but the addition of the specialist parasitoids resulted in better and more cost-effective pest control. Implementation of this method would therefore increase the robustness and reliability of biocontrol-based integrated pest management programmes for tomato crops, over methods based exclusively on D. hesperus release.

  11. Air Pollution Control and Waste Management

    EPA Science Inventory

    This special issue addresses air pollution control and waste management, two environmental problems that are usually considered separately. Indeed, one of the challenges of environmental protection is that problems are addressed in 'media-specific' ways. In reality, these problem...

  12. Comparison of performance on the Shipley Institute of Living Scale, air traffic control specialist selection test, and FAA Academy screen.

    DOT National Transportation Integrated Search

    1992-11-01

    This study was conducted to establish norms for ATCS personnel on a group test of intellectual functioning, the Shipley Institute of Living Scale (SILS), to screen subjects for future research on the effects of Air Traffic Control Specialist (ATCS) r...

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

    PubMed

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

    2018-02-26

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

  14. Problems in air traffic management. VI., Interaction of training-entry age with intellectual and personality characteristics of air traffic control specialists.

    DOT National Transportation Integrated Search

    1965-07-01

    Over 900 Enroute and Terminal Air Traffic Controller Specialist (ATCS) trainees were administered a large number of aptitude and personality tests. Examination of the relationships between the performance scores and age at entry into training reveale...

  15. Specialist outreach clinics in primary care and rural hospital settings.

    PubMed

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

    2004-01-01

    Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. To undertake a descriptive overview of studies of specialist outreach clinics and to assess the effectiveness of specialist outreach clinics on access, quality, health outcomes, patient satisfaction, use of services, and costs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) specialised register (March 2002), the Cochrane Controlled Trials Register (CCTR) (Cochrane Library Issue 1, 2002), MEDLINE (including HealthStar) (1966 to May 2002), EMBASE (1988 to March 2002), CINAHL (1982 to March 2002), the Primary-Secondary Care Database previously maintained by the Centre for Primary Care Research in the Department of General Practice at the University of Manchester, a collection of studies from the UK collated in "Specialist Outreach Clinics in General Practice" (Roland 1998), and the reference lists of all retrieved articles. Randomised trials, controlled before and after studies and interrupted time series analyses of visiting specialist outreach clinics in primary care or rural hospital settings, either providing simple consultations or as part of complex multifaceted interventions. The participants were patients, specialists, and primary care providers. The outcomes included objective measures of access, quality, health outcomes, satisfaction, service use, and cost. Four reviewers working in pairs independently extracted data and assessed study quality. 73 outreach interventions were identified covering many specialties, countries and settings. Nine studies met the inclusion criteria. Most comparative studies came from urban non-disadvantaged populations in developed countries. Simple 'shifted outpatients

  16. Waste incineration, Part I: Technology.

    PubMed

    1990-02-01

    Based upon an overview of the technology of incineration and the nature of hospital waste, HHMM offers the following suggestions: Old retort or other excess air incinerators should be replaced regardless of age. Even if emissions control equipment and monitoring devices can be retrofitted, excess-air incinerators are no longer cost-effective in terms of capacity, fuel consumption, and heat recovery. Audit (or have a specialist audit) your waste stream thoroughly. Consult a qualified engineering company experienced in hospital installations to get a system specified as exactly as possible to your individual conditions and needs. Make sure that the capacity of your incinerator will meet projections for future use. Anticipate the cost of emissions control and monitoring devices whether your state currently requires them or not. Make sure that your incinerator installation is engineered to accept required equipment in the future. Develop a strong community relations program well in advance of committing to incinerator installation. Take a proactive position by inviting your neighbors in during the planning stages. Be sure the contract governing incinerator purchase and installation has a cancellation clause, preferably without penalties, in case community action or a change in state regulations makes installation and operation impractical. The technology is available to enable hospitals to burn waste effectively, efficiently, and safely. HHMM echoes the concerns of Frank Cross--that healthcare facilities, as well as regional incinerators and municipalities, show the same concern for environmental protection as for their bottom lines. When emissions are under control and heat is recovered, both the environment and the bottom line are healthier.

  17. Incremental Validity of Biographical Data in the Prediction of En Route Air Traffic Control Specialist Technical Skills

    DTIC Science & Technology

    2012-07-01

    Incremental Validity of Biographical Data in the Prediction of En Route Air Traffic Control Specialist Technical Skills Dana Broach Civil Aerospace...Medical Institute Federal Aviation Administration Oklahoma City, OK 73125 July 2012 Final Report DOT/FAA/AM- 12 /8 Office of Aerospace Medicine...FAA/AM- 12 /8 4. Title and Subtitle 5. Report Date July 2012 Incremental Validity of Biographical Data in the Prediction of En Route Air

  18. Performance of color-dependent tasks of air traffic control specialists as a function of type and degree of color vision deficiency.

    DOT National Transportation Integrated Search

    1992-08-01

    This experiment was conducted to expand initial efforts to validate the requirement for normal color vision in Air Traffic Control Specialist (ATCS) personnel who work at en route center, terminal, and flight service station facilities. An enlarged d...

  19. Studies of poststrike air traffic control specialist trainees. I., Age, biographic factors, and selection test performance related to academy training success.

    DOT National Transportation Integrated Search

    1984-06-01

    The August 1981 strike of air traffic control specialists (ATCS's) and their subsequent firing led to the air traffic strike recovery program, which included the unprecedented hiring and basic training of over 8,000 ATCS applicants in a 2-year period...

  20. Extension Specialists: A Self-Analysis.

    ERIC Educational Resources Information Center

    Gerber, John M.

    1985-01-01

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

  1. 40 CFR 261.8 - PCB wastes regulated under Toxic Substance Control Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false PCB wastes regulated under Toxic... (CONTINUED) SOLID WASTES (CONTINUED) IDENTIFICATION AND LISTING OF HAZARDOUS WASTE General § 261.8 PCB wastes regulated under Toxic Substance Control Act. The disposal of PCB-containing dielectric fluid and electric...

  2. 40 CFR 261.8 - PCB wastes regulated under Toxic Substance Control Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false PCB wastes regulated under Toxic... (CONTINUED) SOLID WASTES (CONTINUED) IDENTIFICATION AND LISTING OF HAZARDOUS WASTE General § 261.8 PCB wastes regulated under Toxic Substance Control Act. The disposal of PCB-containing dielectric fluid and electric...

  3. 40 CFR 261.8 - PCB wastes regulated under Toxic Substance Control Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false PCB wastes regulated under Toxic... (CONTINUED) SOLID WASTES (CONTINUED) IDENTIFICATION AND LISTING OF HAZARDOUS WASTE General § 261.8 PCB wastes regulated under Toxic Substance Control Act. The disposal of PCB-containing dielectric fluid and electric...

  4. 40 CFR 261.8 - PCB wastes regulated under Toxic Substance Control Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false PCB wastes regulated under Toxic... (CONTINUED) SOLID WASTES (CONTINUED) IDENTIFICATION AND LISTING OF HAZARDOUS WASTE General § 261.8 PCB wastes regulated under Toxic Substance Control Act. The disposal of PCB-containing dielectric fluid and electric...

  5. 40 CFR 261.8 - PCB wastes regulated under Toxic Substance Control Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false PCB wastes regulated under Toxic... (CONTINUED) SOLID WASTES (CONTINUED) IDENTIFICATION AND LISTING OF HAZARDOUS WASTE General § 261.8 PCB wastes regulated under Toxic Substance Control Act. The disposal of PCB-containing dielectric fluid and electric...

  6. Challenges of pain control and the role of the ambulatory pain specialist in the outpatient surgery setting.

    PubMed

    Vadivelu, Nalini; Kai, Alice M; Kodumudi, Vijay; Berger, Jack M

    2016-01-01

    Ambulatory surgery is on the rise, with an unmet need for optimum pain control in ambulatory surgery centers worldwide. It is important that there is a proportionate increase in the availability of acute pain-management services to match the rapid rise of clinical patient load with pain issues in the ambulatory surgery setting. Focus on ambulatory pain control with its special challenges is vital to achieve optimum pain control and prevent morbidity and mortality. Management of perioperative pain in the ambulatory surgery setting is becoming increasingly complex, and requires the employment of a multimodal approach and interventions facilitated by ambulatory surgery pain specialists, which is a new concept. A focused ambulatory pain specialist on site at each ambulatory surgery center, in addition to providing safe anesthesia, could intervene early once problematic pain issues are recognized, thus preventing emergency room visits, as well as readmissions for uncontrolled pain. This paper reviews methods of acute-pain management in the ambulatory setting with risk stratification, the utilization of multimodal interventions, including pharmacological and nonpharmacological options, opioids, nonopioids, and various routes with the goal of preventing delayed discharge and unexpected hospital admissions after ambulatory surgery. Continued research and investigation in the area of pain management with outcome studies in acute surgically inflicted pain in patients with underlying chronic pain treated with opioids and the pattern and predictive factors for pain in the ambulatory surgical setting is needed.

  7. Understanding the needs of hand control users, driver rehabilitation specialists, and dealers/installers.

    PubMed

    Lowe, Evan; Drouin, Nathalie; Venhovens, Paul J; Brooks, Johnell O

    2014-10-01

    Understanding unique perspectives from key stakeholder groups involved in the hand control (HC) industry, including driver rehabilitation specialists (DRSs) who train users how to use their HCs, dealers/installers, and users, may become increasingly important in the United States due to increases in elderly, diabetic, and wounded warrior amputee driving populations. In this exploratory study, phone interviews were conducted with 20 DRSs, 20 dealers/installers, and 20 users regarding their perspectives about HC training, maintenance and operation, and design improvements. Results revealed common views and differences in perspectives about whether HC users should receive training and for how long, when and how often users should receive maintenance on their HCs, and what DRSs, dealers/installers, and users would like to see in the future.

  8. STS-55 German Payload Specialist Schlegel manipulates ROTEX controls in SL-D2

    NASA Technical Reports Server (NTRS)

    1993-01-01

    STS-55 German Payload Specialist 2 Hans Schlegel, wearing goggles (eye glasses) and positioned in front of Spacelab Deutsche 2 (SL-D2) Rack 4 System Rack controls, operates Robotics Technology Experiment (ROTEX) arm. ROTEX is a robotic arm that operates within an enclosed workcell in Rack 6 (partially visible in the foreground) and uses teleoperation from both an onboard station located nearby in Rack 4 and from a station on the ground. The device uses teleprogramming and artificial intelligence to look at the design, verification and operation of advanced autonomous systems for use in future applications. Schlegel represents the German Aerospace Research Establishment (DLR). SL-D2, a German-managed payload, is aboard Columbia, Orbiter Vehicle (OV) 102, for this science research mission.

  9. 48 CFR 552.236-72 - Specialist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 552.236-72... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 552.236-72 Specialist. As prescribed in 536.570-3, insert the following clause: Specialist (APR 1984) The term “Specialist...

  10. Uranium-233 waste definition: Disposal options, safeguards, criticality control, and arms control

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

    Forsberg, C.W.; Storch, S.N.; Lewis, L.C.

    1998-07-07

    The US investigated the use of {sup 233}U for weapons, reactors, and other purposes from the 1950s into the 1970s. Based on the results of these investigations, it was decided not to use {sup 233}U on a large scale. Most of the {sup 233}U-containing materials were placed in long-term storage. At the end of the cold war, the US initiated, as part of its arms control policies, a disposition program for excess fissile materials. Other programs were accelerated for disposal of radioactive wastes placed in storage during the cold war. Last, potential safety issues were identified related to the storagemore » of some {sup 233}U-containing materials. Because of these changes, significant activities associated with {sup 233}U-containing materials are expected. This report is one of a series of reports to provide the technical bases for future decisions on how to manage this material. A basis for defining when {sup 233}U-containing materials can be managed as waste and when they must be managed as concentrated fissile materials has been developed. The requirements for storage, transport, and disposal of radioactive wastes are significantly different than those for fissile materials. Because of these differences, it is important to classify material in its appropriate category. The establishment of a definition of what is waste and what is fissile material will provide the guidance for appropriate management of these materials. Wastes are defined in this report as materials containing sufficiently small masses or low concentrations of fissile materials such that they can be managed as typical radioactive waste. Concentrated fissile materials are defined herein as materials containing sufficient fissile content such as to warrant special handling to address nuclear criticality, safeguards, and arms control concerns.« less

  11. International Atomic Energy Agency specialists meeting on experience in ageing, maintenance, and modernization of instrumentation and control systems for improving nuclear power plant availability

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

    Not Available

    1993-10-01

    This report presents the proceedings of the Specialist`s Meeting on Experience in Aging, Maintenance and Modernization of Instrumentation and Control Systems for Improving Nuclear Power Plant Availability that was held at the Ramada Inn in Rockville, Maryland on May 5--7, 1993. The Meeting was presented in cooperation with the Electric Power Research Institute, Oak Ridge National Laboratory and the International Atomic Energy Agency. There were approximately 65 participants from 13 countries at the Meeting. Individual reports have been cataloged separately.

  12. Carbon bed mercury emissions control for mixed waste treatment.

    PubMed

    Soelberg, Nick; Enneking, Joe

    2010-11-01

    Mercury has various uses in nuclear fuel reprocessing and other nuclear processes, and so it is often present in radioactive and mixed (radioactive and hazardous) wastes. Compliance with air emission regulations such as the Hazardous Waste Combustor (HWC) Maximum Achievable Control Technology (MACT) standards can require off-gas mercury removal efficiencies up to 99.999% for thermally treating some mixed waste streams. Test programs have demonstrated this level of off-gas mercury control using fixed beds of granular sulfur-impregnated activated carbon. Other results of these tests include (1) the depth of the mercury control mass transfer zone was less than 15-30 cm for the operating conditions of these tests; (2) MERSORB carbon can sorb mercury up to 19 wt % of the carbon mass; and (3) the spent carbon retained almost all (98.3-99.99%) of the mercury during Toxicity Characteristic Leachability Procedure (TCLP) tests, but when even a small fraction of the total mercury dissolves, the spent carbon can fail the TCLP test when the spent carbon contains high mercury concentrations.

  13. Small Business Specialists.

    DTIC Science & Technology

    1997-12-01

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

  14. An EHR Prototype Using Structured ISO/EN 13606 Documents to Respond to Identified Clinical Information Needs of Diabetes Specialists: A Controlled Study on Feasibility and Impact

    PubMed Central

    Huebner-Bloder, Gudrun; Duftschmid, Georg; Kohler, Michael; Rinner, Christoph; Saboor, Samrend; Ammenwerth, Elske

    2012-01-01

    Cross-institutional longitudinal Electronic Health Records (EHR), as introduced in Austria at the moment, increase the challenge of information overload of healthcare professionals. We developed an innovative cross-institutional EHR query prototype that offers extended query options, including searching for specific information items or sets of information items. The available query options were derived from a systematic analysis of information needs of diabetes specialists during patient encounters. The prototype operates in an IHE-XDS-based environment where ISO/EN 13606-structured documents are available. We conducted a controlled study with seven diabetes specialists to assess the feasibility and impact of this EHR query prototype on efficient retrieving of patient information to answer typical clinical questions. The controlled study showed that the specialists were quicker and more successful (measured in percentage of expected information items found) in finding patient information compared to the standard full-document search options. The participants also appreciated the extended query options. PMID:23304308

  15. STS-120 Mission Specialist Doug Wheelock During EVA

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Astronaut Doug Wheelock, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, astronaut Scott Parazynski (out of frame), mission specialist, cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Wheelock assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

  16. Sexual health clinics for women led by specialist nurses or senior house officers in a central London GUM service: a randomised controlled trial.

    PubMed

    Miles, K; Penny, N; Mercey, D; Power, R

    2002-04-01

    To assess the care process and clinical outcomes for two different models of GUM clinic for women: one led by specialist nurses and the other by senior house officers (SHOs). An open randomised controlled trial was carried out in a central London genitourinary medicine (GUM) women's clinic. Of 1172 women telephoning for an appointment, 880 were randomised to provide 169 eligible patients in the specialist nurse arm and 178 in the SHO arm. Of the eligible patients a total of 224 attended their appointment. The clinical records of the randomised women were audited for adequacy of care according to local guidelines. 30 key variables were objectively assessed and recorded on a standard audit form. An overall unitary index score (%) was calculated for each patient. The main variables associated with the outcome of specialist nurse and SHO decision making (diagnostic test request, preliminary diagnosis, and treatment provided) were then analysed independently. The median documentation audit scores for specialist nurses (n=103) and SHOs (n=121) were 92% and 85% respectively (p<0.0001). The specialist nurses' documentation was significantly (p<0.05) more complete than the SHOs' for five variables: details of menstrual cycle, physical examination, medication instructions given to patients, health promotion discussion, and provision of condoms. Specialist nurses performed equally to the SHOs with regard to requesting the correct diagnostic tests, providing the correct preliminary diagnosis, and providing the correct treatment. A model of care using trained GUM nurses working within agreed protocols can provide comprehensive patient care for female patients that is equal to care provided by SHOs. Our results raise important issues regarding advanced GUM nursing education and training, protocol development, and accountability.

  17. CONTROLLING EMISSIONS FROM FUEL AND WASTE COMBUSTION

    EPA Science Inventory

    Control of emissions from combustion of fuels and wastes has been a traditional focus of air pollution regulations. Significant technology developments of the '50s and '60s have been refined into reliable chemical and physical process unit operations. In the U.S., acid rain legis...

  18. The Development of a Technical Conceptual Structure for the Concepts Possessed by Selected Quality Control Specialists. Report of a Research Project.

    ERIC Educational Resources Information Center

    Nee, John G.

    This project had as its specific objective the development and field testing of a procedure for identifying the structure of technical concepts possessed by a group of selected quality control specialists. The associative theory of verbal behavior served as the rationale by which conceptual structures depicted by graphical maps of technical…

  19. A randomized controlled evaluation of specialist nurse education following accident and emergency department attendance for acute asthma.

    PubMed

    Levy, M L; Robb, M; Allen, J; Doherty, C; Bland, J M; Winter, R J

    2000-09-01

    We investigated whether hospital-based specialist asthma nurses improved recognition and self-treatment of asthma episodes by patients followed up after attending accident and emergency departments (A&E) for asthma exacerbations. We carried out a randomized prospective controlled trial of adult asthma self-management, following a hospital outpatient nurse consultation in two outer-London District General Hospitals (secondary care centres). The study included 211 adults, over 18 years old (mean age 40 years) who attended for asthma in two accident and emergency departments over 13 months. One hundred and eight evaluable patients were randomized into the control group who continued with their usual medical treatment and were not offered any intervention during the study period. One hundred and three evaluable patients were randomized into the intervention group. They were offered three 6-weekly outpatient appointments with one of two specialist asthma nurses for a structured asthma consultation, after attendance at the accident and emergency department. Following assessment of their asthma treatment and control, the nurses advised patients, through the use of self-management-plans, how to recognize and manage uncontrolled asthma and when to seek medical assistance. Medication and inhaler device type were altered if necessary The primary outcome was patient reported self-management of asthma exacerbations for 6 months. Secondary outcomes were assessed at baseline, 3 months and 6 months. These included home peak flow and symptom diaries, structured telephone questionnaires and audit of general practitioner records to determine utilization of services (6 months before and after A&E). Data were analysed on an intention to treat basis by multiple and logistic regression. The intervention group increased their use of inhaled topical steroids in 31/61 (51%) vs. 15/70 (21%) attacks in controls (OR 3.91 CI 1.8-8.4, P<0.001) and their use of rescue medication in 54/61 (89

  20. Leptospira Exposure and Waste Pickers: A Case-Control Seroprevalence Study in Durango, Mexico

    PubMed Central

    Alvarado-Esquivel, Cosme; Hernandez-Tinoco, Jesus; Sanchez-Anguiano, Luis Francisco; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Guido-Arreola, Carlos Alberto

    2015-01-01

    Background Infection with Leptospira may occur by contact with Leptospira-infected animals. Waste pickers are in contact with rodents and dogs while picking in the garbage. Whether waste pickers are at risk for Leptospira infection is largely unknown. This study was aimed to determine the association of Leptospira IgG seroprevalence with the occupation of waste picking, and to determine the epidemiological characteristics of the waste pickers with Leptospira exposure. Methods Through a case-control study, we determined the seroprevalence of anti-Leptospira IgG antibodies in 90 waste pickers and 90 age- and gender-matched control subjects in Durango City, Mexico using an enzyme immunoassay. Data were analyzed by bivariate and multivariate analyses. Results The prevalence of anti-Leptospira IgG antibodies was similar in waste pickers (4/90: 4.4%) to that in control subjects (5/90: 5.6%) (P = 1.00). Bivariate analysis showed that Leptospira exposure in waste pickers was associated with increasing age (P = 0.009), no education (P = 0.008), and consumption of rat meat (P = 0.04). However, these associations were no longer found by multivariate analysis. Leptospira exposure in waste pickers was not associated with health status, duration in the activity, wearing hand gloves and facemasks, history of injuries with sharp material of the garbage, or contact with animals or soil. Conclusions This is the first study about Leptospira exposure in waste pickers. Results suggest that waste pickers are not at increasing risk for Leptospira exposure in Durango City, Mexico. Further research with a larger sample size to elucidate the association of Leptospira exposure with waste picking activity is needed. PMID:26124911

  1. Leptospira Exposure and Waste Pickers: A Case-Control Seroprevalence Study in Durango, Mexico.

    PubMed

    Alvarado-Esquivel, Cosme; Hernandez-Tinoco, Jesus; Sanchez-Anguiano, Luis Francisco; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Guido-Arreola, Carlos Alberto

    2015-08-01

    Infection with Leptospira may occur by contact with Leptospira-infected animals. Waste pickers are in contact with rodents and dogs while picking in the garbage. Whether waste pickers are at risk for Leptospira infection is largely unknown. This study was aimed to determine the association of Leptospira IgG seroprevalence with the occupation of waste picking, and to determine the epidemiological characteristics of the waste pickers with Leptospira exposure. Through a case-control study, we determined the seroprevalence of anti-Leptospira IgG antibodies in 90 waste pickers and 90 age- and gender-matched control subjects in Durango City, Mexico using an enzyme immunoassay. Data were analyzed by bivariate and multivariate analyses. The prevalence of anti-Leptospira IgG antibodies was similar in waste pickers (4/90: 4.4%) to that in control subjects (5/90: 5.6%) (P = 1.00). Bivariate analysis showed that Leptospira exposure in waste pickers was associated with increasing age (P = 0.009), no education (P = 0.008), and consumption of rat meat (P = 0.04). However, these associations were no longer found by multivariate analysis. Leptospira exposure in waste pickers was not associated with health status, duration in the activity, wearing hand gloves and facemasks, history of injuries with sharp material of the garbage, or contact with animals or soil. This is the first study about Leptospira exposure in waste pickers. Results suggest that waste pickers are not at increasing risk for Leptospira exposure in Durango City, Mexico. Further research with a larger sample size to elucidate the association of Leptospira exposure with waste picking activity is needed.

  2. 48 CFR 536.570-3 - Specialist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  3. Validation of enhanced stabilization of municipal solid waste under controlled leachate recirculation using FTIR and XRD.

    PubMed

    Sethi, Sapna; Kothiyal, N C; Nema, Arvind K

    2012-07-01

    Leachate recirculation at neutral PH accompanied with buffer/nutrients addition has been used successfully in earlier stabilization of municipal solid waste in bioreactor landfills. In the present study, efforts were made to enhance the stabilization rate of municipal solid waste (MSW) and organic solid waste (OSW) in simulated landfill bioreactors by controlling the pH of recirculated leachate towards slightly alkaline side in absence of additional buffer and nutrients addition. Enhanced stabilization in waste samples was monitored with the help of analytical tools like Fourier Transform Infrared Spectroscopy (FTIR) and X-Ray Diffraction (XRD). Predominance of bands assigned to inorganic compounds and comparatively lower intensities of bands for organic compounds in the FTIR spectra of waste samples degraded with leachate recirculation under controlled pH confirmed higher rate of biodegradation and mineralization of waste than the samples degraded without controlled leachate recirculation. XRD spectra also confirmed to a greater extent of mineralization in the waste samples degraded under leachate recirculation with controlled pH. Comparison of XRD spectra of two types of wastes pointed out higher degree of mineralization in organic solid waste as compared to municipal solid waste.

  4. Development of consistent hazard controls for DOE transuranic waste operations

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

    Woody, W.J.

    2007-07-01

    This paper describes the results of a re-engineering initiative undertaken with the Department of Energy's (DOE) Office of Environmental Management (EM) in order to standardize hazard analysis assumptions and methods and resulting safety controls applied to multiple transuranic (TRU) waste operations located across the United States. A wide range of safety controls are historically applied to transuranic waste operations, in spite of the fact that these operations have similar operational characteristics and hazard/accident potential. The re-engineering effort supported the development of a DOE technical standard with specific safety controls designated for accidents postulated during waste container retrieval, staging/storage, venting, onsitemore » movements, and characterization activities. Controls cover preventive and mitigative measures; include both hardware and specific administrative controls; and provide protection to the facility worker, onsite co-located workers and the general public located outside of facility boundaries. The Standard development involved participation from all major DOE sites conducting TRU waste operations. Both safety analysts and operations personnel contributed to the re-engineering effort. Acknowledgment is given in particular to the following individuals who formed a core working group: Brenda Hawks, (DOE Oak Ridge Office), Patrice McEahern (CWI-Idaho), Jofu Mishima (Consultant), Louis Restrepo (Omicron), Jay Mullis (DOE-ORO), Mike Hitchler (WSMS), John Menna (WSMS), Jackie East (WSMS), Terry Foppe (CTAC), Carla Mewhinney (WIPP-SNL), Stephie Jennings (WIPP-LANL), Michael Mikolanis (DOESRS), Kraig Wendt (BBWI-Idaho), Lee Roberts (Fluor Hanford), and Jim Blankenhorn (WSRC). Additional acknowledgment is given to Dae Chung (EM) and Ines Triay (EM) for leadership and management of the re-engineering effort. (authors)« less

  5. Invisible Roles of Doctoral Program Specialists

    ERIC Educational Resources Information Center

    Bachman, Eva Burns; Grady, Marilyn L.

    2016-01-01

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

  6. STS-88 Pilot Sturckow and Mission Specialist Currie arrive for launch

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Pilot Frederick W. 'Rick' Sturckow and Mission Specialist Nancy J. Currie walk across the landing strip at the Shuttle Landing Facility after exiting the T-38 jet aircraft behind them that brought them to KSC. They join other crew members Mission Commander Robert D. Cabana, Mission Specialist Jerry L. Ross, Mission Specialist James H. Newman and Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut, for pre-launch preparations for mission STS-88 aboard Space Shuttle Endeavour. The scheduled time of launch is 3:56 a.m. EST on Dec. 3 from Launch Pad 39A. The mission is the first U.S. launch for the International Space Station. Endeavour carries the Unity connecting module which the crew will be mating with the Russian- built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. Endeavour is expected to land at KSC at 10:17 p.m. on Monday, Dec. 14.

  7. Refrigeration and Cryogenics Specialist. J3ABR54530

    ERIC Educational Resources Information Center

    Air Force Training Command, Sheppard AFB, TX.

    This document package contains an Air Force course used to train refrigeration and cryogenics specialists. The course is organized in six blocks designed for group instruction. The blocks cover the following topics: electrical principles; fundamentals of tubing and piping; metering devices, motor controls, domestic and commercial refrigeration;…

  8. 40 CFR 266.202 - Definition of solid waste.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MANAGEMENT FACILITIES Military Munitions § 266.202 Definition of solid waste. (a) A military munition is not... personnel or explosives and munitions emergency response specialists (including training in proper destruction of unused propellant or other munitions); or (ii) Use in research, development, testing, and...

  9. 40 CFR 266.202 - Definition of solid waste.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MANAGEMENT FACILITIES Military Munitions § 266.202 Definition of solid waste. (a) A military munition is not... personnel or explosives and munitions emergency response specialists (including training in proper destruction of unused propellant or other munitions); or (ii) Use in research, development, testing, and...

  10. 40 CFR 266.202 - Definition of solid waste.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MANAGEMENT FACILITIES Military Munitions § 266.202 Definition of solid waste. (a) A military munition is not... personnel or explosives and munitions emergency response specialists (including training in proper destruction of unused propellant or other munitions); or (ii) Use in research, development, testing, and...

  11. Performance of air traffic control specialists (ATCS'S) on a laboratory radar monitoring task : an exploratory study of complacency and a comparison of ATCS and non-ATCS performance.

    DOT National Transportation Integrated Search

    1982-04-01

    The role of the air traffic control specialist (ATCS) is proposed highly automated air traffic systems of the future is currently receiving considerable attention. At the present time, a prevalent conception of the controller's role in such systems i...

  12. Pediatric Specialists

    MedlinePlus

    ... this site from a secured browser on the server. Please enable scripts and reload this page. Turn ... for Referral to Pediatric Surgical Specialists Sports Medicine Professionals What is a Child Abuse Pediatrician? What is ...

  13. MERCURY CONTROL IN MUNICIPAL WASTE COMBUSTORS AND COAL-FIRED UTILITIES

    EPA Science Inventory

    Control of mercury (Hg) emissions from municipal waste combustors (MWCs) and coal-fired utilities has attracted attention due to current and potential regulations. Among several techniques evaluated for Hg control, dry sorbent injection (primarily injection of activated carbon) h...

  14. Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

    PubMed

    Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

    2017-07-01

    Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

  15. Certification of School Media Specialists.

    ERIC Educational Resources Information Center

    Hawthorne, Dorothy, Ed.

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

  16. Clinical nurse specialists as entrepreneurs: constrained or liberated.

    PubMed

    Austin, Lynn; Luker, Karen; Roland, Martin; Ronald, Martin

    2006-12-01

    This qualitative study explored the experiences of two groups of clinical nurse specialists--continence advisors and tissue viability nurses--working in primary care in the UK. In particular, the study focused on how clinical nurse specialists' relationships with other health-care professionals had an impact on their role. Clinical nurse specialists are recognized worldwide as having expertise in a given field, which they use to develop the practice of others. Additionally, clinical nurse specialists share many of the characteristics of entrepreneurs, which they use to develop services related to their speciality. However, little research has been conducted in relation to clinical nurse specialists' experiences as they attempt to diversify nursing practice. An ethnographic approach was adopted comprising many elements of Glaserian grounded theory. Data were collected via participant observation and face-to-face interviews with 22 clinical nurse specialists. Services provided by clinical nurse specialists were not static, clinical nurse specialists being the main drivers for service developments. However, clinical nurse specialists encountered difficulties when introducing new ideas. Given their role as advisors, clinical nurse specialists lacked authority to bring about change and were dependent on a number of mechanisms to bring about change, including 'cultivating relationships' with more powerful others, most notably the speciality consultant. The UK government has pledged to 'liberate the talents of nurses' so that their skills can be used to progress patient services. This study highlights the fact that a lack of collaborative working practices between health-care professionals led to clinical nurse specialists being constrained. Health-care organizations need to provide an environment in which the entrepreneurial skills of clinical nurse specialists may be capitalized on. In the absence of an outlet for their ideas regarding service developments, clinical

  17. Relative costs of specialist services in a family practice population

    PubMed Central

    Norton, Peter G.; Nelson, Wendy; Rudner, Howard L.; Dunn, Earl V.

    1985-01-01

    The frequency and cost of referrals to specialists in March 1984 for 8980 rostered patients attending a family practice clinic located in a teaching hospital were analysed. The patients made 1891 visits to specialists. In all age groups and for all specialties female patients were more likely to be seen. The total direct provider costs were higher for female patients than for male patients. However, costs per patient seen were higher for male patients, except for psychiatry and medicine. Visits to surgeons had the highest total cost, while visits to psychiatrists had the highest cost per patient seen. Of the direct provider costs 61% was for specialist services. The family physician, in the “gatekeeper” role, has an opportunity to control some of the costs of the health care system by ensuring that the best and most efficient use is made of the referral network. PMID:4042059

  18. 14 CFR 1214.305 - Payload specialist responsibilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  19. 14 CFR 1214.305 - Payload specialist responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  20. 14 CFR 1214.305 - Payload specialist responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  1. 14 CFR 1214.305 - Payload specialist responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  2. 20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. ...

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

    20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. THE BUILDING 371/374 COMPLEX WAS DESIGNED TO EMPHASIZE AUTOMATICALLY CONTROLLED, REMOTELY OPERATED PROCESSES. (1/80) - Rocky Flats Plant, Plutonium Recovery Facility, Northwest portion of Rocky Flats Plant, Golden, Jefferson County, CO

  3. A typology of specialists' clinical roles.

    PubMed

    Forrest, Christopher B

    2009-06-08

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

  4. Guided graded exercise self-help plus specialist medical care versus specialist medical care alone for chronic fatigue syndrome (GETSET): a pragmatic randomised controlled trial.

