Use of the Air Force Post-Deployment Health Reassessment for the identification of depression and posttraumatic stress disorder: public health implications for suicide prevention.

Science.gov (United States)

McCarthy, Michael D; Thompson, Sanna J; Knox, Kerry L

2012-03-01

Military members are required to complete the Post-Deployment Health Assessment on return from deployment and the Post-Deployment Health Reassessment (PHDRA) 90 to 180 days later, and we assessed the PDHRA's sensitivity and specificity in identifying posttraumatic stress disorder (PTSD) and depression after a military deployment among US Air Force personnel. We computed the PDHRA's sensitivity and specificity for depression and PTSD and developed a structural model to suggest possible improvements to it. For depression, sensitivity and specificity were 0.704 and 0.651, respectively; for PTSD, they were 0.774 and 0.650, respectively. Several variables produced significant direct effects on depression and trauma, suggesting that modifications could increase its sensitivity and specificity. The PDHRA was moderately effective in identifying airmen with depression and PTSD. It identified behavioral health concerns in many airmen who did not develop a diagnostic mental health condition. Its low level of specificity may result in reduced barriers to care and increased support services, key components of a public health approach to suicide prevention, for airmen experiencing subacute levels of distress after deployment, which may, in part, account for lower suicide rates among airmen after deployment.

Pre-defined and optional staging for the deployment of enterprise systems: a case study and a framework

Science.gov (United States)

Lichtenstein, Yossi; Cucuy, Shy; Fink, Lior

2017-03-01

The effective deployment of enterprise systems has been a major challenge for many organisations. Customising the new system, changing business processes, and integrating multiple information sources are all difficult tasks. As such, they are typically done in carefully planned stages in a process known as phased implementation. Using ideas from Option Theory, this article critiques aspects of phased implementation. One customer relationship management (CRM) project and its phased implementation are described in detail and ten other enterprise system deployments are summarised as a basis for the observation that almost all deployment stages are pre-defined operational steps rather than decision points. However, Option Theory suggests that optional stages, to be used only when risk materialises, should be integral parts of project plans. Although such optional stages are often more valuable than pre-defined stages, the evidence presented in this article shows that they are only rarely utilised. Therefore, a simple framework is presented; it first identifies risks related to the deployment of enterprise systems, then identifies optional stages that can mitigate these risks, and finally compares the costs and benefits of both pre-defined and optional stages.

Home front: post-deployment mental health and divorces.

Science.gov (United States)

Negrusa, Brighita; Negrusa, Sebastian

2014-06-01

Since 2003, about 14 % of U.S. Army soldiers have reported symptoms of posttraumatic stress disorder (PTSD) following deployments. In this article, we examine how post-deployment symptoms of PTSD and of other mental health conditions are related to the probability of divorce among married active-duty U.S. Army soldiers. For this purpose, we combine Army administrative individual-level longitudinal data on soldiers' deployments, marital history, and sociodemographic characteristics with their self-reported post-deployment health information. Our estimates indicate that time spent in deployment increases the divorce risk among Army enlisted personnel and that PTSD symptoms are associated with further increases in the odds of divorce. Although officers are generally less likely to screen positive for PTSD than enlisted personnel, we find a stronger relationship between PTSD symptoms and divorces among Army officers who are PTSD-symptomatic than among enlisted personnel. We estimate a larger impact of deployments on the divorce risk among female soldiers, but we do not find a differential impact of PTSD symptoms by gender. Also, we find that most of the effect of PTSD symptoms occurs early in the career of soldiers who deploy multiple times.

A Comparison of Dependent Primary Care Utilization Rates Based on Deployments

Science.gov (United States)

2009-03-09

analysis to obtain the deployment data was completed by ASMR , another contractor used to Health Care Utilization and Deployments 15 complete...2007. The deployment dataset was created by ASMR using all encounter data for active duty Soldiers and running the Social Security numbers of these

Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review.

Science.gov (United States)

Ehiri, John E; Gunn, Jayleen K L; Center, Katherine E; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E

2014-01-01

Training of lay refugees/internally displaced persons (IDPs) and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014) with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Ten studies (five cross-sectional, four pre-post, and one post-test only) conducted in Africa (Guinea and Tanzania), Central America (Belize), and Asia (Myanmar) were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Although available evidence suggests a positive impact of training and deployment

The financial impact of deployments on reserve health care providers.

Science.gov (United States)

Petinaux, Bruno

2008-08-01

This study retrospectively surveyed the financial impact of deployments on 17 U.S. Army Reserve health care providers. Due to multiple mobilizations, 29 separate deployments were reported. The deployments, mostly between 2001 and 2005, typically lasted 3 months during which 86% reported no civilian income and 76% reported no civilian benefits. Solo practice providers reported the greatest financial losses due to continuing financial responsibility related to their civilian practice despite being deployed. Overall, 2 deployments did not change, 9 increased, and 16 decreased the medical officer's income. Two were not reported. In this small retrospective convenience sample study, solo practice U.S. Army Reserve health care providers were found to be at highest risk of financial losses during military deployments. This being said, no price can be put on the privilege of serving our men and women in uniform.

Comparing post-deployment mental health services utilization in soldiers deployed to Balkan, Iraq and Afghanistan

DEFF Research Database (Denmark)

Madsen, T; Sadowa Vedtofte, M; Nordentoft, M

2017-01-01

OBJECTIVE: Insight on how different missions have impacted rates of mental health service (MHS) utilization is unexplored. We compared postdeployment MHS utilization in a national cohort of first-time deployed to missions in Balkan, Iraq, and Afghanistan respectively. METHODS: A prospective...... national cohort study of 13 246 first-time deployed in the period 1996 through 2012 to missions in Balkan area, Iraq, or Afghanistan respectively. Soldiers 'MHS utilization was also compared with a 5:1 sex-, age-, and calendar year-matched never-deployed background population. Postdeployment utilization...... of psychotropics. RESULTS: Utilizing of psychiatric outpatient services and psychotropics was significantly higher in first-time deployed to Iraq and Afghanistan compared with deployed to Balkan. However, the rate of postdeployment admission to psychiatric hospital did not differ between missions. Postdeployment...

Weight based stereotyping amongst pre-service health and physical educators

OpenAIRE

Werkhoven, Thea; Cotton, Wayne; Russell, Kate

2015-01-01

The purpose of this study was to examine the fat stereotyping attitudes of pre-service health and physical educators towards overweight and obese children and to determine if these attitudes were influenced by gender or degree progression. Pre-service health and physical educators (n=38) completed the Fat Stereotypes Questionnaire and endorsed fat stereotyping attitudes on characteristics and attributes including laziness, attractiveness and friendship. Males and females exhibited differing a...

Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review

Science.gov (United States)

Ehiri, John E.; Gunn, Jayleen K.L.; Center, Katherine E.; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E.

2014-01-01

Background Training of lay refugees/internally displaced persons (IDPs) and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. Objectives To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Methods PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014) with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Results Ten studies (five cross-sectional, four pre-post, and one post-test only) conducted in Africa (Guinea and Tanzania), Central America (Belize), and Asia (Myanmar) were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Conclusion Although available evidence

Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review

Directory of Open Access Journals (Sweden)

John E. Ehiri

2014-10-01

Full Text Available Background: Training of lay refugees/internally displaced persons (IDPs and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. Objectives: To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Methods: PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014 with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Results: Ten studies (five cross-sectional, four pre-post, and one post-test only conducted in Africa (Guinea and Tanzania, Central America (Belize, and Asia (Myanmar were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Conclusion: Although

'Post-deployment appraisal' and the relationship with stress and psychological health in Australian veterans.

Science.gov (United States)

Wright, Breanna; Forbes, Andrew; Kelsall, Helen; Clarke, David; Ikin, Jill; Sim, Malcolm

2015-12-01

Understanding how veterans appraise their post-deployment experiences could provide insight into better assisting their deployment transitions. We aimed to assess the factor structure of positive and negative post-deployment appraisals in Australian veterans and to examine the resultant factors in their relationship with military stress and psychological health. Questions capturing post-deployment attitudes were developed by the researchers in collaboration with veterans. The questions were administered to 1938 veterans and the results factor analysed. The relationships between post-deployment appraisal, military stress and psychological health were examined using Structural Equation Modelling. A three-factor solution was found for the post-deployment appraisal questions; representing personal development, lack of recognition, and appreciation of life and country. Military stress was associated with the three factors and psychological health. The three factors were weakly to moderately associated with psychological health. Mediation between military stress and psychological health by any post-deployment appraisal factor was minimal. Post-deployment appraisal measures three important attitudes and concerns of veterans after deployment. Military stress is associated with the post-deployment appraisal factors. However, the factors did not mediate the relationship between military stress and psychological health. These factors provide insight into how veterans appraise their complex array of post-deployment experiences, and may provide useful in regard to transitions and integration into civilian life.

The influence of pre-deployment cognitive ability on post-traumatic stress disorder symptoms and trajectories

DEFF Research Database (Denmark)

Sørensen, Holger J; Andersen, Søren B; Karstoft, Karen-Inge

2016-01-01

(based on logical, verbal, numerical and spatial reasoning) were converted to a mean of 100 and with a standard deviation of 15. Results Higher pre-deployment cognitive ability scores were associated with lower risk of PTSD symptoms as assessed by the Posttraumatic Stress Disorder Checklist......-Civilian Version (PCL-C) 2.5 years post-deployment (OR=0.97; 95% CI 0.95-1.00) after adjustment for educational length, baseline PCL-C score and perceived war-zone stress. Compared to a resilient trajectory, a non-resilient relieved-worsening trajectory (high baseline mental symptoms, being symptom free during...

Deployment stressors and physical health among OEF/OIF veterans: the role of PTSD.

Science.gov (United States)

Nillni, Yael I; Gradus, Jaimie L; Gutner, Cassidy A; Luciano, Matthew T; Shipherd, Jillian C; Street, Amy E

2014-11-01

There is a large body of literature documenting the relationship between traumatic stress and deleterious physical health outcomes. Although posttraumatic stress disorder (PTSD) symptoms have been proposed to explain this relationship, previous research has produced inconsistent results when moderating variables such as gender or type of traumatic stressor are considered. Within a large sample of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, the current study examined if deployment stressors (i.e., combat stress, harassment stress) contributed unique variance to the prediction of physical health symptoms (i.e., pain, nonpain) beyond the effects of PTSD symptoms. A total of 2,332 OEF/OIF Veterans, with equal representation of women and men, completed a series of self-report measures assessing deployment stressors, PTSD symptoms, and physical health symptoms. RESULTS revealed that harassment, but not combat stress, added unique variance in the prediction of pain and nonpain symptoms after accounting for PTSD symptoms. This study extends the existing literature by demonstrating the unique influence of harassment stress on physical health outcomes. Specifically, the relationship between combat stress and physical health symptoms appears to be explained mainly by an individual's experience of PTSD symptoms, whereas the relationship between harassment stress and physical health symptoms is not fully explained by PTSD symptoms, suggesting that other variables may be involved in the pathway from harassment stress to physical health symptoms. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A scoping review of training and deployment policies for human resources for health for maternal, newborn, and child health in rural Africa.

Science.gov (United States)

Murphy, Gail Tomblin; Goma, Fastone; MacKenzie, Adrian; Bradish, Stephanie; Price, Sheri; Nzala, Selestine; Rose, Annette Elliott; Rigby, Janet; Muzongwe, Chilweza; Chizuni, Nellisiwe; Carey, Amanda; Hamavhwa, Derrick

2014-12-16

Most African countries are facing a human resources for health (HRH) crisis, lacking the required workforce to deliver basic health care, including care for mothers and children. This is especially acute in rural areas and has limited countries' abilities to meet maternal, newborn, and child health (MNCH) targets outlined by Millennium Development Goals 4 and 5. To address the HRH challenges, evidence-based deployment and training policies are required. However, the resources available to country-level policy makers to create such policies are limited. To inform future HRH planning, a scoping review was conducted to identify the type, extent, and quality of evidence that exists on HRH policies for rural MNCH in Africa. Fourteen electronic health and health education databases were searched for peer-reviewed papers specific to training and deployment policies for doctors, nurses, and midwives for rural MNCH in African countries with English, Portuguese, or French as official languages. Non-peer reviewed literature and policy documents were also identified through systematic searches of selected international organizations and government websites. Documents were included based on pre-determined criteria. There was an overall paucity of information on training and deployment policies for HRH for MNCH in rural Africa; 37 articles met the inclusion criteria. Of these, the majority of primary research studies employed a variety of qualitative and quantitative methods. Doctors, nurses, and midwives were equally represented in the selected policy literature. Policies focusing exclusively on training or deployment were limited; most documents focused on both training and deployment or were broader with embedded implications for the management of HRH or MNCH. Relevant government websites varied in functionality and in the availability of policy documents. The lack of available documentation and an apparent bias towards HRH research in developed areas suggest a need for

Early identification of posttraumatic stress following military deployment: Application of machine learning methods to a prospective study of Danish soldiers.

Science.gov (United States)

Karstoft, Karen-Inge; Statnikov, Alexander; Andersen, Søren B; Madsen, Trine; Galatzer-Levy, Isaac R

2015-09-15

Pre-deployment identification of soldiers at risk for long-term posttraumatic stress psychopathology after home coming is important to guide decisions about deployment. Early post-deployment identification can direct early interventions to those in need and thereby prevents the development of chronic psychopathology. Both hold significant public health benefits given large numbers of deployed soldiers, but has so far not been achieved. Here, we aim to assess the potential for pre- and early post-deployment prediction of resilience or posttraumatic stress development in soldiers by application of machine learning (ML) methods. ML feature selection and prediction algorithms were applied to a prospective cohort of 561 Danish soldiers deployed to Afghanistan in 2009 to identify unique risk indicators and forecast long-term posttraumatic stress responses. Robust pre- and early postdeployment risk indicators were identified, and included individual PTSD symptoms as well as total level of PTSD symptoms, previous trauma and treatment, negative emotions, and thought suppression. The predictive performance of these risk indicators combined was assessed by cross-validation. Together, these indicators forecasted long term posttraumatic stress responses with high accuracy (pre-deployment: AUC = 0.84 (95% CI = 0.81-0.87), post-deployment: AUC = 0.88 (95% CI = 0.85-0.91)). This study utilized a previously collected data set and was therefore not designed to exhaust the potential of ML methods. Further, the study relied solely on self-reported measures. Pre-deployment and early post-deployment identification of risk for long-term posttraumatic psychopathology are feasible and could greatly reduce the public health costs of war. Copyright © 2015 Elsevier B.V. All rights reserved.

Military deployment and reintegration: a systematic review of child coping.

Science.gov (United States)

Bello-Utu, Cindy F; DeSocio, Janiece E

2015-02-01

Child coping with parent military deployment and family reintegration. A systematic review of research literature was conducted to examine the effects of deployment and family reintegration on children in military families. A search of CINAHL, PubMed, Psyc-INFO, and SocINDEX databases was performed using the terms "military family," "military child," "child coping," "deployment," and "reintegration." The search was limited to publications between 2001 and 2014 to focus on the effects of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND). Twenty-seven research reports met inclusion criteria. Three themes were extracted: A child's coping is influenced by (a) the child's age and development, (b) the mental health and coping of the non-deployed parent during deployment, and the mental health of both parents during family reintegration, and (c) the pre-existing resilience/vulnerability, cumulative risks, and resources of the child and family. © 2015 Wiley Periodicals, Inc.

Military youth and the deployment cycle: emotional health consequences and recommendations for intervention.

Science.gov (United States)

Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M; Bodzy, Mary; Swenson, Rebecca R; Spirito, Anthony

2011-08-01

The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and reintegration periods. Despite widespread acknowledgment of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle.

Can Completing a Mental Health Nursing Course Change Students' Attitudes?

Science.gov (United States)

Hastings, Todd; Kroposki, Margaret; Williams, Gail

2017-05-01

Nursing program graduates rarely choose mental health nursing as a career. A quasi-experimental study was conducted to examine attitudes of 310 nursing students towards persons with mental illness. Students completed surveys on the first and last days of their program's psychiatric mental health nursing course. The pre- and post-test survey analysis indicated that students improved their attitude, knowledge and preparedness to care for persons with mental illness. However, students maintained little interest in working as a mental health nurse. Modifications in mental health nursing courses could be made to improve students' interest in choosing a career in mental health nursing.

Assessing Health Outcomes After Environmental Exposures Associated With Open Pit Burning in Deployed US Service Members.

Science.gov (United States)

Rohrbeck, Patricia; Hu, Zheng; Mallon, Col Timothy M

2016-08-01

This study assessed the long-term health impact of environmental exposures associated with open pit burning in deployed US service members. Two hundred individuals deployed to Balad, Iraq, and Bagram, Afghanistan, with known exposure to open pits, were matched to 200 non-deployed service members. Both cohorts were observed for adverse health outcomes after returning from deployment. Slight increased risks were observed for respiratory diseases in the Bagram cohort (adj RR: 1.259), and for cardiovascular disease in the Balad cohort (adj RR: 1.072), but the findings were not significant. The combined deployed cohort showed lower risks for adverse health outcomes, suggesting a healthy deployer effect. In conclusion, this study did not find significantly increased risks for selected health outcomes after burn pit exposure during deployment among two deployed cohorts compared with a non-deployed cohort.

Effects of combat deployment on risky and self-destructive behavior among active duty military personnel.

Science.gov (United States)

Thomsen, Cynthia J; Stander, Valerie A; McWhorter, Stephanie K; Rabenhorst, Mandy M; Milner, Joel S

2011-10-01

Although research has documented negative effects of combat deployment on mental health, few studies have examined whether deployment increases risky or self-destructive behavior. The present study addressed this issue. In addition, we examined whether deployment effects on risky behavior varied depending on history of pre-deployment risky behavior, and assessed whether psychiatric conditions mediated effects of deployment on risky behavior. In an anonymous survey, active duty members of the U.S. Marine Corps and U.S. Navy (N = 2116) described their deployment experiences and their participation in risky recreational activities, unprotected sex, illegal drug use, self-injurious behavior, and suicide attempts during three time frames (civilian, military pre-deployment, and military post-deployment). Respondents also reported whether they had problems with depression, anxiety, or PTSD during the same three time frames. Results revealed that risky behavior was much more common in civilian than in military life, with personnel who had not deployed, compared to those who had deployed, reporting more risky behavior and more psychiatric problems as civilians. For the current time period, in contrast, personnel who had deployed (versus never deployed) were significantly more likely to report both risky behavior and psychiatric problems. Importantly, deployment was associated with increases in risky behavior only for personnel with a pre-deployment history of engaging in risky behavior. Although psychiatric conditions were associated with higher levels of risky behavior, psychiatric problems did not mediate associations between deployment and risky behavior. Implications for understanding effects of combat deployment on active duty personnel and directions for future research are discussed. Published by Elsevier Ltd.

Psychiatric History, Deployments, and Potential Impacts of Mental Health Care in a Combat Theater.

