Evaluation of the low-temperature heat-exchanger fouling problem. Phase I report. Literature review and work plan

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

Butcher, T.A.

1983-05-01

This report describes Phase I of a study of the fouling of condensing heat exchangers in residential oil-fired boiler and furnaces. The first phase consists of a review of available information on soot information in residential systems and the preparation of a work plan for Phase II. In the literature review the effects of burner type, startup and shutdown, time from tuning, fuel quality, combustion chambers, nozzles, and fuel additives are discussed. While data are available on soot emissions with current burners and fuels there are limited data available on advanced burners and degraded fuels with modern burners. The Phasemore » II work will provide an evaluation of the need for the development of advanced burner concepts for oil-fired condensing systems. Planned experimental work includes a furnace draft optimization study, extended fouling tests, a blue flame/yellow flame comparative test, and some degraded fuel teste.« less

Advanced Education and Technology Business Plan, 2009-12

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2009

2009-01-01

The Ministry of Advanced Education and Technology consists of the following entities for budget purposes: Department of Advanced Education and Technology, the Access to the Future Fund, Alberta Enterprise Corporation, Alberta Research Council Inc., and iCORE Inc. Achieving the Ministry's goals involves the work and coordination of many…

Applying Planning Algorithms to Argue in Cooperative Work

NASA Astrophysics Data System (ADS)

Monteserin, Ariel; Schiaffino, Silvia; Amandi, Analía

Negotiation is typically utilized in cooperative work scenarios for solving conflicts. Anticipating possible arguments in this negotiation step represents a key factor since we can take decisions about our participation in the cooperation process. In this context, we present a novel application of planning algorithms for argument generation, where the actions of a plan represent the arguments that a person might use during the argumentation process. In this way, we can plan how to persuade the other participants in cooperative work for reaching an expected agreement in terms of our interests. This approach allows us to take advantages since we can test anticipated argumentative solutions in advance.

Rewards and advancements for clinical pharmacists.

PubMed

Goodwin, S Diane; Kane-Gill, Sandra L; Ng, Tien M H; Melroy, Joel T; Hess, Mary M; Tallian, Kimberly; Trujillo, Toby C; Vermeulen, Lee C

2010-01-01

The American College of Clinical Pharmacy charged the Clinical Practice Affairs Committee to review and update the College's 1995 White Paper, "Rewards and Advancements for Clinical Pharmacy Practitioners." Because of the limited data on the present state of rewards and advancements for clinical pharmacists, an online survey of "front-line" clinical pharmacists and pharmacy managers was conducted (1126 total respondents, 14% response rate). The resulting White Paper discusses motivators and existing systems of rewards and advancements for clinical pharmacists, as well as perceived barriers to implementation of these systems. Clinical pharmacists reported work-life balance, a challenging position, and opportunities for professional advancement as the most important factors for career success. At the time of the survey, financial rewards appeared not to be a major motivator for clinical pharmacists. Managers underestimated the importance that clinical pharmacists place on work-life balance and favorable work schedules. Although almost two thirds of the clinical pharmacists surveyed had not developed a professional development plan, 84% indicated an interest in career planning. Both clinical pharmacists and managers rated the lack of a clear reward and advancement structure as the most important barrier to effective systems of rewards and advancements. Pharmacy managers and administrators are encouraged to develop effective systems of rewards and advancements for clinical pharmacists that positively impact patient care and the institution's mission; these systems will benefit the clinical pharmacist, the health care institution, and the patient.

The Technical Work Plan Tracking Tool

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Leighton, Adele; Weller, Richard A.; Woodfill, Jared; Parkman, William E.; Ellis, Glenn L.; Wilson, Marilyn M.

2003-01-01

The Technical Work Plan Tracking Tool is a web-based application that enables interactive communication and approval of contract requirements that pertain to the administration of the Science, Engineering, Analysis, and Test (SEAT) contract at Johnson Space Center. The implementation of the application has (1) shortened the Technical Work Plan approval process, (2) facilitated writing and documenting requirements in a performance-based environment with associated surveillance plans, (3) simplified the contractor s estimate of the cost for the required work, and (4) allowed for the contractor to document how they plan to accomplish the work. The application is accessible to over 300 designated NASA and contractor employees via two Web sites. For each employee, the application regulates access according to the employee s authority to enter, view, and/or print out diverse information, including reports, work plans, purchase orders, and financial data. Advanced features of this application include on-line approval capability, automatic e-mail notifications requesting review by subsequent approvers, and security inside and outside the firewall.

An Incentive Pay Plan for Advanced Practice Registered Nurses: Impact On Provider and Organizational Outcomes.

PubMed

Rhodes, Catherine A; Bechtle, Mavis; McNett, Molly

2015-01-01

Advanced practice registered nurses (APRNs) are integral to the provision of quality, cost-effective health care throughout the continuum of care. To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated. Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers. After the first year of implementation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges. The incentive plan is a win-win for hospitals that employ APRNs.

Curriculum Planning and the Concept of Participation in the Reggio Emilia Pedagogical Approach

ERIC Educational Resources Information Center

Hocevar, Andreja; Šebart, Mojca Kovac; Štefanc, Damijan

2013-01-01

The article analyses two defining assumptions about the Reggio Emilia (RE) approach: the absence of a planned curriculum designed in advance as a basis for educational work and children's participation in preschools. The authors demonstrate that different approaches to planning preschool education have advantages and disadvantages, which we cannot…

Doctors, Lawyers and Advance Care Planning: Time for Innovation to Work Together to Meet Client Needs

PubMed Central

Douglas, Maureen; Simon, Jessica; Fassbender, Konrad

2016-01-01

Health organizations in Canada have invested considerable resources in strategies to improve knowledge and uptake of advance care planning (ACP). Yet barriers persist and many Canadians do not engage in the full range of ACP behaviours, including writing an advance directive and appointing a legally authorized decision-maker. Not engaging effectively in ACP disadvantages patients, their loved ones and their healthcare providers. This article advocates for greater collaboration between health and legal professionals to better support clients in ACP and presents a framework for action to build connections between these typically siloed professions. PMID:28032821

Advanced Simulation and Computing Fiscal Year 2016 Implementation Plan, Version 0

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

McCoy, M.; Archer, B.; Hendrickson, B.

2015-08-27

The Stockpile Stewardship Program (SSP) is an integrated technical program for maintaining the safety, surety, and reliability of the U.S. nuclear stockpile. The SSP uses nuclear test data, computational modeling and simulation, and experimental facilities to advance understanding of nuclear weapons. It includes stockpile surveillance, experimental research, development and engineering programs, and an appropriately scaled production capability to support stockpile requirements. This integrated national program requires the continued use of experimental facilities and programs, and the computational capabilities to support these programs. The purpose of this IP is to outline key work requirements to be performed and to control individualmore » work activities within the scope of work. Contractors may not deviate from this plan without a revised WA or subsequent IP.« less

Chemical release and radiation effects experiment advanced planning and coordination

NASA Technical Reports Server (NTRS)

Vaughan, William W.; Alzmann, Melanie

1991-01-01

The efforts conducted to provide assessments and planning support for the Chemical Release and Radiation Effects Satellite (CRRES) Experiments are summarized. Included are activities regarding scientific working group and workshop development including the preparation of descriptive information on the CRRES Project.

Chemical release and radiation effects experiment advanced planned

NASA Technical Reports Server (NTRS)

Vaughan, William W.; Alzmann, Melanie

1990-01-01

A summary of the efforts conducted to provide assessments and planning support for the Chemical Release and Radiation Experiment Satellite (CRRES) is reported. Included are activities regarding scientific working group and workshop development including the preparation of descriptive information on the CRRES project.

This is Your Life: A Career and Education Planning Guide: Educator's Companion

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2009

2009-01-01

This guide was developed to fill a need identified by high school educators and Alberta Advanced Education and Technology staff. The Guide introduces students to the principles of career and education planning and various authorized Alberta resources by helping students work through the planning process. The student guide is a series of modules…

33 CFR 209.345 - Water resource policies and authorities.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Reimbursement for Advance Non-Federal Participation in Civil Works Projects (a) Purpose. This regulation gives... regulation applies to all field operating agencies having Civil Works responsibilities. (c) References. (1... develop the design memorandum, engineering plans, and specifications for the work it proposes to undertake...

Working memory and planning during sentence production.

PubMed

Martin, Randi C; Yan, Hao; Schnur, Tatiana T

2014-10-01

Speakers retrieve conceptual, syntactic and lexical information in advance of articulation during sentence production. What type of working memory (WM) store is used to hold the planned information before speaking? To address this question, we measured onset latencies when subjects produced sentences that began with either a complex or a simple initial noun phrase, while holding semantic, phonological or spatial information in WM. Although we found that subjects had longer onset latencies for sentences beginning with a complex noun phrase, showing a phrasal scope of planning, the magnitude of this complexity effect was not affected by any type of WM load. However, subjects made more syntactic errors (but not lexical errors) for sentences beginning with a complex noun phrase, suggesting that advance planning for these phrases occurs at a syntactic rather than lexical-semantic level, which may account for the lack of effect with various types of WM load in the current study. Copyright © 2014 Elsevier B.V. All rights reserved.

Advance care planning: challenges and approaches for pediatricians.

PubMed

Heckford, Emma; Beringer, Antonia Jane

2014-09-01

There is increasing recognition of the value of advance care planning for children with life-limiting conditions. It is important that we acknowledge and reflect on the challenges that this work presents in order to optimize practice. Our aim was to review advance care planning for children with life-threatening or life-limiting conditions (LTLLCs) in our local area. We conducted a retrospective case note review. Study subjects were from two National Health Service (NHS) Trusts in Bristol in the United Kingdom. Cases were identified from Child Death Overview Panel data. Forty-two sets of case notes were reviewed in relation to 20 children. Measurements included quantitative and qualitative review of advance care planning in relation to standards set by The Association for Children's Palliative Care (ACT). In 25% of cases there was no documented discussion with families about the approach to end of life (EOL). In 25% of cases there was no evidence of an advance care plan, and the content and accessibility of those that did exist was variable. Forty-five percent of families were not offered a choice with regard to location of care (LOC) in the last months of life and 50% were not offered a choice about location of death (LOD). We hope that acknowledgement of some of the challenges, alongside recognition of the clear benefits, of planning will help pediatricians to deliver this important area of care.

Advance care planning for haemodialysis patients.

PubMed

Lim, Chi Eung Danforn; Ng, Rachel W C; Cheng, Nga Chong Lisa; Cigolini, Maria; Kwok, Cannas; Brennan, Frank

2016-07-26

End-stage kidney disease (ESKD) is a chronic, debilitative and progressive illness that may need interventions such as dialysis, transplantation, dietary and fluid restrictions. Most patients with ESKD will require renal replacement therapy, such as kidney transplantation or maintenance dialysis. Advance care planning traditionally encompass instructions via living wills, and concern patient preferences about interventions such as cardiopulmonary resuscitation and feeding tubes, or circumstances around assigning surrogate decision makers. Most people undergoing haemodialysis are not aware of advance care planning and few patients formalise their wishes as advance directives and of those who do, many do not discuss their decisions with a physician. Advance care planning involves planning for future healthcare decisions and preferences of the patient in advance while comprehension is intact. It is an essential part of good palliative care that likely improves the lives and deaths of haemodialysis patients. The objective of this review was to determine whether advance care planning in haemodialysis patients, compared with no or less structured forms of advance care planning, can result in fewer hospital admissions or less use of treatments with life-prolonging or curative intent, and if patient's wishes were followed at end-of-life. We searched the Cochrane Kidney and Transplant Specialised Register to 27 June 2016 through contact with the Information Specialist using search terms relevant to this review. We also searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Social Work Abstracts (OvidSP). All randomised controlled trials (RCTs) and quasi-RCTs (RCTs in which allocation to treatment was obtained by alternation, use of alternate medical records, date of birth or other predictable methods) looking at advance care planning versus no form of advance care planning in haemodialysis patients was considered for inclusion without language restriction. Data extraction was carried out independently by two authors using standard data extraction forms. Studies reported in non-English language journals were translated before assessment. Where more than one publication of one study exists, reports were grouped together and the publication with the most complete data was used in the analyses. Where relevant outcomes are only published in earlier versions these data were used. Any discrepancies between published versions were highlighted. Non-randomised controlled studies were excluded. We included two studies (three reports) that involved 337 participants which investigated advance care planning for people with ESKD. Neither of the included studies reported outcomes relevant to this review. Study quality was assessed as suboptimal. We found sparse data that were assessed at suboptimal quality and therefore we were unable to formulate conclusions about whether advance care planning can influence numbers of hospital admissions and treatment required by people with ESKD, or if patients' advance care directives were followed at end-of-life. Further well designed and adequately powered RCTs are needed to better inform patient and clinical decision-making about advance care planning and advance directives among people with ESKD who are undergoing dialysis.

Research and development program plan for the Center for Engineering Systems Advanced Research (CESAR)

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

Weisbin, C.R.; Hamel, W.R.; Barhen, J.

1986-02-01

The Oak Ridge National Laboratory has established the Center for Engineering Systems Advanced Research (CESAR) for the purpose of addressing fundamental problems of intelligent machine technologies. The purpose of this document is to establish a framework and guidelines for research and development within ORNL's CESAR program in areas pertaining to intelligent machines. The specific objective is to present a CESAR Research and Development Plan for such work with a planning horizon of five to ten years, i.e., FY 1985 to FY 1990 and beyond. As much as possible, the plan is based on anticipated DOE needs in the area ofmore » productivity increase and safety to the end of this century.« less

ESL for Hotel/Hospitality Industry. Level: Advanced Beginner/Intermediate.

ERIC Educational Resources Information Center

Western Suffolk County Board of Cooperative Educational Services, Northport, NY.

This document contains 16 lesson plans for an advanced beginning and intermediate course in work-related English for non-English- or limited-English-speaking entry-level employees in the hotel and hospitality industry. Course objectives are as follows: helping participants understand and use job-specific vocabulary; receive and understand…

Neural mechanisms of movement planning: motor cortex and beyond.

PubMed

Svoboda, Karel; Li, Nuo

2018-04-01

Neurons in motor cortex and connected brain regions fire in anticipation of specific movements, long before movement occurs. This neural activity reflects internal processes by which the brain plans and executes volitional movements. The study of motor planning offers an opportunity to understand how the structure and dynamics of neural circuits support persistent internal states and how these states influence behavior. Recent advances in large-scale neural recordings are beginning to decipher the relationship of the dynamics of populations of neurons during motor planning and movements. New behavioral tasks in rodents, together with quantified perturbations, link dynamics in specific nodes of neural circuits to behavior. These studies reveal a neural network distributed across multiple brain regions that collectively supports motor planning. We review recent advances and highlight areas where further work is needed to achieve a deeper understanding of the mechanisms underlying motor planning and related cognitive processes. Copyright © 2017. Published by Elsevier Ltd.

Conceptual definition of a technology development mission for advanced solar dynamic power systems

NASA Technical Reports Server (NTRS)

Migra, R. P.

1986-01-01

An initial conceptual definition of a technology development mission for advanced solar dynamic power systems is provided, utilizing a space station to provide a dedicated test facility. The advanced power systems considered included Brayton, Stirling, and liquid metal Rankine systems operating in the temperature range of 1040 to 1400 K. The critical technologies for advanced systems were identified by reviewing the current state of the art of solar dynamic power systems. The experimental requirements were determined by planning a system test of a 20 kWe solar dynamic power system on the space station test facility. These requirements were documented via the Mission Requirements Working Group (MRWG) and Technology Development Advocacy Group (TDAG) forms. Various concepts or considerations of advanced concepts are discussed. A preliminary evolutionary plan for this technology development mission was prepared.

DoD Workshop on Southeast Regional Planning and Sustainability

DTIC Science & Technology

2007-04-01

development (Berke, 2007). Weak plans and ordinances in these locations mean limited knowledge about existing human and natural resource systems...research on sustainable community design, and disseminate that knowledge through innovative teaching and outreach. Rather than serving as outside...technical work is being done to address these issues, much institutional change will be needed to tie this knowledge to advance regional plans and

Hybrid Program Design: What Works for Adult Learners in a Professional Degree Program?

ERIC Educational Resources Information Center

Stevens, Christine Rowader

2017-01-01

Working adults planning to pursue higher education programs to advance their careers often face conflicting demands. Colleges and universities are challenged to offer non-traditional programs with more scheduling flexibility, allowing adult learners to manage multiple work, family, and other obligations while attending school (Dana, 2013;…

2010 Chemical Working Group Status

NASA Technical Reports Server (NTRS)

Reid, Concha M.

2010-01-01

The Steering Group for the Interagency Advanced Power Group (IAPG) held their business meeting on November 30-December 1st in McLean, Virginia. Status reports were presented from each of the IAPG's Working Groups. These charts contain a brief summary of the IAPG Chemical Working Group's activities during 2010 and its plans for 2011.

30 CFR 75.222 - Roof control plan-approval criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., roof bolts should be installed on at least 5-foot centers where the work is performed. (2) Where the... opening before any other work or travel in the intersection. (f) ATRS systems in working sections where... panel in advance of the frontal abutment stresses of the panel being mined. (2) When a ground failure...

30 CFR 75.222 - Roof control plan-approval criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., roof bolts should be installed on at least 5-foot centers where the work is performed. (2) Where the... opening before any other work or travel in the intersection. (f) ATRS systems in working sections where... panel in advance of the frontal abutment stresses of the panel being mined. (2) When a ground failure...

Microgravity strategic planning exercise

NASA Technical Reports Server (NTRS)

Halpern, Richard; Downey, Jim; Harvey, Harold

1991-01-01

The Center for Space and Advanced Technology supported a planning exercise for the Microgravity Program management at the Marshall Space Flight Center. The effort focused on the status of microgravity work at MSFC and elsewhere with the objective of preparing a goal-oriented strategic planning document which could be used for informational/brochure purposes. The effort entailed numerous interactions and presentations with Field Center programmatic components and Headquarters personnel. Appropriate material was consolidated in a draft format for a MSFC Strategic Plan.

Advanced software development workstation: Object-oriented methodologies and applications for flight planning and mission operations

NASA Technical Reports Server (NTRS)

Izygon, Michel

1993-01-01

The work accomplished during the past nine months in order to help three different organizations involved in Flight Planning and in Mission Operations systems, to transition to Object-Oriented Technology, by adopting one of the currently most widely used Object-Oriented analysis and Design Methodology is summarized.

Helping Managers and Employees Cope with Work-Force Cutbacks.

ERIC Educational Resources Information Center

Morton, Gene L.

1983-01-01

Steps can be taken to reduce the need for work-force cutbacks and to prepare in advance by planning activities, defining severance awards, reducing anxiety, setting layoff criteria, providing outplacement services, and handling the timing, logistics, and aftermath of layoffs with sensitivity. (SK)

A Qualitative Study of Work-Life Choices in Academic Internal Medicine

PubMed Central

Isaac, Carol; Byars-Winston, Angela; McSorley, Rebecca; Schultz, Alexandra; Kaatz, Anna; Carnes, Mary L.

2013-01-01

The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career advancement. Semi-structured interviews were conducted with a purposeful sample of 18 residents and 34 faculty members representing male and female physicians at different career stages. Using thematic analysis, three themes emerged: 1) the love of being a physician (“Raison d’être”), 2) family obligations (“2nd Shift”), and 3) balancing work demands with non-work life (“Negotiating Academic Medicine”). Female researchers and educators reported more strategies for multiple role planning and management than female practitioners. Interventions aimed at enhancing academic internists’ planning and self-efficacy for multiple role management should be investigated as a potential means for increasing participation and facilitate advancement. PMID:23605099

Streamlining Collaborative Planning in Spacecraft Mission Architectures

NASA Technical Reports Server (NTRS)

Misra, Dhariti; Bopf, Michel; Fishman, Mark; Jones, Jeremy; Kerbel, Uri; Pell, Vince

2000-01-01

During the past two decades, the planning and scheduling community has substantially increased the capability and efficiency of individual planning and scheduling systems. Relatively recently, research work to streamline collaboration between planning systems is gaining attention. Spacecraft missions stand to benefit substantially from this work as they require the coordination of multiple planning organizations and planning systems. Up to the present time this coordination has demanded a great deal of human intervention and/or extensive custom software development efforts. This problem will become acute with increased requirements for cross-mission plan coordination and multi -spacecraft mission planning. The Advanced Architectures and Automation Branch of NASA's Goddard Space Flight Center is taking innovative steps to define collaborative planning architectures, and to identify coordinated planning tools for Cross-Mission Campaigns. Prototypes are being developed to validate these architectures and assess the usefulness of the coordination tools by the planning community. This presentation will focus on one such planning coordination too], named Visual Observation Layout Tool (VOLT), which is currently being developed to streamline the coordination between astronomical missions

The effects of crisis plans for patients with psychotic and bipolar disorders: a randomised controlled trial.

PubMed

Ruchlewska, A; Mulder, C L; Smulders, R; Roosenschoon, B J; Koopmans, G; Wierdsma, A

2009-07-09

Crises and (involuntary) admissions have a strong impact on patients and their caregivers. In some countries, including the Netherlands, the number of crises and (involuntary) admissions have increased in the last years. There is also a lack of effective interventions to prevent their occurrence. Previous research has shown that a form of psychiatric advance statement - joint crisis plan - may prevent involuntary admissions, but another study showed no significant results for another form. The question remains which form of psychiatric advance statement may help to prevent crisis situations. This study examines the effects of two other psychiatric advance statements. The first is created by the patient with help from a patient's advocate (Patient Advocate Crisis Plan: PACP) and the second with the help of a clinician only (Clinician facilitated Crisis Plan: CCP). We investigate whether patients with a PACP or CCP show fewer emergency visits and (involuntary) admissions as compared to patients without a psychiatric advance statement. Furthermore, this study seeks to identify possible mechanisms responsible for the effects of a PACP or a CCP. This study is a randomised controlled trial with two intervention groups and one control condition. Both interventions consist of a crisis plan, facilitated through the patient's advocate or the clinician respectively.Outpatients with psychotic or bipolar disorders, who experienced at least one psychiatric crisis during the previous two years, are randomly allocated to one of the three groups. Primary outcomes are the number of emergency (after hour) visits, (involuntary) admissions and the length of stay in hospital. Secondary outcomes include psychosocial functioning and treatment satisfaction. The possible mediator variables of the effects of the crisis plans are investigated by assessing the patient's involvement in the creation of the crisis plan, working alliance, insight into illness, recovery style, social support, locus of control, service engagement and coping with crises situations. The interviews take place before randomisation, nine month later and finally eighteen months after randomisation. This study examines the effects of two types of crisis plans. In addition, the results offer an understanding of the way these advance statements work and whether it is more effective to include a patients' advocate in the process of creating a psychiatric advance statement. These statements may be an intervention to prevent crises and the use of compulsion in mental health care. The strength and limitations of this study are discussed. Current Controlled Trails NTR1166.

FY 1987 current fiscal year work plan

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

Not Available

This Current Year Work Plan presents a detailed description of the activities to be performed by the Joint Integration Office during FY87. It breaks down the activities into two major work areas: Program Management and Program Analysis. Program Management is performed by the JIO by providing technical planning and guidance for the development of advanced TRU waste management capabilities. This includes equipment/facility design, engineering, construction, and operations. These functions are integrated to allow transition from interim storage to final disposition. JIO tasks include program requirements identification, long-range technical planning, budget development, program planning document preparation, task guidance, task monitoring, informationmore » gathering and task reporting to DOE, interfacing with other agencies and DOE lead programs, integrating public involvement with program efforts, and preparation of program status reports for DOE. Program Analysis is performed by the JIO to support identification and assessment of alternatives, and development of long-term TRU waste program capabilities. This work plan includes: system analyses, requirements analyses, interim and procedure development, legislative and regulatory analyses, dispatch and traffic analyses, and data bases.« less

Three Methods of Assessing Values for Advance Care Planning

PubMed Central

Karel, Michele J.; Moye, Jennifer; Bank, Adam; Azar, Armin R.

2016-01-01

Advance care planning ideally includes communication about values between patients, family members, and care providers. This study examined the utility of health care values assessment tools for older adults with and without dementia. Adults aged 60 and older, with and without dementia, completed three values assessment tools—open-ended, forced-choice, and rating scale questions—and named a preferred surrogate decision maker. Responses to forced-choice items were examined at 9-month retest. Adults with and without dementia appeared equally able to respond meaningfully to questions about values regarding quality of life and health care decisions. People with dementia were generally as able as controls to respond consistently after 9 months. Although values assessment methods show promise, further item and scale development work is needed. Older adults with dementia should be included in clarifying values for advance care planning to the extent that they desire and are able. PMID:17215205

Manager's assistant systems for space system planning

NASA Technical Reports Server (NTRS)

Bewley, William L.; Burnard, Robert; Edwards, Gary E.; Shoop, James

1992-01-01

This paper describes a class of knowledge-based 'assistant' systems for space system planning. Derived from technology produced for the DARPA/USAF Pilot's Associate program, these assistant systems help the human planner by doing the bookkeeping to maintain plan data and executing the procedures and heuristics currently used by the human planner to define, assess, diagnose, and revise plans. Intelligent systems for Space Station Freedom assembly sequence planning and Advanced Launch System modeling will be presented as examples. Ongoing NASA-funded work on a framework supporting the development of such tools will also be described.

Advance care planning, palliative care, and end-of-life care interventions for homeless people: A systematic review.

PubMed

Sumalinog, Rafael; Harrington, Katy; Dosani, Naheed; Hwang, Stephen W

2017-02-01

Homeless individuals have a high prevalence of multiple chronic comorbidities and early mortality compared to the general population. They also experience significant barriers to access and stigmatization in the healthcare system. Providing advance care planning, palliative care, and end-of-life care for this underserved population is an important health issue. To summarize and evaluate the evidence surrounding advance care planning, palliative care, and end-of-life care interventions for homeless persons. A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Articles from MEDLINE, EMBASE, CINAHL, PsycINFO, Social Work Abstracts, Cochrane Library, Web of Science, and PubMed databases were searched through 13 June 2015. Peer-reviewed studies that implemented advance care planning, palliative care, and end-of-life care interventions for homeless populations were included. Data from studies were independently extracted by two investigators using pre-specified criteria, and quality was assessed using modified Cochrane and Critical Appraisal Skills Programme tools. Six articles met inclusion criteria. Two studies were randomized controlled trials involving advance directive completion. Two cohort studies investigated the costs of a shelter-based palliative care intervention and predictors for completing advance directives. These studies were rated low to fair quality. Two qualitative studies explored the interface between harm-reduction services and end-of-life care and the conditions for providing palliative care for homeless persons in a support home. The effectiveness of advance care planning, palliative care, and end-of-life care interventions for homeless individuals is uncertain. High-quality studies of interventions that reflect the unique and complex circumstances of homeless populations and investigate patient-related outcomes, caregiver burden, and cost-effectiveness are needed.

On the flexibility of grammatical advance planning during sentence production: Effects of cognitive load on multiple lexical access.

PubMed

Wagner, Valentin; Jescheniak, Jörg D; Schriefers, Herbert

2010-03-01

Three picture-word interference experiments addressed the question of whether the scope of grammatical advance planning in sentence production corresponds to some fixed unit or rather is flexible. Subjects produced sentences of different formats under varying amounts of cognitive load. When speakers described 2-object displays with simple sentences of the form "the frog is next to the mug," the 2 nouns were found to be lexically-semantically activated to similar degrees at speech onset, as indexed by similarly sized interference effects from semantic distractors related to either the first or the second noun. When speakers used more complex sentences (including prenominal color adjectives; e.g., "the blue frog is next to the blue mug") much larger interference effects were observed for the first than the second noun, suggesting that the second noun was lexically-semantically activated before speech onset on only a subset of trials. With increased cognitive load, introduced by an additional conceptual decision task and variable utterance formats, the interference effect for the first noun was increased and the interference effect for second noun disappeared, suggesting that the scope of advance planning had been narrowed. By contrast, if cognitive load was induced by a secondary working memory task to be performed during speech planning, the interference effect for both nouns was increased, suggesting that the scope of advance planning had not been affected. In all, the data suggest that the scope of advance planning during grammatical encoding in sentence production is flexible, rather than structurally fixed.

Public Health Education in Florida.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee.

This report documents issues related to the work of the Florida Comprehensive Health Professions Education Plan. Public health education prepares students for initial employment or advancement in a number of positions. While the public health work force is primarily employed in various units in local, state, and federal governments, industry also…

When your child's treatment stops working

MedlinePlus

... animals your child loves. Alternative Names End of life care - children; Palliative care - children; Advance care planning - children References American Society of Clinical Oncology (ASCO). Caring for a Terminally Ill Child: A ...

Graphics simulation and training aids for advanced teleoperation

NASA Technical Reports Server (NTRS)

Kim, Won S.; Schenker, Paul S.; Bejczy, Antal K.

1993-01-01

Graphics displays can be of significant aid in accomplishing a teleoperation task throughout all three phases of off-line task analysis and planning, operator training, and online operation. In the first phase, graphics displays provide substantial aid to investigate work cell layout, motion planning with collision detection and with possible redundancy resolution, and planning for camera views. In the second phase, graphics displays can serve as very useful tools for introductory training of operators before training them on actual hardware. In the third phase, graphics displays can be used for previewing planned motions and monitoring actual motions in any desired viewing angle, or, when communication time delay prevails, for providing predictive graphics overlay on the actual camera view of the remote site to show the non-time-delayed consequences of commanded motions in real time. This paper addresses potential space applications of graphics displays in all three operational phases of advanced teleoperation. Possible applications are illustrated with techniques developed and demonstrated in the Advanced Teleoperation Laboratory at JPL. The examples described include task analysis and planning of a simulated Solar Maximum Satellite Repair task, a novel force-reflecting teleoperation simulator for operator training, and preview and predictive displays for on-line operations.

Space transfer vehicle concepts and requirements study. Volume 2, book 4: Integrated advanced technology development

NASA Technical Reports Server (NTRS)

Weber, Gary A.

1991-01-01

The Space Transfer Vehicle (STV) program provides both an opportunity and a requirement to increase our upper stage capabilities with the development and applications of new technologies. Issues such as man rating, space basing, reusability, and long lunar surface storage times drive the need for new technology developments and applications. In addition, satisfaction of mission requirements such as lunar cargo delivery capability and lunar landing either require new technology development or can be achieved in a more cost-effective manner with judicious applications of advanced technology. During the STV study, advanced technology development requirements and plans have been addressed by the Technology/Advanced Development Working Group composed of NASA and contractor representatives. This report discusses the results to date of this working group. The first section gives an overview of the technologies that have potential or required applications for the STV and identifies those technologies baselined for the STV. Figures are provided that list the technology categories and show the priority placed on those technology categories for either the space-based or ground-based options. The second section covers the plans and schedules for incorporating the technologies into the STV program.

Making High Schools Work through Blended Instruction. A Vision and Plan for the Integration of Academic and Career and Technology Education in Maryland.

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

A team consisting of Maryland State Department of Education (MSDE) staff, local educators, and other representatives developed an action plan to assist in advancing the blending of academic, career, and technology education. The team prepared a vision statement, set strategic directions, analyzed barriers, and developed recommendations and actions…

Handling Office Politics. [Second Edition.

ERIC Educational Resources Information Center

Stevens, Paul

This book is designed to help people develop an action plan to enhance their situation at work. Part 1 focuses on political behavior at work as a key to advancement. It discusses assessing career setbacks and recovery from them. Subsequent sections focus on the following areas of self-study that are necessary to enable the individual to manage…

Final Technical Report on the Institute for Advanced Study in Student Personnel Work.

ERIC Educational Resources Information Center

Callis, Robert

This document reports the planning, implementation, and evaluation of a 9-month institute held at the University of Missouri-Columbia to prepare participants (approximately 20) for leadership positions in student personnel work at junior colleges and technical institutes. The following aspects of the instructional program are discussed and…

Site Safety Plan for Lawrence Livermore National Laboratory CERCLA investigations

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

Bainer, R.; Duarte, J.

1993-07-01

The safety policy of LLNL is to take every reasonable precaution in the performance of work to protect the environment and the health and safety of employees and the public, and to prevent property damage. With respect to hazardous agents, this protection is provided by limiting human exposures, releases to the environment, and contamination of property to levels that are as low as reasonably achievable (ALARA). It is the intent of this Plan to supply the broad outline for completing environmental investigations within ALARA guidelines. It may not be possible to determine actual working conditions in advance of the work;more » therefore, planning must allow the opportunity to provide a range of protection based upon actual working conditions. Requirements will be the least restrictive possible for a given set of circumstances, such that work can be completed in an efficient and timely fashion. Due to the relatively large size of the LLNL Site and the different types of activities underway, site-specific Operational Safety Procedures (OSPs) will be prepared to supplement activities not covered by this Plan. These site-specific OSPs provide the detailed information for each specific activity and act as an addendum to this Plan, which provides the general plan for LLNL Main Site operation.« less

Level-2 Milestone 5588: Deliver Strategic Plan and Initial Scalability Assessment by Advanced Architecture and Portability Specialists Team

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

Draeger, Erik W.

This report documents the fact that the work in creating a strategic plan and beginning customer engagements has been completed. The description of milestone is: The newly formed advanced architecture and portability specialists (AAPS) team will develop a strategic plan to meet the goals of 1) sharing knowledge and experience with code teams to ensure that ASC codes run well on new architectures, and 2) supplying skilled computational scientists to put the strategy into practice. The plan will be delivered to ASC management in the first quarter. By the fourth quarter, the team will identify their first customers within PEMmore » and IC, perform an initial assessment and scalability and performance bottleneck for next-generation architectures, and embed AAPS team members with customer code teams to assist with initial portability development within standalone kernels or proxy applications.« less

Does implementation matter if comprehension is lacking? A qualitative investigation into perceptions of advance care planning in people with cancer.

PubMed

Ugalde, Anna; O'Callaghan, Clare; Byard, Clem; Brean, Samantha; MacKay, Jenelle; Boltong, Anna; Davoren, Sondra; Lawson, Deborah; Parente, Phillip; Michael, Natasha; Livingston, Patricia

2018-05-11

While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended advance care plans and examine how accurately advance care planning documentation represented patient wishes. This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants' existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate, Statement of Choices, and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91), and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: incomplete advance care planning understanding and confidence, limited congruence for attitude and documentation, advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants' attitudes and their written document congruence were limited, but advance care planning was seen as helpful. This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation.

Advanced transportation management technologies : participant reference guide : Demonstration Project No. 105

DOT National Transportation Integrated Search

1997-04-01

This demonstration project will provide an opportunity for policy and decision makers from transportation agencies including State and local Departments of Transportation (DOTs), Departments of Public Works (DPWs), and Metropolitan Planning Organizat...

Plan EJ 2014: Resources Tools Development

EPA Pesticide Factsheets

EPA's efforts advance the Administrator’s priority of Expanding the Conversation on Environmentalism and Working for Environmental Justice by establishing a new paradigm for the delivery of EPA assistance to minority, low-income, tribal, and indigenous pe

Conference Proceedings on Guidance and Control Techniques for Advanced Space Vehicles (37th) Held at Florence, Italy on 27-30 September 1983.

DTIC Science & Technology

1984-01-01

P AD-A14l 969 CONFERENCE PROCEEDINGS ON GUIDANCE AND CONTROL 1 TECHNIQUES FOR ADVANCED SP-.(U,) ADVISORY GROUP FOR AEROSPACE RESEARCH AND DEVELOPMENT...findings of these various planning groups relativie to the ’e for advanced controls technology, and the perceived status of the technology t. me-,t... control of large flexible spacecraft. The program has also involved experimental activities to guide Ind validate the theoretical work. The

Integrated flexible manufacturing program for manufacturing automation and rapid prototyping

NASA Technical Reports Server (NTRS)

Brooks, S. L.; Brown, C. W.; King, M. S.; Simons, W. R.; Zimmerman, J. J.

1993-01-01

The Kansas City Division of Allied Signal Inc., as part of the Integrated Flexible Manufacturing Program (IFMP), is developing an integrated manufacturing environment. Several systems are being developed to produce standards and automation tools for specific activities within the manufacturing environment. The Advanced Manufacturing Development System (AMDS) is concentrating on information standards (STEP) and product data transfer; the Expert Cut Planner system (XCUT) is concentrating on machining operation process planning standards and automation capabilities; the Advanced Numerical Control system (ANC) is concentrating on NC data preparation standards and NC data generation tools; the Inspection Planning and Programming Expert system (IPPEX) is concentrating on inspection process planning, coordinate measuring machine (CMM) inspection standards and CMM part program generation tools; and the Intelligent Scheduling and Planning System (ISAPS) is concentrating on planning and scheduling tools for a flexible manufacturing system environment. All of these projects are working together to address information exchange, standardization, and information sharing to support rapid prototyping in a Flexible Manufacturing System (FMS) environment.

Implementation Plan for Qualification of Sodium-Cooled Fast Reactor Technology Information

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

Moe, Wayne; Honma, George

This document identifies and discusses implementation elements that can be used to facilitate consistent and systematic evaluation processes relating to quality attributes of technical information (with focus on SFR technology) that will be used to support licensing of advanced reactor designs. Information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The approach for determining acceptability of test data, analysis, and/or other technical informationmore » is based on guidance provided in INL/EXT-15-35805, “Guidance on Evaluating Historic Technology Information for Use in Advanced Reactor Licensing.” The implementation plan can be adopted into a working procedure at each of the national laboratories performing data qualification, or by applicants seeking future license application for advanced reactor technology.« less

Newsletter: Council on Physics in Education

ERIC Educational Resources Information Center

Foster, Howard

1972-01-01

Explains the need to encourage minority students to choose physics as the field for advanced work. Institutes were organized during summer, enrolling minority students to enrich their backgrounds. Results have been encouraging and more extensive planning is underway. (PS)

Advanced Free Flight Planner and Dispatcher's Workstation: Preliminary Design Specification

NASA Technical Reports Server (NTRS)

Wilson, J.; Wright, C.; Couluris, G. J.

1997-01-01

The National Aeronautics and Space Administration (NASA) has implemented the Advanced Air Transportation Technology (AATT) program to investigate future improvements to the national and international air traffic management systems. This research, as part of the AATT program, developed preliminary design requirements for an advanced Airline Operations Control (AOC) dispatcher's workstation, with emphasis on flight planning. This design will support the implementation of an experimental workstation in NASA laboratories that would emulate AOC dispatch operations. The work developed an airline flight plan data base and specified requirements for: a computer tool for generation and evaluation of free flight, user preferred trajectories (UPT); the kernel of an advanced flight planning system to be incorporated into the UPT-generation tool; and an AOC workstation to house the UPT-generation tool and to provide a real-time testing environment. A prototype for the advanced flight plan optimization kernel was developed and demonstrated. The flight planner uses dynamic programming to search a four-dimensional wind and temperature grid to identify the optimal route, altitude and speed for successive segments of a flight. An iterative process is employed in which a series of trajectories are successively refined until the LTPT is identified. The flight planner is designed to function in the current operational environment as well as in free flight. The free flight environment would enable greater flexibility in UPT selection based on alleviation of current procedural constraints. The prototype also takes advantage of advanced computer processing capabilities to implement more powerful optimization routines than would be possible with older computer systems.

The Paper Beam: Hands-On Design for Team Work Experience of Freshman in Engineering

ERIC Educational Resources Information Center

Kalkani, Efrossini C.; Boussiakou, Iris K.; Boussiakou, Leda G.

2005-01-01

The present research refers to the assigning of a hands-on group project to freshman engineering students, evaluating their performance, and deriving conclusions on student benefits and educational advances. The research procedure included action plans for the instructor and the students, instructions to the students on performing the work,…

30 CFR 75.1507 - Emergency Response Plan; refuge alternatives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... affirmative statement that the locations are— (i) Not within direct line of sight of the working face; and (ii... direct line of sight of the working face. (12) The maximum mine air temperature at each of the locations... 48 hours, the ERP shall detail advanced arrangements that have been made to assure that persons who...

Exploring the knowledge, attitudes and needs of advance care planning in older Chinese Australians.

PubMed

Yap, Sok Shin; Chen, Karren; Detering, Karen M; Fraser, Scott A

2017-05-23

To identify factors that influence the engagement of Chinese Australians with advance care planning. Despite the benefits of advance care planning, there is a low prevalence of advance care planning in the Chinese Australian community. Reasons for this are often cited as cultural considerations and taboos surrounding future medical planning and death; however, other logistical factors may also be important. This qualitative study used a thematic analysis grounded theory approach to explore facilitators and barriers to engagement in advance care planning. Semistructured interviews were conducted in-language (Mandarin or Cantonese) exploring the views of a purposive sample of 30 community-dwelling older Chinese Australians within Victoria, Australia. Three key themes were identified: knowledge of, attitudes towards and needs for undertaking advance care planning amongst the Chinese Australians. There was a low awareness of advance care planning amongst the participants and some confusion regarding the concept. Most participants reported positive attitudes towards advance care planning but acknowledged that others may be uncomfortable discussing death-related topics. Participants would want to know the true status of their health and plan ahead in consultation with family members to reduce the burden on the family and suffering for themselves. Language was identified as the largest barrier to overcome to increase advance care planning awareness. In-language materials and key support networks including GPs, family and Chinese community groups were identified as ideal forums for the promotion of advance care planning. The participants of this study were open to conversations regarding future medical planning and end-of-life care, suggesting the low uptake of advance care planning amongst Chinese Australians is not culturally motivated but may be due a lack of knowledge relating to advance care planning. The results highlight the need to provide access to appropriate in-language advance care planning resources and promotion of advance care planning across the Chinese community. © 2017 John Wiley & Sons Ltd.

Work Values, Early Career Difficulties, and the U.S. Economic Recession

PubMed Central

Johnson, Monica Kirkpatrick; Sage, Rayna Amber; Mortimer, Jeylan T.

2012-01-01

We examine how work difficulties in the early career, and the generally deteriorating work conditions associated with the recent U.S. economic recession, shape individuals’ work values. Drawing on panel data from the Youth Development Study, we test whether individuals change their work values in response to concerns about satisfying material needs or the features of jobs that they are able to attain. Results indicate that extrinsic values are weakened in the face of unemployment, as well as reduced job security, income, and advancement. These patterns support a reinforcement and accentuation model in which workers adjust their values to emphasize what they actually obtain from the job. Intrinsic values are weakened by working in a job unrelated to one’s career plans; they are reinforced by the experience of greater intrinsic rewards and advancement opportunities. PMID:23503050

What's Ahead for 1990?

ERIC Educational Resources Information Center

Platt, John

1973-01-01

New patterns of politics, rights, and human relations are surveyed in this article about life in the future. Discusses ways in which technological advancement is changing education, work, and public health. The dilemma between planning and decentralization in government is also considered. (DN)

Working with the Mental Capacity Act: findings from specialist palliative and neurological care settings.

PubMed

Wilson, Eleanor; Seymour, Jane E; Perkins, Paul

2010-06-01

Since October 2007 staff across health and social care services in England and Wales have been guided by the Mental Capacity Act (2005) in the provision of care for those who may lack capacity to make some decisions for themselves. This paper reports on the findings from a study with 26 staff members working in three palliative and three neurological care centres. Semistructured interviews were used to gain an understanding of their knowledge of the Mental Capacity Act, the issue of capacity itself and the documentation processes associated with the introduction of the Act and in line with advance care planning. Within this setting advance care planning is a key part of care provision and the mental capacity of service users is a regular issue. Findings show that staff generally had a good understanding of issues around capacity but felt unclear about some of the terminology related to the Mental Capacity Act, impacting on their confidence to discuss issues with service users and complete the documentation. Many felt the Act and its associated documentation had aided record-keeping in an area staff already delivered well in practice. Advance care planning in the context of the Mental Capacity Act is not as well embedded in practice as providers would like and consideration needs to be given to how and when staff should approach these issues with service users.

'Advancement of KHPS to DOE TRL 7/8' Project - Final Technical Report

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

Adonizio, Mary Ann; Corren, Dean; Smith, Ron

Final Report describing activities performed under the 'Advancement of the KHPS to DOE TRL 7/8' project, including the development of critical component test protocols, testing and analysis of the Gen5 KHPS main shaft seal, and continuing compliance work on approved operational environmental monitoring plans in anticipation of KHPS turbine installation at Verdant Power's Roosevelt Island Tidal Energy (RITE) Project site in New York, NY.

U.S. Climate Change Technology Program: Strategic Plan

DTIC Science & Technology

2006-09-01

and Long Term, provides details on the 85 technologies in the R&D portfolio. 21 (Figure 2-1) Continuing Process The United States, in partnership with...locations may be centered near or in residential locations, and work processes and products may be more commonly communicated or delivered via digital... chemical properties, along with advanced methods to simulate processes , will stem from advances in computational technology. Current Portfolio The current

Motion Planning of Two Stacker Cranes in a Large-Scale Automated Storage/Retrieval System

NASA Astrophysics Data System (ADS)

Kung, Yiheng; Kobayashi, Yoshimasa; Higashi, Toshimitsu; Ota, Jun

We propose a method for reducing the computational time of motion planning for stacker cranes. Most automated storage/retrieval systems (AS/RSs) are only equipped with one stacker crane. However, this is logistically challenging, and greater work efficiency in warehouses, such as those using two stacker cranes, is required. In this paper, a warehouse with two stacker cranes working simultaneously is proposed. Unlike warehouses with only one crane, trajectory planning in those with two cranes is very difficult. Since there are two cranes working together, a proper trajectory must be considered to avoid collision. However, verifying collisions is complicated and requires a considerable amount of computational time. As transport work in AS/RSs occurs randomly, motion planning cannot be conducted in advance. Planning an appropriate trajectory within a restricted duration would be a difficult task. We thereby address the current problem of motion planning requiring extensive calculation time. As a solution, we propose a “free-step” to simplify the procedure of collision verification and reduce the computational time. On the other hand, we proposed a method to reschedule the order of collision verification in order to find an appropriate trajectory in less time. By the proposed method, we reduce the calculation time to less than 1/300 of that achieved in former research.

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

None

AvalonBay Communities, which is a large multifamily developer, was developing a three-building complex in Elmsford, New York. The buildings were planned to be certified to the ENERGY STAR® Homes Version 3 program. This plan led to AvalonBay partnering with the Advanced Residential Integrated Solutions (ARIES) collaborative, which is a U.S. Department of Energy Building America team. ARIES worked with AvalonBay to redesign the project to comply with Zero Energy Ready Home (ZERH) criteria.

14 CFR 151.117 - Advance planning proposals: Procedures; application.

Code of Federal Regulations, 2011 CFR

2011-01-01

... desiring to obtain Federal aid for the purpose of advance planning and engineering must submit a completed... existence, must accompany the advance planning proposal. If the advance planning proposal includes...

14 CFR 151.117 - Advance planning proposals: Procedures; application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... desiring to obtain Federal aid for the purpose of advance planning and engineering must submit a completed... existence, must accompany the advance planning proposal. If the advance planning proposal includes...

[Family and career planning in young physicians].

PubMed

Buddeberg-Fischer, Barbara; Stamm, Martina; Klaghofer, Richard

2008-01-01

The study investigates in what way physicians integrate their desire to have children into their career planning. Within the framework of a prospective cohort study of Swiss medical school graduates on career development of young physicians, beginning in 2001, 534 participants (285 women, 249 men) were assessed in January 2007, in terms of having children, planning to have children, the career aspired to and the work-family balance used or planned. Among the study participants, 19% (54) of the women and 24% (59) of the men have children. Of the others 88% plan to start a family in the future. Female physicians with children are less advanced in their careers than women without children; for male physicians no such difference can be observed. Of the female physicians with children or the desire for children 42% aspire to work in a practice, 28% to a clinical and only 4% to an academic career. Of the male physicians with children or the desire for children one third aspire to work in a practice, one third to a clinical and 14% to an academic career. The preferred model of work repartition of female physicians with children is father full time/mother part time or both parents part time; the preferred model of male physicians is father full time/mother part time or not working. Children are an important factor in the career and life planning of physicians, female physicians paying more attention to an even work-family balance than male physicians. Copyright 2008 S. Karger AG, Basel.

41 CFR 102-79.110 - What Integrated Workplace policy must Federal agencies strive to promote?

Code of Federal Regulations, 2011 CFR

2011-01-01

... concepts (see § 102-76.55); (b) Align with the organization's mission and strategic plan; (c) Serve the needs and work practices of the occupants; (d) Can be quickly and inexpensively adjusted by the user to... advanced and allow people to accomplish their work in the most efficient way; (f) Meet the office's needs...

41 CFR 102-79.110 - What Integrated Workplace policy must Federal agencies strive to promote?

Code of Federal Regulations, 2010 CFR

2010-07-01

... concepts (see § 102-76.55); (b) Align with the organization's mission and strategic plan; (c) Serve the needs and work practices of the occupants; (d) Can be quickly and inexpensively adjusted by the user to... advanced and allow people to accomplish their work in the most efficient way; (f) Meet the office's needs...

Application of ant colony algorithm in path planning of the data center room robot

NASA Astrophysics Data System (ADS)

Wang, Yong; Ma, Jianming; Wang, Ying

2017-05-01

According to the Internet Data Center (IDC) room patrol robot as the background, the robot in the search path of autonomous obstacle avoidance and path planning ability, worked out in advance of the robot room patrol mission. The simulation experimental results show that the improved ant colony algorithm for IDC room patrol robot obstacle avoidance planning, makes the robot along an optimal or suboptimal and safe obstacle avoidance path to reach the target point to complete the task. To prove the feasibility of the method.