    PubMed

    Clark, Lucy V; Pesola, Francesca; Thomas, Janice M; Vergara-Williamson, Mario; Beynon, Michelle; White, Peter D

    2017-07-22

    Graded exercise therapy is an effective and safe treatment for chronic fatigue syndrome, but it is therapist intensive and availability is limited. We aimed to test the efficacy and safety of graded exercise delivered as guided self-help. In this pragmatic randomised controlled trial, we recruited adult patients (18 years and older) who met the UK National Institute for Health and Care Excellence criteria for chronic fatigue syndrome from two secondary-care clinics in the UK. Patients were randomly assigned to receive specialist medical care (SMC) alone (control group) or SMC with additional guided graded exercise self-help (GES). Block randomisation (randomly varying block sizes) was done at the level of the individual with a computer-generated sequence and was stratified by centre, depression score, and severity of physical disability. Patients and physiotherapists were necessarily unmasked from intervention assignment; the statistician was masked from intervention assignment. SMC was delivered by specialist doctors but was not standardised; GES consisted of a self-help booklet describing a six-step graded exercise programme that would take roughly 12 weeks to complete, and up to four guidance sessions with a physiotherapist over 8 weeks (maximum 90 min in total). Primary outcomes were fatigue (measured by the Chalder Fatigue Questionnaire) and physical function (assessed by the Short Form-36 physical function subscale); both were self-rated by patients at 12 weeks after randomisation and analysed in all randomised patients with outcome data at follow-up (ie, by modified intention to treat). We recorded adverse events, including serious adverse reactions to trial interventions. We used multiple linear regression analysis to compare SMC with GES, adjusting for baseline and stratification factors. This trial is registered at ISRCTN, number ISRCTN22975026. Between May 15, 2012, and Dec 24, 2014, we recruited 211 eligible patients, of whom 107 were assigned to the

  5. Making Generalists Out of Specialists.

    ERIC Educational Resources Information Center

    Malinowski, Jon C.

    2001-01-01

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

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

    PubMed

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

    2014-01-01

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

  7. Elementary Reading Specialists' Perspectives towards Their Work

    ERIC Educational Resources Information Center

    Bunker, Wendy Woods

    2017-01-01

    The purpose of this qualitative interview study was to explore the narratives of 22 elementary reading specialists about their work. It asked: What were reading specialists' narratives about their work and their influences? The study looked at reading specialists' day-to-day functioning within an institution and at reading specialists'…

  8. Developing the Librarians' Role in Supporting Grant Applications and Reducing Waste in Research: Outcomes from a Literature Review and Survey in the NIHR Research Design Service

    ERIC Educational Resources Information Center

    Edmunds Otter, Mary L.; Wright, Judy M.; King, Natalie V.

    2017-01-01

    Librarians and information specialists' involvement during the development of grant applications for external funding can save researchers' time, provide specialist support, and contribute to reducing avoidable waste in research. This article presents a survey of information specialists working for the National Institute for Health Research's…

  9. Specialist clinics: a better way to care?

    PubMed Central

    Mutch, W J

    1992-01-01

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

  10. Current biomedical waste management practices and cross-infection control procedures of dentists in India.

    PubMed

    Singh, Balendra Pratap; Khan, Suleman A; Agrawal, Neeraj; Siddharth, Ramashanker; Kumar, Lakshya

    2012-06-01

    To investigate the knowledge, attitudes and behaviour of dentists working in dental clinics and dental hospitals regarding biomedical waste management and cross-infection control. A national survey was conducted. Self-administered questionnaires were sent to 800 dentists across India. A total of 494 dentists responded, giving a response rate of 61.8%. Of these, 228 of 323 (70.6%) general dentists reported using boiling water as a sterilising medium and 339 (68.6%) dentists reported disposing of hazardous waste such as syringes, blades and ampoules in dustbins and emptying these into municipal corporation bins. Dentists should undergo continuing education programmes on biomedical waste management and infection control guidelines. Greater cooperation between dental clinics and hospitals and pollution control boards is needed to ensure the proper handling and disposal of biomedical waste. © 2012 FDI World Dental Federation.

  11. Randomised controlled trial of specialist nurse intervention in heart failure

    PubMed Central

    Blue, Lynda; Lang, Elanor; McMurray, John J V; Davie, Andrew P; McDonagh, Theresa A; Murdoch, David R; Petrie, Mark C; Connolly, Eugene; Norrie, John; Round, Caroline E; Ford, Ian; Morrison, Caroline E

    2001-01-01

    Objectives To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure. Design Randomised controlled trial. Setting Acute medical admissions unit in a teaching hospital. Participants 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year. Main outcome measures Time to first event analysis of death from all causes or readmission to hospital with worsening heart failure. Results 31 patients (37%) in the intervention group died or were readmitted with heart failure compared with 45 (53%) in the usual care group (hazard ratio=0.61, 95% confidence interval 0.33 to 0.96).Compared with usual care, patients in the intervention group had fewer readmissions for any reason (86 v 114, P=0.018), fewer admissions for heart failure (19 v 45, P<0.001) and spent fewer days in hospital for heart failure (mean 3.43 v 7.46 days, P=0.0051). Conclusions Specially trained nurses can improve the outcome of patients admitted to hospital with heart failure. What is already known on this topicStudies have suggested that nurse intervention may reduce readmission in patients with heart failureWhat this study addsHome based intervention from nurses reduces readmissions for worsening heart failureRegular contact to review treatment and patient education are likely to contribute to this effect PMID:11576977

  12. Randomized, single-blind, controlled trial of a specialist behavior therapy team for challenging behavior in adults with intellectual disabilities.

    PubMed

    Hassiotis, Angela; Robotham, Dan; Canagasabey, Anton; Romeo, Renee; Langridge, Diane; Blizard, Robert; Murad, Shahed; King, Michael

    2009-11-01

    Community-based specialist behavior therapy teams may be helpful in managing challenging behavior, but evidence of their effectiveness is limited. This study was designed to examine the effectiveness and costs associated with treatment by a specialist behavior therapy team. This was a parallel-group, randomized, single-blind controlled trial carried out in an intellectual disabilities service in England. Participants were 63 male and female service users with mild to severe intellectual disability who presented with challenging behavior. The interventions were standard treatment plus applied behavioral analysis (N=32) and standard treatment only (N=31). The primary outcome measure was challenging behavior, as measured by total and subscale scores on the Aberrant Behavior Checklist 3 and 6 months after randomization. Secondary outcome measures were psychiatric comorbidity assessed at 3 and 6 months using the Psychiatric Assessment Schedule for Adults With a Developmental Disability Checklist (PAS-ADD) and total costs recorded at 6 months. Multilevel modeling was used to compare square root transformations of Aberrant Behavior Checklist scores. Significant differences were found in the transformed total scores on the Aberrant Behavior Checklist (difference=-0.89, 95% CI=-1.74 to -0.04) and transformed lethargy and hyperactivity subscale scores (common intervention effect=-0.56, 95% CI=-0.97 to -0.15). Standard care participants fared worse on the PAS-ADD comorbid organic disorder subscale. There was a clear trend for lower overall costs of the intervention. Use of a specialist behavior therapy team in addition to standard treatment appears to be more effective in improving challenging behavior and may have financial advantages over standard treatment.

  13. Cognition and aging in a complex work environment: relationships with performance among air traffic control specialists.

    PubMed

    Becker, J T; Milke, R M

    1998-10-01

    Chronological age affects the performance of demanding cognitive tasks within the aviation environment. Within the domain of air traffic control (ATC), the ability to handle simultaneous visual and auditory input, or to return to a task after a break to complete another task, is critical to success and is the sort of cognitive function most affected by age. The limited available data suggest a strong relationship between age and job performance among ATC specialists, whether measured at the time of entry into the system or during the working lifetime of a full-performance-level controller. An analysis of the distribution of the ages of controllers currently in the system, and a projection for the years 2001 and 2006, leads to the conclusion that a high proportion of the ATC work force will be at risk for displaying age-related changes in job performance efficiency over the next 10 yr. It seems important, therefore, to determine the nature and extent of the age-related cognitive changes that can occur during the lifespan of a controller (i.e., 25-55 yr of age) and how these changes may affect job performance. The results of such an analysis should aid in the design and implementation of new control systems to minimize any deleterious effects of aging on performance.

  14. Underwater characterization of control rods for waste disposal using SMOPY

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

    Gallozzi-Ulmann, A.; Couturier, P.; Amgarou, K.

    Storage of spent fuel assemblies in cooling ponds requires careful control of the geometry and proximity of adjacent assemblies. Measurement of the fuel burnup makes it possible to optimise the storage arrangement of assemblies taking into account the effect of the burnup on the criticality safety margins ('burnup credit'). Canberra has developed a measurement system for underwater measurement of spent fuel assemblies. This system, known as 'SMOPY', performs burnup measurements based on gamma spectroscopy (collimated CZT detector) and neutron counting (fission chamber). The SMOPY system offers a robust and waterproof detection system as well as the needed capability of performingmore » radiometric measurements in the harsh high dose - rate environments of the cooling ponds. The gamma spectroscopy functionality allows powerful characterization measurements to be performed, in addition to burnup measurement. Canberra has recently performed waste characterisation measurements at a Nuclear Power Plant. Waste activity assessment is important to control costs and risks of shipment and storage, to ensure that the activity level remains in the range allowed by the facility, and to declare activity data to authorities. This paper describes the methodology used for the SMOPY measurements and some preliminary results of a radiological characterisation of AIC control rods. After describing the features and normal operation of the SMOPY system, we describe the approach used for establishing an optimum control rod geometric scanning approach (optimum count time and speed) and the method of the gamma spectrometry measurements as well as neutron check measurements used to verify the absence of neutron sources in the waste. We discuss the results obtained including {sup 60}Co, {sup 110m}Ag and {sup 108m}Ag activity profiles (along the length of the control rods) and neutron results including Total Measurement Uncertainty evaluations. Full self-consistency checks were performed

  15. What Is an Adolescent Health Specialist?

    MedlinePlus

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

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

    PubMed

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

    2017-07-01

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

  17. Outcomes of a four-year specialist-taught physical education program on physical activity: a cluster randomized controlled trial, the LOOK study.

    PubMed

    Telford, Rohan M; Olive, Lisa S; Cochrane, Thomas; Davey, Rachel; Telford, Richard D

    2016-06-08

    The objective of this study was to investigate the effect of a 4-year specialist-taught Physical Education (PE) program on physical activity (PA) among primary school children. A 4-year cluster randomised controlled trial was conducted in children (initially aged 8 years) from 29 primary schools (13 Intervention, 16 Control). Intervention students (N = 457) received 2 × 45 min PE lessons per week from specialist-trained PE teachers (68 lessons per year, 272 lessons over 4 years). Control group students (N = 396) received usual practice PE from generalist classroom teachers. PA during PE lessons was examined using the System for Observing Fitness Instruction Time (SOFIT). Pedometers (steps/day) were worn for 7 days each year, and accelerometers were worn concurrently in the final two years to assess moderate to vigorous (MVPA) and sedentary activity. Linear and generalized mixed models were used to determine differences in Intervention and Control student PA and the proportion of students meeting PA guidelines. The intervention increased SOFIT-observed student MVPA during PE lessons by 6.5 mins (16.7 v 10.2, p < 0.001). Within intervention schools, participants increased their whole-day step counts (boys = 449 [CI,140 to 756]; girls = 424 [CI,222 to 626]) and minutes of MVPA (boys = 8.0 [CI,6.8 to 9.2]; girls = 3.5 [CI,1.7 to 5.4]) on PE days. However, compared to the Control group the Intervention did not: increase habitual steps/day or MVPA when averaged over 7 days; elicit greater improvements in these measures over time; or increase the odds of meeting step/day or MVPA recommendations. At age 11 years Intervention group boys were 20 mins less sedentary per day (380 [CI,369 to 391] vs 360 [CI,350 to 369]) and this effect was sustained at age 12 years. Well-designed specialist-taught PE can improve student PA during PE lessons. However for PE to be a significant contributor to improving habitual PA in pre-adolescent children, daily

  18. 78 FR 23548 - Draft Supplemental Environmental Impact Statement for the Long-Term Management and Storage of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-19

    ... Control Specialists, LLC, site near Andrews, Texas. Since publication of the 2011 Mercury Storage EIS, DOE... identified the Waste Control Specialists, LLC location near Andrews, Texas, as the Preferred Alternative in...

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

    PubMed Central

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

    2011-01-01

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

  20. Attitudes regarding specialist referrals in periodontics.

    PubMed

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

    2007-02-24

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

  1. 78 FR 42776 - Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL9834-8] Underground Injection Control Program; Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection; Blanchard Refining... migration petition reissuance. SUMMARY: Notice is hereby given that a reissuance of an exemption to the land...

  2. Gravity packaging final waste recovery based on gravity separation and chemical imaging control.

    PubMed

    Bonifazi, Giuseppe; Serranti, Silvia; Potenza, Fabio; Luciani, Valentina; Di Maio, Francesco

    2017-02-01

    Plastic polymers are characterized by a high calorific value. Post-consumer plastic waste can be thus considered, in many cases, as a typical secondary solid fuels according to the European Commission directive on End of Waste (EoW). In Europe the practice of incineration is considered one of the solutions for waste disposal waste, for energy recovery and, as a consequence, for the reduction of waste sent to landfill. A full characterization of these products represents the first step to profitably and correctly utilize them. Several techniques have been investigated in this paper in order to separate and characterize post-consumer plastic packaging waste fulfilling the previous goals, that is: gravity separation (i.e. Reflux Classifier), FT-IR spectroscopy, NIR HyperSpectralImaging (HSI) based techniques and calorimetric test. The study demonstrated as the proposed separation technique and the HyperSpectral NIR Imaging approach allow to separate and recognize the different polymers (i.e. PolyVinyl Chloride (PVC), PolyStyrene (PS), PolyEthylene (PE), PoliEtilene Tereftalato (PET), PolyPropylene (PP)) in order to maximize the removal of the PVC fraction from plastic waste and to perform the full quality control of the resulting products, can be profitably utilized to set up analytical/control strategies finalized to obtain a low content of PVC in the final Solid Recovered Fuel (SRF), thus enhancing SRF quality, increasing its value and reducing the "final waste". Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Regulatory control of low level radioactive waste in Taiwan

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

    Liu, T.D.S.; Chiou, Syh-Tsong

    1996-12-31

    The commercial operation of Chinshan Nuclear Power Plant (NPP) Unit One marked the beginning of Taiwan`s nuclear power program. There are now three NPPs, each consisting of two units, in operation. This represents a generating capacity of 5,144 MWe. Nuclear power plants are sharing some 30 percent of electricity supplies in Taiwan. As far as low level radwaste (LLRW) is concerned, Taiwan Power Company (TPC) is the principal producer, contributing more than 90 percent of total volume of waste arising in Taiwan. Small producers, other than nuclear industries, medicine, research institutes, and universities, are responsible for the remaining 10 percent.more » In the paper, the LLRW management policy, organizational scheme, regulatory control over waste treatment, storage, transportation and disposal are addressed. Added to the paper in the last is how this country is managing its Naturally Occurring Radioactive Materials (NORM) waste.« less

  4. Simulation-Based Assessment of ECMO Clinical Specialists.

    PubMed

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

    2016-06-01

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

  5. 75 FR 60457 - Underground Injection Control Program Hazardous Waste Injection Restrictions; Petition for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ... ENVIRONMENTAL PROTECTION AGENCY [FRL-9208-4] Underground Injection Control Program Hazardous Waste Injection Restrictions; Petition for Exemption--Class I Hazardous Waste Injection Dow Chemical Company (DOW... Petition. SUMMARY: Notice is hereby given that an exemption to the land disposal restrictions under the...

  6. Information specialist for a coming age (1)

    NASA Astrophysics Data System (ADS)

    Fujii, Kunihiko

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

  7. 14 CFR 1214.812 - Payload specialists.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  8. 14 CFR 1214.812 - Payload specialists.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  9. 14 CFR 1214.812 - Payload specialists.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  10. 14 CFR 1214.812 - Payload specialists.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

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

    PubMed

    Arab, Alberto; Trigo, José Roberto

    2011-05-01

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

  12. ATTITUDE OF CLEFT CARE SPECIALISTS IN AFRICA TOWARDS PRESURGICAL ORTHOPAEDICS.

    PubMed

    Adeyemi, A T; Bankole, O O

    2012-12-01

    To determine the attitude of cleft care specialists working in Africa towards pre-surgical orthopaedics. A cross sectional study. Pan-African conference on cleft lip and palate in Nigeria. Sixty cleft care specialists working in Africa. The general attitude towards pre-surgicalorthopaedics was positive. Majority of the specialists employ pre-surgical orthopaedics before surgical repair. Fifty four (91%) of the specialists use plaster strapping for cases of bilateral cleft, five (8.3%) use nasoalveolar molding and one (2%) use feeding plate. Half of the specialists (50%) felt that pre-surgical orthopaedics is to be managed by orthodontists alone. There were significant difference in attitude towards pre-surgical orthopaedics between providers (p < 0.05). Orthodontists had a strong positive attitude towards pre-surgical orthopaedics than other specialists. Younger specialists had a more positive attitude towards pre-surgical orthopaedics than older specialists. Cleft care specialists in Africa have a positive attitude towards pre-surgical orthopaedics. Majority of them use plaster strapping technique. Younger specialists have a more favorable attitude towards pre-surgical orthopaedics than older specialists.

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

    PubMed Central

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

    2017-01-01

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

  14. Are peer specialists happy on the job?

    PubMed

    Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina

    2018-03-01

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

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

    PubMed Central

    Kusurkar, Rashmi A.; Croiset, Gerda; Peerdeman, Saskia M.

    2018-01-01

    Objectives The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. Methods A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Results Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists’ motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one’s planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists’ motivation. Regarding the design of the study, we found that situational motivation is indeed observable. Conclusions The basic psychological needs autonomy, competence, and relatedness are important for specialists’ motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research. PMID:29485972

  16. Behavior medicine specialist.

    PubMed

    Tuso, Phillip

    2014-01-01

    Total Health is a vision for the future and a strategy to prevent preventable disease, save lives, and make health care more affordable. Total Health means health of mind (behavior health) and health of body (physical health). To achieve Total Health we need healthy people in healthy communities. A behavior medicine specialist is a psychologist who works in the medical home with the primary care physician instead of in the Mental Health Department with a psychiatrist. The key to achieving Total Health will be to transform our current health care system from a focus on treating disease to a focus on preventing disease. This transformation will require complex behavior change interventions and services not usually provided in the medical home. The behavior medicine specialist will bring the knowledge and experience used to treat mental illness into the medical home to help the primary care physician improve the care of all patients in the medical home. The behavior medicine specialist will help improve outcomes in synergy with the primary care physician by universal screening of high-risk diseases, stepped care protocols, and efficient use of all resources available to care for patients in the medical home (health education classes, wellness coaches, and online social networking lifestyle management programs). These interventions should increase patient satisfaction, increase access to specialty care (psychiatry), and help us achieve Total Health.

  17. Telecommunications Specialist.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This publication contains 17 subjects appropriate for use in a competency list for the occupation of telecommunications specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 17 units are as…

  18. Learning Opportunities for Library Media Specialists

    ERIC Educational Resources Information Center

    Newton, Jennifer W.

    2008-01-01

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

  19. Brazilian infectious diseases specialists: who and where are they?

    PubMed

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

    2016-01-01

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

  20. STS-46 ESA MS Nicollier conducts IFM on OV-104's waste collection system

    NASA Technical Reports Server (NTRS)

    1992-01-01

    STS-46 European Space Agency (ESA) Mission Specialist (MS) Claude Nicollier, wearing goggles, face mask, and rubber gloves, reviews inflight maintenance (IFM) checklist procedures before starting waste collection system (WCS) fan separator repair. One of two fan separators used to transfer waster water from the waste management compartment (WMC) to the waste water tank has failed. The suspected accumulation of water in the separator was believed to have occurred during a test dumping of waste water at a lower than normal pressure to evaluate the performance of new nozzles. The WMC is located on the middeck of Atlantis, Orbiter Vehicle (OV) 104.

  1. 14 CFR § 1214.305 - Payload specialist responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  2. Accounting Specialist.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This publication identifies 20 subjects appropriate for use in a competency list for the occupation of accounting specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 20 units are as follows:…

  3. Guidelines for Certification of Media Specialists.

    ERIC Educational Resources Information Center

    Galey, Minaruth; Grady, William F.

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

  4. Preferential edge habitat colonization by a specialist weevil, Rhinoncomimus latipes (Coleoptera: Curculionidae)

    Treesearch

    J.A. Hough-Goldstein; E. Lake; V. D' Amico; S.H. Berg

    2012-01-01

    Understanding the behavioral basis of dispersal and colonization is critical in biological control systems, where success of a natural enemy depends in part on its ability to find and move to new host patches. We studied behavior of the specialist weevil Rhinoncomimus latipes Korotyaev, a biological control agent of mile-a-minute weed, ...

  5. Waste Controls at Base Metal Mines

    ERIC Educational Resources Information Center

    Bell, Alan V.

    1976-01-01

    Mining and milling of copper, lead, zinc and nickel in Canada involves an accumulation of a half-million tons of waste material each day and requires 250 million gallons of process water daily. Waste management considerations for handling large volumes of wastes in an economically and environmentally safe manner are discussed. (BT)

  6. Extending specialist palliative care to all?

    PubMed

    Field, D; Addington-Hall, J

    1999-05-01

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

  7. Cost-Effectiveness of a Specialist Geriatric Medical Intervention for Frail Older People Discharged from Acute Medical Units: Economic Evaluation in a Two-Centre Randomised Controlled Trial (AMIGOS).

    PubMed

    Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Edmans, Judi; Conroy, Simon; Bradshaw, Lucy E; Gladman, John R F; Elliott, Rachel A

    2015-01-01

    Poor outcomes and high resource-use are observed for frail older people discharged from acute medical units. A specialist geriatric medical intervention, to facilitate Comprehensive Geriatric Assessment, was developed to reduce the incidence of adverse outcomes and associated high resource-use in this group in the post-discharge period. To examine the costs and cost-effectiveness of a specialist geriatric medical intervention for frail older people in the 90 days following discharge from an acute medical unit, compared with standard care. Economic evaluation was conducted alongside a two-centre randomised controlled trial (AMIGOS). 433 patients (aged 70 or over) at risk of future health problems, discharged from acute medical units within 72 hours of attending hospital, were recruited in two general hospitals in Nottingham and Leicester, UK. Participants were randomised to the intervention, comprising geriatrician assessment in acute units and further specialist management, or to control where patients received no additional intervention over and above standard care. Primary outcome was incremental cost per quality adjusted life year (QALY) gained. We undertook cost-effectiveness analysis for 417 patients (intervention: 205). The difference in mean adjusted QALYs gained between groups at 3 months was -0.001 (95% confidence interval [CI]: -0.009, 0.007). Total adjusted secondary and social care costs, including direct costs of the intervention, at 3 months were £4412 (€5624, $6878) and £4110 (€5239, $6408) for the intervention and standard care groups, the incremental cost was £302 (95% CI: 193, 410) [€385, $471]. The intervention was dominated by standard care with probability of 62%, and with 0% probability of cost-effectiveness (at £20,000/QALY threshold). The specialist geriatric medical intervention for frail older people discharged from acute medical unit was not cost-effective. Further research on designing effective and cost-effective specialist

  8. Generation of and control measures for, e-waste in Hong Kong

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

    Chung Shanshan, E-mail: sschung@hkbu.edu.hk; Lau Kayan; Zhang Chan

    2011-03-15

    While accurately estimating electrical and electronic waste (e-waste) generation is important for building appropriate infrastructure for its collection and recycling, making reliable estimates of this kind is difficult in Hong Kong owing to the fact that neither accurate trade statistics nor sales data of relevant products are available. In view of this, data of e-products consumption at household level was collected by a tailor-made questionnaire survey from the public for obtaining a reasonable e-waste generation estimate. It was estimated that on average no more than 80,443 tonnes (11.5 kg/capita) of waste is generated from non-plasma and non-liquid crystal display televisions,more » refrigerators, washing machines, air-conditioners and personal computers each year by Hong Kong households. However, not more than 17% of this is disposed as waste despite a producer responsibility scheme (PRS) not being in place because of the existence of a vibrant e-waste trading sector. The form of PRS control that can possibly win most public support is one that would involve the current e-waste traders as a major party in providing the reverse logistics with a visible recycling charge levied at the point of importation. This reverse logistic service should be convenient, reliable and highly accessible to the consumers.« less

  9. Generation of and control measures for, e-waste in Hong Kong.

    PubMed

    Chung, Shan-shan; Lau, Ka-yan; Zhang, Chan

    2011-03-01

    While accurately estimating electrical and electronic waste (e-waste) generation is important for building appropriate infrastructure for its collection and recycling, making reliable estimates of this kind is difficult in Hong Kong owing to the fact that neither accurate trade statistics nor sales data of relevant products are available. In view of this, data of e-products consumption at household level was collected by a tailor-made questionnaire survey from the public for obtaining a reasonable e-waste generation estimate. It was estimated that on average no more than 80,443 tones (11.5 kg/capita) of waste is generated from non-plasma and non-liquid crystal display televisions, refrigerators, washing machines, air-conditioners and personal computers each year by Hong Kong households. However, not more than 17% of this is disposed as waste despite a producer responsibility scheme (PRS) not being in place because of the existence of a vibrant e-waste trading sector. The form of PRS control that can possibly win most public support is one that would involve the current e-waste traders as a major party in providing the reverse logistics with a visible recycling charge levied at the point of importation. This reverse logistic service should be convenient, reliable and highly accessible to the consumers. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. 42 CFR 410.76 - Clinical nurse specialists' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  11. Burnout control at the Albright coal-waste-bank fire. Rept. of investigations/1991

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

    Chaiken, R.F.; Bayles, L.G.

    1991-01-01

    Burnout Control is a process developed by the U.S. Bureau of Mines for accelerating the burning of wasted coal fires in situ, while at the same time controlling the heat and fumes produced. The Albright fire project is a first field trial of Burnout Control as applied to a coal waste bank. An exhaust ventilation system was designed and constructed and then operated over a 1-year period at the site of an existing abandoned mine land fire near the town of Albright, W.V. While predicted exhaust gas temperatures of 900 C and thermal power levels of 5 MW were achievedmore » at 20- to 30-in H2O vacuum levels, problems were encountered with engineering designs, equipment breakdown, and fuel-rich combustion that curtailed the time period of satisfactory operation. Effective afterburning of the exhaust gases (as they were drawn from the bank) corrected the problems associated with combustion stoichiometry and led to high thermal outputs. It is believed that with (1) improvements in engineering design and construction, (2) better control of the afterburning process, and (3) the use of conventional stack gas air-pollution controls, Burnout Control can be applied successfully to a coal waste bank fire.« less

  12. Waste-to-energy plants face costly emissions-control upgrades

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

    McIlvaine, R.W.

    1995-06-01

    One treatment method of municipal solid waste, incineration, has fallen in and out of public favor. In the 1970s, emerging consciousness of the threat to groundwater posed by leaking landfills made incineration an attractive option. Prompted by disrupted energy supplies and steeply rising prices, more than 100 municipalities began to generate electricity from the heat produced by burning trash. In the 1990s, the pendulum of public enthusiasm has swung away from incineration. Energy prices have declined dramatically, and safety and siting concerns complicate new projects. A recent Supreme Court decision ruled that municipal incinerator ash must be tested as hazardousmore » waste and disposed accordingly if levels of such pollutants as cadmium and lead exceed Resource Conservation and Recovery Act limits. So-called flow control regulations, which allowed municipalities to apportion garbage disposal to ensure steady supplies to incinerators, also have been struck down. EPA is tackling the issue of air emissions from waste-to-energy and non-energy-producing municipal waste combustors. Emissions guidelines for MWCs and new-source performance standards for new units, proposed Sept. 20 under Sec. 129 of the Clean Air Act Amendments of 1990, are the culmination of a stalled and litigated initiative dating back to the CAA Amendments of 1977.« less

  13. Commissioning of specialist palliative care services in England.

    PubMed

    Lancaster, Harriet; Finlay, Ilora; Downman, Maxwell; Dumas, James

    2018-03-01

    Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services. 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services. The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Electric controlled air incinerator for radioactive wastes

    DOEpatents

    Warren, Jeffery H.; Hootman, Harry E.

    1981-01-01

    A two-stage incinerator is provided which includes a primary combustion chamber and an afterburner chamber for off-gases. The latter is formed by a plurality of vertical tubes in combination with associated manifolds which connect the tubes together to form a continuous tortuous path. Electrically-controlled heaters surround the tubes while electrically-controlled plate heaters heat the manifolds. A gravity-type ash removal system is located at the bottom of the first afterburner tube while an air mixer is disposed in that same tube just above the outlet from the primary chamber. A ram injector in combination with rotary magazine feeds waste to a horizontal tube forming the primary combustion chamber.

  15. Valorizing waste iron powder in biogas production: Hydrogen sulfide control and process performances.

    PubMed

    Andriamanohiarisoamanana, Fetra J; Shirai, Tomoya; Yamashiro, Takaki; Yasui, Seiichi; Iwasaki, Masahiro; Ihara, Ikko; Nishida, Takehiro; Tangtaweewipat, Suchon; Umetsu, Kazutaka

    2018-02-15

    Biogas is composed of different gases including hydrogen sulfide (H 2 S), which is a hazardous gas that damages pipes and generators in anaerobic digestion system. The objective of this study was to control H 2 S by waste iron powder produced by laser cutting machine in a steel and iron industry. Waste iron powder was mixed with dairy manure at a concentration between 2.0 and 20.0 g/L in batch experiments, while the concentration was varied between 1.0 and 4.0 g/L in bench experiment. In batch experiment, a reduction of up to 93% of H 2 S was observed at waste iron powder of 2.0 g/L (T1), while the reduction was of more than 99% at waste iron powder beyond 8.0 g/L (T4 ∼ T6). The total sulfide concentration (S T ) increased together with waste iron powder concentration and was fitted with a quadratic equation with a maximum S T of 208.0 mg/L at waste iron powder of 20.2 g/L. Waste iron powder did not have significant effect on methane yield in batch and bench experiments. However, hydrolysis rate constant was increased by almost 100%, while the lag-phase period was reduced to half in test digesters compared to that in control digester. In bench experiment, H 2 S concentration was reduced by 89% at 2.0 g/L, while 50% at 1.0 g/L. Therefore, waste iron powder was effectively removed H 2 S and did not affect negatively anaerobic digestion process. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Organizing uninsured safety-net access to specialist physician services.

    PubMed

    Hall, Mark A

    2013-05-01

    Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.

  17. Preparing Elementary Mathematics-Science Teaching Specialists.

    ERIC Educational Resources Information Center

    Miller, L. Diane

    1992-01-01

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

  18. Thermal stress control using waste steel fibers in massive concretes

    NASA Astrophysics Data System (ADS)

    Sarabi, Sahar; Bakhshi, Hossein; Sarkardeh, Hamed; Nikoo, Hamed Safaye

    2017-11-01

    One of the important subjects in massive concrete structures is the control of the generated heat of hydration and consequently the potential of cracking due to the thermal stress expansion. In the present study, using the waste turnery steel fibers in the massive concretes, the amount of used cement was reduced without changing the compressive strength. By substituting a part of the cement with waste steel fibers, the costs and the generated hydration heat were reduced and the tensile strength was increased. The results showed that by using 0.5% turnery waste steel fibers and consequently, reducing to 32% the cement content, the hydration heat reduced to 23.4% without changing the compressive strength. Moreover, the maximum heat gradient reduced from 18.5% in the plain concrete sample to 12% in the fiber-reinforced concrete sample.

  19. STS-120 Mission Specialist Scott Parazynski Repairs ISS Solar Array

    NASA Technical Reports Server (NTRS)

    2007-01-01

    While anchored to a foot restraint on the end of the Orbiter Boom Sensor System (OBSS), astronaut Scott Parazynski, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, Parazynski cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Astronaut Doug Wheelock (out of frame), mission specialist, assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

  20. STS-120 Mission Specialist Scott Parazynski Repairs ISS Solar Array

    NASA Technical Reports Server (NTRS)

    2006-01-01

    While anchored to a foot restraint on the end of the Orbiter Boom Sensor System (OBSS), astronaut Scott Parazynski, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, Parazynski cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Astronaut Doug Wheelock (out of frame), mission specialist, assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

  1. CONTROL OF PCDD/PCDF EMISSIONS FROM MUNICIPAL WASTE COMBUSTION SYSTEMS

    EPA Science Inventory

    The article gives results of tests on five modern municipal waste combustors (MWCs) to characterize or determine the performance of representative combustor types and associated air emission control systems in the regulatory development process. Test results for uncontrolled (com...