Science.gov (United States)

Varga, Colleen M; Haibach, Michael A; Rowan, Anderson B; Haibach, Jeffrey P

2018-01-01

Increasing numbers of U.S. service members access mental health care while deployed and at home station. Multiple deployments carry with them a higher risk of exposure to combat as well as the impact of cumulative stressors associated with separation from family, hostile environments, and high operations tempo. However, mental health care resources continue to be underutilized, potentially because of higher levels of stigma regarding mental health care and concerns about career impact among service members. Some studies indicate that service members who have previously sought mental health care are likely to continue to do so proactively as needed. This study examined the associations between prior deployments, prior mental health treatment, and subsequent career-impacting recommendations (e.g., duty limitations and medical evacuation) among deployed service members seeking mental health care. Materials and. This study is a retrospective review of clinical records from three U.S. military Combat and Operational Stress Control units in Afghanistan. Data were drawn from the mental health records of 1,639 Army service members presenting for outpatient mental health services while deployed in Afghanistan from years 2006 to 2008. In an unadjusted logistic regression model, service members with at least one prior deployment had a 38% greater odds (odds ratio [OR] = 1.38, 95% confidence interval [95% CI] 1.06, 1.80; p mental health treatment had a 57% lower odds (OR = 0.43, 95% CI 0.34, 0.56; p mental health treatment. After adjusting for demographics and number of prior deployments, service members with prior mental health treatment had a 58% lower odds (OR = 0.42, 95% CI 0.33, 0.56; p mental health treatment. Among service members who had a clinical mental health encounter, prior deployment was not associated with career-impacting recommendations and prior mental health treatment appeared to be protective against career-impacting recommendations. These results are in

Childhood adversity and traumatic exposures during deployment as predictors of mental health in Australian military veterans.

Science.gov (United States)

Zheng, Wu Yi; Kanesarajah, Jeeva; Waller, Michael; McGuire, Annabel C; Treloar, Susan A; Dobson, Annette J

2016-02-01

To examine whether the relationship between traumatic exposure on deployment and poor mental health varies by the reported level of childhood adversity experienced in Australian military veterans deployed to the Bougainville or East Timor military operations. Cross-sectional self-reported survey data were collected in 2008 from 3,564 Australian military veterans who deployed to East Timor or Bougainville on their deployment experiences, health and recall of childhood events. Multivariable logistic regression was used to investigate the association between childhood adversity, deployment exposures and mental health. The most common childhood adversity reported was 'not having a special teacher, youth worker or family friend who looked out for them while growing up'. On average, responders reported experiencing 3.5 adverse childhood experiences (SD 2.7) and averaged 5.3 (SD 4.9) traumatic exposures on deployment. Both childhood adversity and traumatic exposures on deployment were associated with higher odds of poorer mental health. However, there was no evidence that level of childhood adversity modified the association between traumatic exposure and mental health. These findings suggest that military personnel who recalled a higher level of childhood adversity may need to be monitored for poor mental health and, if required, provided with appropriate support. © 2015 Public Health Association of Australia.

Large Scale eHealth Deployment in Europe: Insights from Concurrent Use of Standards.

Science.gov (United States)

Eichelberg, Marco; Chronaki, Catherine

2016-01-01

Large-scale eHealth deployment projects face a major challenge when called to select the right set of standards and tools to achieve sustainable interoperability in an ecosystem including both legacy systems and new systems reflecting technological trends and progress. There is not a single standard that would cover all needs of an eHealth project, and there is a multitude of overlapping and perhaps competing standards that can be employed to define document formats, terminology, communication protocols mirroring alternative technical approaches and schools of thought. eHealth projects need to respond to the important question of how alternative or inconsistently implemented standards and specifications can be used to ensure practical interoperability and long-term sustainability in large scale eHealth deployment. In the eStandards project, 19 European case studies reporting from R&D and large-scale eHealth deployment and policy projects were analyzed. Although this study is not exhaustive, reflecting on the concepts, standards, and tools for concurrent use and the successes, failures, and lessons learned, this paper offers practical insights on how eHealth deployment projects can make the most of the available eHealth standards and tools and how standards and profile developing organizations can serve the users embracing sustainability and technical innovation.

The Impact of Combat Deployment on Health Care Provider Burnout in a Military Emergency Department: A Cross-Sectional Professional Quality of Life Scale V Survey Study.

Science.gov (United States)

Cragun, Joshua N; April, Michael D; Thaxton, Robert E

2016-08-01

Compassion fatigue is a problem for many health care providers manifesting as physical, mental, and spiritual exhaustion. Our objective was to evaluate the association between prior combat deployment and compassion fatigue among military emergency medicine providers. We conducted a nonexperimental cross-sectional survey of health care providers assigned to the San Antonio Military Medical Center, Department of Emergency Medicine. We used the Professional Quality of Life Scale V survey instrument that evaluates provider burnout, secondary traumatic stress, and compassion satisfaction. Outcomes included burnout, secondary traumatic stress, and compassion satisfaction raw scores. Scores were compared between providers based on previous combat deployments using two-tailed independent sample t tests and multiple regression models. Surveys were completed by 105 respondents: 42 nurses (20 previously deployed), 30 technicians (11 previously deployed), and 33 physicians (16 previously deployed). No statistically significant differences in burnout, secondary traumatic stress, or compassion satisfaction scores were detected between previously deployed providers versus providers not previously deployed. There was no association between previous combat deployment and emergency department provider burnout, secondary traumatic stress, or compassion satisfaction scores. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Cognitive ability and risk of post-traumatic stress disorder after military deployment

DEFF Research Database (Denmark)

Nissen, Lars R.; Karstoft, Karen-Inge; Vedtofte, Mia S.

2017-01-01

Background: Studies of the association between pre-deployment cognitive ability and post-deployment post-traumatic stress disorder (PTSD) have shown mixed results. Aims: To study the influence of pre-deployment cognitive ability on PTSD symptoms 6-8 months post-deployment in a large population...

Interpersonal conflict and referrals to counseling among married soldiers following return from deployment.

Science.gov (United States)

Gibbs, Deborah A; Clinton-Sherrod, A Monique; Johnson, Ruby E

2012-10-01

Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.

The medical software quality deployment method.

Science.gov (United States)

Hallberg, N; Timpka, T; Eriksson, H

1999-03-01

The objective of this study was to develop a Quality Function Deployment (QFD) model for design of information systems in health-care environments. Consecutive blocked-subject case studies were conducted, based on action research methods. Starting with a QFD model for software development, a model for information system design, the Medical Software Quality Deployment (MSQD) model, was developed. The MSQD model was divided into the pre-study phase, in which the customer categories and their power to influence the design are determined; the data collection phase, in which the voice of customers (VoC) is identified by observations and interviews and quantified by Critical. Incident questionnaires; the need specification phase, where the VoC is specified into ranked customer needs; and the design phase where the customer needs are transformed stepwise to technical requirements and design attributes. QFD showed to be useful for integrating the values of different customer categories in software development for health-care settings. In the later design phases, other quality methods should be used for software implementation and testing.

Perceived effect of deployment on families of UK military personnel.

Science.gov (United States)

Thandi, G; Greenberg, N; Fear, N T; Jones, N

2017-10-01

In the UK, little is known about the perceived effects of deployment, on military families, from military personnel in theatre. To investigate military personnel's perceptions of the impact of deployment on intimate relationships and children. Deployed service personnel who were in a relationship, and who had children, completed a survey while deployed on combat operations. Data were taken from four mental health surveys carried out in Iraq in 2009 and Afghanistan in 2010, 2011 and 2014. Among 4265 participants, after adjusting for military and social-demographic covariates, perceiving that deployment had a negative impact on intimate relationships and children was associated with psychological distress, and traumatic stress symptoms. Military personnel who reported being in danger of being injured or killed during deployment, were more likely to report a perceived negative effect of deployment on their intimate relationships. Reservists were less likely to report a perceived negative impact of deployment on their children compared with regulars. Military personnel who themselves planned to separate from their partner were more likely to report psychological distress, and stressors at home. Perceived insufficient support from the Ministry of Defence was associated with poor mental health, and holding a junior rank. Deployed UK military personnel with symptoms of psychological distress, who experienced stressors at home, were especially likely to perceive that their family were inadequately supported by the military. Those planning to separate from their partner were at increased risk of suffering with mental health problems while deployed. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

The effect of military deployment on mental health

DEFF Research Database (Denmark)

Vincent, Stéphanie; Weatherall, Cecilie Dohlmann; W. Jepsen, Peter

2016-01-01

Public concern about soldiers’ mental health has increased over the last decade. Yet the large literature on the mental health problems of returning soldiers relies primarily on self-reported measures that may suffer from non-response bias, usually refers to older conflicts, and focuses mainly...... on specific diagnoses such as PTSD. Another challenge is that the differences between soldiers and non-soldiers are not necessarily causal, instead possibly reflecting an underlying propensity towards active military service. Using the objective measures of hospitalizations and the purchase of mental health...... medication, this paper is the first to investigate the effect of recent military deployments on a broader measure of mental health, for a full population of Danish soldiers and a comparison group of eligible men. We exploit a panel of Danish health administrative records and use propensity score matching...

Gastrointestinal illnesses among French forces deployed to Djibouti: French military health surveillance, 2005-2009.

Science.gov (United States)

Ollivier, Lénaïck; Decam, Christophe; Pommier de Santi, Vincent; Darar, Houssein Y; Dia, Aïssata; Nevin, Remington L; Romand, Olivier; Bougère, Jacques; Deparis, Xavier; Boutin, Jean-Paul

2010-10-01

Despite an increase in foreign tourism and in the numbers of foreign military personnel deployed to Djibouti, little is known about the risk of gastrointestinal illness in this country in eastern Africa. To assess risk and to describe common features of gastrointestinal illnesses, reports of illness derived from military health surveillance data collected during 2005-2009 among French service members deployed to Djibouti were reviewed. Diarrhea was the most common problem; it had an annual incidence ranging from 260 to 349 cases per 1,000 person-years. The risk was higher among soldiers deployed short-term (four months) than among soldiers deployed long-term (two years). This five-year review of French health surveillance data documents a significant burden of diarrhea among French soldiers in Djibouti. The identification of factors associated with risk may permit efficient targeting of interventions to reduce morbidity from gastrointestinal illness.

The impact of deployment length on the health and well-being of military personnel: a systematic review of the literature.

Science.gov (United States)

Buckman, Joshua E J; Sundin, Josefin; Greene, Talya; Fear, Nicola T; Dandeker, Christopher; Greenberg, Neil; Wessely, Simon

2011-01-01

To determine the current state of knowledge regarding the effects of deployment length and a 'mismatch' between the expected and actual length of deployments on the health and well-being of military personnel in order to draw relevant conclusions for all organisations that deploy personnel to conflict zones. A systematic review was conducted of studies measuring deployment length to theatres of operations and the issue of 'mismatch' between expected and actual tour lengths. The nine studies included were rated for quality. Of the nine studies reviewed, six were rated as high quality, two as moderate quality and one as low quality. Seven of these studies found adverse effects of longer deployments on health and well-being. The two studies that measured 'mismatch' found adverse effects on mental health and well-being when deployments lasted longer than personnel expected. There are a limited number of studies which have assessed the effects of deployment length and very few that have assessed the effects of 'mismatch' on health and well-being. However, this review suggests that, as deployment length increases, the potential for personnel to suffer adverse health effects also increases. Further research is required to investigate the effects of spending prolonged periods of time away from family and friends, especially when deployment lasts longer than expected by personnel. These results are important not only for the Armed Forces, but also for other organisations that place employees in similar working conditions. Taking account of these findings may allow better preparation for the potentially harmful effects that deployments can have on employees' health and well-being.

Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

Science.gov (United States)

Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy; Babigumira, Joseph B

2014-10-11

Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes. This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use. This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

A pilot survey of post-deployment health care needs in small community-based primary care clinics

Directory of Open Access Journals (Sweden)

Pugh Mary J

2011-07-01

Full Text Available Abstract Background Relatively little is known regarding to what extent community-based primary care physicians are encountering post-deployment health care needs among veterans of the Afghanistan or Iraq conflicts and their family members. Methods This pilot study conducted a cross-sectional survey of 37 primary care physicians working at small urban and suburban clinics belonging to a practice-based research network in the south central region of Texas. Results Approximately 80% of the responding physicians reported caring for patients who have been deployed to the Afghanistan or Iraq war zones, or had a family member deployed. Although these physicians noted a variety of conditions related to physical trauma, mental illnesses and psychosocial disruptions such as marital, family, financial, and legal problems appeared to be even more prevalent among their previously deployed patients and were also noted among family members of deployed veterans. Conclusions Community-based primary care physicians should be aware of common post-deployment health conditions and the resources that are available to meet these needs.

Gastrointestinal Illnesses among French Forces Deployed to Djibouti: French Military Health Surveillance, 2005–2009

Science.gov (United States)

Ollivier, Lénaïck; Decam, Christophe; de Santi, Vincent Pommier; Darar, Houssein Y.; Dia, Aïssata; Nevin, Remington L.; Romand, Olivier; Bougère, Jacques; Deparis, Xavier; Boutin, Jean-Paul

2010-01-01

Despite an increase in foreign tourism and in the numbers of foreign military personnel deployed to Djibouti, little is known about the risk of gastrointestinal illness in this country in eastern Africa. To assess risk and to describe common features of gastrointestinal illnesses, reports of illness derived from military health surveillance data collected during 2005–2009 among French service members deployed to Djibouti were reviewed. Diarrhea was the most common problem; it had an annual incidence ranging from 260 to 349 cases per 1,000 person-years. The risk was higher among soldiers deployed short-term (four months) than among soldiers deployed long-term (two years). This five-year review of French health surveillance data documents a significant burden of diarrhea among French soldiers in Djibouti. The identification of factors associated with risk may permit efficient targeting of interventions to reduce morbidity from gastrointestinal illness. PMID:20889897

War-related stressors as predictors of post-deployment health of Air Force women.

Science.gov (United States)

Pierce, Penny F; Lewandowski-Romps, Lisa; Silverschanz, Perry

2011-01-01

Little is known about the effects of combat exposure on women's health after service in Operation Iraqi Freedom (OIF). Our purpose was to describe the incidence and nature of physical heath symptoms reported by deployed women to identify problematic areas where early intervention or better surveillance might be directed. Using a random, stratified sample (theater vs. non-theater; parent vs. non-parent; and military component including active, guard, and reserve members) of 1,114 Air Force women, we provide descriptive statistics, group comparisons, and multiple regression models to identify health concerns and potential predictors of physical health outcomes. Findings revealed that those in the reserve/guard forces (vs. active duty) and those in the theater of operations (vs. elsewhere during the same time period) reported greater physical health problems (β = -0.07, p social functioning (β = 0.08, p war-related predictors of health among women serving in deployed locations around the world. Copyright © 2011. Published by Elsevier Inc.

Ensemble modeling of the likely public health impact of a pre-erythrocytic malaria vaccine.

Directory of Open Access Journals (Sweden)

Thomas Smith

2012-01-01

Full Text Available BACKGROUND: The RTS,S malaria vaccine may soon be licensed. Models of impact of such vaccines have mainly considered deployment via the World Health Organization's Expanded Programme on Immunization (EPI in areas of stable endemic transmission of Plasmodium falciparum, and have been calibrated for such settings. Their applicability to low transmission settings is unclear. Evaluations of the efficiency of different deployment strategies in diverse settings should consider uncertainties in model structure. METHODS AND FINDINGS: An ensemble of 14 individual-based stochastic simulation models of P. falciparum dynamics, with differing assumptions about immune decay, transmission heterogeneity, and treatment access, was constructed. After fitting to an extensive library of field data, each model was used to predict the likely health benefits of RTS,S deployment, via EPI (with or without catch-up vaccinations, supplementary vaccination of school-age children, or mass vaccination every 5 y. Settings with seasonally varying transmission, with overall pre-intervention entomological inoculation rates (EIRs of two, 11, and 20 infectious bites per person per annum, were considered. Predicted benefits of EPI vaccination programs over the simulated 14-y time horizon were dependent on duration of protection. Nevertheless, EPI strategies (with an initial catch-up phase averted the most deaths per dose at the higher EIRs, although model uncertainty increased with EIR. At two infectious bites per person per annum, mass vaccination strategies substantially reduced transmission, leading to much greater health effects per dose, even at modest coverage. CONCLUSIONS: In higher transmission settings, EPI strategies will be most efficient, but vaccination additional to the EPI in targeted low transmission settings, even at modest coverage, might be more efficient than national-level vaccination of infants. The feasibility and economics of mass vaccination, and the

Structure of a Complete Mediator-RNA Polymerase II Pre-Initiation Complex.

Science.gov (United States)

Robinson, Philip J; Trnka, Michael J; Bushnell, David A; Davis, Ralph E; Mattei, Pierre-Jean; Burlingame, Alma L; Kornberg, Roger D

2016-09-08

A complete, 52-protein, 2.5 million dalton, Mediator-RNA polymerase II pre-initiation complex (Med-PIC) was assembled and analyzed by cryo-electron microscopy and by chemical cross-linking and mass spectrometry. The resulting complete Med-PIC structure reveals two components of functional significance, absent from previous structures, a protein kinase complex and the Mediator-activator interaction region. It thereby shows how the kinase and its target, the C-terminal domain of the polymerase, control Med-PIC interaction and transcription. Copyright © 2016 Elsevier Inc. All rights reserved.

A Systematic Review on Recent Advances in mHealth Systems: Deployment Architecture for Emergency Response.

Science.gov (United States)

Gonzalez, Enrique; Peña, Raul; Avila, Alfonso; Vargas-Rosales, Cesar; Munoz-Rodriguez, David

2017-01-01

The continuous technological advances in favor of mHealth represent a key factor in the improvement of medical emergency services. This systematic review presents the identification, study, and classification of the most up-to-date approaches surrounding the deployment of architectures for mHealth. Our review includes 25 articles obtained from databases such as IEEE Xplore, Scopus, SpringerLink, ScienceDirect, and SAGE. This review focused on studies addressing mHealth systems for outdoor emergency situations. In 60% of the articles, the deployment architecture relied in the connective infrastructure associated with emergent technologies such as cloud services, distributed services, Internet-of-things, machine-to-machine, vehicular ad hoc network, and service-oriented architecture. In 40% of the literature review, the deployment architecture for mHealth considered traditional connective infrastructure. Only 20% of the studies implemented an energy consumption protocol to extend system lifetime. We concluded that there is a need for more integrated solutions specifically for outdoor scenarios. Energy consumption protocols are needed to be implemented and evaluated. Emergent connective technologies are redefining the information management and overcome traditional technologies.

A Systematic Review on Recent Advances in mHealth Systems: Deployment Architecture for Emergency Response

Directory of Open Access Journals (Sweden)

Enrique Gonzalez

2017-01-01

Full Text Available The continuous technological advances in favor of mHealth represent a key factor in the improvement of medical emergency services. This systematic review presents the identification, study, and classification of the most up-to-date approaches surrounding the deployment of architectures for mHealth. Our review includes 25 articles obtained from databases such as IEEE Xplore, Scopus, SpringerLink, ScienceDirect, and SAGE. This review focused on studies addressing mHealth systems for outdoor emergency situations. In 60% of the articles, the deployment architecture relied in the connective infrastructure associated with emergent technologies such as cloud services, distributed services, Internet-of-things, machine-to-machine, vehicular ad hoc network, and service-oriented architecture. In 40% of the literature review, the deployment architecture for mHealth considered traditional connective infrastructure. Only 20% of the studies implemented an energy consumption protocol to extend system lifetime. We concluded that there is a need for more integrated solutions specifically for outdoor scenarios. Energy consumption protocols are needed to be implemented and evaluated. Emergent connective technologies are redefining the information management and overcome traditional technologies.

DEPLOYMENT OF INNOVATIVE CHARACTERIZATION TECHNOLOGIES AND IMPLEMENTATION OF THE MARSSIM PROCESS AT RADIOLOGICALLY CONTAMINATED SITES.

Energy Technology Data Exchange (ETDEWEB)

KALB,P.D.; MILIAN,L.; LUCKETT,L.; WATTERS,D.; MILLER,K.M.; GOGOLAK,C.