Impact of postgraduate education on advanced practice nurse activity - a national survey.

PubMed

Wilkinson, J; Carryer, J; Budge, C

2018-03-22

There is a wealth of international evidence concerning the contribution post-registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional contribution these nurses make to the work environment through advanced practice activities has not, hitherto, been documented. To report the extent of advanced practice nurse activity associated with various levels of nursing education in a sample of nurses working in clinical practice in New Zealand. A replication of recent Australian research was done via a national cross-sectional survey of 3255 registered nurses and nurse practitioners in New Zealand using an online questionnaire to collect responses to the amended Advanced Practice Delineation survey tool. In addition, demographic data were collected including position titles and levels of postgraduate education. A positive association was found between postgraduate education at any level and more time spent in advanced practice activities. Independent of level of postgraduate education, the role a nurse holds also effects the extent of involvement in advanced practice activities. There is an additional contribution made to the work environment by nurses with master's level education which occurs even when they are not employed in an advanced practice role. These findings are of significance to workforce policy and planning across the globe as countries work to sustain health services by increasing nursing capacity effectively within available resources. © 2018 International Council of Nurses.

Advance Care Planning for Serious Illness

MedlinePlus

ADVANCE CARE PLANNING FOR SERIOUS ILLNESS Making plans for the health care you want during a serious illness is called “advance care planning.” Planning involves learning about your illness, understanding choices ...

Advance care planning for nursing home residents with dementia: policy vs. practice.

PubMed

Ampe, Sophie; Sevenants, Aline; Smets, Tinne; Declercq, Anja; Van Audenhove, Chantal

2016-03-01

The aims of this study were: to evaluate the advance care planning policy for people with dementia in nursing homes; to gain insight in the involvement of residents with dementia and their families in advance care planning, and in the relationship between the policy and the actual practice of advance care planning. Through advance care planning, nursing home residents with dementia are involved in care decisions, anticipating their reduced decision-making capacity. However, advance care planning is rarely realized for this group. Prevalence and outcomes have been researched, but hardly any research has focused on the involvement of residents/families in advance care planning. Observational cross-sectional study in 20 nursing homes. The ACP audit assessed the views of the nursing homes' staff on the advance care planning policy. In addition, individual conversations were analysed with 'ACP criteria' (realization of advance care planning) and the 'OPTION' instrument (involvement of residents/families). June 2013-September 2013. Nursing homes generally met three quarters of the pre-defined criteria for advance care planning policy. In almost half of the conversations, advance care planning was explained and discussed substantively. Generally, healthcare professionals only managed to involve residents/families on a baseline skill level. There were no statistically significant correlations between policy and practice. The evaluations of the policy were promising, but the actual practice needs improvement. Future assessment of both policy and practice is recommended. Further research should focus on communication interventions for implementing advance care planning in the daily practice. © 2015 John Wiley & Sons Ltd.

Erosion Control and Environment Restoration Plan Development, Matagorda County, Texas. Phase 2. Preliminary Design

DTIC Science & Technology

2013-08-01

recommended groin system. ......................... 37  Figure 23. H1% and Hs at the groin toe as a function of storm surge...phases of work. Keep in mind, the recommended groin system design will advance the shoreline; however, without dune and vegetation management, it...will not create a wider dry beach. Since the existing beach is presumably in equili- brium, the dune and vegetation will advance with the shoreline

Opening end-of-life discussions: how to introduce Voicing My CHOiCES™, an advance care planning guide for adolescents and young adults.

PubMed

Zadeh, Sima; Pao, Maryland; Wiener, Lori

2015-06-01

Each year, more than 11,000 adolescents and young adults (AYAs), aged 15-34, die from cancer and other life-threatening conditions. In order to facilitate the transition from curative to end-of-life (EoL) care, it is recommended that EoL discussions be routine, begin close to the time of diagnosis, and continue throughout the illness trajectory. However, due largely to discomfort with the topic of EoL and how to approach the conversation, healthcare providers have largely avoided these discussions. We conducted a two-phase study through the National Cancer Institute with AYAs living with cancer or pediatric HIV to assess AYA interest in EoL planning and to determine in which aspects of EoL planning AYAs wanted to participate. These results provided insight regarding what EoL concepts were important to AYAs, as well as preferences in terms of content, design, format, and style. The findings from this research led to the development of an age-appropriate advance care planning guide, Voicing My CHOiCES™. Voicing My CHOiCES™: An Advanced Care Planning Guide for AYA became available in November 2012. This manuscript provides guidelines on how to introduce and utilize an advance care planning guide for AYAs and discusses potential barriers. Successful use of Voicing My CHOiCES™ will depend on the comfort and skills of the healthcare provider. The present paper is intended to introduce the guide to providers who may utilize it as a resource in their practice, including physicians, nurses, social workers, chaplains, psychiatrists, and psychologists. We suggest guidelines on how to: incorporate EoL planning into the practice setting, identify timepoints at which a patient's goals of care are discussed, and address how to empower the patient and incorporate the family in EoL planning. Recommendations for introducing Voicing My CHOiCES™ and on how to work through each section alongside the patient are provided.

Contribution of FDOPA PET to radiotherapy planning for advanced glioma

NASA Astrophysics Data System (ADS)

Dowson, Nicholas; Fay, Michael; Thomas, Paul; Jeffree, Rosalind; McDowall, Robert; Winter, Craig; Coulthard, Alan; Smith, Jye; Gal, Yaniv; Bourgeat, Pierrick; Salvado, Olivier; Crozier, Stuart; Rose, Stephen

2014-03-01

Despite radical treatment with surgery, radiotherapy and chemotherapy, advanced gliomas recur within months. Geographic misses in radiotherapy planning may play a role in this seemingly ineluctable recurrence. Planning is typically performed on post-contrast MRIs, which are known to underreport tumour volume relative to FDOPA PET scans. FDOPA PET fused with contrast enhanced MRI has demonstrated greater sensitivity and specificity than MRI alone. One sign of potential misses would be differences between gross target volumes (GTVs) defined using MRI alone and when fused with PET. This work examined whether such a discrepancy may occur. Materials and Methods: For six patients, a 75 minute PET scan using 3,4-dihydroxy-6-18F-fluoro-L-phynel-alanine (18F-FDOPA) was taken within 2 days of gadolinium enhanced MRI scans. In addition to standard radiotherapy planning by an experienced radiotherapy oncologist, a second gross target volume (GTV) was defined by an experienced nuclear medicine specialist for fused PET and MRI, while blinded to the radiotherapy plans. The volumes from standard radiotherapy planning were compared to the PET defined GTV. Results: The comparison indicated radiotherapy planning would change in several cases if FDOPA PET data was available. PET-defined contours were external to 95% prescribed dose for several patients. However, due to the radiotherapy margins, the discrepancies were relatively small in size and all received a dose of 50 Gray or more. Conclusions: Given the limited size of the discrepancies it is uncertain that geographic misses played a major role in patient outcome. Even so, the existence of discrepancies indicates that FDOPA PET could assist in better defining margins when planning radiotherapy for advanced glioma, which could be important for highly conformal radiotherapy plans.

Choosing the route to traveler information systems deployment : decision factors for creating public/private business plans

DOT National Transportation Integrated Search

1998-01-01

Advanced traveler information systems (ATIS) are moving beyond the research stage to become fully integrated elements of urban transportation management systems. By definition, ATIS work best when multiple public and private organizations are able to...

Aircraft Noise Reduction Subproject Overview

NASA Technical Reports Server (NTRS)

Fernandez, Hamilton; Nark, Douglas M.; Van Zante, Dale E.

2016-01-01

The material presents highlights of propulsion and airframe noise research being completed for the Advanced Air Transport Technology Project. The basis of noise reduction plans along with representative work for the airframe, propulsion, and propulsion-airframe integration is discussed for the Aircraft Noise reduction Subproject.

Future Work II.

ERIC Educational Resources Information Center

Harris, Philip R.

1985-01-01

Looks at changes in the manager's role due to technological advancement in the workplace. Discusses wider range of uses for computers (analysis, decision making, communications, planning, tracking trends), importance of supervisor training, cyberphobia (fear of new technology), cyberphrenia (addiction to new technology), and the effect of a work…

Defense Advanced Research Projects Agency: Strategic Plan

DTIC Science & Technology

2009-05-01

technologies to detect, prevent, or mitigate asymmetric attacks, including suicide bombers, improvised explosive devices, and weapons of mass destruction...the Army’s Command Post of the Future (CPOF) to amplify the capabilities of overworked combat command and control staffs. Working with CPOF, PAL

Advance care planning for nursing home residents with dementia: Influence of 'we DECide' on policy and practice.

PubMed

Ampe, Sophie; Sevenants, Aline; Smets, Tinne; Declercq, Anja; Van Audenhove, Chantal

2017-01-01

(1) To pilot 'we DECide' in terms of influence on advance care planning policy and practice in nursing home dementia care units. (2) To investigate barriers and facilitators for implementing 'we DECide'. This was a pre-test-post-test study in 18 nursing homes. Measurements included: compliance with best practice of advance care planning policy (ACP-audit); advance care planning practice (ACP criteria: degree to which advance care planning was discussed, and OPTION scale: degree of involvement of residents and families in conversations). Advance care planning policy was significantly more compliant with best practice after 'we DECide'; policy in the control group was not. Advance care planning was not discussed more frequently, nor were residents and families involved to a higher degree in conversations after 'we DECide'. Barriers to realizing advance care planning included staff's limited responsibilities; facilitators included support by management staff, and involvement of the whole organization. 'We DECide' had a positive influence on advance care planning policy. Daily practice, however, did not change. Future studies should pay more attention to long-term implementation strategies. Long-term implementation of advance care planning requires involvement of the whole organization and a continuing support system for health care professionals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Using the Light Microscopy Module (LMM) on the International Space Station (ISS), The Advanced Colloids Experiment (ACE) and MacroMolecular Biophysics (MMB)

NASA Technical Reports Server (NTRS)

Meyer, William; Foster, William M.; Motil, Brian J.; Sicker, Ronald; Abbott-Hearn, Amber; Chao, David; Chiaramonte, Fran; Atherton, Arthur; Beltram, Alexander; Bodzioney, Christopher M.;

Validation of a Novel Electronic Health Record Patient Portal Advance Care Planning Delivery System.

PubMed

Bose-Brill, Seuli; Feeney, Michelle; Prater, Laura; Miles, Laura; Corbett, Angela; Koesters, Stephen

2018-06-26

Advance care planning allows patients to articulate their future care preferences should they no longer be able to make decisions on their own. Early advance care planning in outpatient settings provides benefits such as less aggressive care and fewer hospitalizations, yet it is underutilized due to barriers such as provider time constraints and communication complexity. Novel methods, such as patient portals, provide a unique opportunity to conduct advance care planning previsit planning for outpatient care. This follow-up to our pilot study aimed to conduct pragmatic testing of a novel electronic health record-tethered framework and its effects on advance care planning delivery in a real-world primary care setting. Our intervention tested a previsit advance care planning workflow centered around a framework sent via secure electronic health record-linked patient portal in a real-world clinical setting. The primary objective of this study was to determine its impact on frequency and quality of advance care planning documentation. We conducted a pragmatic trial including 2 sister clinical sites, one site implementing the intervention and the other continuing standard care. A total of 419 patients aged between 50 and 93 years with active portal accounts received intervention (n=200) or standard care (n=219). Chart review analyzed the presence of advance care planning and its quality and was graded with previously established scoring criteria based on advance care planning best practice guidelines from multiple nations. A total of 19.5% (39/200) of patients who received previsit planning responded to the framework. We found that the intervention site had statistically significant improvement in new advance care planning documentation rates (P<.01) and quality (P<.01) among all eligible patients. Advance care planning documentation rates increased by 105% (19/39 to 39/39) and quality improved among all patients who engaged in the previsit planning framework (n=39). Among eligible patients aged between 50 and 60 years at the intervention site, advance care planning documentation rates increased by 37% (27/96 to 37/96). Advance care planning documentation rates increased 34% among high users (27/67 to 36/67). Advance care planning previsit planning using a secure electronic health record-supported patient portal framework yielded improvement in the presence of advance care planning documentation, with highest improvement in active patient portal users and patients aged between 50 and 60 years. Targeted previsit patient portal advance care planning delivery in these populations can potentially improve the quality of care in these populations. ©Seuli Bose-Brill, Michelle Feeney, Laura Prater, Laura Miles, Angela Corbett, Stephen Koesters. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.06.2018.

Provider Perspectives on Advance Care Planning for Patients with Kidney Disease: Whose Job Is It Anyway?

PubMed Central

Szarka, Jackie; McFarland, Lynne V.; Taylor, Janelle S.; Sudore, Rebecca L.; Trivedi, Ranak; Reinke, Lynn F.; Vig, Elizabeth K.

2016-01-01

Background and objectives There is growing interest in efforts to enhance advance care planning for patients with kidney disease. Our goal was to elicit the perspectives on advance care planning of multidisciplinary providers who care for patients with advanced kidney disease. Design, setting, participants, & measurements Between April and December of 2014, we conducted semistructured interviews at the Department of Veterans Affairs Puget Sound Health Care System with 26 providers from a range of disciplines and specialties who care for patients with advanced kidney disease. Participants were asked about their perspectives and experiences related to advance care planning in this population. Interviews were audiotaped, transcribed, and analyzed inductively using grounded theory. Results The comments of providers interviewed for this study spoke to significant system–level barriers to supporting the process of advance care planning for patients with advanced kidney disease. We identified four overlapping themes: (1) medical care for this population is complex and fragmented across settings and providers and over time; (2) lack of a shared understanding and vision of advance care planning and its relationship with other aspects of care, such as dialysis decision making; (3) unclear locus of responsibility and authority for advance care planning; and (4) lack of active collaboration and communication around advance care planning among different providers caring for the same patients. Conclusions The comments of providers who care for patients with advanced kidney disease spotlight both the need for and the challenges to interdisciplinary collaboration around advance care planning for this population. Systematic efforts at a variety of organizational levels will likely be needed to support teamwork around advance care planning among the different providers who care for patients with advanced kidney disease. PMID:27084877

Provider Perspectives on Advance Care Planning for Patients with Kidney Disease: Whose Job Is It Anyway?

PubMed

O'Hare, Ann M; Szarka, Jackie; McFarland, Lynne V; Taylor, Janelle S; Sudore, Rebecca L; Trivedi, Ranak; Reinke, Lynn F; Vig, Elizabeth K

2016-05-06

There is growing interest in efforts to enhance advance care planning for patients with kidney disease. Our goal was to elicit the perspectives on advance care planning of multidisciplinary providers who care for patients with advanced kidney disease. Between April and December of 2014, we conducted semistructured interviews at the Department of Veterans Affairs Puget Sound Health Care System with 26 providers from a range of disciplines and specialties who care for patients with advanced kidney disease. Participants were asked about their perspectives and experiences related to advance care planning in this population. Interviews were audiotaped, transcribed, and analyzed inductively using grounded theory. The comments of providers interviewed for this study spoke to significant system-level barriers to supporting the process of advance care planning for patients with advanced kidney disease. We identified four overlapping themes: (1) medical care for this population is complex and fragmented across settings and providers and over time; (2) lack of a shared understanding and vision of advance care planning and its relationship with other aspects of care, such as dialysis decision making; (3) unclear locus of responsibility and authority for advance care planning; and (4) lack of active collaboration and communication around advance care planning among different providers caring for the same patients. The comments of providers who care for patients with advanced kidney disease spotlight both the need for and the challenges to interdisciplinary collaboration around advance care planning for this population. Systematic efforts at a variety of organizational levels will likely be needed to support teamwork around advance care planning among the different providers who care for patients with advanced kidney disease. Copyright © 2016 by the American Society of Nephrology.

Reaching for the Horizon: The 2015 NSAC Long Range Plan

NASA Astrophysics Data System (ADS)

Geesaman, Donald

2015-10-01

In April 2014, the Nuclear Science Advisory Committee was charged to conduct a new study of the opportunities and priorities for United States nuclear physics research and to recommend a long range plan for the coordinated advancement of the Nation's nuclear science program over the next decade. The entire community actively contributed to developing this plan. Ideas and goals, new and old, were examined and community priorities were established. The Long Range Plan Working Group gathered at Kitty Hawk, NC to converge on the recommendations. In this talk I will discuss the vision for the future that has emerged from this process. The new plan, ``Reaching for the Horizon,'' offers the promise of great leaps forward in our understanding of nuclear science and new opportunities for nuclear science to serve society. This work was supported by the U. S. Department of Energy, Office of Science, Office of Nuclear Physics, under Contract No. DE-AC02-06CH11357.

Perceived Motivating Factors and Barriers for the Completion of Postgraduate Training Among American Pharmacy Students Prior to Beginning Advanced Pharmacy Practice Experiences

PubMed Central

Oyler, Douglas R.; Devlin, John W.; Painter, Jacob T.; Bolesta, Scott; Swanson, Joseph M.; Bailey, Brett J.; Branan, Trisha; Barletta, Jeffrey F.; Dunn, Brianne; Haney, Jason S.; Juang, Paul; Kane-Gill, Sandra L.; Kiser, Tyree H.; Shafeeq, Hira; Skaar, Debra; Smithburger, Pamela; Taylor, Jodi

2017-01-01

Objective. To examine perceived motivating factors and barriers (MFB) to postgraduate training (PGT) pursuit among pharmacy students. Methods. Third-year pharmacy students at 13 schools of pharmacy provided demographics and their plan and perceived MFBs for pursuing PGT. Responses were characterized using descriptive statistics. Kruskal-Wallis equality-of-proportions rank tests determined if differences in perceived MFBs existed between students based on plan to pursue PGT. Results. Among 1218 (69.5%) respondents, 37.1% planned to pursue PGT (32.9% did not, 30% were undecided). Students introduced to PGT prior to beginning pharmacy school more frequently planned to pursue PGT. More students who planned to pursue PGT had hospital work experience. The primary PGT rationale was, “I desire to gain more knowledge and experience.” Student debt was the most commonly cited barrier. Conclusion. Introducing pharmacy students early to PGT options and establishing work experiences in the hospital setting may increase students’ desire to pursue PGT. PMID:28720918

OAST Space Theme Workshop. Volume 1: Summary report. 1: Introduction. 2: General observations and some key findings. 3: Follow-on activity. Quick-look comments and working papers

NASA Technical Reports Server (NTRS)

1976-01-01

The Outlook for Space Study, consideration of National needs and OAST technology goals were factors in the selection of the following themes for candidate technical initiative and supporting program plans: space power station; search for extraterrestrial life; industrialization of space; global service station; exploration of the solar system; and advanced space transportation system. An overview is presented of the Space Theme Workshop activities in developing technology needs, program requirements, and proposed plans in support of each theme. The unedited working papers used by team members are included.

Monte Carlo treatment planning with modulated electron radiotherapy: framework development and application

NASA Astrophysics Data System (ADS)

Alexander, Andrew William

Within the field of medical physics, Monte Carlo radiation transport simulations are considered to be the most accurate method for the determination of dose distributions in patients. The McGill Monte Carlo treatment planning system (MMCTP), provides a flexible software environment to integrate Monte Carlo simulations with current and new treatment modalities. A developing treatment modality called energy and intensity modulated electron radiotherapy (MERT) is a promising modality, which has the fundamental capabilities to enhance the dosimetry of superficial targets. An objective of this work is to advance the research and development of MERT with the end goal of clinical use. To this end, we present the MMCTP system with an integrated toolkit for MERT planning and delivery of MERT fields. Delivery is achieved using an automated "few leaf electron collimator" (FLEC) and a controller. Aside from the MERT planning toolkit, the MMCTP system required numerous add-ons to perform the complex task of large-scale autonomous Monte Carlo simulations. The first was a DICOM import filter, followed by the implementation of DOSXYZnrc as a dose calculation engine and by logic methods for submitting and updating the status of Monte Carlo simulations. Within this work we validated the MMCTP system with a head and neck Monte Carlo recalculation study performed by a medical dosimetrist. The impact of MMCTP lies in the fact that it allows for systematic and platform independent large-scale Monte Carlo dose calculations for different treatment sites and treatment modalities. In addition to the MERT planning tools, various optimization algorithms were created external to MMCTP. The algorithms produced MERT treatment plans based on dose volume constraints that employ Monte Carlo pre-generated patient-specific kernels. The Monte Carlo kernels are generated from patient-specific Monte Carlo dose distributions within MMCTP. The structure of the MERT planning toolkit software and optimization algorithms are demonstrated. We investigated the clinical significance of MERT on spinal irradiation, breast boost irradiation, and a head and neck sarcoma cancer site using several parameters to analyze the treatment plans. Finally, we investigated the idea of mixed beam photon and electron treatment planning. Photon optimization treatment planning tools were included within the MERT planning toolkit for the purpose of mixed beam optimization. In conclusion, this thesis work has resulted in the development of an advanced framework for photon and electron Monte Carlo treatment planning studies and the development of an inverse planning system for photon, electron or mixed beam radiotherapy (MBRT). The justification and validation of this work is found within the results of the planning studies, which have demonstrated dosimetric advantages to using MERT or MBRT in comparison to clinical treatment alternatives.

Readiness to participate in advance care planning: A qualitative study of renal failure patients, families and healthcare providers.

PubMed

Hutchison, Lauren A; Raffin-Bouchal, Donna S; Syme, Charlotte A; Biondo, Patricia D; Simon, Jessica E

2017-09-01

Objectives Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context. Methods Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program. Semi-structured interviews were recorded, transcribed and then analyzed using interpretive description. Results Readiness for advance care planning was driven by individual values perceived by a collaborative encounter between clinicians and patients/families. If advance care planning is not valued, then patients/families and clinicians are not ready to initiate the process. Patients and clinicians are delaying conversations until "illness burden necessitates," so there is little "advance" care planning, only care planning in-the-moment closer to the end of life. Discussion The value of advance care planning in collaboration with clinicians, patients and their surrogates needs reframing as an ongoing process early in the patient's illness trajectory, distinguished from end-of-life decision making.

Advance care planning in a community setting.

PubMed

Connolly, Josaleen; Milligan, Stuart; Stevens, Elaine; Jackson, Susan; Rooney, Kevin

2015-02-10

To evaluate the effects of implementing an advance care planning process within pilot sites in North Ayrshire in 2010, focusing on people with palliative care needs. Data were collected from participants in advance care planning training using a questionnaire. Semi-structured interviews were conducted and an audit of documentation was undertaken. Thirty nine questionnaires were returned, a response rate of 16%. Twenty four out of 25 (96%) participants rated the training as having improved their understanding of the advance care planning process. The general consensus in interviews was that advance care planning is a worthwhile process. Participants reported patients achieving their preferred place of end of life care and greater consultation regarding hospitalisation. Within the pilot sites, advance care planning training enhanced the ability of professionals to implement the advance care planning process and record the wishes of patients and residents.

Deja vu: The Unified Command Plan of the Future Revisited

DTIC Science & Technology

2011-05-19

Command Plan of the Future Revisited. 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) Col( S ) Edward F...Martignetti 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Advanced Operational Art... S ) AND ADDRESS(ES) U.S. Army Command and General Staff College 100 Stimson Avenue Fort Leavenworth, KS 66027-2301 10. SPONSOR/MONITOR’S ACRONYM

The development and validation of the advance care planning questionnaire in Malaysia.

PubMed

Lai, Pauline Siew Mei; Mohd Mudri, Salinah; Chinna, Karuthan; Othman, Sajaratulnisah

2016-10-18

Advance care planning is a voluntary process whereby individual preferences, values and beliefs are used to aid a person in planning for end-of-life care. Currently, there is no local instrument to assess an individual's awareness and attitude towards advance care planning. This study aimed to develop an Advance Care Planning Questionnaire and to determine its validity and reliability among older people in Malaysia. The Advance Care Planning Questionnaire was developed based on literature review. Face and content validity was verified by an expert panel, and piloted among 15 participants. Our study was conducted from October 2013 to February 2014, at an urban primary care clinic in Malaysia. Included were those aged >50 years, who could understand English. A retest was conducted 2 weeks after the first administration. Participants from the pilot study did not encounter any problems in answering the Advance Care Planning Questionnaire. Hence, no further modifications were made. Flesch reading ease was 71. The final version of the Advance Care Planning Questionnaire consists of 66 items: 30 items were measured on a nominal scale, whilst 36 items were measured on a Likert-like scale; of which we were only able to validate 22 items, as the remaining 14 items were descriptive in nature. A total of 245 eligible participants were approached; of which 230 agreed to participate (response rate = 93.9 %). Factor analysis on the 22 items measured on a Likert-scale revealed four domains: "feelings regarding advance care planning", "justifications for advance care planning", "justifications for not having advance care planning: fate and religion", and "justifications for not having advance care planning: avoid thinking about death". The Cronbach's alpha values for items each domain ranged from 0.637-0.915. In test-retest, kappa values ranged from 0.738-0.947. The final Advance Care Planning Questionnaire consisted of 63 items and 4 domains. It was found to be a valid and reliable instrument to assess the awareness and attitude of older people in Malaysia towards advance care planning.

Planning for life after orthopaedics.

PubMed

Barr, Joseph S; McCaslin, Michael J; Hinds, Cynthia K

2014-01-01

The word retirement is going out of fashion. Many orthopaedic surgeons want to work in some capacity when they stop performing surgery. Making a smooth transition from a busy orthopaedic practice to alternative work demands advanced planning. The surgeon must consider personal issues that involve how to use human capital (his or her accumulated knowledge and experience). New ventures, hobbies, travel, and spending time with family and friends are some possibilities. Plans for slowing down or leaving the practice should be discussed and agreed on well ahead of time. Agreements for buyouts may be difficult to work out and will require creative thinking. The solo practitioner can close the practice or hire a successor. Financial planning is perhaps the most important consideration and should be started by approximately age 40. It is recommended that the surgeon develop a portfolio of secure investments and annuities to provide adequate income for as long as is needed and then to turn the residual income to one's family, favorite charities, or other desired cause. A team of competent advisors is needed to help develop and achieve one's goals, create financial security, and provide the discipline to carry out the needed planning for life after orthopaedics.

75 FR 38850 - NNI Strategic Plan 2010; Request for Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... implements strategies that maximize the economic benefits of its investments in nanotechnology, based on... innovation strategy, NNI member agencies have identified areas ripe for significant advances through closer... human health, resulting in better risk assessment and risk mitigation strategies. Each center works as a...

Webspinning in the Language Classroom.

ERIC Educational Resources Information Center

Taylor, Greg; And Others

1997-01-01

Teachers can use the World Wide Web to create multimedia foreign language activities without expensive software. Describes and includes a lesson plan for a mystery game suitable for high school advanced placement or intermediate university Spanish students requiring students to work together solving clues and writing short compositions. Includes…

Creating an advance-care-planning decision aid for high-risk surgery: a qualitative study

PubMed Central

2014-01-01

Background High-risk surgery patients may lose decision-making capacity as a result of surgical complications. Advance care planning prior to surgery may be beneficial, but remains controversial and is hindered by a lack of appropriate decision aids. This study sought to examine stakeholders’ views on the appropriateness of using decision aids, in general, to support advance care planning among high-risk surgery populations and the design of such a decision aid. Methods Key informants were recruited through purposive and snowball sampling. Semi-structured interviews were conducted by phone until data collected reached theoretical saturation. Key informants were asked to discuss their thoughts about advance care planning and interventions to support advance care planning, particularly for this population. Researchers took de-identified notes that were analyzed for emerging concordant, discordant, and recurrent themes using interpretative phenomenological analysis. Results Key informants described the importance of initiating advance care planning preoperatively, despite potential challenges present in surgical settings. In general, decision aids were viewed as an appropriate approach to support advance care planning for this population. A recipe emerged from the data that outlines tools, ingredients, and tips for success that are needed to design an advance care planning decision aid for high-risk surgical settings. Conclusions Stakeholders supported incorporating advance care planning in high-risk surgical settings and endorsed the appropriateness of using decision aids to do so. Findings will inform the next stages of developing the first advance care planning decision aid for high-risk surgery patients. PMID:25067908

Creating an advance-care-planning decision aid for high-risk surgery: a qualitative study.

PubMed

Schuster, Anne Lr; Aslakson, Rebecca A; Bridges, John Fp

2014-01-01

High-risk surgery patients may lose decision-making capacity as a result of surgical complications. Advance care planning prior to surgery may be beneficial, but remains controversial and is hindered by a lack of appropriate decision aids. This study sought to examine stakeholders' views on the appropriateness of using decision aids, in general, to support advance care planning among high-risk surgery populations and the design of such a decision aid. Key informants were recruited through purposive and snowball sampling. Semi-structured interviews were conducted by phone until data collected reached theoretical saturation. Key informants were asked to discuss their thoughts about advance care planning and interventions to support advance care planning, particularly for this population. Researchers took de-identified notes that were analyzed for emerging concordant, discordant, and recurrent themes using interpretative phenomenological analysis. Key informants described the importance of initiating advance care planning preoperatively, despite potential challenges present in surgical settings. In general, decision aids were viewed as an appropriate approach to support advance care planning for this population. A recipe emerged from the data that outlines tools, ingredients, and tips for success that are needed to design an advance care planning decision aid for high-risk surgical settings. Stakeholders supported incorporating advance care planning in high-risk surgical settings and endorsed the appropriateness of using decision aids to do so. Findings will inform the next stages of developing the first advance care planning decision aid for high-risk surgery patients.

2001 Defence Attitude Survey Report

DTIC Science & Technology

2001-09-01

Plan on a Page and Best Way to Advance Career............................14 Flexible Working Hours and Gender/Service Unit Composition ....15 Equity...2283 100 3179 100 10488 100 2 0 0 1 D e f e n c e A t t i t u d e S u r v e y R e p o r t 15 Flexible Working Hours and Gender/Service Unit Composition...Civilians reported the highest availability of flexible working hours , with 89% of Civilian respondents stating they were available in their workplace

Astrophysics at RIA (ARIA) Working Group

NASA Astrophysics Data System (ADS)

Smith, Michael S.; Schatz, Hendrik; Timmes, Frank X.; Wiescher, Michael; Greife, Uwe

2006-07-01

The Astrophysics at RIA (ARIA) Working Group has been established to develop and promote the nuclear astrophysics research anticipated at the Rare Isotope Accelerator (RIA). RIA is a proposed next-generation nuclear science facility in the U.S. that will enable significant progress in studies of core collapse supernovae, thermonuclear supernovae, X-ray bursts, novae, and other astrophysical sites. Many of the topics addressed by the Working Group are relevant for the RIKEN RI Beam Factory, the planned GSI-Fair facility, and other advanced radioactive beam facilities.

"Hope for the best, prepare for the worst": A qualitative interview study on parents' needs and fears in pediatric advance care planning.

PubMed

Lotz, Julia Desiree; Daxer, Marion; Jox, Ralf J; Borasio, Gian Domenico; Führer, Monika

2017-09-01

Pediatric advance care planning is advocated by healthcare providers because it may increase the chance that patient and/or parent wishes are respected and thus improve end-of-life care. However, since end-of-life decisions for children are particularly difficult and charged with emotions, physicians are often afraid of addressing pediatric advance care planning. We aimed to investigate parents' views and needs regarding pediatric advance care planning. We performed a qualitative interview study with parents of children who had died from a severe illness. The interviews were analyzed by descriptive and evaluation coding according to Saldaña. We conducted semi-structured interviews with 11 parents of 9 children. Maximum variation was sought regarding the child's illness, age at death, care setting, and parent gender. Parents find it difficult to engage in pediatric advance care planning but consider it important. They argue for a sensitive, individualized, and gradual approach. Hope and quality of life issues are primary. Parents have many non-medical concerns that they want to discuss. Written advance directives are considered less important, but medical emergency plans are viewed as necessary in particular cases. Continuity of care and information should be improved through regular pediatric advance care planning meetings with the various care providers. Parents emphasize the importance of a continuous contact person to facilitate pediatric advance care planning. Despite a need for pediatric advance care planning, it is perceived as challenging. Needs-adjusted content and process and continuity of communication should be a main focus in pediatric advance care planning. Future research should focus on strategies that facilitate parent engagement in pediatric advance care planning to increase the benefit for the families.

Advance Care Planning Meets Group Medical Visits: The Feasibility of Promoting Conversations

PubMed Central

Lum, Hillary D.; Jones, Jacqueline; Matlock, Daniel D.; Glasgow, Russell E.; Lobo, Ingrid; Levy, Cari R.; Schwartz, Robert S.; Sudore, Rebecca L.; Kutner, Jean S.

2016-01-01

PURPOSE Primary care needs new models to facilitate advance care planning conversations. These conversations focus on preferences regarding serious illness and may involve patients, decision makers, and health care providers. We describe the feasibility of the first primary care–based group visit model focused on advance care planning. METHODS We conducted a pilot demonstration of an advance care planning group visit in a geriatrics clinic. Patients were aged at least 65 years. Groups of patients met in 2 sessions of 2 hours each facilitated by a geriatrician and a social worker. Activities included considering personal values, discussing advance care planning, choosing surrogate decision-makers, and completing advance directives. We used the RE-AIM framework to evaluate the project. RESULTS Ten of 11 clinicians referred patients for participation. Of 80 patients approached, 32 participated in 5 group visit cohorts (a 40% participation rate) and 27 participated in both sessions (an 84% retention rate). Mean age was 79 years; 59% of participants were female and 72% white. Most evaluated the group visit as better than usual clinic visits for discussing advance care planning. Patients reported increases in detailed advance care planning conversations after participating (19% to 41%, P = .02). Qualitative analysis found that older adults were willing to share personal values and challenges related to advance care planning and that they initiated discussions about a broad range of relevant topics. CONCLUSION A group visit to facilitate discussions about advance care planning and increase patient engagement is feasible. This model warrants further evaluation for effectiveness in improving advance care planning outcomes for patients, clinicians, and the system. PMID:26951587

Advance care planning in CKD/ESRD: an evolving process.

PubMed

Holley, Jean L

2012-06-01

Advance care planning was historically considered to be simply the completion of a proxy (health care surrogate designation) or instruction (living will) directive that resulted from a conversation between a patient and his or her physician. We now know that advance care planning is a much more comprehensive and dynamic patient-centered process used by patients and families to strengthen relationships, achieve control over medical care, prepare for death, and clarify goals of care. Some advance directives, notably designated health care proxy documents, remain appropriate expressions of advance care planning. Moreover, although physician orders, such as do-not-resuscitate orders and Physician Orders for Life-Sustaining Treatment, may not be strictly defined as advance directives, their completion, when appropriate, is an integral component of advance care planning. The changing health circumstances and illness trajectory characteristic of ESRD mandate that advance care planning discussions adapt to a patient's situation and therefore must be readdressed at appropriate times and intervals. The options of withholding and withdrawing dialysis add ESRD-specific issues to advance care planning in this population and are events each nephrologist will at some time confront. Advance care planning is important throughout the spectrum of ESRD and is a part of nephrology practice that can be rewarding to nephrologists and beneficial to patients and their families.

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

Advanced exterior sensor project : final report, September 2004.

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

Ashby, M. Rodema

2004-12-01

This report (1) summarizes the overall design of the Advanced Exterior Sensor (AES) system to include detailed descriptions of system components, (2) describes the work accomplished throughout FY04 to evaluate the current health of the original prototype and to return it to operation, (3) describes the status of the AES and the AES project as of September 2004, and (4) details activities planned to complete modernization of the system to include development and testing of the second-generation AES prototype.

Advance Care Planning and the Quality of End-of-Life Care among Older Adults

PubMed Central

Bischoff, Kara E.; Sudore, Rebecca; Miao, Yinghui; Boscardin, W. John; Smith, Alexander K.

2013-01-01

Background Advance care planning is increasingly common, but whether it influences end-of-life quality of care remains controversial. Design Medicare data and survey data from the Health and Retirement Study were combined to determine whether advance care planning was associated with quality metrics. Setting The nationally representative Health and Retirement Study. Participants 4394 decedent subjects (mean age 82.6 years at death, 55% women). Measurements Advance care planning was defined as having an advance directive, durable power of attorney or having discussed preferences for end-of-life care with a next-of-kin. Outcomes included previously reported quality metrics observed during the last month of life (rates of hospital admission, in-hospital death, >14 days in the hospital, intensive care unit admission, >1 emergency department visit, hospice admission, and length of hospice ≤3 days). Results Seventy-six percent of subjects engaged in advance care planning. Ninety-two percent of advance directives stated a preference to prioritize comfort. After adjustment, subjects who engaged in advance care planning were less likely to die in a hospital (adjusted RR 0.87, 95% CI 0.80-0.94), more likely to be enrolled in hospice (aRR 1.68, 1.43-1.97), and less likely to receive hospice for ≤3 days before death (aRR 0.88, 0.85-0.91). Having an advance directive, a durable-power-of-attorney or an advance care planning discussion were each independently associated with a significant increase in hospice use (p<0.01 for all). Conclusion Advance care planning was associated with improved quality of care at the end of life, including less in-hospital death and increased use of hospice. Having an advance directive, assigning a durable power of attorney and conducting advance care planning discussions are all important elements of advance care planning. PMID:23350921

The space shuttle payload planning working groups. Volume 10: Space technology

NASA Technical Reports Server (NTRS)

1973-01-01

The findings and recommendations of the Space Technology group of the space shuttle payload planning activity are presented. The elements of the space technology program are: (1) long duration exposure facility, (2) advanced technology laboratory, (3) physics and chemistry laboratory, (4) contamination experiments, and (5) laser information/data transmission technology. The space technology mission model is presented in tabular form. The proposed experiments to be conducted by each test facility are described. Recommended approaches for user community interfacing are included.

Science for Society--Education Review, Volume 1 Number 3.

ERIC Educational Resources Information Center

American Association for the Advancement of Science, Washington, DC. Commission on Science Education.

Advances in environmental education by professional and science-oriented organizations are enumerated in this newsletter. An effort is made to describe the work being done by large and representative groups whose headquarters are not located in the Nation's capital and whose principle concerns include curriculum planning and preparation of…

New Directions in Planning for a World of Work.

ERIC Educational Resources Information Center

Cross, William C.

This career education conference was for school counselors, vocational education workers, public school teachers, school administrators, and others interested in advancing career possibilities for students in schools in New Mexico. Recognized authorities in career education were invited to be participants and to share with conference enrollees the…

Ramps, Balls, and Measuring Distance--For All

ERIC Educational Resources Information Center

Miller, Bridget; Satsangi, Rajiv

2018-01-01

Today's classrooms contain students with a variety of needs. Although teachers work to differentiate and meet the needs of diverse students, inclusion of students with physical disabilities can present multiple obstacles in science classrooms. However, with advanced planning and strategic accommodations, the needs of these students can often be…

The Challenge of a Knowledge Society. A Philippine Plan of Action.

ERIC Educational Resources Information Center

Diaz, Rony V.; And Others

This volume explores the potentials of advanced technologies as they apply to education and training and looks at efforts to exploit these potentials in three areas: vocational-technical training, formal education, and corporate programs. An introduction, "The Age of Knowledge Work" (Emmanuel T. Velasco, Gayla C. Carreon), defines…

How Data Use for Accountability Undermines Equitable Science Education

ERIC Educational Resources Information Center

Braaten, Melissa; Bradford, Chris; Kirchgasler, Kathryn L.; Barocas, Sadie Fox

2017-01-01

Purpose: When school leaders advance strategic plans focused on improving educational equity through data-driven decision making, how do policies-as-practiced unfold in the daily work of science teachers? The paper aims to discuss this issue. Design/methodology/approach: This ethnographic study examines how data-centric accountability and…

Facilitating Change through Integrated Strategic Planning

ERIC Educational Resources Information Center

Freeman, Jerrid P.; Wilmes, David M.

2009-01-01

Planners strive to develop the best programs and strategies to enhance student learning and advance their institutional mission while meeting their desired outcomes. This work, while rewarding, can be time intensive and demanding and developing new initiatives is not without risks. Some common reasons these efforts fail include: lack of buy-in…

Coastal Fortifications and National Military Policy, 1815-1835

DTIC Science & Technology

2015-05-21

my work and not spilling apple juice on my laptop. To Dr. Rick Herrera at the School for Advanced Military Studies for his support, mentorship and...and men, the amount required to protect planned fortification locations would be $16,750,000 plus the loss in labor force, versus $5,658,000

Linking the NIH strategic plan to the research agenda for social workers in health and aging.

PubMed

Raveis, Victoria H; Gardner, Daniel S; Berkman, Barbara; Harootyan, Linda

2010-01-01

Although social work has a long and distinctive tradition of practice-relevant research aimed at enhancing the health and well-being of older adults, the profession has been underrepresented among the ranks of academic researchers and the National Institutes of Health's (NIH) scientific endeavors. In this article, the inherent capacities of social workers to generate and disseminate empirical health-related knowledge are discussed and recent developments in social work's geriatric research infrastructure are described. Emerging domains for advancing the profession's contribution to practice-relevant geriatric research on the federal level are identified and the next steps toward advancing the field's research agenda are posed.

High satisfaction and low decisional conflict with advance care planning among chronically ill patients with advanced chronic obstructive pulmonary disease or heart failure using an online decision aid: A pilot study.

PubMed

Van Scoy, Lauren J; Green, Michael J; Dimmock, Anne Ef; Bascom, Rebecca; Boehmer, John P; Hensel, Jessica K; Hozella, Joshua B; Lehman, Erik B; Schubart, Jane R; Farace, Elana; Stewart, Renee R; Levi, Benjamin H

2016-09-01

Many patients with chronic illnesses report a desire for increased involvement in medical decision-making. This pilot study aimed to explore how patients with exacerbation-prone disease trajectories such as advanced heart failure or chronic obstructive pulmonary disease experience advance care planning using an online decision aid and to compare whether patients with different types of exacerbation-prone illnesses had varied experiences using the tool. Pre-intervention questionnaires measured advance care planning knowledge. Post-intervention questionnaires measured: (1) advance care planning knowledge; (2) satisfaction with tool; (3) decisional conflict; and (4) accuracy of the resultant advance directive. Comparisons were made between patients with heart failure and chronic obstructive pulmonary disease. Over 90% of the patients with heart failure (n = 24) or chronic obstructive pulmonary disease (n = 25) reported being "satisfied" or "highly satisfied" with the tool across all satisfaction domains; over 90% of participants rated the resultant advance directive as "very accurate." Participants reported low decisional conflict. Advance care planning knowledge scores rose by 18% (p < 0.001) post-intervention. There were no significant differences between participants with heart failure and chronic obstructive pulmonary disease. Patients with advanced heart failure and chronic obstructive pulmonary disease were highly satisfied after using an online advance care planning decision aid and had increased knowledge of advance care planning. This tool can be a useful resource for time-constrained clinicians whose patients wish to engage in advance care planning. © The Author(s) 2016.

Knowledge, attitudes, and practice behaviors of oncology advanced practice nurses regarding advanced care planning for patients with cancer.

PubMed

Zhou, Guiyun; Stoltzfus, Jill C; Houldin, Arlene D; Parks, Susan M; Swan, Beth Ann

2010-11-01

To establish initial reliability and validity of a Web-based survey focused on oncology advanced practice nurses' (APNs') knowledge, attitudes, and practice behaviors regarding advanced care planning, and to obtain preliminary understanding of APNs' knowledge, attitudes, and practice behaviors and perceived barriers to advanced care planning. Descriptive, cross-sectional, pilot survey study. The eastern United States. 300 oncology APNs. Guided by the Theory of Planned Behavior, a knowledge, attitudes, and practice behaviors survey was developed and reviewed for content validity. The survey was distributed to 300 APNs via e-mail and sent again to the 89 APNs who responded to the initial survey. Exploratory factor analysis was used to examine the construct validity and test-retest reliability of the survey's attitudinal and practice behavior portions. Respondents' demographics, knowledge, attitudes, practice behaviors, and perceived barriers to advanced care planning practice. Exploratory factor analysis yielded a five-factor solution from the survey's attitudes and practice behavior portions with internal consistency using Cronbach alpha. Respondents achieved an average of 67% correct answers in the 12-item knowledge section and scored positively in attitudes toward advanced care planning. Their practice behavior scores were marginally positive. The most common reported barriers were from patients' and families' as well as physicians' reluctance to discuss advanced care planning. The attitudinal and practice behaviors portions of the survey demonstrated preliminary construct validity and test-retest reliability. Regarding advanced care planning, respondents were moderately knowledgeable, but their advanced care planning practice was not routine. Validly assessing oncology APNs' knowledge, attitudes, and practice behaviors regarding advanced care planning will enable more tailored approaches to improve end-of-life care outcomes.

25 CFR 1000.52 - What criteria will the Director use to award advance planning grants?

Code of Federal Regulations, 2010 CFR

2010-04-01

... planning grants? 1000.52 Section 1000.52 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS... INDIAN SELF-DETERMINATION AND EDUCATION ACT Section 402(d) Planning and Negotiation Grants Advance Planning Grant Funding § 1000.52 What criteria will the Director use to award advance planning grants...

Closeout Technical Report

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

Dr. Kenneth W. Gentle

2004-11-29

We are conducting a collaborative research program on two tokamaks, HT-7 and EAST (Experimental Advanced Superconducting Tokamak, formerly HT-7U), with the Institute of Plasma Physics of the Chinese Academy of Sciences (CASIPP) located in Hefei, PRC. The work that we planned for this year included conducting transport experiments on HT-7, completing plans for expansion of the HT-7 diagnostic set, and reaching an agreement on how UT-FRC can best participate in experiments on HT-7U. These goals were accomplished as summarized in the next section. Note that the experimental portion of the work is still underway. The experimental campaign for HT-7 beganmore » just a few weeks before this report was compiled.« less

[Who should decide at the end of life? International practice of advance care planning and possibilities for adaptation in Hungary].

PubMed

Busa, Csilla; Zeller, Judit; Csikós, Ágnes

2018-01-01

At the advanced stage of serious illness, end-of-life decisions need to be made. Advance care planning offers patients the right to decide on their own future care when independent decision-making is no longer possible. The most complex and effective advance care plans include patients' preferred or refused medical treatments, care-related wishes, and individual values as well. Advance care planning can improve end-of-life care and contribute to higher satisfaction. It can also reduce distress in relatives and the costs of care. Patients' preferences provide a guidance for professional care. A number of studies have identified the benefits of advance care planning, and it has been included in guidelines. Potential barriers to advance care planning could be as follows: taboo of talking about dying, negative attitudes of patients and relatives, poor knowledge of professional caregivers, lack of necessary circumstances to have the conversation. Advance care planning is almost unknown in Hungary, although it is possible to refuse certain types of treatments. Cooperation of professionals, development of gradual and postgraduate trainings, and improvement of social awareness are also needed so that advance care planning can be adapted in Hungary. Orv Hetil. 2018; 159(4): 131-140.

Impact of advance care planning on the care of patients with heart failure: study protocol for a randomized controlled trial.

PubMed

Malhotra, Chetna; Sim, David Kheng Leng; Jaufeerally, Fazlur; Vikas, Nivedita Nadkarni; Sim, Genevieve Wong Cheng; Tan, Boon Cheng; Ng, Clarice Shu Hwa; Tho, Pei Leng; Lim, Jingfen; Chuang, Claire Ya-Ting; Fong, Florence Hui Mei; Liu, Joy; Finkelstein, Eric A

2016-06-10

Despite the promise and popularity of advance care planning, there is insufficient evidence that advance care planning helps patients to meet their end-of-life care preferences, especially in Asian settings. Thus, the proposed study aims to assess whether patients with advanced heart failure who are receiving advance care planning have a greater likelihood of receiving end-of-life care consistent with their preferences compared to patients receiving usual care. Secondary objectives are to compare differences in health care expenditures, quality of life, anxiety and depression, understanding of own illness, participation in decision-making and concordance with their caregiver's preferences for end-of-life care, between patients with advanced heart failure receiving advance care planning and usual care. This is a two-arm randomized controlled trial of advance care planning versus usual care (control) conducted at two institutions in Singapore. Two hundred and eighty-two patients with advanced heart failure (n = 94 in the advance care planning arm; n = 188 in the control arm receiving usual care) will be recruited from these centers and followed for 1 year or until they die, whichever is earlier. Additionally, the study will include up to one caregiver per patient enrolled. If advance care planning is proven to be effective, the results will help to promote its uptake among health care providers and patients both within Singapore and in other countries. NCT02299180 . Registered on 18 November 2014.

Dementia and Robotics: People with Advancing Dementia and Their Carers Driving an Exploration into an Engineering Solution to Maintaining Safe Exercise Regimes.

PubMed

Cooper, Carol; Penders, Jacques; Procter, Paula M

2016-01-01

The merging of the human world and the information technology world is advancing at a pace, even for those with dementia there are many useful smart 'phone applications including reminders, family pictures display, GPS functions and video communications. This paper will report upon initial collaborative work developing a robotic solution to engaging individuals with advancing dementia in safe exercise regimes. The research team has been driven by the needs of people with advancing dementia and their carers through a focus group methodology, the format, discussions and outcomes of these groups will be reported. The plans for the next stage of the research will be outlined including the continuing collaboration with advancing dementia and their carers.

Where There's a Will: The Link Between Estate Planning and Disparities in Advance Care Planning by White and Black Older Adults.

PubMed

Koss, Catheryn S; Baker, Tamara A

2018-03-01

Data from the Health and Retirement Study ( n = 6,946) were used to test whether differences in estate planning accounted for disparities in advance care planning between White and Black older adults. White participants were more likely to have advance directives after controlling for demographic, health, and financial variables. When estate planning was also controlled, the odds of having an advance directive were equal for White and Black participants. In contrast, Whites remained more likely to discuss end-of-life preferences after controlling for demographic, health, financial, and estate planning variables. White participants were almost four times as likely to have wills or trusts. Wealth, income, and home ownership were predictive of estate planning. Financial disparities contributed to lower rates of estate planning which in turn explained in large part why Black older adults were less likely to have advance directives but did not account for race disparities in advance care discussion.