  2. STS-107 Mission Specialist Laurel Clark at SPACEHAB

    NASA Technical Reports Server (NTRS)

    2000-01-01

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

  3. [New business model for medical specialists].

    PubMed

    Houwen, L G H J Louis

    2013-01-01

    The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

  4. STS-55 crewmembers repair waste water tank under OV-102's middeck subfloor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    STS-55 Pilot Terence T. Henricks uses a spotlight and pen to point out a possible problem area on a waste water tank in the bilge area below Columbia's, Orbiter Vehicle (OV) 102's, middeck. Mission Specialist 1 (MS1) and Payload Commander (PLC) Jerry L. Ross records the activity with a video camcorder. The crewmembers are participating in an inflight maintenance (IFM) exercise to counter problems experienced with the waste water tank.

  5. Energy aspects of solid waste management: Proceedings

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

    Not Available

    1990-12-31

    The Eighteenth Annual Illinois Energy Conference entitled ``Energy Aspects of Solid Waste Management`` was held in Chicago, Illinois on October 29--30, 1990. The conference program was developed by a planning committee that drew upon Illinois energy and environmental specialists from the major sectors including energy industries, environmental organizations, research universities, utility companies, federal, state and local government agencies, and public interest groups. Within this framework, the committee identified a number of key topic areas surrounding solid waste management in Illinois which were the focus of the conference. These issues included: review of the main components of the solid waste cyclemore » in the Midwest and what the relative impact of waste reduction, recycling, incineration and land disposal might be on Illinois` and the Midwest`s solid waste management program. Investigation of special programs in the Midwest dealing with sewage sludge, combustion residuals and medical/infectious wastes. Review of the status of existing landfills in Illinois and the Midwest and an examination of the current plans for siting of new land disposal systems. Review of the status of incinerators and waste-to-energy systems in Illinois and the Midwest, as well as an update on activities to maximize methane production from landfills in the Midwest.« less

  6. Energy aspects of solid waste management: Proceedings

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

    Not Available

    1990-01-01

    The Eighteenth Annual Illinois Energy Conference entitled Energy Aspects of Solid Waste Management'' was held in Chicago, Illinois on October 29--30, 1990. The conference program was developed by a planning committee that drew upon Illinois energy and environmental specialists from the major sectors including energy industries, environmental organizations, research universities, utility companies, federal, state and local government agencies, and public interest groups. Within this framework, the committee identified a number of key topic areas surrounding solid waste management in Illinois which were the focus of the conference. These issues included: review of the main components of the solid waste cyclemore » in the Midwest and what the relative impact of waste reduction, recycling, incineration and land disposal might be on Illinois' and the Midwest's solid waste management program. Investigation of special programs in the Midwest dealing with sewage sludge, combustion residuals and medical/infectious wastes. Review of the status of existing landfills in Illinois and the Midwest and an examination of the current plans for siting of new land disposal systems. Review of the status of incinerators and waste-to-energy systems in Illinois and the Midwest, as well as an update on activities to maximize methane production from landfills in the Midwest.« less

  7. Remote mission specialist - A study in real-time, adaptive planning

    NASA Technical Reports Server (NTRS)

    Rokey, Mark J.

    1990-01-01

    A high-level planning architecture for robotic operations is presented. The remote mission specialist integrates high-level directives with low-level primitives executable by a run-time controller for command of autonomous servicing activities. The planner has been designed to address such issues as adaptive plan generation, real-time performance, and operator intervention.

  8. Media Specialist's Corner.

    ERIC Educational Resources Information Center

    Parrini, Michelle; Kittlaus, Jennifer

    2002-01-01

    Presents an annotated bibliography of resources for students, teachers, and school library media specialists related to the topic, "Youth, Rights, and the Constitution," found in this issue of "Insights on Law and Society." Includes books and primary sources for students. (CMK)

  9. An audit of management of differentiated thyroid cancer in specialist and non-specialist clinic settings.

    PubMed

    Kumar, H; Daykin, J; Holder, R; Watkinson, J C; Sheppard, M C; Franklyn, J A

    2001-06-01

    Thyroid cancer is the most common endocrine malignancy but is none the less rare. Some aspects of its management remain controversial. Previous audits of patient management in the United Kingdom have revealed deficiencies, especially in communication between specialists. We have audited patient management in a large university-associated teaching hospital, assessing points of good practice identified from published guidelines and reviews, and have compared findings in groups of patients managed jointly by specialists with an interest in thyroid cancer (including surgeon, endocrinologist and oncologist) with a group managed by other clinicians outside that setting. Retrospective case-note review of 205 patients with differentiated (papillary or follicular) cancer including group A (n = 134; managed in a specialist multi-disciplinary clinic setting) and group B (n = 71; managed in other clinic settings). Points of good practice investigated were adequacy of surgery, surgical complications, prescription and adequacy of T4 treatment, adequacy of monitoring by measurement of serum thyroglobulin and action taken and appropriate administration of ablative radioiodine. Deficiencies in management of the cohort as a whole were identified, including inadequate surgery and inadequate TSH suppression in approximately one-fifth of the cases. Monitoring with thyroglobulin measurements and action when serum thyroglobulin was high were also inadequate in some cases and ablative radioiodine was not given, despite being indicated in 11.7% of the cohort. Inadequate surgery and failure to administer radioiodine were less common in those managed in a specialist clinic setting than in those managed in other clinic settings. The findings highlight the need for locally agreed protocols in managing relatively rare endocrine disorders such as thyroid cancer and argue in favour of centralization of expertise and patient management in multi-disciplinary specialist clinic settings.

  10. The need for PGY2-trained clinical pharmacy specialists.

    PubMed

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

    2014-06-01

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

  11. Academic learning for specialist nurses: a grounded theory study.

    PubMed

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

    2014-11-01

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

  12. Problems in air traffic management. IV., Comparison of pre-employment, job-related experience with aptitude tests as predictors of training and job performance of air traffic control specialists.

    DOT National Transportation Integrated Search

    1963-12-01

    In addition to passing a second class aviation medical examination, individuals applying for training as an Air Traffic Control Specialist (ATCS) with the Federal Aviation Agency have, in the past, been required to have previous experience which was ...

  13. Energy efficiency in waste-to-energy and its relevance with regard to climate control.

    PubMed

    Ragossnig, Arne M; Wartha, Christian; Kirchner, Andreas

    2008-02-01

    This article focuses on systematically highlighting the ways to optimize waste-to-energy plants in terms of their energy efficiency as an indicator of the positive effect with regard to climate control. Potentials for increasing energy efficiency are identified and grouped into categories. The measures mentioned are illustrated by real-world examples. As an example, district cooling as a means for increasing energy efficiency in the district heating network of Vienna is described. Furthermore a scenario analysis shows the relevance of energy efficiency in waste management scenarios based on thermal treatment of waste with regard to climate control. The description is based on a model that comprises all relevant processes from the collection and transportation up to the thermal treatment of waste. The model has been applied for household-like commercial waste. The alternatives compared are a combined heat and power incinerator, which is being introduced in many places as an industrial utility boiler or in metropolitan areas where there is a demand for district heating and a classical municipal solid waste incinerator producing solely electrical power. For comparative purposes a direct landfilling scenario has been included in the scenario analysis. It is shown that the energy efficiency of thermal treatment facilities is crucial to the quantity of greenhouse gases emitted.

  14. Role Transition After Clinical Nurse Specialist Education.

    PubMed

    Ares, Terri L

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

  15. MINE WASTE TECHNOLOGY PROGRAM - UNDERGROUND MINE SOURCE CONTROL DEMONSTRATION PROJECT

    EPA Science Inventory

    This report presents results of the Mine Waste Technology Program Activity III, Project 8, Underground Mine Source Control Demonstration Project implemented and funded by the U. S. Environmental Protection Agency (EPA) and jointly administered by EPA and the U. S. Department of E...

  16. Composition and analysis of a model waste for a CELSS (Controlled Ecological Life Support System)

    NASA Technical Reports Server (NTRS)

    Wydeven, T. J.

    1983-01-01

    A model waste based on a modest vegetarian diet is given, including composition and elemental analysis. Its use is recommended for evaluation of candidate waste treatment processes for a Controlled Ecological Life Support System (CELSS).

  17. Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

    PubMed

    Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

    2010-01-01

    The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic

  18. Life-cycle-assessment of the historical development of air pollution control and energy recovery in waste incineration.

    PubMed

    Damgaard, Anders; Riber, Christian; Fruergaard, Thilde; Hulgaard, Tore; Christensen, Thomas H

    2010-07-01

    Incineration of municipal solid waste is a debated waste management technology. In some countries it is the main waste management option whereas in other countries it has been disregarded. The main discussion point on waste incineration is the release of air emissions from the combustion of the waste, but also the energy recovery efficiency has a large importance. The historical development of air pollution control in waste incineration was studied through life-cycle-assessment modelling of eight different air pollution control technologies. The results showed a drastic reduction in the release of air emissions and consequently a significant reduction in the potential environmental impacts of waste incineration. Improvements of a factor 0.85-174 were obtained in the different impact potentials as technology developed from no emission control at all, to the best available emission control technologies of today (2010). The importance of efficient energy recovery was studied through seven different combinations of heat and electricity recovery, which were modelled to substitute energy produced from either coal or natural gas. The best air pollution control technology was used at the incinerator. It was found that when substituting coal based energy production total net savings were obtained in both the standard and toxic impact categories. However, if the substituted energy production was based on natural gas, only the most efficient recovery options yielded net savings with respect to the standard impacts. With regards to the toxic impact categories, emissions from the waste incineration process were always larger than those from the avoided energy production based on natural gas. The results shows that the potential environmental impacts from air emissions have decreased drastically during the last 35 years and that these impacts can be partly or fully offset by recovering energy which otherwise should have been produced from fossil fuels like coal or natural gas

  19. Mission Specialist (MS) Ride adjusts headset (HDST) on middeck

    NASA Image and Video Library

    1983-06-24

    STS007-11-495 (18-24 June 1983) --- Astronaut Sally K. Ride, STS-7 mission specialist, communicates with ground controllers from the mid deck of the Earth-orbiting Space Shuttle Challenger. She has just opened one of the large lockers during the operation and monitoring of the continuous flow electrophoresis system (CFES) experiment at left edge. This photograph was made with a 35mm camera.

  20. System to control contamination during retrieval of buried TRU waste

    DOEpatents

    Menkhaus, Daniel E.; Loomis, Guy G.; Mullen, Carlan K.; Scott, Donald W.; Feldman, Edgar M.; Meyer, Leroy C.

    1993-01-01

    A system to control contamination during the retrieval of hazardous waste comprising an outer containment building, an inner containment building, within the outer containment building, an electrostatic radioactive particle recovery unit connected to and in communication with the inner and outer containment buildings, and a contaminate suppression system including a moisture control subsystem, and a rapid monitoring system having the ability to monitor conditions in the inner and outer containment buildings.

  1. Enabling factors for specialist outreach in western KwaZulu-Natal

    PubMed Central

    2018-01-01

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

  2. Administrative Assistant and Correspondence Specialist: Task List Competency Record.

    ERIC Educational Resources Information Center

    Minnesota Instructional Materials Center, White Bear Lake.

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

  3. System to control contamination during retrieval of buried TRU waste

    DOEpatents

    Menkhaus, D.E.; Loomis, G.G.; Mullen, C.K.; Scott, D.W.; Feldman, E.M.; Meyer, L.C.

    1993-04-20

    A system is described to control contamination during the retrieval of hazardous waste comprising an outer containment building, an inner containment building, within the outer containment building, an electrostatic radioactive particle recovery unit connected to and in communication with the inner and outer containment buildings, and a contaminate suppression system including a moisture control subsystem, and a rapid monitoring system having the ability to monitor conditions in the inner and outer containment buildings.

  4. 14 CFR § 1214.812 - Payload specialists.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  5. CSHCN in Texas: meeting the need for specialist care.

    PubMed

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

    2005-06-01

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

  6. COMBUSTION CONTROL OF TRACE ORGANIC AIR POLLUTANTS FROM MUNICIPAL WASTE COMBUSTORS

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) is considering the use of combustion techniques for controlling air emissions of chlorinated dioxins, chlorinated furans, and other trace organics from municipal waste combustion (MWC) facilities. Recommendations for good combustion pr...

  7. Diet Therapy Specialist.

    ERIC Educational Resources Information Center

    Air Force Training Command, Sheppard AFB, TX.

    This four-volume student text is intended for use in training Air Force diet therapy specialists. The first volume, a study guide and workbook for self-directed instruction, covers nutrition, food processing and preparation, therapeutic diets, security precautions in medical food service, procedures for ordering equipment and supplies, food…

  8. Clinical nurse specialist prescriber characteristics and challenges in Oregon.

    PubMed

    Klein, Tracy

    2015-01-01

    The purpose of this study was to assess role characteristics of clinical nurse specialists (CNSs) with prescriptive authority in Oregon 10 years after passage of Senate Bill 460. Factors examined included role preparation and mentorship, use and maintenance of authority, prescribing benefits and barriers, and types of drugs/nondrugs prescribed. This study was a descriptive survey using both quantitative and qualitative analysis. The sample was obtained from a list provided on June 13, 2014, by the Oregon State Board of Nursing of all CNSs in Oregon who had ever been granted prescriptive authority (n = 40). Twenty-nine with active authority, 7 with expired authority, and 4 with inactive status were sampled. E-mail distribution with Qualtrics software was released on June 27, 2014. Reminder e-mails were sent at 1 and 2 weeks. Of the 38 e-mails successfully delivered, 23 responses were received for a total response rate of 60%. Clinical nurse specialists successfully maintained their authority in Oregon and felt well prepared for their role. Their prescribing mentorship included nurse and nonnurse prescribers. They were most likely to have ever prescribed psychiatric, noncontrolled analgesics and durable medical equipment. They most frequently prescribed nutrition/electrolytes/fluids, durable medical equipment, and controlled analgesics. Lapse in authority was attributed to constraints regarding certification or credentialing in the role. Clinical nurse specialists uniformly expressed benefits from prescriptive authority. There were no differences in perceptions of preparation based on type of mentorship or educational modality for completion of prescribing requirements. There were systems barriers including lack of employer and colleague support to use of authority. Durable medical equipment authority is important to the CNS role. Clinical nurse specialists valued and maintained their prescriptive authority despite barriers. Further research is recommended to support

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

    PubMed

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

    2013-06-01

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

  10. 17 CFR 240.11b-1 - Regulation of specialists.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  11. Sports Medicine: What is a Sports Medicine Specialist?

    MedlinePlus

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

  12. EPA ASSESSMENT OF TECHNOLOGIES FOR CONTROLLING EMISSIONS FROM MUNICIPAL WASTE COMBUSTION

    EPA Science Inventory

    The article examines EPA technical activities relating to the development of regulations pertaining to the control of both new and existing municipal waste combustion facilities (MWCs). The activities include: (1) assessing combustion and flue gas cleaning technologies, (2) colle...

  13. Portrait view of ESA Spacelab Specialists

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Portrait view of European Space Agency (ESA) Spacelab Specialist Byron K. Lichtenberg in civilian clothes standing in front of a display case. The photo was taken at the Marshall Space Flight Center (MSFC), Huntsville, Alabama (31779); portrait view of ESA Spacelab Specialist Michael L. Lampton, also in civilian clothes in front of display at MSFC (31780); portrait view of Wubbo Ockels, also in civilian clothes in front of display at MSFC (31781).

  14. EXPLORING ENGINEERING CONTROL THROUGH PROCESS MANIPULATION OF RADIOACTIVE LIQUID WASTE TANK CHEMICAL CLEANING

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

    Brown, A.

    2014-04-27

    One method of remediating legacy liquid radioactive waste produced during the cold war, is aggressive in-tank chemical cleaning. Chemical cleaning has successfully reduced the curie content of residual waste heels in large underground storage tanks; however this process generates significant chemical hazards. Mercury is often the bounding hazard due to its extensive use in the separations process that produced the waste. This paper explores how variations in controllable process factors, tank level and temperature, may be manipulated to reduce the hazard potential related to mercury vapor generation. When compared using a multivariate regression analysis, findings indicated that there was amore » significant relationship between both tank level (p value of 1.65x10{sup -23}) and temperature (p value of 6.39x10{sup -6}) to the mercury vapor concentration in the tank ventilation system. Tank temperature showed the most promise as a controllable parameter for future tank cleaning endeavors. Despite statistically significant relationships, there may not be confidence in the ability to control accident scenarios to below mercury’s IDLH or PAC-III levels for future cleaning initiatives.« less

  15. QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES. Project Summary

    EPA Science Inventory

    It is generally agreed that both quality assurance (QA) and quality control (QC) are essential to the proper installation and eventual performance of environmentally safe and secure waste containment systems. Even further, there are both manufacturing and construction aspects to...

  16. Information Support Specialist.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This publication contains 22 subjects appropriate for use in a competency list for the occupation of information support specialist, 1 of occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 22 units are as…

  17. Microcomputer Applications Specialist.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This publication contains 16 subjects appropriate for use in a competency list for the occupation of microcomputer applications specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 16 units are…

  18. A&M. Hot liquid waste building (TAN616). Interior of evaporator control ...

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

    A&M. Hot liquid waste building (TAN-616). Interior of evaporator control room. Date: 1962. INEEL negative no. 62-6824 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  19. Preferential Edge Habitat Colonization by a Specialist Weevil, Rhinoncomimus latipes (Coleoptera: Curculionidae)

    USDA-ARS?s Scientific Manuscript database

    Understanding the behavioral basis of dispersal and colonization is critical in biological control systems, where success of a natural enemy depends in part on its ability to find and move to new host patches. We studied behavior of the specialist weevil Rhinoncomimus latipes Korotyaev, a biological...

  20. [Health care waste management of potentially infectious medical waste by healthcare professionals in a private medical practice: a study of practices].

    PubMed

    Brunot, Alain; Thompson, Céline

    2010-01-01

    A cross-sectional study was conducted with a sample of 278 health professionals (GPs and specialists, dentists, physical therapists and nurses) in a private medical practice in Paris to study the medical waste management practices related to the production and disposal of potentially hazardous health care waste. With the exception of physical therapists, most professionals produced medical waste (72% to 96,2% according to occupation), with a monthly median of 3 liters (inter-quartile range 1-15 liters). All sharp objects and needles were separated and 91% of them eliminated via a specific process for that sector. These percentages were respectively 84% and 69% concerning contaminated waste that was neither needles or used for cutting. 48% of the professionals reported the existence of documents that could track the disposal of their medical waste. To improve practice, professionals cited collection on-site at the office (74%) and reliability of the contracted service provider to collect the waste (59%). The study showed that health professionals need information on the regulations regarding potentially infectious medical waste, in particular on the traceability of its elimination. They also noted the lack of clarity and precision with regard to the definition of risk of infection: 31,7% of professionals only declare the production of sharp or cutting waste without having specified criteria for risk of infection.

  1. Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder.

    PubMed

    Morriss, Richard; Marttunnen, Sarah; Garland, Anne; Nixon, Neil; McDonald, Ruth; Sweeney, Tim; Flambert, Heather; Fox, Richard; Kaylor-Hughes, Catherine; James, Marilyn; Yang, Min

    2010-11-29

    Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived. Single blind individually randomised controlled trial of a specialist depression disorder team (psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment) versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale (HDRS) score ≥ 16 and global assessment of function (GAF) ≤ 60 after ≥ 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis including the EQ5 D and analysis of barriers to care, implementation and the process of care. Audits to benchmark both treatment arms against national standards of care will aid the interpretation of the results of the study. This trial will be the first to assess the effectiveness and implementation of a community based specialist depression disorder team. The study has been specially designed as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire joint collaboration between university, health and social care organisations to provide information of direct relevance to decisions on commissioning, service provision and

  2. STS-87 Mission Specialist Scott in white room

    NASA Technical Reports Server (NTRS)

    1997-01-01

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

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

    PubMed

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

    2001-01-01

    Multiple sclerosis (MS) is a disease of the central nervous system. The cause is unknown. There are about 80-160 people with MS per 100,000 population, with twice as many women affected as men. The management of individuals with MS includes treatment of acute relapses and chronic symptoms. The care of MS patients is provided by various healthcare professionals, such as general practitioners (GPs), neurologists, physiotherapists, occupational therapists and nurses. Some MS patients have access to an MS specialist nurse, although this provision varies geographically. The aim of this report is to assess the effectiveness and relative cost-effectiveness of MS specialist nurses in improving care and outcomes for patients with MS. A systematic review of the literature, involving a range of databases, was performed. Full details are described in the main report. Only one study was identified that tried to evaluate the benefit of MS specialist nurses. The study concluded that MS patients and their carers found the MS specialist nurse to be helpful, particularly in improving their knowledge of MS, ability to cope, mood and confidence about the future. GPs also reported finding the nurse to be helpful with their MS patients, and 40% of the GPs stated they would purchase the services of an MS specialist nurse if their practices became fundholding. However, there were considerable methodological weaknesses inherent in the study design, and it was unclear whether the results of the study could be extrapolated to other settings or to other MS patient groups. RESULTS - ONGOING RESEARCH: There are two ongoing research studies regarding MS specialist nurses. One of these studies involves the provision of MS nurses to several areas, but also has two control populations to allow evaluation of the health benefits of the nurses to MS patients and their carers. This study will help to fill the evidence gap. RESULTS - COSTS: The costs of providing MS specialist nurses consist of their

  4. Management Information Specialist.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This publication contains 19 subjects appropriate for use in a competency list for the occupation of management information specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 19 units are as…

  5. IET control building (TAN620). equipment removed. Lube oil and waste ...

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

    IET control building (TAN-620). equipment removed. Lube oil and waste piping at upper right. Fire door on right. Rebar exposed in concrete of ceiling. INEEL negative no. HD-21-5-3 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

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

    PubMed Central

    Halper, June

    2014-01-01

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

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

    PubMed

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

    2004-01-01

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

  8. The evolution of resource adaptation: how generalist and specialist consumers evolve.

    PubMed

    Ma, Junling; Levin, Simon A

    2006-07-01

    Why and how specialist and generalist strategies evolve are important questions in evolutionary ecology. In this paper, with the method of adaptive dynamics and evolutionary branching, we identify conditions that select for specialist and generalist strategies. Generally, generalist strategies evolve if there is a switching benefit; specialists evolve if there is a switching cost. If the switching cost is large, specialists always evolve. If the switching cost is small, even though the consumer will first evolve toward a generalist strategy, it will eventually branch into two specialists.

  9. [Research advances in control of N2O emission from municipal solid waste landfill sites].

    PubMed

    Cai, Chuan-Yu; Li, Bo; Lü, Hao-Hao; Wu, Wei-Xiang

    2012-05-01

    Landfill is one of the main approaches for municipal solid waste treatment, and landfill site is a main emission source of greenhouse gases nitrous oxide (N2O) and methane (CH4). As a high-efficient trace greenhouse gas, N2O has a very high warming potential, with a warming capacity 296 times of CO2, and has a long-term stability in atmosphere, giving greater damage to the ozone layer. Aiming at the researches in the control of N2O emission from municipal solid waste landfill sites, this paper summarized the characteristics and related affecting factors of the N2O emission from the landfill sites, and put forward a series of the measures adaptable to the N2O emission control of present municipal solid waste landfill sites in China. Some further research focuses on the control of N2O emission from the landfill sites were also presented.

  10. Does the specialist nurse enhance or deskill the general nurse?

    PubMed

    Marshall, Z; Luffingham, N

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

  11. Developing a speciality: regearing the specialist public health workforce.

    PubMed

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

    2005-03-01

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

  12. Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Bracun Sova, Rajka

    2015-01-01

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

  14. TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

    EPA Science Inventory

    This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. he document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic drai...

  15. TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

    EPA Science Inventory

    This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. The document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic dr...

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

    PubMed

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

    2016-08-01

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

  17. Lean Six Sigma in Health Care: Improving Utilization and Reducing Waste.

    PubMed

    Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Healthcare costs have been increasing worldwide mainly due to over utilization of resources. The savings potentially achievable from systematic, comprehensive, and cooperative reduction in waste are far higher than from more direct and blunter cuts in care and coverage. At King Faisal Specialist Hospital and Research Center inappropriate and over utilization of the glucose test strips used for whole blood glucose determination using glucometers was observed. The hospital implemented a project to improve its utilization. Using the Six Sigma DMAIC approach (Define, Measure, Analyze, Improve and Control), an efficient practice was put in place including updating the related internal policies and procedures and the proper implementation of an effective users' training and competency check off program. That resulted in decreasing the unnecessary Quality Control (QC) runs from 13% to 4%, decreasing the failed QC runs from 14% to 7%, lowering the QC to patient testing ratio from 24/76 to 19/81.

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

    ERIC Educational Resources Information Center

    Stahl, Klaus, Ed.

    1999-01-01

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

  19. STS-87 Mission Specialist Doi in white room

    NASA Technical Reports Server (NTRS)

    1997-01-01

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

  20. STS-55 German payload specialists (and backups) in LESs during JSC training

    NASA Technical Reports Server (NTRS)

    1992-01-01

    STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists and backup (alternate) payload specialists, wearing launch and entry suits (LESs), pose for group portrait outside mockup side hatch in JSC's Mockup and Integration Laboratory (MAIL) Bldg 9NE. These payload specialists will support the STS-55 Spacelab Deutsche 2 (SL-D2) mission. It is the second dedicated German (Deutsche) Spacelab flight. Left to right are backup Payload Specialists Renate Brummer and Dr. P. Gerhard Thiele, Payload Specialist 1 Ulrich Walter, and Payload Specialist 2 Hans Schlegel.

  1. Determinants of consumer food waste behaviour: Two routes to food waste.

    PubMed

    Stancu, Violeta; Haugaard, Pernille; Lähteenmäki, Liisa

    2016-01-01

    Approximately one quarter of the food supplied for human consumption is wasted across the food supply chain. In the high income countries, the food waste generated at the household level represents about half of the total food waste, making this level one of the biggest contributors to food waste. Yet, there is still little evidence regarding the determinants of consumers' food waste behaviour. The present study examines the effect of psycho-social factors, food-related routines, household perceived capabilities and socio-demographic characteristics on self-reported food waste. Survey data gathered among 1062 Danish respondents measured consumers' intentions not to waste food, planning, shopping and reuse of leftovers routines, perceived capability to deal with household food-related activities, injunctive and moral norms, attitudes towards food waste, and perceived behavioural control. Results show that perceived behavioural control and routines related to shopping and reuse of leftovers are the main drivers of food waste, while planning routines contribute indirectly. In turn, the routines are related to consumers' perceived capabilities to deal with household related activities. With regard to intentional processes, injunctive norms and attitudes towards food waste have an impact while moral norms and perceived behavioural control make no significant contribution. Implications of the study for initiatives aimed at changing consumers' food waste behaviour are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Understanding practice patterns of glaucoma sub-specialists in India

    PubMed Central

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

    2017-01-01

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

  3. Treatment of CELSS and PCELSS waste to produce nutrients for plant growth. [Controlled Ecological Life Support Systems and Partially Controlled Ecological Life Support Systems

    NASA Technical Reports Server (NTRS)

    Modell, M.; Meissner, H.; Karel, M.; Carden, J.; Lewis, S.

    1981-01-01

    The research program entitled 'Development of a Prototype Experiment for Treating CELSS (Controlled Ecological Life Support Systems) and PCELSS (Partially Controlled Ecological Life Support Systems) Wastes to Produce Nutrients for Plant Growth' consists of two phases: (1) the development of the neccessary facilities, chemical methodologies and models for meaningful experimentation, and (2) the application of what methods and devices are developed to the interfacing of waste oxidation with plant growth. Homogeneous samples of freeze-dried human feces and urine have been prepared to ensure comparability of test results between CELSS waste treatment research groups. A model of PCELSS food processing wastes has been developed, and an automated gas chromatographic system to analyze oxidizer effluents was designed and brought to operational status. Attention is given the component configuration of the wet oxidation system used by the studies.

  4. Preliminary observation on the effect of baking soda volume on controlling odour from discarded organic waste.

    PubMed

    Qamaruz-Zaman, N; Kun, Y; Rosli, R-N

    2015-01-01

    Food wastes with high moisture and organic matter content are likely to emit odours as a result of the decomposition process. The management of odour from decomposing wastes is needed to sustain the interest of residents and local councils in the source separation of kitchen wastes. This study investigated the potential of baking soda (at 50 g, 75 g and 100g per kg food waste) to control odour from seven days stored food waste. It was found that 50 g of baking soda, spread at the bottom of 8l food wastes bin, can reduce the odour by about 70%. A higher amount (above 100g) is not advised as a pH higher than 9.0 may be induced leading to the volatilization of odorous ammonia. This research finding is expected to benefit the waste management sector, food processing industries as well as the local authorities where malodour from waste storage is a pressing issue. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Impact of specialist home-based palliative care services in a tertiary oncology set up: a prospective non-randomized observational study.

    PubMed

    Dhiliwal, Sunil R; Muckaden, Maryann

    2015-01-01

    Home-based specialist palliative care services are developed to meet the needs of the patients in advanced stage of cancer at home with physical symptoms and distress. Specialist home care services are intended to improve symptom control and quality of life, enable patients to stay at home, and avoid unnecessary hospital admission. Total 690 new cases registered under home-based palliative care service in the year 2012 were prospectively studied to assess the impact of specialist home-based services using Edmonton symptom assessment scale (ESAS) and other parameters. Out of the 690 registered cases, 506 patients received home-based palliative care. 50.98% patients were cared for at home, 28.85% patients needed hospice referral and 20.15% patients needed brief period of hospitalization. All patients receiving specialist home care had good relief of physical symptoms (P < 0.005). 83.2% patients received out of hours care (OOH) through liaising with local general practitioners; 42.68% received home based bereavement care and 91.66% had good bereavement outcomes. Specialist home-based palliative care improved symptom control, health-related communication and psychosocial support. It promoted increased number of home-based death, appropriate and early hospice referral, and averted needless hospitalization. It improved bereavement outcomes, and caregiver satisfaction.

  6. 42 CFR 410.76 - Clinical nurse specialists' services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  7. Community palliative care clinical nurse specialists as independent prescribers: part 2.

    PubMed

    Latham, Kathy; Nyatanga, Brian

    2018-03-02

    This study explored the lived experiences of clinical nurse specialists who can prescribe independently in their role of providing support to patients with palliative care needs within the community. Part 1 of this study examined how the study was carried out; this second part explores the findings. The nurses reported that being able to prescribe enabled them to provide seamless, holistic care, which gave patients faster access to medicines, especially at weekends when their GP was unavailable. Prompt availability of medicines led to effective symptom control and consequently a better quality of life for patients. The main barrier to prescribing was difficulty in accessing patient records. Independent prescribing by community nurse specialists is beneficial for patients receiving palliative care and their families while they are being cared for at home, and provides job satisfaction for the nurses.

  8. STS-86 Mission Specialist David Wolf in white room

    NASA Technical Reports Server (NTRS)

    1997-01-01

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

  9. Higher Education Institutions and Specialist Schools: Potential Partnerships

    ERIC Educational Resources Information Center

    Penney, Dawn; Houlihan, Barrie

    2003-01-01

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

  10. Sports medicine and the accident and emergency medicine specialist.

    PubMed

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

    2002-05-01

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

  11. STS-95 Mission Specialist Duque suits up during TCDT

    NASA Technical Reports Server (NTRS)

    1998-01-01

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

  12. HANDBOOK: QUALITY ASSURANCE/QUALITY CONTROL (QA/QC) PROCEDURES FOR HAZARDOUS WASTE INCINERATION

    EPA Science Inventory

    Resource Conservation and Recovery Act regulations for hazardous waste incineration require trial burns by permit applicants. uality Assurance Project Plan (QAPjP) must accompany a trial burn plan with appropriate quality assurance/quality control procedures. uidance on the prepa...

  13. Influence of cnicin, a sesquiterpene lactone ofCentaurea maculosa (Asteraceae), on specialist and generalist insect herbivores.

    PubMed

    Landau, I; Müller-Schärer, H; Ward, P I

    1994-04-01

    The sesquiterpene lactone cnicin was extracted fromCentaurea maculosa andCentaurea vallesiaca. We examined its effects on the ovipositional response and larval development of generalist and specialist insect herbivores associated withC. maculosa. For the oviposition trials, three plant species (C. maculosa, Achillea millefolium, andCichorium intybus), half of which were sprayed with 3% of cnicin, were exposed to the specialist mothsStenodes straminea, Agapeta zoegana, andPterolonche inspersa in field cages. All three species significantly preferredC. maculosa to other plants andP. inspersa significantly preferred cnicin-sprayed plants to untreated plants for oviposition. Tested over all species, cnicin significantly increased the number of eggs laid on a given plant. A larval diet test examined the toxicity of cnicin for larvae of the generalist noctuid mothSpodoptera littoralis. Cnicin concentrations of 3% and 6% were lethal and 1% and 0.5% seriously inhibited growth and development. The larvae of theC. maculosa specialistStenodes straminea survived at 6% cnicin, but none of the pupae hatched.Agapeta zoegana was able to survive at 1% and 3% cnicin. Both specialists had difficulties with the artificial diet, but weight increase and survival was not further reduced when cnicin was present compared with on the control diet. In conclusion, cnicin influenced host recognition by the specialist species, and larvae of the generalist did not survive on natural levels of cnicin. Growth and survival of the specialist were not influenced by cnicin but were considerably hampered on artificial diet.