2001-05-01

The success of this Accelerated Site Technology Deployment (ASTD) project is measured on several levels. First, the deployment of this innovative approach using in situ characterization, portable field laboratory measurements, and implementation of MARSSIM was successfully established for all three phases of D and D characterization, i.e., pre-job scoping, on-going disposition of waste, and final status surveys upon completion of the activity. Unlike traditional D and D projects, since the Brookhaven Graphite Research Reactor Decommissioning Project (BGRR-DP) is operating on an accelerated schedule, much of the work is being carried out simultaneously. Rather than complete a full characterization of the facility before D and D work begins, specific removal actions require characterization as the activity progresses. Thus, the need for rapid and cost-effective techniques for characterization is heightened. Secondly, since the approach used for this ASTD project was not thoroughly proven prior to deployment, a large effort was devoted to demonstrating technical comparability to project managers, regulators and stakeholders. During the initial phases, large numbers of replicate samples were taken and analyzed by conventional baseline techniques to ensure that BGRR-DP quality assurance standards were met. ASTD project staff prepared comparisons of data gathered using ISOCS and BetaScint with traditional laboratory methods and presented this information to BGRR-DP staff and regulators from EPA Region II, NYS Department of Environmental Conservation, and the Suffolk County Board of Health. As the results of comparability evaluations became available, approval for these methods was received and the techniques associated with in situ characterization, portable field laboratory measurements, and implementation of MARSSIM were gradually integrated into BGRR-DP procedures.

DEPLOYMENT OF INNOVATIVE CHARACTERIZATION TECHNOLOGIES AND IMPLEMENTATION OF THE MARSSIM PROCESS AT RADIOLOGICALLY CONTAMINATED SITES

International Nuclear Information System (INIS)

KALB, P.D.; MILIAN, L.; LUCKETT, L.; WATTERS, D.; MILLER, K.M.; GOGOLAK, C.

2001-01-01

The success of this Accelerated Site Technology Deployment (ASTD) project is measured on several levels. First, the deployment of this innovative approach using in situ characterization, portable field laboratory measurements, and implementation of MARSSIM was successfully established for all three phases of D and D characterization, i.e., pre-job scoping, on-going disposition of waste, and final status surveys upon completion of the activity. Unlike traditional D and D projects, since the Brookhaven Graphite Research Reactor Decommissioning Project (BGRR-DP) is operating on an accelerated schedule, much of the work is being carried out simultaneously. Rather than complete a full characterization of the facility before D and D work begins, specific removal actions require characterization as the activity progresses. Thus, the need for rapid and cost-effective techniques for characterization is heightened. Secondly, since the approach used for this ASTD project was not thoroughly proven prior to deployment, a large effort was devoted to demonstrating technical comparability to project managers, regulators and stakeholders. During the initial phases, large numbers of replicate samples were taken and analyzed by conventional baseline techniques to ensure that BGRR-DP quality assurance standards were met. ASTD project staff prepared comparisons of data gathered using ISOCS and BetaScint with traditional laboratory methods and presented this information to BGRR-DP staff and regulators from EPA Region II, NYS Department of Environmental Conservation, and the Suffolk County Board of Health. As the results of comparability evaluations became available, approval for these methods was received and the techniques associated with in situ characterization, portable field laboratory measurements, and implementation of MARSSIM were gradually integrated into BGRR-DP procedures

Longitudinal changes in glucocorticoid receptor exon 1F methylation and psychopathology after military deployment.

Science.gov (United States)

Schür, R R; Boks, M P; Rutten, B P F; Daskalakis, N P; de Nijs, L; van Zuiden, M; Kavelaars, A; Heijnen, C J; Joëls, M; Kahn, R S; Geuze, E; Vermetten, E; Vinkers, C H

2017-07-25

Several cross-sectional studies have demonstrated the relevance of DNA methylation of the glucocorticoid receptor exon 1 F region (GR-1 F ) for trauma-related psychopathology. We conducted a longitudinal study to examine GR-1 F methylation changes over time in relation to trauma exposure and the development of post-deployment psychopathology. GR-1 F methylation (52 loci) was quantified using pyrosequencing in whole blood of 92 military men 1 month before and 6 months after a 4-month deployment period to Afghanistan. GR-1 F methylation overall (mean methylation and the number of methylated loci) and functional methylation (methylation at loci associated with GR exon 1 F expression) measures were examined. We first investigated the effect of exposure to potentially traumatic events during deployment on these measures. Subsequently, changes in GR-1 F methylation were related to changes in mental health problems (total Symptom Checklist-90 score) and posttraumatic stress disorder (PTSD) symptoms (Self-Report Inventory for PTSD). Trauma exposure during deployment was associated with an increase in all methylation measures, but development of mental health problems 6 months after deployment was only significantly associated with an increased functional methylation. Emergence of post-deployment PTSD symptoms was not related to increased functional methylation over time. Pre-deployment methylation levels did not predict post-deployment psychopathology. To our knowledge, this is the first study to prospectively demonstrate trauma-related increases in GR-1 F methylation, and it shows that only increases at specific functionally relevant sites predispose for post-deployment psychopathology.

Post-deployment usability evaluation of a radiology workstation

NARCIS (Netherlands)

Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi; Oudkerk, Matthijs; van Ooijen, Peter

2015-01-01

Objective To evaluate the usability of a radiology workstation after deployment in a hospital. Significance In radiology, it is difficult to perform valid pre-deployment usability evaluations due to the heterogeneity of the user group, the complexity of the radiological workflow, and the complexity

Public health foodborne illness case study during a Special Operations Forces deployment to South America.

Science.gov (United States)

McCown, Michael; Grzeszak, Benjamin

2010-01-01

Although many public health articles have been published detailing foodborne illness outbreaks, a medical literature search revealed no articles that detail a case study or a specific response of a deployed U.S. military unit to a potential foodborne illness. This article describes a recent public health case study of a U.S. Special Operations Forces (SOF) team sickened while deployed to South America. It highlights public health factors which may affect U.S. personnel deployed or serving overseas and may serve as a guide for a deployed SOF medic to reference in response to a potential food- or waterborne illness outbreak. Eight food samples and five water samples were collected. The food samples were obtained from the host nation kitchen that provided food to the SOF team. The water samples were collected from the kitchen as well as from multiple sites on the host nation base. These samples were packaged in sterile containers, stored at appropriate temperatures, and submitted to a U.S. Army diagnostic laboratory for analysis. Laboratory results confirmed the presence of elevated aerobic plate counts (APCs) in the food prepared by the host nation and consumed by the SOF team. High APCs in food are the primary indicator of improper sanitation of food preparation surfaces and utensils. This case study concluded that poor kitchen sanitation, improper food storage, preparation, and/or holding were the probable conditions that led to the team?s symptoms. These results emphasize the importance of ensuring safe food and water for U.S. personnel serving overseas, especially in a deployment or combat setting. Contaminated food and/or water will negatively impact the health and availability of forces, which may lead to mission failure. The SOF medic must respond to potential outbreaks and be able to (1) critically inspect food preparation areas and accurately advise commanders in order to correct deficiencies and (2) perform food/water surveillance testing consistently

Design aspects of a deployable tensegrity-hollow-rope footbridge

OpenAIRE

Rhode-Barbarigos , Landolf; Bel Hadj Ali , Nizar; Motro , René; Smith , Ian F.C.

2012-01-01

International audience; Tensegrity structures are composed of cables and struts in a pre-stressed self-equilibrium. Although tensegrity first appeared in the 1950s, it is seldom used in civil engineering. This paper focuses on the design aspects of a deployable tensegrity-hollow-rope footbridge. Deployment is usually not a critical design case for traditional deployable structures. However, for tensegrity systems deployment may be critical due to the actuation required. In this paper, deploym...

Hard is Normal: Military Families' Transitions Within the Process of Deployment.

Science.gov (United States)

Yablonsky, Abigail M; Barbero, Edie Devers; Richardson, Jeanita W

2016-02-01

US military deployments have become more frequent and lengthier in duration since 2003. Over half of US military members are married, and many also have children. The authors sought to understand the process of deployment from the perspective of the military family. After a thorough search of the literature, 21 primary research reports of 19 studies with an aggregate sample of 874 were analyzed using qualitative metasynthesis. The deployment process was experienced in four temporal domains. The military family as a whole shared the pre-deployment transition: all family members felt uncertain about the future, needed to complete tasks to "get ready" for deployment, and experienced a sense of distancing in preparation for the upcoming separation. The AD member went through the deployment transition independently, needing to "stay engaged" with the military mission, building a surrogate family and simultaneously trying to maintain connection with the family at home. In parallel, the home front family was going through a transposement transition, moving forward as an altered family unit, taking on new roles and responsibilities, and trying to simultaneously connect with the deployed member and find support from other military families. In post-deployment, the family went through the "reintegration" transition together, managing expectations, and readjusting family roles, all needing understanding and appreciation for their sacrifices during the recent separation. Effective family communication was important for military family well-being after deployment but unexpectedly challenging for many. Clinical, research, and policy recommendations are discussed. © 2015 Wiley Periodicals, Inc. This article has been contributed to by a US Government employee and her work is in the public domain in the USA.

Costs of war: excess health care burdens during the wars in Afghanistan and Iraq (relative to the health care experience pre-war).

Science.gov (United States)

2012-11-01

This report estimates the health care burden related to the wars in Iraq and Afghanistan by calculating the difference between the total health care delivered to U.S. military members during wartime (October 2001 to June 2012) and that which would have been delivered if pre-war (January 1998 to August 2001) rates of ambulatory visits, hospitalizations, and hospital bed days of active component members of the U.S. Armed Forces had persisted during the war. Overall, there were estimated excesses of 17,023,491 ambulatory visits, 66,768 hospitalizations, and 634,720 hospital bed days during the war period relative to that expected based on pre-war experience. Army and Marine Corps members and service members older than 30 accounted for the majority of excess medical care during the war period. The illness/injury-specific category of mental disorders was the single largest contributor to the total estimated excesses of ambulatory visits, hospitalizations, and bed days. The total health care burdens associated with the wars in Afghanistan and Iraq are undoubtedly greater than those enumerated in this report because this analysis did not address care delivered in deployment locations or at sea, care rendered by civilian providers to reserve component members in their home communities, care of veterans by the Departments of Defense and Veterans Affairs, preventive care for the sake of force health protection, and future health care associated with wartime injuries and illnesses.

Personal values in soldiers after military deployment: associations with mental health and resilience.

Science.gov (United States)

Zimmermann, Peter; Firnkes, Susanne; Kowalski, Jens T; Backus, Johannes; Siegel, Stefan; Willmund, Gerd; Maercker, Andreas

2014-01-01

After military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context. Schwartz's Portrait Values Questionnaire (PVQ), the Posttraumatic Stress Diagnostic Scale (PDS), and the 11-item version of the Resilience Scale (RS-11) were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated). Logistic regression showed that the value types of hedonism (-), power (-), tradition (+), and universalism (+) were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values. Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches.

Use of a patient completed iPad questionnaire to improve pre-operative assessment.

Science.gov (United States)

Howell, M; Hood, A J; Jayne, D G

2017-02-01

Developments in healthcare technology could improve patient care and reduce healthcare costs. There is a need to facilitate communication and increase efficiency in surgical pre-assessment clinics. This study aimed to develop an iPad application to deliver an electronic patient questionnaire, and to evaluate its use in the pre-assessment environment. Software was developed, MyOp, for a standard iPad that mirrored the paper-based pre-assessment system, with features designed for ease of patient use and remote data transfer. A case-control study was conducted, comparing use of MyOp with paper-based practice, to evaluate feasibility and patient preference. Patients were offered the use of MyOp or paper-based system. Outcomes measured included time to complete iPad questionnaire, consultation duration, and a patient preference questionnaire. MyOp cost £3500 to develop. 104 individuals participated in the study, 53 MyOp and 51 controls. MyOp reduced the median consultation duration by 5.00 min. A reduction was seen in all subgroups except those aged over 70 or urology patients. Patients preferred to complete the form independently, using a touchpad or computer but expressed concerns about data security. Use of an electronic patient questionnaire reduces consultation time delivering greater efficiency of pre-assessment nurse time. Preconceived ideas about the use of technology in older age groups are likely inaccurate and less of a barrier than previously thought. Electronic pre-assessments could be used routinely to reduce demands on healthcare facilities, improve patient care, and triage patients prior to clinic attendance.

Optimum wireless sensor deployment scheme for structural health monitoring: a simulation study

International Nuclear Information System (INIS)

Liu, Chengyin; Fang, Kun; Teng, Jun

2015-01-01

With the rapid advancements in smart sensing technology and wireless communication technology, the wireless sensor network (WSN) offers an alternative solution to structural health monitoring (SHM). In WSNs, dense deployment of wireless nodes aids the identification of structural dynamic characteristics, while data transmission is a significant issue since wireless channels typically have a lower bandwidth and a limited power supply. This paper provides a wireless sensor deployment optimization scheme for SHM, in terms of both energy consumption and modal identification accuracy. A spherical energy model is established to formulate the energy consumption within a WSN. The optimal number of sensors and their locations are obtained through solving a multi-objective function with weighting factors on energy consumption and modal identification accuracy using a genetic algorithm (GA). Simulation and comparison results with traditional sensor deployment methods demonstrate the efficiency of the proposed optimization scheme. (paper)

Personal values in soldiers after military deployment: associations with mental health and resilience

Directory of Open Access Journals (Sweden)

Peter Zimmermann

2014-05-01

Full Text Available Background: After military deployment, soldiers are at an increased risk of developing posttraumatic psychiatric disorders. The correlation of personal values with symptoms, however, has not yet been examined within a military context. Method: Schwartz's Portrait Values Questionnaire (PVQ, the Posttraumatic Stress Diagnostic Scale (PDS, and the 11-item version of the Resilience Scale (RS-11 were completed by 117 soldiers of the German Armed Forces who had recently been deployed to Afghanistan (n=40 undergoing initial psychiatric treatment, n=77 untreated. Results: Logistic regression showed that the value types of hedonism (−, power (−, tradition (+, and universalism (+ were significantly correlated with the probability and severity of PTSD and whether the participant was in treatment or not. The effects were partially mediated by the RS-11 scale values. Conclusions: Value types seem to be associated with psychiatric symptoms in soldiers after deployment. These results could contribute to the further development of therapeutic approaches.

[Mental disorders in German soldiers after deployment - impact of personal values and resilience].

Science.gov (United States)

Zimmermann, Peter; Firnkes, Susanne; Kowalski, Jens; Backus, Johannes; Alliger-Horn, Christina; Willmund, Gerd; Hellenthal, Andrea; Bauer, Amanda; Petermann, Franz; Maercker, Andreas

2015-11-01

Soldiers are at increased risk of developing mental health disorders after military deployment. The impact of personal values on psychological symptomatology based on an empirical working model has not yet been studied in a military environment. 117 German Armed Forces soldiers completed the Portrait-Values-Questionnaire (PVQ), the Patient-Health-Questionnaire (PHQ) and the Resilience-Scale (RS-11) after their deployment to Afghanistan. In the regression analyses the values hedonism, benevolence, tradition, self-direction and universalism had a differential significant impact on depression, anxiety and somatoform symptoms of the PHQ. The RS-11 sum scale values were negatively correlated with symptomatology. Personal values and resilience seem to be associated with psychological symptomatology in soldiers after military deployment. The results can contribute to the further development of both preventive and therapeutic approaches. © Georg Thieme Verlag KG Stuttgart · New York.

Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments

Directory of Open Access Journals (Sweden)

Waller Michael

2012-07-01

Full Text Available Abstract Background The association between stressful events on warlike deployments and subsequent mental health problems has been established. Less is known about the effects of stressful events on peacekeeping deployments. Methods Two cross sectional studies of the Australian Defence Force were used to contrast the prevalence of exposures reported by a group deployed on a peacekeeping operation (Bougainville, n = 1704 and those reported by a group deployed on operations which included warlike and non-warlike exposures (East Timor, n = 1333. A principal components analysis was used to identify groupings of non-traumatic exposures on deployment. Multiple regression models were used to assess the association between self-reported objective and subjective exposures, stressors on deployment and subsequent physical and mental health outcomes. Results The principal components analysis produced four groups of non-traumatic stressors which were consistent between the peacekeeping and more warlike deployments. These were labelled ‘separation’, ‘different culture’, ‘other people’ and ‘work frustration’. Higher levels of traumatic and non-traumatic exposures were reported by veterans of East Timor compared to Bougainville. Higher levels of subjective traumatic exposures were associated with increased rates of PTSD in East Timor veterans and more physical and psychological health symptoms in both deployed groups. In Bougainville and East Timor veterans some non-traumatic deployment stressors were also associated with worse health outcomes. Conclusion Strategies to best prepare, identify and treat those exposed to traumatic events and other stressors on deployment should be considered for Defence personnel deployed on both warlike and peacekeeping operations.

Association between baseline psychological attributes and mental health outcomes after soldiers returned from deployment.

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Shen, Yu-Chu; Arkes, Jeremy; Lester, Paul B

2017-10-05

Psychological health is vital for effective employees, especially in stressful occupations like military and public safety sectors. Yet, until recently little empirical work has made the link between requisite psychological resources and important mental health outcomes across time in those sectors. In this study we explore the association between 14 baseline psychological health attributes (such as adaptability, coping ability, optimism) and mental health outcomes following exposure to combat deployment. Retrospective analysis of all U.S. Army soldiers who enlisted between 2009 and 2012 and took the Global Assessment Tools (GAT) before their first deployment (n = 63,186). We analyze whether a soldier screened positive for depression and posttraumatic stress disorder (PTSD) after returning from deployment using logistic regressions. Our key independent variables are 14 psychological attributes based on GAT, and we control for relevant demographic and service characteristics. In addition, we generate a composite risk score for each soldier based on the predicted probabilities from the above multivariate model using just baseline psychological attributes and demographic information. Comparing those who scored in the bottom 5 percentile of each attribute to those in the top 95 percentile, the odds ratio of post-deployment depression symptoms ranges from 1.21 (95% CI 1.06, 1.40) for organizational trust to 1.73 (CI 1.52, 1.97) for baseline depression. The odds ratio of positive screening of PTSD symptoms ranges from 1.22 for family support (CI 1.08, 1.38) to 1.51 for baseline depression (CI 1.32, 1.73). The risk profile analysis shows that 31% of those who screened positive for depression and 27% of those who screened positive for PTSD were concentrated among the top 5% high risk population. A set of validated, self-reported questions administered early in a soldier's career can predict future mental health problems, and can be used to improve workforce fit and

The health worker recruitment and deployment process in Kenya: an emergency hiring program.