25 CFR 1001.9 - Selection criteria for tribes/consortia seeking advance planning grant funding.

Code of Federal Regulations, 2010 CFR

2010-04-01

... planning grant funding. 1001.9 Section 1001.9 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS... advance planning grant funding. (a) Who is eligible to apply for a planning grant that will be awarded...-governance tribe and needs advance funding in order to complete the planning phase requirement may apply...

The Role of Social Workers in Spiritual Care to Facilitate Coping With Chronic Illness and Self-Determination in Advance Care Planning.

PubMed

Francoeur, Richard B; Burke, Nancy; Wilson, Alicia M

2016-01-01

Spiritual values and beliefs of patients and families influence resilience during chronic illness and shape patient choices during advance care planning. The spiritual needs of Baby Boomers will be more diverse than previous generations, in connection with the questioning, experimental mind-set of this group and the fact that it includes a higher proportion of immigrant populations outside the Judeo-Christian tradition. Social workers are trained explicitly to intervene with diverse populations and are well positioned to offer spiritual support in ways that do not necessarily conform to traditional religions. To the extent of their individual expertise and competence, social workers should assess and provide spiritual care to clients, including those who either are underserved or prefer not to seek assistance from clergy or chaplains because they feel alienated from religious institutions and representatives. They should also be aware of ethical dilemmas in consulting with spiritual care professionals in developing spiritual interventions. Social work education should address clients' humanistic and existential concerns, beliefs and behaviors of the major religions, and forms of nontraditional religious and spiritual experiences; it should also provide experiential opportunities for engaging with grief and earlier advance care planning. There should be attention to different theodical perspectives of the major religions regarding the problem of good and evil, which may preoccupy even clients who no longer participate in organized religion, because these unresolved existential issues may weaken client coping with chronic conditions and may diminish clarity and self-awareness for engaging authentically and effectively in advance care planning.

National Institutes of Health Research Plan on Rehabilitation.

PubMed

2017-04-01

One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Simulation of Hawaiian Electric Companies Feeder Operations with Advanced Inverters and Analysis of Annual Photovoltaic Energy Curtailment

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

Giraldez Miner, Julieta I.; Nagarajan, Adarsh; Gotseff, Peter

The Hawaiian Electric Companies achieved a consolidated Renewable Portfolio Standard (RPS) of approximately 26% at the end of 2016. This significant RPS performance was achieved using various renewable energy sources - biomass, geothermal, solar photovoltaic (PV) systems, hydro, wind, and biofuels - and customer-sited, grid-connected technologies (primarily private rooftop solar PV systems). The Hawaiian Electric Companies are preparing grid-modernization plans for the island grids. The plans outline specific near-term actions to accelerate the achievement of Hawai'i's 100% RPS by 2045. A key element of the Companies' grid-modernization strategy is to utilize new technologies - including storage and PV systems withmore » grid-supportive inverters - that will help to more than triple the amount of private rooftop solar PV systems. The Hawaiian Electric Companies collaborated with the Smart Inverter Technical Working Group Hawai'i (SITWG) to partner with the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) to research the implementation of advanced inverter grid support functions (GSF). Together with the technical guidance from the Companies's planning engineers and stakeholder input from the SITWG members, NREL proposed a scope of work that explored different modes of voltage-regulation GSF to better understand the trade-offs of the grid benefits and curtailment impacts from the activation of selected advanced inverter grid support functions. The simulation results presented in this report examine the effectiveness in regulating voltage as well as the impact to the utility and the customers of various inverter-based grid support functions on two Hawaiian Electric distribution substations.« less

Automatic Operation For A Robot Lawn Mower

NASA Astrophysics Data System (ADS)

Huang, Y. Y.; Cao, Z. L.; Oh, S. J.; Kattan, E. U.; Hall, E. L.

1987-02-01

A domestic mobile robot, lawn mower, which performs the automatic operation mode, has been built up in the Center of Robotics Research, University of Cincinnati. The robot lawn mower automatically completes its work with the region filling operation, a new kind of path planning for mobile robots. Some strategies for region filling of path planning have been developed for a partly-known or a unknown environment. Also, an advanced omnidirectional navigation system and a multisensor-based control system are used in the automatic operation. Research on the robot lawn mower, especially on the region filling of path planning, is significant in industrial and agricultural applications.

End of life care: The experiences of advance care planning amongst family caregivers of people with advanced dementia - A qualitative study.

PubMed

Ashton, Susan Elizabeth; Roe, Brenda; Jack, Barbara; McClelland, Bob

2016-09-01

End of life decisions for people with advanced dementia are reported as often being difficult for families as they attempt to make appropriate and justified decisions. To explore the experiences of advance care planning amongst family caregivers of people with advanced dementia. Qualitative research including a series of single cases (close family relatives). A purposive sample of 12 family caregivers within a specialist dementia unit was interviewed about their experiences of advance care planning between August 2009 and February 2010. Family caregivers need encouragement to ask the right questions during advance care planning to discuss the appropriateness of nursing and medical interventions at the end of life. Advance care planning can be facilitated with the family caregiver in the context of everyday practice within the nursing home environment for older people with dementia. © The Author(s) 2014.

Initial Efficacy Testing of an Autobiographical Memory Intervention on Advance Care Planning for Patients With Terminal Cancer.

PubMed

Brohard, Cheryl

2017-11-01

To test the efficacy of a novel intervention to facilitate advance care planning.
. Exploratory, quasiexperimental pilot study with two independent groups.
. A large hospice located in the southwestern United States. 
. A convenience sample of 50 participants with terminal cancer enrolled in hospice.
. An autobiographical memory (ABM) intervention used the participants' experiences with cancer and end of life for the purpose of directing advance care planning.
. Two domains of advance care planning, decision making and communication, were measured in relation to 11 variables. The ABM intervention was nonthreatening, short in duration, and easily completed with participants as they recalled, without hesitation, specific personal memories of family and friends who had died and their advance care plans. The Mann-Whitney nonparametric test revealed that participants in the experimental group had a higher average rank than those in the control group for communicating the decision about antibiotics, as well as exhibited a trend toward significance for five other advance care planning variables.
. Findings showed that directive ABMs may be effective in influencing the decision making and communication of advance care planning for terminally ill patients with cancer.
. The current level of understanding about using the ABM intervention suggests that nurses can initiate an advance care planning conversation using this approach.

Automatic mission planning algorithms for aerial collection of imaging-specific tasks

NASA Astrophysics Data System (ADS)

Sponagle, Paul; Salvaggio, Carl

2017-05-01

The rapid advancement and availability of small unmanned aircraft systems (sUAS) has led to many novel exploitation tasks utilizing that utilize this unique aerial imagery data. Collection of this unique data requires novel flight planning to accomplish the task at hand. This work describes novel flight planning to better support structure-from-motion missions to minimize occlusions, autonomous and periodic overflight of reflectance calibration panels to permit more efficient and accurate data collection under varying illumination conditions, and the collection of imagery data to study optical properties such as the bidirectional reflectance distribution function without disturbing the target in sensitive or remote areas of interest. These novel mission planning algorithms will provide scientists with additional tools to meet their future data collection needs.

NREL 2009 Video

ScienceCinema

McGrath, Robert; Arvizu, Dan; Garrett, Bobi; Porto, Casey; Glover, William

2017-12-11

The National Renewable Energy Laboratory (NREL) located in Golden, Colorado, is charting the course with an aggressive plan to position the lab as the pivotal contributor to a new energy economy. NRELs work focuses on advancing renewable energy and energy efficiency technologies from concept to commercialization. The laboratory partners with industry to move technologies to the marketplace.

The Database Business: Managing Today--Planning for Tomorrow. Optimizing Human Resource Factors.

ERIC Educational Resources Information Center

Clark, Joseph E.; And Others

1988-01-01

The first paper describes the National Technical Information Service productivity improvement system and its emphasis on human resources development. The second addresses the benefits of telecommuting to employers and employees. The third discusses the problems generated by the baby boom work force pressing for advancement at a time when many…

Technology, Policy, and School Change: The Role of Intermediary Organizations

ERIC Educational Resources Information Center

Forthe, Darrell

2012-01-01

As educators work to advance 21st century teaching and learning in schools, numerous reforms are needed but none greater than the necessity to integrate technology. Technology integration presents complex challenges because numerous changes must take place. The National Education Technology Plan 2010 (NETP) provides a road map for these necessary…

7 CFR 4274.338 - Loan agreements between the Agency and the intermediary.

Code of Federal Regulations, 2010 CFR

2010-01-01

... necessary to cover a 30-day period in implementing its approved work plan. Advances must be requested by the... by the intermediary. (ii) Ordinarily, life insurance, which may be decreasing term insurance, is... Agency following default by the intermediary, to the Agency. A schedule of life insurance available for...

Trigonometry and Advanced Math. De Soto Parish Curriculum Guide.

ERIC Educational Resources Information Center

DeSoto Parish School Board, Mansfield, LA.

The primary aim of this guide is to aid teachers in planning and preparing a senior high school mathematics course for students preparing for college work. It is divided into separate one-semester courses of seven chapters each. The first-semester course consists of a traditional approach to the introduction of trigonometry and trigonometric…

Training Research Program and Plans: Advanced Simulation in Undergraduate Pilot Training.

ERIC Educational Resources Information Center

Matheny, W. G.

The study reports the work done by a panel of experts in training research toward defining priority research investigations to be undertaken through the Human Resources Laboratory, Flying Training Division (HRL/FT). A list of recommended investigations judged to be important for increasing the effectiveness of beginning pilot training was…

Abrasives and Grinding Machines; Machine Shop Work--Advanced: 9557.02.

ERIC Educational Resources Information Center

Dade County Public Schools, Miami, FL.

The course outline has been prepared as a guide to assist the instructor in systematically planning and presenting a variety of meaningful lessons to facilitate the necessary training for the machine shop student. The material contained in the outline is designed to enable the student to learn the manipulative skills and related knowledge…

Advancing Ambitions: The Role of Career Guidance in Supporting Social Mobility

ERIC Educational Resources Information Center

Hooley, Tristram; Matheson, Jesse; Watts, A. G.

2014-01-01

Career guidance describes activities that support individuals in learning about education and employment, and in planning for their future lives, learning, and work. These activities contribute to social mobility, which helps people discover and access opportunities that might exist outside of their immediate networks. Changes in funding and in…

Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long-term care settings: a cross-sectional survey.

PubMed

Beck, Esther-Ruth; McIlfatrick, Sonja; Hasson, Felicity; Leavey, Gerry

2017-09-01

To examine nursing home managers' knowledge, attitudes, beliefs and current practice regarding advance care planning for people with dementia in long-term care settings informed by the theory of planned behaviour. Internationally, advance care planning is advocated for people with dementia. However, evidence suggests that discussions with people with dementia are rare, particularly in long-term care settings. Whilst nursing home managers can be considered central to implementation in this setting, there is a dearth of research that has examined their perspective. This study reports on their role with regard to advance care planning and the perceived factors which influence this. A cross-sectional postal survey was carried out as part of a larger scale sequential explanatory mixed-methods study between January-March 2015. Nursing home managers in a region in the UK (n = 178). A response rate of 66% (n = 116) was achieved. Nursing home managers demonstrated a lack of knowledge of advance care planning, with negative attitudes underpinned by concerns regarding the capacity and lack of perceived benefits to the person with dementia. Currently, they do not view advance care planning as part of their role, with lack of ownership impacting upon current practice behaviours. Whilst nursing home managers recognise the potential benefits of advance care planning, barriers and challenges create a reluctance to facilitate. Targeted training to address the knowledge deficit is required, with the wider components of advance care planning promoted. There is a need for greater role clarification to ensure nurses in long-term care settings identify with the process in the future. A gap between rhetoric and reality of implementation is evident; therefore, long-term care settings must critically examine system, organisational and individual factors for failure to implement advance care planning for people with dementia. Increased cognisance of the context in which advance care planning takes place is vital for improved implementation in this context. In addition strong nursing leadership is imperative to facilitate initiation, engagement and re-evaluation of the process of advance care planning. © 2016 John Wiley & Sons Ltd.

14 CFR 151.111 - Advance planning proposals: General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Engineering Proposals § 151.111 Advance planning proposals: General. (a) Each advance planning and engineering... application, under §§ 151.21(c) and 151.27, or both. (c) Each proposal must relate to planning and engineering... “Airport Activity Statistics of Certificated Route Air Carriers” (published jointly by FAA and the Civil...

Teaching and learning in the operating theatre: a framework for trainers and advanced trainees in obstetrics and gynaecology.

PubMed

Mukhopadhyay, S; China, S

2010-04-01

Surgical training of 'advanced trainees' in Obstetrics and Gynaecology currently occurs in a rather unstructured fashion. This is even more complicated by reduced training time of doctors necessitated by the European working time directive. Teaching and learning in theatre is a combination of art and science. This paper attempts to address the issues hampering effective theatre training and suggests ways to overcome them. The 'operating theatre' plan includes a needs assessment of trainees, goal setting and instructional methodologies. Various learning styles could potentially be adopted, although it might be difficult to choose a learning style suitable for a particular trainee. Additionally, team working skills and experiential learning need to be facilitated.

Military Social Work: Opportunities and Challenges for Social Work Education

PubMed Central

Wooten, Nikki R.

2015-01-01

Military social work is a specialized field of practice spanning the micro-macro continuum and requiring advanced social work knowledge and skills. The complex behavioral health problems and service needs of Iraq and Afghanistan veterans highlight the need for highly trained social work professionals who can provide militarily-relevant and culturally-responsive evidence-informed services. Responding to the military behavioral health workforce and service needs of recently returned veterans presents both opportunities and challenges for military social work education. This article discusses the rationale for a military social work specialization, the need for military social work education, and opportunities and challenges for social work education. An integrated model of intellectual capital is proposed to guide strategic planning for future military social work education. PMID:26089628

Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented?

PubMed

Lyon, Cheryl

2007-12-01

Background  Advance care planning in a residential care setting aims to assist residents to make decisions about future healthcare and to improve end-of-life care through medical and care staff knowing and respecting the wishes of the resident. The process enables individuals and others who are important to them, to reflect on what is important to the resident including their beliefs/values and preferences about care when they are dying. This paper describes a project conducted as part of the Joanna Briggs Institute Clinical Aged Care Fellowship Program implemented at the Manningham Centre in metropolitan Melbourne in a unit providing services for 46 low and high care residents. Objectives  The objectives of the study were to document implementation of best practice in advance care planning in a residential aged care facility using a cycle of audit, feedback and re-audit cycle audit with a clinical audit software program, the Practical Application of Clinical Evidence System. The evidence-based guidelines found in 'Guidelines for a Palliative Approach in Residential Aged Care' were used to inform the process of clinical practice review and to develop a program to implement advance care planning. Results  The pre-implementation audit results showed that advance care planning practice was not based on high level evidence as initial compliance with five audit criteria was 0%. The barriers to implementation that became apparent during the feedback stage included the challenge of creating a culture where advance care planning policy, protocols and guidelines could be implemented, and advance care planning discussions held, by adequately prepared health professionals and carers. Opportunities were made to equip the resident to discuss their wishes with family, friends and healthcare staff. Some residents made the decision to take steps to formally document those wishes and/or appoint a Medical Enduring Power of Attorney to act on behalf of the resident when they are unable to communicate wishes. The post-implementation audit showed a clear improvement as compliance ranged from 15-100% for the five audit criteria. Strong leadership by the project team was effective in engaging staff in this quality improvement program. Conclusion  The outcomes of the project were extremely positive and demonstrate a genuine improvement in practice. All audit criteria indicate that the Manningham Centre is now positively working towards improved practice based on the best available evidence. It is hoped that as the expertise developed during this project is shared, other areas of gerontological practice will be similarly improved and more facilities caring for the older person will embrace evidence-based practice.

Fuel Cycle Technologies 2014 Achievement Report

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

Hong, Bonnie C.

2015-01-01

The Fuel Cycle Technologies (FCT) program supports the Department of Energy’s (DOE’s) mission to: “Enhance U.S. security and economic growth through transformative science, technology innovation, and market solutions to meet our energy, nuclear security, and environmental challenges.” Goal 1 of DOE’s Strategic Plan is to innovate energy technologies that enhance U.S. economic growth and job creation, energy security, and environmental quality. FCT does this by investing in advanced technologies that could transform the nuclear fuel cycle in the decades to come. Goal 2 of DOE’s Strategic Plan is to strengthen national security by strengthening key science, technology, and engineering capabilities.more » FCT does this by working closely with the National Nuclear Security Administration and the U.S Department of State to develop advanced technologies that support the Nation’s nuclear nonproliferation goals.« less

Advance care planning in a multi-cultural family-centric community: A qualitative study of healthcare professionals', patients' and caregivers' perspectives.

PubMed

Menon, Sumytra; Kars, Marijke; Malhotra, Chetna; Campbell, Alastair V; van Delden, J J M

2018-05-15

Advance care planning has been shown to improve end-of-life care but it was developed in the USA and most research has been conducted in western communities. We aimed to study the attitudes and perceptions of patients with life-limiting illnesses, informal caregivers, doctors, nurses and medical social workers regarding advance care planning in a multi-cultural family-centric community. We conducted an explorative qualitative study, using focus groups and individual in-depth interviews. We used purposive sampling techniques to recruit 61 adults (15 doctors, 13 nurses, 5 medical social workers, 15 patients and 13 caregivers) from multiple healthcare settings across the country. The participants are genuinely anxious about the implementation of advance care planning. They had positive and negative expectations of advance care planning. Many were confused about the legal framework for healthcare decision-making and expected advance care planning to be of limited value because family members, rather than the patient, were usually the key decision-makers. A nuanced approach to advance care planning which considers the family network is required in multi-cultural family centric communities. Policies should be reconciled to create a more consistent message that respects patients, the family, and is legally coherent. Further research could focus on adaptations of advance care planning to promote its acceptance in such communities. Copyright © 2018. Published by Elsevier Inc.

The effectiveness of advance organiser model on students' academic achievement in learning work and energy

NASA Astrophysics Data System (ADS)

Gidena, Asay; Gebeyehu, Desta

2017-11-01

The purpose of this study was to investigate the effectiveness of the advance organiser model (AOM) on students' academic achievement in learning work and energy. The design of the study was quasi-experimental pretest-posttest nonequivalent control groups. The total population of the study was 139 students of three sections in Endabaguna preparatory school in Tigray Region, Ethiopia. Two sections with equivalent means on the pretest were taken to participate in the study purposely and one section assigned as the experimental group and the other section assigned as the control group randomly. The experimental group was taught using the lesson plan based on the AOM, and the control group was taught using the lesson plan based on the conventional teaching method. Pretest and posttest were administered before and after the treatment, respectively. Independent sample t-test was used to analyse the data at the probability level of 0.05. The findings of the study showed that the AOM was more effective than the conventional teaching method with effect size of 0.49. This model was also effective to teach male and female students and objectives namely understanding and application. However, both methods were equally important to teach work and energy under the objective knowledge level.

Building foundations for the future: the NHS Scotland advanced practice succession planning development pathway.

PubMed

Currie, Kay; Grundy, Maggie

2011-10-01

To highlight implications for managers from the implementation of a national advanced practice succession planning development pathway within Scotland. Internationally, advanced practice posts have often developed in an ad-hoc manner, with little organizational attention to succession planning. Evaluation of a pilot national succession planning development pathway identified mechanisms which facilitate or hamper effective planning for advanced practice roles. A responsive evaluation design incorporating semi-structured questionnaires to pathway participants (n = 15) and semi-structured telephone interviews with case-site pathway participants (n = 7) and their line managers. Managers believed the development pathway was worthwhile; however, there was limited strategic planning to match individuals' development to service need. Practitioners generally perceived managers as interested in their development, although levels of practical support varied. There is concern from both managers and practitioners regarding ongoing funding for advanced practice development. The present evaluation study reiterates the need for organizational commitment to succession planning including robust service needs analysis mechanisms and adequate funding for development processes. Nurse managers are viewed as the 'gatekeepers' to opportunities for developing advanced nurse practitioners; scare resources must be targeted effectively to support succession planning through the development of selected individuals for future advanced practice posts, justified by service need. © 2011 Blackwell Publishing Ltd.

Parallel plan execution with self-processing networks

NASA Technical Reports Server (NTRS)

Dautrechy, C. Lynne; Reggia, James A.

1989-01-01

A critical issue for space operations is how to develop and apply advanced automation techniques to reduce the cost and complexity of working in space. In this context, it is important to examine how recent advances in self-processing networks can be applied for planning and scheduling tasks. For this reason, the feasibility of applying self-processing network models to a variety of planning and control problems relevant to spacecraft activities is being explored. Goals are to demonstrate that self-processing methods are applicable to these problems, and that MIRRORS/II, a general purpose software environment for implementing self-processing models, is sufficiently robust to support development of a wide range of application prototypes. Using MIRRORS/II and marker passing modelling techniques, a model of the execution of a Spaceworld plan was implemented. This is a simplified model of the Voyager spacecraft which photographed Jupiter, Saturn, and their satellites. It is shown that plan execution, a task usually solved using traditional artificial intelligence (AI) techniques, can be accomplished using a self-processing network. The fact that self-processing networks were applied to other space-related tasks, in addition to the one discussed here, demonstrates the general applicability of this approach to planning and control problems relevant to spacecraft activities. It is also demonstrated that MIRRORS/II is a powerful environment for the development and evaluation of self-processing systems.

Identifying the Factors That Facilitate or Hinder Advance Planning by Persons With Dementia

PubMed Central

Hirschman, Karen B.; Kapo, Jennifer M.; Karlawish, Jason H. T.

2009-01-01

We performed semistructured interviews with 30 family members of patients with advanced dementia to identify the factors that facilitate or hinder advance planning by persons with dementia. All interviews were analyzed using qualitative data analysis techniques. The majority (77%) of family members reported that their relative had some form of written advance directive, and at least half reported previous discussions about health care preferences (57%), living situation or placement issues (50%), and finances or estate planning (60%) with the patient. Family members reported some themes that prompted planning and others that were barriers to planning. Events that most often triggered planning were medical, living situation, or financial issues associated with a friend or family member of the patient (57%). Barriers to planning included both passive and active avoidance. The most common form of passive avoidance was not realizing the importance of planning until it was too late to have the discussion (63%). The most common form of active avoidance was avoiding the discussion (53%). These data suggest potentially remediable strategies to address barriers to advance planning discussions. PMID:18580595

Does facilitated Advance Care Planning reduce the costs of care near the end of life? Systematic review and ethical considerations.

PubMed

Klingler, Corinna; in der Schmitten, Jürgen; Marckmann, Georg

2016-05-01

While there is increasing evidence that Advance Care Planning has the potential to strengthen patient autonomy and improve quality of care near the end of life, it remains unclear whether it could also reduce net costs of care. This study aims to describe the cost implications of Advance Care Planning programmes and discusses ethical conflicts arising in this context. We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We systematically searched the databases PubMed, NHS EED, EURONHEED, Cochrane Library and EconLit. We included empirical studies (no limitation to study type) that investigated the cost implications of Advance Care Planning programmes involving professionally facilitated end-of-life discussions. Seven studies met our inclusion criteria. Four of them used a randomised controlled design, one used a before-after design and two were observational studies. Six studies found reductions in costs of care ranging from USD1041 to USD64,827 per patient, depending on the study period and the cost measurement. One study detected no differences in costs. Studies varied considerably regarding the Advance Care Planning intervention, patient selection and costs measured which may explain some of the variations in findings. Looking at the impact of Advance Care Planning on costs raises delicate ethical issues. Given the increasing pressure to reduce expenditures, there may be concerns that cost considerations could unduly influence the sensitive communication process, thus jeopardising patient autonomy. Safeguards are proposed to reduce these risks. The limited data indicate net cost savings may be realised with Advance Care Planning. Methodologically robust trials with clearly defined Advance Care Planning interventions are needed to make the costs and returns of Advance Care Planning transparent. © The Author(s) 2015.

Solving the English-as-a-Second Language Writers' Dilemma

ERIC Educational Resources Information Center

Nowalk, Thomas

2010-01-01

This brief work stands against a four-year stretch of writing classes at Northern Virginia Community College, with the author teaching English-as-a-Second-Language (ESL) students how to write academic essays. The courses taught have included high intermediate and advanced writers, many of whom plan to earn a degree at the college or any number of…

Masonry. Progress Record, Theory Outline.

ERIC Educational Resources Information Center

Connecticut State Dept. of Education, Hartford. Div. of Vocational-Technical Schools.

Intended to reduce unnecessary paper work on the part of the shop instructor in a masonry course, this job assignment book offers a simplified method of keeping student records up-to-date. It lists theory objectives and specific objectives for masonry courses in grades 10, 11, and 12. To help the instructor in planning and organizing in advance, a…

Community views of fuels management: are national forest local recreation users more supportive?

Treesearch

Christine Vogt; Greg Winter; Sarah McCaffrey

2007-01-01

Significant advances in social science-based wildfire research have occurred in the past five years. Managers, policy makers, and researchers have worked to better understand the perspectives of homeowners, residents, tourists, and recreationists on fire and fuels management and how to better involve them in the planning process. This research examines how the...

Students' Experiences and Expectations of Technologies: An Australian Study Designed to Inform Planning and Development Decisions

ERIC Educational Resources Information Center

Gosper, Maree; Malfroy, Janne; McKenzie, Jo

2013-01-01

The pace of technological change accompanied by an evolution in social, work-based and study behaviours and norms poses particular challenges for universities as they strive to develop high quality and sustainable technology-rich learning environments. Maintaining currency with the latest advances is resource intensive, hence the costs incurred in…

Advancing the state of the art in healthcare strategic planning.

PubMed

Zuckerman, Alan M

2006-01-01

A recent survey of the state of strategic planning among healthcare organizations indicates that planners and executives believe that healthcare strategic planning practices are effective and provide the appropriate focus and direction for their organizations. When compared to strategic planning practices employed outside of the healthcare field, however, most healthcare strategic planning processes have not evolved to the more advanced, state-of-the-art levels of planning being used successfully outside of healthcare. While organizations that operate in stable markets may be able to survive using basic strategic planning practices, the volatile healthcare market demands that providers be nimble competitors with advanced, ongoing planning processes that drive growth and organizational effectiveness. What should healthcare organizations do to increase the rigor and sophistication of their strategic planning practices? This article identifies ten current healthcare strategic planning best practices and recommends five additional innovative approaches from pathbreaking companies outside of healthcare that have used advanced strategic planning practices to attain high levels of organizational success.

Beyond Coordination: Joint Planning and Program Execution. The IHPRPT Materials Working Group

NASA Technical Reports Server (NTRS)

Stropki, Michael A.; Cleyrat, Danial A.; Clinton, Raymond G., Jr.; Rogacki, John R. (Technical Monitor)

2000-01-01

"Partnership is more than just coordination," stated then-Commander of the Air Force Research Laboratory (AFRL), Major General Dick Paul (USAF-Ret), at this year's National Space and Missile Materials Symposium. His comment referred to the example of the joint planning and program execution provided by the Integrated High Payoff Rocket Propulsion Technology (IHPRPT) Materials Working Group (IMWG). Most people agree that fiscal pressures imposed by shrinking budgets have made it extremely difficult to build upon our existing technical capabilities. In times of sufficient budgets, building advanced systems poses no major difficulties. However, with today's budgets, realizing enhanced capabilities and developing advanced systems often comes at an unaffordable cost. Overcoming this problem represents both a challenge and an opportunity to develop new business practices that allow us to develop advanced technologies within the restrictions imposed by current funding levels. Coordination of technology developments between different government agencies and organizations is a valuable tool for technology transfer. However, rarely do the newly developed technologies have direct applicability to other ongoing programs. Technology requirements are typically determined up-front during the program planning stage so that schedule risk can be minimized. The problem with this process is that the costs associated with the technology development are often borne by a single program. Additionally, the potential exists for duplication of technical effort. Changing this paradigm is a difficult process but one that can be extremely worthwhile should the right opportunity arise. The IMWG is one such example where NASA, the DoD, and industry have developed joint requirements that are intended to satisfy multiple program needs. More than mere coordination, the organizations comprising the group come together as partners, sharing information and resources, proceeding from a joint roadmap.

Capability Investment Strategy to Enable JPL Future Space Missions

NASA Technical Reports Server (NTRS)

Lincoln, William; Merida, Sofia; Adumitroaie, Virgil; Weisbin, Charles R.

2006-01-01

The Jet Propulsion Laboratory (JPL) formulates and conducts deep space missions for NASA (the National Aeronautics and Space Administration). The Chief Technologist of JPL has responsibility for strategic planning of the laboratory's advanced technology program to assure that the required technological capabilities to enable future missions are ready as needed. The responsibilities include development of a Strategic Plan (Antonsson, E., 2005). As part of the planning effort, a structured approach to technology prioritization, based upon the work of the START (Strategic Assessment of Risk and Technology) (Weisbin, C.R., 2004) team, was developed. The purpose of this paper is to describe this approach and present its current status relative to the JPL technology investment.

Used Fuel Disposition in Crystalline Rocks: FY16 Progress Report

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

Wang, Y.; Hadgu, Teklu; Kalinina, Elena Arkadievna

The objective of the Crystalline Disposal R&D Work Package is to advance our understanding of long-term disposal of used fuel in crystalline rocks and to develop necessary experimental and computational capabilities to evaluate various disposal concepts in such media. FY16 continued to be a successful year in both experimental and modeling arenas in evaluation of used fuel disposal in crystalline rocks. The work covers a wide range of research topics identified in the R&D plan.

14 CFR 151.119 - Advance planning proposals: Procedures; funding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Advance planning proposals: Procedures; funding. 151.119 Section 151.119 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and...

14 CFR 151.117 - Advance planning proposals: Procedures; application.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Advance planning proposals: Procedures; application. 151.117 Section 151.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and...

14 CFR 151.117 - Advance planning proposals: Procedures; application.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Advance planning proposals: Procedures; application. 151.117 Section 151.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and...

14 CFR 151.117 - Advance planning proposals: Procedures; application.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Advance planning proposals: Procedures; application. 151.117 Section 151.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and...

14 CFR 151.129 - Payments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151.129 Payments. (a) The United States' share of advance planning costs is paid in two installments unless the advance planning grant agreement provides otherwise. Upon request by sponsor, the first payment may be...

Provider Tools for Advance Care Planning and Goals of Care Discussions: A Systematic Review.

PubMed

Myers, Jeff; Cosby, Roxanne; Gzik, Danusia; Harle, Ingrid; Harrold, Deb; Incardona, Nadia; Walton, Tara

2018-01-01

Advance care planning and goals of care discussions involve the exploration of what is most important to a person, including their values and beliefs in preparation for health-care decision-making. Advance care planning conversations focus on planning for future health care, ensuring that an incapable person's wishes are known and can guide the person's substitute decision maker for future decision-making. Goals of care discussions focus on preparing for current decision-making by ensuring the person's goals guide this process. To provide evidence regarding tools and/or practices available for use by health-care providers to effectively facilitate advance care planning conversations and/or goals of care discussions. A systematic review was conducted focusing on guidelines, randomized trials, comparative studies, and noncomparative studies. Databases searched included MEDLINE, EMBASE, and the proceedings of the International Advance Care Planning Conference and the American Society of Clinical Oncology Palliative Care Symposium. Although several studies report positive findings, there is a lack of consistent patient outcome evidence to support any one clinical tool for use in advance care planning or goals of care discussions. Effective advance care planning conversations at both the population and the individual level require provider education and communication skill development, standardized and accessible documentation, quality improvement initiatives, and system-wide coordination to impact the population level. There is a need for research focused on goals of care discussions, to clarify the purpose and expected outcomes of these discussions, and to clearly differentiate goals of care from advance care planning.

Experiences and perspectives of older people regarding advance care planning: A meta-synthesis of qualitative studies.

PubMed

Ke, Li-Shan; Huang, Xiaoyan; Hu, Wen-Yu; O'Connor, Margaret; Lee, Susan

2017-05-01

Studies have indicated that family members or health professionals may not know or predict their older relatives' or patients' health preferences. Although advance care planning is encouraged for older people to prepare end-of-life care, it is still challenging. To understand the experiences and perspectives of older people regarding advance care planning. A systematic review of qualitative studies and meta-synthesis was conducted. CINAHL, MEDLINE, EMBASE, and PsycINFO databases were searched. A total of 50 articles were critically appraised and a thematic synthesis was undertaken. Four themes were identified: life versus death, internal versus external, benefits versus burdens, and controlling versus being controlled. The view of life and death influenced older people's willingness to discuss their future. The characteristics, experiences, health status, family relationship, and available resources also affected their plans of advance care planning. Older people needed to balance the benefits and burdens of advance care planning, and then judge their own ability to make decisions about end-of-life care. Older people's perspectives and experiences of advance care planning were varied and often conflicted; cultural differences amplified variances among older people. Truthful information, available resources, and family support are needed to enable older people to maintain dignity at the end of life. The views of life and death for older people from different cultures should be compared to assist health professionals to understand older people's attitudes toward advance care planning, and thus to develop appropriate strategies to promote advance care planning in different cultures.

Strategic Plan. Volume 2

NASA Technical Reports Server (NTRS)

2002-01-01

The Mission of the NSBRI will be to lead a National effort for accomplishing the integrated, critical path, biomedical research necessary to support the long term human presence, development, and exploration of space and to enhance life on Earth by applying the resultant advances in human knowledge and technology acquired through living and working in space. To carry out this mission, the NSBRI focuses its activities on three Strategic Programs: Strategic Program 1: Countermeasure Research Strategic Program 2: Education, Training and Outreach Strategic Program 3: Cooperative Research and Development. This document contains the detailed Team Strategic Plans for the 11 research teams focused on Strategic Program 1, and the Education and Outreach Team focused on Strategic Program 2. There is overlap and integration among the Programs and Team Strategic Plans, as described in each of the Plans.

Using Iterative Repair to Increase the Responsiveness of Planning and Scheduling for Autonomous Spacecraft

NASA Technical Reports Server (NTRS)

Chien, Steve; Knight, Russell; Stechert, Andre; Sherwood, Rob; Rabideau, Gregg

1998-01-01

An autonomous spacecraft must balance long-term and short-term considerations. It must perform purposeful activities that ensure long-term science and engineering goals are achieved and ensure that it maintains positive resource margins. This requires planning in advance to avoid a series of shortsighted decisions that can lead to failure, However, it must also respond in a timely fashion to a somewhat dynamic and unpredictable environment. Thus, spacecraft plans must often be modified due to fortuitous events such as early completion of observations and setbacks such as failure to acquire a guidestar for a science observation. This paper describes the use of iterative repair to support continuous modification and updating of a current working plan in light of changing operating context.

Human Factors and Modeling Methods in the Development of Control Room Modernization Concepts

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

Hugo, Jacques V.; Slay III, Lorenzo

nuclear power plants. Although the nuclear industry has made steady improvement in outage optimization, each day of a refueling outage still represents an opportunity to save millions of dollars and each day an outage extends past its planned end date represents millions of dollars that may have been spent unnecessarily. Reducing planned outage duration or preventing outage extensions requires careful management of the outage schedule as well as constant oversight and monitoring of work completion during the outage execution. During a typical outage, there are typically more than 10,000 activities on the schedule that, if not managed efficiently, may causemore » expensive outage delays. Management of outages currently relies largely on paper-based resources and general-purpose office software. A typical tool currently used to monitor work performance is a burn-down curve, where total remaining activities are plotted against the baseline schedule to track bulk work completion progress. While these tools are useful, there is still considerable uncertainty during a typical outage that bulk work progress is adequate and therefore a lot of management time is spent analyzing the situation on a daily basis. This paper describes recent advances made in developing a framework for the design of visual outage information presentation, as well as an overview of the scientific principles that informed the development of the visualizations. To test the utility of advanced visual outage information presentation, an outage management dashboard software application was created as part of the Department of Energy’s Advanced Outage Control Center project. This dashboard is intended to present all the critical information an outage manager would need to understand the current status of a refueling outage. The dashboard presents the critical path, bulk work performance, key performance indicators, outage milestones and metrics relating current performance to historical performance. Additionally, the dashboard includes data analysis tools to allow outage managers to drill down into the underlying data to understand the drivers of the indicators.« less

Fundamental Aeronautics Program: Overview of Project Work in Supersonic Cruise Efficiency

NASA Technical Reports Server (NTRS)

Castner, Raymond

2011-01-01

The Supersonics Project, part of NASA?s Fundamental Aeronautics Program, contains a number of technical challenge areas which include sonic boom community response, airport noise, high altitude emissions, cruise efficiency, light weight durable engines/airframes, and integrated multi-discipline system design. This presentation provides an overview of the current (2011) activities in the supersonic cruise efficiency technical challenge, and is focused specifically on propulsion technologies. The intent is to develop and validate high-performance supersonic inlet and nozzle technologies. Additional work is planned for design and analysis tools for highly-integrated low-noise, low-boom applications. If successful, the payoffs include improved technologies and tools for optimized propulsion systems, propulsion technologies for a minimized sonic boom signature, and a balanced approach to meeting efficiency and community noise goals. In this propulsion area, the work is divided into advanced supersonic inlet concepts, advanced supersonic nozzle concepts, low fidelity computational tool development, high fidelity computational tools, and improved sensors and measurement capability. The current work in each area is summarized.

Fundamental Aeronautics Program: Overview of Propulsion Work in the Supersonic Cruise Efficiency Technical Challenge

NASA Technical Reports Server (NTRS)

Castner, Ray

2012-01-01

The Supersonics Project, part of NASA's Fundamental Aeronautics Program, contains a number of technical challenge areas which include sonic boom community response, airport noise, high altitude emissions, cruise efficiency, light weight durable engines/airframes, and integrated multi-discipline system design. This presentation provides an overview of the current (2012) activities in the supersonic cruise efficiency technical challenge, and is focused specifically on propulsion technologies. The intent is to develop and validate high-performance supersonic inlet and nozzle technologies. Additional work is planned for design and analysis tools for highly-integrated low-noise, low-boom applications. If successful, the payoffs include improved technologies and tools for optimized propulsion systems, propulsion technologies for a minimized sonic boom signature, and a balanced approach to meeting efficiency and community noise goals. In this propulsion area, the work is divided into advanced supersonic inlet concepts, advanced supersonic nozzle concepts, low fidelity computational tool development, high fidelity computational tools, and improved sensors and measurement capability. The current work in each area is summarized.

Work Breakdown Structure (WBS) and WBS dictionary. [advanced x ray astrophysics facility (AXAF)

NASA Technical Reports Server (NTRS)

Cocuzzo, F.

1994-01-01

This document is intended to provide the framework for defining all work to be accomplished under the proposed contract for the mission support program as defined by Section J-1 Statement of Work (SOW) of the RFP No.8-1-3-TA-50030 dated 11/2/93. The time period of performance of this contract will be from 3/1/94 through to the end of fiscal 1999. In addition to providing the framework for the integration of the cost, schedule, and manpower planning necessary to accomplish this work it establishes the association among the WBS elements, the SOW, and the Technical Proposal.

FY 1986 current fiscal year work plan

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

Not Available

This Current Year Work Plan presents in detail a description of the activities to be performed by the Joint Integration Office/RI during FY86. It breaks down the activities into two major work areas: Program Management and Program Analysis. Program Management is performed by the JIO/RI by providing technical planning and guidance for the development of advanced TRU waste management capabilities. This includes equipment/facility design, engineering, construction, and operations. These functions are integrated to allow transition from interim storage to final disposition. JIO/RI tasks include program requirements identification, long-range technical planning, budget development, program planning document preparation, task guidance development, taskmore » monitoring, task progress information gathering and reporting to DOE, interfacing with other agencies and DOE lead programs, integrating public involvement with program efforts, and preparation of reports for DOE detailing program status. Program Analysis is performed by the JIO/RI to support identification and assessment of alternatives, and development of long-term TRU waste program capabilities. These analyses include short term analyses in response to DOE information requests, along with performing an RH Cost/Schedule Optimization report. System models will be developed, updated, and upgraded as needed to enhance JIO/RI's capability to evaluate the adequacy of program efforts in various fields. A TRU program data base will be maintained and updated to provide DOE with timely responses to inventory related questions.« less

Adversaries at the Bedside: Advance Care Plans and Future Welfare.

PubMed

Kestigian, Aidan; London, Alex John

2016-10-01

Advance care planning refers to the process of determining how one wants to be cared for in the event that one is no longer competent to make one's own medical decisions. Some have argued that advance care plans often fail to be normatively binding on caretakers because those plans do not reflect the interests of patients once they enter an incompetent state. In this article, we argue that when the core medical ethical principles of respect for patient autonomy, honest and adequate disclosure of information, institutional transparency, and concern for patient welfare are upheld, a policy that would allow for the disregard of advance care plans is self-defeating. This is because when the four principles are upheld, a patient's willingness to undergo treatment depends critically on the willingness of her caretakers to honor the wishes she has outlined in her advance care plan. A patient who fears that her caretakers will not honor her wishes may choose to avoid medical care so as to limit the influence of her caretakers in the future, which may lead to worse medical outcomes than if she had undergone care. In order to avoid worse medical outcomes and uphold the four core principles, caregivers who are concerned about the future welfare of their patients should focus on improving advance care planning and commit to honoring their patients' advance care plans. © 2016 John Wiley & Sons Ltd.

Advanced planetary studies

NASA Technical Reports Server (NTRS)

1977-01-01

Results of planetary advanced studies and planning support are summarized. The scope of analyses includes cost estimation research, planetary mission performance, penetrator advanced studies, Mercury mission transport requirements, definition of super solar electric propulsion/solar sail mission discriminators, and advanced planning activities.

Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 6. Development and Transition Plans.

DOT National Transportation Integrated Search

1974-02-01

The volume presents the plans for implementing the Satellite-Based Advanced Air Traffic Management System (SAATMS) described in Volumes II, III, and IV. Two plans are presented: an RDT&E plan and a transition plan. The RDT&E plan is presented as a se...

Advance care treatment plan (ACT-Plan) for African American family caregivers: a pilot study.

PubMed

Bonner, Gloria J; Wang, Edward; Wilkie, Diana J; Ferrans, Carol E; Dancy, Barbara; Watkins, Yashika

2014-01-01

Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.

78 FR 40745 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

.... Description: The Advance Planning Document (APD) process, established in the rules at 45 CFR part 95, subpart F, is the procedure by which States request and obtain approval for Federal financial participation... Advance Planning Document 34 1.2 120 4,896 Operational Advance Planning Document 20 1 30 600 Estimated...

78 FR 14556 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... for ACF. OMB No.: 0992-0005. Description: The Advance Planning Document (APD) process, established in... Biennial Reports 54 1 1.50 81 Advance Planning Document 34 1.2 120 4,896 Operational Advance Planning... for the proper performance of the functions of the agency, including whether the information shall...

Advanced techniques in neoadjuvant radiotherapy allow dose escalation without increased dose to the organs at risk : Planning study in esophageal carcinoma.

PubMed

Fakhrian, K; Oechsner, M; Kampfer, S; Schuster, T; Molls, M; Geinitz, H

2013-04-01

The goal of this work was to investigate the potential of advanced radiation techniques in dose escalation in the radiotherapy (RT) for the treatment of esophageal carcinoma. A total of 15 locally advanced esophageal cancer (LAEC) patients were selected for the present study. For all 15 patients, we created a 3D conformal RT plan (3D-45) with 45 Gy in fractions of 1.8 Gy to the planning target volume (PTV1), which we usually use to employ in the neoadjuvant treatment of LAEC. Additionally, a 3D boost (as in the primary RT of LAEC) was calculated with 9 Gy in fractions of 1.8 Gy to the boost volume (PTV2) (Dmean) to a total dose of 54 Gy (3D-54 Gy), which we routinely use for the definitive treatment of LAEC. Three plans with a simultaneous integrated boost (SIB) were then calculated for each patient: sliding window intensity-modulated radiotherapy (IMRT-SIB), volumetric modulated arc therapy (VMAT-SIB), and helical tomotherapy (HT-SIB). For the SIB plans, the requirement was that 95 % of the PTV1 receive ≥ 100 % of the prescription dose (45 Gy in fractions of 1.8 Gy, D95) and the PTV2 was dose escalated to 52.5 Gy in fractions of 2.1 Gy (D95). The median PTV2 dose for 3D-45, 3D-54, HT-SIB, VMAT-SIB, and IMRT-SIB was 45, 55, 54, 56, and 55 Gy, respectively. Therefore, the dose to PTV2 in the SIB plans was comparable to the 3D-54 plan. The lung dose in the SIB plans was in the range of the standard 3D-45, which is applied for neoadjuvant radiotherapy. The mean lung dose for the same plans was 13, 15, 12, 12, and 13 Gy, respectively. The V5 lung volumes were 71, 74, 79, 75, and 73 %, respectively. The V20 lung volumes were 20, 25, 16, 18, and 19 %, respectively. New treatment planning techniques enable higher doses to be delivered for neoadjuvant radiotherapy of LAEC without a significant increase in the delivered dose to the organs at risk. Clinical investigations are warranted to study the clinical safety and feasibility of applying higher doses through advanced techniques in the neoadjuvant treatment of LAEC.

Light Microscopy Module: International Space Station Premier Automated Microscope

NASA Technical Reports Server (NTRS)

Sicker, Ronald J.; Foster, William M.; Motil, Brian J.; Meyer, William V.; Chiaramonte, Francis P.; Abbott-Hearn, Amber; Atherton, Arthur; Beltram, Alexander; Bodzioney, Christopher; Brinkman, John;

Space architecture monograph series. Volume 4: Genesis 2: Advanced lunar outpost

NASA Technical Reports Server (NTRS)

Fieber, Joseph P.; Huebner-Moths, Janis; Paruleski, Kerry L.; Moore, Gary T. (Editor)

1991-01-01

This research and design study investigated advanced lunar habitats for astronauts and mission specialists on the Earth's moon. Design recommendations are based on environmental response to the lunar environment, human habitability (human factors and environmental behavior research), transportability (structural and materials system with least mass), constructability (minimizing extravehicular time), construction dependability and resilience, and suitability for NASA launch research missions in the 21st century. The recommended design uses lunar lava tubes, with construction being a combination of Space Station Freedom derived hard modules and light weight Kevlar laminate inflatable structures. The proposed habitat includes research labs and a biotron, crew quarters and crew support facility, mission control, health maintenance facility, maintenance work areas for psychological retreat, privacy, and comtemplation. Furniture, specialized equipment, and lighting are included in the analysis and design. Drawings include base master plans, construction sequencing, overall architectural configuration, detailed floor plans, sections and axonometrics, with interior perspectives.

Riding the circuit for IRP

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

Mashaw, R.

In its original usage, the term {open_quotes}circuit rider{close_quotes} described a minister supported by several congregations, who rode from rural church to rural church spreading religion. Today, thanks to a grant from the Department of Energy, there`s a new kind of circuit rider at work in small communities and rural areas, spreading the gospel of integrated resource planning. The concept of the circuit rider was advanced in 1994 by a coalition of associations, private businesses and government agencies, including the American Public Power Association, the National Rural Electric Cooperative Association, the federal power marketing agencies and the National Renewable Energy Laboratory.more » The group proposed to DOE the creation of a program for the advancement of integrated resource planning (IRP) in public power, designed to extend the resources and capabilities of publicly and cooperatively owned utilities in IRP by offering a several types of assistance, including training, direct consultation and publications.« less

Strengthening laboratory systems in resource-limited settings.

PubMed

Olmsted, Stuart S; Moore, Melinda; Meili, Robin C; Duber, Herbert C; Wasserman, Jeffrey; Sama, Preethi; Mundell, Ben; Hilborne, Lee H

2010-09-01

Considerable resources have been invested in recent years to improve laboratory systems in resource-limited settings. We reviewed published reports, interviewed major donor organizations, and conducted case studies of laboratory systems in 3 countries to assess how countries and donors have worked together to improve laboratory services. While infrastructure and the provision of services have seen improvement, important opportunities remain for further advancement. Implementation of national laboratory plans is inconsistent, human resources are limited, and quality laboratory services rarely extend to lower tier laboratories (eg, health clinics, district hospitals). Coordination within, between, and among governments and donor organizations is also frequently problematic. Laboratory standardization and quality control are improving but remain challenging, making accreditation a difficult goal. Host country governments and their external funding partners should coordinate their efforts effectively around a host country's own national laboratory plan to advance sustainable capacity development throughout a country's laboratory system.

Mobile Launch Platform Vehicle Assembly Area (SWMU 056) Biosparge Expansion Interim Measures Work Plan

NASA Technical Reports Server (NTRS)

Burcham, Michael S.; Daprato, Rebecca C.

2016-01-01

This document presents the design details for an Interim Measure (IM) Work Plan (IMWP) for the Mobile Launch Platform/Vehicle Assembly Building (MLPV) Area, located at the John F. Kennedy Space Center (KSC), Florida. The MLPV Area has been designated Solid Waste Management Unit Number 056 (SWMU 056) under KSC's Resource Conservation and Recovery Act (RCRA) Corrective Action Program. This report was prepared by Geosyntec Consultants (Geosyntec) for the National Aeronautics and Space Administration (NASA) under contract number NNK09CA02B and NNK12CA13B, project control number ENV1642. The Advanced Data Package (ADP) presentation covering the elements of this IMWP report received KSC Remediation Team (KSCRT) approval at the December 2015 Team Meeting; the meeting minutes are included in Appendix A.