  14. Early stages of development of a peer specialist fidelity measure

    PubMed Central

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

    2017-01-01

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

  15. Specialist training of Emergency Medicine in Finland.

    PubMed

    Naskali, Jarno; Lehtonen, Jarmo; Palomäki, Ari

    Emergency Medicine with a six-year specialist training became a main specialty in Finland in the beginning of 2013. Specialist training has developed very quickly over just a few years. In the frontline clinics, the clinical results have already reached high international quality. When developing a new specialty, not only active research and high-quality training but also good co-operation with other specialties are of utmost importance.

  16. Risk mitigation by waste-based permeable reactive barriers for groundwater pollution control at e-waste recycling sites.

    PubMed

    Beiyuan, Jingzi; Tsang, Daniel C W; Yip, Alex C K; Zhang, Weihua; Ok, Yong Sik; Li, Xiang-Dong

    2017-02-01

    Permeable reactive barriers (PRBs) have proved to be a promising passive treatment to control groundwater contamination and associated human health risks. This study explored the potential use of low-cost adsorbents as PRBs media and assessed their longevity and risk mitigation against leaching of acidic rainfall through an e-waste recycling site, of which Cu, Zn, and Pb were the major contaminants. Batch adsorption experiments suggested a higher adsorption capacity of inorganic industrial by-products [acid mine drainage sludge (AMDS) and coal fly ash (CFA)] and carbonaceous recycled products [food waste compost (FWC) and wood-derived biochar] compared to natural inorganic minerals (limestone and apatite). Continuous leaching tests of sand columns with 10 wt% low-cost adsorbents were then conducted to mimic the field situation of acidic rainfall infiltration through e-waste-contaminated soils (collected from Qingyuan, China) by using synthetic precipitation leaching procedure (SPLP) solution. In general, Zn leached out first, followed by Cu, and finally delayed breakthrough of Pb. In the worst-case scenario (e.g., at initial concentrations equal to 50-fold of average SPLP result), the columns with limestone, apatite, AMDS, or biochar were effective for a relatively short period of about 20-40 pore volumes of leaching, after which Cu breakthrough caused non-cancer risk concern and later-stage Pb leaching considerably increased both non-cancer and lifetime cancer risk associated with portable use of contaminated water. In contrast, the columns with CFA or FWC successfully mitigated overall risks to an acceptable level for a prolonged period of 100-200 pore volumes. Therefore, with proper selection of low-cost adsorbents (or their mixture), waste-based PRBs is a technically feasible and economically viable solution to mitigate human health risk due to contaminated groundwater at e-waste recycling sites.

  17. Quantitative study of controlled substance bedside wasting, disposal and evaluation of potential ecologic effects.

    PubMed

    Mankes, Russell F; Silver, Charles D

    2013-02-01

    Drugs in wastewater arise from many sources. For health care, these include excretion and direct disposal (bedside wasting). The present study reports on the dispensing and wasting of 15 controlled substances (CS) at two health care facilities in Albany, NY over a nearly two year period. The study considered measures of ecotoxicity, drug metabolism, excretion and disposal of these CS. Potential alternatives to flushing of CS into wastewaters from healthcare facilities are discussed. Drug medication and waste collection records (12,345) included: numbers of drugs dispensed, returned and wasted. Overall, 8528 g of 15 CS were wasted. Three (midazolam, acetaminophen-codeine and fentanyl) accounted for 87.5% of the total wasted. Wasting varied by hospital, 14 CS at the academic medical center hospital and 8 at the surgical care center were wasted. Liquids were more frequently wasted than tablets or pills. Some combination drugs (acetaminophen (APAP)-codeine) were frequently (50% of drug dispensed) wasted while others were less wasted (APAP-hydrocodone-6.3%; APAP-oxycodone-1.3%). The 8 CS judged more hazardous to aquatic life were: APAP-codeine, APAP-hydrocodone, APAP-oxycodone, alprazolam, diazepam, fentanyl, midazolam, and testosterone. Ketamine, morphine, oxycodone and zolpidem were of lesser acute toxicity based on available LC50 values. These CS might provide a therapeutically equivalent alternative to the more environmentally harmful drugs. In health care facilities, professionals dispose of CS by bedside wasting into water or other receptacles. This can be avoided by returning CS to the hospital's pharmacy department, thence to a licensed distributor. Study of this process of drug wasting can identify opportunities for process improvements. We found 3 CS (APAP-codeine, midazolam and testosterone) where ½ to 1/3 of the drug was wasted and 5 others with 30 to 13% wasted. Knowledge of the adverse impacts from the release of highly toxic drugs into the environment

  18. Characterizations of the radioactive waste by the remotely-controlled collimated spectrometric system

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

    Stepanov, Vyacheslav E.; Potapov, Victor N.; Smirnov, Sergey V.

    Decontamination and decommissioning of the research reactors MR (Testing Reactor) and RFT (Reactor of Physics and Technology) has recently been initiated in the National Research Center (NRC) 'Kurchatov institute', Moscow. In the building, neighboring to the reactor, the storage of HLRW is located. The storage is made of monolithic concrete in which steel cells depth 4 m are located. In cells of storage the HLRW packed into cases are placed. These the radioactive waste are also subject to export on long storage in the specialized organization. For characterization of the radioactive waste in cases the remote-controlled collimated spectrometer system wasmore » used. The system consists of a spectrometric collimated gamma-ray detector, a color video camera and a control unit, mounted on a rotator, which are mounted on a tripod with the host computer. For determination of specific activity of radionuclides in cases, it is developed programs of calculation of coefficients of proportionality of specific activity to the corresponding speeds of the account in peaks of full absorption at single specific activity of radionuclides in cases. For determination of these coefficients the mathematical model of spectrometer system based on the Monte-Carlo method was used. Dependences of calibration coefficients for various radionuclides from distance between the detector and a case at various values of the radioactive waste density in cases are given. Measurements of specific activity in cases are taken and are discussed. By results of measurements decisions on the appeal of the radioactive waste being in cases are made. (authors)« less

  19. Influences of Plant Traits on Immune Responses of Specialist and Generalist Herbivores

    PubMed Central

    Lampert, Evan

    2012-01-01

    Specialist and generalist insect herbivore species often differ in how they respond to host plant traits, particularly defensive traits, and these responses can include weakened or strengthened immune responses to pathogens and parasites. Accurate methods to measure immune response in the presence and absence of pathogens and parasites are necessary to determine whether susceptibility to these natural enemies is reduced or increased by host plant traits. Plant chemical traits are particularly important in that host plant metabolites may function as antioxidants beneficial to the immune response, or interfere with the immune response of both specialist and generalist herbivores. Specialist herbivores that are adapted to process and sometimes accumulate specific plant compounds may experience high metabolic demands that may decrease immune response, whereas the metabolic demands of generalist species differ due to more broad-substrate enzyme systems. However, the direct deleterious effects of plant compounds on generalist herbivores may weaken their immune responses. Further research in this area is important given that the ecological relevance of plant traits to herbivore immune responses is equally important in natural systems and agroecosystems, due to potential incompatibility of some host plant species and cultivars with biological control agents of herbivorous pests. PMID:26466545

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

    PubMed

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

    2014-01-01

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

  1. 42 CFR 410.76 - Clinical nurse specialists' services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  2. CAPSULE REPORT: SOURCES AND AIR EMISSION CONTROL TECHNOLOGIES AT WASTE MANAGEMENT FACILITIES

    EPA Science Inventory

    The chemicals processed during waste management operations can volatilize into the atmosphere and cause carcinogenic or other toxic effects or contribute to ozone formation. Regulations have been developed to control air emissions from these operations. The EPA has promulgated st...

  3. Optometry Specialist (AFSC 91255).

    ERIC Educational Resources Information Center

    Kille, Michael O.

    This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for optometry specialists. Covered in the individual volumes are optometry clinic administration (optometry career and field training, ethical relationships and professionalism, eligibility for optometric care and appointment…

  4. Battery collection in municipal waste management in Japan: challenges for hazardous substance control and safety.

    PubMed

    Terazono, Atsushi; Oguchi, Masahiro; Iino, Shigenori; Mogi, Satoshi

    2015-05-01

    To clarify current collection rules of waste batteries in municipal waste management in Japan and to examine future challenges for hazardous substance control and safety, we reviewed collection rules of waste batteries in the Tokyo Metropolitan Area. We also conducted a field survey of waste batteries collected at various battery and small waste electric and electronic equipment (WEEE) collection sites in Tokyo. The different types of batteries are not collected in a uniform way in the Tokyo area, so consumers need to pay attention to the specific collection rules for each type of battery in each municipality. In areas where small WEEE recycling schemes are being operated after the enforcement of the Act on Promotion of Recycling of Small Waste Electrical and Electronic Equipment in Japan in 2013, consumers may be confused about the need for separating batteries from small WEEE (especially mobile phones). Our field survey of collected waste batteries indicated that 6-10% of zinc carbon and alkaline batteries discarded in Japan currently could be regarded as containing mercury. More than 26% of zinc carbon dry batteries currently being discarded may have a lead content above the labelling threshold of the EU Batteries Directive (2006/66/EC). In terms of safety, despite announcements by producers and municipalities about using insulation (tape) on waste batteries to prevent fires, only 2.0% of discarded cylindrical dry batteries were insulated. Our field study of small WEEE showed that batteries made up an average of 4.6% of the total collected small WEEE on a weight basis. Exchangeable batteries were used in almost all of mobile phones, digital cameras, radios, and remote controls, but the removal rate was as low as 22% for mobile phones. Given the safety issues and the rapid changes occurring with mobile phones or other types of small WEEE, discussion is needed among stakeholders to determine how to safely collect and recycle WEEE and waste batteries. Copyright

  5. A qualitative evaluation of the Scottish Staff and Associate Specialist Development Programme.

    PubMed

    Cleland, Jennifer; Burr, Jacqueline; Johnston, Peter

    2016-05-01

    The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances. An inductive and data-driven thematic analysis was carried out and then the realist framework was applied to the data. We interviewed 22 key stakeholders: staff and associate specialist doctors, staff and associate specialist educational advisors, programme architects and clinical directors, between end February and May 2014. The resultant data indicated five broad themes: organisational barriers to continued professional development for staff and associate specialist doctors, the purpose of funding, gains from funding, the need for better communication about the staff and associate specialist Programme Development Fund, and the interplay between individual and systems factors. The staff and associate specialist Programme Development Fund has changed the opportunities available to staff and associate specialist doctors in Scotland and, in that sense, has changed the context for this group - or at least those who have realised the opportunities. © The Author(s) 2016.

  6. 48 CFR 1519.201-72 - Small and disadvantaged business utilization specialists.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  7. Management Matters: The Library Media Specialist's Management Toolbox

    ERIC Educational Resources Information Center

    Pappas, Marjorie L.

    2004-01-01

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

  8. Weather Specialist (AFSC 25120).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This correspondence course is designed for self-study to help military personnel to attain the rating of weather specialist. The course is organized in three volumes. The first volume, containing seven chapters, covers background knowledge, meteorology, and climatology. In the second volume, which also contains seven chapters, surface…

  9. Evaluation of outreach clinics held by specialists in general practice in England

    PubMed Central

    Bond, M.; Bowling, A.; Abery, A.; McClay, M.; Dickinson, E.

    2000-01-01

    OBJECTIVES—To measure the processes of care, health benefits and costs of outreach clinics held by hospital specialists in primary care settings.
DESIGN—The study was designed as a case-referent (comparative) study in which the features of 19 outreach clinics (cases) were compared with matched outpatient clinics (controls). The measuring instruments were self administered questionnaires. Patients were followed up at six months to reassess health status. The specialties included in the study were cardiology, ENT, general medicine, general surgery, gynaecology and rheumatology.
SETTING—Specialist outreach clinics in general practice in England, with matched outpatient clinic controls.
SUBJECTS—Consecutive patient attenders in the outreach and outpatient clinics, their specialists, the outreach patients' general practitioners, practice managers and trust accountants. Patients' response rate at baseline: 78% (1420).
MAIN OUTCOME MEASURES—Patient satisfaction, doctors' attitudes, processes and health outcomes, costs.
RESULTS—Outreach patients were more satisfied with the processes of their care than outpatients, their access to specialist care was better than that for outpatients and they were more likely to be discharged. Doctors reported that the main advantages of the outreach clinic were improved patient access to specialists and convenience for patients, in comparison with outpatients, and most GPs and specialists felt the outreach clinic was "worthwhile". At six month follow up, the health status of the outreach sample had significantly improved more than that of the outpatients on all eight sub-scales of the HSQ-12, but this was probably because of their better starting point at baseline. The impact of outreach on health outcomes was small. The NHS costs of outreach were significantly higher than outpatients. An increase in outreach clinic size would reduce cost per patient, but would lead to the loss of most of the clinics' benefits

  10. Waste management system

    NASA Technical Reports Server (NTRS)

    Sauer, R. L.; Jorgensen, G. K.

    1975-01-01

    The function of the waste management system was to control the disposition of solid and liquid wastes and waste stowage gases. The waste management system consisting of a urine subsystem and a fecal subsystem is described in detail and its overall performance is evaluated. Recommendations for improvement are given.

  11. The clinical nurse specialist: leadership in quality improvement.

    PubMed

    Finkelman, Anita

    2013-01-01

    Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

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

    PubMed

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

    2013-09-01

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

  13. STS-95 Mission Specialist Robinson suits up during TCDT

    NASA Technical Reports Server (NTRS)

    1998-01-01

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

  14. Controlled Ecological Life Support Systems (CELSS) physiochemical waste management systems evaluation

    NASA Technical Reports Server (NTRS)

    Oleson, M.; Slavin, T.; Liening, F.; Olson, R. L.

    1986-01-01

    Parametric data for six waste management subsystems considered for use on the Space Station are compared, i.e.: (1) dry incineration; (2) wet oxidation; (3) supercritical water oxidation; (4) vapor compression distillation; (5) thermoelectric integrated membrane evaporation system; and (6) vapor phase catalytic ammonia removal. The parameters selected for comparison are on-orbit weight and volume, resupply and return to Earth logistics, power consumption, and heat rejection. Trades studies are performed on subsystem parameters derived from the most recent literature. The Boeing Engineering Trade Study (BETS), an environmental control and life support system (ECLSS) trade study computer program developed by Boeing Aerospace Company, is used to properly size the subsystems under study. The six waste treatment subsystems modeled in this program are sized to process the wastes for a 90-day Space Station mission with an 8-person crew, and an emergency supply period of 28 days. The resulting subsystem parameters are compared not only on an individual subsystem level but also as part of an integrated ECLSS.

  15. Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  16. Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  17. Paediatric specialist registrars' views of educational supervision and how it can be improved: a questionnaire study.

    PubMed

    Lloyd, B W; Becker, D

    2007-08-01

    To determine what paediatric specialist registrars think of the educational supervision they have received and what advice they would give to a consultant who wanted to be a more effective educational supervisor. A questionnaire study. The North Thames Deanery, UK. 129 year 3, 4 or 5 paediatric specialist registrars in the North Thames Deanery. Reported value of educational supervision on a Likert scale; what elements of educational supervision were reported to be most useful; what elements of educational supervision were reported to be done poorly; what advice would specialist registrars give to a consultant who wanted to be a more effective educational supervisor. 86/129 specialist registrars responded (67%). The mean score on the Likert scale (0-a complete waste of time; 100-excellent) was 57 with 37% of respondents giving a score of less than 50. The most valued aspects of educational supervision were: feedback on performance--cited by 50 respondents (56% of respondents); career advice--cited by 43 (48%); objective setting--cited by 36 (40%); pastoral support--cited by 25 (28%). Aspects of educational supervision that were reported to be often not done well were: commitment to educational supervision--cited by 44 respondents (49% of respondents); ensuring sessions are bleep-free-cited by 43 (48%); listening rather than talking--cited by 23 (26%); being encouraging--cited by 18 (20%). Advice to consultants about how to improve educational supervision included: listen rather than talk; be encouraging; treat the trainee as an individual with individual needs. We can find no other study of trainees' views about how educational supervision can be improved. Although some trainees found educational supervision very valuable, many did not. Educational supervision should only be carried out by consultants who are committed to the task. An educational supervisor should listen carefully in order to understand the trainee's individual ambitions and needs, should provide

  18. Specialist health visitor-led weight management intervention in primary care: exploratory evaluation.

    PubMed

    Jackson, Cath; Coe, Anne; Cheater, Francine M; Wroe, Stephen

    2007-04-01

    This paper is a report of an exploratory study to evaluate the effectiveness and acceptability of a specialist health visitor-led weight management clinic in primary care. Tackling obesity is a global health priority. Whilst there is evidence to support a role for primary healthcare professionals in its management, provision in England varies widely. Using designated 'obesity specialists' is an approach warranting further investigation. In 2003-2004, patients with a body mass index of 30 or more received a specialist health visitor-led intervention based on the Jan Felgens 'I2E2' model. Clinical outcome data and self-reported dietary consumption data were collected at weeks 1, 13, 27 and 52. Quantitative and qualitative data on patient acceptability of the clinic were collected at week 26. Eighty-nine patients attended the clinic. Mean body weight and body mass index and systolic and diastolic blood pressure decreased over time by statistically significant amounts. There was a non-significant decrease in fasting blood sugar over time, but approximately one in 10 patients with undiagnosed diabetes were identified. No statistically significant change was evident for cholesterol levels. Mean self-reported weekly consumption of cakes, desserts and snacks decreased and that of fruit and vegetables increased, each by statistically significant amounts. Participants found the clinic highly acceptable and identified the specialist health visitor as fundamental to its success. A partnership approach to weight management through which patients are empowered to make sustainable lifestyle changes now needs to be tested in a multi-centre randomized controlled trial.

  19. Real-time Control of sewer pumps by using ControlNEXT to smooth inflow at Waste Water Treatment Plant Garmerwolde

    NASA Astrophysics Data System (ADS)

    van Heeringen, Klaas-Jan; van Nooijen, Ronald; Kooij, Kees; Postma, Bokke

    2016-04-01

    The Garmerwolde waste water treatment plant (WWTP) in the Groningen area of the Netherlands, receives waste water from a large area. That waste water is collected from many sewer systems and transported to the WWTP through pressurized pipes. The supply of waste water to the WWTP is relatively low and very irregular during dry-weather conditions, resulting in a random pattern of flows. This irregularity is the effect of the local control of the pumps, where the pumps are individually operated as an on/off control based on the water levels in the connected sewer system. The influent may change from zero to high values in a few minutes. The treatment processes at the WWTP are negatively influenced by this irregularity, which ends in high costs for energy and use of chemicals. The ControlNEXT central control system is used to control the 5 largest pump stations, such that the total inflow at the WWTP becomes much smoother. This results in a reduction of operational costs of about 10%. The control algorithm determines whether the actual condition is dry or wet, based on real-time radar precipitation images and the rainfall forecast product HiRLAM. All actual data is also collected and validated, like water levels, pump operations and pump availability. This data management is done using Delft-FEWS. If the situation is identified as "wet", the sewer systems are emptied as far as possible to create maximum storage. If the situation is "dry" (and of course there is a dead band between dry and wet), the pumps are operated such that the total inflow into the WWTP is smoothed. This is done with a Greedy algorithm, developed by Delft University of Technology. The algorithm makes a plan for the next 24 hours (as the daily inflow has a typical daily pattern) and generally stores some water volume in the sewer systems during the day to be able to continue operations during the night. The pumps are controlled with a time step of 5 minutes, where ControlNEXT manages the

  20. Of Specialists and Generalists.

    ERIC Educational Resources Information Center

    DeVore, Paul W.

    The issues involving the role and impact of specialists and generalists in society are critically examined in this paper. Currently held views on specialization are analyzed and challenged. Perspectives on this dilemma are developed in the following areas: (1) limitations of experts (casts doubt on the assumption that ordinary citizens are…

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

    ERIC Educational Resources Information Center

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

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

  2. Host specialist clownfishes are environmental niche generalists.

    PubMed

    Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas

    2014-11-22

    Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  3. Host specialist clownfishes are environmental niche generalists

    PubMed Central

    Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas

    2014-01-01

    Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. PMID:25274370

  4. Let's Waste Less Waste, Level 4. Teacher Guide. Operation Waste Watch.

    ERIC Educational Resources Information Center

    Virginia State Dept. of Waste Management, Richmond. Div. of Litter & Recycling.

    Operation Waste Watch is a series of seven sequential learning units which addresses the subject of litter control and solid waste management. Each unit may be used in a variety of ways, depending on the needs and schedules of individual schools, and may be incorporated into various social studies, science, language arts, health, mathematics, and…

  5. STS-88 Mission Specialist Currie prepares to enter Endeavour

    NASA Technical Reports Server (NTRS)

    1998-01-01

    STS-88 Mission Specialist Nancy Jane Currie is assisted with her ascent and re-entry flight suit in the white room at Launch Pad 39A before entering Space Shuttle Endeavour for launch. During the nearly 12-day mission, the six-member crew will mate the first two elements of the International Space Station -- the already-orbiting Zarya control module with the Unity connecting module carried by Endeavour. She is making her third spaceflight as the crew's flight engineer and prime operator of the Remote Manipulator System, the robotic arm.

  6. An organization for academic specialists: the time has come.

    PubMed

    Thompson, L Chesney; Chelmow, David; Hitt, Wilbur; Learman, Lee A; Ogburn, Tony

    2014-07-01

    The Society for Academic Specialists in General Obstetrics and Gynecology was recently formed to meet the professional needs of general obstetrician-gynecologists (ob-gyns) in academic settings. Historically there has been little communication and poor networking among this group, largely as a result of lack of infrastructure. Until the Society for Academic Specialists in General Obstetrics and Gynecology, there has been no common venue to unite academic specialists nor a means to identify colleagues and develop professional relationships. The Society is creating avenues for communication and collaboration among general ob-gyn faculty across institutions. The Society for Academic Specialists in General Obstetrics and Gynecology is hosting national meetings, conducting workshops and webinars, and developing other media to promote research training, share administrative skills, and help members to become more effective educators. One major focus of the new organization is to provide resources to facilitate faculty development. Formation of the Society for Academic Specialists in General Obstetrics and Gynecology is particularly timely given that ob-gyns, without subspecialty fellowship training, have assumed major roles in academic departments. Their contribution to educational, scholarly, and clinical responsibilities is a significant benefit to the well-being of the departments of obstetrics and gynecology. In turn, the role of educator and scholar is of value to the general academic ob-gyn. The Society for Academic Specialists in General Obstetrics and Gynecology will help academic faculty and their institutions by filling current gaps in professional and career development, which should improve scholarship, enhance retention, and improve the ability for academic departments to fulfill their educational and clinical missions.

  7. Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

    PubMed

    Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

    2015-10-28

    Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

  8. The visiting specialist model of rural health care delivery: a survey in Massachusetts.

    PubMed

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

    2006-01-01

    Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of satisfaction and intention to continue the visiting arrangement. Visiting specialists at 11 rural hospitals were asked to complete a mailed survey. Visiting specialists were almost evenly split between the medical (54%) and surgical (46%) specialties, with ophthalmology, nephrology, and obstetrics/gynecology the most common specialties reported. A higher proportion of visiting specialists than specialists statewide were male (P = .001). Supplementing their patient base and income were the most important reasons visiting specialists reported for having initiated an ancillary clinic. There was a significant negative correlation between a hospital's number of staffed beds and the total number of visiting specialists it hosted (r =-0.573, P = .032); study hospitals ranged in bed size from 15 to 129. The goal of matching supply of health care services with demand has been elusive. Visiting specialist clinics may represent an element of a market structure that expands access to needed services in rural areas. They should be included in any enumeration of physician availability.

  9. Clinical nurse specialists: essential resource for an effective NHS.

    PubMed

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

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

  10. Space Station Environmental Control and Life Support Systems: An Update on Waste Water Reclamation

    NASA Technical Reports Server (NTRS)

    Ferner, Kathleen M.

    1994-01-01

    Since the mid-1980's, work has been ongoing In the development of the various environmental control and life support systems (ECLSS) for the space station. Part of this effort has been focused on the development of a new subsystem to reclaim waste water that had not been previously required for shuttle missions. Because of the extended manned missions proposed, reclamation of waste water becomes imperative to avoid the weight penalties associated with resupplying a crew's entire water needs for consumption and daily hygiene. Hamilton Standard, under contract to Boeing Aerospace and Electronics, has been designing the water reclamation system for space station use. Since June of 1991, Hamilton Standard has developed a combined water processor capable of reclaiming potable quality water from waste hygiene water, used laundry water, processed urine, Shuttle fuel cell water, humidity condensate and other minor waste water sources. The system was assembled and then tested with over 27,700 pounds of 'real' waste water. During the 1700 hours of system operation required to process this waste water, potable quality water meeting NASA and Boeing specifications was produced. This paper gives a schematic overview of the system, describes the test conditions and test results and outlines the next steps for system development.

  11. Preliminary observation on the effect of baking soda volume on controlling odour from discarded organic waste

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

    Qamaruz-Zaman, N., E-mail: cenastaein@usm.my; Kun, Y.; Rosli, R.-N.

    Highlights: • Approximately 50 g baking soda reduced odour concentration by 70%. • Reducing volatile acid concentration reduces odour concentration. • Ammonia has less effect on odour concentration. - Abstract: Food wastes with high moisture and organic matter content are likely to emit odours as a result of the decomposition process. The management of odour from decomposing wastes is needed to sustain the interest of residents and local councils in the source separation of kitchen wastes. This study investigated the potential of baking soda (at 50 g, 75 g and 100 g per kg food waste) to control odour frommore » seven days stored food waste. It was found that 50 g of baking soda, spread at the bottom of 8 l food wastes bin, can reduce the odour by about 70%. A higher amount (above 100 g) is not advised as a pH higher than 9.0 may be induced leading to the volatilization of odorous ammonia. This research finding is expected to benefit the waste management sector, food processing industries as well as the local authorities where malodour from waste storage is a pressing issue.« less

  12. Parent training for Attention Deficit/Hyperactivity Disorder: is it as effective when delivered as routine rather than as specialist care?

    PubMed

    Sonuga-Barke, Edmund J S; Thompson, Margaret; Daley, David; Laver-Bradbury, Cathy

    2004-11-01

    The effectiveness of parent training (PT) when delivered as part of specialist tier-two services for preschool AD/HD children has been recently demonstrated. To assess the effectiveness of the same PT programme when delivered as part of routine primary care by non-specialist nurses. A sample of 89 3-year-old children with preschool AD/HD took part in a controlled trial of an eight-week (one hour a week), health visitor delivered, PT package. Children, allocated randomly to PT (n = 59) and waiting list control (WLC; n = 30) groups, were compared. PT did not reduce AD/HD symptoms. Maternal well-being decreased in both PT and WLC groups. While PT is an effective intervention for preschool AD/HD when delivered in specialized settings, these benefits do not appear to generalize when programme are delivered as part of routine primary care by non-specialist nurses.

  13. Control technology assessment of hazardous waste disposal operations in chemicals manufacturing: walk-through survey report of Olin Chemicals Group, Charleston, Tennessee

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

    Crandall, M.S.

    1983-08-01

    A walk through survey was conducted to assess control technology for hazardous wastes disposal operations at Olin Chemicals Group (SIC-2800, SIC-2812, SIC-2819), Charleston, Tennessee in May 1982. Hazardous wastes generated at the facility included brine sludge, thick mercury (7439954) (Hg) butter, and calcium-hypochlorite (7778543). An estimated 8500 tons of waste were disposed of annually. The Hg waste underwent a retorting process that recycled the Hg. The final detoxified waste was land filled. Brine sludge and calcium-hypochlorite were also land filled. No controls beyond those normally used at such sites were found at the landfills. Periodic monitoring of Hg vapor concentrationsmore » was conducted by the company. Medical monitoring of urine for Hg exposure was conducted. Specific limits were set for urinary Hg concentrations. When these limits were exceeded the workers were removed from exposure. Personal protective equipment consisted of hard hats, safety glasses, and spirators specially designed for Hg exposure. The author concludes that the hazardous waste disposal and treatment operations at the facility are well controlled.« less

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  15. The School Librarian as Information Specialist: A Vibrant Species

    ERIC Educational Resources Information Center

    Harris, Frances Jacobson

    2011-01-01

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

  16. Payload specialist Merbold performing experiment in Spacelab

    NASA Image and Video Library

    1983-11-28

    STS009-13-699 (28 Nov - 8 Dec 1983) --? Ulf Merbold, Spacelab 1 payload specialist, carries out one of the experiments using the gradient heating facility on the materials science double rack facility in the busy science module aboard the Earth-orbiting Space Shuttle Columbia. Representing the European Space Agency, Dr. Merbold comes from Max-Planck Institute in Stuttgart, the Federal Republic of Germany. He is a specialist in crystal lattice defects and low temperature physics. The photograph was made with a 35mm camera.

  17. A paradigm of international environmental law: the case for controlling the transboundary movements of hazardous wastes.

    PubMed

    Asante-Duah, K; Nagy, I V

    2001-06-01

    The production of large quantities of wastes globally has created a commercial activity involving the transfrontier shipments of hazardous wastes, intended to be managed at economically attractive waste-handling facilities located elsewhere. In fact, huge quantities of hazardous wastes apparently travel the world in search of "acceptable" waste management facilities. For instance, within the industrialized countries alone, millions of tonnes of potentially hazardous waste cross national frontiers each year on their way for recycling or to treatment, storage, and disposal facilities (TSDFs) because there is no local disposal capacity for these wastes, or because legal disposal or reuse in a foreign country may be more environmentally sound, or managing the wastes in the foreign country may be less expensive than at home. The cross-boundary traffic in hazardous wastes has lately been under close public scrutiny, however, resulting in the accession of several international agreements and laws to regulate such activities. This paper discusses and analyzes the most significant control measures and major agreements in this new commercial activity involving hazardous wastes. In particular, the discussion recognizes the difficulties with trying to implement the relevant international agreements among countries of vastly different socioeconomic backgrounds. Nonetheless, it is also noted that global environmental agreements will generally be a necessary component of ensuring adequate environmental protection for the world community-and thus a need for the careful implementation of such agreements and regulations.

  18. Apprentice Heating Systems Specialist, 11-1. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This military-developed text consists of four volumes of materials for use by those studying to become apprentice heating system specialists. Covered in the individual volumes are the following topics: related subjects (basic electricity, electrical controls, pipe and copper tubing, the principles of heating, fuels, and fuel systems); heating…

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

    PubMed

    Wright, Donald J

    2007-09-01

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

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

    NASA Technical Reports Server (NTRS)

    1990-01-01

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

  1. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  2. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  3. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  4. Becoming a Specialist Nurse in Psychiatric Mental Health Care

    ERIC Educational Resources Information Center

    Södergren, Ulrika; Benjaminson, Carin; Mattsson, Janet

    2017-01-01

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

  5. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  6. 22 CFR 61.6 - Consultation with subject matter specialists.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

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

    NASA Astrophysics Data System (ADS)

    Papanastasiou, Elena C.; Zembylas, Michalinos

    2006-12-01

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

  8. Polish Code of Ethics of a Medical Laboratory Specialist.

    PubMed

    Elżbieta, Puacz; Waldemar, Glusiec; Barbara, Madej-Czerwonka

    2014-09-01

    Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists' identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world.

  9. Ethanol confers differential protection against generalist and specialist parasitoids of Drosophila melanogaster.

    PubMed

    Lynch, Zachary R; Schlenke, Todd A; Morran, Levi T; de Roode, Jacobus C

    2017-01-01

    As parasites coevolve with their hosts, they can evolve counter-defenses that render host immune responses ineffective. These counter-defenses are more likely to evolve in specialist parasites than generalist parasites; the latter face variable selection pressures between the different hosts they infect. Natural populations of the fruit fly Drosophila melanogaster are commonly threatened by endoparasitoid wasps in the genus Leptopilina, including the specialist L. boulardi and the generalist L. heterotoma, and both wasp species can incapacitate the cellular immune response of D. melanogaster larvae. Given that ethanol tolerance is high in D. melanogaster and stronger in the specialist wasp than the generalist, we tested whether fly larvae could use ethanol as an anti-parasite defense and whether its effectiveness would differ against the two wasp species. We found that fly larvae benefited from eating ethanol-containing food during exposure to L. heterotoma; we observed a two-fold decrease in parasitization intensity and a 24-fold increase in fly survival to adulthood. Although host ethanol consumption did not affect L. boulardi parasitization rates or intensities, it led to a modest increase in fly survival. Thus, ethanol conferred stronger protection against the generalist wasp than the specialist. We tested whether fly larvae can self-medicate by seeking ethanol-containing food after being attacked by wasps, but found no support for this hypothesis. We also allowed female flies to choose between control and ethanol-containing oviposition sites in the presence vs. absence of wasps and generally found significant preferences for ethanol regardless of wasp presence. Overall, our results suggest that D. melanogaster larvae obtain protection from certain parasitoid wasp species through their mothers' innate oviposition preferences for ethanol-containing food sources.