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Adano, Ummuro

2008-09-16

Despite a pool of unemployed health staff available in Kenya, staffing levels at most facilities were only 50%, and maldistribution of staff left many people without access to antiretroviral therapy (ART). Because in the current system it takes one to two years to fill vacant positions, even when funding is available, an emergency approach was needed to fast-track the hiring and deployment process. A stakeholder group was formed to bring together leaders from several sectors to design and implement a fast-track hiring and deployment model that would mobilize 830 additional health workers. This model used the private sector to recruit and deploy new health workers and manage the payroll and employment contracts, with an agreement from the government to transfer these staff to the government payroll after three years. The recruitment process was shortened to less than three months. By providing job orientation and on-time pay checks, the program increased employee retention and satisfaction. Most of the active roadblocks to changes in the health workforce policies and systems are 'human' and not technical, stemming from a lack of leadership, a problem-solving mindset and the alignment of stakeholders from several sectors. It is essential to establish partnerships and foster commitment and collaboration to create needed change in human resource management (HRM). Strengthening appointment on merit is one of the most powerful, yet simplest ways in which the health sector and governments that seek to tackle the challenges of corruption and poor governance can improve their image and efficiency. The quality and integrity of the public health sector can be improved only through professionalizing HRM, reformulating and consolidating the currently fragmented HR functions, and bringing all the pieces together under the authority and influence of HR departments and units with expanded scopes. HR staff must be specialists with strategic HR functions and not generalists who are

The health worker recruitment and deployment process in Kenya: an emergency hiring program

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Adano Ummuro

2008-09-01

Full Text Available Abstract Despite a pool of unemployed health staff available in Kenya, staffing levels at most facilities were only 50%, and maldistribution of staff left many people without access to antiretroviral therapy (ART. Because in the current system it takes one to two years to fill vacant positions, even when funding is available, an emergency approach was needed to fast-track the hiring and deployment process. A stakeholder group was formed to bring together leaders from several sectors to design and implement a fast-track hiring and deployment model that would mobilize 830 additional health workers. This model used the private sector to recruit and deploy new health workers and manage the payroll and employment contracts, with an agreement from the government to transfer these staff to the government payroll after three years. The recruitment process was shortened to less than three months. By providing job orientation and on-time pay checks, the program increased employee retention and satisfaction. Most of the active roadblocks to changes in the health workforce policies and systems are 'human' and not technical, stemming from a lack of leadership, a problem-solving mindset and the alignment of stakeholders from several sectors. It is essential to establish partnerships and foster commitment and collaboration to create needed change in human resource management (HRM. Strengthening appointment on merit is one of the most powerful, yet simplest ways in which the health sector and governments that seek to tackle the challenges of corruption and poor governance can improve their image and efficiency. The quality and integrity of the public health sector can be improved only through professionalizing HRM, reformulating and consolidating the currently fragmented HR functions, and bringing all the pieces together under the authority and influence of HR departments and units with expanded scopes. HR staff must be specialists with strategic HR functions

Undiagnosed Diabetes and Pre-Diabetes in Health Disparities.

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Susan P Fisher-Hoch

Full Text Available Globally half of all diabetes mellitus is undiagnosed. We sought to determine the extent and characteristics of undiagnosed type 2 diabetes mellitus and pre-diabetes in Mexican Americans residing in the United States. This disadvantaged population with 50% lifetime risk of diabetes is a microcosm of the current pandemic. We accessed baseline data between 2004 and 2014 from 2,838 adults recruited to our Cameron County Hispanic Cohort (CCHC; a two-stage randomly selected 'Framingham-like' cohort of Mexican Americans on the US Mexico border with severe health disparities. We examined prevalence, risk factors and metabolic health in diagnosed and undiagnosed diabetes and pre-diabetes. Two thirds of this Mexican American population has diabetes or pre-diabetes. Diabetes prevalence was 28.0%, nearly half undiagnosed, and pre-diabetes 31.6%. Mean BMI among those with diabetes was 33.5 kg/m2 compared with 29.0 kg/m2 for those without diabetes. Significant risk factors were low income and educational levels. Most with diabetes had increased waist/hip ratio. Lack of insurance and access to health services played a decisive role in failure to have diabetes diagnosed. Participants with undiagnosed diabetes and pre-diabetes had similar measures of poor metabolic health similar but generally not as severe as those with diagnosed diabetes. More than 50% of a minority Mexican American population in South Texas has diabetes or pre-diabetes and is metabolically unhealthy. Only a third of diabetes cases were diagnosed. Sustained efforts are imperative to identify, diagnose and treat individuals in underserved communities.

School Climate, Deployment, and Mental Health among Students in Military-Connected Schools

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De Pedro, Kris Tunac; Astor, Ron Avi; Gilreath, Tamika D.; Benbenishty, Rami; Berkowitz, Ruth

2018-01-01

Research has found that when compared with civilian students, military-connected students in the United States have more negative mental health outcomes, stemming from the stress of military life events (i.e., deployment). To date, studies on military-connected youth have not examined the role of protective factors within the school environment,…

Labeling of Deployment Sexual Harassment Experiences Among Male and Female Veterans.

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Dardis, Christina M; Vento, Stephanie A; Gradus, Jaimie L; Street, Amy E

2017-11-20

Victims' conceptualizations of traumatic experiences can impact screening responses and decisions to utilize health care. Despite experiencing events constituting sexual harassment, many victims do not label their experiences as such. In the military, specific situational factors (e.g., occurred on-duty, higher ranking harasser) and victim appraisals of experiences (e.g., offensive, threatening) have been associated with increased labeling of sexual harassment. However, no research has examined sexual harassment labeling among those deployed in recent Afghanistan and Iraq conflicts, where the context of harassment may differ from peacetime settings. The purpose of the present study was to examine frequencies of labeling sexual harassment during deployment, factors associated with labeling, and associations between labeling and perceived need for and use of mental health services. 2,348 veterans (51% women, 49% men) drawn from a random sample of veterans deployed in support of the wars in Afghanistan and Iraq completed a mail survey. Women were significantly more likely than men to label experiences as harassment. Whereas appraisals of events were associated with both women's and men's labeling, situational factors were only associated with women's labeling. Among women, labeling was associated with a greater perceived need for and use of mental health services among those who experienced nonassaultive harassment. These results confirm the importance of using behavioral language when screening for experiences of harassment among veterans returning from deployment. We discuss strategies for addressing labeling in the context of mental health treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Supporting deployed operations: are military nurses gaining the relevant experience from MDHUs to be competent in deployed operations?

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Beaumont, Steven P; Allan, Helen T

2014-01-01

To explore how peacetime employment of military nurses in the UK National Health Service Medical Defence Hospital Units prepares them to be competent to practise in their role on deployment. Military secondary care nurses are employed within UK National Health Service Trusts to gain clinical experience that will be relevant to their military nursing role. A two-stage grounded theory study using mixed methods: postal questionnaire survey and in-depth interviews. In stage one a postal questionnaire was distributed to all serving military nurses. Stage two involved 12 semi-structured interviews. The data from both parts of the study were analysed using grounded theory. Four categories and one core category were identified, which suggested that participants did not feel fully prepared for deployment. Their feelings of preparedness increased with deployment experience and decreased when the nature of injuries seen on deployment changed. Respondents argued that even when unprepared, they did not feel incompetent. The findings suggest that the peacetime clinical experience gained in the National Health Service did not always develop the necessary competencies to carry out roles as military nurses on deployment. This study highlights the unique role of military nurses. We discuss these findings in the light of the literature on competency and expertise. The military nurses in this study did not feel fully prepared for deployed operations. We propose a new model for how military nurses could gain relevant experience from their National Health Service placements. National Health Service clinical placements need to be reassessed regularly to ensure that they are meeting military nurses' clinical requirements. Experiences of nurses returning from deployment could be shared and used as a basis for reflection and learning within National Health Service Trusts and also inform decisions regarding the appropriateness of clinical placements for qualified military nurses. © 2012

Pre-evacuation hCG glycoforms in uneventful complete hydatidiform mole and persistent trophoblastic disease.

NARCIS (Netherlands)

Thomas, C.M.G.; Kerkmeijer, L.G.W.; Ariaens, H.J.; Steen, R. van der; Massuger, L.F.A.G.; Sweep, F.C.

2010-01-01

OBJECTIVE: To investigate whether the glycoform distribution patterns of human chorionic gonadotropin (hCG) obtained by chromatofocusing in pre-evacuation serum are different for patients who will eventually develop into persistent trophoblastic disease in case of complete hydatidiform mole

Characterizing spouse/partner depression and alcohol problems over the course of military deployment.

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Erbes, Christopher R; Kramer, Mark; Arbisi, Paul A; DeGarmo, David; Polusny, Melissa A

2017-04-01

Spouse/partners of military personnel demonstrate elevated levels of distress during military deployments, yet there is insufficient information about courses of adjustment over time. The current study identified trajectories of depression and alcohol use problems and predictors of those trajectories across the deployment cycle. National Guard soldiers (N = 1973) and spouses/intimate partners (N = 1020) completed assessments of risk/protective factors and baseline measures of mental health functioning 2 to 5 months prior to soldiers' 1-year deployments (Time 1) to Kuwait/Iraq in support of Operation New Dawn or Afghanistan in support of Operation Enduring Freedom. Partners' mental health was reassessed at 4 months (Time 2) and 8 months (Time 3) after soldiers deployed, and both spouses/partners and soldiers were reassessed 2-3 months postdeployment (Time 4). Latent class growth modeling of partner depression symptoms over time revealed 4 groups: Resilience (79.9%), Deployment Distress (8.9%), Anticipatory Distress (8.4%), and Post-Deployment Distress (2.7%). Three alcohol misuse trajectories were identified: Resilience (91.3%), Deployment Onset (5.4%), and Deployment Desistance (3.3%). Predeployment predictors of partners' depression symptom trajectories varied by group and included soldier reports of stressors and social support and partner levels of neuroticism, introversion, disconstraint, and reported stressors. Predeployment predictors of alcohol misuse trajectories varied by group, and included soldier levels of alcohol misuse as well as partner neuroticism, disconstraint, and family readiness. Delineating and predicting trajectories of partner adjustment can allow for better targeted interventions toward those most at risk for heightened distress or alcohol problems over the deployment cycle. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Power Balance Aware Wireless Charger Deployment Method for Complete Coverage in Wireless Rechargeable Sensor Networks

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Tu-Liang Lin

2016-08-01

Full Text Available Traditional sensor nodes are usually battery powered, and the limited battery power constrains the overall lifespan of the sensors. Recently, wireless power transmission technology has been applied in wireless sensor networks (WSNs to transmit wireless power from the chargers to the sensor nodes and solve the limited battery power problem. The combination of wireless sensors and wireless chargers forms a new type of network called wireless rechargeable sensor networks (WRSNs. In this research, we focus on how to effectively deploy chargers to maximize the lifespan of a network. In WSNs, the sensor nodes near the sink consume more power than nodes far away from the sink because of frequent data forwarding. This important power unbalanced factor has not been considered, however, in previous charger deployment research. In this research, a power balance aware deployment (PBAD method is proposed to address the power unbalance in WRSNs and to design the charger deployment with maximum charging efficiency. The proposed deployment method is effectively aware of the existence of the sink node that would cause unbalanced power consumption in WRSNs. The simulation results show that the proposed PBAD algorithm performs better than other deployment methods, and fewer chargers are deployed as a result.

Risk and resilience factors affecting the psychological wellbeing of individuals deployed in humanitarian relief roles after a disaster.

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Brooks, Samantha K; Dunn, Rebecca; Sage, Clara A M; Amlôt, Richard; Greenberg, Neil; Rubin, G James

2015-12-01

When disasters occur, humanitarian relief workers frequently deploy to assist in rescue/recovery efforts. To conduct a systematic review of factors affecting the psychological wellbeing of disaster relief workers and identify recommendations for interventions. We searched MEDLINE®, Embase, PsycINFO® and Web of Science for relevant studies, supplemented by hand searches. We performed thematic analysis on their results to identify factors predicting wellbeing. Sixty-one publications were included. Key themes were: pre-deployment factors (preparedness/training); peri-deployment factors (deployment length/timing; traumatic exposure; emotional involvement; leadership; inter-agency cooperation; support; role; demands and workload; safety/equipment; self-doubt/guilt; coping strategies) and post-deployment factors (support; media; personal and professional growth). As well as role-specific stressors, many occupational stressors not specific to humanitarian relief (e.g. poor leadership, poor support) present a significant health hazard to relief workers. Humanitarian organisations should prioritise strengthening relationships between team members and supervisors, and dealing effectively with non-role-specific stressors, to improve the psychological resilience of their workforce.

Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions.

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McCord, Gordon C; Liu, Anne; Singh, Prabhjot

2013-04-01

To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were calculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1 CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$ 6.86 per year per inhabitant covered by the CHW subsystem and into US$ 2.72 per year per inhabitant. Alternatively, it would take an annual average of US$ 3750 to train, equip and support each CHW. Comprehensive CHW subsystems can be deployed across sub-Saharan Africa at cost that is modest compared with the projected costs of the primary-health-care system. Given their documented successes, they offer a strong complement to facility-based care in rural African settings.

Self-Perceptions of Pre-Service Mathematics Teachers Completing a Graduate Diploma of Secondary Education

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Hine, Gregory S. C.

2015-01-01

This qualitative research project explored the self-perceptions of pre-service secondary mathematics teachers completing a Graduate Diploma of Secondary Education. Specifically, the researcher investigated the extent to which teachers perceived their readiness to commence a secondary mathematics teaching position. The project relied principally on…

[Quality planning of Family Health Units using Quality Function Deployment (QFD)].

Science.gov (United States)

Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

2010-08-01

Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.

Work stressors, sleep quality, and alcohol-related problems across deployment: A parallel process latent growth modeling approach among Navy members.

Science.gov (United States)

Bravo, Adrian J; Kelley, Michelle L; Hollis, Brittany F

2017-10-01

This study examined how work stressors were associated with sleep quality and alcohol-related problems among U.S. Navy members over the course of deployment. Participants were 101 U.S. Navy members assigned to an Arleigh Burke-class destroyer who experienced an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Approximately 6 weeks prior to deployment, 6 weeks after deployment, and 6 months reintegration, participants completed measures that assessed work stressors, sleep quality, and alcohol-related problems. A piecewise latent growth model was conducted in which the structural paths assessed if work stressors influenced sleep quality or its growth over time, and in turn if sleep quality influenced alcohol-related problems intercepts or growth over time. A significant indirect effect was found such that increases in work stressors from pre- to postdeployment predicted decreases in sleep quality, which in turn were associated with increases in alcohol-related problems from pre- to postdeployment. These effects were maintained from postdeployment through the 6-month reintegration. Findings suggest that work stressors may have important implications for sleep quality and alcohol-related problems. Positive methods of addressing stress and techniques to improve sleep quality are needed as both may be associated with alcohol-related problems among current Navy members. Copyright © 2016 John Wiley & Sons, Ltd.

Remote Systems Design & Deployment

Energy Technology Data Exchange (ETDEWEB)

Bailey, Sharon A.; Baker, Carl P.; Valdez, Patrick LJ

2009-08-28

The Pacific Northwest National Laboratory (PNNL) was tasked by Washington River Protection Solutions, LLC (WRPS) to provide information and lessons learned relating to the design, development and deployment of remote systems, particularly remote arm/manipulator systems. This report reflects PNNL’s experience with remote systems and lays out the most important activities that need to be completed to successfully design, build, deploy and operate remote systems in radioactive and chemically contaminated environments. It also contains lessons learned from PNNL’s work experiences, and the work of others in the national laboratory complex.

Optimizing and Validating a Brief Assessment for Identifying Children of Service Members at Risk for Psychological Health Problems Following Parent Deployment

Science.gov (United States)

2016-07-01

Journal of Family Therapy, 21, 313-323. Behar, L.B. (1997). The Preschool Behavior Questionnaire. Journal of Abnormal Child Psychology , 5, 265-275... Psychological Health Problems Following Parent Deployment PRINCIPAL INVESTIGATOR: Julie Wargo Aikins, PhD CONTRACTING ORGANIZATION: Wayne State...Validating a Brief Assessment for Identifying Children of Service Members at Risk for Psychological Health Problems Following Parent Deployment 5b. GRANT

Long-term military work outcomes in soldiers who become mental health casualties when deployed on operations.

Science.gov (United States)

Jones, Norman; Fear, Nicola T; Jones, Margaret; Wessely, Simon; Greenberg, Neil

2010-01-01

little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of "Forward Psychiatry," aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. to examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. FMHT clinical records were linked to occupational records with 825 resulting matches. 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. the results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.

Medical impulsive therapy (MIT): the impact of 1 week of preoperative tamsulosin on deployment of 16-French ureteral access sheaths without preoperative ureteral stent placement.

Science.gov (United States)

Kaler, Kamaljot S; Safiullah, Shoaib; Lama, Daniel J; Parkhomenko, Egor; Okhunov, Zhamshid; Ko, Young H; Huynh, Linda; Patel, Roshan M; Landman, Jaime; Clayman, Ralph V

2018-05-25

Medical expulsive therapy is based on pharmacologic ureteral relaxation. We hypothesized this concept may facilitate the deployment of the large 16 French (F) ureteral access sheath (UAS) when patients are intentionally pre-treated with oral tamsulosin, i.e., medical impulsive therapy. We retrospectively analyzed our experience with UAS deployment during endoscopic-guided percutaneous nephrolithotomy in prone position in patients pre-treated for 1 week with oral tamsulosin with a contemporary untreated cohort. Between January 2015 and September 2016, seventy-seven patients without a pre-existing ureteral stent met inclusion criteria. Demographic data, tamsulosin usage, UAS size, deployment failure, ureteral injuries, stone-free rates, and complications were recorded. Univariate and multivariate analysis was conducted to assess the impact of tamsulosin on deployment of the 16F UAS. There was no statistical difference between the tamsulosin (n = 40) group and non-tamsulosin (n = 37) group in regard to demographic data. The tamsulosin group had a significantly higher percentage of 16F UAS deployment, 87 vs. 43% (p < 0.001), and no significant difference in ureteral injuries (p = 0.228). Univariate and multivariate analysis revealed that tamsulosin significantly increased the odds ratio (9.3 and 19.4, respectively) for successful passage of a 16F UAS. Despite a larger stone volume, there was no significant difference in computed tomography scan complete stone-free rates (29 vs. 42%; p = 0.277) at median post-operative time of only 3 days. In this retrospective study, 1 week of preoperative tamsulosin was associated with an increase in the deployment of a 16F UAS in patients without preoperative ureteral stent placement.

The development and deployment of electronic personal health records records: a strategic positioning perspective.

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Lewis, Mark; Baxter, Ryan; Pouder, Richard

2013-01-01

The purpose of this study is to examine the impact of strategic position on the ability of an entrepreneurial firm to successfully develop and deploy electronic personal health records technology within the US healthcare industry. This study uses an in-depth longitudinal case study methodology. The study contributes by juxtaposing a longitudinal view of how the focal firm proposed and acted on different strategic positions in an attempt to achieve development and deployment success. In doing so, the study also elaborates on Porter's recognition that firms need to make trade-offs when choosing a strategic position, as the purposeful limitation of service offerings can protect against the degradation of existing value creating activities. The authors' study highlights the enormous challenge of facilitating the adoption and diffusion of technology enabled interventions in the US healthcare ecosystem. Future research that combines both interdisciplinary and multi-level investigation and analysis is sorely needed to develop a more sophisticated understanding of the phenomenon and to encourage the development and deployment of useful technology enabled interventions within the US healthcare industry. While the fragmented nature of the healthcare industry provides opportunities for entrepreneurial firms, such complexity within the ecosystem should not be underestimated as a reason for concern for small firms. Total economic burden due to chronic diseases and other healthcare-related expenses is massive for the USA. Consequently, prevention and early detection of future disease states has become a core component of the current healthcare reform debate. EPHRs are considered one core component of a broader healthcare strategy to improve health outcomes and lower costs. By deepening our understanding of how best to develop and deploy such interventions, society will surely benefit. The longitudinal nature of the authors' study provides a unique opportunity to understand the

Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments

OpenAIRE

Waller, Michael; Treloar, Susan A; Sim, Malcolm R; McFarlane, Alexander C; McGuire, Annabel C L; Bleier, Jonathan; Dobson, Annette J

2012-01-01

Abstract Background The association between stressful events on warlike deployments and subsequent mental health problems has been established. Less is known about the effects of stressful events on peacekeeping deployments. Methods Two cross sectional studies of the Australian Defence Force were used to contrast the prevalence of exposures reported by a group deployed on a peacekeeping operation (Bougainville, n = 1704) and those reported by a group deployed on operations which included warl...

Health care provider knowledge and routine management of pre-eclampsia in Pakistan.