Simulation modelling for new gas turbine fuel controller creation.

NASA Astrophysics Data System (ADS)

Vendland, L. E.; Pribylov, V. G.; Borisov, Yu A.; Arzamastsev, M. A.; Kosoy, A. A.

2017-11-01

State of the art gas turbine fuel flow control systems are based on throttle principle. Major disadvantage of such systems is that they require high pressure fuel intake. Different approach to fuel flow control is to use regulating compressor. And for this approach because of controller and gas turbine interaction a specific regulating compressor is required. Difficulties emerge as early as the requirement definition stage. To define requirements for new object, his properties must be known. Simulation modelling helps to overcome these difficulties. At the requirement definition stage the most simplified mathematical model is used. Mathematical models will get more complex and detailed as we advance in planned work. If future adjusting of regulating compressor physical model to work with virtual gas turbine and physical control system is planned.

An optimization design for evacuation planning based on fuzzy credibility theory and genetic algorithm

NASA Astrophysics Data System (ADS)

Zhang, D.; Zhang, W. Y.

2017-08-01

Evacuation planning is an important activity in disaster management. It has to be planned in advance due to the unpredictable occurrence of disasters. It is necessary that the evacuation plans are as close as possible to the real evacuation work. However, the evacuation plan is extremely challenging because of the inherent uncertainty of the required information. There is a kind of vehicle routing problem based on the public traffic evacuation. In this paper, the demand for each evacuation set point is a fuzzy number, and each routing selection of the point is based on the fuzzy credibility preference index. This paper proposes an approximate optimal solution for this problem by the genetic algorithm based on the fuzzy reliability theory. Finally, the algorithm is applied to an optimization model, and the experiment result shows that the algorithm is effective.

Advanced Education and Technology Business Plan, 2010-13

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2010

2010-01-01

This paper presents the business plan of the Ministry of Advanced Education and Technology for 2010 to 2013. Advanced Education and Technology supports the advanced learning system by providing funding for advanced learning providers, coordinating and approving programs of study at public institutions, licensing and approving programs at private…

Teaching Advance Care Planning to Medical Students with a Computer-Based Decision Aid

PubMed Central

Levi, Benjamin H.

2013-01-01

Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n=60) outperformed the Standard Group (n=61) in terms of students´ knowledge (p<0.01), confidence in helping patients with advance care planning (p<0.01), knowledge of what matters to patients (p=0.05), and satisfaction with their learning experience (p<0.01). Likewise, patients in the Decision Aid Group were more satisfied with the advance care planning method (p<0.01) and with several aspects of student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients. PMID:20632222

Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities.

PubMed

Street, Maryann; Ottmann, Goetz; Johnstone, Megan-Jane; Considine, Julie; Livingston, Patricia M

2015-09-01

The purpose of this retrospective, cross-sectional study was to determine the prevalence of advance care planning (ACP) among older people presenting to an Emergency Department (ED) from the community or a residential aged care facility. The study sample comprised 300 older people (aged 65+ years) presenting to three Victorian EDs in 2011. A total of 150 patients transferred from residential aged care to ED were randomly selected and then matched to 150 people who lived in the community and attended the ED by age, gender, reason for ED attendance and triage category on arrival. Overall prevalence of ACP was 13.3% (n = 40/300); over one-quarter (26.6%, n = 40/150) of those presenting to the ED from residential aged care had a documented Advance Care Plan, compared to none (0%, n = 0/150) of the people from the community. There were no significant differences in the median ED length of stay, number of investigations and interventions undertaken in ED, time seen by a doctor or rate of hospital admission for those with an Advance Care Plan compared to those without. Those with a comorbidity of cerebrovascular disease or dementia and those assessed with impaired brain function were more likely to have a documented Advance Care Plan on arrival at ED. Length of hospital stay was shorter for those with an Advance Care Plan [median (IQR) = 3 days (2-6) vs. 6 days (2-10), P = 0.027] and readmission lower (0% vs. 13.7%). In conclusion, older people from the community transferred to ED were unlikely to have a documented Advance Care Plan. Those from residential aged care who were cognitively impaired more frequently had an Advance Care Plan. In the ED, decisions of care did not appear to be influenced by the presence or absence of Advance Care Plans, but length of hospital admission was shorter for those with an Advance Care Plan. © 2014 John Wiley & Sons Ltd.

5 CFR 720.304 - Agency plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) AFFIRMATIVE EMPLOYMENT PROGRAMS Disabled Veterans Affirmative Action Program § 720.304 Agency plan. (a) Plan... advancement of disabled veterans. (1) Each agency must review its plan on an annual basis, together with its... advancement of disabled veterans. OPM must be informed when headquarters offices require plans at the field or...

Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia.

PubMed

Ampe, Sophie; Sevenants, Aline; Coppens, Evelien; Spruytte, Nele; Smets, Tinne; Declercq, Anja; van Audenhove, Chantal

2015-05-01

To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia. Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions). This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff. 'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010). The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers. © 2014 John Wiley & Sons Ltd.

Japan's telecommunications - New initiatives in space communications

NASA Astrophysics Data System (ADS)

Iida, T.

1992-04-01

Despite recent advances in optical transmission technology, intensive R&D work in the field of satellite communications is now being undertaken in Japan. It is believed that satellites offer advantages in several important areas, including wide coverage broadcasting, immediacy of service, suitability for the implementation of HDTV, and advantages in disaster communications and other social services. Here, some experimental projects in the field of satellite communications planned in Japan for the 1990s are summarized. In particular, attention is given to broadcast satellite development, intersatellite links, advanced mobile communication concepts, large antenna assembly experiment, small satellite R&D, and Pan-Pacific information network experiment.

Subsonic Ultra Green Aircraft Research Phase II: N+4 Advanced Concept Development

NASA Technical Reports Server (NTRS)

Bradley, Marty K.; Droney, Christopher K.

2012-01-01

This final report documents the work of the Boeing Subsonic Ultra Green Aircraft Research (SUGAR) team on Task 1 of the Phase II effort. The team consisted of Boeing Research and Technology, Boeing Commercial Airplanes, General Electric, and Georgia Tech. Using a quantitative workshop process, the following technologies, appropriate to aircraft operational in the N+4 2040 timeframe, were identified: Liquefied Natural Gas (LNG), Hydrogen, fuel cell hybrids, battery electric hybrids, Low Energy Nuclear (LENR), boundary layer ingestion propulsion (BLI), unducted fans and advanced propellers, and combinations. Technology development plans were developed.

Towards Certification of a Space System Application of Fault Detection and Isolation

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Markosian, Lawrence Z.

2008-01-01

Advanced fault detection, isolation and recovery (FDIR) software is being investigated at NASA as a means to the improve reliability and availability of its space systems. Certification is a critical step in the acceptance of such software. Its attainment hinges on performing the necessary verification and validation to show that the software will fulfill its requirements in the intended setting. Presented herein is our ongoing work to plan for the certification of a pilot application of advanced FDIR software in a NASA setting. We describe the application, and the key challenges and opportunities it offers for certification.

Brief Report: The Role of National Brain and Tissue Banks in Research on Autism and Developmental Disorders.

ERIC Educational Resources Information Center

Zielke, H. Ronald; And Others

1996-01-01

This paper describes the establishment and work of two brain and tissue banks, which collect brain and other tissues from newly deceased individuals with autism and make these tissues available to researchers. Issues in tissue collection are identified, including the importance of advance planning, religious concerns of families, and the need for…

Utah's 1988-93 Vocational-Technical Education Master Plan: A Powerful Resource for Human and Economic Development.

ERIC Educational Resources Information Center

Utah State Board of Higher Education, Salt Lake City.

For Utah residents to remain in the forefront or even stay competitive economically, the state's work force must acquire the knowledge and skills that match or exceed those of their most technically advanced competitors. A powerful engine for economic growth is a high-quality system of vocational-technical education. The majority of Utah public…

Preparing the Next American Manufacturing Workforce

ERIC Educational Resources Information Center

Taraman, Khalil S.

2010-01-01

Manufacturing has a new face--and the future it offers is exciting. But in order to take advantage of what it offers, one needs a plan and he/she has to know how to execute it. In this article, the author discusses how the Society of Manufacturing Engineers (SME) is working to get the message out that the future of advanced manufacturing will…

Numerical Simulation of Ground Coupling of Low Yield Nuclear Detonation

DTIC Science & Technology

2010-06-01

Without nuclear testing, advanced simulation and experimental facilities, such as the National Ignition Facility ( NIF ), are essential to assuring...in planning future experimental work at NIF . 15. NUMBER OF PAGES 93 14. SUBJECT TERMS National Ignition Facility, GEODYN, Ground Coupling...simulation and experimental facilities, such as the National Ignition Facility ( NIF ), are essential to assuring safety, reliability, and effectiveness

77 FR 70693 - Approval and Promulgation of State Implementation Plans; State of New Mexico; Regional Haze Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

... Backstop Sulfur Dioxide Trading Program, for the inventorying of emissions, for smoke management, and open... make an appointment. If possible, please make the appointment at least two working days in advance of... percent worst days in 2018 and no degradation in visibility conditions on the 20 percent best days at all...

Sociological Portrait of Applicants and Students of the Most Popular and Perspective Specialties of Secondary Vocational Education: A Comparative Aspect

ERIC Educational Resources Information Center

Novikova, Svetlana S.; Romanova, Galina M.; Simonyan, Arsen R.; Ukraintseva, Irina I.; Khachaturova, Natalya Yu.

2018-01-01

The relevance of the study is caused by the necessity to form a plan for the development of secondary vocational education that provides training of the most popular and promising specialties and working professions in accordance with international standards and advanced technologies on the basis of the leading professional educational…

Advanced rural transportation systems (ARTS) : rural intelligent transportation systems (ITS) : program plan

DOT National Transportation Integrated Search

1996-08-01

This Program Plan for the Advanced Rural Transportation Systems (ARTS) implements the goals and objectives established in the U.S. Department of Transportations (USDOTs) Strategic Plan for the ARTS. This Program Plan proposes five years (FY 97...

78 FR 37819 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

.... Description: The Advance Planning Document (APD) process, established in the rules at 45 CFR Part 95, Subpart F, is the procedure by which States request and obtain approval for Federal financial participation... Advance Planning Document 34 1.2 120 4,896 Operational Advance Planning Document 20 1 30 600 [[Page 37820...

14 CFR 151.113 - Advance planning proposals: Sponsor eligibility.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Engineering Proposals § 151.113 Advance planning proposals: Sponsor eligibility. The sponsor of an advance planning and engineering proposal must be a public agency, as defined in § 151.37(a), and must be legally... agreement; (c) Provide enough funds to pay all estimated proposal costs not borne by the United States; and...

14 CFR 151.113 - Advance planning proposals: Sponsor eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Engineering Proposals § 151.113 Advance planning proposals: Sponsor eligibility. The sponsor of an advance planning and engineering proposal must be a public agency, as defined in § 151.37(a), and must be legally... agreement; (c) Provide enough funds to pay all estimated proposal costs not borne by the United States; and...

45 CFR 1355.54 - Submittal of advance planning documents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Submittal of advance planning documents. 1355.54 Section 1355.54 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... § 1355.54 Submittal of advance planning documents. The State title IV-E agency must submit an APD for a...

Advance care planning for adolescent patients with life-threatening neurological conditions: a survey of Japanese paediatric neurologists.

PubMed

Yotani, Nobuyuki; Kizawa, Yoshiyuki; Shintaku, Haruo

2017-01-01

To evaluate current attitudes and barriers to advance care planning for adolescent patients with life-threatening conditions among paediatric neurologists. Cross-sectional study. A self-reported questionnaire was administered to assess the practice of advance care planning, advance directives and barriers to advance care planning for adolescent patients with life-threatening conditions. All board-certified paediatric neurologists in Japan were surveyed and those who had experience in taking care of adolescent patients with decision-making capacity were analysed. We compared the results with those of paediatric haematologists reported previously. In total, 186 paediatric neurologists were analysed. If the patient's prognosis was <3 months, only about 30% of paediatric neurologists reported having discussions with patients, such as 'do not attempt resuscitation' orders (28%) and ventilator use (32%), whereas more than 70% did discuss these topics with patients' families. About half of the paediatric neurologists did not discuss advance directives at the end of life with their patients, whereas over 75% did discuss advance directives with patients' families. Compared with paediatric haematologists, paediatric neurologists had more end-of-life discussions with patients, such as where treatment and care will take place, do not attempt resuscitation orders, and the use of a ventilator, if the patient's prognosis was >1 year. About half or less of the paediatric neurologists discussed advance care planning and advance directives with their adolescent patients who had life-threatening conditions, even if the patient's prognosis was <3 months. They tended to discuss advance care planning and advance directives more with families than with patients themselves.

Autonomy, liberalism and advance care planning.

PubMed Central

Ikonomidis, S; Singer, P A

1999-01-01

The justification for advance directives is grounded in the notion that they extend patient autonomy into future states of incompetency through patient participation in decision making about end-of-life care. Four objections challenge the necessity and sufficiency of individual autonomy, perceived to be a defining feature of liberal philosophical theory, as a basis of advance care planning. These objections are that the liberal concept of autonomy (i) implies a misconception of the individual self, (ii) entails the denial of values of social justice, (iii) does not account for justifiable acts of paternalism, and (iv) does not account for the importance of personal relationships in the advance care planning process. The last objection is especially pertinent in light of recent empirical research highlighting the importance of personal relationships in advance care planning. This article examines these four objections to autonomy, and the liberal theoretical framework with which it is associated, in order to re-evaluate the philosophical basis of advance care planning. We argue that liberal autonomy (i) is not a misconceived concept as critics assume, (ii) does not entail the denial of values of social justice, (iii) can account for justifiable acts of paternalism, though it (iv) is not the best account of the value of personal relationships that arise in advance care planning. In conclusion, we suggest that liberalism is a necessary component of a theoretical framework for advance care planning but that it needs to be supplemented with theories that focus explicitly on the significance of personal relationships. PMID:10635509

Does facilitated Advance Care Planning reduce the costs of care near the end of life? Systematic review and ethical considerations

PubMed Central

Klingler, Corinna; in der Schmitten, Jürgen; Marckmann, Georg

2015-01-01

Background: While there is increasing evidence that Advance Care Planning has the potential to strengthen patient autonomy and improve quality of care near the end of life, it remains unclear whether it could also reduce net costs of care. Aim: This study aims to describe the cost implications of Advance Care Planning programmes and discusses ethical conflicts arising in this context. Design: We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources: We systematically searched the databases PubMed, NHS EED, EURONHEED, Cochrane Library and EconLit. We included empirical studies (no limitation to study type) that investigated the cost implications of Advance Care Planning programmes involving professionally facilitated end-of-life discussions. Results and discussion: Seven studies met our inclusion criteria. Four of them used a randomised controlled design, one used a before-after design and two were observational studies. Six studies found reductions in costs of care ranging from USD1041 to USD64,827 per patient, depending on the study period and the cost measurement. One study detected no differences in costs. Studies varied considerably regarding the Advance Care Planning intervention, patient selection and costs measured which may explain some of the variations in findings. Normative appraisal: Looking at the impact of Advance Care Planning on costs raises delicate ethical issues. Given the increasing pressure to reduce expenditures, there may be concerns that cost considerations could unduly influence the sensitive communication process, thus jeopardising patient autonomy. Safeguards are proposed to reduce these risks. Conclusion: The limited data indicate net cost savings may be realised with Advance Care Planning. Methodologically robust trials with clearly defined Advance Care Planning interventions are needed to make the costs and returns of Advance Care Planning transparent. PMID:26294218

Too Soon to Give Up? Re-examining the Value of Advance Directives

PubMed Central

Levi, Benjamin H.; Green, Michael J.

2013-01-01

In the face of mounting criticism against advance directives, we describe how a novel, computer-based decision aid addresses some of these important concerns. This decision aid, Making Your Wishes Known: Planning Your Medical Future, translates an individual’s values and goals into a meaningful advance directive that explicitly reflects their healthcare wishes and outlines a plan for how they wish to be treated. It does this by 1) educating users about advance care planning; 2) helping individuals identify, clarify, and prioritize factors that influence their decision-making about future medical conditions; 3) explaining common end-of-life medical conditions and life-sustaining treatment; 4) helping users articulate a coherent set of wishes with regard to advance care planning—in the form of an advance directive readily interpretable by physicians; and 5) helping individuals both choose a spokesperson, and prepare to engage family, friends, and healthcare providers in discussions about advance care planning. PMID:20379910

Support and Dissemination of Teacher-Authored Lesson Plans: a Digital Library for Earth System Education (DLESE) and Geological Society of America (GSA) Collaboration

NASA Astrophysics Data System (ADS)

Devaul, H.; Pandya, R. E.; McLelland, C. V.

2003-12-01

The Digital Library for Earth System Education (www.dlese.org) and the Geological Society of America (www.geosociety.org) are working together to publish and disseminate teacher-authored Earth science lesson plans. DLESE is a community-based effort involving teachers, students, and scientists working together to create a library of educational resources and services to support Earth system science education. DLESE offers free access to electronic resources including lesson plans, maps, images, data sets, visualizations, and assessment activities. A number of thematic collections have recently been accessioned, which has substantially increased library holdings. Working in concert with GSA, a non-profit organization dedicated to the advancement of the geosciences, small-scale resource creators such as classroom teachers without access to a web server can also share educational resources of their own design. Following a two-step process, lesson plans are submitted to the GSA website, reviewed and posted to the K-12 resource area: http://www.geosociety.org/educate/resources.htm. These resources are also submitted to the DLESE Community Collection using a simple cataloging tool. In this way resources are available to other teachers via the GSA website as well as via the DLESE collection. GSA provides a template for lesson plan developers which assists in providing the necessary information to help users find and understand the intent of the activity when searching in DLESE. This initial effort can serve as a prototype for important services allowing individual community members to contribute their work to DLESE with little technical overhead.

An Initial Strategy for Commercial Industry Awareness of the International Space Station

NASA Technical Reports Server (NTRS)

Jorgensen, Catherine A.

1999-01-01

While plans are being developed to utilize the ISS for scientific research, and human and microgravity experiments, it is time to consider the future of the ISS as a world-wide commercial marketplace developed from a government owned, operated and controlled facility. Commercial industry will be able to seize this opportunity to utilize the ISS as a unique manufacturing platform and engineering testbed for advanced technology. NASA has begun the strategic planning of the evolution and commercialization of the ISS. The Pre-Planned Program Improvement (P3I) Working Group at NASA is assessing the future ISS needs and technology plans to enhance ISS performance. Some of these enhancements will allow the accommodation of commercial applications and the Human Exploration and Development of Space mission support. As this information develops, it is essential to disseminate this information to commercial industry, targeting not only the private and public space sector but also the non-aerospace commercial industries. An approach is presented for early distribution of this information via the ISS Evolution Data book that includes ISS baseline system information, baseline utilization and operations plans, advanced technologies, future utilization opportunities, ISS evolution and Design Reference Missions (DRM). This information source and tool can be used as catalyst in the commercial world for the generation of ideas and options to enhance the current capabilities of the ISS.

Evaluation of the trade-offs encountered in planning and treating locally advanced head and neck cancer: intensity-modulated radiation therapy vs dual-arc volumetric-modulated arc therapy

PubMed Central

Oliver, M; McConnell, D; Romani, M; McAllister, A; Pearce, A; Andronowski, A; Wang, X; Leszczynski, K

2012-01-01

Objective The primary purpose of this study was to assess the practical trade-offs between intensity-modulated radiation therapy (IMRT) and dual-arc volumetric-modulated arc therapy (DA-VMAT) for locally advanced head and neck cancer (HNC). Methods For 15 locally advanced HNC data sets, nine-field step-and-shoot IMRT plans and two full-rotation DA-VMAT treatment plans were created in the Pinnacle3 v. 9.0 (Philips Medical Systems, Fitchburg, WI) treatment planning environment and then delivered on a Clinac iX (Varian Medical Systems, Palo Alto, CA) to a cylindrical detector array. The treatment planning goals were organised into four groups based on their importance: (1) spinal cord, brainstem, optical structures; (2) planning target volumes; (3) parotids, mandible, larynx and brachial plexus; and (4) normal tissues. Results Compared with IMRT, DA-VMAT plans were of equal plan quality (p>0.05 for each group), able to be delivered in a shorter time (3.1 min vs 8.3 min, p<0.0001), delivered fewer monitor units (on average 28% fewer, p<0.0001) and produced similar delivery accuracy (p>0.05 at γ2%/2mm and γ3%/3mm). However, the VMAT plans took more planning time (28.9 min vs 7.7 min per cycle, p<0.0001) and required more data for a three-dimensional dose (20 times more, p<0.0001). Conclusions Nine-field step-and-shoot IMRT and DA-VMAT are both capable of meeting the majority of planning goals for locally advanced HNC. The main trade-offs between the techniques are shorter treatment time for DA-VMAT but longer planning time and the additional resources required for implementation of a new technology. Based on this study, our clinic has incorporated DA-VMAT for locally advanced HNC. Advances in knowledge DA-VMAT is a suitable alternative to IMRT for locally advanced HNC. PMID:22806619

Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among Persons with Severe Mental Illness

PubMed Central

Swanson, Jeffrey W.; Swartz, Marvin S.; Elbogen, Eric B.; Van Dorn, Richard A.; Ferron, Joelle; Wagner, H. Ryan; McCauley, Barbara J.; Kim, Mimi

2013-01-01

Objective Studies show a high potential demand for psychiatric advance directives but low completion rates. The authors conducted a randomized study of a structured, manualized intervention to facilitate completion of psychiatric advance directives. Method A total of 469 patients with severe mental illness were randomly assigned to a facilitated psychiatric advance directive session or a control group that received written information about psychiatric advance directives and referral to resources in the public mental health system. Completion of an advance directive, its structure and content, and its short-term effects on working alliance and treatment satisfaction were recorded. Results Sixty-one percent of participants in the facilitated session completed an advance directive or authorized a proxy decision maker, compared with only 3% of control group participants. Psychiatrists rated the advance directives as highly consistent with standards of community practice. Most participants used the advance directive to refuse some medications and to express preferences for admission to specific hospitals and not others, although none used an advance directive to refuse all treatment. At 1-month follow-up, participants in the facilitated session had a greater working alliance with their clinicians and were more likely than those in the control group to report receiving the mental health services they believed they needed. Conclusions The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients’ treatment preferences. Achieving the promise of psychiatric advance directives may require system-level policies to embed facilitation of these instruments in usual-care care settings. PMID:17074946

Advanced planetary analyses. [for planetary mission planning

NASA Technical Reports Server (NTRS)

1974-01-01

The results are summarized of research accomplished during this period concerning planetary mission planning are summarized. The tasks reported include the cost estimations research, planetary missions handbook, and advanced planning activities.

Using advanced mobile devices in nursing practice--the views of nurses and nursing students.

PubMed

Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla

2014-09-01

Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research. © The Author(s) 2013.

Challenges in implementing an advance care planning programme in long-term care.

PubMed

McGlade, Ciara; Daly, Edel; McCarthy, Joan; Cornally, Nicola; Weathers, Elizabeth; O'Caoimh, Rónán; Molloy, D William

2017-02-01

A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. Research aim: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families. Participants and research context: long-term-care residents in two nursing homes and one community hospital. Ethical considerations: The local research ethics committee granted ethical approval. Following implementation, over 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training. The challenges encountered were largely concerned with preserving resident's autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources. Although it may be too late for many long-term-care residents to complete their own advance care directive, the ' Let Me Decide' programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice.

National Research Council Dialogue to Assess Progress on NASA's Transformational Spaceport and Range Technologies Capability Roadmap Development: General Background and Introduction

NASA Technical Reports Server (NTRS)

Skelly, Darin M.

2005-01-01

Viewgraphs on the National Research Council's diaglog to assess progress on NASA's transformational spaceport and range technologies capability roadmap development is presented. The topics include: 1) Agency Goals and Objectives; 2) Strategic Planning Transformation; 3) Advanced Planning Organizational Roles; 4) Public Involvement in Strategic Planning; 5) Strategic Roadmaps; 6) Strategic Roadmaps Schedule; 7) Capability Roadmaps; 8) Capability Charter; 9) Process for Team Selection; 10) Capability Roadmap Development Schedule Overview; 11) Purpose of NRC Review; 12) Technology Readiness Levels; 13) Capability Readiness Levels; 14) Crosswalk Matrix Trans Spaceport & Range; 15) Example linkage to other roadmaps; 16) Capability Readiness Levels Defined; and 17) Crosswalk Matrix Ratings Work In-progress.

NASA's Radioisotope Power Systems - Plans

NASA Technical Reports Server (NTRS)

Hamley, John A.; Mccallum, Peter W.; Sandifer, Carl E., II; Sutliff, Thomas J.; Zakrajsek, June F.

2015-01-01

NASA's Radioisotope Power Systems (RPS) Program continues to plan and implement content to enable planetary exploration where such systems could be needed, and to prepare more advanced RPS technology for possible infusion into future power systems. The 2014-2015 period saw significant changes, and strong progress. Achievements of near-term objectives have enabled definition of a clear path forward in which payoffs from research investments and other sustaining efforts can be applied. The future implementation path is expected to yield a higher-performing thermoelectric generator design, a more isotope-fuel efficient system concept design, and a robust RPS infrastructure maintained effectively within both NASA and the Department of Energy. This paper describes recent work with an eye towards the future plans that result from these achievements.

Informed, advance refusals of treatment by people with severe mental illness in a randomised controlled trial of joint crisis plans: demand, content and correlates.

PubMed

Henderson, Claire; Farrelly, Simone; Flach, Clare; Borschmann, Rohan; Birchwood, Max; Thornicroft, Graham; Waheed, Waquas; Szmukler, George

2017-11-24

In the UK, crisis planning for mental health care should acknowledge the right to make an informed advance treatment refusal under the Mental Capacity Act 2005. Our aims were to estimate the demand for such treatment refusals within a sample of service users who had had a recent hospital admission for psychosis or bipolar disorder, and to examine the relationship between refusals, and service user characteristics. To identify refusals we conducted content analysis of Joint Crisis Plans, which are plans formulated by service users and their clinical team with involvement from an external facilitator, and routine care plans in sub-samples from a multi-centre randomised controlled trial of Joint Crisis Plans (plus routine mental health care) versus routine care alone (CRIMSON) in England. Factors hypothesised to be associated with refusals were identified using the trial data collected through baseline interviews of service users and clinicians and collection of routine clinical data. Ninety-nine of 221 (45%) of the Joint Crisis Plans contained a treatment refusal compared to 10 of 424 (2.4%) baseline routine care plans. No Joint Crisis Plans recorded disagreement with refusals on the part of clinicians. Among those with completed Joint Crisis Plans, adjusted analyses indicated a significant association between treatment refusals and perceived coercion at baseline (odds ratio = 1.21, 95% CI 1.02-1.43), but not with baseline working alliance or a past history of involuntary admission. We demonstrated significant demand for written treatment refusals in line with the Mental Capacity Act 2005, which had not previously been elicited by the process of treatment planning. Future treatment/crisis plans should incorporate the opportunity for service users to record a treatment refusal during the drafting of such plans. ISRCTN11501328 Registered 13th March 2008.

Galileo mission planning for Low Gain Antenna based operations

NASA Technical Reports Server (NTRS)

Gershman, R.; Buxbaum, K. L.; Ludwinski, J. M.; Paczkowski, B. G.

1994-01-01

The Galileo mission operations concept is undergoing substantial redesign, necessitated by the deployment failure of the High Gain Antenna, while the spacecraft is on its way to Jupiter. The new design applies state-of-the-art technology and processes to increase the telemetry rate available through the Low Gain Antenna and to increase the information density of the telemetry. This paper describes the mission planning process being developed as part of this redesign. Principal topics include a brief description of the new mission concept and anticipated science return (these have been covered more extensively in earlier papers), identification of key drivers on the mission planning process, a description of the process and its implementation schedule, a discussion of the application of automated mission planning tool to the process, and a status report on mission planning work to date. Galileo enhancements include extensive reprogramming of on-board computers and substantial hard ware and software upgrades for the Deep Space Network (DSN). The principal mode of operation will be onboard recording of science data followed by extended playback periods. A variety of techniques will be used to compress and edit the data both before recording and during playback. A highly-compressed real-time science data stream will also be important. The telemetry rate will be increased using advanced coding techniques and advanced receivers. Galileo mission planning for orbital operations now involves partitioning of several scarce resources. Particularly difficult are division of the telemetry among the many users (eleven instruments, radio science, engineering monitoring, and navigation) and allocation of space on the tape recorder at each of the ten satellite encounters. The planning process is complicated by uncertainty in forecast performance of the DSN modifications and the non-deterministic nature of the new data compression schemes. Key mission planning steps include quantifying resource or capabilities to be allocated, prioritizing science observations and estimating resource needs for each, working inter-and intra-orbit trades of these resources among the Project elements, and planning real-time science activity. The first major mission planning activity, a high level, orbit-by-orbit allocation of resources among science objectives, has already been completed; and results are illustrated in the paper. To make efficient use of limited resources, Galileo mission planning will rely on automated mission planning tools capable of dealing with interactions among time-varying downlink capability, real-time science and engineering data transmission, and playback of recorded data. A new generic mission planning tool is being adapted for this purpose.

Galileo mission planning for Low Gain Antenna based operations

NASA Astrophysics Data System (ADS)

Gershman, R.; Buxbaum, K. L.; Ludwinski, J. M.; Paczkowski, B. G.

1994-11-01

The Galileo mission operations concept is undergoing substantial redesign, necessitated by the deployment failure of the High Gain Antenna, while the spacecraft is on its way to Jupiter. The new design applies state-of-the-art technology and processes to increase the telemetry rate available through the Low Gain Antenna and to increase the information density of the telemetry. This paper describes the mission planning process being developed as part of this redesign. Principal topics include a brief description of the new mission concept and anticipated science return (these have been covered more extensively in earlier papers), identification of key drivers on the mission planning process, a description of the process and its implementation schedule, a discussion of the application of automated mission planning tool to the process, and a status report on mission planning work to date. Galileo enhancements include extensive reprogramming of on-board computers and substantial hard ware and software upgrades for the Deep Space Network (DSN). The principal mode of operation will be onboard recording of science data followed by extended playback periods. A variety of techniques will be used to compress and edit the data both before recording and during playback. A highly-compressed real-time science data stream will also be important. The telemetry rate will be increased using advanced coding techniques and advanced receivers. Galileo mission planning for orbital operations now involves partitioning of several scarce resources. Particularly difficult are division of the telemetry among the many users (eleven instruments, radio science, engineering monitoring, and navigation) and allocation of space on the tape recorder at each of the ten satellite encounters. The planning process is complicated by uncertainty in forecast performance of the DSN modifications and the non-deterministic nature of the new data compression schemes. Key mission planning steps include quantifying resource or capabilities to be allocated, prioritizing science observations and estimating resource needs for each, working inter-and intra-orbit trades of these resources among the Project elements, and planning real-time science activity. The first major mission planning activity, a high level, orbit-by-orbit allocation of resources among science objectives, has already been completed; and results are illustrated in the paper. To make efficient use of limited resources, Galileo mission planning will rely on automated mission planning tools capable of dealing with interactions among time-varying downlink capability, real-time science and engineering data transmission, and playback of recorded data. A new generic mission planning tool is being adapted for this purpose.

Realization of planning design of mechanical manufacturing system by Petri net simulation model

NASA Astrophysics Data System (ADS)

Wu, Yanfang; Wan, Xin; Shi, Weixiang

1991-09-01

Planning design is to work out a more overall long-term plan. In order to guarantee a mechanical manufacturing system (MMS) designed to obtain maximum economical benefit, it is necessary to carry out a reasonable planning design for the system. First, some principles on planning design for MMS are introduced. Problems of production scheduling and their decision rules for computer simulation are presented. Realizable method of each production scheduling decision rule in Petri net model is discussed. Second, the solution of conflict rules for conflict problems during running Petri net is given. Third, based on the Petri net model of MMS which includes part flow and tool flow, according to the principle of minimum event time advance, a computer dynamic simulation of the Petri net model, that is, a computer dynamic simulation of MMS, is realized. Finally, the simulation program is applied to a simulation exmple, so the scheme of a planning design for MMS can be evaluated effectively.

Health System Advance Care Planning Culture Change for High-Risk Patients: The Promise and Challenges of Engaging Providers, Patients, and Families in Systematic Advance Care Planning.

PubMed

Reidy, Jennifer; Halvorson, Jennifer; Makowski, Suzana; Katz, Delila; Weinstein, Barbara; McCluskey, Christine; Doering, Alex; DeCarli, Kathryn; Tjia, Jennifer

2017-04-01

The success of a facilitator-based model for advance care planning (ACP) in LaCrosse, Wisconsin, has inspired health systems to aim for widespread documentation of advance directives, but limited resources impair efforts to replicate this model. One promising strategy is the development of interactive, Internet-based tools that might increase access to individualized ACP at minimal cost. However, widespread adoption and implementation of Internet-based ACP efforts has yet to be described. We describe our early experiences in building a systematic, population-based ACP initiative focused on health system-wide deployment of an Internet-based tool as an adjunct to a facilitator-based model. With the sponsorship of our healthcare system's population health leadership, we engaged a diverse group of clinical stakeholders as champions to design an Internet-based ACP tool and facilitate local practice change. We describe how we simultaneously began to train clinicians in ACP conversations, engage patients and health system employees in thinking about ACP, redesign clinic workflows to accommodate ACP discussions, and integrate the Internet-based tool into the electronic medical record (EMR). Over 18 months, our project engaged two subspecialty clinics in a systematic ACP process and began work with a large primary care practice with a large Medicare Accountable Care Organization at-risk population. Overall, 807 people registered at the Internet site and 85% completed ACPs. We learned that changing culture and systems to promote ACP requires a comprehensive vision with simultaneous, interconnected strategies targeting patient education, clinician training, EMR documentation, and community awareness.

Effectiveness of advance care planning with family carers in dementia nursing homes: A paired cluster randomized controlled trial.

PubMed

Brazil, Kevin; Carter, Gillian; Cardwell, Chris; Clarke, Mike; Hudson, Peter; Froggatt, Katherine; McLaughlin, Dorry; Passmore, Peter; Kernohan, W George

2018-03-01

In dementia care, a large number of treatment decisions are made by family carers on behalf of their family member who lacks decisional capacity; advance care planning can support such carers in the decision-making of care goals. However, given the relative importance of advance care planning in dementia care, the prevalence of advance care planning in dementia care is poor. To evaluate the effectiveness of advance care planning with family carers in dementia care homes. Paired cluster randomized controlled trial. The intervention comprised a trained facilitator, family education, family meetings, documentation of advance care planning decisions and intervention orientation for general practitioners and nursing home staff. A total of 24 nursing homes with a dementia nursing category located in Northern Ireland, United Kingdom. Family carers of nursing home residents classified as having dementia and judged as not having decisional capacity to participate in advance care planning discussions. The primary outcome was family carer uncertainty in decision-making about the care of the resident (Decisional Conflict Scale). There was evidence of a reduction in total Decisional Conflict Scale score in the intervention group compared with the usual care group (-10.5, 95% confidence interval: -16.4 to -4.7; p < 0.001). Advance care planning was effective in reducing family carer uncertainty in decision-making concerning the care of their family member and improving perceptions of quality of care in nursing homes. Given the global significance of dementia, the implications for clinicians and policy makers include them recognizing the importance of family carer education and improving communication between family carers and formal care providers.

The economic evidence for advance care planning: Systematic review of evidence.

PubMed

Dixon, Josie; Matosevic, Tihana; Knapp, Martin

2015-12-01

Advance care planning is a process of discussion and review concerning future care in the event of losing capacity. Aimed at improving the appropriateness and quality of care, it is also often considered a means of making better use of healthcare resources at the end of life. To review and summarise economic evidence on advance care planning. A systematic review of the academic literature. We searched for English language, peer-reviewed journal articles, 1990-2014, using relevant research databases: PubMed, ProQuest, CINAHL Plus with Full Text; EconLit, PsycINFO, SocINDEX with Full Text and International Bibliography of the Social Sciences. Empirical studies using statistical methods in which advance care planning and costs are variables were included. There are no published cost-effectiveness studies. Included studies focus on healthcare savings, usually associated with reduced demand for hospital care. Advance care planning appears to be associated with healthcare savings for some people in some circumstances, such as people living with dementia in the community, people in nursing homes or in areas with high end-of-life care spending. There is no evidence that advance care planning is likely to be more expensive. There is need for clearer articulation of the likely mechanisms by which advance care planning can lead to reduced care costs or improved cost-effectiveness, particularly for people who retain capacity. There is also a need to consider wider costs, including the costs of advance care planning facilitation or interventions and the costs of substitute health, social and informal care. Economic outcomes need to be considered in the context of quality benefits. © The Author(s) 2015.

Advance Care Planning in palliative care: a qualitative investigation into the perspective of Paediatric Intensive Care Unit staff.

PubMed

Mitchell, Sarah; Dale, Jeremy

2015-04-01

The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. To explore the experiences of senior medical and nursing staff regarding the challenges associated with Advance Care Planning in relation to children and young people with life-limiting illnesses in the Paediatric Intensive Care Unit environment and opportunities for improvement. Qualitative one-to-one, semi-structured interviews were conducted with Paediatric Intensive Care Unit consultants and senior nurses, to gain rich, contextual data. Thematic content analysis was carried out. UK tertiary referral centre Paediatric Intensive Care Unit. Eight Paediatric Intensive Care Unit consultants and six senior nurses participated. Four main themes emerged: recognition of an illness as 'life-limiting'; Advance Care Planning as a multi-disciplinary, structured process; the value of Advance Care Planning and adverse consequences of inadequate Advance Care Planning. Potential benefits of Advance Care Planning include providing the opportunity to make decisions regarding end-of-life care in a timely fashion and in partnership with patients, where possible, and their families. Barriers to the process include the recognition of the life-limiting nature of an illness and gaining consensus of medical opinion. Organisational improvements towards earlier recognition of life-limiting illness and subsequent Advance Care Planning were recommended, including education and training, as well as the need for wider societal debate. Advance Care Planning for children and young people with life-limiting conditions has the potential to improve care for patients and their families, providing the opportunity to make decisions based on clear information at an appropriate time, and avoid potentially harmful intensive clinical interventions at the end of life. © The Author(s) 2015.

Individualised advance care planning in children with life-limiting conditions.

PubMed

Loeffen, Erik A H; Tissing, Wim J E; Schuiling-Otten, Meggi A; de Kruiff, Chris C; Kremer, Leontien C M; Verhagen, A A Eduard

2018-05-01

In 2013, the Pediatric Association of the Netherlands launched an evidence-based guideline 'Palliative care for children'. To promote implementation in daily practice and hereby improve quality of paediatric palliative care, we aimed to develop a functional individualised paediatric palliative care plan (IPPCP) that covers physical, psychological, spiritual and social functioning, with great emphasis on the guideline's recommendations, advance care planning and patients' and parents' preferences and desires. A Dutch working group (28 individuals) with a strong multidisciplinary character developed a draft IPPCP, which was piloted retrospectively and prospectively. In the pilots we completed, the IPPCPs for patients who were recently diagnosed with a life-threatening or life-limiting condition and evaluated completeness, usability and user-friendliness. The final IPPCP comprised five domains: (1) IPPCP data, (2) basics, (3) social, (4) psychosocial and spiritual and (5) physical care. Each domain covered various components. In both pilots, the IPPCP was considered a comprehensive document that covered all areas of paediatric palliative care and was experienced as an improvement to the present situation. However, the current form was regarded to lack user-friendliness. We propose a set of essential components of a comprehensive IPPCP for paediatric palliative care with extra attention for advance care planning and anticipatory action. Patients' and parents' preferences and desires are included next to the recommendations of the evidence-based guideline 'Palliative care for children'. © 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.

Advanced space program studies. Overall executive summary

NASA Technical Reports Server (NTRS)

Wolfe, M. G.

1977-01-01

NASA and DoD requirements and planning data were used in multidiscipline advanced planning investigations of space operations and associated elements (including man), identification of potential low cost approaches, vehicle design, cost synthesis techniques, technology forecasting and opportunities for DoD technology transfer, and the development near-, mid-, and far-term space initiatives and development plans with emphasis on domestic and military commonality. An overview of objectives and results are presented for the following studies: advanced space planning and conceptual analysis, shuttle users, technology assessment and new opportunities, standardization and program practice, integrated STS operations planning, solid spinning upper stage, and integrated planning support functions.

Multi-Element Integrated Project Planning at Kennedy Space Center

NASA Technical Reports Server (NTRS)

Mullon, Robert

2008-01-01

This presentation demonstrates how the ASRC Scheduling team developed working practices to support multiple NASA and ASRC Project Managers using the enterprise capabilities of Primavera P6 and P6 Web Access. This work has proceeded as part of Kennedy Ground Systems' preparation for its transition from the Shuttle Program to the Constellation Program. The presenters will cover Primavera's enterprise-class capabilities for schedule development, integrated critical path analysis, and reporting, as well as advanced Primavera P6 Web Access tools and techniques for communicating project status.

Development and evaluation of an aged care specific Advance Care Plan.

PubMed

Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie

2013-06-01

To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.

Stress Corrosion Testing

NASA Technical Reports Server (NTRS)

1985-01-01

Advanced testing of structural materials was developed by Lewis Research Center and Langley Research Center working with the American Society for Testing and Materials (ASTM). Under contract, Aluminum Company of America (Alcoa) conducted a study for evaluating stress corrosion cracking, and recommended the "breaking load" method which determines fracture strengths as well as measuring environmental degradation. Alcoa and Langley plan to submit the procedure to ASTM as a new testing method.

77 FR 4937 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Determination of Failure to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

.../region6/r6coment.htm . Please click on ``6PD'' (Multimedia) and select ``Air'' before submitting comments... at least two working days in advance of your visit. There will be a 15 cent per page fee for making... ozone standard of 0.12 parts per million (ppm) (44 FR 8202, February 8, 1979).\\1\\ \\1\\ For ease of...

Master plan nurse duty roster using the 0-1 goal programming technique

NASA Astrophysics Data System (ADS)

Ismail, Wan Rosmanira; Jenal, Ruzzakiah

2013-04-01

The scheduling of nurses is particularly challenging because of the nature of the work which is around the clock. In addition, inefficient duty roster can have an effect on the nurses well being as well as their job satisfaction. In nurse scheduling problem (NSP), nurses are generally allocated to periods of work over a specified time horizon. A typical length of the schedule varies from a few weeks to a month. The schedule will be consistently rebuilt after the specified time period and will result in a time-consuming task for the administrative staff involved. Moreover, the task becomes overwhelming when the staff needs to consider the previous duty rosters in order to maintain the quality of schedules. Therefore, this study suggests the development of a master plan for a nurse duty roster for approximately one year. The master plan starts with the development of a blue print for the nurse duty roster using a 0-1 goal programming technique. The appropriate working period for this blue print is formulated based on the number of night shifts and the number of required nurses for night shift per schedule. Subsequently, the blue print is repeated to complete the annual nurse duty roster. These newly developed procedures were then tested on several data sets. The test results found that the master plan has successfully distributed the annual workload evenly among nurses. In addition, the master plan allows nurses to arrange their career and social activities in advance.

42 CFR 495.326 - Disallowance of FFP.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., requirements, and other undertakings described in the approved HIT planning advance planning document and HIT implementation advance planning document to the detriment of the proper and efficient operation of the Medicaid program, payment of FFP may be disallowed. In the case of a suspension of approval of a HIT planning...

77 FR 66783 - National Oil and Hazardous Substances Pollution Contingency Plan; Revision To Increase Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-07

...-AG73] National Oil and Hazardous Substances Pollution Contingency Plan; Revision To Increase Public... Contingency Plan, to acknowledge advancements in technologies used to manage and convey information to the... Substances Pollution Contingency Plan (NCP), to acknowledge advancements in technologies used to manage and...

Development and Validation of a Questionnaire to Detect Behavior Change in Multiple Advance Care Planning Behaviors

PubMed Central

Sudore, Rebecca L.; Stewart, Anita L.; Knight, Sara J.; McMahan, Ryan D.; Feuz, Mariko; Miao, Yinghui; Barnes, Deborah E.

2013-01-01

Introduction Advance directives have traditionally been considered the gold standard for advance care planning. However, recent evidence suggests that advance care planning involves a series of multiple discrete behaviors for which people are in varying stages of behavior change. The goal of our study was to develop and validate a survey to measure the full advance care planning process. Methods The Advance Care Planning Engagement Survey assesses “Process Measures” of factors known from Behavior Change Theory to affect behavior (knowledge, contemplation, self-efficacy, and readiness, using 5-point Likert scales) and “Action Measures” (yes/no) of multiple behaviors related to surrogate decision makers, values and quality of life, flexibility for surrogate decision making, and informed decision making. We administered surveys at baseline and 1 week later to 50 diverse, older adults from San Francisco hospitals. Internal consistency reliability of Process Measures was assessed using Cronbach's alpha (only continuous variables) and test-retest reliability of Process and Action Measures was examined using intraclass correlations. For discriminant validity, we compared Process and Action Measure scores between this cohort and 20 healthy college students (mean age 23.2 years, SD 2.7). Results Mean age was 69.3 (SD 10.5) and 42% were non-White. The survey took a mean of 21.4 minutes (±6.2) to administer. The survey had good internal consistency (Process Measures Cronbach's alpha, 0.94) and test-retest reliability (Process Measures intraclass correlation, 0.70; Action Measures, 0.87). Both Process and Action Measure scores were higher in the older than younger group, p<.001. Conclusion A new Advance Care Planning Engagement Survey that measures behavior change (knowledge, contemplation, self-efficacy, and readiness) and multiple advance care planning actions demonstrates good reliability and validity. Further research is needed to assess whether survey scores improve in response to advance care planning interventions and whether scores are associated with receipt of care consistent with one's wishes. PMID:24039772

Legal Briefing: Medicare Coverage of Advance Care Planning.

PubMed

Pope, Thaddeus Mason

2015-01-01

This issue's "Legal Briefing" column covers the recent decision by the Centers for Medicare and Medicaid Services (CMS) to expand Medicare coverage of advance care planning, beginning 1 January 2016. Since 2009, most "Legal Briefings" in this journal have covered a wide gamut of judicial, legislative, and regulatory developments concerning a particular topic in clinical ethics. In contrast, this "Legal Briefing" is more narrowly focused on one single legal development. This concentration on Medicare coverage of advance care planning seems warranted. Advance care planning is a frequent subject of articles in JCE. After all, it has long been seen as an important, albeit only partial, solution to a significant range of big problems in clinical ethics. These problems range from medical futility disputes to decision making for incapacitated patients who have no available legally authorized surrogate. Consequently, expanded Medicare coverage of advance care planning is a potentially seismic development. It may materially reduce both the frequency and severity of key problems in clinical ethics. Since the sociological, medical, and ethical literature on advance care planning is voluminous, I will not even summarize it here. Instead, I focus on Medicare coverage. I proceed, chronologically, in six stages: 1. Prior Medicare Coverage of Advance Care Planning 2. Proposed Expanded Medicare Coverage in 2015 3. Proposed Expanded Medicare Coverage in 2016 4. The Final Rule Expanding Medicare Coverage in 2016 5. Remaining Issues for CMS to Address in 2017 6. Pending Federal Legislation. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

Advanced rural transportation systems (ARTS) : strategic plan

DOT National Transportation Integrated Search

1997-08-01

This Strategic Plan has been developed for the Advanced Rural Transportation Systems (ARTS) portion of the ITS Program. The plan focuses on the Federal Government's role in developing rural ITS options and prudently managing emerging ITS technologies...

DE-FOA-EE0005502 Advanced Percussive Drilling Technology for Geothermal Exploration and Development Phase II Report.

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

Su, Jiann-Cherng; Raymond, David W.; Prasad, Somuri V.

Percussive hammers are a promising advance in drilling technology for geothermal since they rely upon rock reduction mechanisms that are well-suited for use in the hard, brittle rock characteristic of geothermal formations. The project research approach and work plan includes a critical path to development of a high-temperature (HT) percussive hammer using a two- phase approach. The work completed in Phase I of the project demonstrated the viability of percussive hammers and that solutions to technical challenges in design, material technology, and performance are likely to be resolved. Work completed in Phase II focused on testing the findings from Phasemore » I and evaluating performance of the materials and designs at high- operating temperatures. A high-operating temperature (HOT) drilling facility was designed, built, and used to test the performance of the DTH under extreme conditions. Results from the testing indicate that a high-temperature capable hammer can be developed and is a viable alternative for user in the driller's toolbox.« less

Advanced Percussive Drilling Technology for Geothermal Exploration and Development

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

Su, Jiann; Raymond, David; Prasad, Somuri

Percussive hammers are a promising advance in drilling technology for geothermal since they rely upon rock reduction mechanisms that are well-suited for use in the hard, brittle rock characteristic of geothermal formations. The project research approach and work plan includes a critical path to development of a high-temperature (HT) percussive hammer using a two phase approach. The work completed in Phase I of the project demonstrated the viability of percussive hammers and that solutions to technical challenges in design, material technology, and performance are likely to be resolved. Work completed in Phase II focused on testing the findings from Phasemore » I and evaluating performance of the materials and designs at high operating temperatures. A high-operating temperature (HOT) drilling facility was designed, built, and used to test the performance of the DTH under extreme conditions. Results from the testing indicate that a high-temperature capable hammer can be developed and is a viable alternative for use in the driller’s toolbox.« less

Ultrasonic Characterization of Aerospace Composites

NASA Technical Reports Server (NTRS)

Leckey, Cara; Johnston, Patrick; Haldren, Harold; Perey, Daniel

2015-01-01

Composite materials have seen an increased use in aerospace in recent years and it is expected that this trend will continue due to the benefits of reduced weight, increased strength, and other factors. Ongoing work at NASA involves the investigation of the large-scale use of composites for spacecraft structures (SLS components, Orion Composite Crew Module, etc). NASA is also involved in work to enable the use of composites in advanced aircraft structures through the Advanced Composites Project (ACP). In both areas (space and aeronautics) there is a need for new nondestructive evaluation and materials characterization techniques that are appropriate for characterizing composite materials. This paper will present an overview of NASA's needs for characterizing aerospace composites, including a description of planned and ongoing work under ACP for the detection of composite defects such as fiber waviness, reduced bond strength, delamination damage, and microcracking. The research approaches include investigation of angle array, guided wave, and phase sensitive ultrasonic methods. The use of ultrasonic simulation tools for optimizing and developing methods will also be discussed.