  10. An analysis of specialist and non-specialist user requirements for geographic climate change information.

    PubMed

    Maguire, Martin C

    2013-11-01

    The EU EuroClim project developed a system to monitor and record climate change indicator data based on satellite observations of snow cover, sea ice and glaciers in Northern Europe and the Arctic. It also contained projection data for temperature, rainfall and average wind speed for Europe. These were all stored as data sets in a GIS database for users to download. The process of gathering requirements for a user population including scientists, researchers, policy makers, educationalists and the general public is described. Using an iterative design methodology, a user survey was administered to obtain initial feedback on the system concept followed by panel sessions where users were presented with the system concept and a demonstrator to interact with it. The requirements of both specialist and non-specialist users is summarised together with strategies for the effective communication of geographic climate change information. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  11. On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists.

    PubMed

    Zambrano, Sofia Carolina; Chur-Hansen, Anna; Crawford, Gregory B

    2012-09-01

    This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. Thirty-three semi-structured individual interviews were analysed using thematic analysis. One of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies. Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.

  12. Specialist Schools and Academies Trust Annual Report, 2008-2009

    ERIC Educational Resources Information Center

    Specialist Schools and Academies Trust, 2010

    2010-01-01

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

  13. Three-Loop Automatic of Control System the Landfill of Household Solid Waste

    NASA Astrophysics Data System (ADS)

    Sereda, T. G.; Kostarev, S. N.

    2017-05-01

    The analysis of models of governance ground municipal solid waste (MSW). Considered a distributed circuit (spatio-temporal) ground control model. Developed a dynamic model of multicontour control landfill. Adjustable parameters are defined (the ratio of CH4 CO2 emission/fluxes, concentrations of heavy metals ions) and control (purging array, irrigation, adding reagents). Based on laboratory studies carried out with the analysis of equity flows and procedures developed by the transferring matrix that takes into account the relationship control loops. A system of differential equations in the frequency and time domains. Given the numerical approaches solving systems of differential equations in finite differential form.

  14. 22 CFR 62.26 - Specialists.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., international educational exchange, museum exhibitions, labor law, public administration, and library science... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Specialists. 62.26 Section 62.26 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program...

  15. Certification of School Media Specialists.

    ERIC Educational Resources Information Center

    Penland, Patrick R.

    1982-01-01

    Professional organizations, such as the American Association of School Librarians and the Association for Educational Communications and Technology, have established guidelines and standards for certification of school media specialists and have identified necessary professional competencies. Issues and problems concerning state certification and…

  16. [Integral financing stifles innovation: consequences of the new form of financing for specialists].

    PubMed

    Berden, H J J M Bart; Keuzenkamp, Hugo A

    2015-01-01

    Of the 22,800 Dutch medical specialists, 43% are self-employed, which involves various tax benefits. In 2015 an important change took place. In the past, specialists declared their services independently from the hospital, which impeded process adjustments. Although this gives the impression of improvement, it is not, mainly because specialists are organized separately from the hospital organization. In addition, specialists are not entrepreneurs, which means that they avoid risks and uncertainty. The complex situation that has arisen is further complicated by fuzzy implementation that lacks an overall plan. For the individual specialist, the situation is unclear. The specialists consider necessary renewals and innovations to be irresponsible risks. This creates a cautious attitude and inertia. To achieve improvement, government and policy-makers should set clear rules and health insurers should value good governance. This protection would allow specialists and hospital boards to balance medical content and finance.

  17. Controlling healthcare costs by removing waste: what American doctors can do now.

    PubMed

    Swensen, Stephen J; Kaplan, Gary S; Meyer, Gregg S; Nelson, Eugene C; Hunt, Gordon C; Pryor, David B; Weissberg, Jed I; Daley, Jennifer; Yates, Gary R; Chassin, Mark R

    2011-06-01

    Healthcare costs are unsustainable. The authors propose a solution to control costs without rationing (deliberate withholding of effective care) or payment reductions to doctors and hospitals. Three physician-led strategies comprise this solution: reduce (1) overuse of health services, (2) preventable complications and (3) waste within healthcare processes. These challenges know no borders.

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

    NASA Technical Reports Server (NTRS)

    1990-01-01

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

  19. Payload specialist Reinhard Furrer show evidence of previous blood sampling

    NASA Technical Reports Server (NTRS)

    1985-01-01

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

  20. Maintenance of CO2 level in a BLSS by controlling solid waste treatment unit

    NASA Astrophysics Data System (ADS)

    Dong, Yingying; Li, Leyuan; Liu, Hong; Fu, Yuming; Xie, Beizhen; Hu, Dawei; Liu, Dianlei; Dong, Chen; Liu, Guanghui

    A bioregenerative life support system (BLSS) is an artificial closed ecosystem for providing basic human life support for long-duration, far-distance space explorations such as lunar bases. In such a system, the circulation of gases is one of the main factor for realizing a higher closure degree. O2 produced by higher plants goes to humans, as well as microorganisms for the treatment of inedible plant biomass and human wastes; CO2 produced by the crew and microorganisms is provided for plant growth. During this process, an excessively high CO2 level will depress plant growth and may be harmful to human health; and if the CO2 level is too low, plant growth will also be affected. Thus, keeping the balance between CO2 and O2 levels is a crucial problem. In this study, a high-efficiency, controllable solid waste treatment unit is constructed, which adopts microbial fermentation of the mixture of inedible biomass and human wastes. CO2 production during the fermentation process is controlled by adjusting fermentation temperature, aeration rate, moisture, etc., so as to meet the CO2 requirement of plants

  1. Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach

    PubMed Central

    Edmunds, Kelly L; Elrahman, Samira Abd; Bell, Diana J; Brainard, Julii; Dervisevic, Samir; Fedha, Tsimbiri P; Few, Roger; Howard, Guy; Lake, Iain; Maes, Peter; Matofari, Joseph; Minnigh, Harvey; Mohamedani, Ahmed A; Montgomery, Maggie; Morter, Sarah; Muchiri, Edward; Mudau, Lutendo S; Mutua, Benedict M; Ndambuki, Julius M; Pond, Katherine; Sobsey, Mark D; van der Es, Mike; Zeitoun, Mark

    2016-01-01

    Abstract Objective To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks. Methods A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point. Findings The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste. Conclusion The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease. PMID:27274594

  2. Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach.

    PubMed

    Edmunds, Kelly L; Elrahman, Samira Abd; Bell, Diana J; Brainard, Julii; Dervisevic, Samir; Fedha, Tsimbiri P; Few, Roger; Howard, Guy; Lake, Iain; Maes, Peter; Matofari, Joseph; Minnigh, Harvey; Mohamedani, Ahmed A; Montgomery, Maggie; Morter, Sarah; Muchiri, Edward; Mudau, Lutendo S; Mutua, Benedict M; Ndambuki, Julius M; Pond, Katherine; Sobsey, Mark D; van der Es, Mike; Zeitoun, Mark; Hunter, Paul R

    2016-06-01

    To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks. A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point. The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste. The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease.

  3. Using non-specialist observers in 4AFC human observer studies

    NASA Astrophysics Data System (ADS)

    Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2017-03-01

    Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

  4. Addressing cultural diversity: the hepatitis B clinical specialist perspective.

    PubMed

    Wallace, Jack; Smith, Elizabeth; Hajarizadeh, Behzad; Richmond, Jacqueline; Lucke, Jayne

    2017-08-31

    Hepatitis B is a viral infection primarily affecting people from culturally diverse communities in Australia. While vaccination prevents infection, there is increasing mortality resulting from liver damage associated with chronic infection. Deficits in the national policy and clinical response to hepatitis B result in a low diagnosis rate, inadequate testing and diagnosis processes, and poor access to hepatitis B treatment services. While research identifies inadequate hepatitis B knowledge among people with the virus and primary health care workers, this project sought to identify how specialist clinicians in Australia negotiate cultural diversity, and provide often complex clinical information to people with hepatitis B. A vignette was developed and presented to thirteen viral hepatitis specialist clinicians prior to an electronically recorded interview. Recruitment continued until saturation of themes was reached. Data were thematically coded into themes outlined in the interview schedule. Ethical approval for the research was provided by the La Trobe University Human Research Ethics Committee. Key messages provided to patients with hepatitis B by clinical specialists were identified. These messages were not consistently provided to all patients with hepatitis B, but were determined on perceptions of patient knowledge, age and highest educational level. While the vignette stated that English was not an issue for the patient, most specialists identified the need for an interpreter. Combating stigma related to hepatitis B was seen as important by the specialists and this was done through normalising the virus. Having an awareness of different cultural understandings about hepatitis B specifically, and health and well-being generally, was noted as a communication strategy. Key core competencies need to be developed to deliver educational messages to people with hepatitis B within clinical encounters. The provision of adequate resources to specialist clinics will

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

    PubMed

    Ares, Terri L

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

  6. Nitrogen conservation and acidity control during food wastes composting through struvite formation.

    PubMed

    Wang, Xuan; Selvam, Ammaiyappan; Chan, Manting; Wong, Jonathan W C

    2013-11-01

    One of the main problems of food waste composting is the intensive acidification due to initial rapid fermentation that retards decomposition efficiency. Lime addition overcame this problem, but resulted in significant loss of nitrogen as ammonia that reduces the nutrient contents of composts. Therefore, this study investigated the feasibility of struvite formation as a strategy to control pH and reduce nitrogen loss during food waste composting. MgO and K2HPO4 were added to food waste in different molar ratios (P1, 1:1; P2, 1:2), and composted in 20-L composters. Results indicate that K2HPO4 buffered the pH in treatment P2 besides supplementing phosphate into the compost. In P2, organic decomposition reached 64% while the formation of struvite effectively reduced the nitrogen loss from 40.8% to 23.3% during composting. However, electrical conductivity of the compost increased due to the addition of Mg and P salts that requires further investigation to improve this technology. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. STS-55 German Payload Specialist Schlegel manipulates ROTEX controls in SL-D2

    NASA Image and Video Library

    1993-05-06

    STS055-106-100 (26 April-6 May 1993) --- Hans Schlegel, wearing special glasses, works at the Robotics Experiment (ROTEX) workstation in the science module aboard the Earth-orbiting Space Shuttle Columbia. Schlegel was one of two payload specialists representing the German Aerospace Research Establishment (DLR) on the 10-day Spacelab D-2 mission. ROTEX is a robotic arm that operates within an enclosed workcell in rack 6 of the Spacelab module and uses teleoperation from both an onboard station located nearby in rack 4 and from a station on the ground. The device uses teleprogramming and artificial intelligence to look at the design, verification and operation of advanced autonomous systems for use in future applications.

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

    ERIC Educational Resources Information Center

    Gallaway, Ricky A.

    2015-01-01

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

  9. Aircraft Electrical Systems Specialist (AFSC 42350), Volumes 1-3, and Change Supplement, Volume 3.

    ERIC Educational Resources Information Center

    Savage, Leslie R.

    This three-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for aircraft electrical systems specialists. Covered in the individual volumes are career field fundamentals, electrical systems and test equipment, and aircraft control and warning systems. Each volume in the set contains a series…

  10. Payload specialists Millie Hughes-Fulford in Body Mass Measurement Device

    NASA Image and Video Library

    1985-02-01

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

  11. Balanced scorecards for specialists: a tool for quality improvement.

    PubMed

    Marr, Thomas J; Mullen, Deborah M

    2004-04-01

    This article describes a program that HealthPartners uses to assess and compare the performance of specialists that serve its members. HealthPartners' Balanced Scorecards program focuses on cardiologist and orthopedist practices in the Minneapolis/St. Paul metro area and St. Cloud, Minnesota. The scorecards assess the clinical and business processes of specialist practices, their use of resources, the degree to which patients and referring physicians are satisfied with their performance, and their patient outcomes. Unblinded comparative data is made available to referring physicians, employers, and consumers only after each individual specialist group has had the opportunity to review its own data against blinded results, discuss the methodology, and comment on the results.

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

    PubMed

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

    2017-01-07

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

  13. [Level of knowledge and action on lipaemia among Spanish primary and specialist care doctors. Press cholesterol study].

    PubMed

    Abellán Alemán, José; Leal Hernández, Mariano; Martínez Pastor, Antonio; Hernández Menárguez, Fernando; García-Galbis Marín, José Antonio; Jara Gómez, Purificación

    2006-09-01

    To find the level of knowledge, the guidelines for action and the monitoring of lipaemia by Spanish primary care and specialist doctors. A self-defined questionnaire of 12 items was designed. Data on the population treated and the subjective evaluation of objectives, and on the management and monitoring of lipid parameters were filled in. A total of 1998 doctors from the whole of Spain took part; 68.8% of the doctors interviewed worked in primary health care and 30.2% in specialist centres or hospitals. A 91% of the doctors said they followed international consensus on monitoring lipaemia. The most commonly used objective therapeutic parameter for treating lipaemia was LDL-cholesterol (83%), followed by total cholesterol (62%), HDL-cholesterol (56%) and triglycerides (51%). If the patient's lipaemia was well controlled, then 21.8% of doctors reduced the doses of lipid-lowerers. In general terms, no great differences were appreciated between the criteria followed by PC and by specialist doctors. The criteria for action on lipaemia could be improved. There are no important differences of view or action in clinical and therapeutic criteria for Lipaemia cases between PC and specialist doctors.

  14. 22 CFR 41.54 - Intracompany transferees (executives, managers, and specialists).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  15. STS-9 payload specialists and backup in training session

    NASA Technical Reports Server (NTRS)

    1983-01-01

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

  16. Specialist mental health consultation for depression in Australian aged care residents with dementia: a cluster randomized trial.

    PubMed

    McSweeney, Kate; Jeffreys, Aimee; Griffith, Joanne; Plakiotis, Chris; Kharsas, Renee; O'Connor, Daniel W

    2012-11-01

    This cluster randomized controlled trial sought to determine whether multidisciplinary specialist mental health consultation was more effective than care as usual in treating the depression of aged care residents with dementia. Three hundred and eighty nine aged care residents were screened for dementia and major depression. Forty four were ultimately included in the intervention sample, selected from 20 aged care facilities located in Melbourne, Australia. Facilities were randomly allocated to an intervention condition involving the provision of multidisciplinary specialist consultation regarding the best-practice management of depression in dementia, or to a care as usual condition. Consultations involved individually tailored medical and psychosocial recommendations provided to care staff and general practitioners. All residents participated in a comprehensive pre-intervention diagnostic assessment, including the administration of the Cornell Scale for Depression in Dementia. This assessment was repeated approximately 15 weeks post-intervention by a rater blind to study condition. Multidisciplinary specialist mental health consultation was significantly more effective than care as usual in treating the clinical depression of aged care residents with dementia (p < 0.05, partial η(2)  = 0.16). At follow-up, the mean Cornell Scale for Depression in Dementia score for the intervention group was 9.47, compared with 14.23 for the control group. In addition, 77% of the intervention group no longer met criteria for major depression. The results of this study suggest that the psychosocial and medical management of depressed aged care residents can be improved by increasing access to specialist mental health consultation. Copyright © 2012 John Wiley & Sons, Ltd.

  17. The feasibility and acceptability of conducting a trial of specialist medical care and the Lightning Process in children with chronic fatigue syndrome: feasibility randomized controlled trial (SMILE study)

    PubMed Central

    2013-01-01

    Background Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is relatively common in children with limited evidence for treatment. The Phil Parker Lightning Process (LP) is a trademarked intervention, which >250 children use annually. There are no reported studies investigating the effectiveness or possible side effects of LP. Methods The trial population was drawn from the Bath and Bristol NHS specialist paediatric CFS or ME service. The study was designed as a pilot randomized trial with children (aged 12 to 18 years) comparing specialist medical care with specialist medical care plus the Lightning Process. Integrated qualitative methodology was used to explore the feasibility and acceptability of the recruitment, randomization and interventions. Results A total of 56 children were recruited from 156 eligible children (1 October 2010 to 16 June 2012). Recruitment, randomization and both interventions were feasible and acceptable. Participants suggested changes to improve feasibility and acceptability and we incorporated the following in the trial protocol: stopped collecting 6-week outcomes; introduced a second reminder letter; used phone calls to collect primary outcomes from nonresponders; informed participants about different approaches of each intervention and changed our recommendation for the primary outcome for the full study from school attendance to disability (SF-36 physical function subscale) and fatigue (Chalder Fatigue Scale). Conclusions Conducting randomized controlled trials (RCTs) to investigate an alternative treatment such as LP is feasible and acceptable for children with CFS or ME. Feasibility studies that incorporate qualitative methodology enable changes to be made to trial protocols to improve acceptability to participants. This is likely to improve recruitment rate and trial retention. Trial registration Feasibility study first randomization: 29 September 2010. Trial registration: Current Controlled Trials ISRCTN81456207

  18. Ethanol confers differential protection against generalist and specialist parasitoids of Drosophila melanogaster

    PubMed Central

    Schlenke, Todd A.; Morran, Levi T.; de Roode, Jacobus C.

    2017-01-01

    As parasites coevolve with their hosts, they can evolve counter-defenses that render host immune responses ineffective. These counter-defenses are more likely to evolve in specialist parasites than generalist parasites; the latter face variable selection pressures between the different hosts they infect. Natural populations of the fruit fly Drosophila melanogaster are commonly threatened by endoparasitoid wasps in the genus Leptopilina, including the specialist L. boulardi and the generalist L. heterotoma, and both wasp species can incapacitate the cellular immune response of D. melanogaster larvae. Given that ethanol tolerance is high in D. melanogaster and stronger in the specialist wasp than the generalist, we tested whether fly larvae could use ethanol as an anti-parasite defense and whether its effectiveness would differ against the two wasp species. We found that fly larvae benefited from eating ethanol-containing food during exposure to L. heterotoma; we observed a two-fold decrease in parasitization intensity and a 24-fold increase in fly survival to adulthood. Although host ethanol consumption did not affect L. boulardi parasitization rates or intensities, it led to a modest increase in fly survival. Thus, ethanol conferred stronger protection against the generalist wasp than the specialist. We tested whether fly larvae can self-medicate by seeking ethanol-containing food after being attacked by wasps, but found no support for this hypothesis. We also allowed female flies to choose between control and ethanol-containing oviposition sites in the presence vs. absence of wasps and generally found significant preferences for ethanol regardless of wasp presence. Overall, our results suggest that D. melanogaster larvae obtain protection from certain parasitoid wasp species through their mothers’ innate oviposition preferences for ethanol-containing food sources. PMID:28700600

  19. How much does the specialist know about cardiogastroenterology?

    PubMed

    Aguilar-Nájera, O; Valdovinos-García, L R; Tepox-Padrón, A; Valdovinos-Díaz, M A

    Cardiovascular disease is a growing public health problem. Forty percent of the general population will suffer from the disease by 2030, consequently requiring antithrombotic therapy. Cardiogastroenterology is a new area of knowledge that evaluates the gastrointestinal effects and complications of antithrombotic therapy. Our aim was to evaluate, through a validated questionnaire, the knowledge held by a group of specialists and residents in the areas of gastroenterology and internal medicine, about pharmacology and drug prescription, as well as gastrointestinal risks and complications, in relation to antithrombotic therapy. A validated questionnaire composed of 30 items was applied to a group of specialists and residents in the areas of gastroenterology and internal medicine. The questions were on indications, pharmacology, evaluation of risks for gastrointestinal bleeding and thromboembolic events, and use of antithrombotic therapy during endoscopic procedures. Sufficient knowledge was defined as 18 or more (≥ 60%) correct answers. The questionnaire was answered by 194 physicians: 82 (42%) internal medicine residents and gastroenterology residents and 112 (58%) specialists. Only 40 (20.6%) of the participants had sufficient knowledge of cardiogastroenterology. Residents had a higher number of correct answers than specialists (53 vs. 36%, P<.0001). The gastroenterology residents had more correct answers than the internal medicine residents, gastroenterologists, and internists (70 vs. 53, 40, and 46%, respectively, P<.001). Only residents had sufficient knowledge regarding pharmacology and the use of antithrombotic therapy in endoscopy (P<.0001). All groups had insufficient knowledge in evaluating the risk for gastrointestinal bleeding and thrombosis. Knowledge of cardiogastroenterology was insufficient in the group of residents and specialists surveyed. There is a need for medical education programs on the appropriate use of antithrombotic therapy. Copyright

  20. Inequalities in Specialist Hand Surgeon Distribution across the United States.

    PubMed

    Rios-Diaz, Arturo J; Metcalfe, David; Singh, Mansher; Zogg, Cheryl K; Olufajo, Olubode A; Ramos, Margarita S; Caterson, Edward J; Talbot, Simon G

    2016-05-01

    Unequal access to hospital specialists for emergency care is an issue in the United States. The authors sought to describe the geographic distribution of specialist hand surgeons and associated factors in the United States. Geographic distributions of surgeons holding a Subspecialty Certificate in Surgery of the Hand and hand surgery fellowship positions were identified from the American Board of Medical Specialties Database and the literature (2013), respectively. State-level population and per capita income were ascertained using U.S. Census data. Variations in hand trauma admissions were determined using Healthcare Cost and Utilization Project national/state inpatient databases. Risk-adjusted generalized linear models were used to assess independent association between hand surgeon density and hand trauma admission density, fellowship position density, and per capita income. Among 2019 specialist hand surgeons identified, 72.1 percent were orthopedic surgeons, 18.3 percent were plastic surgeons, and 9.6 percent were general surgeons. There were 157 hand surgery fellowship positions nationwide. There were 149,295 annual hand trauma admissions. The national density of specialist hand surgeons and density of trauma admission were 0.6 and 47.6, respectively. The density of specialist hand surgeons varied significantly between states. State-level variations in density of surgeons were independent and significantly associated with median per capita income (p < 0.001) and with density of fellowships (p = 0.014). Specialist hand surgeons are distributed unevenly across the United States. State-level analyses suggest that states with lower per capita incomes may be particularly underserved, which may contribute to regional disparities in access to emergency hand trauma care.

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

    PubMed

    Gruen, Russell; Bailie, Ross

    2004-10-01

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

  2. Pest Management Specialist (AFSC 56650).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This eight-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for pest management specialists. Covered in the individual volumes are civil engineering; pest management (entomology, pest management planning and coordination, and safety and protective equipment); pest management chemicals and…

  3. 14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  4. 14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  5. 14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  6. 14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  7. 20 CFR 702.408 - Evaluation of medical questions; impartial specialists.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  8. Community mobilization and household level waste management for dengue vector control in Gampaha district of Sri Lanka; an intervention study.

    PubMed

    Abeyewickreme, W; Wickremasinghe, A R; Karunatilake, K; Sommerfeld, J; Axel, Kroeger

    2012-12-01

    Waste management through community mobilization to reduce breeding places at household level could be an effective and sustainable dengue vector control strategy in areas where vector breeding takes place in small discarded water containers. The objective of this study was to assess the validity of this assumption. An intervention study was conducted from February 2009 to February 2010 in the populous Gampaha District of Sri Lanka. Eight neighborhoods (clusters) with roughly 200 houses each were selected randomly from high and low dengue endemic areas; 4 of them were allocated to the intervention arm (2 in the high and 2 in the low endemicity areas) and in the same way 4 clusters to the control arm. A baseline household survey was conducted and entomological and sociological surveys were carried out simultaneously at baseline, at 3 months, at 9 months and at 15 months after the start of the intervention. The intervention programme in the treatment clusters consisted of building partnerships of local stakeholders, waste management at household level, the promotion of composting biodegradable household waste, raising awareness on the importance of solid waste management in dengue control and improving garbage collection with the assistance of local government authorities. The intervention and control clusters were very similar and there were no significant differences in pupal and larval indices of Aedes mosquitoes. The establishment of partnerships among local authorities was well accepted and sustainable; the involvement of communities and households was successful. Waste management with the elimination of the most productive water container types (bowls, tins, bottles) led to a significant reduction of pupal indices as a proxy for adult vector densities. The coordination of local authorities along with increased household responsibility for targeted vector interventions (in our case solid waste management due to the type of preferred vector breeding places) is

  9. Twelve Scientific Specialists of the Peenemuende Team

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Twelve scientific specialists of the Peenemuende team at the front of Building 4488, Redstone Arsenal, Huntsville, Alabama. They led the Army's space efforts at ABMA before transfer of the team to National Aeronautic and Space Administration (NASA), George C. Marshall Space Flight Center (MSFC). (Left to right) Dr. Ernst Stuhlinger, Director, Research Projects Office; Dr. Helmut Hoelzer, Director, Computation Laboratory: Karl L. Heimburg, Director, Test Laboratory; Dr. Ernst Geissler, Director, Aeroballistics Laboratory; Erich W. Neubert, Director, Systems Analysis Reliability Laboratory; Dr. Walter Haeussermarn, Director, Guidance and Control Laboratory; Dr. Wernher von Braun, Director Development Operations Division; William A. Mrazek, Director, Structures and Mechanics Laboratory; Hans Hueter, Director, System Support Equipment Laboratory;Eberhard Rees, Deputy Director, Development Operations Division; Dr. Kurt Debus, Director Missile Firing Laboratory; Hans H. Maus, Director, Fabrication and Assembly Engineering Laboratory

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

    PubMed

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

    2015-03-01

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

  11. STS-75 Payload Specialist Umberto Guidoni suits up

    NASA Technical Reports Server (NTRS)

    1996-01-01

    STS-75 Payload Specialist Umberto Guidoni (right) chats with fellow crew member Mission Specialist Claude Nicollier during suitup activities in the Operations and Checkout Building. Guidoni represents the Italian Space Agency and is one of three international crew members assigned to STS-75. He and six fellow crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff during a two-and-a-half- hour launch window opening at 3:18 p.m. EST.

  12. Payload specialist Robert Cenker after adjusting DSO equipment

    NASA Image and Video Library

    1986-01-12

    61C-05-035 (12-17 Jan 1986) --- Robert J. Cenker, 61-C payload specialist representing RCA, returns a tiny tool to its stowage position after adjusting the inner workings of a device used in one of a number of detailed supplementary objective (DSO) studies for NASA's Space Biomedical Research Institute. The device is a pair of ocular counter-rolling goggles used by U.S. Rep. Bill Nelson (D., Florida), 61-C's other payload specialist aboard the Columbia for this five-day flight.

  13. STS-87 Mission Specialist Takao Doi suits up

    NASA Technical Reports Server (NTRS)

    1997-01-01

    STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, gives a thumbs up in his launch and entry suit in the Operations and Checkout Building. He and the five other crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff on a 16-day mission to perform microgravity and solar research. Dr. Doi is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Winston Scott during STS-87.

  14. Human factors in waste management - potential and reality

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

    Thompson, J.S.

    There is enormous potential for human factors contributions in the realm of waste management. The reality, however, is very different from the potential. This is particularly true for low-level and low-level mixed-waste management. The hazards are less severe; therefore, health and safety requirements (including human factors) are not as rigorous as for high-level waste. High-level waste management presents its own unique challenges and opportunities. Waste management is strongly driven by regulatory compliance. When regulations are flexible and open to interpretation and the environment is driven so strongly by regulatory compliance, standard practice is to drop {open_quotes}nice to have{close_quotes} features, likemore » a human factors program, to save money for complying with other requirements. The challenge is to convince decision makers that human factors can help make operations efficient and cost-effective, as well as improving safety and complying with regulations. A human factors program should not be viewed as competing with compliance efforts; in fact, it should complement them and provide additional cost-effective means of achieving compliance with other regulations. Achieving this synergy of human factors with ongoing waste management operations requires educating program and facility managers and other technical specialists about human factors and demonstrating its value {open_quotes}through the back door{close_quotes} on existing efforts. This paper describes ongoing projects at Los Alamos National Laboratory (LANL) in support of their waste management groups. It includes lessons learned from hazard and risk analyses, safety analysis reports, job and task analyses, operating procedure development, personnel qualification/certification program development, and facility- and job-specific training program and course development.« less

  15. Portrait view of ESA Spacelab Specialists

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Portrait view of European Space Agency (ESA) Spacelab Specialist Ulf Merbold in civilian clothes standing in front of a display case. The photo was taken at the Marshall Space Flight Center (MSFC), Huntsville, Alabama.

  16. [Smoking among patients of selected specialist clinics of Miedzylesie Specialist Hospital in Warsaw].

    PubMed

    Pytka, Dorota; Doboszyńska, Anna

    2011-01-01

    The purpose of the study is to examine the issue of smoking among patients of selected clinics of the Miedzylesie Specialist Hospital in Warsaw, assessment of nicotine addiction of smokers and motivation to give up smoking. The survey was carried out in June and July 2009 after obtaining the consent of the Director of Miedzylesie Specialist Hospital in Warsaw. The survey was participated in by 100 patients of selected specialist clinics. The survey was carried out on the basis of a questionnaire consisting of 7 questions. Furthermore, the "Test of motivation to give up smoking" (Schneider's test) and the "Assessment of nicotine addiction level" (Fagerström's test), published in the "Consensus regarding recognition and treatment of nicotine addiction", were used. When processing data, the descriptive statistics were applied. Those surveyed included 53 former cigarette smokers 47 active smokers and. In the group of former smokers, 19 people still were exposed to passive smoking. In the past, the problem regarded 41 people. Thirty former smokers smoked cigarettes among non-smokers, including young children (18 people) and when pregnant and breastfeeding (2 people). Also 30 respondents smoked despite medical contraindications and bad conscience. For 27 people, expenditures on cigarettes constituted a considerable burden of their respective household budgets, and 20 said that it was a significant item in their expenditures. Smokers have been smoking cigarettes for 30 years, on average 20 cigarettes a day. Those patients began to smoke at the age of 20. Thirty one active smokers exposed other people to passive smoking and 38 respondents smoked cigarettes despite medical contraindications and with bad conscience. For 22 people, expenditures related to smoking are a considerable burden of the household budget and for 21 people, it is a significant expenditure. Almost one half of the patients smoke cigarettes although they should brake off smoking for medical reasons. Most

  17. The Snowtweets Project: communicating snow depth measurements from specialists and non-specialists via mobile communication technologies and social networks

    NASA Astrophysics Data System (ADS)

    King, J. M.; Cabrera, A. R.; Kelly, R. E.

    2009-12-01

    With the global decline of in situ snow measurements for hydrometeorological applications, there is an evolving need to find alternative ways to collect localized measurements of snow. The Snowtweets Project is an experiment aimed at providing a way for people interested in making snow measurements to quickly broadcast their measurements to the internet. The goal of the project is to encourage specialists and non-specialists alike to share simple snow depth measurements through widely available social networking sites. We are currently using the rapidly growing microblogging site Twitter (www.twitter.com) as a broadcasting vehicle to collect the snow depth measurements. Using 140 characters or less, users "tweet" their snow depth from their location through the Twitter website. This can be done from a computer or smartphone with internet access or through SMS messaging. The project has developed a Snowtweets web application that interrogates Twitter by parsing the 140 character string to obtain a geographic position and snow depth. GeoRSS and KML feeds are available to visualize the tweets in GoogleEarth or they can be viewed in our own visualiser, Snowbird. The emphasis is on achieving wide coverage to increase the number of microblogs. Furthermore, after some quality control filters, the project is able to combine the broadcast snow depths with traditional and objective satellite remote sensing-based observations or hydrologic model estimates. Our site, snowcore.uwaterloo.ca, was launched in July 2009 and is ready for the 2009-2010 northern hemisphere winter. We invite comments from experienced community participation projects to help improve our product.

  18. Biogenic carbon in combustible waste: waste composition, variability and measurement uncertainty.

    PubMed

    Larsen, Anna W; Fuglsang, Karsten; Pedersen, Niels H; Fellner, Johann; Rechberger, Helmut; Astrup, Thomas

    2013-10-01

    Obtaining accurate data for the contents of biogenic and fossil carbon in thermally-treated waste is essential for determination of the environmental profile of waste technologies. Relations between the variability of waste chemistry and the biogenic and fossil carbon emissions are not well described in the literature. This study addressed the variability of biogenic and fossil carbon in combustible waste received at a municipal solid waste incinerator. Two approaches were compared: (1) radiocarbon dating ((14)C analysis) of carbon dioxide sampled from the flue gas, and (2) mass and energy balance calculations using the balance method. The ability of the two approaches to accurately describe short-term day-to-day variations in carbon emissions, and to which extent these short-term variations could be explained by controlled changes in waste input composition, was evaluated. Finally, the measurement uncertainties related to the two approaches were determined. Two flue gas sampling campaigns at a full-scale waste incinerator were included: one during normal operation and one with controlled waste input. Estimation of carbon contents in the main waste types received was included. Both the (14)C method and the balance method represented promising methods able to provide good quality data for the ratio between biogenic and fossil carbon in waste. The relative uncertainty in the individual experiments was 7-10% (95% confidence interval) for the (14)C method and slightly lower for the balance method.