Science.gov (United States)

Sheikh, Sana; Qureshi, Rahat Najam; Khowaja, Asif Raza; Salam, Rehana; Vidler, Marianne; Sawchuck, Diane; von Dadelszen, Peter; Zaidi, Shujat; Bhutta, Zulfiqar

2016-09-30

Maternal mortality ratio is 276 per 100,000 live births in Pakistan. Eclampsia is responsible for one in every ten maternal deaths despite the fact that management of this disease is inexpensive and has been available for decades. Many studies have shown that health care providers in low and middle-income countries have limited training to manage patients with eclampsia. Hence, we aimed to explore the knowledge of different cadres of health care providers regarding aetiology, diagnosis and treatment of pre-eclampsia and eclampsia and current management practices. We conducted a mixed method study in the districts of Hyderabad and Matiari in Sindh province, Pakistan. Focus group discussions and interviews were conducted with community health care providers, which included Lady Health Workers and their supervisors; traditional birth attendants and facility care providers. In total seven focus groups and 26 interviews were conducted. NVivo 10 was used for analysis and emerging themes and sub-themes were drawn. All participants were providing care for pregnant women for more than a decade except one traditional birth attendant and two doctors. The most common cause of pre-eclampsia mentioned by community health care providers was stress of daily life: the burden of care giving, physical workload, short birth spacing and financial constraints. All health care provider groups except traditional birth attendants correctly identified the signs, symptoms, and complications of pre-eclampsia and eclampsia and were referring such women to tertiary health facilities. Only doctors were aware that magnesium sulphate is recommended for eclampsia management and prevention; however, they expressed fears regarding its use at first and secondary level health facilities. This study found several gaps in knowledge regarding aetiology, diagnosis and treatment of pre-eclampsia among health care providers in Sindh. Findings suggest that lesser knowledge regarding management of pre

Couples’ Educational Needs Referred to Ershad and Fazel Health Centers of Tehran for Pre-marriage Tests in 2014

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ّFarima Mohammadi

2016-12-01

Full Text Available Background and Objective: Premarital education is the foundation for the development of couples’ communications, sexual relationships, health and fertility. Therefore, this study was done with the purpose of determining couples’ educational needs referred to Ershad and Fazel health centers of Tehran for pre-marriage tests.Materials and Methods: A Cross Sectional study was conducted among couples who referred to health centers. The sample size was 1672 and the sampling method was convenience.. Demographic data was collected through interview with women based on questionnaires. Then the couples responded to the self-administered educational needs questionnaire. The collected data were entered into SPSS-21 statistical software and analyzed using Chi-Square test.Results: 883 women and 789 men completed the educational needs questionnaire. The mean (SD age of women and men were 27.1 (4.5 and 30.2 (5.3 years respectively. Of all female participants 483 (54.7% and 369 (41.8% of male participants had a bachelor's degree. 97.5% of men and 57.1% of women were employed. The ethnicity of about 72% of participants was Far. Most of the pre-marriage educational needs of men and women were marital health, importance of pre-marriage tests, unintended pregnancy prevention methods, correct marital relationship and prenatal care. 313 (64.6% women and 238 (42.8% men reported the pre-marriage educational class to be very helpful. The educational needs of couples were not different based on education, ethnicity and place of residence.Conclusion: Results of the currents study shows the need for pre-marriage education in all evaluated aspects and the importance of paying attention to it for prospering the pre-marital classes.

Work stressors, depressive symptoms and sleep quality among US Navy members: a parallel process latent growth modelling approach across deployment.

Science.gov (United States)

Bravo, Adrian J; Kelley, Michelle L; Swinkels, Cindy M; Ulmer, Christi S

2017-11-03

The present study examined whether work stressors contribute to sleep problems and depressive symptoms over the course of deployment (i.e. pre-deployment, post-deployment and 6-month reintegration) among US Navy members. Specifically, we examined whether depressive symptoms or sleep quality mediate the relationships between work stressors and these outcomes. Participants were 101 US Navy members who experienced an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Using piecewise latent growth models, we found that increased work stressors were linked to increased depressive symptoms and decreased sleep quality across all three deployment stages. Further, increases in work stressors from pre- to post-deployment contributed to poorer sleep quality post-deployment via increasing depressive symptoms. Moreover, sleep quality mediated the association between increases in work stressors and increases in depressive symptoms from pre- to post-deployment. These effects were maintained from post-deployment through the 6-month reintegration. Although preliminary, our results suggest that changes in work stressors may have small, but significant implications for both depressive symptoms and quality of sleep over time, and a bi-directional relationship persists between sleep quality and depression across deployment. Strategies that target both stress and sleep could address both precipitating and perpetuating factors that affect sleep and depressive symptoms. © 2017 European Sleep Research Society.

Center for Deployment Psychology

Data.gov (United States)

Federal Laboratory Consortium — The Center for Deployment Psychology was developed to promote the education of psychologists and other behavioral health specialists about issues pertaining to the...

Finding Their Way Back In: Family Reintegration Following Guard Deployment.

Science.gov (United States)

Messecar, Deborah C

2017-03-01

The aim of this study was to describe deployed National Guard members' and their families' perceptions of their experience with family reintegration, and the causes and conditions of challenges reintegration presents after deployment. A total of 26 National Guard members and 19 family members participated in individual (n = 22), couples (n = 6), or focus group (n = 17) interviews. In-depth interviews were used to assess needs and maximize input from military families regarding deployment-related experiences and reintegration issues. Qualitative coding and analysis of data were completed using NVivo. Finding their way back in is the key process that the military members must complete to successfully reestablish their desired social connections with the family and reclaim their place within the family. Several conditions shape the degree of challenges with reintegration that veterans and their family will encounter. These include preparation for deployment, length and type of deployment, communication during deployment, and finally, awareness of how deployment changes the military member and the family. Support resources dedicated to providing National Guard members and their families with assistance in preparing for deployments and educating them about the importance of communication during deployment should be maintained and expanded. Broader educational efforts that increase awareness of what to expect regarding how deployment changes the military member and the family are needed. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Helping military children cope with parental deployment: role of attachment theory and recommendations for mental health clinicians and counselors.

Science.gov (United States)

Miller, Laurence; Miller, Halle B; Bjorklund, David

2010-01-01

Military deployment of a parent carries with it a number of stresses for children, all centering around uncertainty, instability and unpredictability. This article conceptualizes military deployment and relocation stress in the context of attachment theory, and describes the types of adverse outcomes that can occur as the result of impaired attachment. It then presents a set of practical recommendations for mental health clinicians and counselors for helping children and families cope productively and negotiate the developmental hurdles associated with maintaining healthy attachment and family stability in the face of military deployment.

Deployment of Analytics into the Healthcare Safety Net: Lessons Learned.

Science.gov (United States)

Hartzband, David; Jacobs, Feygele

2016-01-01

As payment reforms shift healthcare reimbursement toward value-based payment programs, providers need the capability to work with data of greater complexity, scope and scale. This will in many instances necessitate a change in understanding of the value of data, and the types of data needed for analysis to support operations and clinical practice. It will also require the deployment of different infrastructure and analytic tools. Community health centers, which serve more than 25 million people and together form the nation's largest single source of primary care for medically underserved communities and populations, are expanding and will need to optimize their capacity to leverage data as new payer and organizational models emerge. To better understand existing capacity and help organizations plan for the strategic and expanded uses of data, a project was initiated that deployed contemporary, Hadoop-based, analytic technology into several multi-site community health centers (CHCs) and a primary care association (PCA) with an affiliated data warehouse supporting health centers across the state. An initial data quality exercise was carried out after deployment, in which a number of analytic queries were executed using both the existing electronic health record (EHR) applications and in parallel, the analytic stack. Each organization carried out the EHR analysis using the definitions typically applied for routine reporting. The analysis deploying the analytic stack was carried out using those common definitions established for the Uniform Data System (UDS) by the Health Resources and Service Administration. 1 In addition, interviews with health center leadership and staff were completed to understand the context for the findings. The analysis uncovered many challenges and inconsistencies with respect to the definition of core terms (patient, encounter, etc.), data formatting, and missing, incorrect and unavailable data. At a population level, apparent underreporting

Connected Vehicle Pilot Deployment Program phase 1 : comprehensive deployment plan : New York City : volume 1 : technical application : part I : technical and management approach.

Science.gov (United States)

2016-08-01

This document describes the Deployment Plan for the New York City Department of Transportation (NYC) Connected Vehicle Pilot Deployment (CVPD) Project. This plan describes the approach to complete Phase 2 Design/Build/Test, and Phase 3 Operate and Ma...

CMS Results of Grid-related activities using the early deployed LCG Implementations

CERN Document Server

Coviello, Tommaso; De Filippis, Nicola; Donvito, Giacinto; Maggi, Giorgio; Pierro, A; Bonacorsi, Daniele; Capiluppi, Paolo; Fanfani, Alessandra; Grandi, Claudio; Maroney, Owen; Nebrensky, H; Donno, Flavia; Jank, Werner; Sciabà, Andrea; Sinanis, Nick; Colling, David; Tallini, Hugh; MacEvoy, Barry C; Wang, Shaowen; Kaiser, Joseph; Osman, Asif; Charlot, Claude; Semenjouk, I; Biasotto, Massimo; Fantinel, Sergio; Corvo, Marco; Fanzago, Federica; Mazzucato, Mirco; Verlato, Marco; Go, Apollo; Khan Chia Ming; Andreozzi, S; Cavalli, A; Ciaschini, V; Ghiselli, A; Italiano, A; Spataro, F; Vistoli, C; Tortone, G

2004-01-01

The CMS Experiment is defining its Computing Model and is experimenting and testing the new distributed features offered by many Grid Projects. This report describes use by CMS of the early-deployed systems of LCG (LCG-0 and LCG-1). Most of the used features here discussed came from the EU implemented middleware, even if some of the tested capabilities were in common with the US developed middleware. This report describes the simulation of about 2 million of CMS detector events, which were generated as part of the official CMS Data Challenge 04 (Pre-Challenge-Production). The simulations were done on a CMS-dedicated testbed (CMS-LCG-0), where an ad-hoc modified version of the LCG-0 middleware was deployed and where the CMS Experiment had a complete control, and on the official early LCG delivered system (with the LCG-1 version). Modifications to the CMS simulation tools for events produc tion where studied and achieved, together with necessary adaptations of the middleware services. Bilateral feedback (betwee...

DEPLOYMENT OF VOIP ON WIRELINE NETWORK USING OPNET

African Journals Online (AJOL)

EKPAH

study of VoIP traffic and other major devices. These results will ... pre-deployment analysis, planning and lack of ... given network under VoIP and data load traffic. OPNET contains a vast amount of models of .... There are a number of tools.

Post-deployment usability evaluation of a radiology workstation

NARCIS (Netherlands)

Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A.; Oudkerk, Matthijs; Van Ooijen, Peter M. A.

Objectives: To determine the number, nature and severity of usability issues radiologists encounter while using a commercially available radiology workstation in clinical practice, and to assess how well the results of a pre-deployment usability evaluation of this workstation generalize to clinical

Climate, air quality and human health benefits of various solar photovoltaic deployment scenarios in China in 2030

Science.gov (United States)

Yang, Junnan; Li, Xiaoyuan; Peng, Wei; Wagner, Fabian; Mauzerall, Denise L.

2018-06-01

Solar photovoltaic (PV) electricity generation can greatly reduce both air pollutant and greenhouse gas emissions compared to fossil fuel electricity generation. The Chinese government plans to greatly scale up solar PV installation between now and 2030. However, different PV development pathways will influence the range of air quality and climate benefits. Benefits depend on how much electricity generated from PV is integrated into power grids and the type of power plant displaced. Using a coal-intensive power sector projection as the base case, we estimate the climate, air quality, and related human health benefits of various 2030 PV deployment scenarios. We use the 2030 government goal of 400 GW installed capacity but vary the location of PV installation and the extent of inter-provincial PV electricity transmission. We find that deploying distributed PV in the east with inter-provincial transmission maximizes potential CO2 reductions and air quality-related health benefits (4.2% and 1.2% decrease in national total CO2 emissions and air pollution-related premature deaths compared to the base case, respectively). Deployment in the east with inter-provincial transmission results in the largest benefits because it maximizes displacement of the dirtiest coal-fired power plants and minimizes PV curtailment, which is more likely to occur without inter-provincial transmission. We further find that the maximum co-benefits achieved with deploying PV in the east and enabling inter-provincial transmission are robust under various maximum PV penetration levels in both provincial and regional grids. We find large potential benefits of policies that encourage distributed PV deployment and facilitate inter-provincial PV electricity transmission in China.

Patient-based cultural competency curriculum for pre-health professionals.

Science.gov (United States)

Melamed, Esther; Wyatt, Lacey E; Padilla, Tony; Ferry, Robert J

2008-01-01

The diverse US population requires medical cultural competency education for health providers throughout their pre-professional and professional years. We present a curriculum to train pre-health professional undergraduates by combining classroom education in the humanities and cross-cultural communication skills with volunteer clinical experiences at the University of California, Los Angeles (UCLA) hospital. The course was open to a maximum of 15 UCLA junior and senior undergraduate students with a pre-health or humanities major and was held in the spring quarters of 2002--2004. The change in students' knowledge of cultural competency was evaluated using the Provider's Guide to Quality and Culture Quiz (QCQ) and through students' written assignments and evaluations. Trainees displayed a statistically significant improvement in scores on the QCQ. Participants' written assignments and subjective evaluations confirmed an improvement in awareness and a high motivation to continue learning at the graduate level. This is the first evaluated undergraduate curriculum that integrates interdisciplinary cultural competency training with patient volunteering in the medical field. The didactic, volunteering, and writing components of the course comprise a broadly applicable tool for training future health care providers at other institutions.

An independent investigation into the deployment of the federal communications commissions' rural health care pilot program.

Science.gov (United States)

Whitten, Pamela; Holtz, Bree; Laplante, Carolyn; Alverson, Dale; Krupinski, Elizabeth

2010-12-01

the goal of this study was to provide an independent and objective evaluation of the implementation of the Federal Communications Commission's Rural Health Care Pilot Program. thirty-nine of the programs that were provided funding through this program were interviewed and asked about their project deployment, network planning, and the involvement of their state in implementation. RESULTS showed that programs recruited project team members from a variety of fields to fulfill different roles. Network partners were often chosen because they were stakeholders in the outcome of the project and because they had a past working relationship with the grant-receiving programs. In terms of deployment, many programs had made progress in filling out necessary paperwork and were tracking milestones, but had experienced changes since first receiving funding, such as losing participants. Additionally, many encountered challenges that inhibited deployment, such as coping with rule fluctuations. Many of the programs received support from their respective state governments in project development, often through matching funds, but few states were involved in the actual management of projects. as rural healthcare facilities often lack the information technology infrastructure compared with many urban facilities, it is important to understand the implementation process for programs such as the Rural Health Care Pilot Program and to examine what contributes to progress, stagnation, or disintegration. Although the programs reported some success, almost all had encountered challenges that inhibited implementation. A follow-up study is planned to further investigate deployment and determine the implications of Federal Communications Commission funding.

Patient Satisfaction with Physician Discussions of Treatment Impact on Fertility, Menopause and Sexual Health among Pre-menopausal Women with Cancer

Directory of Open Access Journals (Sweden)

Maura Scanlon, Anne Blaes, Melissa Geller, Navneet S Majhail, Bruce Lindgren, Tufia Haddad

2012-01-01

Full Text Available PURPOSE: Pre-menopausal women with cancer are at risk of therapy-associated infertility, premature menopause, and sexual dysfunction. However, it is unknown whether oncologists adequately address these risks during treatment planning. We conducted a study to evaluate physician-patient discussions addressing the impact of cancer treatment and actual treatment effects on fertility, menopause status, and general sexual health.METHODS: A questionnaire was administered in four oncology clinics specializing in breast, gynecologic, general hematology-oncology, and blood and marrow transplantation (BMT cancer care at a single institution. Eligible participants were pre-menopausal at the time of diagnosis and either actively receiving or within 24 months from completion of treatment. Participants completed the questionnaire at enrollment and at 1-year follow-up.RESULTS: Of the 104 eligible women, a majority were satisfied with the quality (68% and length (66% of reproductive health discussions, with the highest satisfaction levels in the gynecologic cancer clinic (85% and the lowest levels in the BMT clinic (53%. Fertility preservation was desired by 20% of women, including some >40 years old. Women were more interested in discussing treatment impact on menopause status and sexual health than fertility. Rates of discussions on treatment impact on sexual health were low despite 77% of women reporting severe sexual dysfunction at 1-year follow-up.CONCLUSIONS: One-third of women are dissatisfied with the quality and length of discussions regarding the impact of cancer treatment on reproductive health. There is notably inadequate counseling on the effect of treatment on fertility in women > 40 and on sexual function in all women. Oncologists must offer better resources and improve communication on the effect of treatment on reproductive health to pre-menopausal women with cancer.

Deploying Missile Defense: Major Operational Challenges

National Research Council Canada - National Science Library

Bunn, M

2004-01-01

By October 2004, the United States will have begun initial deployment of a missile defense capability albeit a modest, limited, and not completely proven one to defend the homeland against a limited...

Psychosocial factors and pre-abortion psychological health: The significance of stigma.

Science.gov (United States)

Steinberg, Julia R; Tschann, Jeanne M; Furgerson, Dorothy; Harper, Cynthia C

2016-02-01

Most research in mental health and abortion has examined factors associated with post-abortion psychological health. However, research that follows women from before to after their abortion consistently finds that depressive, anxiety, and stress symptoms are highest just before an abortion compared to any time afterwards. This finding suggests that studies investigating psychosocial factors related to pre-abortion mental health are warranted. The current study uses data from 353 women seeking abortions at three community reproductive health clinics to examine predictors of pre-abortion psychological health. Drawing from three perspectives in the abortion and mental health literature, common risks, stress and coping, and sociocultural context, we conducted multivariable analyses to examine the contribution of important factors on depressive, anxiety, and stress symptoms just before an abortion, including sociodemographics, abortion characteristics, childhood adversities, recent adversities with an intimate partner, relationship context, future pregnancy desires, and perceived abortion stigma. Childhood and partner adversities, including reproductive coercion, were associated with negative mental health symptoms, as was perceived abortion stigma. Before perceived abortion stigma was entered into the model, 18.6%, 20.7%, and 16.8% of the variance in depressive, anxiety, and stress symptoms respectively, was explained. Perceived abortion stigma explained an additional 13.2%, 9.7%, and 10.7% of the variance in depressive, anxiety, and stress symptoms pre-abortion. This study, one of the first to focus on pre-abortion mental health as an outcome, suggests that addressing stigma among women seeking abortions may significantly lower their psychological distress. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pre-treatment attachment anxiety predicts change in depressive symptoms in women who complete day hospital treatment for anorexia and bulimia nervosa.

Science.gov (United States)

Keating, Leah; Tasca, Giorgio A; Bissada, Hany

2015-03-01

Individuals with eating disorders are prone to depressive symptoms. This study examines whether depressive symptoms can change in women who complete intensive day treatment for anorexia and bulimia nervosa (BN), and whether these changes are associated with pre-treatment attachment insecurity. Participants were 141 women with anorexia nervosa restricting type (n = 24), anorexia nervosa binge purge type (n = 30), and BN (n = 87) who completed a day hospital treatment programme for eating disorders. They completed a pre-treatment self-report measure of attachment, and a pre-treatment and post-treatment self-report measure of depressive symptoms. Participants experienced significant reductions in depressive symptoms at post-treatment. Eating disorder diagnosis was not related to these improvements. However, participants lower in attachment anxiety experienced significantly greater improvement in depressive symptoms than those who were higher in attachment anxiety. These results suggest that clinicians may tailor eating disorders treatments to patients' attachment patterns and focus on their pre-occupation with relationships and affect regulation to improve depressive symptoms. That depressive symptoms can decrease in women who complete day hospital treatment for anorexia and BN. That improvements in depressive symptoms do not vary according to eating disorder diagnosis in these women. That patients who complete treatment and who have higher attachment anxiety experience less improvements in depressive symptoms compared to those lower in attachment anxiety. That clinicians may attend to aspects of attachment anxiety, such as need for approval and up-regulation of emotions, to improve depressive symptoms in female patients with eating disorders. © 2014 The British Psychological Society.