Autonomous search and surveillance with small fixed wing aircraft

NASA Astrophysics Data System (ADS)

McGee, Timothy Garland

Small unmanned aerial vehicles (UAVs) have the potential to act as low cost tools in a variety of both civilian and military applications including traffic monitoring, border patrol, and search and rescue. While most current operational UAV systems require human operators, advances in autonomy will allow these systems to reach their full potential as sensor platforms. This dissertation specifically focuses on developing advanced control, path planning, search, and image processing techniques that allow small fixed wing aircraft to autonomously collect data. The problems explored were motivated by experience with the development and experimental flight testing of a fleet of small autonomous fixed wing aircraft. These issues, which have not been fully addressed in past work done on ground vehicles or autonomous helicopters, include the influence of wind and turning rate constraints, the non-negligible velocity of ground targets relative to the aircraft velocity, and limitations on sensor size and processing power on small vehicles. Several contributions for the autonomous operation of small fixed wing aircraft are presented. Several sliding surface controllers are designed which extend previous techniques to include variable sliding surface coefficients and the use of spatial vehicle dynamics. These advances eliminate potential singularities in the control laws to follow spatially defined paths and allow smooth transition between controllers. The optimal solution for the problem of path planning through an ordered set of points for an aircraft with a bounded turning rate in the presence of a constant wind is then discussed. Path planning strategies are also explored to guarantee that a searcher will travel within sensing distance of a mobile ground target. This work assumes only a maximum velocity of the target and is designed to succeed for any possible path of the target. Closed-loop approximations of both the path planning and search techniques, using the sliding surface controllers already discussed, are also studied. Finally, a novel method is presented to detect obstacles by segmenting an image into sky and non-sky regions. The feasibility of this method is demonstrated experimentally on an aircraft test bed.

The ADVANCE network: accelerating data value across a national community health center network

PubMed Central

DeVoe, Jennifer E; Gold, Rachel; Cottrell, Erika; Bauer, Vance; Brickman, Andrew; Puro, Jon; Nelson, Christine; Mayer, Kenneth H; Sears, Abigail; Burdick, Tim; Merrell, Jonathan; Matthews, Paul; Fields, Scott

2014-01-01

The ADVANCE (Accelerating Data Value Across a National Community Health Center Network) clinical data research network (CDRN) is led by the OCHIN Community Health Information Network in partnership with Health Choice Network and Fenway Health. The ADVANCE CDRN will ‘horizontally’ integrate outpatient electronic health record data for over one million federally qualified health center patients, and ‘vertically’ integrate hospital, health plan, and community data for these patients, often under-represented in research studies. Patient investigators, community investigators, and academic investigators with diverse expertise will work together to meet project goals related to data integration, patient engagement and recruitment, and the development of streamlined regulatory policies. By enhancing the data and research infrastructure of participating organizations, the ADVANCE CDRN will serve as a ‘community laboratory’ for including disadvantaged and vulnerable patients in patient-centered outcomes research that is aligned with the priorities of patients, clinics, and communities in our network. PMID:24821740

The Second Physical Therapy Summit on Global Health: developing an action plan to promote health in daily practice and reduce the burden of non-communicable diseases.

PubMed

Dean, Elizabeth; de Andrade, Armele Dornelas; O'Donoghue, Grainne; Skinner, Margot; Umereh, Gloria; Beenen, Paul; Cleaver, Shaun; Afzalzada, DelAfroze; Delaune, Mary Fran; Footer, Cheryl; Gannotti, Mary; Gappmaier, Ed; Figl-Hertlein, Astrid; Henderson, Bobbie; Hudson, Megan K; Spiteri, Karl; King, Judy; Klug, Jerry L; Laakso, E-Liisa; LaPier, Tanya; Lomi, Constantina; Maart, Soraya; Matereke, Noel; Meyer, Erna Rosenlund; M'kumbuzi, Vyvienne R P; Mostert-Wentzel, Karien; Myezwa, Hellen; Olsén, Monika Fagevik; Peterson, Cathy; Pétursdóttir, Unnur; Robinson, Jan; Sangroula, Kanchan; Stensdotter, Ann-Katrin; Tan, Bee Yee; Tschoepe, Barbara A; Bruno, Selma; Mathur, Sunita; Wong, Wai Pong

2014-05-01

Based on indicators that emerged from The First Physical Therapy Summit on Global Health (2007), the Second Summit (2011) identified themes to inform a global physical therapy action plan to integrate health promotion into practice across the World Confederation for Physical Therapy (WCPT) regions. Working questions were: (1) how well is health promotion implemented within physical therapy practice; and (2) how might this be improved across five target audiences (i.e. physical therapist practitioners, educators, researchers, professional body representatives, and government liaisons/consultants). In structured facilitated sessions, Summit representatives (n = 32) discussed: (1) within WCPT regions, what is working and the challenges; and (2) across WCPT regions, what are potential directions using World Café(TM) methodology. Commonalities outweighed differences with respect to strategies to advance health-focused physical therapy as a clinical competency across regions and within target audiences. Participants agreed that health-focused practice is a professional priority, and a strategic action plan was needed to develop it as a clinical competency. The action plan and recommendations largely paralleled the principles and objectives of the World Health Organization's non-communicable diseases action plan. A third Summit planned for 2015 will provide a mechanism for follow-up to evaluate progress in integrating health-focused physical therapy within the profession.

Managing Jordanian nurse migration to the Gulf Cooperation Council states.

PubMed

Al-Nawafleh, A H

2015-05-19

The migration of nurses from Jordan to the Gulf Cooperation Council (GCC) states has occurred for decades, although substantial increases have been noted since the 1990s. This study aimed to identify the push and pull factors for Jordanian-trained nurses to work in the GCC states in order to inform retention policies that might address the issue of nurse migration. An online survey of a convenience sample of 1241 Jordanian nurses working in GCC states showed that 93% had been employed in Jordan before migration, 85% had migrated to obtain employment and 94% were motivated by higher salary and benefits. Although 93% planned to return to work in Jordan, only 15% planned to do so in the next 2 years. Major incentives to migrate were relocation assistance, salary and benefits and career advancement/professional education. Policy-makers and nurse leaders in Jordan and the GCC states are urged to use these findings to formulate strategies to retain Jordanian nurses in their workplaces.

National Rocket Propulsion Materials Plan: A NASA, Department of Defense, and Industry Partnership

NASA Technical Reports Server (NTRS)

Clinton, Raymond G., Jr.; Munafo, Paul M. (Technical Monitor)

2001-01-01

NASA, Department of Defense, and rocket propulsion industry representatives are working together to create a national rocket propulsion materials development roadmap. This "living document" will facilitate collaboration among the partners, leveraging of resources, and will be a highly effective tool for technology development planning. The structuring of the roadmap, and development plan, which will combine the significant efforts of the Integrated High Payoff Rocket Propulsion Technology (IHPRPT) Program, and NASA's Integrated Space Transportation Plan (ISTP), is being lead by the IHPRPT Materials Working Group (IMWG). The IHPRPT Program is a joint DoD, NASA, and industry effort to dramatically improve the nation's rocket propulsion capabilities. This phased program is structured with increasingly challenging goals focused on performance, reliability, and cost to effectively double rocket propulsion capabilities by 2010. The IHPRPT program is focused on three propulsion application areas: Boost and Orbit Transfer (both liquid rocket engines and solid rocket motors), Tactical, and Spacecraft. Critical to the success of this initiative is the development and application of advanced materials, processes, and manufacturing technologies. NASA's ISTP is a comprehensive strategy focusing on the aggressive safety, reliability, and affordability goals for future space transportation systems established by the agency. Key elements of this plan are the 2 nd and 3 d Generation Reusable Launch Vehicles (RLV). The affordability and safety goals of these generational systems are, respectively, 10X cheaper and 100X safer by 2010, and 100X cheaper and 10,000X safer by 2025. Accomplishment of these goals requires dramatic and sustained breakthroughs, particularly in the development and the application of advanced material systems. The presentation will provide an overview of the IHPRPT materials initiatives, NASA's 2nd and 3 rd Generation RLV propulsion materials projects, and the approach for the development of the national rocket propulsion materials roadmap.

Automated Work Packages Prototype: Initial Design, Development, and Evaluation. Light Water Reactor Sustainability Program

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

Oxstrand, Johanna Helene; Ahmad Al Rashdan; Le Blanc, Katya Lee

The goal of the Automated Work Packages (AWP) project is to demonstrate how to enhance work quality, cost management, and nuclear safety through the use of advanced technology. The work described in this report is part of the digital architecture for a highly automated plant project of the technical program plan for advanced instrumentation, information, and control (II&C) systems technologies. This report addresses the DOE Milestone M2LW-15IN0603112: Describe the outcomes of field evaluations/demonstrations of the AWP prototype system and plant surveillance and communication framework requirements at host utilities. A brief background to the need for AWP research is provided, thenmore » two human factors field evaluation studies are described. These studies focus on the user experience of conducting a task (in this case a preventive maintenance and a surveillance test) while using an AWP system. The remaining part of the report describes an II&C effort to provide real time status updates to the technician by wireless transfer of equipment indications and a dynamic user interface.« less

Social Media, Big Data, and Mental Health: Current Advances and Ethical Implications.

PubMed

Conway, Mike; O'Connor, Daniel

2016-06-01

Mental health (including substance abuse) is the fifth greatest contributor to the global burden of disease, with an economic cost estimated to be US $2.5 trillion in 2010, and expected to double by 2030. Developing information systems to support and strengthen population-level mental health monitoring forms a core part of the World Health Organization's Comprehensive Action Plan 2013-2020. In this paper, we review recent work that utilizes social media "big data" in conjunction with associated technologies like natural language processing and machine learning to address pressing problems in population-level mental health surveillance and research, focusing both on technological advances and core ethical challenges.

Progress on the Design of the Storage Ring Vacuum System for the Advanced Photon Source Upgrade Project

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

Stillwell, B.; Billett, B.; Brajuskovic, B.

2017-06-20

Recent work on the design of the storage ring vacuum system for the Advanced Photon Source Upgrade project (APS-U) includes: revising the vacuum system design to accommodate a new lattice with reverse bend magnets, modifying the designs of vacuum chambers in the FODO sections for more intense incident synchrotron radiation power, modifying the design of rf-shielding bellows liners for better performance and reliability, modifying photon absorber designs to make better use of available space, and integrated planning of components needed in the injection, extraction and rf cavity straight sections. An overview of progress in these areas is presented.

7 CFR 1781.14 - Planning, options, and appraisals.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Planning, options, and appraisals. 1781.14 Section...) LOANS AND ADVANCES § 1781.14 Planning, options, and appraisals. (a) WS and RCD area plans are developed... designated agent when a WS loan, WS advance or RCD loan is made. (d) Options and appraisals related to the...

Advanced Education and Technology Business Plan, 2007-10

ERIC Educational Resources Information Center

Alberta Enterprise and Advanced Education, 2007

2007-01-01

The Government of Alberta Strategic Business Plan addresses significant opportunities and challenges facing Alberta over the next three years and positions Alberta to make the most of its economic, social and natural advantages. It is a plan to strategically manage growth and plan for a sustainable and secure future. Advanced Education and…

Temporal Investment Strategy to Enable JPL Future Space Missions

NASA Technical Reports Server (NTRS)

Lincoln, William P.; Hua, Hook; Weisbin, Charles R.

2006-01-01

The Jet Propulsion Laboratory (JPL) formulates and conducts deep space missions for NASA (the National Aeronautics and Space Administration). The Chief Technologist of JPL has the responsibility for strategic planning of the laboratory's advanced technology program to assure that the required technological capabilities to enable future JPL deep space missions are ready as needed; as such he is responsible for the development of a Strategic Plan. As part of the planning effort, he has supported the development of a structured approach to technology prioritization based upon the work of the START (Strategic Assessment of Risk and Technology) team. A major innovation reported here is the addition of a temporal model that supports scheduling of technology development as a function of time. The JPL Strategic Technology Plan divides the required capabilities into 13 strategic themes. The results reported here represent the analysis of an initial seven.

Business planning: can the health service move from strategy into action?

PubMed

Bennett, A R

1994-01-01

Advances the case for the use of one particular business planning technique within a National Health Service Trust. At the present time, NHS trusts are required to write strategic direction statements. Evidence suggests that these documents provide an accurate account of past performance and present position of the trust, but do not express the future position intended to be achieved. These documents also tend to be lengthy and lack strategic focus, which means that they are not helpful to managers who want clear organizational goals and objectives to which to work. Attempts to address the difficulties associated with determining how existing skills and resources can be used as the platform for future growth strategies by using the Ansoff Matrix and SWOT Analysis planning tools, given the external changes in the marketplace. Also attempts to shed light on some of the important links between busines strategy and management development by extending planning theory into practice.

The Evolution of Health Care Advance Planning Law and Policy

PubMed Central

Sabatino, Charles P

2010-01-01

Context: The legal tools of health care advance planning have substantially changed since their emergence in the mid-1970s. Thirty years of policy development, primarily at the state legislative level addressing surrogate decision making and advance directives, have resulted in a disjointed policy landscape, yet with important points of convergence evolving over time. An understanding of the evolution of advance care planning policy has important implications for policy at both the state and federal levels. Methods: This article is a longitudinal statutory and literature review of health care advance planning from its origins to the present. Findings: While considerable variability across the states still remains, changes in law and policy over time suggest a gradual paradigm shift from what is described as a “legal transactional approach” to a “communications approach,” the most recent extension of which is the emergence of Physician Orders for Life-Sustaining Treatment, or POLST. The communications approach helps translate patients’ goals into visible and portable medical orders. Conclusions: States are likely to continue gradually moving away from a legal transactional mode of advance planning toward a communications model, albeit with challenges to authentic and reliable communication that accurately translates patients’ wishes into the care they receive. In the meantime, the states and their health care institutions will continue to serve as the primary laboratory for advance care planning policy and practice. PMID:20579283

The evolution of health care advance planning law and policy.

PubMed

Sabatino, Charles P

2010-06-01

The legal tools of health care advance planning have substantially changed since their emergence in the mid-1970s. Thirty years of policy development, primarily at the state legislative level addressing surrogate decision making and advance directives, have resulted in a disjointed policy landscape, yet with important points of convergence evolving over time. An understanding of the evolution of advance care planning policy has important implications for policy at both the state and federal levels. This article is a longitudinal statutory and literature review of health care advance planning from its origins to the present. While considerable variability across the states still remains, changes in law and policy over time suggest a gradual paradigm shift from what is described as a "legal transactional approach" to a "communications approach," the most recent extension of which is the emergence of Physician Orders for Life-Sustaining Treatment, or POLST. The communications approach helps translate patients' goals into visible and portable medical orders. States are likely to continue gradually moving away from a legal transactional mode of advance planning toward a communications model, albeit with challenges to authentic and reliable communication that accurately translates patients' wishes into the care they receive. In the meantime, the states and their health care institutions will continue to serve as the primary laboratory for advance care planning policy and practice.

Gender differences in academic surgery, work-life balance, and satisfaction.

PubMed

Baptiste, Dadrie; Fecher, Alison M; Dolejs, Scott C; Yoder, Joseph; Schmidt, C Maximillian; Couch, Marion E; Ceppa, DuyKhanh P

2017-10-01

An increasing number of women are pursuing a career in surgery. Concurrently, the percentage of surgeons in dual-profession partnerships is increasing. We sought to evaluate the gender differences in professional advancement, work-life balance, and satisfaction at a large academic center. All surgical trainees and faculty at a single academic medical center were surveyed. Collected variables included gender, academic rank, marital status, family size, division of household responsibilities, and career satisfaction. Student t-test, Fisher's exact test, and chi-square test were used to compare results. There were 127 faculty and 116 trainee respondents (>80% response rate). Respondents were mostly male (77% of faculty, 58% of trainees). Women were more likely than men to be married to a professional (90% versus 37%, for faculty; 82% versus 41% for trainees, P < 0.001 for both) who was working full time (P < 0.001) and were less likely to be on tenure track (P = 0.002). Women faculty were more likely to be primarily responsible for childcare planning (P < 0.001), meal planning (P < 0.001), grocery shopping (P < 0.001), and vacation planning (P = 0.003). Gender-neutral responsibilities included financial planning (P = 0.04) and monthly bill payment (P = 0.03). Gender differences in division of household responsibilities were similar in surgical trainees except for childcare planning, which was a shared responsibility. Women surgeons are more likely to be partnered with a full-time working spouse and to be primarily responsible for managing their households. Additional consideration for improvement in recruitment and retention strategies for surgeons might address barriers to equalizing these gender disparities. Published by Elsevier Inc.

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

Hugo, Jacques Victor; Gertman, David Ira

The new generation of nuclear power plants (NPPs) will likely make use of state-of-the-art technologies in many areas of the plant. The analysis, design, and selection of advanced human–system interfaces (HSIs) constitute an important part of power plant engineering. Designers need to consider the new capabilities afforded by these technologies in the context of current regulations and new operational concepts, which is why they need a more rigorous method by which to plan the introduction of advanced HSIs in NPP work areas. Much of current human factors research stops at the user interface and fails to provide a definitive processmore » for integration of end user devices with instrumentation and control (I&C) and operational concepts. The current lack of a clear definition of HSI technology, including the process for integration, makes characterization and implementation of new and advanced HSIs difficult. This paper describes how new design concepts in the nuclear industry can be analyzed and how HSI technologies associated with new industrial processes might be considered. Furthermore, it also describes a basis for an understanding of human as well as technology characteristics that could be incorporated into a prioritization scheme for technology selection and deployment plans.« less

Light Microsopy Module, International Space Station Premier Automated Microscope

NASA Technical Reports Server (NTRS)

Meyer, William V.; Sicker, Ronald J.; Chiaramonte, Francis P.; Brown, Daniel F.; O'Toole, Martin A.; Foster, William M.; Motil, Brian J.; Abbot-Hearn, Amber Ashley; Atherton, Arthur Johnson; Beltram, Alexander;

Advanced manufacturing development of a composite empennage component for L-1011 aircraft

NASA Technical Reports Server (NTRS)

Alva, T.; Henkel, J.; Johnson, R.; Carll, B.; Jackson, A.; Mosesian, B.; Brozovic, R.; Obrien, R.; Eudaily, R.

1982-01-01

This is the final report of technical work conducted during the fourth phase of a multiphase program having the objective of the design, development and flight evaluation of an advanced composite empennage component manufactured in a production environment at a cost competitive with those of its metal counterpart, and at a weight savings of at least 20 percent. The empennage component selected for this program is the vertical fin box of the L-1011 aircraft. The box structure extends from the fuselage production joint to the tip rib and includes front and rear spars. During Phase 4 of the program, production quality tooling was designed and manufactured to produce three sets of covers, ribs, spars, miscellaneous parts, and subassemblies to assemble three complete ACVF units. Recurring and nonrecurring cost data were compiled and documented in the updated producibility/design to cost plan. Nondestruct inspections, quality control tests, and quality acceptance tests were performed in accordance with the quality assurance plan and the structural integrity control plan. Records were maintained to provide traceability of material and parts throughout the manufacturing development phase. It was also determined that additional tooling would not be required to support the current and projected L-1011 production rate.

Advanced Telescopes and Observatories and Scientific Instruments and Sensors Capability Roadmaps: General Background and Introduction

NASA Technical Reports Server (NTRS)

Coulter, Dan; Bankston, Perry

2005-01-01

Agency objective are: Strategic Planning Transformation. Advanced Planning Organizational Roles. Public Involvement in Strategic Planning. Strategic Roadmaps and Schedule. Capability Roadmaps and Schedule. Purpose of NRC Review. Capability Roadmap Development (Progress to Date).

How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review.

PubMed

Biondo, Patricia D; Lee, Lydia D; Davison, Sara N; Simon, Jessica E

2016-09-01

Advance care planning initiatives are being implemented across healthcare systems around the world, but how best to evaluate their implementation is unknown. To identify gaps and/or redundancies in current evaluative strategies to help healthcare systems develop future evaluative frameworks for ACP. Systematic review. Peer-reviewed and gray literature searches were conducted till February 2015 to answer: "What methods have healthcare systems used to evaluate implementation of advance care planning initiatives?" A PICOS framework was developed to identify articles describing the implementation and evaluation of a health system-level advance care planning initiative. Outcome measures were mapped onto a conceptual quality indicator framework based on the Institute of Medicine and Donabedian models of healthcare quality. A total of 46 studies met inclusion criteria for analysis. Most articles reported on single parts of a healthcare system (e.g. continuing care). The most common outcome measures pertained to document completion, followed by healthcare resource use. Patient-, family-, or healthcare provider-reported outcomes were less commonly measured. Concordance measures (e.g. dying in place of choice) were reported by only 26% of studies. The conceptual quality indicator framework identified gaps and redundancies in measurement and is presented as a potential foundation from which to develop a comprehensive advance care planning evaluation framework. Document completion is frequently used to evaluate advance care planning program implementation; capturing the quality of care appears to be more difficult. This systematic review provides health system administrators with a comprehensive summary of measures used to evaluate advance care planning and may identify gaps in evaluation within their local context. © The Author(s) 2016.

Prevalence and predictors of advance directives in Australia.

PubMed

White, B; Tilse, C; Wilson, J; Rosenman, L; Strub, T; Feeney, R; Silvester, W

2014-10-01

Advance care planning is regarded as integral to better patient outcomes, yet little is known about the prevalence of advance directives (AD) in Australia. To determine the prevalence of AD in the Australian population. A national telephone survey about estate and advance planning. Sample was stratified by age (18-45 and >45 years) and quota sampling occurred based on population size in each state and territory. Fourteen per cent of the Australian population has an AD. There is state variation with people from South Australia and Queensland more likely to have an AD than people from other states. Will making and particularly completion of a financial enduring power of attorney are associated with higher rates of AD completion. Standard demographic variables were of limited use in predicting whether a person would have an AD. Despite efforts to improve uptake of advance care planning (including AD), barriers remain. One likely trigger for completing an AD and advance care planning is undertaking a wider future planning process (e.g. making a will or financial enduring power of attorney). This presents opportunities to increase advance care planning, but steps are needed to ensure that planning, which occurs outside the health system, is sufficiently informed and supported by health information so that it is useful in the clinical setting. Variations by state could also suggest that redesign of regulatory frameworks (such as a user-friendly and well-publicised form backed by statute) may help improve uptake of AD. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

The Space Science Enterprise Strategic Plan

NASA Technical Reports Server (NTRS)

2000-01-01

It is a pleasure to present our new Space Science Strategic Plan. It represents contributions by hundreds of members of the space science community, including researchers, technologists, and educators, working with staff at NASA, over a period of nearly two years. Our time is an exciting one for space science. Dramatic advances in cosmology, planetary research, and solar-terrestrial science form a backdrop for this ambitious plan. Our program boldly addresses the most fundamental questions that science can ask: (1) how the universe began and is changing, (2) what are the past and future of humanity, and (3) whether we are alone. In taking up these questions, researchers and the general public--for we are all seekers in this quest--will draw upon all areas of science and the technical arts. Our Plan outlines how we will communicate our findings to interested young people and adults. The program that you will read about in this Plan includes forefront research and technology development on the ground as well as development and operation of the most complex spacecraft conceived. The proposed flight program is a balanced portfolio of small missions and larger spacecraft. Our goal is to obtain the best science at the lowest cost, taking advantage of the most advanced technology that can meet our standards for expected mission success. In driving hard to achieve this goal, we experienced some very disappointing failures in 1999. But NASA, as a research and development agency, makes progress by learning also from mistakes, and we have learned from these.

Reintegration Difficulty of Military Couples Following Deployment

DTIC Science & Technology

2016-07-01

supervision, four Ph.D. students were employed during the 2015-16 academic year to gain research experience and complete advanced research tasks...Working group member, Battle Plan for Military Families Symposium, Military Family Research Institute at Purdue University. Knobloch, L. K. (2016...using an experimental paradigm: The moderating effect of acute sad mood. Behaviour Research and Therapy, 48, 97–105. doi:10.1016/j.brat.2009.09.013

Space Solar Power Technical Interchange Meeting 2: SSP TIM 2

NASA Technical Reports Server (NTRS)

Sanders, Jim; Hawk, Clark W.

1998-01-01

The 2nd Space Solar Power Technical Interchange Meeting (SSP TIM 2) was conducted September 21st through 24th with the first part consisting of a Plenary session. The summary results of this Plenary session are contained in part one of this report. The attendees were then organized into Working Breakout Sessions and Integrated Product Team (IPT) Sessions for the purpose of conducting in-depth discussions in specific topic areas and developing a consensus as to appropriate study plans and actions to be taken. The Second part covers the Plenary Summary Session, which contains the summary results of the Working Breakout Sessions and IPT Sessions. The appendix contains the list of attendees. The ob'jective was to provide an update for the study teams and develop plans for subsequent study activities. This SSP TIM 2 was initiated and the results reported electronically over the Internet. The International Space Station (ISS) could provide the following opportunities for conducting research and technology (R&T) which are applicable to SSP: (1) Automation and Robotics, (2) Advanced Power Generation, (3) Advanced Power Management & Distribution (PMAD), (4) Communications Systems and Networks, (5) Energy Storage, (6) In Space Propulsion (ISP), (7) Structural Dynamics and Control, and Assembly and (8) Wireless Power Transmission.

Advances and challenges in oral health after a decade of the "Smiling Brazil" Program.

PubMed

Scherer, Charleni Inês; Scherer, Magda Duarte dos Anjos

2015-01-01

To analyze oral health work changes in primary health care after Brazil's National Oral Health Policy Guidelines were released. A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people's participation and social control; and intersectorial actions. Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.

How to achieve the desired outcomes of advance care planning in nursing homes: a theory of change.

PubMed

Gilissen, J; Pivodic, L; Gastmans, C; Vander Stichele, R; Deliens, L; Breuer, E; Van den Block, L

2018-02-14

Advance care planning (ACP) has been identified as particularly relevant for nursing home residents, but it remains unclear how or under what circumstances ACP works and can best be implemented in such settings. We aimed to develop a theory that outlines the hypothetical causal pathway of ACP in nursing homes, i.e. what changes are expected, by means of which processes and under what circumstances. The Theory of Change approach is a participatory method of programme design and evaluation whose underlying intention is to improve understanding of how and why a programme works. It results in a Theory of Change map that visually represents how, why and under what circumstances ACP is expected to work in nursing home settings in Belgium. Using this approach, we integrated the results of two workshops with stakeholders (n = 27) with the results of a contextual analysis and a systematic literature review. We identified two long-term outcomes that ACP can achieve: to improve the correspondence between residents’ wishes and the care/treatment they receive and to make sure residents and their family feel involved in planning their future care and are confident their care will be according to their wishes. Besides willingness on the part of nursing home management to implement ACP and act accordingly, other necessary preconditions are identified and put in chronological order. These preconditions serve as precursors to, or requirements for, accomplishing successful ACP. Nine original key intervention components with specific rationales are identified at several levels (resident/family, staff or nursing home) to target the preconditions: selection of a trainer, ensuring engagement by management, training ACP reference persons, in-service education for healthcare staff, information for staff, general practitioners, residents and their family, ACP conversations and documentation, regular reflection sessions, multidisciplinary meetings, and formal monitoring. The Theory of Change map presented here illustrates a theory of how ACP is expected to work in order to achieve its desired long-term outcomes while highlighting organisational factors that potentially facilitate the implementation and sustainability of ACP. We provide the first comprehensive rationale of how ACP is expected to work in nursing homes, something that has been called for repeatedly.

Psychological predictors of cultural diversity support at work.

PubMed

Hiemstra, Annemarie M F; Derous, Eva; Born, Marise Ph

2017-07-01

As diversity management activities become more prominent worldwide it is important to understand psychological reactions to them to ensure success, but empirical evidence is lacking. This study investigated employees' and managers' intentions and behavior to promote cultural diversity at work in a variety of organizations in the Netherlands, using Ajzen's theory of planned behavior. Predictors of intentions to promote cultural diversity at work (N = 670) and actual behavior after 6 months were assessed among managers and employees using self-reports in a 2-wave survey design. Participants' average age at Time 1 was 38.26 years (SD = 11.86), 56% was female, and there were 78.1% Dutch ethnic majority and 21.9% ethnic minority participants. Attitude to cultural diversity promotion at work and perceived behavioral control (PBC) related positively to both individuals' intentions to promote cultural diversity at work, which in turn predicted behavior. The strongest driver, however, was attitude. Managers' reported PBC and behavior were higher compared to employees. This study supported the applicability of the theory of planned behavior to predict intentions and behavior to promote cultural diversity at work. With an increasingly diverse workforce, this study aimed to advance our understanding of drivers of individual reactions and behavior to support cultural diversity at work. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Ethical and methodological issues in academic mental health research in populations affected by disasters: the Oklahoma City experience relevant to September 11, 2001.

PubMed

North, Carol S; Pfefferbaum, Betty; Tucker, Phebe

2002-08-01

Empirical data from research studies are vital to guiding mental health interventions following disasters. However, few data are available for this purpose. Important advances in policy and procedures for the conduct of organized research emerged from the Oklahoma City bombing, yielding cooperative working relationships among researchers and culminating in the ethical attainment of informative research data. However, the academic community was again caught off guard after the September 11, 2001, terrorist attacks. Suggestions to surmount these obstacles include incorporating research infrastructures into disaster preparedness plans in advance; organizing the community of researchers; and working closely with major funding organizations. Methodological issues pertaining to measurement of psychopathology include the importance of obtaining diagnostic data; interpreting the meaning of symptoms in the absence of a psychiatric disorder; differentiating preexisting symptoms from those that emerged after the disaster, and optimal timing of postdisaster assessment.

Repopulation Kinetics and the Linear-Quadratic Model

NASA Astrophysics Data System (ADS)

O'Rourke, S. F. C.; McAneney, H.; Starrett, C.; O'Sullivan, J. M.

2009-08-01

The standard Linear-Quadratic (LQ) survival model for radiotherapy is used to investigate different schedules of radiation treatment planning for advanced head and neck cancer. We explore how these treament protocols may be affected by different tumour repopulation kinetics between treatments. The laws for tumour cell repopulation include the logistic and Gompertz models and this extends the work of Wheldon et al. [1], which was concerned with the case of exponential repopulation between treatments. Treatment schedules investigated include standarized and accelerated fractionation. Calculations based on the present work show, that even with growth laws scaled to ensure that the repopulation kinetics for advanced head and neck cancer are comparable, considerable variation in the survival fraction to orders of magnitude emerged. Calculations show that application of the Gompertz model results in a significantly poorer prognosis for tumour eradication. Gaps in treatment also highlight the differences in the LQ model with the effect of repopulation kinetics included.

Education, empowerment, and elderly adults--enhancing nursing expertise in the long-term care setting.

PubMed

LeCount, Jill

2004-03-01

The rapidly emerging changes in health care needs of elderly individuals have prompted many articles and public policy proposals in support of the advancement of gerontological nursing education. Although more financial support for gerontological expertise is necessary, nurses have begun to move ahead with innovative programs to enhance their own geriatric practice. In this article, the author describes a collaboration among a long-term care facility and local universities created to provide an advanced practice degree program for working nurses interested in gerontology. A needs assessment survey, program planning, and implementation are outlined. The end result is 20 RNs graduating from a master's level program who anecdotally identify increased confidence, critical thinking, and use of research and evidenced-based practice as a result of their graduate studies. The author concludes that more programs accommodating the complex needs of working nurses are needed to develop nursing expertise in gerontology.

Investigation of Integrated Vehicle Health Management Approaches

NASA Technical Reports Server (NTRS)

Paris, Deidre

2005-01-01

This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

The views of patients with severe chronic obstructive pulmonary disease on advance care planning: a qualitative study.

PubMed

MacPherson, Anna; Walshe, Catherine; O'Donnell, Valerie; Vyas, Aashish

2013-03-01

Chronic obstructive pulmonary disease (COPD) is a major cause of death worldwide and there are concerns that end-of-life care for these patients is inadequate. Advance care planning is encouraged, with the hope that it will improve communication and avoid unwanted interventions, which have been particular concerns; in practice, these discussions rarely occur. We have little knowledge of the views of patients with COPD on advance care planning. Understanding this could help integrate advance care planning into the routine management of patients with COPD. To explore the views of people with severe COPD about advance care planning. Qualitative design, with data collection incorporating audio recorded semi-structured interviews. Analysis followed a grounded theory approach. Patients with severe COPD (n =10, Gold Standards Framework criteria) were recruited from primary and secondary care settings. Participants felt they had not been given enough information about their diagnosis and prognosis, and were keen for more discussion with healthcare professionals. They wanted more involvement in decisions about their treatment when those decisions were required. Participants were happy to discuss their general views about future care, but felt uncomfortable with the traditional model of binding 'advance directives'. Considering advance care planning as a repeated process of discussion of prognosis, concerns and probable preferences for care would be more useful than encouraging binding advance decisions. Further research should assess the effectiveness of this approach. Local coordination of who is responsible for information provision is needed, and greater involvement of patients with COPD in management decisions as they arise.

Advanced planetary studies

NASA Technical Reports Server (NTRS)

1976-01-01

Results of planetary advanced studies and planning support are summarized. The scope of analyses includes cost estimation research, planetary mission performance, penetrator mission concepts for airless planets/satellites, geology orbiter payload adaptability, lunar mission performance, and advanced planning activities. Study reports and related publications are included in a bibliography section.

CASL Verification and Validation Plan

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

Mousseau, Vincent Andrew; Dinh, Nam

2016-06-30

This report documents the Consortium for Advanced Simulation of LWRs (CASL) verification and validation plan. The document builds upon input from CASL subject matter experts, most notably the CASL Challenge Problem Product Integrators, CASL Focus Area leaders, and CASL code development and assessment teams. This document will be a living document that will track progress on CASL to do verification and validation for both the CASL codes (including MPACT, CTF, BISON, MAMBA) and for the CASL challenge problems (CIPS, PCI, DNB). The CASL codes and the CASL challenge problems are at differing levels of maturity with respect to validation andmore » verification. The gap analysis will summarize additional work that needs to be done. Additional VVUQ work will be done as resources permit. This report is prepared for the Department of Energy’s (DOE’s) CASL program in support of milestone CASL.P13.02.« less

Advance care planning with individuals experiencing homelessness: Literature review and recommendations for public health practice.

PubMed

Hubbell, Sarah A

2017-09-01

Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness. Trials of clinician-guided interventions with homeless individuals demonstrated effectiveness in achieving advance directive completion and surrogate decision-maker designation. End-of-life concerns among homeless persons included fears of dying alone, dying unnoticed, or remaining unidentified after death. Research participants also reported concerns regarding burial and notification of family members. Public health practitioners should facilitate advance care planning for people who are homeless by providing opportunities for education and discussion on care options and advance directives. © 2017 Wiley Periodicals, Inc.

Distribution of a Generic Mission Planning and Scheduling Toolkit for Astronomical Spacecraft

NASA Technical Reports Server (NTRS)

Kleiner, Steven C.

1996-01-01

Work is progressing as outlined in the proposal for this contract. A working planning and scheduling system has been documented and packaged and made available to the WIRE Small Explorer group at JPL, the FUSE group at JHU, the NASA/GSFC Laboratory for Astronomy and Solar Physics and the Advanced Planning and Scheduling Branch at STScI. The package is running successfully on the WIRE computer system. It is expected that the WIRE will reuse significant portions of the SWAS code in its system. This scheduling system itself was tested successfully against the spacecraft hardware in December 1995. A fully automatic scheduling module has been developed and is being added to the toolkit. In order to maximize reuse, the code is being reorganized during the current build into object-oriented class libraries. A paper describing the toolkit has been written and is included in the software distribution. We have experienced interference between the export and production versions of the toolkit. We will be requesting permission to reprogram funds in order to purchase a standalone PC onto which to offload the export version.

"I'm still here": Exploring what matters to people with intellectual disability during advance care planning.

PubMed

McKenzie, Nicola; Mirfin-Veitch, Brigit; Conder, Jennifer; Brandford, Sharon

2017-11-01

This study sought to identify, from the perspective of people with intellectual disabilities and life limiting conditions, the factors that strengthened and inhibited their Advance Care Planning. This in depth qualitative study explored the experiences of four people with intellectual disability and life limiting conditions, through interviews and documentation reviews. There was strong agreement across all participants about what positively influenced Advance Care Planning, namely; going at my pace; supporting me to make my own choices; adapting the process to suit me, and, most importantly; continuing to support and plan the life I'm still living. With the exception of being comfortable/skilled in end-of-life support, the skills required of facilitators were similar to those required for all forms of person-centred planning. The findings are encouraging and demonstrate that Advance Care Planning is a useful tool in ensuring that people with intellectual disability have control and choice over their lives, right to the end. © 2017 John Wiley & Sons Ltd.

Strategic planning by the palliative care steering committee of the Middle East Cancer Consortium.

PubMed

Moore, Shannon Y; Pirrello, Rosene D; Christianson, Sonya K; Ferris, Frank D

2011-04-01

High quality comprehensive palliative care is a critical need for millions of patients and families, but remains only a dream in many parts of the world. The failure to do a strategic planning process is one obstacle to advancing education and pain prevention and relief. The Middle Eastern Cancer Consortium Steering Committee attendees completed an initial strategic planning process and identified "developmental steps" to advance palliative care. Underscoring the multi-disciplinary nature of comprehensive palliative care, discipline-specific planning was done (adult and pediatric cancer and medicine, pharmacy, nursing) in a separate process from country-specific planning. Delineating the layers of intersection and differences between disciplines and countries was very powerful. Finding the common strengths and weaknesses in the status quo creates the potential for a more powerful regional response to the palliative care needs. Implementing and refining these preliminary strategic plans will augment and align the efforts to advance palliative care education and pain management in the Middle East. The dream to prevent and relieve suffering for millions of patients with advanced disease will become reality with a powerful strategic planning process well implemented.

Space Transportation Propulsion Systems

NASA Technical Reports Server (NTRS)

Liou, Meng-Sing; Stewart, Mark E.; Suresh, Ambady; Owen, A. Karl

2001-01-01

This report outlines the Space Transportation Propulsion Systems for the NPSS (Numerical Propulsion System Simulation) program. Topics include: 1) a review of Engine/Inlet Coupling Work; 2) Background/Organization of Space Transportation Initiative; 3) Synergy between High Performance Computing and Communications Program (HPCCP) and Advanced Space Transportation Program (ASTP); 4) Status of Space Transportation Effort, including planned deliverables for FY01-FY06, FY00 accomplishments (HPCCP Funded) and FY01 Major Milestones (HPCCP and ASTP); and 5) a review current technical efforts, including a review of the Rocket-Based Combined-Cycle (RBCC), Scope of Work, RBCC Concept Aerodynamic Analysis and RBCC Concept Multidisciplinary Analysis.

New Whole-House Solutions Case Study: A Production Builder's Passive House - Denver, Colorado

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

None

Brookfield Home’s first project is in a community called Midtown in Denver, Colorado, in which the builder took on the challenge of increased energy efficiency by creating a Passive House (PH)-certified model home. Brookfield worked with the U.S. Department of Energy’s Building America research team IBACOS to create the home, evaluate advanced building technologies, and use the home as a marketing tool for potential homebuyers. Brookfield also worked with KGA studio architects to create a new floor plan that would be constructed to the PH standard as an upgrade option.

The Integration of Climate Science and Collaborative Processes in Building Regional Climate Resiliency in Southeast Florida

NASA Astrophysics Data System (ADS)

Jurado, J.

2016-12-01

Southeast Florida is widely recognized as one of the most vulnerable regions in the United States to the impacts of climate change, especially sea level rise. Dense urban populations, low land elevations, flat topography, complex shorelines and a porous geology all contribute to the region's challenges. Regional and local governments have been working collaboratively to address shared climate mitigation and adaptation concerns as part of the four-county Southeast Florida Regional Climate Change Compact (Compact). This partnership has emphasized, in part, the use of climate data and the development of advanced technical tools and visualizations to help inform decision-making, improve communications, and guide investments. Prominent work products have included regional vulnerability maps and assessments, a unified sea level rise projection for southeast Florida, the development and application of hydrologic models in scenario planning, interdisciplinary resilient redesign planning workshops, and the development of regional climate indicators. Key to the Compact's efforts has been the engagement and expertise of academic and agency partners, including a formal collaboration between the Florida Climate Institute and the Compact to improve research and project collaborations focused on southeast Florida. This presentation will focus on the collaborative processes and work products that have served to accelerate resiliency planning and investments in southeast Florida, with specific examples of how local governments are using these work products to modernize agency processes, and build support among residents and business leaders.

Site characterization progress report: Yucca Mountain, Nevada, October 1, 1994--March 31, 1995, Number 12. Nuclear Waste Policy Act (Section 113)

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

NONE

1995-08-01

During the first half of fiscal year 1995, most activities at the Yucca Mountain Site Characterization Project were directed at implementing the Program Plan developed by the Office of Civilian Radioactive Waste Management. The Plan is designed to enable the Office to make measurable and significant progress toward key objectives over the next five years within the financial resources that can be realistically expected. Activities this period focused on the immediate goal of determining by 1998 whether Yucca Mountain, Nevada, is technically suitable as a possible site for a geologic repository for the permanent disposal of spent nuclear fuel andmore » high-level radioactive waste. Work on the Project advanced in several critical areas, including programmatic activities such as issuing the Program Plan, completing the first technical basis report to support the assessment of three 10 CFR 960 guidelines, developing the Notice of Intent for the Environmental Impact Statement, submitting the License Application Annotated Outline, and beginning a rebaselining effort to conform with the goals of the Program Plan. Scientific investigation and analysis of the site and design and construction activities to support the evaluation of the technical suitability of the site also advanced. Specific details relating to all Project activities and reports generated are presented in this report.« less

A framework for interactive visualization of digital medical images.

PubMed

Koehring, Andrew; Foo, Jung Leng; Miyano, Go; Lobe, Thom; Winer, Eliot

2008-10-01

The visualization of medical images obtained from scanning techniques such as computed tomography and magnetic resonance imaging is a well-researched field. However, advanced tools and methods to manipulate these data for surgical planning and other tasks have not seen widespread use among medical professionals. Radiologists have begun using more advanced visualization packages on desktop computer systems, but most physicians continue to work with basic two-dimensional grayscale images or not work directly with the data at all. In addition, new display technologies that are in use in other fields have yet to be fully applied in medicine. It is our estimation that usability is the key aspect in keeping this new technology from being more widely used by the medical community at large. Therefore, we have a software and hardware framework that not only make use of advanced visualization techniques, but also feature powerful, yet simple-to-use, interfaces. A virtual reality system was created to display volume-rendered medical models in three dimensions. It was designed to run in many configurations, from a large cluster of machines powering a multiwalled display down to a single desktop computer. An augmented reality system was also created for, literally, hands-on interaction when viewing models of medical data. Last, a desktop application was designed to provide a simple visualization tool, which can be run on nearly any computer at a user's disposal. This research is directed toward improving the capabilities of medical professionals in the tasks of preoperative planning, surgical training, diagnostic assistance, and patient education.

START: an advanced radiation therapy information system.

PubMed

Cocco, A; Valentini, V; Balducci, M; Mantello, G

1996-01-01

START is an advanced radiation therapy information system (RTIS) which connects direct information technology present in the devices with indirect information technology for clinical, administrative, information management integrated with the hospital information system (HIS). The following objectives are pursued: to support decision making in treatment planning and functional and information integration with the rest of the hospital; to enhance organizational efficiency of a Radiation Therapy Department; to facilitate the statistical evaluation of clinical data and managerial performance assessment; to ensure the safety and confidentiality of used data. For its development a working method based on the involvement of all operators of the Radiation Therapy Department, was applied. Its introduction in the work activity was gradual, trying to reuse and integrate the existing information applications. The START information flow identifies four major phases: admission, visit of admission, planning, therapy. The system main functionalities available to the radiotherapist are: clinical history/medical report linking function; folder function; planning function; tracking function; electronic mail and banner function; statistical function; management function. Functions available to the radiotherapy technician are: the room daily list function; management function: to the nurse the following functions are available: patient directing function; management function. START is a departmental client (pc-windows)-server (unix) developed on an integrated database of all information of interest (clinical, organizational and administrative) coherent with the standard and with a modular architecture which can evolve with additional functionalities in subsequent times. For a more thorough evaluation of its impact on the daily activity of a radiation therapy facility, a prolonged clinical validation is in progress.

Advanced planning surveys using automatic license plate reading equipment and evaluation of automatic license plate reading equipment for advanced planning

DOT National Transportation Integrated Search

1998-05-01

Recent technological advances in computer hardware, software, and image processing have led to the development of automated license plate reading equipment. This equipment has primarily been developed for enforcement and security applications, such a...

15 CFR 713.4 - Advance declaration requirements for additionally planned production, processing, or consumption...

Code of Federal Regulations, 2010 CFR

2010-01-01

... INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 2 CHEMICALS § 713.4 Advance declaration requirements for additionally planned production... additionally planned production, processing, or consumption of Schedule 2 chemicals. 713.4 Section 713.4...

15 CFR 713.4 - Advance declaration requirements for additionally planned production, processing, or consumption...

Code of Federal Regulations, 2011 CFR

2011-01-01

... INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 2 CHEMICALS § 713.4 Advance declaration requirements for additionally planned production... additionally planned production, processing, or consumption of Schedule 2 chemicals. 713.4 Section 713.4...

Advanced Life Support Systems

NASA Technical Reports Server (NTRS)

Barta, Daniel J.

2004-01-01

This presentation is planned to be a 10-15 minute "catalytic" focused presentation to be scheduled during one of the working sessions at the TIM. This presentation will focus on Advanced Life Support technologies key to future human Space Exploration as outlined in the Vision, and will include basic requirements, assessment of the state-of-the-art and gaps, and include specific technology metrics. The presentation will be technical in character, lean heavily on data in published ALS documents (such as the Baseline Values and Assumptions Document) but not provide specific technical details or build to information on any technology mentioned (thus the presentation will be benign from an export control and a new technology perspective). The topics presented will be focused on the following elements of Advanced Life Support: air revitalization, water recovery, waste management, thermal control, habitation systems, food systems and bioregenerative life support.

Ceramic technology for advanced heat engines project. Semiannual progress report, April-September 1985

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

Not Available

1986-05-01

An assessment of needs was completed, and a five-year project plan was developed with input from private industry. Objective is to develop the industrial technology base required for reliable ceramics for application in advanced automotive heat engines. Focus is on structural ceramics for advanced gas turbine and diesel engines, ceramic bearings and attachments, and ceramic coatings for thermal barrier and wear applications in these engines. The work described in this report is organized according to the following WBS project elements: management and coordination; materials and processing (monolithics, ceramic composites, thermal and wear coatings, joining); materials design methodology (contact interfaces, newmore » concepts); data base and life prediction (time-dependent behavior, environmental effects, fracture mechanics, NDE development); and technology transfer. This report includes contributions from all currently active project participants.« less

Roll and pitch set-up errors during volumetric modulated arc delivery: can adapting gantry and collimator angles compensate?

PubMed

Hoffmans-Holtzer, Nienke A; Hoffmans, Daan; Dahele, Max; Slotman, Ben J; Verbakel, Wilko F A R

2015-03-01

The purpose of this work was to investigate whether adapting gantry and collimator angles can compensate for roll and pitch setup errors during volumetric modulated arc therapy (VMAT) delivery. Previously delivered clinical plans for locally advanced head-and-neck (H&N) cancer (n = 5), localized prostate cancer (n = 2), and whole brain with simultaneous integrated boost to 5 metastases (WB + 5M, n = 1) were used for this study. Known rigid rotations were introduced in the planning CT scans. To compensate for these, in-house software was used to adapt gantry and collimator angles in the plan. Doses to planning target volumes (PTV) and critical organs at risk (OAR) were calculated with and without compensation and compared with the original clinical plan. Measurements in the sagittal plane in a polystyrene phantom using radiochromic film were compared by gamma (γ) evaluation for 2 H&N cancer patients. For H&N plans, the introduction of 2°-roll and 3°-pitch rotations reduced mean PTV coverage from 98.7 to 96.3%. This improved to 98.1% with gantry and collimator compensation. For prostate plans respective figures were 98.4, 97.5, and 98.4%. For WB + 5M, compensation worked less well, especially for smaller volumes and volumes farther from the isocenter. Mean comparative γ evaluation (3%, 1 mm) between original and pitched plans resulted in 86% γ < 1. The corrected plan restored the mean comparison to 96% γ < 1. Preliminary data suggest that adapting gantry and collimator angles is a promising way to correct roll and pitch set-up errors of < 3° during VMAT for H&N and prostate cancer.