  19. Establishing a Research Agenda for Understanding the Role and Impact of Mental Health Peer Specialists.

    PubMed

    Chinman, Matthew; McInnes, D Keith; Eisen, Susan; Ellison, Marsha; Farkas, Marianne; Armstrong, Moe; Resnick, Sandra G

    2017-09-01

    Mental health peer specialists are individuals with serious mental illnesses who receive training to use their lived experiences to help others with serious mental illnesses in clinical settings. This Open Forum discusses the state of the research for mental health peer specialists and suggests a research agenda to advance the field. Studies have suggested that peer specialists vary widely in their roles, settings, and theoretical orientations. Theories of action have been proposed, but none have been tested. Outcome studies have shown benefits of peer specialists; however, many studies have methodological shortcomings. Qualitative descriptions of peer specialists are plentiful but lack grounding in implementation science frameworks. A research agenda advancing the field could include empirically testing theoretical mechanisms of peer specialists, developing a measure of peer specialist fidelity, conducting more rigorous outcomes studies, involving peer specialists in executing the research, and assessing various factors that influence implementing peer specialist services and testing strategies that could address those factors.

  20. Are Specialist Certification Examinations a Reliable Measure of Physician Competence?

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  1. The Role of the Technical Specialist in Disaster Response and Recovery

    NASA Astrophysics Data System (ADS)

    Curtis, J. C.

    2017-12-01

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

  2. Understanding specialist sharing: A mixed-method exploration in an increasingly price-competitive hospital market.

    PubMed

    Westra, Daan; Angeli, Federica; Jatautaitė, Evelina; Carree, Martin; Ruwaard, Dirk

    2016-08-01

    Medical specialists seem to increasingly work in- and be affiliated to- multiple organizations. We define this phenomenon as specialist sharing. This form of inter-organizational cooperation has received scant scholarly attention. We investigate the extent of- and motives behind- specialist sharing, in the price-competitive hospital market of the Netherlands. A mixed-method was adopted. Social network analysis was used to quantitatively examine the extent of the phenomenon. The affiliations of more than 15,000 medical specialists to any Dutch hospital were transformed into 27 inter-hospital networks, one for each medical specialty, in 2013 and in 2015. Between February 2014 and February 2016, 24 semi-structured interviews with 20 specialists from 13 medical specialties and four hospital executives were conducted to provide in-depth qualitative insights regarding the personal and organizational motives behind the phenomenon. Roughly, 20% of all medical specialists are affiliated to multiple hospitals. The phenomenon occurs in all medical specialties and all Dutch hospitals share medical specialists. Rates of specialist sharing have increased significantly between 2013 and 2015 in 14 of the 27 specialties. Personal motives predominantly include learning, efficiency, and financial benefits. Increased workload and discontinuity of care are perceived as potential drawbacks. Hospitals possess the final authority to decide whether and which specialists are shared. Adhering to volume norms and strategic considerations are seen as their main drivers to share specialists. We conclude that specialist sharing should be interpreted as a form of inter-organizational cooperation between healthcare organizations, facilitating knowledge flow between them. Although quality improvement is an important perceived factor underpinning specialist sharing, evidence of enhanced quality of care is anecdotal. Additionally, the widespread occurrence of the phenomenon and the underlying

  3. Neurofibromatosis and the role of the specialist adviser.

    PubMed

    Redman, Carolyn

    2017-09-11

    Neurofibromatosis (NF) is a genetic condition that mainly involves the nervous system. There are two types: NF1 affects about one in 2,500 of the population worldwide and NF2 affects one in 35,000. Both types result in complex health problems for patients and can pose significant challenges for all those involved in their management. Established in 1981, The Neuro Foundation is a patient-focused charity that funds a network of specialist advisers who work in partnership with the NHS to offer support and advice for families affected by NF and the professionals who care for them. With a significant level of autonomy, the specialist adviser role is flexible in matching the needs of those affected while working cooperatively alongside the national specialist services for NF1 and NF2. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

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

    ERIC Educational Resources Information Center

    Dossey, John A.

    1984-01-01

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

  5. Internet for Library Media Specialists.

    ERIC Educational Resources Information Center

    Simpson, Carol Mann

    This guide introduces the library media specialist to the Internet, its history and features, and provides information on specific uses of the Internet in school libraries and specific areas. Section 1, "What is the Internet?" introduces the reader to the Internet; electronic mail; telnet; file transfer protocol (FTP); wide area…

  6. Dental Assistant Specialist. (AFSC 98150).

    ERIC Educational Resources Information Center

    Eling, David R.

    This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for dental assistant specialists. Covered in the individual volumes are an introduction to dental services (the mission and organization of medical/dental service, career ladder progressions, medical readiness/wartime training, and…

  7. Metal Fabricating Specialist (AFSC 55252).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This seven-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for metal fabricating specialists. Covered in the individual volumes are general subjects (career progression, management of activities and resources, shop mathematics, and characteristics of metals); sheet metal tools and equipment…

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

    PubMed

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

    2016-07-11

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

  9. Care in specialist medical and mental health unit compared with standard care for older people with cognitive impairment admitted to general hospital: randomised controlled trial (NIHR TEAM trial)

    PubMed Central

    Goldberg, Sarah E; Bradshaw, Lucy E; Kearney, Fiona C; Russell, Catherine; Whittamore, Kathy H; Foster, Pippa E R; Mamza, Jil; Gladman, John R F; Jones, Rob G; Lewis, Sarah A; Porock, Davina

    2013-01-01

    Objective To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment. Design Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system. Setting Large acute general hospital in the United Kingdom. Participants 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission. Interventions Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of the specialist unit included joint staffing by medical and mental health professionals; enhanced staff training in delirium, dementia, and person centred dementia care; provision of organised purposeful activity; environmental modification to meet the needs of those with cognitive impairment; delirium prevention; and a proactive and inclusive approach to family carers. Main outcome measures Primary outcome: number of days spent at home over the 90 days after randomisation. Secondary outcomes: structured non-participant observations to ascertain patients’ experiences; satisfaction of family carers with hospital care. When possible, outcome assessment was blind to allocation. Results There was no significant difference in days spent at home between the specialist unit and standard care groups (median 51 v 45 days, 95% confidence interval for difference −12 to 24; P=0.3). Median index hospital stay was 11 versus 11 days, mortality 22% versus 25% (−9% to 4%), readmission 32% versus 35% (−10% to 5%), and new admission to care home 20% versus 28% (−16% to 0) for the specialist unit and standard care groups, respectively. Patients returning home spent a median of 70.5 versus 71.0 days at home (−6.0 to 6.5). Patients on the specialist unit spent significantly more time with positive mood or

  10. Peculiarities of Future Social Sphere Specialists' Professional Training in Poland

    ERIC Educational Resources Information Center

    Zieba, Beata

    2016-01-01

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

  11. STS-55 crewmembers repair waste water tank on OV-102's middeck

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Three STS-55 crewmembers participate in an inflight maintenance (IFM) exercise to counter problems experienced with a waste water tank below Columbia's, Orbiter Vehicle (OV) 102's, middeck. Mission Specialist 3 (MS3) Bernard A. Harris, Jr, inside the airlock, holds middeck floor access panel MD54G and looks below at Pilot Terence T. Henricks who is in the bilge area. Commander Steven R. Nagel is lying on middeck floor at the left.

  12. Use of organic waste as biofumigant for controlling root knot nematodes (Meloidogyne spp.) on potato

    NASA Astrophysics Data System (ADS)

    Sari, D. I. P.; Lisnawita; Oemry, S.; Safni, I.; Lubis, K.; Tantawi, A. R.

    2018-02-01

    Root knot nematode (Meloidogyne spp.) is one of the important pathogens that causes big impact on potato crop yields. One of the control strategies for controlling this nematode is the use of biofumigants. Biofumigants are volatile toxic compound derived from plants, and have biocide properties against insects and plant pathogens. Organic waste such as Brassicaceae, Leguminoceae, and Solanaceae can be used as biofumigant sources. This research was conducted to determine the effectiveness of Brassicaceae, Leguminoceae, and Solanaceae as biofumigants against Meloidogyne spp. The experiment was set in a completely randomized design (CRD) with the treatments were organic wastes including Brassicaceae, Leguminoceae, and Solanaceae, both single and combinations, and 2 controls (positive and negative controls) with 3 replications. Each of the biofumigant treatments was prepared and stored for 2 weeks. Potato tubers were transplanted 15 days after germination into polybag inoculated with 1,000 Meloidogyne spp. J2s. The results showed that Brassicaceae + Solanaceae were effective in decreasing the number of galls in potato plants, however only Solanaceae improved plant growth.

  13. Secondary Waste Cast Stone Waste Form Qualification Testing Plan

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

    Westsik, Joseph H.; Serne, R. Jeffrey

    2012-09-26

    The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is being constructed to treat the 56 million gallons of radioactive waste stored in 177 underground tanks at the Hanford Site. The WTP includes a pretreatment facility to separate the wastes into high-level waste (HLW) and low-activity waste (LAW) fractions for vitrification and disposal. The LAW will be converted to glass for final disposal at the Integrated Disposal Facility (IDF). Cast Stone – a cementitious waste form, has been selected for solidification of this secondary waste stream after treatment in the ETF. The secondary-waste Cast Stone waste form must be acceptablemore » for disposal in the IDF. This secondary waste Cast Stone waste form qualification testing plan outlines the testing of the waste form and immobilization process to demonstrate that the Cast Stone waste form can comply with the disposal requirements. Specifications for the secondary-waste Cast Stone waste form have not been established. For this testing plan, Cast Stone specifications are derived from specifications for the immobilized LAW glass in the WTP contract, the waste acceptance criteria for the IDF, and the waste acceptance criteria in the IDF Permit issued by the State of Washington. This testing plan outlines the testing needed to demonstrate that the waste form can comply with these waste form specifications and acceptance criteria. The testing program must also demonstrate that the immobilization process can be controlled to consistently provide an acceptable waste form product. This testing plan also outlines the testing needed to provide the technical basis for understanding the long-term performance of the waste form in the disposal environment. These waste form performance data are needed to support performance assessment analyses of the long-term environmental impact of the secondary-waste Cast Stone waste form in the IDF« less

  14. Payload Specialist Gregory T. Linteris

    NASA Technical Reports Server (NTRS)

    1997-01-01

    KENNEDY SPACE CENTER, FLA. -- STS-83 Payload Specialist Gregory T. Linteris chats with white room closeout crew members as he prepares to enter the Space Shuttle Columbia at Launch Pad 39A. Closeout crew workers Max Kandler (second from right) and Bob Saulnier wait to assist Linteris with his ascent/reentry suit.

  15. Control of Effluent Gases from Solid Waste Processing using Impregnated Carbon Nanotubes

    NASA Technical Reports Server (NTRS)

    Li, Jing; Fisher, John; Wignarajah, Kanapathipillai

    2005-01-01

    One of the major problems associated with solid waste processing technologies is effluent contaminants that are released in gaseous forms from the processes. This is a concern in both biological as well as physicochemical solid waste processing. Carbon dioxide (CO2), the major gas released, does not present a serious problem and there are currently in place a number of flight-qualified technologies for CO2 removal. However, a number of other gases, in particular NOx, SO2, NH3, and various hydrocarbons (e.g. CH4) do present health hazards to the crew members in space habitats. In the present configuration of solid waste processing in the International Space Station (ISS), some of these gases are removed by the Trace Contaminant Control System (TCCS), demands a major resupply. Reduction of the resupply can be effective by using catalyst impregnated carbon nanotubes. For example, NO decomposition to N2 and O2 is thermodynamically favored. Data showing decomposition of NO on metal impregnated carbon nanotubes is presented. Comparisons are made of the existing TCCS systems with the carbon nanotube based technology for removing NOx based on mass/energy penalties.

  16. STS-88 Mission Specialists Currie and Ross inside Endeavour

    NASA Technical Reports Server (NTRS)

    1998-01-01

    STS-88 Mission Specialists Nancy J. Currie, Ph.D., (back) and Jerry L. Ross (front) check over equipment inside orbiter Endeavour during Terminal Countdown Demonstration Activities (TCDT). The TCDT includes mission familiarization activities, emergency egress training, and the simulated main engine cut-off exercise. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module. Unity will be mated with the already orbiting Russian-built Zarya control module. The 12-day mission includes three planned spacewalks to connect power, data and utility lines and install exterior equipment.

  17. Battery collection in municipal waste management in Japan: Challenges for hazardous substance control and safety

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

    Terazono, Atsushi, E-mail: terazono@nies.go.jp; Oguchi, Masahiro; Iino, Shigenori

    Highlights: • Consumers need to pay attention to the specific collection rules for each type of battery in each municipality in Japan. • 6–10% of zinc carbon and alkaline batteries discarded in Japan currently could be regarded as containing mercury. • Despite announcements by producers and municipalities, only 2.0% of discarded cylindrical dry batteries were insulated. • Batteries made up an average of 4.6% of the total collected small WEEE under the small WEEE recycling scheme in Japan. • Exchangeable batteries were used in almost all of mobile phones, but the removal rate was as low as 22% for mobilemore » phones. - Abstract: To clarify current collection rules of waste batteries in municipal waste management in Japan and to examine future challenges for hazardous substance control and safety, we reviewed collection rules of waste batteries in the Tokyo Metropolitan Area. We also conducted a field survey of waste batteries collected at various battery and small waste electric and electronic equipment (WEEE) collection sites in Tokyo. The different types of batteries are not collected in a uniform way in the Tokyo area, so consumers need to pay attention to the specific collection rules for each type of battery in each municipality. In areas where small WEEE recycling schemes are being operated after the enforcement of the Act on Promotion of Recycling of Small Waste Electrical and Electronic Equipment in Japan in 2013, consumers may be confused about the need for separating batteries from small WEEE (especially mobile phones). Our field survey of collected waste batteries indicated that 6–10% of zinc carbon and alkaline batteries discarded in Japan currently could be regarded as containing mercury. More than 26% of zinc carbon dry batteries currently being discarded may have a lead content above the labelling threshold of the EU Batteries Directive (2006/66/EC). In terms of safety, despite announcements by producers and municipalities about using

  18. After flow control: The steps taken by Dade County to ensure continued operation of its solid waste management system

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

    Mauriello, P.J.; Ragbeer, D.

    1997-12-01

    In the wake of the U.S. Supreme Court decision in the Carbone vs. Clarkstown case striking down waste flow control as unconstitutional, Dade County, Florida, one of the most severely impacted communities in the nation, has managed to stabilize its waste stream and balance its solid waste department finances; although the road taken to restabilization has been a difficult one. At its peak in 1995, Dade County experienced an annual loss of solid waste in excess of 1,000,000 tons, or over 40 percent of the waste stream normally handled by the County. This diversion of waste was accompanied by amore » net revenue loss of $30 million per year. The County lost its ability to plan for future capacity needs, or to assure sufficient future waste flows to meet its put-or-pay obligation to the County`s Resources Recovery plant operator. The County`s solid waste management system bonds were downgraded by Moody`s Investors Service and Standard and Poors. With the help of a special solid waste management team, appointed by the County Manager, the department was able to rightsize its waste disposal operations to fit its reduced waste flows, stabilize its waste stream, and develop strategies to solve its long-term funding shortfall.« less

  19. The Changing Role of the Reading Specialist: A Case Study

    ERIC Educational Resources Information Center

    Ginsburg, Victoria Elaine

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  1. Toxic Substances Control Act (TSCA) Polychlorinated Biphenyl (PCB)/Radioactive Waste Annual Inventory for Calendar Year 2013

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

    no author on report

    2014-06-01

    The Toxic Substances Control Act, 40 CFR 761.65(a)(1) provides an exemption from the one year storage time limit for PCB/radioactive waste. PCB/radioactive waste may exceed the one year time limit provided that the provisions at 40 CFR 761.65(a)(2)(ii) and 40 CFR 761.65(a)(2)(iii) are followed. These two subsections require, (ii) "A written record documenting all continuing attempts to secure disposal is maintained until the waste is disposed of" and (iii) "The written record required by subsection (ii) of this section is available for inspection or submission if requested by EPA." EPA Region 10 has requested the Department of Energy (DOE) tomore » submit an inventory of radioactive-contaminated PCB waste in storage at the Idaho National Laboratory (INL) for the previous calendar year. The annual inventory is separated into two parts, INL without Advanced Mixed Waste Treatment Project (AMWTP) (this includes Battelle Energy Alliance, LLC, CH2M-WG Idaho, LLC, and the Naval Reactors Facility), and AMWTP.« less

  2. [Demand and supply of otolaryngology specialists based on evidence: What is the required number of specialists who should be trained?].

    PubMed

    Sánchez Gómez, Serafín; Suárez Nieto, Carlos; Cobeta Marco, Ignacio

    2009-01-01

    Several concurrent circumstances have created an impression through the media of a presumed lack of specialists in Spain, which has one of the highest densities of doctors per population in the world: simultaneous creation of jobs in many newly built hospitals; accepting garbage contracts (for months, half/thirds of days, shifts) in relevant hospitals rather than moving to unattractive positions; full dedication to the field of public or private healthcare rather than matching them; bad public healthcare working conditions (low wages, excessive healthcare pressure, lack of respect from the public and from healthcare managers, shifts, scarce professional promotion, difficult family reunification); decreased mobility due to insulation of the markets as a result of decentralization of healthcare by regions. There is no shortage of specialists in otolaryngology, but instead there are sporadic inequalities in their geographical distribution. The current number of positions as training doctors offered annually is higher at the moment than the demand of the Spanish society, for specialists who have adapted smoothly to the requirements of the new medical practice: clinical management, care quality, technology-based efficiency, evidence-based medicine. The modification of working conditions through higher flexibility in the working models and an increase of salaries based on activity and quality will show that the otolaryngology workforce which is generated with the current offer can assume the present and future demand. A high quality of specialized otolaryngology training is the substrate to be improved, so that future otolaryngology specialists will be able to face health challenges without unduly increasing their number.

  3. Waste disposal package

    DOEpatents

    Smith, M.J.

    1985-06-19

    This is a claim for a waste disposal package including an inner or primary canister for containing hazardous and/or radioactive wastes. The primary canister is encapsulated by an outer or secondary barrier formed of a porous ceramic material to control ingress of water to the canister and the release rate of wastes upon breach on the canister. 4 figs.

  4. Non-Specialist Psychosocial Interventions for Children and Adolescents with Intellectual Disability or Lower-Functioning Autism Spectrum Disorders: A Systematic Review

    PubMed Central

    Yasamy, M. Taghi; Barbui, Corrado; Saxena, Shekhar

    2013-01-01

    Background The development of effective treatments for use by non-specialists is listed among the top research priorities for improving the lives of people with mental illness worldwide. The purpose of this review is to appraise which interventions for children with intellectual disabilities or lower-functioning autism spectrum disorders delivered by non-specialist care providers in community settings produce benefits when compared to either a no-treatment control group or treatment-as-usual comparator. Methods and Findings We systematically searched electronic databases through 24 June 2013 to locate prospective controlled studies of psychosocial interventions delivered by non-specialist providers to children with intellectual disabilities or lower-functioning autism spectrum disorders. We screened 234 full papers, of which 34 articles describing 29 studies involving 1,305 participants were included. A majority of the studies included children exclusively with a diagnosis of lower-functioning autism spectrum disorders (15 of 29, 52%). Fifteen of twenty-nine studies (52%) were randomized controlled trials and just under half of all effect sizes (29 of 59, 49%) were greater than 0.50, of which 18 (62%) were statistically significant. For behavior analytic interventions, the best outcomes were shown for development and daily skills; cognitive rehabilitation, training, and support interventions were found to be most effective for improving developmental outcomes, and parent training interventions to be most effective for improving developmental, behavioral, and family outcomes. We also conducted additional subgroup analyses using harvest plots. Limitations include the studies' potential for performance bias and that few were conducted in lower- and middle-income countries. Conclusions The findings of this review support the delivery of psychosocial interventions by non-specialist providers to children who have intellectual disabilities or lower-functioning autism

  5. Work-related stress, job resources, and well-being among psychiatrists and other medical specialists in Finland.

    PubMed

    Heponiemi, Tarja; Aalto, Anna-Mari; Puttonen, Sampsa; Vänskä, Jukka; Elovainio, Marko

    2014-06-01

    Previous studies suggest that psychiatrists may be more stressed than other medical specialists and mental health professionals. This study examined differences in stress factors, job resources, psychological distress, and job satisfaction between psychiatrists and other medical specialists. In addition, the study examined whether stress factors or job resources accounted for possible differences between the groups in psychological distress or job satisfaction. In 2010, the authors obtained cross-sectional, Web-based survey data from a random sample of 2,776 Finnish physicians, including 1,647 women (59%), ranging in age from 25 to 69 years old. Comparisons between the two groups used analyses of covariance adjusted for gender, age, and employment sector. Psychiatrists were less satisfied with their jobs, felt more stressed about patients, and experienced more psychological distress compared with other medical specialists. However, psychiatrists had more opportunities to control their jobs and better team climate compared with other medical specialists. High psychological distress among psychiatrists was partly accounted for by high patient-related stress. The differences in psychological distress and job satisfaction between the two groups were not accounted for by work-family conflicts or optimism. It is important to try to alleviate the high levels of patient-related stress among psychiatrists and to further increase their job resources. Doing so may enhance the attractiveness of psychiatry as a specialty choice.

  6. U.S. Department of Energy Implementation of Chemical Evaluation Requirements for Transuranic Waste Disposal at the Waste Isolation Pilot Plant

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

    Moon, Alison; Barkley, Michelle; Poppiti, James

    This report summarizes new controls designed to ensure that transuranic waste disposed at the Waste Isolation Pilot Plant (WIPP) does not contain incompatible chemicals. These new controls include a Chemical Compatibility Evaluation, an evaluation of oxidizing chemicals, and a waste container assessment to ensure that waste is safe for disposal. These controls are included in the Chapter 18 of the Documented Safety Analysis for WIPP (1).

  7. Coupling plant growth and waste recycling systems in a controlled life support system (CELSS)

    NASA Technical Reports Server (NTRS)

    Garland, Jay L.

    1992-01-01

    The development of bioregenerative systems as part of the Controlled Ecological Life Support System (CELSS) program depends, in large part, on the ability to recycle inorganic nutrients, contained in waste material, into plant growth systems. One significant waste (resource) stream is inedible plant material. This research compared wheat growth in hydroponic solutions based on inorganic salts (modified Hoagland's) with solutions based on the soluble fraction of inedible wheat biomass (leachate). Recycled nutrients in leachate solutions provided the majority of mineral nutrients for plant growth, although additions of inorganic nutrients to leachate solutions were necessary. Results indicate that plant growth and waste recyling systems can be effectively coupled within CELSS based on equivalent wheat yield in leachate and Hoagland solutions, and the rapid mineralization of waste organic material in the hydroponic systems. Selective enrichment for microbial communities able to mineralize organic material within the leachate was necessary to prevent accumulation of dissolved organic matter in leachate-based solutions. Extensive analysis of microbial abundance, growth, and activity in the hydroponic systems indicated that addition of soluble organic material from plants does not cause excessive microbial growth or 'biofouling', and helped define the microbially-mediated flux of carbon in hydroponic solutions.

  8. A controlled evaluation of case clinical effect coding by poison center specialists for detection of WMD scenarios.

    PubMed

    Beuhler, Michael C; Wittler, Mary A; Ford, Marsha; Dulaney, Anna R

    2011-08-01

    Many public health entities employ computer-based syndromic surveillance to monitor for aberrations including possible exposures to weapons of mass destruction (WMD). Often, this is done by screening signs and symptoms reported for cases against syndromic definitions. Poison centers (PCs) may offer significant contributions to public health surveillance because of their detailed clinical effect data field coding and real-time data entry. Because improper clinical effect coding may impede syndromic surveillance, it is important to assess this accuracy for PCs. An AAPCC-certified regional PC assessed the accuracy of clinical effect coding by specialists in poison information (SPIs) listening to audio recordings of standard cases. Eighteen different standardized cases were used, consisting of six cyanide, six botulism, and six control cases. Cases were scripted to simulate clinically relevant telephone conversations and converted to audio recordings. Ten SPIs were randomly selected from the center's staff to listen to and code case information from the recorded cases. Kappa scores and the percentage of correctly coding a present clinical effect were calculated for individual clinical effects summed over all test cases along with corresponding 95% confidence intervals. The rate of the case coding by the SPIs triggering the PC's automated botulism and cyanide alerts was also determined. The kappa scores and the percentage of correctly coding a present clinical effect varied depending on the specific clinical effect, with greater accuracy observed for the clinical effects of vomiting and agitation/irritability, and poor accuracy observed for the clinical effects of visual defect and anion gap increase. Lack of correct coding resulted in only 60 and 86% of the cases that met the botulism and cyanide surveillance definitions, respectively, triggering the corresponding alert. There was no difference observed in the percentage of coding a present clinical effect between

  9. The requirements of a specialist Breast Centre.

    PubMed

    Wilson, A R M; Marotti, L; Bianchi, S; Biganzoli, L; Claassen, S; Decker, T; Frigerio, A; Goldhirsch, A; Gustafsson, E G; Mansel, R E; Orecchia, R; Ponti, A; Poortmans, P; Regitnig, P; Rosselli Del Turco, M; Rutgers, E J Th; van Asperen, C; Wells, C A; Wengström, Y; Cataliotti, L

    2013-11-01

    In recognition of the advances and evidence based changes in clinical practice that have occurred in recent years and taking into account the knowledge and experience accumulated through the voluntary breast unit certification programme, Eusoma has produced this up-dated and revised guidelines on the requirements of a Specialist Breast Centre (BC). The content of these guidelines is based on evidence from the recent relevant peer reviewed literature and the consensus of a multidisciplinary team of European experts. The guidelines define the requirements for each breast service and for the specialists who work in specialist Breast Centres. The guidelines identify the minimum requirements needed to set up a BC, these being an integrated Breast Centre, dealing with a sufficient number of cases to allow effective working and continuing expertise, dedicated specialists working with a multidisciplinary approach, providing all services throughout the patients pathway and data collection and audit. It is essential that the BC also guarantees the continuity of care for patients with advanced (metastatic) disease offering treatments according to multidisciplinary competencies and a high quality palliative care service. The BC must ensure that comprehensive support and expertise may be needed, not only through the core BC team, but also ensure that all other medical and paramedical expertise that may be necessary depending on the individual case are freely available, referring the patient to the specific care provider depending on the problem. Applying minimum requirements and quality indicators is essential to improve organisation, performance and outcome in breast care. Efficacy and compliance have to be constantly monitored to evaluate the quality of patient care and to allow appropriate corrective actions leading to improvements in patient care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Polish Code of Ethics of a Medical Laboratory Specialist

    PubMed Central

    2014-01-01

    Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists’ identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world. PMID:27683468

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2006-08-01

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

  13. Controlling mechanisms of metals release form cement-based waste form in acetic acid solution

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

    Cheng, Kuang Ye.

    1991-01-01

    The purpose of this dissertation is to identify the individual leaching mechanisms of metals by knowing the pH profile within the leached specimen and the physical and chemical properties of the leached material. Leaching of cement-based waste form in acetic acid solutions with different acidic strengths has been investigated in this work. The pH profile along the acid penetration route in the cement-based waste form was identified by various pH color indicators. The pH in the surface altered layer varies from 5.0 to 6.0, which is very close to the pH in the bulk leachate. A reacting zone, where themore » pH abruptly changes from 6 to 12, sharply divides the altered surface layer from the remaining unleached waste form or kernel. Leaching of metals is controlled by the acidity available in the leachant. Dissolution of alkaline materials leaves a silica-rich layer on the surface of the cement-based waste form. This surface layer exhibits different properties than those of the unleached material. The surface layer has a higher water content, is lighter weight, and is soft and friable. Furthermore, the abundant silicate content on the solid surface detains portion of the leached metals, while they are moving through the leached layer into bulk solution. The leaching of metals is a consequence of acid penetration. The distance from the solid/solution interface to the front of the leaching boundary can be regarded as the depth of leaching zone, where the metals dissolve and diffuse out of the waste form. The metal ions diffuse through the leached layer may be retarded on the solid surface by the pH-dependent adsorption reactions. It is found that the leaching process through the leached layer is diffusion-controlled for calcium and cadmium, whereas diffusion and adsorption occur simultaneously in the leached layer for lead and arsenic.« less

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

    PubMed

    Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges

    2012-12-31

    Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of

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

    PubMed Central

    2012-01-01

    Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important influencing factors in

  16. Integrating HCI Specialists into Open Source Software Development Projects

    NASA Astrophysics Data System (ADS)

    Hedberg, Henrik; Iivari, Netta

    Typical open source software (OSS) development projects are organized around technically talented developers, whose communication is based on technical aspects and source code. Decision-making power is gained through proven competence and activity in the project, and non-technical end-user opinions are too many times neglected. In addition, also human-computer interaction (HCI) specialists have encountered difficulties in trying to participate in OSS projects, because there seems to be no clear authority and responsibility for them. In this paper, based on HCI and OSS literature, we introduce an extended OSS development project organization model that adds a new level of communication and roles for attending human aspects of software. The proposed model makes the existence of HCI specialists visible in the projects, and promotes interaction between developers and the HCI specialists in the course of a project.

  17. [Co-composting high moisture vegetable waste and flower waste in a sequential fed operation].

    PubMed

    Zhang, Xiangfeng; Wang, Hongtao; Nie, Yongfeng

    2003-11-01

    Co-composting of high moisture vegetable wastes (celery and cabbage) and flower wastes (carnation) were studied in a sequential fed bed. The preliminary materials of composting were celery and carnation wastes. The sequential fed materials of composting were cabbage wastes and were fed every 4 days. Moisture content of mixture materials was between 60% and 70%. Composting was done in an aerobic static bed of composting based temperature feedback and control via aeration rate regulation. Aeration was ended when temperature of the pile was about 40 degrees C. Changes of composting of temperature, aeration rate, water content, organic matter, ash, pH, volume, NH4(+)-N, and NO3(-)-N were studied. Results show that co-composting of high moisture vegetable wastes and flower wastes, in a sequential fed aerobic static bed based temperature feedback and control via aeration rate regulation, can stabilize organic matter and removal water rapidly. The sequential fed operation are effective to overcome the difficult which traditional composting cannot applied successfully where high moisture vegetable wastes in more excess of flower wastes, such as Dianchi coastal.

  18. Environmental Support Specialist, Blocks III & IV, 17-5. Military Curriculum Materials for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This military-developed text contains the second section of a four-part course to train environmental support specialists. Covered in the individual course blocks are operative principles of water treatment plants (principles of water treatment plants, the clarification process, water systems filters, chemical disinfection, taste and odor control,…

  19. Regulatory Exclusions and Alternative Standards for the Recycling of Materials, Solid Wastes and Hazardous Wastes

    EPA Pesticide Factsheets

    Determining the Level of Regulation for Hazardous Waste Recycling, Recycled Materials that are not Subject to RCRA Hazardous Waste Regulation, Materials Subject to Alternative Regulatory Controls, Materials Subject to Full Hazardous Waste Regulations.

  20. Basic diagnosis of solid waste generated at Agua Blanca State Park to propose waste management strategies.

    PubMed

    Laines Canepa, José Ramón; Zequeira Larios, Carolina; Valadez Treviño, Maria Elena Macías; Garduza Sánchez, Diana Ivett

    2012-03-01

    State parks are highly sensitive areas of great natural importance and tourism value. Herein a case study involving a basic survey of solid waste which was carried out in 2006 in Agua Blanca State Park, Macuspana, Tabasco, Mexico with two sampling periods representing the high and low tourist season is presented. The survey had five objectives: to find out the number of visitors in the different seasons, to consider the daily generation of solid waste from tourist activities, to determine bulk density, to select and quantify sub-products; and to suggest a possible treatment. A daily average of 368 people visited the park: 18,862 people in 14 days during the high season holiday (in just one day, Easter Sunday, up to 4425 visitors) and 2092 visitors in 43 days during the low season. The average weight of the generated solid waste was 61.267 kg day(-1) and the generated solid waste average per person was 0.155 kg person(-1 ) day(-1). During the high season, the average increased to 0.188 kg person(-1 ) day(-1) and during the low season, the average decreased to 0.144 kg person(-1 ) day(-1). The bulk density average was 75.014 kg m(-3), the maximum value was 92.472 kg m(-3) and the minimum was 68.274 kg m(-3). The sub-products comprised 54.52% inorganic matter; 32.03% organic matter, 10.60% non-recyclable and 2.85% others. Based on these results, waste management strategies such as reuse/recycling, aerobic and anaerobic digestion, the construction of a manual landfill and the employment of a specialist firm were suggested.