Services oriented architectures and rapid deployment of ad-hoc health surveillance systems: lessons from Katrina relief efforts.

Science.gov (United States)

Mirhaji, Parsa; Casscells, S Ward; Srinivasan, Arunkumar; Kunapareddy, Narendra; Byrne, Sean; Richards, David Mark; Arafat, Raouf

2006-01-01

During the Hurricane Katrina relief efforts, a new city was born overnight within the City of Houston to provide accommodation and health services for thousands of evacuees deprived of food, rest, medical attention, and sanitation. The hurricane victims had been exposed to flood water, toxic materials, physical injury, and mental stress. This scenario was an invitation for a variety of public health hazards, primarily infectious disease outbreaks. Early detection and monitoring of morbidity and mortality among evacuees due to unattended health conditions was an urgent priority and called for deployment of real-time surveillance to collect and analyze data at the scene, and to enable and guide appropriate response and planning activities. The University of Texas Health Science Center at Houston (UTHSC) and the Houston Department of Health and Human Services (HDHHS) deployed an ad hoc surveillance system overnight by leveraging Internet-based technologies and Services Oriented Architecture (SOA). The system was post-coordinated through the orchestration of Web Services such as information integration, natural language processing, syndromic case finding, and online analytical processing (OLAP). Here we will report the use of Internet-based and distributed architectures in providing timely, novel, and customizable solutions on demand for unprecedented events such as natural disasters.

EarthScope's Transportable Array: Status of the Alaska Deployment and Guide to Resources for Lower48 Deployment

Science.gov (United States)

Busby, R. W.; Woodward, R.; Aderhold, K.; Frassetto, A.

2017-12-01

The Alaska Transportable Array deployment is completely installed, totaling 280 stations, with 194 new stations and 86 existing stations, 28 of those upgraded with new sensor emplacement. We briefly summarize the deployment of this seismic network, describe the added meteorological instruments and soil temperature gauges, and review our expectations for operation and demobilization. Curation of data from the contiguous Lower-48 States deployment of Transportable Array (>1800 stations, 2004-2015) has continued with the few gaps in real-time data replaced by locally archived files as well as minor adjustments in metadata. We highlight station digests that provide more detail on the components and settings of individual stations, documentation of standard procedures used throughout the deployment and other resources available online. In cooperation with IRIS DMC, a copy of the complete TA archive for the Lower-48 period has been transferred to a local disk to experiment with data access and software workflows that utilize most or all of the seismic timeseries, in contrast to event segments. Assembling such large datasets reliably - from field stations to a well managed data archive to a user's workspace - is complex. Sharing a curated and defined data volume with researchers is a potentially straightforward way to make data intensive analyses less difficult. We note that data collection within the Lower-48 continues with 160 stations of the N4 network operating at increased sample rates (100 sps) as part of the CEUSN, as operational support transitions from NSF to USGS.

A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports.

Science.gov (United States)

Heywood, Anita E; Watkins, Rochelle E; Iamsirithaworn, Sopon; Nilvarangkul, Kessarawan; MacIntyre, C Raina

2012-05-02

Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. Cross-sectional surveys were conducted between July and December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health advice than Australian

A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports

Science.gov (United States)

2012-01-01

Background Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. Methods Cross-sectional surveys were conducted between July and December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. Results A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health

Automating Behavioral Health Screening - Addressing Risk Communication Electronically

National Research Council Canada - National Science Library

Crow, Bruce E; Gahm, Gregory

2004-01-01

... outpatient behavioral health clinic and 3,451 Soldiers screened 90 days following return from OIF deployment. The screening was completed via scanning software and has more recently been updated to a completed automated kiosk system...

Hitting the ground running: Healthgrid deployment and adoption

NARCIS (Netherlands)

Gwadry-Sridhar, Femida; Olabarriaga, Silvia D.; van Kampen, Antoine; Bauer, Michael; Solomonides, Tony

2010-01-01

We consider the issues of healthgrid development, deployment and adoption in health care and research environments. While healthgrid technology could be deployed to support advanced medical research, we are not seeing its wide adoption. Understanding why this technology is not being exploited is one

Pre-travel health seeking practices of Umrah pilgrims departing from Assiut International Airport, Egypt.

Science.gov (United States)

Aziz, Mirette M; Abd El-Megeed, Hosnia S; Abd Ellatif, Mennat Allah M

2018-04-22

to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services. Copyright © 2018. Published by Elsevier Ltd.

Small cell networks deployment, management, and optimization

CERN Document Server

Claussen, Holger; Ho, Lester; Razavi, Rouzbeh; Kucera, Stepan

2018-01-01

Small Cell Networks: Deployment, Management, and Optimization addresses key problems of the cellular network evolution towards HetNets. It focuses on the latest developments in heterogeneous and small cell networks, as well as their deployment, operation, and maintenance. It also covers the full spectrum of the topic, from academic, research, and business to the practice of HetNets in a coherent manner. Additionally, it provides complete and practical guidelines to vendors and operators interested in deploying small cells. The first comprehensive book written by well-known researchers and engineers from Nokia Bell Labs, Small Cell Networks begins with an introduction to the subject--offering chapters on capacity scaling and key requirements of future networks. It then moves on to sections on coverage and capacity optimization, and interference management. From there, the book covers mobility management, energy efficiency, and small cell deployment, ending with a section devoted to future trends and applicat...

The Effectiveness of a Cohort Model as a Predictor of Grade Point Average and Graduation Status of Pre-Health Sciences Students in a Public Community College

Science.gov (United States)

Brandon, Elvis Nash

2017-01-01

There is a college completion crisis in the United States. In today's competitive job market, health sciences students cannot afford to fail in their educational attainment. The purpose of this study was to determine if participation in the cohort model is a predictor of the success of public community college pre-health sciences students.…

Pre-transplant history of mental health concerns, non-adherence, and post-transplant outcomes in kidney transplant recipients.

Science.gov (United States)

Gumabay, Franz Marie; Novak, Marta; Bansal, Aarushi; Mitchell, Margot; Famure, Olusegun; Kim, S Joseph; Mucsi, Istvan

2018-02-01

The association between pre-transplant mental health concerns and non-adherence and post-transplant outcomes after kidney transplantation is not fully established. We examined the relationship between a pre-transplant history of mental health concerns and non-adherence and post-transplant outcomes among kidney transplant recipients. In this retrospective single center cohort study of adult kidney transplant recipients (n=955) the associations between the history of mental health concerns or non-adherence and the time from kidney transplant to biopsy proven acute rejection; death-censored graft failure and total graft failure were examined using Cox proportional hazards models. Mean (SD) age was 51 (13) years, 61% were male and 27% had a history of diabetes. Twenty-two and 11% of patients had mental health concerns and non-adherence, respectively. Fifteen percent of the patients had acute rejection, 5.6% had death-censored graft failure and 13.0% had total graft failure. The history of mental health concerns was not associated with acute rejection, death-censored graft failure or total graft failure. Patients with versus without a history of non-adherence tended to have higher cumulative incidence of acute rejection (23.3% [95% CI: 16.1, 33.2] vs. 13.6% [95% CI: 11.4, 16.2]) and death-censored graft failure (15.0% [95% CI: 6.9, 30.8] vs. 6.4% [95% CI: 4.7, 8.7]) (log rank p=0.052 and p=0.086, respectively). These trends were not significant after multivariable adjustment. In summary, a history of pre-transplant mental health concerns or non-adherence is not associated with adverse outcomes in patients who completed transplant workup and received a kidney transplant. Copyright © 2018 Elsevier Inc. All rights reserved.

Assessment of a Post-deployment Yellow Ribbon Reintegration Program for National Guard Members and Supporters

Science.gov (United States)

Scherrer, Jeffrey F.; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi Kato

2014-01-01

The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP’s delivery of information and assistance during the post-deployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and help provision, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed education needs being met (76.8% and 78.2% respectively) and were least likely to endorse legal needs being met (63.5% and 60% respectively). Significantly more supporters than service members (p family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2-4 months after a deployment. PMID:25373071

The mental health and substance misuse needs of male ex-armed forces personnel in prison.

Science.gov (United States)

Wainwright, Verity; Lennox, Charlotte; McDonnell, Sharon; Shaw, Jenny; Senior, Jane

2018-01-01

Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed. Thirty-nine (37%) had a mental health diagnosis recorded, most commonly for post-traumatic stress disorder (PTSD), depression and personality disorder. Those who screened for a CCMH problem were more likely to have pre-service vulnerability to negative health outcomes and those with dual symptomology were more likely to have experienced deployment during their service. Findings suggest the mental health needs of this group are similar to the general prison population. Potentially higher prevalences of PTSD and alcohol misuse may direct service provision.

Depression in Female Veterans Returning from Deployment: The Role of Social Factors.

Science.gov (United States)

Sairsingh, Holly; Solomon, Phyllis; Helstrom, Amy; Treglia, Dan

2018-03-01

Women are serving in the armed forces and deployed to areas of conflict in increasing numbers. Problems such as depressive symptoms and risks related to combat exposure can have negative effects on adjustment following service; understanding the relationship between these problems may contribute to strategies providers can use to facilitate healthy adjustment after deployment. The purpose of this study is to examine social factors as they relate to mental health adjustment, namely depressive symptoms among female veterans who served in Iraq and Afghanistan as part of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OND). We hypothesized that combat exposure would predict higher levels of depressive symptoms and that social support would moderate the relationship between combat exposure and depression. In a cross-sectional design, 128 female Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans completed an online survey about combat experience, social support, depression, demographic characteristics, and behavioral health symptom history. We conducted multiple regression analyses to examine linear and moderating relationships. There was no significant relationship between combat exposure and depression; social support did not significantly moderate the relationship between combat exposure and depression. However, higher levels of social support and financial comfort were significantly related to lower levels of depression. This study highlights the role of social factors, specifically social support and perceived financial status, as potential barriers to healthy emotional readjustment following deployment. These findings suggest that it may be beneficial for mental health providers to screen female veterans and refer them to appropriate services to reduce financial stressors and strengthen their use of social support. More research should continue to examine more fully the impact of combat exposure on female

The risk for marital infidelity across a year-long deployment.

Science.gov (United States)

Balderrama-Durbin, Christina; Stanton, Kimberley; Snyder, Douglas K; Cigrang, Jeffrey A; Talcott, G Wayne; Smith Slep, Amy M; Heyman, Richard E; Cassidy, Daniel G

2017-08-01

Military deployment can create significant relationship strain. Although most couples navigate the challenges of deployment successfully, this period may render some couples more vulnerable to adverse relationship outcomes such as infidelity due to a convergence of factors including geographic separation and reduced emotional and physical intimacy. Despite anecdotal reports of increased rates of infidelity during deployment, empirical findings are lacking. This study used a prospective design to examine the prevalence and risk factors of infidelity across the deployment cycle including a year-long deployment to Iraq. A total of 63 married male Airmen were assessed both pre- and 6-9 months postdeployment. The rate of sexual infidelity prior to deployment (21%) was commensurate with the lifetime rate of sexual involvement outside the marriage in representative community samples of men. Across the deployment period, the prevalence of sexual infidelity was strikingly high (22.6%) compared with annual community estimates (1.5-4%; Allen et al., 2005). Findings demonstrated that service members with a prior history of separation, steps toward divorce, and relationship distress prior to deployment had elevated risk for infidelity over the deployment cycle. Moreover, roughly 75% of Airmen who experienced infidelity over the deployment cycle divorced by 6-9 months postdeployment whereas only 5% of service members without infidelity divorced during this same time period. Considering well-documented adverse impacts of infidelity and divorce, the current findings may assist in identifying military couples at risk for infidelity and informing targeted prevention or early intervention strategies for these couples prior to or immediately following deployment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Deploying HEP applications using Xen and Globus Virtual Workspaces

International Nuclear Information System (INIS)

Agarwal, A; Desmarais, R; Gable, I; Grundy, D; P-Brown, D; Seuster, R; Vanderster, D C; Sobie, R; Charbonneau, A; Enge, R

2008-01-01

The deployment of HEP applications in heterogeneous grid environments can be challenging because many of the applications are dependent on specific OS versions and have a large number of complex software dependencies. Virtual machine monitors such as Xen could be used to package HEP applications, complete with their execution environments, to run on resources that do not meet their operating system requirements. Our previous work has shown HEP applications running within Xen suffer little or no performance penalty as a result of virtualization. However, a practical strategy is required for remotely deploying, booting, and controlling virtual machines on a remote cluster. One tool that promises to overcome the deployment hurdles using standard grid technology is the Globus Virtual Workspaces project. We describe strategies for the deployment of Xen virtual machines using Globus Virtual Workspace middleware that simplify the deployment of HEP applications

Accelerating the deployment of offshore renewable energy technologies. Final Report

Energy Technology Data Exchange (ETDEWEB)

MacDonald, Mott

2011-02-15

Offshore wind energy and ocean energy (i.e. wave and tidal) are at different stages of technology development and deployment, and, as such, they require different approaches for successful deployment. However, regardless of their deployment stage, these technologies may face common hurdles in their way to market competitiveness. IEA-RETD has completed a study with the overall objective to assist policy makers and project developers in a better understanding of these barriers and the specifics of offshore renewable energy and to give them practical guidelines. These include an offshore energy deployment framework, substantiated by evidence-based analyses, and recommendations for future policies design, including best practices for allocation of seafloor rights.

Clinical Predictive Modeling Development and Deployment through FHIR Web Services.

Science.gov (United States)

Khalilia, Mohammed; Choi, Myung; Henderson, Amelia; Iyengar, Sneha; Braunstein, Mark; Sun, Jimeng

2015-01-01

Clinical predictive modeling involves two challenging tasks: model development and model deployment. In this paper we demonstrate a software architecture for developing and deploying clinical predictive models using web services via the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) standard. The services enable model development using electronic health records (EHRs) stored in OMOP CDM databases and model deployment for scoring individual patients through FHIR resources. The MIMIC2 ICU dataset and a synthetic outpatient dataset were transformed into OMOP CDM databases for predictive model development. The resulting predictive models are deployed as FHIR resources, which receive requests of patient information, perform prediction against the deployed predictive model and respond with prediction scores. To assess the practicality of this approach we evaluated the response and prediction time of the FHIR modeling web services. We found the system to be reasonably fast with one second total response time per patient prediction.

Pre-Service Teacher Education for Mental Health and Inclusion in Schools

Science.gov (United States)

Atkins, Melanie-Anne; Rodger, Susan

2016-01-01

Pre-service teacher education in mental health and mental health literacy is essential to creating the conditions necessary to support the mental health and wellness of children and youth in schools. Many teachers report never having received any education about mental health, but recognize the importance of this knowledge in meeting the needs of…

Experiences and career intentions of combat-deployed UK military personnel.

Science.gov (United States)

Morris-Butler, R; Jones, N; Greenberg, N; Campion, B; Wessely, S

2018-05-17

Most studies of the psychological impact of military deployment focus on the negative and traumatic aspects. Less is known about the full range of deployment experiences nor how these may impact on career intentions. To examine subjective operational experiences and career intentions in deployed UK military personnel using data gathered toward the end of an operational deployment. Data were gathered during deployment in Iraq and Afghanistan. A self-report survey collected data on sociodemographic, operational and military factors. Respondents provided their strength of agreement or disagreement with six potentially positive deployment experiences and their endorsement or rejection of six possible career intentions. Two mental health measures assessed symptoms of common mental disorder and post-traumatic stress disorder. Responses were 681 in Iran 2009 (100% response rate); 1421 in Afghanistan in 2010 (100%), 1362 in 2011 (96%) and 860 in 2015 (91%). Five of the potentially positive outcomes were endorsed by >50% of the sample: confidence about remaining healthy after returning home, pride in accomplishments, increased confidence in abilities, improved unit cohesion and experiencing a positive life effect. Ninety per cent of respondents planned to continue in service after returning home. Fewer positive deployment experiences, poorer mental health, lesser unit cohesion and more negative impressions of leadership were significantly associated with intention to leave service. Contrary to the popular belief that UK military personnel deployed to Iraq or Afghanistan experience negative outcomes, this paper shows that deployment can be a positive experience for a substantial majority of deployed personnel.

Mental Health and Job Burnout Among Pre-Hospital Emergency Care Personnel

Directory of Open Access Journals (Sweden)

Mahsa Haji Mohammad Hoseini

2017-01-01

Full Text Available Background: Work environment dictates physical, social and mental tensions each of which affect the staff’s health. Likewise, pre-hospital emergency care staff, due to the special nature of their job, are exposed to the tensions of emergency situations which can affect their health. Therefore, this study was conducted to scrutinize the relationship between the job burnout and mental health in pre-hospital emergencies of Qom Province. Materials and Methods: In this descriptive sectional study, 150 employed personnel of Qom 115 Emergency Care entered the study using census method. Data were gathered using questionnaires of “Background and Clinical Information”, “Mental Health”, and “Job Burnout”, and then based on central indices, Pearson correlation test and multiple linear regression statistical tests were run through software SPSS13 and then analyzed. Results: The average age of the participants was 30.8±5.8. The averages of the values of burnout and mental health were 69.43±12.4 and 60±14.1, respectively. According to Pearson correlation test, the values of the burnout and mental health have a significant negative correlation (r=-0.8. The results of multiple linear regression test showed that the correlation of the burnout and mental health considering the confounding variables is significant. (P=0.05 Conclusion: Pre-hospital employed personnel have desirable mental health and [low] burnout. Furthermore, improved mental health results in decreasing job burnout. Therefore, it is advisable to consider necessary facilities for caring for oneself.

Supporting Military Families with Young Children throughout the Deployment Lifecycle

Science.gov (United States)

2016-10-01

Group, Family Advocacy, Child and Family Behavioral Health, Soldier Readiness Program (SRP), Family Life Chaplain Training Center, Fort Hood Housing ...resilience and child well-being, Soldier and non-deploying parents must successfully meet the challenges of caregiving throughout the deployment cycle ...reintegration program to reduce parenting stress and promote family resilience in Active Duty military families through all phases of the deployment cycle

Quality Function Deployment for Large Systems

Science.gov (United States)

Dean, Edwin B.

1992-01-01

Quality Function Deployment (QFD) is typically applied to small subsystems. This paper describes efforts to extend QFD to large scale systems. It links QFD to the system engineering process, the concurrent engineering process, the robust design process, and the costing process. The effect is to generate a tightly linked project management process of high dimensionality which flushes out issues early to provide a high quality, low cost, and, hence, competitive product. A pre-QFD matrix linking customers to customer desires is described.

Travel risk behaviors as a determinants of receiving pre-travel health consultation and prevention.

Science.gov (United States)

Shady, Ibrahim; Gaafer, Mohammed; Bassiony, Lamiaa

2015-01-01

An estimated 30-60 % of travelers experience an illness while traveling. The incidence of travel-related illness can be reduced by preventive measures such as those provided by the Traveler Health Clinic (THC) in Kuwait. The present study is an analytical comparative study between groups of travelers visiting the THC during the study period (May 2009 - December 2010) and an age- and gender-matched control group of non-visitors (800 people). Both groups completed a modified pre-departure questionnaire. Bivariate analysis revealed that Kuwaitis (68.2 %), those traveling for work (25.3 %) or leisure (59.5 %), those living in camps (20.4 %) or hotels (64.0 %), and those with knowledge of the THC from the media (28.1 %) or other sources (57.3 %), were more likely to be associated with a high frequency of visits to the THC ( p  travelers heading to Africa (47 %) and South America (10 %) visited the THC more than did others ( P  travel, duration of stay, and choice of travel destination are independent predictors of receiving pre-travel consultation from the THC. Nationality, purpose of travel, length of stay, and travel destination are predictors for receiving a pre-travel consultation from the THC.