Joint crisis plans and psychiatric advance directives in German psychiatric practice.

PubMed

Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

2014-05-01

This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

Palliative Care, Hospice, and Advance Care Planning: Views of People Living with HIV and Other Chronic Conditions.

PubMed

Slomka, Jacquelyn; Prince-Paul, Maryjo; Webel, Allison; Daly, Barbara J

2016-01-01

People living with HIV (PLWH) who survive to older adulthood risk developing multiple chronic medical conditions. Health policymakers recognize the role of early palliative care and advance care planning in improving health quality for at-risk populations, but misperceptions about palliative care, hospice, and advance care planning are common. Before testing a program of early palliative care for PLWH and other chronic conditions, we conducted focus groups to elicit perceptions of palliative care, hospice, and advance care planning in our target population. Overall, participants were unfamiliar with the term palliative care, confused concepts of palliative care and hospice, and/or associated hospice care with dying. Participants misunderstood advance care planning, but valued communication about health care preferences. Accepting palliative care was contingent on distinguishing it from hospice and historical memories of HIV and dying. Provision of high-quality, comprehensive care will require changing public perceptions and individuals' views in this high-risk population. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

42 CFR 495.324 - Prior approval conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: (1) The HIT advance planning document and the implementation advance planning document. (2) A request... $100,000 or contract time extensions of more than 60 days. (4) The State Medicaid HIT plan. (c) Failure...-competitively from a nongovernmental source HIT equipment or services, with proposed FFP under this subpart if...

15 CFR 714.3 - Advance declaration requirements for additionally planned production of Schedule 3 chemicals.

Code of Federal Regulations, 2011 CFR

2011-01-01

... COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 3 CHEMICALS § 714.3 Advance declaration requirements for additionally planned production of Schedule 3 chemicals. (a) Declaration... additionally planned production of Schedule 3 chemicals. 714.3 Section 714.3 Commerce and Foreign Trade...

Radiological emergency: Malaysian preparedness and response.

PubMed

Yusof, Mohd Abd Wahab; Ali, Hamrah Mohd

2011-07-01

Planning and preparation in advance for radiological emergencies can help to minimise potential public health and environmental threats if and when an actual emergency occurs. During the planning process, emergency response organisations think through how they would respond to each type of incident and the resources that will be needed. In Malaysia, planning, preparation for and response to radiological emergencies involve many parties. In the event of a radiological emergency and if it is considered a disaster, the National Security Council, the Atomic Energy Licensing Board and the Malaysian Nuclear Agency (Nuclear Malaysia) will work together with other federal agencies, state and local governments, first responders and international organisations to monitor the situation, contain the release, and clean up the contaminated site. Throughout the response, these agencies use their protective action guidelines. This paper discusses Malaysian preparedness for, and response to, any potential radiological emergency.

Health Planning in the United States and the Decline of Public-interest Policymaking

PubMed Central

Melhado, Evan M

2006-01-01

In the 1960s and 1970s, health planning formed a major theme of American health policy. Planners aimed to improve health services and make them broadly available while using resources efficiently. This article provides a history, both intellectual and political, of the origins of planning, its rise, and—in the face of mounting problems—its decline. The story also illustrates broader changes in the culture of policymaking in American health care. From the Progressive Era through the 1960s, reform-minded experts in health worked to advance the public interest. Thereafter, they increasingly left behind public-interest ideals and their underlying extramarket values in favor of organizing and improving health care markets. Whatever the deficiencies of traditional policymaking may be, this study suggests the need to resurrect extramarket values in health policy. PMID:16771822

Health planning in the United States and the decline of public-interest policymaking.

PubMed

Melhado, Evan M

2006-01-01

In the 1960s and 1970s, health planning formed a major theme of American health policy. Planners aimed to improve health services and make them broadly available while using resources efficiently. This article provides a history, both intellectual and political, of the origins of planning, its rise, and--in the face of mounting problems--its decline. The story also illustrates broader changes in the culture of policymaking in American health care. From the Progressive Era through the 1960s, reform-minded experts in health worked to advance the public interest. Thereafter, they increasingly left behind public-interest ideals and their underlying extramarket values in favor of organizing and improving health care markets. Whatever the deficiencies of traditional policymaking may be, this study suggests the need to resurrect extramarket values in health policy.

Rehabilitation Options

MedlinePlus

... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ...

A Research Planning Assessment for Applications of Artificial Intelligence in Manufacturing.

DTIC Science & Technology

1986-01-01

to apply,based on their needs.___ *PROJECT OESCRIPTION/ APPROACH : -The project will apply A_ in r’ejpesent ni ri O siri ct...of this project are essential for the practical implementation of Al-based approaches to improving unit processes. This work will enable advances in ...July 1985 to 1 August 1985. The authors wish to thank all workshop participants for their contributions to this effort. In particular, we wish to

The subscale orbital fluid transfer experiment

NASA Technical Reports Server (NTRS)

Collins, Frank G.; Antar, Basil N.; Menzel, Reinhard W.; Meserole, Jere S.; Meserole, Jere S.; Jones, Ogden

1990-01-01

The Subscale Orbital Fluid Transfer Experiment (SOFTE) is a planned Shuttle Orbiter fluid transfer experiment. CASP (Center for Advanced Space Propulsion) performed certain aspects of the conceptual design of this experiment. The CASP work consisted of the conceptual design of the optical system, the search for alternative experimental fluids, the determination of the flow meter specifications and the examination of materials to use for a bladder that will empty one of the tanks in the experiment.

Advanced construction management for lunar base construction - Surface operations planner

NASA Technical Reports Server (NTRS)

Kehoe, Robert P.

1992-01-01

The study proposes a conceptual solution and lays the framework for developing a new, sophisticated and intelligent tool for a lunar base construction crew to use. This concept integrates expert systems for critical decision making, virtual reality for training, logistics and laydown optimization, automated productivity measurements, and an advanced scheduling tool to form a unique new planning tool. The concept features extensive use of computers and expert systems software to support the actual work, while allowing the crew to control the project from the lunar surface. Consideration is given to a logistics data base, laydown area management, flexible critical progress scheduler, video simulation of assembly tasks, and assembly information and tracking documentation.

Social Media, Big Data, and Mental Health: Current Advances and Ethical Implications

PubMed Central

Conway, Mike; O’Connor, Daniel

2016-01-01

Mental health (including substance abuse) is the fifth greatest contributor to the global burden of disease, with an economic cost estimated to be US $2.5 trillion in 2010, and expected to double by 2030. Developing information systems to support and strengthen population-level mental health monitoring forms a core part of the World Health Organization’s Comprehensive Action Plan 2013–2020. In this paper, we review recent work that utilizes social media “big data” in conjunction with associated technologies like natural language processing and machine learning to address pressing problems in population-level mental health surveillance and research, focusing both on technological advances and core ethical challenges. PMID:27042689

Hypermedia and visual technology

NASA Technical Reports Server (NTRS)

Walker, Lloyd

1990-01-01

Applications of a codified professional practice that uses visual representations of the thoughts and ideas of a working group are reported in order to improve productivity, problem solving, and innovation. This visual technology process was developed under the auspices of General Foods as part of a multi-year study. The study resulted in the validation of this professional service as a way to use art and design to facilitate productivity and innovation and to define new opportunities. It was also used by NASA for planning Lunar/Mars exploration and by other companies for general business and advanced strategic planning, developing new product concepts, and litigation support. General Foods has continued to use the service for packaging innovation studies.

Health worker shortages in Zambia: an assessment of government responses.

PubMed

Gow, Jeff; George, Gavin; Mutinta, Given; Mwamba, Sylvia; Ingombe, Lutungu

2011-11-01

A dire health worker shortage in Zambia's national health programs is adversely impacting the quantity and quality of health care and posing a serious barrier to achieving Millennium Development Goals to improve population health. In 2005, Zambia's Ministry of Health developed a 10-year strategic plan for human resources for health to address the crisis through improved training, hiring, and retention. The plan has neither arrested nor reduced the shortage. We review the causes of the shortage, present results from a health worker survey showing that safe work conditions, manageable workloads, and career advancement opportunities matter more to respondents than financial compensation. We comment on the adequacy of government efforts to address the health worker shortage.

Evaluating research for disruptive innovation in the space sector

NASA Astrophysics Data System (ADS)

Summerer, L.

2012-12-01

Many governmental space activities need to be planned with a time horizon that extends beyond the comfort zone of reliable technology development assessments and predictions. In an environment of accelerating technological change, a methodological approach to addressing non-core technology trends and potentially disruptive, game-changing developments not yet linked to the space sector is increasingly important to complement efforts in core technology R&D planning. Various models and organisational setups aimed at fulfilling this purpose are in existence. These include, with varying levels of relevance to space, the National Aeronautics and Space Administration (NASA) Institute for Advanced Concepts (NIAC, operational form 1998 to 2007 and recently re-established), the Defence Advanced Research Projects Agency of the US Department of Defence, the Massachusetts Institute of Technology (MIT) Medialab, the early versions of Starlab, the Lockheed Skunk Works and the European Space Agency's Advanced Concepts Team. Some of these organisations have been reviewed and assessed individually, though systematic comparison of their methods, approaches and results have not been published. This may be due in part to the relatively sparse scientific literature on organisational parameters for enabling disruptive innovation as well as to the lack of commonly agreed indicators for the evaluation of their performance. Furthermore, innovation support systems in the space sector are organised differently than in traditional, open competitive markets, which serve as the basis for most scholarly literature on the organisation of innovation. The present paper is intended to advance and stimulate discussion on the organisation of disruptive innovation mechanisms specifically for the space sector. It uses the examples of the NASA Institute for Advanced Concepts and the ESA Advanced Concepts Team, analyses their respective approaches and compares their results, leading to the proposal of measures for the analysis and eventual evaluation of research for disruptive innovation in the space sector.

National Institutes of Health Research Plan on Rehabilitation

PubMed Central

O’Mara, Ann; Rowland, Julia H.; Greenwell, Thomas N.; Wiggs, Cheri L.; Fleg, Jerome; Joseph, Lyndon; McGowan, Joan; Panagis, James S.; Washabaugh, Charles; Peng, Grace C. Y.; Bray, Rosalina; Cernich, Alison N.; Cruz, Theresa H.; Marden, Sue; Michel, Mary Ellen; Nitkin, Ralph; Quatrano, Louis; Spong, Catherine Y.; Shekim, Lana; Jones, Teresa L. Z.; Juliano-Bult, Denise; Panchinson, David M.; Chen, Daofen; Jakeman, Lyn; Knebel, Ann; Tully, Lois A.; Chan, Leighton; Damiano, Diane; Tian, Biao; McInnes, Pamela; Khalsa, Partap; Reider, Eve; Shurtleff, David; Elwood, William; Ballard, Rachel; Ershow, Abby G.; Begg, Lisa

2017-01-01

Abstract One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation. This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: NIH Medical Rehabilitation Coordinating Committee. Am J Phys Med Rehabil. 2017;97(4):404—407. PMID:28499003

An Assessment of Social Diffusion in the Respecting Choices Advance Care Planning Program

ERIC Educational Resources Information Center

Moorman, Sara M.; Carr, Deborah; Kirchhoff, Karin T.; Hammes, Bernard J.

2012-01-01

This study examines the potential social diffusion effects of the Respecting Choices advance care planning program administered in La Crosse, Wisconsin, since 1991. The program produces educational materials for patients, trains facilitators to help patients prepare for end of life, and ensures that advance directives are connected to patients'…

CAREER PLANS OF GRADUATES OF A CANADIAN DENTAL SCHOOL: PRELIMINARY REPORT OF A 5-YEAR SURVEY.

PubMed

Nassar, Usama; Fairbanks, Connor; Flores-Mir, Carlos; Kilistoff, Alan; Easton, Rick

2016-07-01

Comprehensive data on the characteristics and opinions of graduating dental students in Canada are lacking. Specifically, only minimal information is available on graduates' immediate career plans and factors that may influence their decisions regarding these plans. Our aim was to gather such data to allow better understanding of this issue and improve the design of future studies on this topic. The Career Development Committee at the school of dentistry, University of Alberta, designed a short survey to be administered to graduating students over 5 years to gain insight into their immediate career plans and opinions on career services at the school. Preliminary results from 2012-2014 are reported here. With a response rate of close to 90% (n = 99/111), the data reveal considerable differences in immediate career plans between the surveyed students and those in other schools in Canada and the United States. Of the students, 89% were planning to work in a general dental practice and only 9% were planning to enroll in advanced education, including general practice residency training. More research is needed to better understand the factors affecting career path decisions of students.

Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.

PubMed

Proctor, Enola; Luke, Douglas; Calhoun, Annaliese; McMillen, Curtis; Brownson, Ross; McCrary, Stacey; Padek, Margaret

2015-06-11

Little is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work. A multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care. Prompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research. Implementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

44 CFR 350.10 - Public meeting in advance of FEMA approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... EMERGENCY PLANS AND PREPAREDNESS § 350.10 Public meeting in advance of FEMA approval. (a) During the FEMA Regional Office review of a State plan and prior to the submission by the Regional Administrator of the evaluation of the plan and exercise to the Deputy Administrator for the National Preparedness Directorate...

The ARL 2030 Scenarios: A User's Guide for Research Libraries

ERIC Educational Resources Information Center

Association of Research Libraries, 2010

2010-01-01

This user's guide was developed to advance local planning at ARL member libraries. It is written for library leaders writ large and for anyone leading or contributing to research library planning processes. Users do not need advanced facilitation skills to benefit from this guide, but facilitators charged with supporting scenario planning will…

SU-E-T-398: Feasibility of Automated Tools for Robustness Evaluation of Advanced Photon and Proton Techniques in Oropharyngeal Cancer

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

Liu, H; Liang, X; Kalbasi, A

2014-06-01

Purpose: Advanced radiotherapy (RT) techniques such as proton pencil beam scanning (PBS) and photon-based volumetric modulated arc therapy (VMAT) have dosimetric advantages in the treatment of head and neck malignancies. However, anatomic or alignment changes during treatment may limit robustness of PBS and VMAT plans. We assess the feasibility of automated deformable registration tools for robustness evaluation in adaptive PBS and VMAT RT of oropharyngeal cancer (OPC). Methods: We treated 10 patients with bilateral OPC with advanced RT techniques and obtained verification CT scans with physician-reviewed target and OAR contours. We generated 3 advanced RT plans for each patient: protonmore » PBS plan using 2 posterior oblique fields (2F), proton PBS plan using an additional third low-anterior field (3F), and a photon VMAT plan using 2 arcs (Arc). For each of the planning techniques, we forward calculated initial (Ini) plans on the verification scans to create verification (V) plans. We extracted DVH indicators based on physician-generated contours for 2 target and 14 OAR structures to investigate the feasibility of two automated tools (contour propagation (CP) and dose deformation (DD)) as surrogates for routine clinical plan robustness evaluation. For each verification scan, we compared DVH indicators of V, CP and DD plans in a head-to-head fashion using Student's t-test. Results: We performed 39 verification scans; each patient underwent 3 to 6 verification scan. We found no differences in doses to target or OAR structures between V and CP, V and DD, and CP and DD plans across all patients (p > 0.05). Conclusions: Automated robustness evaluation tools, CP and DD, accurately predicted dose distributions of verification (V) plans using physician-generated contours. These tools may be further developed as a potential robustness screening tool in the workflow for adaptive treatment of OPC using advanced RT techniques, reducing the need for physician-generated contours.« less

Asteroid Redirect Crewed Mission Space Suit and EVA System Architecture Trade Study

NASA Technical Reports Server (NTRS)

Bowie, Jonathan; Buffington, Jesse; Hood, Drew; Kelly, Cody; Naids, Adam; Watson, Richard; Blanco, Raul; Sipila, Stephanie

2014-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment selected for both functions is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS) currently under development for Advanced Exploration Systems (AES). The proposed architecture meets the ARCM constraints, but much more work is required to determine the details of the suit upgrades, the integration with the PLSS, and the tools and equipment necessary to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations were completed in the Neutral Buoyancy Lab (NBL) and interfacing options were prototyped and analyzed with testing planned for late 2014. This paper discusses the work done over the last year on the MACES enhancements, the use of tools while using the suit, and the integration of the PLSS with the MACES.

Asteroid Redirect Crewed Mission Space Suit and EVA System Maturation

NASA Technical Reports Server (NTRS)

Bowie, Jonathan; Buffington, Jesse; Hood, Drew; Kelly, Cody; Naids, Adam; Watson, Richard

2015-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment selected for both functions is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS) currently under development for Advanced Exploration Systems (AES). The proposed architecture meets the ARCM constraints, but much more work is required to determine the details of the suit upgrades, the integration with the PLSS, and the tools and equipment necessary to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations were completed in the Neutral Buoyancy Lab (NBL) and interfacing options were prototyped and analyzed with testing planned for late 2014. This paper discusses the work done over the last year on the MACES enhancements, the use of tools while using the suit, and the integration of the PLSS with the MACES.

Mask cost of ownership for advanced lithography

NASA Astrophysics Data System (ADS)

Muzio, Edward G.; Seidel, Philip K.

2000-07-01

As technology advances, becoming more difficult and more expensive, the cost of ownership (CoO) metric becomes increasingly important in evaluating technical strategies. The International SEMATECH CoC analysis has steadily gained visibility over the past year, as it attempts to level the playing field between technology choices, and create a fair relative comparison. In order to predict mask cots for advanced lithography, mask process flows are modeled using bets-known processing strategies, equipment cost, and yields. Using a newly revised yield mode, and updated mask manufacture flows, representative mask flows can be built. These flows are then used to calculate mask costs for advanced lithography down to the 50 nm node. It is never the goal of this type of work to provide absolute cost estimates for business planning purposes. However, the combination of a quantifiable yield model with a clearly defined set of mask processing flows and a cost model based upon them serves as an excellent starting point for cost driver analysis and process flow discussion.

A method to select human-system interfaces for nuclear power plants

DOE PAGES

Hugo, Jacques Victor; Gertman, David Ira

2015-10-19

The new generation of nuclear power plants (NPPs) will likely make use of state-of-the-art technologies in many areas of the plant. The analysis, design, and selection of advanced human–system interfaces (HSIs) constitute an important part of power plant engineering. Designers need to consider the new capabilities afforded by these technologies in the context of current regulations and new operational concepts, which is why they need a more rigorous method by which to plan the introduction of advanced HSIs in NPP work areas. Much of current human factors research stops at the user interface and fails to provide a definitive processmore » for integration of end user devices with instrumentation and control (I&C) and operational concepts. The current lack of a clear definition of HSI technology, including the process for integration, makes characterization and implementation of new and advanced HSIs difficult. This paper describes how new design concepts in the nuclear industry can be analyzed and how HSI technologies associated with new industrial processes might be considered. Furthermore, it also describes a basis for an understanding of human as well as technology characteristics that could be incorporated into a prioritization scheme for technology selection and deployment plans.« less

An environmental scan of advance care planning decision AIDS for patients undergoing major surgery: a study protocol.

PubMed

Aslakson, Rebecca A; Schuster, Anne L R; Miller, Judith; Weiss, Matthew; Volandes, Angelo E; Bridges, John F P

2014-01-01

Patients who undergo major surgery are at risk for perioperative morbidity and mortality. It would be appropriate to initiate advance care planning with patients prior to surgery, but surgeons may experience difficulty initiating such conversations. Rather than focus on changing clinician behavior, advance care planning decision aids can be an innovative vehicle to motivate advance care planning among surgical patients and their families. The purpose of this paper is to describe a study protocol for conducting an environmental scan concerning advance care planning decision aids that may be relevant to patients undergoing high-risk surgery. This study will gather information from written or verbal data sources that incorporate professional and lay perspectives: a systematic review, a grey literature review, key informant interviews, and patient and family engagement. It is envisioned that this study will generate three outcomes: a synthesis of current evidence, a summary of gaps in knowledge, and a taxonomy of existing advance care planning decision aids. This environmental scan will demonstrate principles of patient-centered outcomes research, and it will exemplify a pioneering approach for reviewing complex interventions. Anticipated limitations are that information will be gathered from a small sample of patients and families, and that potentially relevant information could also be missing from the environmental scan due to the inclusion/exclusion criteria. Outcomes from the environmental scan will inform future patient-centered research to develop and evaluate a new decision aid.

Advances and challenges in oral health after a decade of the “Smiling Brazil” Program

PubMed Central

Scherer, Charleni Inês; Scherer, Magda Duarte dos Anjos

2016-01-01

ABSTRACT OBJECTIVE To analyze oral health work changes in primary health care after Brazil’s National Oral Health Policy Guidelines were released. METHODS A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people’s participation and social control; and intersectorial actions. CONCLUSIONS Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities. PMID:26815162

SPANR planning and scheduling

NASA Astrophysics Data System (ADS)

Freund, Richard F.; Braun, Tracy D.; Kussow, Matthew; Godfrey, Michael; Koyama, Terry

2001-07-01

SPANR (Schedule, Plan, Assess Networked Resources) is (i) a pre-run, off-line planning and (ii) a runtime, just-in-time scheduling mechanism. It is designed to support primarily commercial applications in that it optimizes throughput rather than individual jobs (unless they have highest priority). Thus it is a tool for a commercial production manager to maximize total work. First the SPANR Planner is presented showing the ability to do predictive 'what-if' planning. It can answer such questions as, (i) what is the overall effect of acquiring new hardware or (ii) what would be the effect of a different scheduler. The ability of the SPANR Planner to formulate in advance tree-trimming strategies is useful in several commercial applications, such as electronic design or pharmaceutical simulations. The SPANR Planner is demonstrated using a variety of benchmarks. The SPANR Runtime Scheduler (RS) is briefly presented. The SPANR RS can provide benefit for several commercial applications, such as airframe design and financial applications. Finally a design is shown whereby SPANR can provide scheduling advice to most resource management systems.

Disease control operations

USGS Publications Warehouse

Friend, M.; Franson, J.C.

1999-01-01

Individual disease outbreaks have killed many thousands of animals on numerous occasions. Tens of thousands of migratory birds have died in single die-offs with as many as 1,000 birds succumbing in 1 day. The ability to successfully combat such explosive situations is highly dependent on the readiness of field personnel to deal with them. Because many disease agents can spread through wildlife populations very quickly, advance preparation is essential for preventing infected animals from spreading disease to additional species and locations. Carefully thought-out disease contingency plans should be developed as practical working documents for field personnel and updated as necessary. Well-designed plans can prove invaluable in minimizing wildlife losses and the costs associated with disease control activities.Although requirements for disease control operations vary and must be tailored to each situation, all disease contingency planning involves general concepts and basic biological information. This chapter, which is intended to be a practical guide, identifies the major activities and needs of disease control operations, and relates them to disease contingency planning.

Computer-assisted innovations in craniofacial surgery.

PubMed

Rudman, Kelli; Hoekzema, Craig; Rhee, John

2011-08-01

Reconstructive surgery for complex craniofacial defects challenges even the most experienced surgeons. Preoperative reconstructive planning requires consideration of both functional and aesthetic properties of the mandible, orbit, and midface. Technological innovations allow for computer-assisted preoperative planning, computer-aided manufacturing of patient-specific implants (PSIs), and computer-assisted intraoperative navigation. Although many case reports discuss computer-assisted preoperative planning and creation of custom implants, a general overview of computer-assisted innovations is not readily available. This article reviews innovations in computer-assisted reconstructive surgery including anatomic considerations when using PSIs, technologies available for preoperative planning, work flow and process of obtaining a PSI, and implant materials available for PSIs. A case example follows illustrating the use of this technology in the reconstruction of an orbital-frontal-temporal defect with a PSI. Computer-assisted reconstruction of complex craniofacial defects provides the reconstructive surgeon with innovative options for challenging reconstructive cases. As technology advances, applications of computer-assisted reconstruction will continue to expand. © Thieme Medical Publishers.

Candidate functions for advanced technology implementation in the Columbus mission planning environment

NASA Technical Reports Server (NTRS)

Loomis, Audrey; Kellner, Albrecht

1988-01-01

The Columbus Project is the European Space Agency's contribution to the International Space Station program. Columbus is planned to consist of three elements (a laboratory module attached to the Space Station base, a man-tended freeflyer orbiting with the Space Station base, and a platform in polar orbit). System definition and requirements analysis for Columbus are underway, scheduled for completion in mid-1990. An overview of the Columbus mission planning environment and operations concept as currently defined is given, and some of the challenges presented to software maintainers and ground segment personnel during mission operators are identified. The use of advanced technologies in system implementation is being explored. Both advantages of such solutions and potential problems they present are discussed, and the next steps to be taken by Columbus before targeting any functions for advanced technology implementation are summarized. Several functions in the mission planning process were identified as candidates for advanced technology implementation. These range from expert interaction with Columbus' data bases through activity scheduling and near-real-time response to departures from the planned timeline. Each function is described, and its potential for advanced technology implementation briefly assessed.

Barriers to Advance Care Planning in End-Stage Renal Disease: Who is to Blame, and What Can be Done?

PubMed

Kelley, Alan Taylor; Turner, Jeffrey; Doolittle, Benjamin

2018-07-01

Patients with end-stage renal disease experience significant mortality and morbidity, including cognitive decline. Advance care planning has been emphasized as a responsibility and priority of physicians caring for patients with chronic kidney disease in order to align with patient values before decision-making capacity is lost and to avoid suffering. This emphasis has proven ineffective, as illustrated in the case of a patient treated in our hospital. Is this ineffectiveness a consequence of failure in the courtroom or the clinic? Through our own experience we affirm what has been written before: that legal precedent favors intensive treatment in virtually all cases without 'clear and convincing evidence' of a patient's previously declared wishes to the contrary. Equally clear is that more than 20 years of support in the clinical literature suggesting advance care planning early in the course of disease can address challenges in the legal system for those lacking capacity. However, many physicians fail to recognize the need for advance care planning in a timely manner and lack the necessary training to provide it. The need for more training and new tools to recognize opportunities for advance care planning in daily practice remains unmet.

Academic Self-Perceptions of Ability and Course Planning among Academically Advanced Students

ERIC Educational Resources Information Center

Rudasill, Kathleen Moritz; Callahan, Carolyn M.

2010-01-01

The purpose of this study is to examine the contribution of gender to the academic self-perceptions of ability and related coursework plans for high school and college across academically advanced students. Participants were academically advanced students (N = 447) from grades 5 to 12. Findings revealed that (a) girls' self-perceptions of ability…

National Research Council Dialogue to Assess Progress on NASA's Advanced Modeling, Simulation and Analysis Capability and Systems Engineering Capability Roadmap Development

NASA Technical Reports Server (NTRS)

Aikins, Jan

2005-01-01

Contents include the following: General Background and Introduction of Capability Roadmaps. Agency Objective. Strategic Planning Transformation. Advanced Planning Organizational Roles. Public Involvement in Strategic Planning. Strategic Roadmaps and Schedule. Capability Roadmaps and Schedule. Purpose of NRC Review. Capability Roadmap Development (Progress to Date).

Advanced Math? Write!

ERIC Educational Resources Information Center

Brandenburg, Sister M. Luka

2002-01-01

High-school mathematics teacher in Rock Island, Illinois, describes plan for using writing assignment to improve student understanding of advanced mathematics. Plan includes the following elements: Start small, be firm with students, make writing assignments count, and inform colleagues. (PKP)

Social Work Involvement in Advance Care Planning: Findings from a Large Survey of Social Workers in Hospice and Palliative Care Settings.

PubMed

Stein, Gary L; Cagle, John G; Christ, Grace H

2017-03-01

Few data are available describing the involvement and activities of social workers in advance care planning (ACP). We sought to provide data about (1) social worker involvement and leadership in ACP conversations with patients and families; and (2) the extent of functions and activities when these discussions occur. We conducted a large web-based survey of social workers employed in hospice, palliative care, and related settings to explore their role, participation, and self-rated competency in facilitating ACP discussions. Respondents were recruited through the Social Work Hospice and Palliative Care Network and the National Hospice and Palliative Care Organization. Descriptive analyses were conducted on the full sample of respondents (N = 641) and a subsample of clinical social workers (N = 456). Responses were analyzed to explore differences in ACP involvement by practice setting. Most clinical social workers (96%) reported that social workers in their department are conducting ACP discussions with patients/families. Majorities also participate in, and lead, ACP discussions (69% and 60%, respectively). Most respondents report that social workers are responsible for educating patients/families about ACP options (80%) and are the team members responsible for documenting ACP (68%). Compared with other settings, oncology and inpatient palliative care social workers were less likely to be responsible for ensuring that patients/families are informed of ACP options and documenting ACP preferences. Social workers are prominently involved in facilitating, leading, and documenting ACP discussions. Policy-makers, administrators, and providers should incorporate the vital contributions of social work professionals in policies and programs supporting ACP.

Instability in the Horn of Africa: An Assessment of Ethiopian-Eritrean Conflict

DTIC Science & Technology

2010-09-01

2000. 169 Zenebeworke Tadesse , “The Ethiopia-Eritrea Conflict,” 113, at: http://www.conflicttransform.net/Eritrea%20&%20Ethiopia.pdf (accessed July 20...dispute. The United States’ rapid diplomatic response team led by Susan Rice, U.S. Assistant Secretary of State, worked closely with Paul Kagame...actors to advance implementation have failed, resulting in continuing deadlock. B. THE U.S-RWANDA PEACE PLAN The U.S-Rwanda team was the first to

SPQR - Spectroscopy: Prospects, Questions & Results

NASA Astrophysics Data System (ADS)

Pennington, M. R.

2014-06-01

Tremendous progress has been made in mapping out the spectrum of hadrons over the past decade with plans to make further advances in the decade ahead. Baryons and mesons, both expected and unexpected, have been found, the results of precision experiments often with polarized beams, polarized targets and sometimes polarization of the final states. All these hadrons generate poles in the complex energy plane that are consequences of the strong coupling regime of QCD. They reveal how this works.

Air Force research in human sensory feedback for telepresence

NASA Technical Reports Server (NTRS)

Julian, Ronald G.

1993-01-01

Telepresence operations require high quality information transfer between the human master and the remotely located slave. Present Air Force research focuses on the human aspects of the information needed to complete the control/feedback loop. Work in three key areas of human sensory feedback for manipulation of objects are described. Specific projects in each key area are outlined, including research tools (hardware), planned research, and test results. Nonmanipulative feedback technologies are mentioned to complete the advanced teleoperation discussions.

Proceedings of Image Understanding Workshop Held in Los Angeles, California on 23-25 February 1987. Volume 1

DTIC Science & Technology

1987-02-01

planning tasks. Reflexive behaviors are procedural units with high demands for immediacy. Typical obstacle related behaviors might be "slow-for...PERFORMING ORG. REPORT NUMBER 8. CONTRACT OR GRANT NUMBERf«) N00014-86-C-0700 10. PROGRAM ELEMENT. PROJECT. TASK AREA A WORK UNIT NUMBERS...either expressed or implied of the Defense Advanced Research Projects Agency or the United States Government. TABLE OF CONTENTS / Page AUTHOR

Software engineering project management - A state-of-the-art report

NASA Technical Reports Server (NTRS)

Thayer, R. H.; Lehman, J. H.

1977-01-01

The management of software engineering projects in the aerospace industry was investigated. The survey assessed such features as contract type, specification preparation techniques, software documentation required by customers, planning and cost-estimating, quality control, the use of advanced program practices, software tools and test procedures, the education levels of project managers, programmers and analysts, work assignment, automatic software monitoring capabilities, design and coding reviews, production times, success rates, and organizational structure of the projects.

Reference Manual on Civil Works Planning, Implementation and Finance,

DTIC Science & Technology

1987-09-01

outstanding bond issue prior to the date on which the outstanding bonds become due or callable . Proceeds of the advance refunding bonds are deposited in... CALLABLE BOND . A bond which is subject to redem’tion at the issuer’s option prior to maturity at a specified price at or above par. COMPETITIVE...states and/or local governments incur debt by issuing tax-exempt bonds to finance public investments. Only the current annual payment of principal and

Treatment of metal-laden hazardous wastes with advanced clean coal technology by-products. Quarterly report, December 30, 1996--March 30, 1997

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

NONE

1997-12-31

The objective of this project is to utilize coal ashes to process hazardous materials such as industrial waste water treatment residues, contaminated soils, and air pollution control dusts from the metal industry and municipal waste incineration. This report describes the activities of the project team during the reporting period. The principal work has focused upon continuing evaluation of aged samples from Phase 1, planning supportive laboratory studies for Phase 2, completing scholarly work, reestablishing MAX Environmental Technologies, Inc., as the subcontractor for the field work of Phase 2, proposing two presentations for later in 1997, and making and responding tomore » several outside contacts.« less

Working with Consortia - Advanced Packaging Reliability

NASA Technical Reports Server (NTRS)

Blanche, Jim; Strickland, Mark

2010-01-01

Description: Support the responsible NASA official for lead-free solder evaluation. Serve as the NASA technical liaison to the NASA/DoD Pb-free Project. Assure NASA areas of interest are included in JG-PP follow-on work. Support NASA/DoD telcons and face-to-face meetings. Update MSFC lead-free solder lessons learned report. FY10 plans: - Reliability data on lead-free solder applications for various part lead finishes and board finishes. - Update lead-free solder risks and risk mitigation strategies for NASA. - Evaluate lead-free alloy/lead-free finish reliability in design application. - Status CAVE project on Pb-free solder aging effects. - Compile the LTESE flight and bench data.

A two-level structure for advanced space power system automation

NASA Technical Reports Server (NTRS)

Loparo, Kenneth A.; Chankong, Vira

1990-01-01

The tasks to be carried out during the three-year project period are: (1) performing extensive simulation using existing mathematical models to build a specific knowledge base of the operating characteristics of space power systems; (2) carrying out the necessary basic research on hierarchical control structures, real-time quantitative algorithms, and decision-theoretic procedures; (3) developing a two-level automation scheme for fault detection and diagnosis, maintenance and restoration scheduling, and load management; and (4) testing and demonstration. The outlines of the proposed system structure that served as a master plan for this project, work accomplished, concluding remarks, and ideas for future work are also addressed.

Discrete Element Modeling (DEM) of Triboelectrically Charged Particles: Revised Experiments

NASA Technical Reports Server (NTRS)

Hogue, Michael D.; Calle, Carlos I.; Curry, D. R.; Weitzman, P. S.

2008-01-01

In a previous work, the addition of basic screened Coulombic electrostatic forces to an existing commercial discrete element modeling (DEM) software was reported. Triboelectric experiments were performed to charge glass spheres rolling on inclined planes of various materials. Charge generation constants and the Q/m ratios for the test materials were calculated from the experimental data and compared to the simulation output of the DEM software. In this paper, we will discuss new values of the charge generation constants calculated from improved experimental procedures and data. Also, planned work to include dielectrophoretic, Van der Waals forces, and advanced mechanical forces into the software will be discussed.

Advanced nickel-metal hydride cell development at Hughes: A joint work with US government

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

Lim, H.S.; Pickett, D.F.; Stockel, J.F.

1995-01-25

Hughes is currently engaged in the development of an advanced nickel-metal hydride (Ni/MHx) cell for spacecraft application with performance goals of 15 years of opertion in a geosynchronous earth orbit at 80% depth of discharge and over 30,000 cycles of life at 30% depth of discharge in a typical low earth orbit. We have developed the basic fabrication technique for a lightweight and potentially long life nickel electrode which is useable in space Ni/MHx cells. We have developed several attractive hydride alloys which are useable in hydride electrodes and basic fabrication techniques for lightweight, inexpensive, and potentially long life hydridemore » electrodes for a Ni/MHx cell. Utilizing Hughes extensive experiences in development of advanced Ni/Cd and Ni/H{sub 2} cells, we plan to develop a first generation space Ni/MHx cell design by 1995 and have the cell flight ready by 1997.« less

Rethinking the Educator Portfolio: An Innovative Criteria-Based Model.

PubMed

Shinkai, Kanade; Chen, Chen Amy; Schwartz, Brian S; Loeser, Helen; Ashe, Cynthia; Irby, David M

2017-11-07

Academic medical centers struggle to achieve parity in advancement and promotions between educators and discovery-oriented researchers in part because of narrow definitions of scholarship, lack of clear criteria for measuring excellence, and barriers to making educational contributions available for peer review. Despite recent progress in expanding scholarship definitions and identifying excellence criteria, these advances are not integrated into educator portfolio (EP) templates or curriculum vitae platforms. From 2013 to 2015, a working group from the Academy of Medical Educators (AME) at the University of California, San Francisco (UCSF) designed a streamlined, criteria-based EP (EP 2.0) template highlighting faculty members' recent activities in education and setting rigorous evaluation methods to enable educational scholarship to be objectively evaluated for academic advancement, AME membership, and professional development. The EP 2.0 template was integrated into the AME application, resulting in high overall satisfaction among candidates and the selection committee and positive feedback on the template's transparency, ease of use, and streamlined format. In 2016, the EP 2.0 template was integrated into the campus-wide curriculum vitae platform and academic advancement system. The authors plan to increase awareness of the EP 2.0 template by educating promotions committees and faculty at UCSF and partnering with other institutions to disseminate it for use. They also plan to study the impact of the template on supporting educators by making their important scholarly contributions available for peer review, providing guidance for professional development, and decreasing disparities in promotions.

Validation and Calibration of Nuclear Thermal Hydraulics Multiscale Multiphysics Models - Subcooled Flow Boiling Study

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

Anh Bui; Nam Dinh; Brian Williams

In addition to validation data plan, development of advanced techniques for calibration and validation of complex multiscale, multiphysics nuclear reactor simulation codes are a main objective of the CASL VUQ plan. Advanced modeling of LWR systems normally involves a range of physico-chemical models describing multiple interacting phenomena, such as thermal hydraulics, reactor physics, coolant chemistry, etc., which occur over a wide range of spatial and temporal scales. To a large extent, the accuracy of (and uncertainty in) overall model predictions is determined by the correctness of various sub-models, which are not conservation-laws based, but empirically derived from measurement data. Suchmore » sub-models normally require extensive calibration before the models can be applied to analysis of real reactor problems. This work demonstrates a case study of calibration of a common model of subcooled flow boiling, which is an important multiscale, multiphysics phenomenon in LWR thermal hydraulics. The calibration process is based on a new strategy of model-data integration, in which, all sub-models are simultaneously analyzed and calibrated using multiple sets of data of different types. Specifically, both data on large-scale distributions of void fraction and fluid temperature and data on small-scale physics of wall evaporation were simultaneously used in this work’s calibration. In a departure from traditional (or common-sense) practice of tuning/calibrating complex models, a modern calibration technique based on statistical modeling and Bayesian inference was employed, which allowed simultaneous calibration of multiple sub-models (and related parameters) using different datasets. Quality of data (relevancy, scalability, and uncertainty) could be taken into consideration in the calibration process. This work presents a step forward in the development and realization of the “CIPS Validation Data Plan” at the Consortium for Advanced Simulation of LWRs to enable quantitative assessment of the CASL modeling of Crud-Induced Power Shift (CIPS) phenomenon, in particular, and the CASL advanced predictive capabilities, in general. This report is prepared for the Department of Energy’s Consortium for Advanced Simulation of LWRs program’s VUQ Focus Area.« less

Informational analysis involving application of complex information system

NASA Astrophysics Data System (ADS)

Ciupak, Clébia; Vanti, Adolfo Alberto; Balloni, Antonio José; Espin, Rafael

The aim of the present research is performing an informal analysis for internal audit involving the application of complex information system based on fuzzy logic. The same has been applied in internal audit involving the integration of the accounting field into the information systems field. The technological advancements can provide improvements to the work performed by the internal audit. Thus we aim to find, in the complex information systems, priorities for the work of internal audit of a high importance Private Institution of Higher Education. The applied method is quali-quantitative, as from the definition of strategic linguistic variables it was possible to transform them into quantitative with the matrix intersection. By means of a case study, where data were collected via interview with the Administrative Pro-Rector, who takes part at the elaboration of the strategic planning of the institution, it was possible to infer analysis concerning points which must be prioritized at the internal audit work. We emphasize that the priorities were identified when processed in a system (of academic use). From the study we can conclude that, starting from these information systems, audit can identify priorities on its work program. Along with plans and strategic objectives of the enterprise, the internal auditor can define operational procedures to work in favor of the attainment of the objectives of the organization.

Exploring uncertainty in advance care planning in African Americans: does low health literacy influence decision making preference at end of life.

PubMed

Melhado, Lolita; Bushy, Angeline

2011-11-01

African Americans over 65 represent 3.5 of the 35.6 million Americans. Morbidity and mortality rates are highest among this group; associated with lack of resources and awareness of health problems. But health needs are the same at end of life, yet care is less than optimal. African Americans are less likely to have advance directives nonetheless desire communication, information, respect, and a trusting doctor-patient relationship. Low health literacy may contribute to this disparity. This scholarly review examines the health literacy in advance care planning and refines concepts of uncertainty in illness theory deriving a model for advance care planning in African Americans.

Advanced Simulation and Computing: A Summary Report to the Director's Review

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

McCoy, M G; Peck, T

2003-06-01

It has now been three years since the Advanced Simulation and Computing Program (ASCI), as managed by Defense and Nuclear Technologies (DNT) Directorate, has been reviewed by this Director's Review Committee (DRC). Since that time, there has been considerable progress for all components of the ASCI Program, and these developments will be highlighted in this document and in the presentations planned for June 9 and 10, 2003. There have also been some name changes. Today, the Program is called ''Advanced Simulation and Computing,'' Although it retains the familiar acronym ASCI, the initiative nature of the effort has given way tomore » sustained services as an integral part of the Stockpile Stewardship Program (SSP). All computing efforts at LLNL and the other two Defense Program (DP) laboratories are funded and managed under ASCI. This includes the so-called legacy codes, which remain essential tools in stockpile stewardship. The contract between the Department of Energy (DOE) and the University of California (UC) specifies an independent appraisal of Directorate technical work and programmatic management. Such represents the work of this DNT Review Committee. Beginning this year, the Laboratory is implementing a new review system. This process was negotiated between UC, the National Nuclear Security Administration (NNSA), and the Laboratory Directors. Central to this approach are eight performance objectives that focus on key programmatic and administrative goals. Associated with each of these objectives are a number of performance measures to more clearly characterize the attainment of the objectives. Each performance measure has a lead directorate and one or more contributing directorates. Each measure has an evaluation plan and has identified expected documentation to be included in the ''Assessment File''.« less

Working the way up in neurological rehabilitation: the holistic approach of nursing care.

PubMed

Portillo, Mari Carmen; Cowley, Sarah

2011-06-01

To provide understanding of the nurses' role in neurological holistic rehabilitation and identify strategies for the enhancement of rehabilitation services. Although acute and chronic neurological patients and relatives experience emotional and social changes, most rehabilitation programmes do not deal with non-physical needs or involve nurses, leading to a poor definition and specialisation of the nursing role. Action research. The project took place in two neurological wards of a highly specialised hospital in Spain and lasted 30 months. An individualised nurse-led social rehabilitation programme was planned, implemented and evaluated. The nursing role and care in rehabilitation were explored with 37 nurses and 40 neurological patients and 40 relatives (convenience sampling). Semi-structured interviews and participant observations were developed. Content (QSR NUDIST Vivo v.2.0) and statistical (SPSS v. 13.0) analyses were run. The lack of time, knowledge and experience, the poor definition of the nursing role and ineffective communication with users limited holistic care in the wards. Some enhancing nursing strategies were proposed and explored: promotion of acceptance/adaptation of the disease through education, reinforcement of the discharge planning and planning of emotional and social choices based on the assessment of individual needs and resources at home. Nursing professionals are in a privileged position to deal with neurological patients' and carers' holistic needs. Several attributes of the advanced nursing role in rehabilitation teams have been proposed to deal with non-physical aspects of care. • Rehabilitation needs of neurological patients and carers at hospital have been described. • Nurses' perceptions of their work and role in rehabilitation have been presented. • Clinical strategies to develop the advanced nursing role in holistic neurological rehabilitation have been highlighted. © 2010 Blackwell Publishing Ltd.

NASA's Plans for Developing Life Support and Environmental Monitoring and Control Systems

NASA Technical Reports Server (NTRS)

Lawson, B. Michael; Jan, Darrell

2006-01-01

Life Support and Monitoring have recently been reworked in response to the Vision for Space Exploration. The Exploration Life Support (ELS) Project has replaced the former Advanced Life Support Element of the Human Systems Research and Technology Office. Major differences between the two efforts include: the separation of thermal systems into a new stand alone thermal project, deferral of all work in the plant biological systems, relocation of food systems to another organization, an addition of a new project called habitation systems, and overall reduction in the number of technology options due to lower funding. The Advanced Environmental Monitoring and Control (AEMC) Element is retaining its name but changing its focus. The work planned in the ELS and AEMC projects is organized around the three major phases of the Exploration Program. The first phase is the Crew Exploration Vehicle (CEV). The ELS and AEMC projects will develop hardware for this short duration orbital and trans-lunar vehicle. The second phase is sortie landings on the moon. Life support hardware for lunar surface access vehicles including upgrades of the CEV equipment and technologies which could not be pursued in the first phase due to limited time and budget will be developed. Monitoring needs will address lunar dust issues, not applicable to orbital needs. The ELS and AEMC equipment is of short duration, but has different environmental considerations. The third phase will be a longer duration lunar outpost. This will consist of a new set of hardware developments better suited for long duration life support and associated monitoring needs on the lunar surface. The presentation will show the planned activities and technologies that are expected to be developed by the ELS and AEMC projects for these program phases.

The advancement of a new human factors report--'The Unique Report'--facilitating flight crew auditing of performance/operations as part of an airline's safety management system.

PubMed

Leva, M C; Cahill, J; Kay, A M; Losa, G; McDonald, N

2010-02-01

This paper presents the findings of research relating to the specification of a new human factors report, conducted as part of the work requirements for the Human Integration into the Lifecycle of Aviation Systems project, sponsored by the European Commission. Specifically, it describes the proposed concept for a unique report, which will form the basis for all operational and safety reports completed by flight crew. This includes all mandatory and optional reports. Critically, this form is central to the advancement of improved processes and technology tools, supporting airline performance management, safety management, organisational learning and knowledge integration/information-sharing activities. Specifically, this paper describes the background to the development of this reporting form, the logic and contents of this form and how reporting data will be made use of by airline personnel. This includes a description of the proposed intelligent planning process and the associated intelligent flight plan concept, which makes use of airline operational and safety analyses information. Primarily, this new reporting form has been developed in collaboration with a major Spanish airline. In addition, it has involved research with five other airlines. Overall, this has involved extensive field research, collaborative prototyping and evaluation of new reports/flight plan concepts and a number of evaluation activities. Participants have included both operational and management personnel, across different airline flight operations processes. Statement of Relevance: This paper presents the development of a reporting concept outlined through field research and collaborative prototyping within an airline. The resulting reporting function, embedded in the journey log compiled at the end of each flight, aims at enabling employees to audit the operations of the company they work for.

Individual versus interprofessional team performance in formulating care transition plans: A randomised study of trainees from five professional groups.

PubMed

Farrell, Timothy W; Supiano, Katherine P; Wong, Bob; Luptak, Marilyn K; Luther, Brenda; Andersen, Troy C; Wilson, Rebecca; Wilby, Frances; Yang, Rumei; Pepper, Ginette A; Brunker, Cherie P

2018-05-01

Health professions trainees' performance in teams is rarely evaluated, but increasingly important as the healthcare delivery systems in which they will practice move towards team-based care. Effective management of care transitions is an important aspect of interprofessional teamwork. This mixed-methods study used a crossover design to randomise health professions trainees to work as individuals and as teams to formulate written care transition plans. Experienced external raters assessed the quality of the written care transition plans as well as both the quality of team process and overall team performance. Written care transition plan quality did not vary between individuals and teams (21.8 vs. 24.4, respectively, p = 0.42). The quality of team process did not correlate with the quality of the team-generated written care transition plans (r = -0.172, p = 0.659). However, there was a significant correlation between the quality of team process and overall team performance (r = 0.692, p = 0.039). Teams with highly engaged recorders, performing an internal team debrief, had higher-quality care transition plans. These results suggest that high-quality interprofessional care transition plans may require advance instruction as well as teamwork in finalising the plan.

Integrated corridor management initiative : demonstration phase evaluation, San Diego traveler response analysis test plan.

DOT National Transportation Integrated Search

1995-10-01

REAL-TIME TRAFFIC INFORMATION, ROUTE GUIDANCE, ROUTE PLANNING, INTELLIGENT VEHICLE INITIATIVE OR IVI ">">KEYWORDS: OPERATIONAL TESTS, TRAVTEK, ADVANCED TRAVELER INFORMATION SYSTEMS OR ATIS, ADVANCED TRAFFIC MANAGEMENT SYSTEMS OR ATMS, INTELLI...

14 CFR 151.119 - Advance planning proposals: Procedures; funding.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Advance planning proposals: Procedures; funding. 151.119 Section 151.119 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... donated labor, materials, or equipment. ...

14 CFR 151.119 - Advance planning proposals: Procedures; funding.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Advance planning proposals: Procedures; funding. 151.119 Section 151.119 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... donated labor, materials, or equipment. ...

14 CFR 151.119 - Advance planning proposals: Procedures; funding.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Advance planning proposals: Procedures; funding. 151.119 Section 151.119 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... donated labor, materials, or equipment. ...

14 CFR 151.119 - Advance planning proposals: Procedures; funding.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Advance planning proposals: Procedures; funding. 151.119 Section 151.119 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... donated labor, materials, or equipment. ...