  1. ISD Designed Medical Specialist Training.

    ERIC Educational Resources Information Center

    Rock, Samuel K., Jr.; Chagalis, George P.

    The Basic Medical Specialist course has one of the largest enrollments of the U.S. Army's Academy of Health Sciences; 11,000 soldiers were trained in this course in 1977 and 1978. Training encompasses both emergency first aid (for field medics) and basic nursing skills. A task force working to improve Army training developed this course, in…

  2. The changing role of specialist care in NHS dentistry.

    PubMed

    Seward, M

    1998-07-11

    Specialisation and Specialist Training in Dentistry in the UK have been central issues for debate in the last few years. The profession has emerged stronger in understanding the respective roles of the generalist who should remain free to practise across the whole spectrum of dentistry and the specialist who can work in primary and secondary care. The overriding principle is that the patient remains the true beneficiary of a specialised service within the NHS.

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

    PubMed

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

    2011-10-31

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

  4. Community mobilization and household level waste management for dengue vector control in Gampaha district of Sri Lanka; an intervention study

    PubMed Central

    Abeyewickreme, W; Wickremasinghe, A R; Karunatilake, K; Sommerfeld, Johannes; Kroeger, Axel

    2012-01-01

    Introduction Waste management through community mobilization to reduce breeding places at household level could be an effective and sustainable dengue vector control strategy in areas where vector breeding takes place in small discarded water containers. The objective of this study was to assess the validity of this assumption. Methods An intervention study was conducted from February 2009 to February 2010 in the populous Gampaha District of Sri Lanka. Eight neighborhoods (clusters) with roughly 200 houses each were selected randomly from high and low dengue endemic areas; 4 of them were allocated to the intervention arm (2 in the high and 2 in the low endemicity areas) and in the same way 4 clusters to the control arm. A baseline household survey was conducted and entomological and sociological surveys were carried out simultaneously at baseline, at 3 months, at 9 months and at 15 months after the start of the intervention. The intervention programme in the treatment clusters consisted of building partnerships of local stakeholders, waste management at household level, the promotion of composting biodegradable household waste, raising awareness on the importance of solid waste management in dengue control and improving garbage collection with the assistance of local government authorities. Results The intervention and control clusters were very similar and there were no significant differences in pupal and larval indices of Aedes mosquitoes. The establishment of partnerships among local authorities was well accepted and sustainable; the involvement of communities and households was successful. Waste management with the elimination of the most productive water container types (bowls, tins, bottles) led to a significant reduction of pupal indices as a proxy for adult vector densities. Conclusion The coordination of local authorities along with increased household responsibility for targeted vector interventions (in our case solid waste management due to the type of

  5. [The main directions of improving the system of state accounting and control of radioactive substances and radioactive waste products].

    PubMed

    2012-01-01

    This paper describes a modification of the basic directions of state accounting and control of radioactive substances and radioactive waste products, whose implementation will significantly improve the efficiency of its operation at the regional level. Selected areas are designed to improve accounting and control system for the submission of the enterprises established by the reporting forms, the quality of the information contained in them, as well as structures of information and process for collecting, analyzing and data processing concerning radioactive substances and waste products.

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

    PubMed

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

    2005-01-01

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

  7. Helping the auto repair industry manage hazardous wastes: an education project in King County, Washington.

    PubMed

    McKenrick, Laurence L; Ii, Keiko; Lawrence, Bill; Kaufmann, Michael; Marshall, Mark

    2003-11-01

    From January 1, 2000, to August 31, 2001, a team of environmental health specialists from Public Health-Seattle & King County, a partner in King County's Local Hazardous Waste Management Program, made educational visits to 981 automotive repair shops. The purpose was to give the auto repair industry technical assistance on hazardous waste management without using enforcement action. Through site inspections and interviews, the environmental health staff gathered information on the types and amounts of conditionally exempt small-quantity generator (CESQG) hazardous wastes and how they were handled. Proper methods of hazardous waste management, storage, and disposal were discussed with shop personnel. The environmental health staff measured the impact of these educational visits by noting changes made between the initial and follow-up visits. This report focuses on nine major waste streams identified in the auto repair industry. Of the 981 shops visited, 497 were already practicing proper hazardous waste management and disposal. The remaining 484 shops exhibited 741 discrepancies from proper practice. Environmental health staff visited these shops again within six months of the initial visit to assess changes in their practices. The educational visits and technical assistance produced a 76 percent correction of all the discrepancies noted.

  8. Occupational medicine specialist referral triggers: Mixed-methods analysis of teleconsult cases.

    PubMed

    Eaton, J L; Mohammad, A; Mohr, D C; Brustein, D J; Kirkhorn, S R

    2017-12-30

    Qualitative analyses can yield critical lessons for learning organizations in healthcare. Few studies have applied these techniques in the field of occupational and environmental medicine (OEM). To describe the characteristics of complex cases referred for OEM subspecialty evaluation and variation by referring provider's training. Using a mixed methods approach, we conducted a content analysis of clinical cases submitted to a national OEM teleconsult service. Consecutive cases entered between April 2014 and July 2015 were screened, coded and analysed. 108 cases were available for analysis. Local Veterans Health Administration (VHA) non-specialist providers entered a primary medical diagnosis in 96% of cases at the time of intake. OEM speciality physicians coded significant medical conditions based on free text comments. Coder inter-rater reliability was 84%. The most frequent medical diagnosis types associated with tertiary OEM referral by non-specialists were endocrine (19%), cardiovascular (18%) and mental health (16%). Concern for usage of controlled and/or sedating medications was cited in 1% of cases. Compared to referring non-specialists, OEM physicians were more likely to attribute case complexity to musculoskeletal (OR: 2.3, 1.68-3.14) or neurological (OR: 1.69, 1.28-2.24) conditions. Medication usage (OR: 2.2, 1.49-2.26) was more likely to be a source of clinical concern among referring providers. The findings highlight the range of triggers for OEM physician subspecialty referral in clinical practice with employee patients. The results of this study can be used to inform development of provider education, standardized clinical practice pathways, and quality review activities for occupational medicine practitioners. Published by Oxford University Press on behalf of The Society of Occupational Medicine 2017.

  9. A new mode of community continuing care service for COPD patients in China: participation of respiratory nurse specialists.

    PubMed

    Li, Pingdong; Gong, Yucui; Zeng, Guangqiao; Ruan, Liang; Li, Guifen

    2015-01-01

    This study explored a community nursing service mode in which respiratory nurse specialists cared for patients with chronic obstructive pulmonary disease (COPD) in a 12-week period after hospital discharge, with the aim of better preventing acute exacerbations, improving health-related quality of life (HRQOL) and reducing medical expenses in these patients. We carried out a prospective randomized controlled study in which 68 COPD patients discharged were recruited from a general hospital in Guangzhou, China, were randomized divided into two groups. The control group underwent conventional nursing care, and the intervention group received community continuing care by respiratory nurse specialists. The observation period was 12 weeks. The results of intervention were evaluated using the Seattle Obstructive Lung Disease Questionnaire (SOLDQ) and the COPD Self-Efficacy Scale (CSES). In addition, the frequency of acute exacerbations, emergency treatments or hospitalizations, and medical expenses were recorded in the 12-week observation period. After six weeks, the total and subscale scores (P < 0.05) of SOLDQ and CSES significantly improved compared to the baseline ones in the intervention group. The control group had significantly higher scores in the treatment satisfaction (TS) of SOLDQ, the total score, and the weather/environment and behavioral risk factors of CSES. After 12 weeks, the total and subscale scores of SOLDQ and CSES showed a sustained and significant growth in the intervention group (P < 0.05). The control group had significantly higher scores only in the weather/environment risk factor of CSES. During the 12-week observation, the intervention group had significantly fewer acute exacerbations, emergency treatments or re-hospitalizations and significantly lower average medical expenses than the control group (P < 0.05). Community continuing care by respiratory nurse specialists may improve HRQOL, increase self-efficacy, reduce incidence of acute

  10. A new mode of community continuing care service for COPD patients in China: participation of respiratory nurse specialists

    PubMed Central

    Li, Pingdong; Gong, Yucui; Zeng, Guangqiao; Ruan, Liang; Li, Guifen

    2015-01-01

    Objective: This study explored a community nursing service mode in which respiratory nurse specialists cared for patients with chronic obstructive pulmonary disease (COPD) in a 12-week period after hospital discharge, with the aim of better preventing acute exacerbations, improving health-related quality of life (HRQOL) and reducing medical expenses in these patients. Methods: We carried out a prospective randomized controlled study in which 68 COPD patients discharged were recruited from a general hospital in Guangzhou, China, were randomized divided into two groups. The control group underwent conventional nursing care, and the intervention group received community continuing care by respiratory nurse specialists. The observation period was 12 weeks. The results of intervention were evaluated using the Seattle Obstructive Lung Disease Questionnaire (SOLDQ) and the COPD Self-Efficacy Scale (CSES). In addition, the frequency of acute exacerbations, emergency treatments or hospitalizations, and medical expenses were recorded in the 12-week observation period. Results: After six weeks, the total and subscale scores (P < 0.05) of SOLDQ and CSES significantly improved compared to the baseline ones in the intervention group. The control group had significantly higher scores in the treatment satisfaction (TS) of SOLDQ, the total score, and the weather/environment and behavioral risk factors of CSES. After 12 weeks, the total and subscale scores of SOLDQ and CSES showed a sustained and significant growth in the intervention group (P < 0.05). The control group had significantly higher scores only in the weather/environment risk factor of CSES. During the 12-week observation, the intervention group had significantly fewer acute exacerbations, emergency treatments or re-hospitalizations and significantly lower average medical expenses than the control group (P < 0.05). Conclusions: Community continuing care by respiratory nurse specialists may improve HRQOL, increase self

  11. Mixing-controlled uncertainty in long-term predictions of acid rock drainage from heterogeneous waste-rock piles

    NASA Astrophysics Data System (ADS)

    Pedretti, D.; Beckie, R. D.; Mayer, K. U.

    2015-12-01

    The chemistry of drainage from waste-rock piles at mine sites is difficult to predict because of a number of uncertainties including heterogeneous reactive mineral content, distribution of minerals, weathering rates and physical flow properties. In this presentation, we examine the effects of mixing on drainage chemistry over timescales of 100s of years. We use a 1-D streamtube conceptualization of flow in waste rocks and multicomponent reactive transport modeling. We simplify the reactive system to consist of acid-producing sulfide minerals and acid-neutralizing carbonate minerals and secondary sulfate and iron oxide minerals. We create multiple realizations of waste-rock piles with distinct distributions of reactive minerals along each flow path and examine the uncertainty of drainage geochemistry through time. The limited mixing of streamtubes that is characteristic of the vertical unsaturated flow in many waste-rock piles, allows individual flowpaths to sustain acid or neutral conditions to the base of the pile, where the streamtubes mix. Consequently, mixing and the acidity/alkalinity balance of the streamtube waters, and not the overall acid- and base-producing mineral contents, control the instantaneous discharge chemistry. Our results show that the limited mixing implied by preferential flow and the heterogeneous distribution of mineral contents lead to large uncertainty in drainage chemistry over short and medium time scales. However, over longer timescales when one of either the acid-producing or neutralizing primary phases is depleted, the drainage chemistry becomes less controlled by mixing and in turn less uncertain. A correct understanding of the temporal variability of uncertainty is key to make informed long-term decisions in mining settings regarding the management of waste material.

  12. Environmental Compliance Specialists, Inc. (ECSI) Information Sheet

    EPA Pesticide Factsheets

    Environmental Compliance Specialists, Inc. (ECSI) (the Company) is located in Kingston, New Hampshire. The Complaint involves renovation activities conducted at property constructed prior to 1978, located in Manchester, New Hampshire.

  13. [Management of allocation of positions for specialist medical training].

    PubMed

    Alonso, M I

    2003-01-01

    Currently there is a large imbalance between supply and demand for medical specialists in the Spanish Health System. The aim of this study was to demonstrate the possible effects of current policies of allocating vacancies for interns and residents as well as to describe several measures and alternative policies. Using the methodology of System Dynamics, we designed a simulation model of the allocation process. Based on the validated model, possible changes in the system through time in response to diverse allocation policies were simulated. Specifically, changes in the accumulated number of graduates who over the years have remained without specialty, the number of unemployed specialists, and the imbalance between supply and demand in the period under consideration were observed. The results obtained from the simulation indicate that allocation policies such as the current one tends to reduce the accumulated number of graduates without specialty, due to the philosophy characterizing this policy, but that it considerably increases the number of unemployed specialists and aggravates the supply-demand imbalance. In the simulation, this tendency remained over time even though more restrictive measures in numerus clausus and retirement age were adopted. Equally, a policy based on social needs and aware of delays in training would substantially contribute to eliminating unemployment among specialists and supply-demand imbalance over time. If such a policy were combined with the above-mentioned measures the results would be even better, more rapidly eliminating graduates without specialty, unemployed specialists, and supply-demand imbalances. If the Health Administration continues with the current system of allocation of places, the present imbalance in supply and demand will become even worse. Therefore, new and far-sighted measures and policies are required, as well as greater coordination between undergraduate and postgraduate training.

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

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

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

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

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

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

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

    NASA Technical Reports Server (NTRS)

    1997-01-01

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

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

    PubMed Central

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

    2006-01-01

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

  19. Apprentice Still Photographic Specialist (AFSC 23132).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice still photographic specialists. Covered in the individual volumes are general subjects (career ladder progression, security, photographic safety, and photographic laboratory administration); still photographic…

  20. Options for reducing food waste by quality-controlled logistics using intelligent packaging along the supply chain.

    PubMed

    Heising, Jenneke K; Claassen, G D H; Dekker, Matthijs

    2017-10-01

    Optimising supply chain management can help to reduce food waste. This paper describes how intelligent packaging can be used to reduce food waste when used in supply chain management based on quality-controlled logistics (QCL). Intelligent packaging senses compounds in the package that correlate with the critical quality attribute of a food product. The information on the quality of each individual packaged food item that is provided by the intelligent packaging can be used for QCL. In a conceptual approach it is explained that monitoring food quality by intelligent packaging sensors makes it possible to obtain information about the variation in the quality of foods and to use a dynamic expiration date (IP-DED) on a food package. The conceptual approach is supported by quantitative data from simulations on the effect of using the information of intelligent packaging in supply chain management with the goal to reduce food waste. This simulation shows that by using the information on the quality of products that is provided by intelligent packaging, QCL can substantially reduce food waste. When QCL is combined with dynamic pricing based on the predicted expiry dates, a further waste reduction is envisaged.

  1. Mechanical diffraction in a sand-specialist snake

    NASA Astrophysics Data System (ADS)

    Schiebel, Perrin E.; Rieser, Jennifer M.; Hubbard, Alex M.; Chen, Lillian; Goldman, Daniel I.

    Limbless locomotors such as snakes move by pressing the trunk against terrain heterogeneities. Our laboratory studies of the desert-dwelling Mojave Shovel-nosed snake (C. occipitalis, 40cm long, N=9) reveal that these animals use a stereotyped sinusoidal traveling wave of curvature. However, this snake also encounters rigid obstacles in its natural environment, and the tradeoff between using a cyclic, shape controlled gait versus one which changes shape in response to the terrain is not well understood. We challenged individuals to move across a model deformable substrate (carpet) through a row of 6.4 mm diameter force-sensitive pegs, a model of obstacles such as grass, oriented perpendicular to the direction of motion. Instead of forward-directed reaction forces, reaction forces generated by the pegs were more often perpendicular to the direction of motion. Distributions of post-peg travel angles displayed preferred directions revealing a diffraction-like pattern with a central peak at zero and symmetric peaks at 193 ° and 415 °. We observed similar dynamics in a robotic snake using shape-based control. This suggests that this sand-specialist snake adheres to its preferred waveform as opposed to changing in response to heterogeneity.

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

    PubMed

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

    2018-06-01

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

  3. The specialist physician's approach to rheumatoid arthritis in South Africa.

    PubMed

    Bester, Frederik C J; Bosch, Fredricka J; van Rensburg, Barend J Jansen

    2016-03-01

    Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles.

  4. Review of LLNL Mixed Waste Streams for the Application of Potential Waste Reduction Controls

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

    Belue, A; Fischer, R P

    2007-01-08

    In July 2004, LLNL adopted the International Standard ISO 14001 as a Work Smart Standard in lieu of DOE Order 450.1. In support of this new requirement the Director issued a new environmental policy that was documented in Section 3.0 of Document 1.2, ''ES&H Policies of LLNL'', in the ES&H Manual. In recent years the Environmental Management System (EMS) process has become formalized as LLNL adopted ISO 14001 as part of the contract under which the laboratory is operated for the Department of Energy (DOE). On May 9, 2005, LLNL revised its Integrated Safety Management System Description to enhance existingmore » environmental requirements to meet ISO 14001. Effective October 1, 2005, each new project or activity is required to be evaluated from an environmental aspect, particularly if a potential exists for significant environmental impacts. Authorizing organizations are required to consider the management of all environmental aspects, the applicable regulatory requirements, and reasonable actions that can be taken to reduce negative environmental impacts. During 2006, LLNL has worked to implement the corrective actions addressing the deficiencies identified in the DOE/LSO audit. LLNL has begun to update the present EMS to meet the requirements of ISO 14001:2004. The EMS commits LLNL--and each employee--to responsible stewardship of all the environmental resources in our care. The generation of mixed radioactive waste was identified as a significant environmental aspect. Mixed waste for the purposes of this report is defined as waste materials containing both hazardous chemical and radioactive constituents. Significant environmental aspects require that an Environmental Management Plan (EMP) be developed. The objective of the EMP developed for mixed waste (EMP-005) is to evaluate options for reducing the amount of mixed waste generated. This document presents the findings of the evaluation of mixed waste generated at LLNL and a proposed plan for reduction.« less

  5. Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices.

    PubMed

    Rodino, Iolanda S; Byrne, Susan M; Sanders, Katherine A

    2017-02-01

    To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. Cross-sectional study. Fertility clinics. Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. None. Responses to an anonymously completed online questionnaire. Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Aerospace vehicle water-waste management

    NASA Technical Reports Server (NTRS)

    Pecoraro, J. N.

    1973-01-01

    The collection and disposal of human wastes, such as urine and feces, in a spacecraft environment are performed in an aesthetic and reliable manner to prevent degradation of crew performance. The waste management system controls, transfers, and processes materials such as feces, emesis, food residues, used expendables, and other wastes. The requirements, collection, transport, and waste processing are described.

  7. [What is parents' and medical health care specialists knowledge about vaccinations?].

    PubMed

    Tarczoń, Izabela; Domaradzka, Ewa; Czajka, Hanna

    2009-01-01

    The aim of the study was to become familiar with parents' and Medical Health Care specialists knowledge and attitude towards vaccinations. The influence of information, provided to patients from various sources, on general opinion about immunization and its coverage within the last year were evaluated. Analysis of questionnaires about vaccinations performed among 151 parents and 180 Medical Health Care specialists. Medical Health Care specialists knowledge was considerably higher in comparison to questioned parents. Surprisingly enough, only approximately 90% of Medical Health Care workers knew about prophylaxis of Hib infections. A doctor is the main and the most reliable source of information for parents. Significant impact on parents' attitude to vaccinations is made not only by campaigns promoting vaccinations, but also by widespread opinions about their harmfulness. The doctor is the major source of reliable information about vaccinations for parents. Therefore, there is the need of continuous improvement of Medical Health Care specialists knowledge, but also the ability of successfully communicating it to parents.

  8. The role of rehabilitation specialists in Canadian NICUs: a national survey.

    PubMed

    Limperopoulos, Catherine; Majnemer, Annette

    2002-01-01

    Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.

  9. A Survey of Headache Medicine Specialists on Career Satisfaction and Burnout.

    PubMed

    Evans, Randolph W; Ghosh, Kamalika

    2015-01-01

    Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists. The aim of the present survey was to learn more about how headache medicine physicians are affected by these issues. An email survey was sent to 749 physician members of the American Headache Society with questions or statements about demographics, professional quality of life and satisfaction, future practice plans, and professional burnout using the Maslach Burnout Inventory. In a sample of 127 headache medicine specialists, 66 (57.4%) physicians reported symptoms of professional burnout reflected by high Emotional Exhaustion and/or high Depersonalization. There is widespread dissatisfaction with work schedules, government regulations, implementation of the Affordable Care Act, insurance company policies, malpractice concerns, patient telephone calls, and compensation. Sixty-two percent of respondents concur that headache medicine is becoming more complicated without patient benefit, 14% concur that headache medicine specialists are fairly compensated, and 59% would go into headache medicine again if they were fourth year medical students. In the next 1 to 3 years, 21.3% plan to cut back on hours, 14.2% plan to cut back on patients seen, and 12.6% plan to switch to a cash practice. Medicine and healthcare are changing in such a way that 33.9% concur that they will accelerate their retirement plans. Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians' age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal

  10. Racial Disparities in Asthma Morbidity Among Pediatric Patients Seeking Asthma Specialist Care.

    PubMed

    Mitchell, Stephanie J; Bilderback, Andrew L; Okelo, Sande O

    2016-01-01

    To elucidate whether there may be a higher morbidity threshold for African American versus white children to be referred to or seek asthma specialist care. Secondary analysis of registry data captured from children presenting for an initial routine outpatient asthma consultation. Parents completed standard survey instruments, and spirometry was conducted when deemed appropriate by the provider. Wilcoxon rank sum tests revealed that African American patients had been hospitalized twice as often and admitted to the intensive care unit or intubated significantly more than 1½ times more frequently than their white patient counterparts. t tests indicated African American patients' forced expiratory volume in 1 second (FEV1) percentage predicted was significantly worse than that of whites, but there was no significant difference for FEV1/forced vital capacity ratio. t tests suggested that African American patients had statistically worse asthma control than did white patients at the time of initial presentation to the pulmonologist, but there was no difference in the distribution of asthma severity categories. Multivariate regression models indicated that racial differences in parent education did not explain the disparities in asthma morbidity. African American patients had significantly worse asthma morbidity than their white counterparts, including higher rates of hospitalization and intensive care unit admission and poorer lung functioning. Given that receipt of asthma specialist care can improve those outcomes that are disparately experienced by African American children, methods of increasing their access to and use of asthma specialist care need to be developed. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

    PubMed

    Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

    2016-12-01

    The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

  12. Payload specialist Ronald Parise using SAREX

    NASA Technical Reports Server (NTRS)

    1995-01-01

    ASTRO-2 payload specialist Ronald A. Parise reminisces on his inspace amateur radio experience of five years ago in the ASTRO-1 mission. Using the Shuttle Amateur Radio Experiment (SAREX), Parise talks to students on Earth from the flight deck of the Earth orbiting Space Shuttle Endeavour.

  13. School Library Media Specialists: Essentially Administrators.

    ERIC Educational Resources Information Center

    Alewine, Martha

    2003-01-01

    Considers how school library media specialist administrative responsibilities can carry over to a job as state consultant for school library media services. Discusses characteristics of effective administrators; collaboration; the appreciative inquiry process for systemic change; and duties and projects of the state program that strengthen media…

  14. Composting on Mars or the Moon: II. Temperature feedback control with top-wise introduction of waste material and air

    NASA Technical Reports Server (NTRS)

    Finstein, M. S.; Hogan, J. A.; Sager, J. C.; Cowan, R. M.; Strom, P. F.; Janes, H. W. (Principal Investigator)

    1999-01-01

    Whereas Earth-based composting reactors that effectively control the process are batch operations with bottom-to-top airflow, in extraterrestrial application both the fresh waste and the air need to be introduced from above. Stabilized compost and used air would exit below. This materials flow pattern permits the addition of waste whenever generated, obviating the need for multiple reactors, and the incorporation of a commode in the lid. Top loading in turn dictates top-down aeration, so that the most actively decomposing material (greatest need for heat removal and O2 replenishment) is first encountered. This novel material and aeration pattern was tested in conjunction with temperature feedback process control. Reactor characteristics were: working, volume, 0.15 m3; charge, 2 kg dry biomass per day (comparable to a 3-4 person self-sufficient bioregenerative habitat); retention time, 7 days. Judging from temperature profile, O2 level, air usage, pressure head loss, moisture, and odor, the system was effectively controlled over a 35-day period. Dry matter disappearance averaged 25% (10-42%). The compost product was substantially, though not completely, stabilized. This demonstrates the compatibility of top-wise introduction of waste and air with temperature feedback process control.

  15. Composting on Mars or the Moon: II. Temperature feedback control with top-wise introduction of waste material and air.

    PubMed

    Finstein, M S; Hogan, J A; Sager, J C; Cowan, R M; Strom, P F

    1999-01-01

    Whereas Earth-based composting reactors that effectively control the process are batch operations with bottom-to-top airflow, in extraterrestrial application both the fresh waste and the air need to be introduced from above. Stabilized compost and used air would exit below. This materials flow pattern permits the addition of waste whenever generated, obviating the need for multiple reactors, and the incorporation of a commode in the lid. Top loading in turn dictates top-down aeration, so that the most actively decomposing material (greatest need for heat removal and O2 replenishment) is first encountered. This novel material and aeration pattern was tested in conjunction with temperature feedback process control. Reactor characteristics were: working, volume, 0.15 m3; charge, 2 kg dry biomass per day (comparable to a 3-4 person self-sufficient bioregenerative habitat); retention time, 7 days. Judging from temperature profile, O2 level, air usage, pressure head loss, moisture, and odor, the system was effectively controlled over a 35-day period. Dry matter disappearance averaged 25% (10-42%). The compost product was substantially, though not completely, stabilized. This demonstrates the compatibility of top-wise introduction of waste and air with temperature feedback process control.

  16. Information specialist for a coming age (11)

    NASA Astrophysics Data System (ADS)

    Kamio, Tatsuo

    In the business world 'CNN REVOLUTION' is prevailing. 'CNN REVOLUTION' means the information system organized mostly by the Computer and the Communication Network through which they can make a vital business judgment. They try to give customers better service, enjoy a higher share and be more competitive through the information system, which enables them to control various information inside their firm completely and use it most usefully. They are also trying to hard to make the information system effective enough to gather information outside their firm. In making use of information for business, it is vital to get 'intelligence' which analized and processed information and to expand information distribution inside their company freely. As a new field of activity information specialist are expected to take a more important role in developing how to get 'good intelligence' and making useful information accessible through the information system.

  17. Administrative Perceptions on the Role of the School Library Media Specialist

    ERIC Educational Resources Information Center

    Page, Kayla

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  19. Molecular identification of Azolla invasions in Africa: The Azolla specialist, Stenopelmus rufinasus proves to be an excellent taxonomist

    USDA-ARS?s Scientific Manuscript database

    Biological control of Azolla filiculoides in South Africa with the Azolla specialist Stenopelmus rufinasus has been highly successful. However, field surveys showed that the agent utilized another Azolla species, thought to be the native Azolla pinnata subsp. africana, which contradicted host specif...

  20. Mineral transformation controls speciation and pore-fluid transmission of contaminants in waste-weathered Hanford sediments

    NASA Astrophysics Data System (ADS)

    Perdrial, Nicolas; Thompson, Aaron; O'Day, Peggy A.; Steefel, Carl I.; Chorover, Jon

    2014-09-01

    Portions of the Hanford Site (WA, USA) vadose zone were subjected to weathering by caustic solutions during documented releases of high level radioactive waste (containing Sr, Cs and I) from leaking underground storage tanks. Previous studies have shown that waste-sediment interactions can promote variable incorporation of contaminants into neo-formed mineral products (including feldspathoids and zeolites), but processes regulating the subsequent contaminant release from these phases into infiltrating background pore waters remain poorly known. In this paper, reactive transport experiments were conducted with Hanford sediments previously weathered for one year in simulated hyper-alkaline waste solutions containing high or low 88Sr, 127I, and 133Cs concentrations, with or without CO2(aq). These waste-weathered sediments were leached in flow-through column experiments with simulated background pore water (characteristic of meteoric recharge) to measure contaminant release from solids formed during waste-sediment interaction. Contaminant sorption-desorption kinetics and mineral transformation reactions were both monitored using continuous-flow and wet-dry cycling regimes for ca. 300 pore volumes. Less than 20% of contaminant 133Cs and 88Sr mass and less than 40% 127I mass were released over the course of the experiment. To elucidate molecular processes limiting contaminant release, reacted sediments were studied with micro- (TEM and XRD) and molecular- (Sr K-edge EXAFS) scale methods. Contaminant dynamics in column experiments were principally controlled by rapid dissolution of labile solids and competitive exchange reactions. In initially feldspathoidic systems, time-dependent changes in the local zeolitic bonding environment observed with X-ray diffraction and EXAFS are responsible for limiting contaminant release. Linear combination fits and shell-by-shell analysis of Sr K-edge EXAFS data revealed modification in Sr-Si/Al distances within the zeolite cage. Wet

  1. STS-95 Payload Specialist Mukai poses with NASDA president

    NASA Technical Reports Server (NTRS)

    1998-01-01

    STS-95 Payload Specialist Chiaki Mukai, M.D. (center), with the National Space Development Agency of Japan (NASDA), poses for a photograph with NASDA President Isao Uchida (left). Behind her at the right is a representative of the European Space Agency (ESA). Mukai was one of a crew of seven aboard orbiter Discovery, which landed at KSC at 12:04 p.m. EST, after a successful mission spanning nine days and 3.6 million miles. The other crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialists Stephen K. Robinson; Scott E. Parazynski and Pedro Duque of Spain, with the European Space Agency; and Payload Specialist John H. Glenn Jr., senator from Ohio. The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

  2. Payload specialists Rodolfo Neri prepares to begin experiments for Mexico

    NASA Image and Video Library

    1985-11-26

    61B-05-021 (26 Nov-3 Dec 1985) --- Payload Specialist Rodolfo Neri, representing Mexico on the STS-61B space mission aboard the Atlantis, prepares to begin one of the experiments for Mexico. Neri used a nearby 35mm camera to record plants and bacteria for various prescribed testing. Here the payload specialist has opened a stowage drawer to retrieve components of one of the tests.

  3. Hazardous waste management in the Pacific basin

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

    Cirillo, R.R.; Chiu, S.; Chun, K.C.

    1994-11-01

    Hazardous waste control activities in Asia and the Pacific have been reviewed. The review includes China (mainland, Hong Kong, and Taiwan), Indonesia, Korea, Malaysia, Papua New Guinea, the Philippines, Singapore, and Thailand. It covers the sources of hazardous waste, the government structure for dealing with hazardous waste, and current hazardous waste control activities in each country. In addition, the hazardous waste program activities of US government agencies, US private-sector organizations, and international organizations are reviewed. The objective of these reviews is to provide a comprehensive picture of the current hazardous waste problems and the waste management approaches being used tomore » address them so that new program activities can be designed more efficiently.« less

  4. [Mobile geriatric consultant services for rest homes. Study of the effects of consultations by internal medicine specialists in the medical care of rest home residents].

    PubMed

    Schippinger, W; Hartinger, G; Hierzer, A; Osprian, I; Bohnstingl, M; Pilgram, E H

    2012-12-01

    Hospital admissions are frequent among long-term residents of nursing homes and can result in detrimental complications affecting the patients' somatic, psychological, and cognitive status. In this prospective controlled study, we investigated the effects of a mobile geriatric consultant service (GECO) offered by specialists in internal medicine on frequency of hospitalizations in nursing home residents. During a 10-month observation period, residents in a control nursing home received medical attendance by general practitioners as is common in Austrian nursing homes. Residents in the intervention nursing home also received the medical service of GECO. Within the group of rest home residents receiving GECO support, a statistically significant lower frequency of acute transports to hospitals was observed in comparison to residents of the control nursing home (mean number of acute transports to hospitals/100 residents/month: 6.1 versus 11.7; p < 0.01). The number of planned non-acute hospital and specialist office presentations was also lower in the intervention nursing home (mean number of hospital and specialist office presentations/100 residents/month: 14.4 versus 18.0); however, this difference did not reach statistical significance. This study shows that a mobile medical geriatric consultant service based on specialists in internal medicine can improve medical care in nursing homes resulting in a statistically significant reduction of acute transports to hospitals.

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

    PubMed

    Wright, Heathcote R; Diamond, Jeremy P

    2015-03-01

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

  6. Seed dispersal by specialist versus generalist foragers: the plant's perspective

    USGS Publications Warehouse

    Larson, D.L.