Soldiers at risk for individual readiness or morale problems during a six-month peacekeeping deployment to the Sinai.

Science.gov (United States)

Schumm, W R; Bell, D B

2000-10-01

Longitudinal data were examined to predict soldiers' morale, satisfaction with Army life, and the effects of family issues on performance of duties during an overseas deployment (Sinai peacekeeping force during the spring of 1995). Few variables were significant predictors of the outcome measures; however, rank, leaders' support for families, prior satisfaction with Army life and with information released about the deployment appeared to predict better outcomes during the deployment. Rank and leaders' support for families appeared to be more important for married soldiers while satisfaction with predeployment information seemed to be more important for single soldiers. Those who were worried about the effects of the deployment on their families also tended to report interference with their duty performance because of family concerns, but that effect was offset by perceived leaders' concern for families. In conclusion, it appears to the authors that the pre-existing factors studied had much less to do with deployment outcomes than did leadership success before and during the deployment. That's good news for Army leaders about their power to have a positive effect on soldiers' morale during overseas deployments but may be bad news for anyone hoping to find a "magic bullet" for pre-identification of soldiers most likely to retain high morale, regardless of their leadership's competence during an overseas deployment.

Coming home: A prospective study of family reintegration following deployment to a war zone.

Science.gov (United States)

Balderrama-Durbin, Christina; Cigrang, Jeffrey A; Osborne, Laura J; Snyder, Douglas K; Talcott, G Wayne; Slep, Amy M Smith; Heyman, Richard E; Tatum, JoLyn; Baker, Monty; Cassidy, Daniel; Sonnek, Scott

2015-08-01

The consequences of deployment extend beyond the service member to impact the entire family. The current investigation evaluated the unique challenges of family reintegration for partnered service members using a prospective design. In total, 76 partnered service members who deployed on a year-long, high-risk mission to Iraq were assessed across the entirety of the deployment cycle, i.e., pre-, during, and postdeployment. At follow-up, nearly 1 in 5 partnered service members reported moderate to severe difficulties in multiple aspects of family reintegration. Prospective interpersonal indicators such as preparations for deployment as a couple, shared commitment to the military, and predeployment relationship distress predicted postdeployment family reintegration difficulties. Significant interpersonal risk factors were medium to large in their effect sizes. Airmen's willingness to disclose deployment- and combat-related experiences, and postdeployment relationship distress served as concurrent interpersonal correlates of difficulties with family reintegration. Intrapersonal factors, including posttraumatic stress symptoms and alcohol misuse were concurrently related to challenges with family reintegration; predeployment alcohol misuse also predicted subsequent family reintegration difficulties. Additional analyses indicated that pre- and postdeployment relationship distress, combat disclosure, and postdeployment alcohol misuse each contributed to family reintegration when controlling for other intra- and interpersonal risk factors. Implications for prevention and early intervention strategies as well as future research are discussed. (c) 2015 APA, all rights reserved).

The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel.

Science.gov (United States)

Welsh, Janet A; Olson, Jonathan; Perkins, Daniel F; Travis, Wendy J; Ormsby, LaJuana

2015-09-01

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.

A quality function deployment framework for the service quality of health information websites.

Science.gov (United States)

Chang, Hyejung; Kim, Dohoon

2010-03-01

This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results.

Why good placements matter: Pre-placement and placement risk factors associated with mental health disorders in pre-school children in foster care.

Science.gov (United States)

Hillen, Thomas; Gafson, Leonie

2015-07-01

Pre-school children placed in local authority care show elevated rates of mental health disorders when compared to the general population. This study investigated risk factors for mental health disorders relating to the period prior to entering care and while in care. A representative sample of 43 children in care aged 0-72 months in an inner London borough underwent comprehensive multidimensional assessments. Presence of emotional, behavioural, attachment and adaptive disorders was ascertained. Exposure to two pre-placement risk factors and six placement risk factors was compared between children with and without a disorder. A total of 26 children (60.5%) had at least one mental health disorder. The two pre-placement risk factors, multiple types of maltreatment and entry into care after the age of 6 months, were both significantly associated with mental health disorders. The three placement risk factors of sudden placement moves, multiple placement moves and child-carer alienation showed a significant association with mental health disorders. There was a strong correlation between the number of risk factors and the number of co-morbid mental health disorders per child (r = .67, p school mental health. © The Author(s) 2014.

Quality function deployment

International Nuclear Information System (INIS)

1981-10-01

This book indicates quality function deployment with quality and deployment of quality function, process and prospect of quality function deployment and development, product process and conception of quality table, deployment of quality demand, design of quality table and application of concurrent multi design, progress design and quality development, main safe part and management of important function part, quality development and deployment of method of construction, quality deployment and economics, total system of quality function deployment and task of quality function deployment in the present and future.

Parental knowledge of pre-school child oral health.

Science.gov (United States)

Prabhu, Anand; Rao, Arun Prasad; Reddy, Venugopal; Ahamed, Syed Shaheed; Muhammad, Shameer; Thayumanavan, Shanmugam

2013-10-01

The dental health of preschool children has extensive implications on the oral heath of the individual as he grows into an adult. Parents/guardians of preschool children play a central role in enforcing proper oral hygiene and preventive regime in these children. This study was conducted with the aim of describing the views of parents/guardians about the dental health of pre-school children. Response was obtained on a 21 point questionnaire from randomly visiting parents of the outpatient section of Rajah Muthiah dental college and Hospital, Annamalainagar, India. The findings of the present study point towards poor awareness among the parents/guardians of preschool children, pertaining to their childs' oral health and this could directly translate to poor oral health among the children in this area.

A space release/deployment system actuated by shape memory wires

Science.gov (United States)

Fragnito, Marino; Vetrella and, Sergio

2002-11-01

In this paper, the design of an innovative hold down/release and deployment device actuated by shape memory wires, to be used for the first time for the S MA RT microsatellite solar wings is shown. The release and deployment mechanisms are actuated by a Shape Memory wire (Nitinol), which allows a complete symmetrical and synchronous release, in a very short time, of the four wings in pairs. The hold down kinematic mechanism is preloaded to avoid vibration nonlinearities and unwanted deployment at launch. The deployment mechanism is a simple pulley system. The stiffness of the deployed panel-hinge system needs to be dimensioned in order to meet the on-orbit requirement for attitude control. One-way roller clutches are used to keep the panel at the desired angle during the mission. An ad hoc software has been developed to simulate both the release and deployment operations, coupling the SMA wire behavior with the system mechanics.

Calibration procedure for Slocum glider deployed optical instruments.

Science.gov (United States)

Cetinić, Ivona; Toro-Farmer, Gerardo; Ragan, Matthew; Oberg, Carl; Jones, Burton H

2009-08-31

Recent developments in the field of the autonomous underwater vehicles allow the wide usage of these platforms as part of scientific experiments, monitoring campaigns and more. The vehicles are often equipped with sensors measuring temperature, conductivity, chlorophyll a fluorescence (Chl a), colored dissolved organic matter (CDOM) fluorescence, phycoerithrin (PE) fluorescence and spectral volume scattering function at 117 degrees, providing users with high resolution, real time data. However, calibration of these instruments can be problematic. Most in situ calibrations are performed by deploying complementary instrument packages or water samplers in the proximity of the glider. Laboratory calibrations of the mounted sensors are difficult due to the placement of the instruments within the body of the vehicle. For the laboratory calibrations of the Slocum glider instruments we developed a small calibration chamber where we can perform precise calibrations of the optical instruments aboard our glider, as well as sensors from other deployment platforms. These procedures enable us to obtain pre- and post-deployment calibrations for optical fluorescence instruments, which may differ due to the biofouling and other physical damage that can occur during long-term glider deployments. We found that biofouling caused significant changes in the calibration scaling factors of fluorescent sensors, suggesting the need for consistent and repetitive calibrations for gliders as proposed in this paper.

Pre-school manager training: a cost-effective tool to promote nutrition- and health-related practice improvements in the Irish full-day-care pre-school setting.

LENUS (Irish Health Repository)

Johnston Molloy, Charlotte

2013-10-18

To evaluate the impact on nutrition- and health-related practice of two methods of delivery of a nutrition and health intervention in Irish full-day-care pre-schools: training of pre-school managers only or training of managers and their staff.

Verification Test for Ultra-Light Deployment Mechanism for Sectioned Deployable Antenna Reflectors

Science.gov (United States)

Zajac, Kai; Schmidt, Tilo; Schiller, Marko; Seifart, Klaus; Schmalbach, Matthias; Scolamiero, Lucio

2013-09-01

The ultra-light deployment mechanism (UDM) is based on three carbon fibre reinforced plastics (CFRP) curved tape springs made of carbon fibre / cyanate ester prepregs.In the frame of the activity its space application suitability for the deployment of solid reflector antenna sections was investigated. A projected diameter of the full reflector of 4 m to 7 m and specific mass in the order of magnitude of 2.6kg/m2 was focused for requirement derivation.Extensive verification tests including health checks, environmental and functional tests were carried out with an engineering model to enable representative characterizing of the UDM unit.This paper presents the design and a technical description of the UDM as well as a summary of achieved development status with respect to test results and possible design improvements.

Preparing British Military nurses to deliver nursing care on deployment. An Afghanistan study.

Science.gov (United States)

Finnegan, Alan; Finnegan, Sara; Bates, David; Ritsperis, Debra; McCourt, Kath; Thomas, Mike

2015-01-01

This paper forms part of the first British Armed forces qualitative nursing research study undertaken on deployment. To provide an analysis of the impact and effectiveness of the pre-deployment educational preparation and clinical placements provided for military nurses. A Constructivist Grounded Theory was utilised with data collected through semi-structured interviews with 18 nurses based in Camp Bastion Hospital, Afghanistan during 2013. Initial coding indicated 21 educational preparation and clinical placement categories that influenced the delivery of nursing care. Analysis of these elements led to the identification of four major clusters: Military Nursing Care; Military Nurse Education; Unique Hospital Environment and Clinical Placements. Educational preparation consists of completing deployable operational nursing competencies, specialist training and individual tailored courses. This strategy was viewed as proving the appropriate academic requirement. However, training would be enhanced by introducing a formalised military preceptorship programme focussing on fundamental nursing skills. Caring for children was a particular concern, and it was emphasised that educational courses must be combined with a standardised clinical placement policy. Adequate clinical exposure can be challenging as nurses are not routinely exposed to War Zone levels of trauma in the UK. Clinical placements need to be standardised and harmonised, and located in areas where nurses cared for patients with similar injury patterns to those witnessed on deployment. Current NHS Trust placements can reduce the opportunities for employment in suitable clinical environments and diminishing the openings for collective military training. Better use should be made of clinical rotation programmes, including high dependency units, elective surgery, medical assessment units, paediatrics, and outreach teams such as burns and plastic surgery and pain management. Practice Educators should be utilised

Predicting health-promoting self-care behaviors in people with pre-diabetes by applying Bandura social learning theory.

Science.gov (United States)

Chen, Mei-Fang; Wang, Ruey-Hsia; Hung, Shu-Ling

2015-11-01

The aim of this study was to apply Bandura social learning theory in a model for identifying personal and environmental factors that predict health-promoting self-care behaviors in people with pre-diabetes. The theoretical basis of health-promoting self-care behaviors must be examined to obtain evidence-based knowledge that can help improve the effectiveness of pre-diabetes care. However, such behaviors are rarely studied in people with pre-diabetes. This quantitative, cross-sectional survey study was performed in a convenience sample of two hospitals in southern Taiwan. Two hundred people diagnosed with pre-diabetes at a single health examination center were recruited. A questionnaire survey was performed to collect data regarding personal factors (i.e., participant characteristics, pre-diabetes knowledge, and self-efficacy) and data regarding environmental factors (i.e., social support and perceptions of empowerment process) that may have associations with health-promoting self-care behaviors in people with pre-diabetes. Multiple linear regression showed that the factors that had the largest influence on the practice of health-promoting self-care behaviors were self-efficacy, diabetes history, perceptions of empowerment process, and pre-diabetes knowledge. These factors explained 59.3% of the variance in health-promoting self-care behaviors. To prevent the development of diabetes in people with pre-diabetes, healthcare professionals should consider both the personal and the environmental factors identified in this study when assessing health promoting self-care behaviors in patients with pre-diabetes and when selecting the appropriate interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

Very Low Head Turbine Deployment in Canada

International Nuclear Information System (INIS)

Kemp, P; Williams, C; Sasseville, Remi; Anderson, N

2014-01-01

The Very Low Head (VLH) turbine is a recent turbine technology developed in Europe for low head sites in the 1.4 - 4.2 m range. The VLH turbine is primarily targeted for installation at existing hydraulic structures to provide a low impact, low cost, yet highly efficient solution. Over 35 VLH turbines have been successfully installed in Europe and the first VLH deployment for North America is underway at Wasdell Falls in Ontario, Canada. Deployment opportunities abound in Canada with an estimated 80,000 existing structures within North America for possible low-head hydro development. There are several new considerations and challenges for the deployment of the VLH turbine technology in Canada in adapting to the hydraulic, environmental, electrical and social requirements. Several studies were completed to determine suitable approaches and design modifications to mitigate risk and confirm turbine performance. Diverse types of existing weirs and spillways pose certain hydraulic design challenges. Physical and numerical modelling of the VLH deployment alternatives provided for performance optimization. For this application, studies characterizing the influence of upstream obstacles using water tunnel model testing as well as full-scale prototype flow dynamics testing were completed. A Cold Climate Adaptation Package (CCA) was developed to allow year-round turbine operation in ice covered rivers. The CCA package facilitates turbine extraction and accommodates ice forces, frazil ice, ad-freezing and cold temperatures that are not present at the European sites. The Permanent Magnet Generator (PMG) presents some unique challenges in meeting Canadian utility interconnection requirements. Specific attention to the frequency driver control and protection requirements resulted in a driver design with greater over-voltage capability for the PMG as well as other key attributes. Environmental studies in Europe included fish friendliness testing comprised of multiple in

Very Low Head Turbine Deployment in Canada

Science.gov (United States)

Kemp, P.; Williams, C.; Sasseville, Remi; Anderson, N.

2014-03-01

The Very Low Head (VLH) turbine is a recent turbine technology developed in Europe for low head sites in the 1.4 - 4.2 m range. The VLH turbine is primarily targeted for installation at existing hydraulic structures to provide a low impact, low cost, yet highly efficient solution. Over 35 VLH turbines have been successfully installed in Europe and the first VLH deployment for North America is underway at Wasdell Falls in Ontario, Canada. Deployment opportunities abound in Canada with an estimated 80,000 existing structures within North America for possible low-head hydro development. There are several new considerations and challenges for the deployment of the VLH turbine technology in Canada in adapting to the hydraulic, environmental, electrical and social requirements. Several studies were completed to determine suitable approaches and design modifications to mitigate risk and confirm turbine performance. Diverse types of existing weirs and spillways pose certain hydraulic design challenges. Physical and numerical modelling of the VLH deployment alternatives provided for performance optimization. For this application, studies characterizing the influence of upstream obstacles using water tunnel model testing as well as full-scale prototype flow dynamics testing were completed. A Cold Climate Adaptation Package (CCA) was developed to allow year-round turbine operation in ice covered rivers. The CCA package facilitates turbine extraction and accommodates ice forces, frazil ice, ad-freezing and cold temperatures that are not present at the European sites. The Permanent Magnet Generator (PMG) presents some unique challenges in meeting Canadian utility interconnection requirements. Specific attention to the frequency driver control and protection requirements resulted in a driver design with greater over-voltage capability for the PMG as well as other key attributes. Environmental studies in Europe included fish friendliness testing comprised of multiple in

The role of postdeployment social factors in linking deployment experiences and current posttraumatic stress disorder symptomatology among male and female veterans.

Science.gov (United States)

Smith, Brian N; Wang, Joyce M; Vaughn-Coaxum, Rachel A; Di Leone, Brooke A L; Vogt, Dawne

2017-01-01

The postdeployment social context is likely highly salient in explaining mental health symptoms following deployment. The aim of this study was to examine the role of postdeployment social factors (social support and social reintegration difficulty) in linking deployment-related experiences (warfare exposure, sexual harassment, concerns about relationship disruptions, and deployment social support) and posttraumatic stress disorder (PTSD) symptomatology in male and female veterans. A survey was administered to 998 potential participants (after accounting for undeliverable mail) who had returned from deployment to Afghanistan or Iraq. Completed surveys were received from 469 veterans, yielding a response rate of 47%. Hypotheses were examined using structural equation modeling. For male and female veterans, deployment factors predicted later PTSD symptoms through postdeployment social support and social reintegration, with lower support and higher social reintegration difficulty both associated with higher PTSD symptomatology. While the final models for women and men indicated similar risk mechanisms, some differences in pathways were observed. Sexual harassment presented more of a risk for women, whereas lower social support was a greater risk factor for men. Postdeployment social factors appear to represent potentially important targets for interventions aiming to reduce the potential impact of stressful deployment experiences.

Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care

Directory of Open Access Journals (Sweden)

Vandenbroucke Jan P

2010-12-01

Full Text Available Abstract Background Clinical and research electives abroad offer medical students many unique experiences. However, participating in an unfamiliar health-care setting combined with limited medical experience may place students at risk of illness. To improve pre-and post-travel care, we assessed the health risks and the quality and comprehensiveness of pre-and post-travel care in a cohort of Dutch medical students returning form an elective abroad. Methods All medical students who had performed an elective in the tropics between July 2006 and December 2008 were sent an informative email asking them to complete a web-based questionnaire. Results 180 of 242 (74% students completed the questionnaire. Regarding the risk of bloodborne viral infection: 67% of all students and 32% of junior students engaged in procedures that constitute a risk of exposure to bloodborne viral infection, often in countries with high HIV prevalence rates. None of nine students who experienced possible or certain mucosal or percutaneous exposure to potentially infectious body fluids reported the exposure at the time it occurred and none used PEP. Regarding other health risks: 8 of 40 (20% students stopped using mefloquine due to adverse effects. This left a sizeable proportion unprotected in countries that are hyperendemic for malaria. Post-travel screening for schistosomiasis, tuberculosis (tuberculin skin test and carriage of methicillin-resistant Staphylococcus aureus (MRSA encompassed approximately half of all students who should have been screened. Conclusions Based on the results of this study we have adopted an integral set of measures to reduce the health risks associated with an elective abroad. The pre and post-travel consult has been centralized and standardized as well as the distribution of PEP. In addition we have developed a mandatory module on Global Health for all medical students planning an elective abroad.

Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care.