Medicare and Advance Planning: The Importance of Context.

PubMed

Dresser, Rebecca

2016-05-01

In January 2016, a long-delayed Medicare change took effect. The Medicare program will now reimburse doctors for time they spend talking with patients about end-of-life care. This is the move that Sarah Palin and other Affordable Care Act critics said would authorize government "death panels" to decide whether older Americans should live or die. Today virtually no one buys into Palin's death panel rhetoric. But many people do think the Medicare change is a big deal. Representative Earl Blumenauer, a Democrat from Oregon who sponsored the original ACA reimbursement proposal, lauded the Medicare provision as "a turning point in end-of-life care." Others are not so sure about that. After all, laws promoting advance care planning have existed for decades. The federal Patient Self-Determination Act of 1990 and the many court decisions and state laws supporting advance care planning have had relatively little impact. Similarly, legal recognition of physician orders for life-sustaining treatment as advance planning instruments have not produced the improvements that were predicted. And from a broad perspective, advance care planning is a small piece of the puzzle. The effort to improve end-of-life care must take into account the limitations of advance decision-making, as well as the overriding importance of the general standard of care for terminally ill patients. © 2016 The Hastings Center.

Lincoln Advanced Science and Engineering Reinforcement (LASER) program

NASA Technical Reports Server (NTRS)

Williams, Willie E.

1989-01-01

Lincoln University, under the Lincoln Advanced Science and Engineering Reinforcement (LASER) Program, has identified and successfully recruited over 100 students for majors in technical fields. To date, over 70 percent of these students have completed or will complete technical degrees in engineering, physics, chemistry, and computer science. Of those completing the undergraduate degree, over 40 percent have gone on to graduate and professional schools. This success is attributable to well planned approaches to student recruitment, training, personal motivation, retention, and program staff. Very closely coupled to the above factors is a focus designed to achieve excellence in program services and student performance. Future contributions by the LASER Program to the pool of technical minority graduates will have a significant impact. This is already evident from the success of the students that began the first year of the program. With program plans to refine many of the already successful techniques, follow-on activities are expected to make even greater contributions to the availability of technically trained minorities. For example, undergraduate research exposure, broadened summer, and co-op work experiences will be enhanced.

Advanced Planning and Scheduling Initiative- MrSpock Aims for Xmas

NASA Astrophysics Data System (ADS)

Steel, R.; Niezette, M.; Cesta, A.; Fratini, S.; Oddi, A.; Cortellessa, G.; Rasconi, R.; Verfaillie, G.; Pralet, C.; Lavagna, M.; Brambilla, A.; Castellini, F.; Donati, A.; Policella, N.

2009-09-01

This paper will outline the framework and tools developed under the Advanced Planning and Schedule Initiative (APSI) study performed by VEGA for the European Space Agency in collaboration with three academic institutions, ISTC-CNR, ONERA, and Politecnico di Milano. We will start by illustrating the background history to APSI and why it was needed, giving a brief summary of all the partners within the project and the roles they played within it. We will then take a closer look at what the APSI study actually consisted of, showing the techniques that were used and illustrating the framework that was developed within the scope of the project. This will be followed by an elaboration on the three demonstration test scenarios that have been developed as part of the project to validated the framework and demonstrate in an operational environment its applicability, illustrating the re-use and synergies between the three cases along the way. We will finally conclude with a brief summary and outline future directions to be further investigated and expanded on within the context of the work performed within the project.

Advances in U.S. Land Imaging Capabilities

NASA Astrophysics Data System (ADS)

Stryker, T. S.

2017-12-01

Advancements in Earth observations, cloud computing, and data science are improving everyday life. Information from land-imaging satellites, such as the U.S. Landsat system, helps us to better understand the changing landscapes where we live, work, and play. This understanding builds capacity for improved decision-making about our lands, waters, and resources, driving economic growth, protecting lives and property, and safeguarding the environment. The USGS is fostering the use of land remote sensing technology to meet local, national, and global challenges. A key dimension to meeting these challenges is the full, free, and open provision of land remote sensing observations for both public and private sector applications. To achieve maximum impact, these data must also be easily discoverable, accessible, and usable. The presenter will describe the USGS Land Remote Sensing Program's current capabilities and future plans to collect and deliver land remote sensing information for societal benefit. He will discuss these capabilities in the context of national plans and policies, domestic partnerships, and international collaboration. The presenter will conclude with examples of how Landsat data is being used on a daily basis to improve lives and livelihoods.

Surface physics with cold and thermal neutron reflectometry. Progress report, April 1, 1991--September 30, 1993

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

Steyerl, A.

1993-09-01

Within the past two and one half years of the project ``Surface Physics With Cold and Thermal Neutron Reflectometry`` a new thermal neutron reflectometer was constructed at the Rhode Island Nuclear Science Center (RINSC). It was used to study various liquid and solid surfaces. Furthermore, neutron reflection experiments were be un at different laboratories in collaboration with Dr. G.P. Fetcher (at Argonne National Laboratory), Dr. T. Russell (IBM Almaden) and Drs. S.K. Satija and A. Karim (at the National Institute for Standards and Technology). The available resources allowed partial construction of an imaging system for ultracold neutrons. It is expectedmore » to provide an extremely high resolution in momentum and energy transfer in surface studies using neutron reflectometry. Much of the work reported here was motivated by the possibility of later implementation at the planned Advanced Neutron Source at Oak Ridge. In a separate project the first concrete plans for an intense source of ultracold neutrons for the Advanced Neutron Source were developed.« less

Strategic plan, 1985

NASA Technical Reports Server (NTRS)

1985-01-01

The Lewis Strategic Plan was updated for 1985 and beyond. Major programs for the space station, the advanced turboprop, the Advanced Communications Technology Satellite (ACTS), and the Altitude Wind Tunnel were begun or greatly expanded during 1984. In parallel, The Lewis aeropropulsion research and technology program was extensively evaluated and reviewed; a reduced and reoriented program emerged. The thrusts and implementation plans for these programs are described as they pertain to the individual directorates. Other key accomplishments and plans are summarized.

Joint Department of Defense, Advance Planning Briefing to Industry, Held at Kissimmee, Florida, on 30 April - 2 May 1996

DTIC Science & Technology

1996-05-01

Systems 17 Motion Bases Upgraded Aero Misc > Contact Info • AMC, Lt Col Letica , Phone (618) 256-5696 L8 Upgrade Flow Plan Advance Planning Briefing...Projected Schedule: FY 05 > Requirement Document: AMMP >• Projected Program Size: ? < $40M > Funding Status/Stability: > POCs: • AMC, Lt Col Letica

Advanced Materials for Exploration Task Research Results

NASA Technical Reports Server (NTRS)

Cook, M. B. (Compiler); Murphy, K. L.; Schneider, T.

2008-01-01

The Advanced Materials for Exploration (AME) Activity in Marshall Space Flight Center s (MSFC s) Exploration Science and Technology Directorate coordinated activities from 2001 to 2006 to support in-space propulsion technologies for future missions. Working together, materials scientists and mission planners identified materials shortfalls that are limiting the performance of long-term missions. The goal of the AME project was to deliver improved materials in targeted areas to meet technology development milestones of NASA s exploration-dedicated activities. Materials research tasks were targeted in five areas: (1) Thermal management materials, (2) propulsion materials, (3) materials characterization, (4) vehicle health monitoring materials, and (5) structural materials. Selected tasks were scheduled for completion such that these new materials could be incorporated into customer development plans.

Final Report for the Advanced Concept Studies for Supersonic Commercial Transports Entering Service in the 2030 to 2035 Period, N+3 Supersonic Program

NASA Technical Reports Server (NTRS)

Morgenstern, John; Norstrud, Nicole; Stelmack, Marc; Skoch, Craig

2010-01-01

The N+3 Final Report documents the work and progress made by Lockheed Martin Aeronautics in response to the NASA sponsored program "N+3 NRA Advanced Concept Studies for Supersonic Commercial Transports Entering Service in the 2030 to 2035 Period." The key technical objective of this effort was to generate promising supersonic concepts for the 2030 to 2035 timeframe and to develop plans for maturing the technologies required to make those concepts a reality. The N+3 program is aligned with NASA's Supersonic Project and is focused on providing alternative system-level solutions capable of overcoming the efficiency, environmental, and performance barriers to practical supersonic flight

A Meta-Analysis of Urban Climate Change Adaptation ...

EPA Pesticide Factsheets

The concentration of people, infrastructure, and ecosystem services in urban areas make them prime sites for climate change adaptation. While advances have been made in developing frameworks for adaptation planning and identifying both real and potential barriers to action, empirical work evaluating urban adaptation planning processes has been relatively piecemeal. Existing assessments of current experience with urban adaptation provide necessarily broad generalizations based on the available peer-reviewed literature. This paper uses a meta-analysis of U.S. cities’ current experience with urban adaptation planning drawing from 54 sources that include peer-reviewed literature, government reports, white papers, and reports published by non-governmental organizations. The analysis specifically evaluates the institutional support structures being developed for urban climate change adaptation. The results demonstrate that adaptation planning is driven by a desire to reduce vulnerability and often catalyzes new collaborations and coordination mechanisms in urban governance. As a result, building capacity for urban climate change adaptation planning requires a focus not only on city governments themselves but also on the complex horizontal and vertical networks that have arisen around such efforts. Existing adaptation planning often lacks attention to equity issues, social vulnerability, and the influence of non-climatic factors on vulnerability. Engaging city govern

[The pharmacist should play an active role in family planning].

PubMed

Portes, M

1983-01-01

Although pharmacies now dispense primarily modern products originating in large multinational corporations, the community pharmacist has not been replaced by any ultramodern technological advance. Many thousand persons acquire family planning products in pharmacies. The pharmacist works many hours a day, is always available, and provides free advice to his clients. Pharmacists are consulted daily on numerous topics, especially on family planning. Many prsons in rural areas are without the services of a physician and rely on pharmacists all the more. Pharmacists could orient the public on family planning in general, help in choosing the most appropriate of available methods, and refer patients to physicians in case of problems. Participants at the recent International Conference on the Role of Retail Pharmacists in Family Planning, held in Alexandria, Egypt, concluded that pharmacists should cooperate with physicians and other health professionals to provide family planning services and should participate in elaboration of laws regulating the manufacture, storage, prices, and distribution of contraceptives. The prices of contraceptive supplies to the consumer could be reduced if taxes and import duties were removed, if supplies were produced locally, or if supplies were subsidized by some donor organization.

Information basis for developing comprehensive waste management system-US-Japan joint nuclear energy action plan waste management working group phase I report.

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

Nutt, M.; Nuclear Engineering Division

2010-05-25

The activity of Phase I of the Waste Management Working Group under the United States - Japan Joint Nuclear Energy Action Plan started in 2007. The US-Japan JNEAP is a bilateral collaborative framework to support the global implementation of safe, secure, and sustainable, nuclear fuel cycles (referred to in this document as fuel cycles). The Waste Management Working Group was established by strong interest of both parties, which arise from the recognition that development and optimization of waste management and disposal system(s) are central issues of the present and future nuclear fuel cycles. This report summarizes the activity of themore » Waste Management Working Group that focused on consolidation of the existing technical basis between the U.S. and Japan and the joint development of a plan for future collaborative activities. Firstly, the political/regulatory frameworks related to nuclear fuel cycles in both countries were reviewed. The various advanced fuel cycle scenarios that have been considered in both countries were then surveyed and summarized. The working group established the working reference scenario for the future cooperative activity that corresponds to a fuel cycle scenario being considered both in Japan and the U.S. This working scenario involves transitioning from a once-through fuel cycle utilizing light water reactors to a one-pass uranium-plutonium fuel recycle in light water reactors to a combination of light water reactors and fast reactors with plutonium, uranium, and minor actinide recycle, ultimately concluding with multiple recycle passes primarily using fast reactors. Considering the scenario, current and future expected waste streams, treatment and inventory were discussed, and the relevant information was summarized. Second, the waste management/disposal system optimization was discussed. Repository system concepts were reviewed, repository design concepts for the various classifications of nuclear waste were summarized, and the factors to consider in repository design and optimization were then discussed. Japan is considering various alternatives and options for the geologic disposal facility and the framework for future analysis of repository concepts was discussed. Regarding the advanced waste and storage form development, waste form technologies developed in both countries were surveyed and compared. Potential collaboration areas and activities were next identified. Disposal system optimization processes and techniques were reviewed, and factors to consider in future repository design optimization activities were also discussed. Then the potential collaboration areas and activities related to the optimization problem were extracted.« less

Summary of Current and Future MSFC International Space Station Environmental Control and Life Support System Activities

NASA Technical Reports Server (NTRS)

Ray, Charles D.; Carrasquillo, Robyn L.; Minton-Summers, Silvia

1997-01-01

This paper provides a summary of current work accomplished under technical task agreement (TTA) by the Marshall Space Flight Center (MSFC) regarding the Environmental Control and Life Support System (ECLSS) as well as future planning activities in support of the International Space Station (ISS). Current activities include ECLSS computer model development, component design and development, subsystem integrated system testing, life testing, and government furnished equipment delivered to the ISS program. A long range plan for the MSFC ECLSS test facility is described whereby the current facility would be upgraded to support integrated station ECLSS operations. ECLSS technology development efforts proposed to be performed under the Advanced Engineering Technology Development (AETD) program are also discussed.

Artificial intelligence and space power systems automation

NASA Technical Reports Server (NTRS)

Weeks, David J.

1987-01-01

Various applications of artificial intelligence to space electrical power systems are discussed. An overview is given of completed, on-going, and planned knowledge-based system activities. These applications include the Nickel-Cadmium Battery Expert System (NICBES) (the expert system interfaced with the Hubble Space Telescope electrical power system test bed); the early work with the Space Station Experiment Scheduler (SSES); the three expert systems under development in the space station advanced development effort in the core module power management and distribution system test bed; planned cooperation of expert systems in the Core Module Power Management and Distribution (CM/PMAD) system breadboard with expert systems for the space station at other research centers; and the intelligent data reduction expert system under development.

Assessing the American Association of Neuroscience Nurses' Progress on the Institute of Medicine Report.

PubMed

Madden, Lori Kennedy; Hundley, Lynn; Summers, Debbie; Villanueva, Nancy; Walter, Suzy Mascaro

2017-06-01

The American Association of Neuroscience Nurses (AANN) has worked toward meeting the challenges and addressing the key messages from the 2010 Institute of Medicine report on the future of nursing. In 2012, AANN developed an article summarizing how the association has addressed key issues. Since that time, new recommendations have been made to advance nursing, and AANN has updated its strategic plan. The AANN has assessed organizational progress in these initiatives in a 2017 white paper. This process included review of plans since the initial report and proposal of further efforts the organization can make in shaping the future of neuroscience nursing. The purpose of this manuscript is to provide an overview of the AANN white paper.

Making the connection: advancing traffic incident management in transportation planning : a primer.

DOT National Transportation Integrated Search

2013-07-01

"The intent of this primer is to inform and guide traffic incident management (TIM) professionals and transportation planners to initiate and develop collaborative relationships and advance TIM programs through the metropolitan planning process. The ...

'Nurses don't deal with these issues': nurses' role in advance care planning for lesbian, gay, bisexual and transgender patients.

PubMed

Carabez, Rebecca; Scott, Megan

2016-12-01

We used a question from the Healthcare Equality Index to explore nurses' knowledge and understanding of medical advance directives, medical power of attorney and other legal documents for lesbian, gay, bisexual and transgender patients. Until the landmark ruling in Obergefell vs. Hodges, lesbian, gay, bisexual and transgender individuals and same-sex couples have had limited relationship rights as only a few states recognised marriages and provided legal protections for same-sex couples. Health care providers' knowledge of and attitudes towards advance care planning plays a significant role in determining whether or not individuals successfully complete advance directives, yet advance care planning for lesbian, gay, bisexual and transgender individuals is poorly understood among both health care providers and same-sex couples. These data were part of a larger research study that explored the current state of lesbian, gay, bisexual and transgender-sensitive nursing practice. Undergraduate nursing students recruited and interviewed nurse key informants (n = 268) about medical advance directives, medical power of attorney and other legal documents for lesbian, gay, bisexual and transgender patients. Nearly 50% of key informants indicated a lack of knowledge of advance directives, over 26% reported the difficulties nurses face regarding advance directives are the same for both lesbian, gay, bisexual and transgender and heterosexual patients, and nearly 25% indicated difficulties including having to decide who has the legal right to make decisions for the patient. The study demonstrated the need for education and training for practising nurses in advance care planning for lesbian, gay, bisexual and transgender patients and same-sex couples. Nurses are in a position to act as educators, advocates and decision makers for their patients. Nurse's lack of understanding of advance care planning may negatively impact the type and quality of care lesbian, gay, bisexual and transgender patients receive. © 2016 John Wiley & Sons Ltd.

Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care.

PubMed

Davison, Sara N; Levin, Adeera; Moss, Alvin H; Jha, Vivekanand; Brown, Edwina A; Brennan, Frank; Murtagh, Fliss E M; Naicker, Saraladevi; Germain, Michael J; O'Donoghue, Donal J; Morton, Rachael L; Obrador, Gregorio T

2015-09-01

Patients with advanced chronic kidney disease (CKD) have a high burden of physical and psychosocial symptoms, poor outcomes, and high costs of care. Current paradigms of care for this highly vulnerable population are variable, prognostic and assessment tools are limited, and quality of care, particularly regarding conservative and palliative care, is suboptimal. The KDIGO Controversies Conference on Supportive Care in CKD reviewed the current state of knowledge in order to define a roadmap to guide clinical and research activities focused on improving the outcomes of people living with advanced CKD, including those on dialysis. An international group of multidisciplinary experts in CKD, palliative care, methodology, economics, and education identified the key issues related to palliative care in this population. The conference led to a working plan to address outstanding issues in this arena, and this executive summary serves as an output to guide future work, including the development of globally applicable guidelines.

3D Seismic Experimentation and Advanced Processing/Inversion Development for Investigations of the Shallow Subsurface

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

Levander, Alan Richard; Zelt, Colin A.

2015-03-17

The work plan for this project was to develop and apply advanced seismic reflection and wide-angle processing and inversion techniques to high resolution seismic data for the shallow subsurface to seismically characterize the shallow subsurface at hazardous waste sites as an aid to containment and cleanup activities. We proposed to continue work on seismic data that we had already acquired under a previous DoE grant, as well as to acquire additional new datasets for analysis. The project successfully developed and/or implemented the use of 3D reflection seismology algorithms, waveform tomography and finite-frequency tomography using compressional and shear waves for highmore » resolution characterization of the shallow subsurface at two waste sites. These two sites have markedly different near-surface structures, groundwater flow patterns, and hazardous waste problems. This is documented in the list of refereed documents, conference proceedings, and Rice graduate theses, listed below.« less

Recent Progress in Engine Noise Reduction Technologies

NASA Technical Reports Server (NTRS)

Huff, Dennis; Gliebe, Philip

2003-01-01

Highlights from NASA-funded research over the past ten years for aircraft engine noise reduction are presented showing overall technical plans, accomplishments, and selected applications to turbofan engines. The work was sponsored by NASA's Advanced Subsonic Technology (AST) Noise Reduction Program. Emphasis is given to only the engine noise reduction research and significant accomplishments that were investigated at Technology Readiness Levels ranging from 4 to 6. The Engine Noise Reduction sub-element was divided into four work areas: source noise prediction, model scale tests, engine validation, and active noise control. Highlights from each area include technologies for higher bypass ratio turbofans, scarf inlets, forward-swept fans, swept and leaned stators, chevron/tabbed nozzles, advanced noise prediction analyses, and active noise control for fans. Finally, an industry perspective is given from General Electric Aircraft Engines showing how these technologies are being applied to commercial products. This publication contains only presentation vu-graphs from an invited lecture given at the 41st AIAA Aerospace Sciences Meeting, January 6-9, 2003.

Distributed Observer Network

NASA Technical Reports Server (NTRS)

2008-01-01

NASA s advanced visual simulations are essential for analyses associated with life cycle planning, design, training, testing, operations, and evaluation. Kennedy Space Center, in particular, uses simulations for ground services and space exploration planning in an effort to reduce risk and costs while improving safety and performance. However, it has been difficult to circulate and share the results of simulation tools among the field centers, and distance and travel expenses have made timely collaboration even harder. In response, NASA joined with Valador Inc. to develop the Distributed Observer Network (DON), a collaborative environment that leverages game technology to bring 3-D simulations to conventional desktop and laptop computers. DON enables teams of engineers working on design and operations to view and collaborate on 3-D representations of data generated by authoritative tools. DON takes models and telemetry from these sources and, using commercial game engine technology, displays the simulation results in a 3-D visual environment. Multiple widely dispersed users, working individually or in groups, can view and analyze simulation results on desktop and laptop computers in real time.

Analysis of post-mining excavations as places for municipal waste

NASA Astrophysics Data System (ADS)

Górniak-Zimroz, Justyna

2018-01-01

Waste management planning is an interdisciplinary task covering a wide range of issues including costs, legal requirements, spatial planning, environmental protection, geography, demographics, and techniques used in collecting, transporting, processing and disposing of waste. Designing and analyzing this issue is difficult and requires the use of advanced analysis methods and tools available in GIS geographic information systems containing readily available graphical and descriptive databases, data analysis tools providing expert decision support while selecting the best-designed alternative, and simulation models that allow the user to simulate many variants of waste management together with graphical visualization of the results of performed analyzes. As part of the research study, there have been works undertaken concerning the use of multi-criteria data analysis in waste management in areas located in southwestern Poland. These works have proposed the inclusion in waste management of post-mining excavations as places for the final or temporary collection of waste assessed in terms of their suitability with the tools available in GIS systems.

Planning for Serious Illness by the General Public: A Population-Based Survey

PubMed Central

Quinlan, Elizabeth; Venne, Rosemary; Hunter, Paulette; Surtees, Doug

2013-01-01

Background. While rates of advance care documentation amongst the general public remain low, there is increasing recognition of the value of informal planning to address patient preferences in serious illness. Objectives. To determine the associations between personal attributes and formal and informal planning for serious illness across age groups. Methods. This population-based, online survey was conducted in Saskatchewan, Canada, in April, 2012, using a nonclinical sample of 827 adults ranging from 18 to 88 years of age and representative of age, sex, and regional distribution of the province. Associations between key predictor variables and planning for serious illness were assessed using binary logistic regression. Results. While 16.6% of respondents had completed a written living will or advance care plan, half reported having conversations about their treatment wishes or states of health in which they would find it unacceptable to live. Lawyers were the most frequently cited source of assistance for those who had prepared advance care plans. Personal experiences with funeral planning significantly increased the likelihood of activities designed to plan for serious illness. Conclusions. Strategies designed to increase the rate of planning for future serious illness amongst the general public must account for personal readiness. PMID:25025030

Origination of medical advance directives among nursing home residents with and without serious mental illness.

PubMed

Cai, Xueya; Cram, Peter; Li, Yue

2011-01-01

Nursing home residents with serious mental illness need a high level of general medical and end-of-life services. This study tested whether persons with serious mental illness are as likely as other nursing home residents to make informed choices about treatments through medical advance care plans. Secondary analyses were conducted with data from a 2004 national survey of nursing home residents with (N=1,769) and without (N=11,738) serious mental illness. Bivariate and multivariate analyses determined differences in documented advance care plans, including living wills; do-not-resuscitate and do-not-hospitalize orders; and orders concerning restriction of feeding tube, medication, or other treatments. The overall rates of having any of the four advance care plans were 57% and 68% for residents with and without serious mental illness, respectively (p<.001). Residents with serious mental illness also showed lower rates for individual advance care plans. In a multivariate analysis that adjusted for resident and facility characteristics (N=1,174 nursing homes) as well as survey procedures, serious mental illness was associated with a 24% reduced odds of having any advance directives (adjusted odds ratio=.76, 95% confidence interval=.66-.87, p<.001). Similar results were found for individual documented plans. Among U.S. nursing home residents, those with serious mental illness were less likely than others to have written medical advance directives. Future research is needed to help understand both resident factors (such as inappropriate behaviors, impaired communication skills, and disrupted family support) and provider factors (including training, experience, and attitude) that underlie this finding.

Advancing Our Understanding of the Etiologies and Mutational Landscapes of Basal-Like, Luminal A, and Luminal B Breast Cancers

DTIC Science & Technology

2015-10-01

an additional 80 to 100 estrogen receptor positive (ER+) cases. In terms of the impact of this change on our specific aims, it impacts only Aims 1...This modification does not impact the work or budget of Dr. Chinnaiyan’s component of this project as there were never any plans to provide samples...increased speed and sequencing yield, months 7-60: We will optimize and incorporate improved methods for library construction, such as transposon based

[A medical consumable material management information system].

PubMed

Tang, Guoping; Hu, Liang

2014-05-01

Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process.

Management Approaches for Enterocutaneous Fistulas.

PubMed

Heimroth, Jamie; Chen, Eric; Sutton, Erica

2018-03-01

There are very few clinical studies that highlight a definitive and comprehensive guideline for the management of enterocutaneous fistulas. Most accepted guidelines are found in textbooks and are taken from expert advice and case reports. The goal of this review is to highlight advancements relevant to the management of enterocutaneous fistulas from the recent two to three years. Although strong evidence-based guidelines are lacking, the consensus is that a multidisciplinary team working with a clear treatment plan targeting multiple aspects of management can maximize patient outcomes.

Research in advanced formal theorem-proving techniques

NASA Technical Reports Server (NTRS)

Rulifson, J. F.

1971-01-01

The present status is summarized of a continuing research program aimed at the design and implementation of a language for expressing problem-solving procedures in several areas of artificial intelligence, including program synthesis, robot planning, and theorem proving. Notations, concepts, and procedures common to the representation and solution of many of these problems were abstracted and incorporated as features into the language. The areas of research covered are described, and abstracts of six papers that contain extensive description and technical detail of the work are presented.

Phase Zero Operations for Contingency and Expeditionary Contracting-Keys to Fully Integrating Contracting into Operational Planning and Execution

DTIC Science & Technology

2010-08-02

Cost and Price Analysis & Negotiations (5-2)—DAU CON 217 & CON 218 Certified; MN3318 Contingency Contracting (3-0)—DAU CON 234 Certified; and...MN3315 Advanced Contract Management (4-0)—DAU CON 214 & CON 215 Certified. CDR (Ret) Yoder has recently been published or cited in the following works...certified as the primary guide for all DAU CON 234 course deliveries. Contracting Out Government Procurement Functions: An Analysis (NPS-CM-07-105), E

Leading Through Civilian Power: The First Quadrennial Diplomacy and Development Review

DTIC Science & Technology

2010-01-01

military power as equal pillars of U.S. for- eign policy. She called for an integrated “ smart power” approach to solving global problems—a concept that is...ing the latest tools and technologies, as well as the innovators and entrepreneurs behind them, and integrating them into our diplomacy and...and planning that will allow us to work smarter to advance our nation’s interests and values. i. buiLding a 21St cEntury workforcE Smart power

Advanced 3-dimensional planning in neurosurgery.

PubMed

Ferroli, Paolo; Tringali, Giovanni; Acerbi, Francesco; Schiariti, Marco; Broggi, Morgan; Aquino, Domenico; Broggi, Giovanni

2013-01-01

During the past decades, medical applications of virtual reality technology have been developing rapidly, ranging from a research curiosity to a commercially and clinically important area of medical informatics and technology. With the aid of new technologies, the user is able to process large amounts of data sets to create accurate and almost realistic reconstructions of anatomic structures and related pathologies. As a result, a 3-diensional (3-D) representation is obtained, and surgeons can explore the brain for planning or training. Further improvement such as a feedback system increases the interaction between users and models by creating a virtual environment. Its use for advanced 3-D planning in neurosurgery is described. Different systems of medical image volume rendering have been used and analyzed for advanced 3-D planning: 1 is a commercial "ready-to-go" system (Dextroscope, Bracco, Volume Interaction, Singapore), whereas the others are open-source-based software (3-D Slicer, FSL, and FreesSurfer). Different neurosurgeons at our institution experienced how advanced 3-D planning before surgery allowed them to facilitate and increase their understanding of the complex anatomic and pathological relationships of the lesion. They all agreed that the preoperative experience of virtually planning the approach was helpful during the operative procedure. Virtual reality for advanced 3-D planning in neurosurgery has achieved considerable realism as a result of the available processing power of modern computers. Although it has been found useful to facilitate the understanding of complex anatomic relationships, further effort is needed to increase the quality of the interaction between the user and the model.

Using highways during evacuation operations for events with advance notice

DOT National Transportation Integrated Search

2006-12-01

This document constitutes the first of a primer series titled 'Routes to Effective Evacuation planning' and covers the use of the highway system during evacuation operations when advance planning is possible [...] This is a basic-level guide on condu...

Maxillary movement in distraction osteogenesis using internal devices in cleft palate patients.

PubMed

Tomita, Daisuke; Omura, Susumu; Ozaki, Shusaku; Shimazaki, Kazuo; Fukuyama, Eiji; Tohnai, Iwai; Torikai, Katsuyuki

2011-03-01

The purpose of this cephalometric study was to compare the actual movement with the planned movement of the maxilla by using internal maxillary distraction in cleft lip and palate patients. Twelve patients, including eight with unilateral and four with bilateral cleft lip and palate, underwent maxillary advancement with internal maxillary distractors. Lateral cephalometric radiographs obtained preoperatively, predistraction, and postdistraction were used for analysis. The movement of the maxilla, angular change of the internal devices and rotation of the mandible were measured at each stage, and the planned vector of advancement predicted from the placement vector of the distractors was compared with the actual vector. Internal maxillary distractors were rotated in a clockwise direction during the distraction period. The angular change of the distractors was 7.7°. The amount of actual advancement at anterior nasal spine with distraction was 6.3 mm, which represented about 70% of the distance of activation of distraction. The actual advanced vector at anterior nasal spine was 9.7° smaller than the planned vector. The mandible underwent a clockwise rotation of 3.5°. In the internal distraction technique, the maxilla was advanced inferiorly to the planned vector and with a slight clockwise rotation. These results are useful for surgical planning when using internal distractors.

Advance care planning within survivorship care plans for older cancer survivors: A systematic review.

PubMed

O'Caoimh, Rónán; Cornally, Nicola; O'Sullivan, Ronan; Hally, Ruth; Weathers, Elizabeth; Lavan, Amanda H; Kearns, Tara; Coffey, Alice; McGlade, Ciara; Molloy, D William

2017-11-01

Advances in the medical treatment of cancer have increased the number of survivors, particularly among older adults, who now represent the majority of these. Survivorship care plans (SCPs) are documents that cancer patients receive summarising their care, usually at the end of treatment but preferably from initial diagnosis. These may increase patient satisfaction and represent an opportunity to initiate preventative strategies and address future care needs. Advance care planning (ACP), incorporating advance healthcare decision-making, including formal written directives, increases satisfaction and end-of-life care. This paper systematically reviews evaluations of ACP within SCPs among older (≥65 years) cancer survivors. No studies meeting the inclusion criteria were identified by search strategies conducted in PubMed/MEDLINE and the Cochrane databases. One paper examined cancer survivors' mainly positive views of ACP. Another discussed the use of a SCP supported by a 'distress inventory' that included an advance care directive (living will) as an issue, though no formal evaluation was reported. Although ACP is important for older adults, no study was found that evaluated its role within survivorship care planning. Despite the risk of recurrence and the potential for morbidity and mortality, especially among older cancer survivors, ACP is not yet a feature of SCPs. Copyright © 2017 Elsevier B.V. All rights reserved.

78 FR 42027 - Proposed Amendment To Advance Notice of Proposed Rulemaking for Pension Benefit Statements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

...The Department of Labor is extending until August 7, 2013, the comment period for an advance notice of proposed rulemaking focusing on lifetime income illustrations given to participants in defined contribution pension plans, such as 401(k) and 403(b) plans. The ANPRM serves as a request for comments on specific language and concepts in advance of a proposed regulation.

Advanced thermal control technologies for space science missions at JPL

NASA Technical Reports Server (NTRS)

Birur, G. C.; O'Donnell, T.

2000-01-01

A wide range of deep space science missions are planned by NASA for the future. Many of these missions are being planned under strict cost caps and advanced technologies are needed in order to enable these challenging mssions. Because of the wide range of thermal environments the spacecraft experience during the mission, advanced thermal control technologies are the key to enabling many of these missions.

Preliminary design study of advanced composite blade and hub and nonmechanical control system for the tilt-rotor aircraft. Volume 2: Project planning data

NASA Technical Reports Server (NTRS)

1980-01-01

Project planning data for a rotor and control system procurement and testing program for modifications to the XV-15 tilt-rotor research demonstrator aircraft is presented. The design, fabrication, and installation of advanced composite blades compatible with the existing hub, an advanced composite hub, and a nonmechanical control system are required.

"I Don't Want to Die like that...": The Impact of Significant Others' Death Quality on Advance Care Planning

ERIC Educational Resources Information Center

Carr, Deborah

2012-01-01

Purpose of the Study: I examine whether 5 aspects of a significant other's death quality (pain, decision-making capacity, location, problems with end-of life care, and preparation) affect whether one does advance care planning (ACP). I also identify specific aspects of others' deaths that respondents say triggered their own planning. Design and…

The Product Quality Research Institute (PQRI) Leachables and Extractables Working Group Initiatives for Parenteral and Ophthalmic Drug Product (PODP).

PubMed

Paskiet, Diane; Jenke, Dennis; Ball, Douglas; Houston, Christopher; Norwood, Daniel L; Markovic, Ingrid

2013-01-01

The Product Quality Research Institute (PQRI) is a non-profit consortium of organizations working together to generate and share timely, relevant, and impactful information that advances drug product quality and development. The collaborative activities of PQRI participants have, in the case of orally inhaled and nasal drug products (OINDPs), resulted in comprehensive and widely-accepted recommendations for leachables assessments to help ensure patient safety with respect to this class of packaged drug products. These recommendations, which include scientifically justified safety thresholds for leachables, represent a significant milestone towards establishing standardized approaches for safety qualification of leachables in OINDP. To build on the success of the OINDP effort, PQRI's Parenteral and Ophthalmic Drug Products (PODP) Leachables and Extractables Working Group was formed to extrapolate the OINDP threshold concepts and best practice recommendations to other dosage forms with high concern for interaction with packaging/delivery systems. This article considers the general aspects of leachables and their safety assessment, introduces the PODP Work Plan and initial study Protocol, discusses the laboratory studies being conducted by the PODP Chemistry Team, outlines the strategy being developed by the PODP Toxicology Team for the safety qualification of PODP leachables, and considers the issues associated with application of the safety thresholds, particularly with respect to large-volume parenterals. Lastly, the unique leachables issues associated with biologics are described. The Product Quality Research Institute (PQRI) is a non-profit consortium involving industry organizations, academia, and regulatory agencies that together provide recommendations in support of regulatory guidance to advance drug product quality. The collaborative activities of the PQRI Orally Inhaled and Nasal Drug Products Leachables and Extractables Working Group resulted in a systematic and science-based approach to identify and qualify leachables, including the concept of safety thresholds. Concepts from this widely accepted approach, formally publicized in 2006, are being extrapolated to parenteral and ophthalmic drug products. This article provides an overview of extractables and leachables in drug products and biologics and discusses the PQRI Work Plan and Protocols developed by the PQRI Parenteral and Ophthalmic Drug Products Leachables and Extractables Working Group.

Completing advance directives for health care decisions: getting to yes.

PubMed

Shewchuk, T R

1998-09-01

The concept of advance directives for health care decision making has been judicially condoned, legislatively promoted, and systematically implemented by health care institutions, yet the execution rate of advance directives remains low. Physicians should discuss with their patients advance care planning generally and end-of-life issues specifically, preferably when patients are in good health and not when they face an acute medical crisis. The physician-hospital relationship poses particular challenges for the optimal implementation of advance directives that must be addressed. Hospital administrators must improve education of patients and physicians on the value of such documents as well as internal mechanisms to ensure better implementation of directives. Health insurance plans may be better able to ensure optimal gathering and implementation of directives. Patients must become more familiar and more comfortable with advance care planning and the reality of death and dying issues. Full acceptance of the value of directives ultimately rests on achieving full participation of all involved--providers, patients, families, and payors--in this most profound process.

TRU Waste Management Program. Cost/schedule optimization analysis

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

Detamore, J.A.; Raudenbush, M.H.; Wolaver, R.W.

This Current Year Work Plan presents in detail a description of the activities to be performed by the Joint Integration Office Rockwell International (JIO/RI) during FY86. It breaks down the activities into two major work areas: Program Management and Program Analysis. Program Management is performed by the JIO/RI by providing technical planning and guidance for the development of advanced TRU waste management capabilities. This includes equipment/facility design, engineering, construction, and operations. These functions are integrated to allow transition from interim storage to final disposition. JIO/RI tasks include program requirements identification, long-range technical planning, budget development, program planning document preparation, taskmore » guidance development, task monitoring, task progress information gathering and reporting to DOE, interfacing with other agencies and DOE lead programs, integrating public involvement with program efforts, and preparation of reports for DOE detailing program status. Program Analysis is performed by the JIO/RI to support identification and assessment of alternatives, and development of long-term TRU waste program capabilities. These analyses include short-term analyses in response to DOE information requests, along with performing an RH Cost/Schedule Optimization report. Systems models will be developed, updated, and upgraded as needed to enhance JIO/RI's capability to evaluate the adequacy of program efforts in various fields. A TRU program data base will be maintained and updated to provide DOE with timely responses to inventory related questions.« less

National space transportation systems planning

NASA Technical Reports Server (NTRS)

Lucas, W. R.

1985-01-01

In the fall of 1984, the DOD and NASA had been asked to identify launch vehicle technologies which could be made available for use in 1995 to 2010. The results of the studies of the two groups were integrated, and a consumer report, dated December 1984, was forwarded to the President. Aspects of mission planning and analysis are discussed along with a combined mission model, future launch system requirements, a launch vehicle planning background, Shuttle derivative vehicle program options, payload modularization, launch vehicle technology implications, a new engine program for the mid-1990's. Future launch systems goals are to achieve an order of magnitude reduction in future launch cost and meet the lift requirements and launch rates. Attention is given to an advanced cryogenic engine, advanced LOX/hydrocarbon engine, advanced power systems, aerodynamics/flight mechanics, reentry/recovery systems, avionics/software, advanced manufacturing techniques, autonomous ground and mission operations, advanced structures/materials, and air breathing propulsion.

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

Advancement Is Seldom Accidental.

ERIC Educational Resources Information Center

Frantzreb, Arthur C.

1981-01-01

Success in college goals and programs for institutional advancement is seldom accidental: success in philanthropic support is seen as 90 percent planning and 10 percent implementation. Trustee membership, long-range plans, the motivational case, experienced staff, adequate budgets, prospect research, supportive communication all meld into a plan…

14 CFR 151.125 - Allowable advance planning costs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary engineering...

14 CFR 151.125 - Allowable advance planning costs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary engineering...

14 CFR 151.125 - Allowable advance planning costs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary engineering...

14 CFR 151.125 - Allowable advance planning costs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary engineering...

14 CFR 151.125 - Allowable advance planning costs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary engineering...

76 FR 41799 - Agency Information Collection Activities: Proposed Collection; Comment Request; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... Checklist: Medicaid Eligibility & Enrollment Systems--Advance Planning Document (E&E-APD); Use: Under... Eligibility/Enrollment Systems APD approval assignment. The information requested on the Checklist will be... an Expedited Checklist: Medicaid Eligibility & Enrollment Systems--Advance Planning Document (E& -APD...

Expanding The INSPIRED COPD Outreach Program™ to the emergency department: a feasibility assessment

PubMed Central

Gillis, Darcy; Demmons, Jillian; Rocker, Graeme

2017-01-01

Background The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%–80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission. Methods Patients were eligible for the INSPIRED-ED study if >40 years of age, diagnosed with AECOPD and discharged from the ED, willing to be referred, community dwelling with at least one of: previous use of the ED services, admission to Intermediate Care Unit/Intensive Care Unit, or admission to hospital with AECOPD in the past year. We set feasibility objectives for referral rates, completion of action plans, advance care planning participation, and reduction in ED visit frequency. Results Referral rates were 0.5/week. Among eligible patients (n=174) 33 (19%) were referred of whom 15 (M=4, F=11) enrolled in INSPIRED-ED. Mean (SD) age was 68 (7) years, post-bronchdilator FEV1 44.2 (15.5) % predicted, and Medical Research Council (MRC) dyspnea score 3.8 (0.41). We met feasibility objectives for action plan and advance care planning completion. Frequency of subsequent ED visits fell by 54%. Mean (SD) Care Transition Measure (CTM-3) improved from 8.6 (2.0) to 11.3 (1.3), P=0.0004, and of 14 patients responding 12 (86%) found the program very helpful. An additional 34 patients were enrolled to our regular program from those referred but ineligible for INSPIRED-ED (n=27) or unwilling to participate (n=7). Conclusions INSPIRED-ED outcomes were generally positive, however referral and enrollment rates were lower than anticipated. Despite the potential of early self-management education, the ED may not be the ideal recruitment setting for home-based programs. Our findings underline the importance of conducting preliminary work to ascertain best settings for implementing new self-management education initiatives. PMID:28615932

Expanding The INSPIRED COPD Outreach Program™ to the emergency department: a feasibility assessment.

PubMed

Gillis, Darcy; Demmons, Jillian; Rocker, Graeme

2017-01-01

The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%-80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission. Patients were eligible for the INSPIRED-ED study if >40 years of age, diagnosed with AECOPD and discharged from the ED, willing to be referred, community dwelling with at least one of: previous use of the ED services, admission to Intermediate Care Unit/Intensive Care Unit, or admission to hospital with AECOPD in the past year. We set feasibility objectives for referral rates, completion of action plans, advance care planning participation, and reduction in ED visit frequency. Referral rates were 0.5/week. Among eligible patients (n=174) 33 (19%) were referred of whom 15 (M=4, F=11) enrolled in INSPIRED-ED. Mean (SD) age was 68 (7) years, post-bronchdilator FEV 1 44.2 (15.5) % predicted, and Medical Research Council (MRC) dyspnea score 3.8 (0.41). We met feasibility objectives for action plan and advance care planning completion. Frequency of subsequent ED visits fell by 54%. Mean (SD) Care Transition Measure (CTM-3) improved from 8.6 (2.0) to 11.3 (1.3), P =0.0004, and of 14 patients responding 12 (86%) found the program very helpful. An additional 34 patients were enrolled to our regular program from those referred but ineligible for INSPIRED-ED (n=27) or unwilling to participate (n=7). INSPIRED-ED outcomes were generally positive, however referral and enrollment rates were lower than anticipated. Despite the potential of early self-management education, the ED may not be the ideal recruitment setting for home-based programs. Our findings underline the importance of conducting preliminary work to ascertain best settings for implementing new self-management education initiatives.

Design and analysis of advanced flight planning concepts

NASA Technical Reports Server (NTRS)

Sorensen, John A.

1987-01-01

The objectives of this continuing effort are to develop and evaluate new algorithms and advanced concepts for flight management and flight planning. This includes the minimization of fuel or direct operating costs, the integration of the airborne flight management and ground-based flight planning processes, and the enhancement of future traffic management systems design. Flight management (FMS) concepts are for on-board profile computation and steering of transport aircraft in the vertical plane between a city pair and along a given horizontal path. Flight planning (FPS) concepts are for the pre-flight ground based computation of the three-dimensional reference trajectory that connects the city pair and specifies the horizontal path, fuel load, and weather profiles for initializing the FMS. As part of these objectives, a new computer program called EFPLAN has been developed and utilized to study advanced flight planning concepts. EFPLAN represents an experimental version of an FPS. It has been developed to generate reference flight plans compatible as input to an FMS and to provide various options for flight planning research. This report describes EFPLAN and the associated research conducted in its development.

Physicians' Views on Advance Care Planning and End-of-Life Care Conversations.

PubMed

Fulmer, Terry; Escobedo, Marcus; Berman, Amy; Koren, Mary Jane; Hernández, Sandra; Hult, Angela

2018-05-23

To evaluate physicians' views on advance care planning, goals of care, and end-of-life conversations. Random sample telephone survey. United States. Physicians (primary care specialists; pulmonology, cardiology, oncology subspecialists) actively practicing medicine and regularly seeing patients aged 65 and older (N=736; 81% male, 75% white, 66% aged ≥50. A 37-item telephone survey constructed by a professional polling group with national expert oversight measured attitudes and perceptions of barriers and facilitators to advance care planning. Summative data are presented here. Ninety-nine percent of participants agreed that it is important to have end-of-life conversations, yet only 29% reported that they have formal training for such conversations. Those most likely to have training included younger physicians and those caring for a racially and ethnically diverse population. Patient values and preferences were the strongest motivating factors in having advance care planning conversations, with 92% of participants rating it extremely important. Ninety-five percent of participants reported that they supported a new Medicare fee-for-service benefit reimbursing advance care planning. The biggest barrier mentioned was time availability. Other barriers included not wanting a patient to give up hope and feeling uncomfortable. With more than half of physicians reporting that they feel educationally unprepared, there medical school curricula need to be strengthened to ensure readiness for end-of-life conversations. Clinician barriers need to be addressed to meet the needs of older adults and families. Policies that focus on payment for quality should be evaluated at regular intervals to monitor their effect on advance care planning. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Lunar exploration rover program developments

NASA Technical Reports Server (NTRS)

Klarer, P. R.

1994-01-01

The Robotic All Terrain Lunar Exploration Rover (RATLER) design concept began at Sandia National Laboratories in late 1991 with a series of small, proof-of-principle, working scale models. The models proved the viability of the concept for high mobility through mechanical simplicity, and eventually received internal funding at Sandia National Laboratories for full scale, proof-of-concept prototype development. Whereas the proof-of-principle models demonstrated the mechanical design's capabilities for mobility, the full scale proof-of-concept design currently under development is intended to support field operations for experiments in telerobotics, autonomous robotic operations, telerobotic field geology, and advanced man-machine interface concepts. The development program's current status is described, including an outline of the program's work over the past year, recent accomplishments, and plans for follow-on development work.

Going for gold: blood planning for the London 2012 Olympic Games.

PubMed

Glasgow, S M; Allard, S; Rackham, R; Doughty, H

2014-06-01

The Olympics is one of the largest sporting events in the world. Major events may be complicated by disruption of normal activity and major incidents. Health care and transfusion planners should be prepared for both. Previously, transfusion contingency planning has focused on seasonal blood shortages and pandemic influenzas. This article is the first published account of transfusion contingency planning for a major event. We describe the issues encountered and the lessons identified during transfusion planning for the London 2012 Olympics. Planning was started 18 months in advance and was led by a project team reporting to the Executive. Planning was based on three periods of Gamestime. The requirements were planned with key stakeholders using normal processes enhanced by service developments. Demand planning was based on literature review together with computer modelling. The aim was blood-stock sufficiency complimented by a high readiness donor panel to minimise waste. Plans were widely communicated and table-top exercised. Full transfusion services were maintained during both Games with all demands met. The new service improvements and high readiness donors worked well. Emergency command and control have been upgraded. Red cell concentrate (RCC) stock aged but wastage was not significantly increased. The key to success was: early planning, stakeholder engagement, service developments, integration of transfusion service planning within the wider health care community and conduct within an assurance framework. © 2014 The Authors. Transfusion Medicine © 2014 British Blood Transfusion Society.

Strategic Computing. New-Generation Computing Technology: A Strategic Plan for Its Development and Application to Critical Problems in Defense

DTIC Science & Technology

1983-10-28

Computing. By seizing an opportunity to leverage recent advances in artificial intelligence, computer science, and microelectronics, the Agency plans...occurred in many separated areas of artificial intelligence, computer science, and microelectronics. Advances in "expert system" technology now...and expert knowledge o Advances in Artificial Intelligence: Mechanization of speech recognition, vision, and natural language understanding. o

25 CFR 1000.54 - How will a Tribe/Consortium know whether or not it has been selected to receive an advance...

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Planning and Negotiation Grants Advance Planning Grant Funding § 1000.54 How will a Tribe/Consortium know... Director will notify the Tribe/Consortium by letter whether it has been selected to receive an advance... 25 Indians 2 2010-04-01 2010-04-01 false How will a Tribe/Consortium know whether or not it has...

48 CFR 806.570 - Planning requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Planning requirements. 806... AND ACQUISITION PLANNING COMPETITION REQUIREMENTS Competition Advocates 806.570 Planning requirements... planning that is required. (3) A description of how to integrate the Competition Plan into advance...