    1996-01-01

    I examined the seed dispersal ecology of the stem parasitic plant, desert mistletoe (Phoradendron californicum, Viscaceae), with the objectives of (1) determining the relative effectiveness of specialist and generalist foragers for seed dispersal, (2) determining the extent to which desert mistletoe fruiting characteristics correspond to those predicted for plants attracting specialist versus generalist foragers, and (3) examining the potential consequences of the observed dispersal strategy for mistletoe reproduction. Three species of birds, phainopepla, Gila woodpecker, and northern mockingbird, fed on desert mistletoe at my study site. The specialist, phainopepla, was the most abundant and the most likely to perch in host species, where defecated seeds had a greater probability of lodging in a site suitable for establishment. Gila woodpeckers, although abundant, spent little time in host plants, thus dooming most of the seeds they consumed. Mockingbirds may disperse a small number of seeds, but were abundant enough to consume only a small portion of the available fruits. As expected for plants attracting specialist frugivores, mistletoes produced fruits throughout the 6-month season in which phainopeplas reside in the Sonoran desert. Contrary to expectation, numbers of fruits produced far exceeded the amount that could be consumed by the frugivores at my study site. Fruit crop size was positively related to absolute fruit removal, but not to proportional removal at the scale of the entire study site. However, crop size was positively related to proportional removal within the neighborhood of mistletoes occupying an individual host tree. Frugivores were attracted to infected hosts, host attractiveness increased, although proportional removal of fruit declined, with number of female mistletoes. The observed dispersal ecology of desert mistletoe suggests the likelihood of increasingly clumped distributions of mistletoe plants, as more and more seeds are deposited

  7. What Is a Pediatric Infectious Diseases Specialist?

    MedlinePlus

    ... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... through the teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases ...

  8. What Is a Pediatric Critical Care Specialist?

    MedlinePlus

    ... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... offered in the PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care ...

  9. 14 CFR § 1214.306 - Payload specialist relationship with sponsoring institutions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    NASA Image and Video Library

    1991-06-14

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

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

    ERIC Educational Resources Information Center

    Berkowitz, Robert E.; Eisenberg, Michael B.

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

  13. A Subject Reference: Benefit-Cost Analysis of Toxic Substances, Hazardous Materials and Solid Waste Control (1977)

    EPA Pesticide Factsheets

    Discussion of methodological issues for conducting benefit-cost analysis and provides guidance for selecting and applying the most appropriate and useful mechanisms in benefit-cost analysis of toxic substances, hazardous materials, and solid waste control

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

    PubMed

    Cheung, Gary; Casey, Jane

    2014-08-01

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

  15. Specialist home-based nursing services for children with acute and chronic illnesses.

    PubMed

    Parab, Chitra S; Cooper, Carolyn; Woolfenden, Susan; Piper, Susan M

    2013-06-15

    Specialist paediatric home-based nursing services have been proposed as a cost-effective means of reducing distress resulting from hospital admissions, while enhancing primary care and reducing length of hospital stay. This review is an update of our original review, which was published in 2006. To evaluate specialist home-based nursing services for children with acute and chronic illnesses. We searched the following databases in February 2012: the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2012 Issue 2, Ovid MEDLINE, EMBASE, PsycINFO, CINAHL and Sociological Abstracts. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. No language restrictions were applied. Randomised controlled trials (RCTs) of children from birth to age 18 years with acute or chronic illnesses allocated to specialist home-based nursing services compared with conventional health care. Outcomes included utilisation of health care, physical and mental health, satisfaction, adverse health outcomes and costs. Two review authors extracted data from the studies independently and resolved any discrepancies by recourse to a third author. Meta-analysis was not appropriate because of the clinical diversity of the studies and the lack of common outcome measures. We screened 4226 titles to yield seven RCTs with a total of 840 participants. Participants, interventions and outcomes were diverse. No significant differences were reported in health outcomes; two studies reported a reduction in the hospital stay with no difference in the hospital readmission rates. Three studies reported a reduction in parental anxiety and improvement in child behaviours was reported in three studies. Overall increased parental satisfaction was reported in three studies. Also, better parental coping and family functioning was reported in one study. By contrast, one study each reported no impact on parental burden of care or on functional status of

  16. Potential for nutrient recovery and biogas production from blackwater, food waste and greywater in urban source control systems.

    PubMed

    Kjerstadius, H; Haghighatafshar, S; Davidsson, Å

    2015-01-01

    In the last decades, the focus on waste and wastewater treatment systems has shifted towards increased recovery of energy and nutrients. Separation of urban food waste (FW) and domestic wastewaters using source control systems could aid this increase; however, their effect on overall sustainability is unknown. To obtain indicators for sustainability assessments, five urban systems for collection, transport, treatment and nutrient recovery from blackwater, greywater and FW were investigated using data from implementations in Sweden or northern Europe. The systems were evaluated against their potential for biogas production and nutrient recovery by the use of mass balances for organic material, nutrients and metals over the system components. The resulting indicators are presented in units suitable for use in future sustainability studies or life-cycle assessment of urban waste and wastewater systems. The indicators show that source control systems have the potential to increase biogas production by more than 70% compared with a conventional system and give a high recovery of phosphorus and nitrogen as biofertilizer. The total potential increase in gross energy equivalence for source control systems was 20-100%; the greatest increase shown is for vacuum-based systems.

  17. Research competency and specialist registration: Quo vadis ?

    PubMed

    Szabo, C P; Ramlall, S

    2016-12-01

    The requirement of 'research completion' as necessary for specialist registration with the Health Professions Council of South Africa (HPCSA) has recently been subject to legal action, with a court order potentially shifting requirements beyond those envisaged by the HPCSA. The research requirement is congruent with National Department of Health strategy in this regard, i.e. the strengthening of research as a stated priority. While the expectation of research competency is not in itself contentious, the capacity of institutions and the ability of registrars to facilitate and complete, respectively, have brought the issue into focus. Specifically, the apparent discrepancy between a court order and a regulation needs to be resolved to ensure that specialist registration is not unduly hampered, while ensuring that a potentially important contributor to a national priority is not prejudiced.

  18. Results of a hospital waste survey in private hospitals in Fars province, Iran

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

    Askarian, Mehrdad; Vakili, Mahmood; Kabir, Gholamhosein

    2004-07-01

    Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day,more » which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field.« less

  19. Using technology to improve access to specialist care in amyotrophic lateral sclerosis: A systematic review.

    PubMed

    Hobson, Esther V; Baird, Wendy O; Cooper, Cindy L; Mawson, Sue; Shaw, Pamela J; Mcdermott, Christopher J

    2016-01-01

    Our objective was to review the evidence for using technology to improve access to specialist care for patients with amyotrophic lateral sclerosis (ALS) and their carers. Medline, Google Scholar and the Cochrane library were searched for articles describing technology that enabled clinical care of patients with ALS or their carers where the patient/carer and clinician were not in the same location. Two applications were identified: telemedicine to facilitate video conferencing as an alternative to outpatient consultations and telehealth monitoring for patients with respiratory failure. One randomized controlled trial using telehealth in patients with respiratory failure including 22 patients with ALS was identified. While rates of hospitalization were reduced, overall mortality was unchanged and there were too few patients with ALS in the study to detect significant benefit. In conclusion, there is limited evidence to support the use of telemedicine or telehealth in the care of patients with ALS. Future research needs to develop an understanding of the key beneficial aspects of the traditional specialist ALS service and how these factors could be delivered using technology. Successful evaluation and implementation of technologies to facilitate access to specialist care will only be possible if all the relevant impacts of an intervention are understood and measured.

  20. Forecasting the need for medical specialists in Spain: application of a system dynamics model

    PubMed Central

    2010-01-01

    Background Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities. Methods We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method. Results In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology. Conclusions The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America. PMID:21034458

  1. Real-time measurement and control of waste anesthetic gases during veterinary surgeries

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

    Burkhart, J.E.; Stobbe, T.J.

    1990-12-01

    Veterinary clinics are typically small businesses without access to sophisticated occupational safety and health programs that may exist for larger firms or hospitals. Exposures to waste anesthetic gases have been linked to a myriad of adverse health-related conditions. Excessive exposures to anesthetic agents are possible because many of the clinics use portable gas delivery carts that are not designed to capture waste gases. While scavenging systems are available to remove waste anesthetic gases, the cost may be prohibitive for smaller clinics and the effectiveness of these systems has not been fully established in veterinary clinics. The National Institute for Occupationalmore » Safety and Health (NIOSH) recommends limiting exposures to nitrous oxide (N2O) to a time-weighted average (TWA) concentration of 25 ppm and halogenated agents to 2 ppm. The NIOSH TWA is based on the weight of the agent collected from a 45-L air sample by charcoal adsorption over a sampling period not to exceed 1 hr. The NIOSH criteria state that, in most situations, control of N2O to the TWA as defined will result in levels of approximately 0.5 ppm of the halogenated agent. At present, no Occupational Safety and Health Administration (OSHA) permissible exposure level (PEL) exists for exposure to anesthetic agents; nor do specific recommendations exist for veterinary scavenging systems. Waste anesthetic gas exposures were determined using a modified MIRAN 1A at five veterinary clinics operating within the Morgantown, West Virginia, vicinity. For unscavenged systems of methoxyflurane and halothane, 1-hr time-weighted average exposures ranged from 0.5 to 45.5 ppm and 0.2 to 105.4 ppm, respectively.« less

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

    PubMed

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

    2006-03-03

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

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

    PubMed Central

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

    2006-01-01

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

  4. COMBUSTION CONTROL OF ORGANIC EMISSIONS FROM MUNICIPAL WASTE COMBUSTORS

    EPA Science Inventory

    More than two decades ago, researchers identified benzo(a)pyrene and other organic species in the emissions from incineration of solid waste. Chlorinated dibenzo-p-dioxins and-furans (CDD/CDF) were first detected in municipal waste combustor (MWC) emissions in 1977. Since then, C...

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

    NASA Technical Reports Server (NTRS)

    1992-01-01

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

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

    PubMed

    French, Fiona; Ikenwilo, Divine; Scott, Anthony

    2007-08-01

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

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

    ERIC Educational Resources Information Center

    Gottemoeller, Rose E.; Langer, Paul F.

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

  8. Mine Waste Technology Program. In Situ Source Control Of Acid Generation Using Sulfate-Reducing Bacteria

    EPA Science Inventory

    This report summarizes the results of the Mine Waste Technology Program (MWTP) Activity III, Project 3, In Situ Source Control of Acid Generation Using Sulfate-Reducing Bacteria, funded by the U.S. Environmental Protection Agency (EPA) and jointly administered by EPA and the U.S....

  9. Controls on the Mobility of Antimony in Mine Waste from Three Deposit Types

    NASA Astrophysics Data System (ADS)

    Jamieson, H.; Radková, A. B.; Fawcett, S.

    2017-12-01

    Antimony can be considered both a critical metal and an environmental hazard, with a toxicity similar to arsenic. It is concentrated in stibnite deposits, but also present in polymetallic and precious metal ores, frequently accompanied by arsenic. We have studied the mineralogical controls on the mobility of antimony in three types of mine waste: stibnite tailings from an antimony mine, tetrahedrite-bearing waste rock from copper mining, and gold mine tailings and ore roaster waste. Our results demonstrate that the tendency of antimony to leach into the aqueous environment or remain sequestered in solid phases depends on the primary host minerals and conditions governing the precipitation of secondary antimony-hosting phases. In tailings at the Beaver Brook antimony mine in Newfoundland, Canada, stibnite oxidizes rapidly, and secondary minerals such as the relatively insoluble Sb-Fe tripuhyite-like phase and Sb-bearing goethite. However, under dry conditions, the most important secondary Sb host is the Mg-Sb hydroxide brandholzite, but this easily soluble mineral disappears when it rains. Antimony that was originally hosted in tetrahedrite, a complex multi-element sulfosalt, in the historic waste rock piles at Špania Dolina-Piesky, Slovakia, is not as mobile as Cu and As during weathering but reprecipiates to a mixture of tripuhyite and romeite. Finally, the original antimony-hosting minerals, both stibnite and sulphosalts, in the gold ore at Giant Mine, Yellowknife, Canada were completely destroyed during ore roasting. In tailings-contaminated sediments, antimony persists in roaster-generated iron oxide phases, except under reducing conditions where some of the antimony forms a Sb-S phase. The combined presence of antimony and arsenic in mine waste complicates risk assessment but in general, our findings suggest that antimony is less mobile than arsenic in the environment.

  10. A guide to breast implants for the non-breast specialist.

    PubMed

    Harvey, Kate L; Clark, Sarah E

    2016-11-01

    Breast augmentation is an increasingly popular cosmetic surgery procedure, and breast implants can also be used in reconstructive surgery following mastectomy. Problematic breast implants can present to any discipline of medicine, most frequently to primary care or acute service such as emergency medicine. This guide aims to inform the non-breast specialist in how to assess and treat common problems and when referral to specialist services is necessary.

  11. A guide to breast implants for the non-breast specialist

    PubMed Central

    Harvey, Kate L.; Clark, Sarah E.

    2016-01-01

    Breast augmentation is an increasingly popular cosmetic surgery procedure, and breast implants can also be used in reconstructive surgery following mastectomy. Problematic breast implants can present to any discipline of medicine, most frequently to primary care or acute service such as emergency medicine. This guide aims to inform the non-breast specialist in how to assess and treat common problems and when referral to specialist services is necessary. PMID:29334026

  12. Municipal waste processing apparatus

    DOEpatents

    Mayberry, J.L.

    1988-04-13

    This invention relates to apparatus for processing municipal waste, and more particularly to vibrating mesh screen conveyor systems for removing grit, glass, and other noncombustible materials from dry municipal waste. Municipal waste must be properly processed and disposed of so that it does not create health risks to the community. Generally, municipal waste, which may be collected in garbage trucks, dumpsters, or the like, is deposited in processing areas such as landfills. Land and environmental controls imposed on landfill operators by governmental bodies have increased in recent years, however, making landfill disposal of solid waste materials more expensive. 6 figs.

  13. Avionics Instrument Systems Specialist (AFSC 32551).

    ERIC Educational Resources Information Center

    Miller, Lawrence B.; Crowcroft, Robert A.

    This six-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for avionics instrument systems specialists. Covered in the individual volumes are career field familiarization (career field progression and training, security, occupational safety and health, and career field reference material);…

  14. Metrication: What Can HRD Specialists Do?

    ERIC Educational Resources Information Center

    Short, Larry G.

    1978-01-01

    First discusses some features of the Metric Conversion Act which established federal support of metric system usage in the United States. Then covers the following: what HRD (Human Resources Development) specialists can do to assist their company managers during the conversion process; metric training strategies; and how to prepare for metric…

  15. Community-Based Prevention Specialist. Trainer Manual.

    ERIC Educational Resources Information Center

    University Research Corp., Bethesda, MD.

    This trainer manual is designed to assist facilitators in the design of entry-level courses and programs for substance abuse prevention specialists. The manual initially concentrates on a basic, generic approach to community work, and introduces the knowledge and skills needed to implement substance abuse prevention programs by using the community…

  16. Specialist Teams Needed to Support Youth.

    ERIC Educational Resources Information Center

    Mellin, Laurel M.

    1991-01-01

    Presents seven reasons why it is important for health specialist teams to take action supporting the prevention and treatment of childhood obesity. The article offers guidelines to help parents assist their children in maintaining positive eating, exercise, and self-esteem patterns, noting sensitive intervention is preferable to imposed diets. (SM)

  17. A tale of two cultures: specialists and generalists sharing the load.

    PubMed

    Manca, Donna P; Breault, Lorraine; Wishart, Paul

    2011-05-01

    To understand what contributes to good collaborative physician working relationships through identifying the factors that affect working relationships between generalist physicians and specialists. Qualitative study using in-depth interviews. University and community hospital inpatient family practice settings in Edmonton, Alta. Eleven physicians from various specialties who graduated between 1977 and 2001. A grounded-theory approach, including constant comparison and creation of memorandums, helped to conceptualize the main concern and generated a framework for how the main concern was being resolved. A semistructured interview guide was developed and individual, in-depth interviews were audiotaped. Purposeful and theoretical sampling techniques were used. Three researchers participated in the analysis. The findings suggested that when generalist physicians perceived that work had been imposed on them by specialists without negotiation, they felt overwhelmed by the workload. Differing priorities determined whether physicians were left holding the bag or sharing the load. In a system that valued technology and specialized knowledge and skills, the specialists were better able to control resources, set boundaries, and influence learners. This precipitated a culture of protecting valuable specialty resources, increasing physician isolation, and generalists feeling that they were left holding the bag. In order to reverse this cycle, it was important for physicians to develop good working relationships based on accessibility to needed expertise and tests, with negotiated agreements on how to share resources; mutual empowerment, including negotiation of roles and responsibilities to develop flexible relationships with a clear understanding of roles; and concern for fairness by sharing the load. Medical systems that value technology and focused interests might lead to someone being left holding the bag, contributing to generalists feeling overwhelmed and isolated within

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Schoonover, Heather

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

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

    PubMed

    Schneider, H

    2018-05-16

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

  1. STS-67 Payload Specialists Durrance and Parise suit up

    NASA Technical Reports Server (NTRS)

    1995-01-01

    In the Operations and Checkout Building, STS-67 Payload Specialists Samuel T. Durrance (left) and Ronald A. Parise have finished donning their launch/entry suits and chat with astronaut Joe Tanner while waiting for the rest of the crew. The two payload specialists -- who are both making their second trip into space -- and five fellow crew members will soon depart for Launch Pad 39A, where the Space Shuttle Endeavour is being readied for liftoff during a launch window opening at 1:37 a.m. EST, March 2.

  2. View of Mission Specialist Judith Resnik on the middeck

    NASA Image and Video Library

    1984-09-08

    41D-13-025 (30 Aug 1984) --- Astronaut Judith A. Resnik, one of three mission specialists, positions herself on the floor of the Space Shuttle Discovery's mid-deck to note some items on a clipboard pad. Nearby, Charles D. Walker, payload specialist (partially out of frame at left), anchors himself with a foot restraint while working at a stowage locker. Between the two is a sign fashioned by Dr. Resnik and held up to a nearby TV camera during early STS-41D downlinked television. This is a 35mm frame.

  3. Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists.

    PubMed

    Morais, Fábio Barreto; Arantes, Tiago Eugênio Faria E; Muccioli, Cristina

    2018-01-01

    To describe treatment practices for ocular toxoplasmosis among members of the Brazilian Uveitis Society. An online questionnaire sent to specialists, between October 2014 and March 2015. Most respondents (67.9%) treat all active cases. Most specialists consider visual acuity <20/200 (88.2%), severe vitreous inflammation (94.1%), and ocular disease during acquired infection (88.2%) as absolute indications for treatment. Systemic steroids are associated with anti-toxoplasmic therapy in most cases by 50.9% of the respondents. For immunocompetent individuals, 57.4% of the respondents chose trimethoprim/sulfamethoxazole. Classical therapy (sulfadiazine/pyrimethamine) is preferred most for patients with central lesions (70.4%), immunosuppression (68.4%), acquired infection (70.4%), and atypical forms (74.1%). For patients with frequent relapses, 84.9% of the respondents preferred antibiotic prophylaxis. Treatment patterns of ocular toxoplasmosis are not uniform among Brazilian specialists. Most specialists treat all cases of active retinochoroiditis. Typical cases are more frequently treated with trimethoprim/sulfamethoxazole. However, classical therapy is the regimen of choice when lesions are considered more severe.

  4. Role expectations in dementia care among family physicians and specialists.

    PubMed

    Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

    2014-09-01

    The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Physicians' clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the "bad cop" to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Future research could further explore physicians' and other multi-disciplinary members' perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario.

  5. Role Expectations in Dementia Care Among Family Physicians and Specialists

    PubMed Central

    Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

    2014-01-01

    Background The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Methods Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Results Physicians’ clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the “bad cop” to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Conclusions Future research could further explore physicians’ and other multi-disciplinary members’ perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario. PMID:25232368

  6. Waste to energy--key element for sustainable waste management.

    PubMed

    Brunner, Paul H; Rechberger, Helmut

    2015-03-01

    Human activities inevitably result in wastes. The higher the material turnover, and the more complex and divers the materials produced, the more challenging it is for waste management to reach the goals of "protection of men and environment" and "resource conservation". Waste incineration, introduced originally for volume reduction and hygienic reasons, went through a long and intense development. Together with prevention and recycling measures, waste to energy (WTE) facilities contribute significantly to reaching the goals of waste management. Sophisticated air pollution control (APC) devices ensure that emissions are environmentally safe. Incinerators are crucial and unique for the complete destruction of hazardous organic materials, to reduce risks due to pathogenic microorganisms and viruses, and for concentrating valuable as well as toxic metals in certain fractions. Bottom ash and APC residues have become new sources of secondary metals, hence incineration has become a materials recycling facility, too. WTE plants are supporting decisions about waste and environmental management: They can routinely and cost effectively supply information about chemical waste composition as well as about the ratio of biogenic to fossil carbon in MSW and off-gas. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed

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

    2013-09-27

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

  9. Apprentice Food Service Specialist (AFSC 62230).

    ERIC Educational Resources Information Center

    Air Univ., Gunter AFS, Ala. Extension Course Inst.

    This two-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice food service specialists. Covered in the first volume are fundamentals of food preparation and service (careers in food service, food service sanitation, principles of food preparation and service, and baking…

  10. Military Hazardous Wastes: An Overview and Analysis.

    DTIC Science & Technology

    1981-12-01

    the soil as fertilizers or soil conditioners * Mining overburden returned to the mine site Utility wastes (fly ash, flue gas desulfurization sludge...19 3.3.2 What Is the Significance of Superfund to Military Wastes? ...... ............... 20 3.4 Toxic Substances Control Act...Hazardous Wastes From Current and Future Operations .... ......... 34 4.4 Organizational Responsibilities ... ............. .. 42 5. CONTROL TECHNOLOGY

  11. Safe use of chemicals by professional users and health care specialists

    PubMed Central

    Apatsidou, Margarita; Konstantopoulou, Ioanna; Foufa, Eleni; Tsarouhas, Konstantinos; Papalexis, Petros; Rezaee, Ramin; Spandidos, Demetrios A.; Kouretas, Demetrios; Tsitsimpikou, Christina

    2018-01-01

    The awareness of Greek professional users and health care specialists regarding the safe use of chemicals was investigated, to be the best of our knowledge, for the first time after the introduction of Regulations (EC) 1907/2006 (REACH) and 1272/2008 (CLP) on chemicals. A total of 200 professional users and 150 health care specialists from various regions of Greece contributed to the use of a closed-ended, anonymous and validated questionnaire. The findings showed that over 85% of the responders were not aware of classification, labelling and packaging (CLP) and 67.8% of the responders were unaware of any changes made in the labeling of the products they were using. The majority (>75%) of individuals were cognizant that they were using hazardous products; however, the perception of hazard varied significantly between the two groups (P=0.012) and statistically were dependent on the educational (P=0.022) and the profession (P=0.014) level. One third of the professional users read the label as the main source of information for the product, while for health care specialists the number increased to 65% and a strong correlation was detected with the educational level (P=0.017). In both groups, 7% of professional users and health care specialists declared that hazard communication through product labeling is not well understood. The use of personal protective equipment (PPE) is almost universal for health care specialists with women being more sensitive (P=0.041), while 25% of the professional users do not use any PPE. Almost 60% of the health care specialists are required to provide instructions regarding the safe use of chemicals or the action to be undertaken in case of accident. In the latter situation, the National Poisoning Centre is the reference point for information. Limited use of the safety data sheets has been observed both for professional users (18%) and health care specialists (23%). In conclusion, rising awareness campaigns are needed, in collaboration

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

    NASA Technical Reports Server (NTRS)

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

    1979-01-01

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

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

    PubMed

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

    2005-08-01

    To evaluate the prescription modalities of general practitioners (GPs) and specialists in symptomatic osteoarthritis (OA) patients enrolled in the AMICA study. This study started in 2001 as a cohort investigation of OA patients seen by 2764 GPs and 316 specialists. Enrolled were 28,981 patients with symptomatic OA of the hand, hip, or knee. GPs and physical medicine specialists treated OA less frequently with pharmacological therapy than rheumatologists (OR 0.35; CI 0.26 to 0.47) or orthopedic surgeons (OR 0.65; CI 0.54 to 0.77). Pharmacological therapies (alone or in association with nonpharmacological modalities) were selected by 97% of the GPs, 96% of the rheumatologists, 94% of the orthopedic surgeons, and 85% of the physical medicine specialists. In comparison with GPs, all of the specialists more frequently used disease-modifying OA drugs (DMOADs) (rheumatologists: OR 6.86, CI 6.03 to 7.80; orthopedic surgeons: OR 2.20, CI 1.94 to 2.49; physical medicine specialists: OR 2.11, CI 1.69 to 2.63). Nonpharmacological therapies were selected by 44% of the GPs, 54% of the rheumatologists, 71% of the orthopedic surgeons, and 90% of the physical medicine specialists. They were used alone uncommonly (by 3% of the GPs, 3% of the rheumatologists, 6% of the orthopedic surgeons, and 15% of the physical medicine specialists). GPs use nonpharmacological treatment less than specialists: OR 0.53; CI 0.47 to 0.60 versus rheumatologists; OR 0.20; CI 0.18 to 0.21 versus orthopedic surgeons; and OR 0.07; CI 0.05 to 0.09 versus physical medicine specialists. Ultrasound (US) (11%) and transcutaneous electrical nerve stimulation (TENS) (7%) were the nonpharmacological therapies most frequently prescribed by GPs. Among the specialists, physical medicine specialists most frequently prescribed US (35%) and TENS (21%); US was also preferred by rheumatologists, whereas the orthopedic surgeon's choice was magnetotherapy (21%). Exercises and other passive or active rehabilitation strategies

  14. Private or public? An empirical analysis of the importance of work values for work sector choice among Norwegian medical specialists.

    PubMed

    Midttun, Linda

    2007-03-01

    In the aftermath of the Norwegian hospital reform of 2002, the private supply of specialized healthcare has increased substantially. This article analyses the likelihood of medical specialists working in the private sector. Sector choice is operationalized in two ways: first, as the likelihood of medical specialists working in the private sector at all (at least 1% of the total work hours), and second, as the likelihood of working full-time (90-100%) privately. The theoretical framework is embedded in work values theory and the results suggest that work values are important predictors of sector choice. All analyses are based on a postal questionnaire survey of medical specialists working in private contract practices and for-profit hospitals and a control group of specialists selected from the Norwegian Medical Association's member register. The analyses revealed that while autonomy values impact positively on the propensity for allocating any time at all to the private sector, professional values have a negative effect. Given that the medical specialist already works in the private sector, a high valuation of professional values and payment and benefit values increases the likelihood of having a dual sector job rather than a full-time private position. However, due to the cross-sectional structure of the data and limitations in the dataset, causality questions cannot be fully settled on the basis of the analyses. The relationship between work values and sector choice should, therefore, be regarded as associations rather than causality links. Finally, the likelihood of working in the private sector varies significantly at the municipality level, suggesting that medical specialist's location is important for sector choice.

  15. STS-87 Payload Specialist Kadenyuk in white room

    NASA Technical Reports Server (NTRS)

    1997-01-01

    STS-87 Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine is assisted with final preparations before launch in the white room at Launch Pad 39B by Danny Wyatt, NASA quality assurance specialist, at left; Dave Law, USA mechanical technician, facing Kadenyuk; and Travis Thompson, USA orbiter vehicle closeout chief, at right. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. The 16- day mission will include the Collaborative Ukrainian Experiment (CUE), a collection of 10 plant space biology experiments that will fly in Columbias middeck and will feature an educational component that involves evaluating the effects of microgravity on Brassica rapa seedlings.

  16. Assessing the impact of waste picking on musculoskeletal disorders among waste pickers in Mumbai, India: a cross-sectional study

    PubMed Central

    Singh, Shrikant; Chokhandre, Praveen

    2015-01-01

    Objective To assess the prevalence of musculoskeletal disorders (MSDs) as well as the impact of the occupation of waste picking on complaints of MSDs among waste pickers. The study attempts to understand the risk factors for MSDs in various areas of the body. Design A cross-sectional household survey was conducted using a case-control design. The survey instrument for measuring musculoskeletal symptoms was adopted from a standardised Nordic questionnaire. The impact of the occupation of waste picking on MSDs was analysed using the propensity score matching (PSM) method. Participants The study population consisted of waste pickers (n=200) who had been working for at least a year and a control group (n=213) selected from among or living close to the same communities. Results The 12-month prevalence of MSDs was higher among waste pickers (79%) compared to controls (55%) particularly in the lower back (54–36%), knee (48–35%), upper back (40–21%) and shoulder (32–12%). Similar patterns were observed in the 12-month prevalence of MSDs which prevented normal activity inside and outside the home, particularly for the lower back (36–21%), shoulder (21–7%) and upper back (25–12%) for waste pickers and controls. Analysis of the impact of waste picking on complaints of MSDs suggests that the occupation of waste picking raises the risk of MSDs particularly in the shoulder, lower and upper back. Older age and longer duration of work are significant risk factors for MSDs. Conclusions The findings suggest a relatively higher prevalence of MSDs among waste pickers, particularly in the lower and upper back and shoulder, compared to controls. Preventive measures and treatment to minimise the burden of MSDs among waste pickers are strongly recommended. PMID:26408284

  17. Personalizing protocol-driven care: the case of specialist heart failure nurses.

    PubMed

    Sanders, Tom; Harrison, Stephen; Checkland, Katherine

    2010-09-01

    This paper is a report of a study conducted to explore how specialist heart failure nurses negotiate treatment advice with patients, in the context of an increasing expectation that clinical staff in the National Health Services will follow guidelines in their daily work. The development of specialist nurse roles has given rise to questions about their compatibility with patient-centred care. However, research has revealed little about how specialist nurses balance clinical guidelines with traditional caring tasks. Semi-structured interviews (n = 10) were conducted with specialist heart failure nurses in northern England recruited from a heart failure specialist nursing contact list. In addition, non-participant observations were carried out on nurse-patient consultations (n = 16) in one regional nurse-led heart failure clinic. Data were collected between 2003 and 2005, and analysed using a variation of grounded theory. Heart failure nurses sought to combine traditional caring work with the wider goal of improving patient outcomes by 'personalizing' their advice to patients and presenting their heart failure as 'typical'. They accommodated protocol-driven care into their daily routines, and perceived no disjuncture between evidence-based practice and patient-centredness. However, their approach allowed little space for the exploration of each patient's own priorities about their illness. There is a need both to re-examine the appropriateness of traditional caring concepts, and to reflect on the need to incorporate patients' own values into the consultation process.

  18. WASTE HANDLING BUILDING ELECTRICAL SYSTEM DESCRIPTION DOCUMENT

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

    S.C. Khamamkar

    2000-06-23

    The Waste Handling Building Electrical System performs the function of receiving, distributing, transforming, monitoring, and controlling AC and DC power to all waste handling building electrical loads. The system distributes normal electrical power to support all loads that are within the Waste Handling Building (WHB). The system also generates and distributes emergency power to support designated emergency loads within the WHB within specified time limits. The system provides the capability to transfer between normal and emergency power. The system provides emergency power via independent and physically separated distribution feeds from the normal supply. The designated emergency electrical equipment will bemore » designed to operate during and after design basis events (DBEs). The system also provides lighting, grounding, and lightning protection for the Waste Handling Building. The system is located in the Waste Handling Building System. The system consists of a diesel generator, power distribution cables, transformers, switch gear, motor controllers, power panel boards, lighting panel boards, lighting equipment, lightning protection equipment, control cabling, and grounding system. Emergency power is generated with a diesel generator located in a QL-2 structure and connected to the QL-2 bus. The Waste Handling Building Electrical System distributes and controls primary power to acceptable industry standards, and with a dependability compatible with waste handling building reliability objectives for non-safety electrical loads. It also generates and distributes emergency power to the designated emergency loads. The Waste Handling Building Electrical System receives power from the Site Electrical Power System. The primary material handling power interfaces include the Carrier/Cask Handling System, Canister Transfer System, Assembly Transfer System, Waste Package Remediation System, and Disposal Container Handling Systems. The system interfaces with the MGR

  19. The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services

    PubMed Central

    Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

    2017-01-01

    Objectives International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. Design A cross-sectional survey of hospital and community-based DNS in Ireland. Methods Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. Results The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Conclusions Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. PMID:28801394

  20. One Team: Classroom Teachers and Specialists

    ERIC Educational Resources Information Center

    Gale, Sheila Levine

    2016-01-01

    This View from the Chalkboard article reflects my view of how today's classroom teacher and specialist have joined together to create "One Team" that benefits the student. This was not always the case but the trend, in my view, is clear and the benefits compelling. I highlight the "reading workshop model" as an approach with…