Barriers to Advance Care Planning at the End of Life: An Explanatory Systematic Review of Implementation Studies

PubMed Central

Lund, Susi; Richardson, Alison; May, Carl

2015-01-01

Context Advance Care Plans (ACPs) enable patients to discuss and negotiate their preferences for the future including treatment options at the end of life. Their implementation poses significant challenges. Objective To investigate barriers and facilitators to the implementation of ACPs, focusing on their workability and integration in clinical practice. Design An explanatory systematic review of qualitative implementation studies. Data sources Empirical studies that reported interventions designed to support ACP in healthcare. Web of Knowledge, Ovid MEDLINE, CINAHL, PsycINFO, British Nursing Index and PubMed databases were searched. Methods Direct content analysis, using Normalization Process Theory, to identify and characterise relevant components of implementation processes. Results 13 papers identified from 166 abstracts were included in the review. Key factors facilitating implementation were: specially prepared staff utilizing a structured approach to interactions around ACPs. Barriers to implementation were competing demands of other work, the emotional and interactional nature of patient-professional interactions around ACPs, problems in sharing decisions and preferences within and between healthcare organizations. Conclusions This review demonstrates that doing more of the things that facilitate delivery of ACPs will not reduce the effects of those things that undermine them. Structured tools are only likely to be partially effective and the creation of a specialist cadre of ACP facilitators is unlikely to be a sustainable solution. The findings underscore both the challenge and need to find ways to routinely incorporate ACPs in clinical settings where multiple and competing demands impact on practice. Interventions most likely to meet with success are those that make elements of Advance Care Planning workable within complex and time pressured clinical workflows. PMID:25679395

WE-B-BRD-00: MRI for Radiation Oncology

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

NONE

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptivemore » QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.« less

Optimization of Deep Drilling Performance--Development and Benchmark Testing of Advanced Diamond Product Drill Bits & HP/HT Fluids to Significantly Improve Rates of Penetration

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

Alan Black; Arnis Judzis

2003-10-01

This document details the progress to date on the OPTIMIZATION OF DEEP DRILLING PERFORMANCE--DEVELOPMENT AND BENCHMARK TESTING OF ADVANCED DIAMOND PRODUCT DRILL BITS AND HP/HT FLUIDS TO SIGNIFICANTLY IMPROVE RATES OF PENETRATION contract for the year starting October 2002 through September 2002. The industry cost shared program aims to benchmark drilling rates of penetration in selected simulated deep formations and to significantly improve ROP through a team development of aggressive diamond product drill bit--fluid system technologies. Overall the objectives are as follows: Phase 1--Benchmark ''best in class'' diamond and other product drilling bits and fluids and develop concepts for amore » next level of deep drilling performance; Phase 2--Develop advanced smart bit--fluid prototypes and test at large scale; and Phase 3--Field trial smart bit--fluid concepts, modify as necessary and commercialize products. Accomplishments to date include the following: 4Q 2002--Project started; Industry Team was assembled; Kick-off meeting was held at DOE Morgantown; 1Q 2003--Engineering meeting was held at Hughes Christensen, The Woodlands Texas to prepare preliminary plans for development and testing and review equipment needs; Operators started sending information regarding their needs for deep drilling challenges and priorities for large-scale testing experimental matrix; Aramco joined the Industry Team as DEA 148 objectives paralleled the DOE project; 2Q 2003--Engineering and planning for high pressure drilling at TerraTek commenced; 3Q 2003--Continuation of engineering and design work for high pressure drilling at TerraTek; Baker Hughes INTEQ drilling Fluids and Hughes Christensen commence planning for Phase 1 testing--recommendations for bits and fluids.« less

A new model for graduate education and innovation in medical technology.

PubMed

Yazdi, Youseph; Acharya, Soumyadipta

2013-09-01

We describe a new model of graduate education in bioengineering innovation and design- a year long Master's degree program that educates engineers in the process of healthcare technology innovation for both advanced and low-resource global markets. Students are trained in an iterative "Spiral Innovation" approach that ensures early, staged, and repeated examination of all key elements of a successful medical device. This includes clinical immersion based problem identification and assessment (at Johns Hopkins Medicine and abroad), team based concept and business model development, and project planning based on iterative technical and business plan de-risking. The experiential, project based learning process is closely supported by several core courses in business, design, and engineering. Students in the program work on two team based projects, one focused on addressing healthcare needs in advanced markets and a second focused on low-resource settings. The program recently completed its fourth year of existence, and has graduated 61 students, who have continued on to industry or startups (one half), additional graduate education, or medical school (one third), or our own Global Health Innovation Fellowships. Over the 4 years, the program has sponsored 10 global health teams and 14 domestic/advanced market medtech teams, and launched 5 startups, of which 4 are still active. Projects have attracted over US$2.5M in follow-on awards and grants, that are supporting the continued development of over a dozen projects.

Results of an Experimental Exploration of Advanced Automated Geospatial Tools: Agility in Complex Planning

DTIC Science & Technology

2009-06-01

AUTOMATED GEOSPATIAL TOOLS : AGILITY IN COMPLEX PLANNING Primary Topic: Track 5 – Experimentation and Analysis Walter A. Powell [STUDENT] - GMU...TITLE AND SUBTITLE Results of an Experimental Exploration of Advanced Automated Geospatial Tools : Agility in Complex Planning 5a. CONTRACT NUMBER...Std Z39-18 Abstract Typically, the development of tools and systems for the military is requirement driven; systems are developed to meet

Advanced Launch System advanced development oxidizer turbopump program: Technical implementation plan

NASA Technical Reports Server (NTRS)

Ferlita, F.

1989-01-01

The Advanced Launch Systems (ALS) Advanced Development Oxidizer Turbopump Program has designed, fabricated and demonstrated a low cost, highly reliable oxidizer turbopump for the Space Transportation Engine that minimizes the recurring cost for the ALS engines. Pratt and Whitney's (P and W's) plan for integrating the analyses, testing, fabrication, and other program efforts is addressed. This plan offers a comprehensive description of the total effort required to design, fabricate, and test the ALS oxidizer turbopump. The proposed ALS oxidizer turbopump reduces turbopump costs over current designs by taking advantage of design simplicity and state-of-the-art materials and producibility features without compromising system reliability. This is accomplished by selecting turbopump operating conditions that are within known successful operating regions and by using proven manufacturing techniques.

Human Exploration of Mars: The Reference Mission of the NASA Mars Exploration Study Team

NASA Astrophysics Data System (ADS)

Hoffman, Stephen J.; Kaplan, David I.

1997-07-01

Personnel representing several NASA field centers have formulated a "Reference Mission" addressing human exploration of Mars. This report summarizes their work and describes a plan for the first human missions to Mars, using approaches that are technically feasible, have reasonable risks, and have relatively low costs. The architecture for the Mars Reference Mission builds on previous work of the Synthesis Group (1991) and Zubrin's (1991) concepts for the use of propellants derived from the Martian Atmosphere. In defining the Reference Mission, choices have been made. In this report, the rationale for each choice is documented; however, unanticipated technology advances or political decisions might change the choices in the future.

Software Schedules Missions, Aids Project Management

NASA Technical Reports Server (NTRS)

2008-01-01

NASA missions require advanced planning, scheduling, and management, and the Space Agency has worked extensively to develop the programs and software suites necessary to facilitate these complex missions. These enormously intricate undertakings have hundreds of active components that need constant management and monitoring. It is no surprise, then, that the software developed for these tasks is often applicable in other high-stress, complex environments, like in government or industrial settings. NASA work over the past few years has resulted in a handful of new scheduling, knowledge-management, and research tools developed under contract with one of NASA s partners. These tools have the unique responsibility of supporting NASA missions, but they are also finding uses outside of the Space Program.

Human Exploration of Mars: The Reference Mission of the NASA Mars Exploration Study Team

NASA Technical Reports Server (NTRS)

Hoffman, Stephen J. (Editor); Kaplan, David I. (Editor)

1997-01-01

Personnel representing several NASA field centers have formulated a "Reference Mission" addressing human exploration of Mars. This report summarizes their work and describes a plan for the first human missions to Mars, using approaches that are technically feasible, have reasonable risks, and have relatively low costs. The architecture for the Mars Reference Mission builds on previous work of the Synthesis Group (1991) and Zubrin's (1991) concepts for the use of propellants derived from the Martian Atmosphere. In defining the Reference Mission, choices have been made. In this report, the rationale for each choice is documented; however, unanticipated technology advances or political decisions might change the choices in the future.

SOARing Into Strategic Planning: Engaging Nurses to Achieve Significant Outcomes.

PubMed

Wadsworth, Barbara; Felton, Fiona; Linus, Rita

2016-01-01

In 2013, a new system chief nursing officer engaged the nursing leaders and staff in an Appreciative Inquiry process utilizing strengths, opportunities, aspirations, and results (SOAR), and a Journey of Excellence to assess and understand the current environment. The ultimate goal was to engage all nurses in strategic planning and goal setting to connect their patient care to the system strategic initiatives. This work led to the creation of a nursing vision, a revised professional practice model and greater council alignment, resulting in significant positive change and ongoing advancement throughout the system. The shared decision-making structure was key to the process with a direct connection of each council's goals, leading to the successful achievement of 34 of the 36 goals in 2 years. This article outlines the process, tools, and staff engagement strategies used to achieve system-wide success. This methodology has improved the outcomes across the organization in both small and system-wide work groups. This work can easily be replicated and adapted to help disparate staffs brought together through mergers or acquisitions to become aligned as a new team. This process, model, and framework, provides structure and results in significant outcomes that recognizes and celebrates the work of individual entities while aligning future strategies and goals.

Putting more ‘modern’ in modern physics education: a Knowledge Building approach using student questions and ideas about the universe

NASA Astrophysics Data System (ADS)

Wagner, Glenn

2017-03-01

Student-generated questions and ideas about our universe are the start of a rich and highly motivating learning environment. Using their curiosity-driven questions and ideas, students form Knowledge Building groups or ‘communities’ where they plan, set goals, design questions for research, and assess the progress of their work, tasks that were once under the control of the teacher. With the understanding that all knowledge and ideas are treated as improvable, students work collaboratively at their level of competency to share their knowledge, ideas and understandings gained from authoritative sources and laboratory activities. Over time, students work collectively to improve the knowledge and ideas of others that result in advances in understanding that benefit not only the individual but the community as a whole. Learning outcomes reported in this paper demonstrate that a Knowledge Building environment applied to introductory cosmology produced similar gains in knowledge and understanding surrounding foundational concepts compared to teacher-centred learning environments. Aside from new knowledge and understanding, students develop important skills and competencies such as question-asking, idea development, communication, collaboration that are becoming ever more important for 21st century living and working. Finally, the process of planning and initiating a Knowledge Building environment that produced the results reported in this paper is outlined.

Barriers to and Facilitators of South Asian Indian-Americans’ Engagement in Advanced Care Planning Behaviors

PubMed Central

Radhakrishnan, Kavita; Saxena, Shubhada; Jillapalli, Regina; Jang, Yuri; Kim, Miyong

2018-01-01

Purpose To identify barriers to and facilitators of older South Asian Indian-Americans’ (SAIAs’) engagement in behaviors associated with advance care planning (ACP). Methods Using a descriptive qualitative design guided by the transcultural nursing assessment model, data were collected in focus groups of community-dwelling older SAIA participants, SAIA family caregivers, and SAIA physicians. A directed approach using predetermined coding categories derived from the Transcultural Nursing Assessment model and aided by NVivo 10 software (Melbourne, Australia) facilitated the qualitative data analysis. Results Eleven focus groups with 36 older SAIAs (61% female, 83% 70+ years old), 10 SAIA family caregivers, and 4 SAIA physicians indicated prior lack of awareness of ACP, good health status, lack of access to linguistically and health literacy–tailored materials, healthcare provider hesitation to initiate discussions on ACP, trust in healthcare providers’ or oldest sons’ decision making, busy family caregiver work routines, and cultural assumptions about filial piety and after-death rituals as major barriers to engaging in ACP. Introducing ACP using personal anecdotes in a neutral, group-based community setting and incentivizing ACP discussions by including long-term care planning were suggested as facilitators to engage in ACP. Clinical Relevance The study’s findings will guide development of culturally sensitive interventions to raise awareness about ACP among SAIAs and encourage SAIA older adults to engage in ACP. PMID:28388828

Barriers to and Facilitators of South Asian Indian-Americans' Engagement in Advanced Care Planning Behaviors.

PubMed

Radhakrishnan, Kavita; Saxena, Shubhada; Jillapalli, Regina; Jang, Yuri; Kim, Miyong

2017-05-01

To identify barriers to and facilitators of older South Asian Indian-Americans' (SAIAs') engagement in behaviors associated with advance care planning (ACP). Using a descriptive qualitative design guided by the transcultural nursing assessment model, data were collected in focus groups of community-dwelling older SAIA participants, SAIA family caregivers, and SAIA physicians. A directed approach using predetermined coding categories derived from the Transcultural Nursing Assessment model and aided by NVivo 10 software (Melbourne, Australia) facilitated the qualitative data analysis. Eleven focus groups with 36 older SAIAs (61% female, 83% 70+ years old), 10 SAIA family caregivers, and 4 SAIA physicians indicated prior lack of awareness of ACP, good health status, lack of access to linguistically and health literacy-tailored materials, healthcare provider hesitation to initiate discussions on ACP, trust in healthcare providers' or oldest sons' decision making, busy family caregiver work routines, and cultural assumptions about filial piety and after-death rituals as major barriers to engaging in ACP. Introducing ACP using personal anecdotes in a neutral, group-based community setting and incentivizing ACP discussions by including long-term care planning were suggested as facilitators to engage in ACP. The study's findings will guide development of culturally sensitive interventions to raise awareness about ACP among SAIAs and encourage SAIA older adults to engage in ACP. © 2017 Sigma Theta Tau International.

Desire for predictive testing for Alzheimer's disease and impact on advance care planning: a cross-sectional study.

PubMed

Sheffrin, Meera; Stijacic Cenzer, Irena; Steinman, Michael A

2016-12-13

It is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer's disease, or whether testing would change behavior. Using a nationally representative sample, we explored who would take a free and definitive test predictive of Alzheimer's disease, and examined how using such a test may impact advance care planning. A cross-sectional study within the 2012 Health and Retirement Study of adults aged 65 years or older asked questions about a test predictive of Alzheimer's disease (N = 874). Subjects were asked whether they would want to take a hypothetical free and definitive test predictive of future Alzheimer's disease. Then, imagining they knew they would develop Alzheimer's disease, subjects rated the chance of completing advance care planning activities from 0 to 100. We classified a score > 50 as being likely to complete that activity. We evaluated characteristics associated with willingness to take a test for Alzheimer's disease, and how such a test would impact completing an advance directive and discussing health plans with loved ones. Overall, 75% (N = 648) of the sample would take a free and definitive test predictive of Alzheimer's disease. Older adults willing to take the test had similar race and educational levels to those who would not, but were more likely to be ≤75 years old (odds ratio 0.71 (95% CI 0.53-0.94)). Imagining they knew they would develop Alzheimer's, 81% would be likely to complete an advance directive, although only 15% had done so already. In this nationally representative sample, 75% of older adults would take a free and definitive test predictive of Alzheimer's disease. Many participants expressed intent to increase activities of advance care planning with this knowledge. This confirms high public interest in predictive testing for Alzheimer's disease and suggests this may be an opportunity to engage patients in advance care planning discussions.

14 CFR 151.111 - Advance planning proposals: General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... airport layout plan, under § 151.5(a), or the development of plans designed to lead to a project... proposal must relate to an airport layout plan or plans and specifications for the development of a new...

14 CFR 151.111 - Advance planning proposals: General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... airport layout plan, under § 151.5(a), or the development of plans designed to lead to a project... proposal must relate to an airport layout plan or plans and specifications for the development of a new...

14 CFR 151.111 - Advance planning proposals: General.

Code of Federal Regulations, 2012 CFR

2012-01-01

... airport layout plan, under § 151.5(a), or the development of plans designed to lead to a project... proposal must relate to an airport layout plan or plans and specifications for the development of a new...

14 CFR 151.111 - Advance planning proposals: General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... airport layout plan, under § 151.5(a), or the development of plans designed to lead to a project... proposal must relate to an airport layout plan or plans and specifications for the development of a new...

Smart-DS: Synthetic Models for Advanced, Realistic Testing: Distribution Systems and Scenarios

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

Krishnan, Venkat K; Palmintier, Bryan S; Hodge, Brian S

The National Renewable Energy Laboratory (NREL) in collaboration with Massachusetts Institute of Technology (MIT), Universidad Pontificia Comillas (Comillas-IIT, Spain) and GE Grid Solutions, is working on an ARPA-E GRID DATA project, titled Smart-DS, to create: 1) High-quality, realistic, synthetic distribution network models, and 2) Advanced tools for automated scenario generation based on high-resolution weather data and generation growth projections. Through these advancements, the Smart-DS project is envisioned to accelerate the development, testing, and adoption of advanced algorithms, approaches, and technologies for sustainable and resilient electric power systems, especially in the realm of U.S. distribution systems. This talk will present themore » goals and overall approach of the Smart-DS project, including the process of creating the synthetic distribution datasets using reference network model (RNM) and the comprehensive validation process to ensure network realism, feasibility, and applicability to advanced use cases. The talk will provide demonstrations of early versions of synthetic models, along with the lessons learnt from expert engagements to enhance future iterations. Finally, the scenario generation framework, its development plans, and co-ordination with GRID DATA repository teams to house these datasets for public access will also be discussed.« less

Psychiatric epidemiology: selected recent advances and future directions.

PubMed Central

Kessler, R. C.

2000-01-01

Reviewed in this article are selected recent advances and future challenges for psychiatric epidemiology. Major advances in descriptive psychiatric epidemiology in recent years include the development of reliable and valid fully structured diagnostic interviews, the implementation of parallel cross-national surveys of the prevalences and correlates of mental disorders, and the initiation of research in clinical epidemiology. Remaining challenges include the refinement of diagnostic categories and criteria, recognition and evaluation of systematic underreporting bias in surveys of mental disorders, creation and use of accurate assessment tools for studying disorders of children, adolescents, the elderly, and people in less developed countries, and setting up systems to carry out small area estimations for needs assessment and programme planning. Advances in analytical and experimental epidemiology have been more modest. A major challenge is for psychiatric epidemiologists to increase the relevance of their analytical research to their colleagues in preventative psychiatry as well as to social policy analysts. Another challenge is to develop interventions aimed at increasing the proportion of people with mental disorders who receive treatment. Despite encouraging advances, much work still needs to be conducted before psychiatric epidemiology can realize its potential to improve the mental health of populations. PMID:10885165

Advanced access: reducing waiting and delays in primary care.

PubMed

Murray, Mark; Berwick, Donald M

2003-02-26

Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support.

Origination of Medical Advance Directives Among Nursing Home Residents With and Without Serious Mental Illness

PubMed Central

Cai, Xueya; Cram, Peter; Li, Yue

2013-01-01

Objective Nursing home residents with serious mental illness need a high level of general medical and end-of-life services. This study tested whether persons with serious mental illness are as likely as other nursing home residents to make informed choices about treatments through medical advance care plans. Methods Secondary analyses were conducted with data from a 2004 national survey of nursing home residents with serious mental illness (N=1,769) and without (N=11,738). Bivariate and multivariate analyses determined differences in documented advance care plans, including living wills; “do not resuscitate” and “do not hospitalize” orders; and orders concerning restriction of feeding tube, medication, or other treatments. Results The overall rates of having any of the four advance care plans were 57% and 68% for residents with and without serious mental illness, respectively (p<.001). Residents with serious mental illness also showed lower rates for individual advance care plans. In a multivariate analysis that adjusted for resident and facility characteristics (N=1,174 nursing homes) as well as survey procedures, serious mental illness was associated with a 24% reduced odds of having any advance directives (adjusted odds ratio=.76, 95% confidence interval=.66–.87, p<.001). Similar results were found for individual documented plans. Conclusions Among U.S. nursing home residents, those with serious mental illness were less likely than others to have written medical advance directives. Future research is needed to help understand both resident factors (such as inappropriate behaviors, impaired communication skills, and disrupted family support) and provider factors (including training, experience, and attitude) that underlie this finding. PMID:21209301

The ASP at 125: Advancing Science Literacy in an Age of Acceleration

NASA Astrophysics Data System (ADS)

Manning, Jim

2014-01-01

On February 7, 2014, the Astronomical Society of the Pacific will celebrate its 125th birthday and a century and a quarter of advancing astronomy and astronomy/science education during a period of revolutionary change in our understanding of the universe. In keeping with both the retrospective and forward-looking nature of such milestones, the presenter will: 1) share highlights of the Society’s work in supporting the communication of astronomy research through its professional publications, and creating innovative astronomy education and public outreach projects and networks to advance student, teacher and public understanding of astronomy and science; 2) report on current NASA- and NSF-funded efforts and on plans going forward; 3) and solicit input from the assembled community on how the ASP can best serve its various constituencies and the cause of science education, communication and literacy at a time when both the universe and life on Earth are accelerating at unprecedented rates. Birthdays are for celebrating; come celebrate with us as we rededicate ourselves to a mission of advancing science literacy through astronomy.

Inventory and comparative evaluation of seabed mapping, classification and modeling activities in the Northwest Atlantic, USA to support regional ocean planning

NASA Astrophysics Data System (ADS)

Shumchenia, Emily J.; Guarinello, Marisa L.; Carey, Drew A.; Lipsky, Andrew; Greene, Jennifer; Mayer, Larry; Nixon, Matthew E.; Weber, John

2015-06-01

Efforts are in motion globally to address coastal and marine management needs through spatial planning and concomitant seabed habitat mapping. Contrasting strategies are often evident in these processes among local, regional, national and international scientific approaches and policy needs. In answer to such contrasts among its member states, the United States Northeast Regional Ocean Council formed a Habitat Working Group to conduct a regional inventory and comparative evaluation of seabed characterization, classification, and modeling activities in New England. The goals of this effort were to advance regional understanding of ocean habitats and identify opportunities for collaboration. Working closely with the Habitat Working Group, we organized and led the inventory and comparative analysis with a focus on providing processes and tools that can be used by scientists and managers, updated and adapted for future use, and applied in other ocean management regions throughout the world. Visual schematics were a critical component of the comparative analysis and aided discussion among scientists and managers. Regional consensus was reached on a common habitat classification scheme (U.S. Coastal and Marine Ecological Classification Standard) for regional seabed maps. Results and schematics were presented at a region-wide workshop where further steps were taken to initiate collaboration among projects. The workshop culminated in an agreement on a set of future seabed mapping goals for the region. The work presented here may serve as an example to other ocean planning regions in the U.S., Europe or elsewhere seeking to integrate a variety of seabed characterization, classification and modeling activities.

Planning for the semiconductor manufacturer of the future

NASA Technical Reports Server (NTRS)

Fargher, Hugh E.; Smith, Richard A.

1992-01-01

Texas Instruments (TI) is currently contracted by the Air Force Wright Laboratory and the Defense Advanced Research Projects Agency (DARPA) to develop the next generation flexible semiconductor wafer fabrication system called Microelectronics Manufacturing Science & Technology (MMST). Several revolutionary concepts are being pioneered on MMST, including the following: new single-wafer rapid thermal processes, in-situ sensors, cluster equipment, and advanced Computer Integrated Manufacturing (CIM) software. The objective of the project is to develop a manufacturing system capable of achieving an order of magnitude improvement in almost all aspects of wafer fabrication. TI was awarded the contract in Oct., 1988, and will complete development with a fabrication facility demonstration in April, 1993. An important part of MMST is development of the CIM environment responsible for coordinating all parts of the system. The CIM architecture being developed is based on a distributed object oriented framework made of several cooperating subsystems. The software subsystems include the following: process control for dynamic control of factory processes; modular processing system for controlling the processing equipment; generic equipment model which provides an interface between processing equipment and the rest of the factory; specification system which maintains factory documents and product specifications; simulator for modelling the factory for analysis purposes; scheduler for scheduling work on the factory floor; and the planner for planning and monitoring of orders within the factory. This paper first outlines the division of responsibility between the planner, scheduler, and simulator subsystems. It then describes the approach to incremental planning and the way in which uncertainty is modelled within the plan representation. Finally, current status and initial results are described.

A facilitated approach to family case conferencing for people with advanced dementia living in nursing homes: perceptions of palliative care planning coordinators and other health professionals in the IDEAL study.

PubMed

Luckett, Tim; Chenoweth, Lynnette; Phillips, Jane; Brooks, Deborah; Cook, Janet; Mitchell, Geoffrey; Pond, Dimity; Davidson, Patricia M; Beattie, Elizabeth; Luscombe, Georgina; Goodall, Stephen; Fischer, Thomas; Agar, Meera

2017-10-01

Palliative care for nursing home residents with advanced dementia is often sub-optimal due to poor communication and limited care planning. In a cluster randomized controlled trial, registered nurses (RNs) from 10 nursing homes were trained and funded to work as Palliative Care Planning Coordinators (PCPCs) to organize family case conferences and mentor staff. This qualitative sub-study aimed to explore PCPC and health professional perceptions of the benefits of facilitated case conferencing and identify factors influencing implementation. Semi-structured interviews were conducted with the RNs in the PCPC role, other members of nursing home staff, and physicians who participated in case conferences. Analysis was conducted by two researchers using a thematic framework approach. Interviews were conducted with 11 PCPCs, 18 other nurses, eight allied health workers, and three physicians. Perceived benefits of facilitated case conferencing included better communication between staff and families, greater multi-disciplinary involvement in case conferences and care planning, and improved staff attitudes and capabilities for dementia palliative care. Key factors influencing implementation included: staffing levels and time; support from management, staff and physicians; and positive family feedback. The facilitated approach explored in this study addressed known barriers to case conferencing. However, current business models in the sector make it difficult for case conferencing to receive the required levels of nursing qualification, training, and time. A collaborative nursing home culture and ongoing relationships with health professionals are also prerequisites for success. Further studies should document resident and family perceptions to harness consumer advocacy.

Room for improvement: An examination of advance care planning documentation among gynecologic oncology patients.

PubMed

Brown, Alaina J; Shen, Megan Johnson; Urbauer, Diana; Taylor, Jolyn; Parker, Patricia A; Carmack, Cindy; Prescott, Lauren; Kolawole, Elizabeth; Rosemore, Carly; Sun, Charlotte; Ramondetta, Lois; Bodurka, Diane C

2016-09-01

The goals of this study were: (1) to evaluate patients' knowledge regarding advance directives and completion rates of advance directives among gynecologic oncology patients and (2) to examine the association between death anxiety, disease symptom burden, and patient initiation of advance directives. 110 gynecologic cancer patients were surveyed regarding their knowledge and completion of advance directives. Patients also completed the MD Anderson Symptom Inventory (MDASI) scale and Templer's Death Anxiety Scale (DAS). Descriptive statistics were utilized to examine characteristics of the sample. Fisher's exact tests and 2-sample t-tests were utilized to examine associations between key variables. Most patients were white (76.4%) and had ovarian (46.4%) or uterine cancer (34.6%). Nearly half (47.0%) had recurrent disease. The majority of patients had heard about advance directives (75%). Only 49% had completed a living will or medical power of attorney. Older patients and those with a higher level of education were more likely to have completed an advance directive (p<0.01). Higher MDASI Interference Score (higher symptom burden) was associated with patients being less likely to have a living will or medical power of attorney (p=0.003). Higher DAS score (increased death anxiety) was associated with patients being less likely to have completed a living will or medical power of attorney (p=0.03). Most patients were familiar with advance directives, but less than half had created these documents. Young age, lower level of education, disease-related interference with daily activities, and a higher level of death anxiety were associated with decreased rates of advance directive completion, indicating these may be barriers to advance care planning documentation. Young patients, less educated patients, patients with increased disease symptom burden, and patients with increased death anxiety should be targeted for advance care planning discussions as they may be less likely to engage in advance care planning. Copyright © 2016. Published by Elsevier Inc.

Room for Improvement: An Examination of Advance Care Planning Documentation among Gynecologic Oncology Patients

PubMed Central

Brown, Alaina J.; Shen, Megan Johnson; Urbauer, Diana; Taylor, Jolyn; Parker, Patricia A.; Carmack, Cindy; Prescott, Lauren; Kowaloe, Elizabeth; Rosemore, Carly; Sun, Charlotte; Ramondetta, Lois; Bodurka, Diane C.

2017-01-01

Objectives The goals of this study were: (1) to evaluate patients’ knowledge regarding advance directives and completion rates of advance directives among gynecologic oncology patients and (2) to examine the association between death anxiety, disease symptom burden, and patient initiation of advance directives. Methods 110 gynecologic cancer patients were surveyed regarding their knowledge and completion of advance directives. Patients also completed the MD Anderson Symptom Inventory (MDASI) scale and Templer’s Death Anxiety Scale (DAS). Descriptive statistics were utilized to examine characteristics of the sample. Fisher’s exact tests and 2-sample t-tests were utilized to examine associations between key variables. Results Most patients were white (76.4%) and had ovarian (46.4%) or uterine cancer (34.6%). Nearly half (47.0%) had recurrent disease. The majority of patients had heard about advance directives (75%). Only 49% had completed a living will or medical power of attorney. Older patients and those with a higher level of education were more likely to have completed an advance directive (p<0.01). Higher MDASI Interference Score (higher symptom burden) was associated with patients being less likely to have a living will or medical power of attorney (p=0.003). Higher DAS score (increased death anxiety) was associated with patients being less likely to have completed a living will or medical power of attorney (p=0.03). Conclusion Most patients were familiar with advance directives, but less than half had created these documents. Young age, lower level of education, disease-related interference with daily activities, and a higher level of death anxiety were associated with decreased rates of advance directive completion, indicating these may be barriers to advance care planning documentation. Young patients, less educated patients, patients with increased disease symptom burden, and patients with increased death anxiety should be targeted for advance care planning discussions as they may be less likely to engage in advance care planning. PMID:27439968

Integrated Facilities and Infrastructure Plan.

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

Reisz Westlund, Jennifer Jill

Our facilities and infrastructure are a key element of our capability-based science and engineering foundation. The focus of the Integrated Facilities and Infrastructure Plan is the development and implementation of a comprehensive plan to sustain the capabilities necessary to meet national research, design, and fabrication needs for Sandia National Laboratories’ (Sandia’s) comprehensive national security missions both now and into the future. A number of Sandia’s facilities have reached the end of their useful lives and many others are not suitable for today’s mission needs. Due to the continued aging and surge in utilization of Sandia’s facilities, deferred maintenance has continuedmore » to increase. As part of our planning focus, Sandia is committed to halting the growth of deferred maintenance across its sites through demolition, replacement, and dedicated funding to reduce the backlog of maintenance needs. Sandia will become more agile in adapting existing space and changing how space is utilized in response to the changing requirements. This Integrated Facilities & Infrastructure (F&I) Plan supports the Sandia Strategic Plan’s strategic objectives, specifically Strategic Objective 2: Strengthen our Laboratories’ foundation to maximize mission impact, and Strategic Objective 3: Advance an exceptional work environment that enables and inspires our people in service to our nation. The Integrated F&I Plan is developed through a planning process model to understand the F&I needs, analyze solution options, plan the actions and funding, and then execute projects.« less

History of Japanese Society of Toxicology.

PubMed

Satoh, Tetsuo

2016-01-01

Founded in 1981, the Japanese Society of Toxicology (JSOT) has grown into an organization of nearly 3,000 members working together to advance the nation's scientific knowledge and understanding of toxicology through the implementation of planning that ensures a systematic and efficient expenditure of energies and resources, and is closely aligned with a strategy for accomplishing the Society's long-range plans. To promote public education in toxicology, the Society organizes public lectures during each year's annual meeting. Other activities include hosting scientific conferences, promoting continuing education, and facilitating international collaboration. Internally, the JSOT operates five standing committees: General Affairs, Educational, Editorial, Finance, and Science and Publicity to handle its necessary relationships. To bestow official recognition, the Society established its Toxicologist Certification Program in 1997, and has certified 536 members as Diplomat Toxicologists (DJSOT) as of May 1, 2016. Furthermore, on the same date, 43 JSOT members were certified as Emeritus Diplomats of the JSOT (EDJSOT). The Society has launched two official journals, the "Journal of Toxicological Sciences (JTS)" in 1981 and "Fundamental Toxicological Sciences (Fundam. Toxicol. Sci.)" in 2014. As for participation in the international organizations, the JSOT (then known as the Toxicological Research Group) joined the International Union of Toxicology as a charter member in 1980, and became a founding member of the Asian Society of Toxicology at its inauguration in 1994. Into the future, the JSOT will continue working diligently to advance knowledge and understanding of toxicology and secure its place among the interdisciplinary fields of science, humane studies, and ethics.

42 CFR 430.12 - Submittal of State plans and plan amendments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... periodic reports on the Medicaid program, excluding periodic statistical, budget and fiscal reports. (iii... the Medicaid program. For changes related to advance directive requirements, amendments must be... concerning advance directives. (2) Prompt submittal of amendments is necessary— (i) So that CMS can determine...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

45 CFR 1355.54 - Submittal of advance planning documents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Submittal of advance planning documents. 1355.54 Section 1355.54 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL...

45 CFR 1355.54 - Submittal of advance planning documents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Submittal of advance planning documents. 1355.54 Section 1355.54 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL...

45 CFR 1355.54 - Submittal of advance planning documents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Submittal of advance planning documents. 1355.54 Section 1355.54 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL...

32 CFR 237a.4 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... interest to industry, local committees, and the DoD (examples—ship launchings, rollouts, and first flights.... (f) Briefings. (1) Advanced planning briefings for industry are governed by DoD Instruction 5230.14, 1 “Advanced Planning Briefings for Industry.” (2) Classified meetings are governed by DoD Directive...

32 CFR 237a.4 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... interest to industry, local committees, and the DoD (examples—ship launchings, rollouts, and first flights.... (f) Briefings. (1) Advanced planning briefings for industry are governed by DoD Instruction 5230.14, 1 “Advanced Planning Briefings for Industry.” (2) Classified meetings are governed by DoD Directive...

14 CFR 151.121 - Procedures: Offer; sponsor assurances.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and..., that is incorporated by reference into Part I of the Advance Planning Agreement: The sponsor— (a) Will... controlled by it, to conduct any aeronautical activities, including, but not limited to, charter flights...

14 CFR 151.121 - Procedures: Offer; sponsor assurances.

Code of Federal Regulations, 2012 CFR

2012-01-01

... TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and..., that is incorporated by reference into Part I of the Advance Planning Agreement: The sponsor— (a) Will... controlled by it, to conduct any aeronautical activities, including, but not limited to, charter flights...

32 CFR 237a.4 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... interest to industry, local committees, and the DoD (examples—ship launchings, rollouts, and first flights.... (f) Briefings. (1) Advanced planning briefings for industry are governed by DoD Instruction 5230.14, 1 “Advanced Planning Briefings for Industry.” (2) Classified meetings are governed by DoD Directive...

14 CFR 151.121 - Procedures: Offer; sponsor assurances.

Code of Federal Regulations, 2013 CFR

2013-01-01

... TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and..., that is incorporated by reference into Part I of the Advance Planning Agreement: The sponsor— (a) Will... controlled by it, to conduct any aeronautical activities, including, but not limited to, charter flights...

14 CFR 151.121 - Procedures: Offer; sponsor assurances.

Code of Federal Regulations, 2014 CFR

2014-01-01

... TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and..., that is incorporated by reference into Part I of the Advance Planning Agreement: The sponsor— (a) Will... controlled by it, to conduct any aeronautical activities, including, but not limited to, charter flights...

32 CFR 237a.4 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... interest to industry, local committees, and the DoD (examples—ship launchings, rollouts, and first flights.... (f) Briefings. (1) Advanced planning briefings for industry are governed by DoD Instruction 5230.14, 1 “Advanced Planning Briefings for Industry.” (2) Classified meetings are governed by DoD Directive...

32 CFR 237a.4 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... interest to industry, local committees, and the DoD (examples—ship launchings, rollouts, and first flights.... (f) Briefings. (1) Advanced planning briefings for industry are governed by DoD Instruction 5230.14, 1 “Advanced Planning Briefings for Industry.” (2) Classified meetings are governed by DoD Directive...

14 CFR 151.121 - Procedures: Offer; sponsor assurances.

Code of Federal Regulations, 2011 CFR

2011-01-01

... TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and..., that is incorporated by reference into Part I of the Advance Planning Agreement: The sponsor— (a) Will... controlled by it, to conduct any aeronautical activities, including, but not limited to, charter flights...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

MSE commissioning and other major diagnostic updates on KSTAR

NASA Astrophysics Data System (ADS)

Ko, Jinseok; Kstar Team

2015-11-01

The motional Stark effect (MSE) diagnostic based on the photoelastic-modulator (PEM) approach has been commissioned for the Korea Superconducting Tokamak Advanced Research (KSTAR). The 25-channel MSE system with the polarization-preserving front optics and precise tilt-tuning narrow bandpass filters provides the spatial resolution less than 1 cm in most of the plasma cross section and about 10 millisecond of time resolution. The polarization response curves with the daily Faraday rotation correction provides reliable pitch angle profiles for the KSTAR discharges with the MSE-optimized energy combination in the three-ion-source neutral beam injection. Some major diagnostic advances such as the poloidal charge exchange spectroscopy, the improved Thomson-scatting system, and the divertor infrared TV are reported as well. Work supported by the Ministry of Science, ICT and Future Planning, Korea.

The flight telerobotic servicer and technology transfer

NASA Technical Reports Server (NTRS)

Andary, James F.; Bradford, Kayland Z.

1991-01-01

The Flight Telerobotic Servicer (FTS) project at the Goddard Space Flight Center is developing an advanced telerobotic system to assist in and reduce crew extravehicular activity (EVA) for Space Station Freedom (SSF). The FTS will provide a telerobotic capability in the early phases of the SSF program and will be employed for assembly, maintenance, and inspection applications. The current state of space technology and the general nature of the FTS tasks dictate that the FTS be designed with sophisticated teleoperational capabilities for its internal primary operating mode. However, technologies such as advanced computer vision and autonomous planning techniques would greatly enhance the FTS capabilities to perform autonomously in less structured work environments. Another objective of the FTS program is to accelerate technology transfer from research to U.S. industry.

Integrating the environment in local strategic planning : Guidelines (Case of Morocco)

NASA Astrophysics Data System (ADS)

Benbrahim, Hafsa

2018-05-01

Since 2010, an advanced regionalization project has been initiated by Morocco, which plans to consolidate the processes of decentralization and deconcentration by extending the powers of the regions and other local authorities. This project, institutionalized in the 2011 Constitution, defines the territorial organization of the Kingdom and reinforces decentralization according to a model of advanced regionalization. Through advanced regionalization, Morocco aims at integrated and sustainable development in economic, social, cultural and environmental terms, through the development of the potential and resources of each region. However, in order to honor this commitment of advanced regionalization, local authorities must be assisted in adopting a local strategic planning approach, allowing them to develop territorial plans for sustainable development in accordance with the national legal framework, specifically the Framework law 99-12, and international commitments in terms of environmental protection. This research deals with the issue of environmental governance in relation to the role and duties of local authorities. Thus, the main goal of our study is to present the guidelines to be followed by the local authorities to improve the quality of the environment integration process in the local strategic planning with the aim of putting it in a perspective of sustainable development.

Publication planning: an effective corporate strategy to influence health professionals.

PubMed

2013-12-01

Pharmaceutical companies integrate scientific publications into the communication strategies they employ to influence the practices of health professionals. In their"publication plan", pharmaceutical companies, or the communication agencies they hire, develop key messages to promote their drugs and then plan in advance how, when and where to disseminate them in medical journals or at conferences. Although their true intent is promotional, these messages must appear to be purely scientific, and are therefore disseminated as research articles, review articles, editorials, commentaries. Publication planning involves the use of "ghost" authors who work directly for pharmaceutical companies, but whose contribution is rarely acknowledged in the final published article. Key opinion leaders are recruited as the honorary authors of these articles, to which they have made little, if any, contribution. The criteria for authorship set by journals that publish primary research articles do not provide adequate protection against the practice of ghost and honorary authorship. Certain journals publishing primary research derive a large proportion of their revenue from selling reprints used by pharmaceutical companies to promote their drugs, especially by their sales representatives.

End-State Comfort Across the Lifespan: A Cross-Sectional Investigation of How Movement Context Influences Motor Planning in an Overturned Glass Task.

PubMed

Scharoun, Sara M; Gonzalez, David A; Roy, Eric A; Bryden, Pamela J

2018-04-01

Young adults plan actions in advance to minimize the cost of movement. This is exemplified by the end-state comfort (ESC) effect. A pattern of improvement in ESC in children is linked to the development of cognitive control processes, and decline in older adults is attributed to cognitive decline. This study used a cross-sectional design to examine how movement context (pantomime, demonstration with image/glass as a guide, actual grasping) influences between-hand differences in ESC planning. Children (5- to 12-year-olds), young adults, and two groups of older adults (aged 60-70, and aged 71 and older) were assessed. Findings provide evidence for adult-like patterns of ESC in 8-year-olds. Results are attributed to improvements in proprioceptive acuity and proficiency in generating and implementing internal representations of action. For older adults early in the aging process, sensitivity to ESC did not differ from young adults. However, with increasing age, differences reflect challenges in motor planning with increases in cognitive demand, similar to previous work. Findings have implications for understanding lifespan motor behavior.

Status of the Advanced Virgo gravitational wave detector

NASA Astrophysics Data System (ADS)

Acernese, F.; Adams, T.; Agatsuma, K.; Aiello, L.; Allocca, A.; Amato, A.; Antier, S.; Arnaud, N.; Ascenzi, S.; Astone, P.; Bacon, P.; Bader, M. K. M.; Baldaccini, F.; Ballardin, G.; Barone, F.; Barsuglia, M.; Barta, D.; Basti, A.; Bawaj, M.; Bazzan, M.; Bejger, M.; Belahcene, I.; Bersanetti, D.; Bertolini, A.; Bitossi, M.; Bizouard, M. A.; Bloemen, S.; Boer, M.; Bogaert, G.; Bondu, F.; Bonnand, R.; Boom, B. A.; Boschi, V.; Bouffanais, Y.; Bozzi, A.; Bradaschia, C.; Branchesi, M.; Briant, T.; Brillet, A.; Brisson, V.; Bulik, T.; Bulten, H. J.; Buskulic, D.; Buy, C.; Cagnoli, G.; Calloni, E.; Canepa, M.; Canizares, P.; Capocasa, E.; Carbognani, F.; Casanueva Diaz, J.; Casentini, C.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cerboni Baiardi, L.; Cerretani, G.; Cesarini, E.; Chassande-Mottin, E.; Chincarini, A.; Chiummo, A.; Christensen, N.; Chua, S.; Ciolfi, R.; Cirone, A.; Cleva, F.; Coccia, E.; Cohadon, P.-F.; Colla, A.; Conti, L.; Cortese, S.; Coulon, J.-P.; Cuoco, E.; D'Antonio, S.; Dattilo, V.; Davier, M.; Degallaix, J.; de Laurentis, M.; Deléglise, S.; Del Pozzo, W.; De Rosa, R.; di Fiore, L.; di Giovanni, M.; di Girolamo, T.; di Lieto, A.; di Pace, S.; di Palma, I.; di Renzo, F.; Dolique, V.; Ducrot, M.; Fafone, V.; Farinon, S.; Ferrante, I.; Ferrini, F.; Fidecaro, F.; Fiori, I.; Fiorucci, D.; Flaminio, R.; Fournier, J.-D.; Frasca, S.; Frasconi, F.; Frey, V.; Gammaitoni, L.; Garufi, F.; Gemme, G.; Genin, E.; Gennai, A.; Germain, V.; Ghosh, A.; Ghosh, S.; Giazotto, A.; Gonzalez Castro, J. M.; Gosselin, M.; Gouaty, R.; Grado, A.; Granata, M.; Greco, G.; Groot, P.; Gruning, P.; Guidi, G. M.; Harms, J.; Heidmann, A.; Heitmann, H.; Hello, P.; Hemming, G.; Hoak, D.; Hofman, D.; Huet, D.; Intini, G.; Isac, J.-M.; Jacqmin, T.; Jaranowski, P.; Jonker, R. J. G.; Kéfélian, F.; Khan, I.; Koley, S.; Kowalska, I.; Królak, A.; Kutynia, A.; Lartaux-Vollard, A.; Lazzaro, C.; Leaci, P.; Leonardi, M.; Leroy, N.; Letendre, N.; Lorenzini, M.; Loriette, V.; Losurdo, G.; Lumaca, D.; Majorana, E.; Maksimovic, I.; Man, N.; Mantovani, M.; Marchesoni, F.; Marion, F.; Martelli, F.; Martellini, L.; Masserot, A.; Mastrogiovanni, S.; Meidam, J.; Merzougui, M.; Metzdorff, R.; Mezzani, F.; Michel, C.; Milano, L.; Miller, A.; Minazzoli, O.; Minenkov, Y.; Moggi, A.; Mohan, M.; Montani, M.; Mours, B.; Nardecchia, I.; Naticchioni, L.; Nelemans, G.; Neri, M.; Nichols, D.; Nissanke, S.; Nocera, F.; Palomba, C.; Paoletti, F.; Paoli, A.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Patricelli, B.; Pedurand, R.; Perreca, A.; Piccinni, O. J.; Pichot, M.; Piergiovanni, F.; Pillant, G.; Pinard, L.; Poggiani, R.; Popolizio, P.; Porter, E. K.; Prodi, G. A.; Punturo, M.; Puppo, P.; Rapagnani, P.; Razzano, M.; Regimbau, T.; Rei, L.; Ricci, F.; Robinet, F.; Rocchi, A.; Rolland, L.; Romano, R.; Rosińska, D.; Ruggi, P.; Salconi, L.; Sassolas, B.; Schmidt, P.; Sentenac, D.; Sequino, V.; Sieniawska, M.; Singhal, A.; Sorrentino, F.; Stratta, G.; Swinkels, B. L.; Tacca, M.; Tiwari, S.; Tonelli, M.; Travasso, F.; Tringali, M. C.; Trozzo, L.; Tsang, K. W.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; van den Broeck, C.; van der Schaaf, L.; van Heijningen, J. V.; Vardaro, M.; Vasúth, M.; Vedovato, G.; Verkindt, D.; Vetrano, F.; Viceré, A.; Vinet, J.-Y.; Vocca, H.; Walet, R.; Wang, G.; Was, M.; Yvert, M.; Zadrożny, A.; Zelenova, T.; Zendri, J.-P.

2017-10-01

Advanced Virgo is the French-Italian second generation laser gravitational wave detector, successor of the Initial Virgo. This new interferometer keeps only the infrastructure of its predecessor and aims to be ten times more sensitive, with its first science run planned for 2017. This article gives an overview of the Advanced Virgo design and the technical choices behind it. Finally, the up-to-date progresses and the planned upgrade for the following years are detailed.

US-RERTR Advanced Fuel Development Plans : 1999.

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

Meyer, M. K.

1998-10-22

Twelve fuel alloys were included in the very-high-density RERTR-1 and RERTR-2 microplate irradiation experiments. Experience gained during fabrication and results from the post-irradiation examination of these fuels has allowed us to narrow the focus of our fuel development efforts in preparation for the next set of irradiation experiments. Specific technical problems in both the areas of fuel fabrication and irradiation performance remain to be addressed. Examples of these are powder fabrication, fuel phase gamma stability versus density, and fuel-matrix interaction. In order to more efficiently address metal alloy fuel performance issues, work will continue on establishing a theoretical basis formore » alloy stability and metal alloy dispersion fuel irradiation performance. Plans to address these fuel development issues in the coming year will be presented.« less

Science sequence design

NASA Technical Reports Server (NTRS)

Koskela, P. E.; Bollman, W. E.; Freeman, J. E.; Helton, M. R.; Reichert, R. J.; Travers, E. S.; Zawacki, S. J.

1973-01-01

The activities of the following members of the Navigation Team are recorded: the Science Sequence Design Group, responsible for preparing the final science sequence designs; the Advanced Sequence Planning Group, responsible for sequence planning; and the Science Recommendation Team (SRT) representatives, responsible for conducting the necessary sequence design interfaces with the teams during the mission. The interface task included science support in both advance planning and daily operations. Science sequences designed during the mission are also discussed.

Securing the High Ground: Dominant Combat Air Force for America. 2008 Combat Air Force Strategic Plan

DTIC Science & Technology

2008-07-28

continue to be beyond our technical ability to realize aggresively pursue advanced technical solutions to stay at the leading edge of technological...inherent to each caf Way and to seek continual improvement through exploration of innovative concepts, advanced capabilities, game -changing...available online at the air force portal: https://wwwd.my.af.mil/afknprod/strat_plan COMBAT AIR FORCE STRATEGIC PLAN Points of Contact securing the high

Social Work Practice with LGBT Elders at End of Life: Developing Practice Evaluation and Clinical Skills Through a Cultural Perspective.

PubMed

Arthur, Darren P

2015-01-01

This article focuses on culturally sensitive clinical issues related to best practices with lesbian, gay, bisexual, transgender (LGBT) elder patients at end-of-life (EOL) at key points in the therapeutic relationship. Vital concepts, including practice evaluation and clinical skills, are presented through a cultural and oncology lens. There is a paucity of LGBT research and literature as well as a shortfall of MSW graduate school education specific to social work palliative and end-of-life care (PELC) practice with LGBT elders. The content of this article is designed to be adapted and used as an educational tool for institutions, agencies, graduate programs, medical professions, social work, and students. Learning the unique elements of LGBT cultural history and their implications on EOL care can improve social work practice. This article provides an examination from assessment and engagement basics to advance care planning incorporating specific LGBT EOL issues.

Advanced Education and Technology Business Plan, 2009-12. Highlights

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2009

2009-01-01

Advanced Education and Technology provides strategic leadership for the development of the next generation economy in Alberta through the provision of accessible, affordable and quality learning opportunities for all Albertans and support for a dynamic and integrated innovation system. This paper provides the highlights of the business plan of the…

Phonological Advance Planning in Sentence Production

ERIC Educational Resources Information Center

Oppermann, Frank; Jescheniak, Jorg D.; Schriefers, Herbert

2010-01-01

Our study addresses the scope of phonological advance planning during sentence production using a novel experimental procedure. The production of German sentences in various syntactic formats (SVO, SOV, and VSO) was cued by presenting pictures of the agents of previously memorized agent-action-patient scenes. To tap the phonological activation of…