Science.gov (United States)

Sharafeldin, Elhadi; Soonawala, Darius; Vandenbroucke, Jan P; Hack, Evelien; Visser, Leo G

2010-12-02

Clinical and research electives abroad offer medical students many unique experiences. However, participating in an unfamiliar health-care setting combined with limited medical experience may place students at risk of illness. To improve pre-and post-travel care, we assessed the health risks and the quality and comprehensiveness of pre-and post-travel care in a cohort of Dutch medical students returning form an elective abroad. All medical students who had performed an elective in the tropics between July 2006 and December 2008 were sent an informative email asking them to complete a web-based questionnaire. 180 of 242 (74%) students completed the questionnaire. Regarding the risk of bloodborne viral infection: 67% of all students and 32% of junior students engaged in procedures that constitute a risk of exposure to bloodborne viral infection, often in countries with high HIV prevalence rates. None of nine students who experienced possible or certain mucosal or percutaneous exposure to potentially infectious body fluids reported the exposure at the time it occurred and none used PEP. Regarding other health risks: 8 of 40 (20%) students stopped using mefloquine due to adverse effects. This left a sizeable proportion unprotected in countries that are hyperendemic for malaria. Post-travel screening for schistosomiasis, tuberculosis (tuberculin skin test) and carriage of methicillin-resistant Staphylococcus aureus (MRSA) encompassed approximately half of all students who should have been screened. Based on the results of this study we have adopted an integral set of measures to reduce the health risks associated with an elective abroad. The pre and post-travel consult has been centralized and standardized as well as the distribution of PEP. In addition we have developed a mandatory module on Global Health for all medical students planning an elective abroad.

Deployment Pulmonary Health

Science.gov (United States)

2015-02-11

of health and hazard data to monitor the extent and severity of occupationally-related lung disease and related workplace exposures for use in public...during pregnancy . J. Occup. Environ. Med. Jun 2012;54(6):689-697. 112. Barton CA, McGuire A, Waller M, et al. Smoking prevalence, its determinants...disease and related workplace exposures for use in public health education and in disease prevention.” 38 Department of Defense (DoD) Directive

A Quality Function Deployment Framework for the Service Quality of Health Information Websites

Science.gov (United States)

Kim, Dohoon

2010-01-01

Objectives This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Methods Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Results Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. Conclusions The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results. PMID:21818418

ISIS Child Soldiers in Syria: The Structural and Predatory Recruitment, Enlistment, Pre-Training Indoctrination, Training, and Deployment

Directory of Open Access Journals (Sweden)

Asaad Almohammad

2018-02-01

Full Text Available Research on the engagement of children with the so-called Islamic State (a.k.a. ISIS relies heavily on the analysis of obtained ISIS documents and ISIS-disseminated propaganda, leaving major elements of the recruitment and deployment process uncovered. Such ambiguities hinder future efforts aimed at dealing with ISIS’ child soldiers. As such, an intensive effort to compile data using interviews and naturalistic observations across ISIS-held territories in Syria was made to exhaustively explore the process of child recruitment and deployment by ISIS. Findings suggest that there are two methods of recruitment: predatory and structural. The enlistment, intensity of indoctrination, types of training, and nature of deployment were found to depend, to a high degree, on the type of recruitment (i.e., predatory or structural, and category of children based on their origin (i.e., local, Middle Eastern and North African [MENA], or foreign and if they are orphans. The data shows that the separation between children and adults’ roles/assignments is diminishing. After a thorough exploration of the elements of ISIS’ recruitment and deployment process, this paper argues its findings, implications, and limitations.

Encounters With Health-Care Providers and Advance Directive Completion by Older Adults.

Science.gov (United States)

Koss, Catheryn

2018-01-01

The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients. Logistic regression using longitudinal data from the 2012 and 2014 waves of the Health and Retirement Study. Participants were 3752 US adults aged 65 and older who reported not possessing advance directives in 2012. Advance directive was defined as a living will and/or durable power of attorney for health care. Four binary variables measured whether participants had spent at least 1 night in a hospital, underwent outpatient surgery, received home health or hospice care, or spent at least one night in a nursing home between 2012 and 2014. Older adults who received hospital, nursing home, or home health/hospice care were more likely to complete advance directives. Outpatient surgery was not associated with advance directive completion. Older adults with no advance directive in 2012 who encountered health-care providers covered by the PSDA were more likely to have advance directives by 2014. The exception was outpatient surgery which is frequently provided in freestanding surgery centers not subject to PSDA mandates. It may be time to consider amending the PSDA to cover freestanding surgery centers.

Risk activities and pre-travel health seeking practices of notified cases of imported infectious diseases in Australia.

Science.gov (United States)

Paudel, Prakash; Raina, C; Zwar, Nicholas; Seale, Holly; Worth, Heather; Sheikh, Mohamud; Heywood, Anita E

2017-09-01

Travellers are at risk of acquiring infectious diseases during travel, with risks differing by destination, travel and traveller characteristics. A pre-travel health consultation may minimize this risk. However, uptake of pre-travel health advice remains low. We investigated pre-travel health preparations and disease-specific risk behaviours among notified cases of selected travel-associated infectious diseases imported into Australia. Prospective enhanced surveillance of notified cases of typhoid, paratyphoid, measles, hepatitis A, hepatitis E, malaria and chikungunya was conducted in two Australian states between February 2013 and January 2014. Details of pre-travel health preparation and disease-specific risk behaviours were collected. Among 180 cases associated with international travel, 28% were travellers and 22% were frequent travellers, having travelled ≥5 times in the past 5 years. 25% had sought pre-travel advice from a healthcare provider, and 16% reported a pre-travel vaccine. Seeking pre-travel health advice did not differ by immigrant status ( P  = 0.22) or by reason for travel ( P  = 0.13) but was more commonly sought by first time travellers ( P  = 0.03). Travellers visiting friends and relatives were more likely to report at-risk activities of brushing teeth with tap water ( P  food ( P  = 0.03) during travel compared to other travellers. Pre-travel health advice seeking practices and vaccine uptake was suboptimal among cases of notified disease. The results of this study highlight the need for a better understanding of barriers to pre-travel health seeking, particularly among high risk travellers, to reduce the importation of infectious diseases into Australia. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Risk Factors Associated With Suicide Completions Among US Enlisted Marines.

Science.gov (United States)

Phillips, Christopher J; LeardMann, Cynthia A; Vyas, Kartavya J; Crum-Cianflone, Nancy F; White, Martin R

2017-09-15

US enlisted Marines have experienced a substantial increase in suicide rates. We sought to identify risk factors for suicide completions among male Marines who entered basic training in San Diego, California, between June 2001 and October 2010. Suicides that occurred during active-duty military service were counted from June 1, 2001, through June 30, 2012. A total of 108,930 male Marines (66,286 deployers and 42,644 never deployed) were followed for 467,857 person-years of active-duty service time. Of the 790 deaths, 123 (15.6%) were suicides. In the final multivariate hazard model, preservice characteristics of not being a high-school graduate (hazard ratio (HR) = 2.17, 95% confidence interval (CI): 1.28, 3.68) and being a smoker at the time of enlistment (HR = 1.91, 95% CI: 1.32, 2.76) were significantly associated with a higher risk for suicide completion. Diagnosed with traumatic brain injury (HR = 4.09, 95% CI: 2.08, 8.05), diagnosed with depression (HR = 2.36, 95% CI: 1.22, 4.58), and received relationship counseling (HR = 3.71, 95% CI: 1.44, 9.54) during military service were significant risks for suicide death. Deployment alone was not significantly associated with a risk for suicide death (HR = 0.53, 95% CI: 0.26, 1.05). Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Teaching Health Education. A Thematic Analysis of Early Career Teachers' Experiences Following Pre-Service Health Training

Science.gov (United States)

Pickett, Karen; Rietdijk, Willeke; Byrne, Jenny; Shepherd, Jonathan; Roderick, Paul; Grace, Marcus

2017-01-01

Purpose: The purpose of this paper is to understand early career teachers' perceptions of the impact of a pre-service health education programme on their health promotion practice in schools and the contextual factors that influence this. Design/methodology/approach: Semi-structured interviews were conducted with 14 primary and secondary trainee…

Validity of Self Completed Health Questionnaire among Oral ...

African Journals Online (AJOL)

Objective of this study is to determine the degree of validity of self completed health questionnaire among oral surgery patient at the Capitol Dental when compared with a structured oral interview. A prospective random selection method was applied using a standardized questionnaire. The cohorts are patients attending ...

Realization and testing of a deployable space telescope based on tape springs

Science.gov (United States)

Lei, Wang; Li, Chuang; Zhong, Peifeng; Chong, Yaqin; Jing, Nan

2017-08-01

For its compact size and light weight, space telescope with deployable support structure for its secondary mirror is very suitable as an optical payload for a nanosatellite or a cubesat. Firstly the realization of a prototype deployable space telescope based on tape springs is introduced in this paper. The deployable telescope is composed of primary mirror assembly, secondary mirror assembly, 6 foldable tape springs to support the secondary mirror assembly, deployable baffle, aft optic components, and a set of lock-released devices based on shape memory alloy, etc. Then the deployment errors of the secondary mirror are measured with three-coordinate measuring machine to examine the alignment accuracy between the primary mirror and the deployed secondary mirror. Finally modal identification is completed for the telescope in deployment state to investigate its dynamic behavior with impact hammer testing. The results of the experimental modal identification agree with those from finite element analysis well.

Pre-Planning and Post-Conflict CMOC/CIMIC Challenges

National Research Council Canada - National Science Library

Hollen, Patrick

2003-01-01

.... It is critical that the United States and its allies make better use of these lessons learned and insist upon robust pre-deployment coordination between civil-military authorities in order to help...

Cloud Environment Automation: from infrastructure deployment to application monitoring

Science.gov (United States)

Aiftimiei, C.; Costantini, A.; Bucchi, R.; Italiano, A.; Michelotto, D.; Panella, M.; Pergolesi, M.; Saletta, M.; Traldi, S.; Vistoli, C.; Zizzi, G.; Salomoni, D.

2017-10-01

The potential offered by the cloud paradigm is often limited by technical issues, rules and regulations. In particular, the activities related to the design and deployment of the Infrastructure as a Service (IaaS) cloud layer can be difficult to apply and time-consuming for the infrastructure maintainers. In this paper the research activity, carried out during the Open City Platform (OCP) research project [1], aimed at designing and developing an automatic tool for cloud-based IaaS deployment is presented. Open City Platform is an industrial research project funded by the Italian Ministry of University and Research (MIUR), started in 2014. It intends to research, develop and test new technological solutions open, interoperable and usable on-demand in the field of Cloud Computing, along with new sustainable organizational models that can be deployed for and adopted by the Public Administrations (PA). The presented work and the related outcomes are aimed at simplifying the deployment and maintenance of a complete IaaS cloud-based infrastructure.

Deployment of e-health services - a business model engineering strategy.

Science.gov (United States)

Kijl, Björn; Nieuwenhuis, Lambert J M; Huis in 't Veld, Rianne M H A; Hermens, Hermie J; Vollenbroek-Hutten, Miriam M R

2010-01-01

We designed a business model for deploying a myofeedback-based teletreatment service. An iterative and combined qualitative and quantitative action design approach was used for developing the business model and the related value network. Insights from surveys, desk research, expert interviews, workshops and quantitative modelling were combined to produce the first business model and then to refine it in three design cycles. The business model engineering strategy provided important insights which led to an improved, more viable and feasible business model and related value network design. Based on this experience, we conclude that the process of early stage business model engineering reduces risk and produces substantial savings in costs and resources related to service deployment.

Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

Science.gov (United States)

Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

2011-01-01

Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

Professional Stress and Burnout in U.S. Military Medical Personnel Deployed to Afghanistan.

Science.gov (United States)

Adler, Amy B; Adrian, Amanda L; Hemphill, Marla; Scaro, Nicole H; Sipos, Maurice L; Thomas, Jeffrey L

2017-03-01

Studies of medical staff members have consistently documented high levels of burnout compared to those in other professions. Although there are studies of burnout in military medical staff, there are gaps in understanding the experience of medical staff while they are deployed and few occupationally-related factors associated with decreased burnout have been identified in this population. To assess work-related variables accounting for burnout over and above rank, post-traumatic stress disorder (PTSD) symptoms, and professional stressors in the deployed environment. U.S. military medical staff members were surveyed in Afghanistan. The survey assessed burnout (emotional exhaustion and depersonalization), PTSD symptoms, perception of professional stressors, self-care behaviors, taking care of team members (team care), general leadership, and health-promoting leadership. Participants provided informed consent under a protocol approved by the institutional review board at Walter Reed Army Institute of Research, and coordinated through the Washington Headquarters Service and the Joint Casualty Care Research Team located in Afghanistan. A total of 344 individuals provided their consent (83.3%) and completed the survey. Correlations found significant positive relationships between perception of professional stressors and levels of burnout. Significant negative correlations were found between burnout and self-care, team care, general leadership, and health-promoting leadership. Regression analyses found self-care and team care accounted for less burnout even after controlling for rank, PTSD symptoms, and professional stressors. Health-promoting leadership accounted for less burnout even after controlling for these same covariates and general leadership as well. Although a cross-sectional survey, results provide three specific directions for reducing burnout in deployed medical staff. By emphasizing self-care, team care, and health-promoting leadership, policy makers

Deployment Repeatability

Science.gov (United States)

2016-04-01

evaluating the deployment repeatability builds upon the testing or analysis of deployment kinematics (Chapter 6) and adds repetition. Introduction...material yield or failure during a test. For the purposes of this chapter, zero shift will refer to permanent changes in the structure, while reversible ...the content of other chapters in this book: Gravity Compensation (Chapter 4) and Deployment Kinematics and Dynamics (Chapter 6). Repeating the

A study of organizational versus individual needs related to recruitment, deployment and promotion of doctors working in the government health system in Odisha state, India.

Science.gov (United States)

Kadam, Shridhar; Nallala, Srinivas; Zodpey, Sanjay; Pati, Sanghamitra; Hussain, Mohammad Akhtar; Chauhan, Abhimanyu Singh; Das, Sovesh; Martineau, Tim

2016-02-24

An effective health workforce is essential for achieving health-related new Sustainable Development Goals. Odisha, one of the states in India with low health indicators, faces challenges in recruiting and retaining health staff in the public sector, especially doctors. Recruitment, deployment and career progression play an important role in attracting and retaining doctors. We examined the policies on recruitment, deployment and promotion for doctors in the state and how these policies were perceived to be implemented. We undertook document review and four key informant interviews with senior state-level officials to delineate the policies for recruitment, deployment and promotion. We conducted 90 in-depth interviews, 86 with doctors from six districts and four at the state level to explore the perceptions of doctors about these policies. Despite the efforts by the Government of Odisha through regular recruitments, a quarter of the posts of doctors was vacant across all institutional levels in the state. The majority of doctors interviewed were unaware of existing government rules for placement, transfer and promotion. In addition, there were no explicit rules followed in placement and transfer. More than half (57%) of the doctors interviewed from well-accessible areas had never worked in the identified hard-to-reach areas in spite of having regulatory and incentive mechanisms. The average length of service before the first promotion was 26 (±3.5) years. The doctors expressed satisfaction with the recruitment process. They stated concerns over delayed first promotion, non-transparent deployment policies and ineffective incentive system. Almost all doctors suggested having time-bound and transparent policies. Adequate and appropriate deployment of doctors is a challenge for the government as it has to align the individual aspirations of employees with organizational needs. Explicit rules for human resource management coupled with transparency in implementation can

Non-deployment factors affecting psychological wellbeing in military personnel: literature review.

Science.gov (United States)

Brooks, Samantha K; Greenberg, Neil

2018-02-01

Most military mental health research focuses on the impact of deployment-related stress; less is known about how everyday work-related factors affect wellbeing. This systematic narrative literature review aimed to identify non-deployment-related factors contributing to the wellbeing of military personnel. Electronic literature databases were searched and the findings of relevant studies were used to explore non-deployment-related risk and resilience factors. Fifty publications met the inclusion criteria. Determinants of non-deployment stress were identified as: relationships with others (including leadership/supervisory support; social support/cohesion; harassment/discrimination) and role-related stressors (role conflict; commitment and effort-reward imbalance; work overload/job demands; family-related issues/work-life balance; and other factors including control/autonomy, physical work environment and financial strain). Factors positively impacting wellbeing (such as exercise) were also identified. The literature suggests that non-deployment stressors present a significant occupational health hazard in routine military environments and interpersonal relationships at work are of fundamental importance. Findings suggest that in order to protect the wellbeing of personnel and improve performance, military organisations should prioritise strengthening relationships between employees and their supervisors/colleagues. Recommendations for addressing these stressors in British military personnel were developed.

A prospective study on personality and the cortisol awakening response to predict posttraumatic stress symptoms in response to military deployment

NARCIS (Netherlands)

van Zuiden, Mirjam; Kavelaars, Annemieke; Rademaker, Arthur R.; Vermetten, Eric; Heijnen, Cobi J.; Geuze, Elbert

2011-01-01

Few prospective studies on pre-trauma predictors for subsequent development of posttraumatic stress disorder (PTSD) have been conducted. In this study we prospectively investigated whether pre-deployment personality and the cortisol awakening response (CAR) predicted development of PTSD symptoms in

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure.

Science.gov (United States)

Donoho, Carrie J; Bonanno, George A; Porter, Ben; Kearney, Lauren; Powell, Teresa M

2017-12-15

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies between individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and the inability to account for combat-related trauma. To determine the trajectories of PTSD symptoms among deployed military personnel with and without combat exposure, we used data from a population-based representative sample of 8,178 US service members who participated in the Millennium Cohort Study from 2001 to 2011. Using latent growth mixture modeling, trajectories of PTSD symptoms were determined in the total sample, as well as in individuals with and without combat exposure, respectively. Overall, 4 trajectories of PTSD were characterized: resilient, pre-existing, new-onset, and moderate stable. Across all trajectories, combat-deployed service members diverged from non-combat-deployed service members, even after a single deployment. The former also generally had higher PTSD symptoms. Based on the models, nearly 90% of those without combat exposure remained resilient over the 10-year period, compared with 80% of those with combat exposure. Findings demonstrate that although the clinical course of PTSD symptoms shows heterogeneous patterns of development, combat exposure is uniformly associated with poor mental health. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Is Military Deployment a Risk Factor for Maternal Depression?

Science.gov (United States)

2013-01-01

679–684. 39. Quevedo LA, Silva RA, Godoy R, et al. The impact of ma- ternal post - partum depression on the language development of children at 12 months...Naval Health Research Center Is Military Deployment A Risk Factor for Maternal Depression ? Stacie Nguyen Cynthia A. LeardMann Besa Smith...Sylvester Road San Diego, California 92106-3521 Original Articles Is Military Deployment a Risk Factor for Maternal Depression ? Stacie Nguyen, MPH

[The effect of pre-surgical orthodontics on secondary alveolar bone grafting in the patients with complete cleft lip and palate].

Science.gov (United States)

Jia, Yi-lin; Fu, Min-kui; Ma, Lian

2004-05-01

To examine the effect of pre-surgical orthodontics on the outcome of the secondary alveolar bone grafting in the patients with complete cleft lip and palate. Sixteen complete cleft lip and palate patients (9 males and 7 females) with collapsed upper arch or severe mal-positioned upper incisors were selected. The cleft was not easily grafted because of the poor access. The total cleft sites were 22 (10 patients with UCLP and 6 patients with BCLP). The age range of the patients was from 8 to 22 years. Pre-surgical orthodontic treatment was mainly to expand the collapsed upper arch and correct the mal-positioned upper incisors. After the secondary alveolar bone grafting, the patients were followed up and anterior occlusal radiograph/intraoral panograph were taken regularly. The observation period was from 6 months to 4 years. Bergland criteria were used to evaluate the interdental septal height. Upper arch expansion and the correction of the mal-positioned upper incisors done by the orthodontic treatment made the bone grafting procedure easier. The clinically successful rate reached 86%. The severe upper arch collapse and mal-positioned upper incisors in the patients with complete cleft lip and palate should be corrected orthodontically before the secondary alveolar bone grafting.

Soldier Dimensions and Operational Readiness in U.S. Army Forces Deployed to Kosovo

National Research Council Canada - National Science Library

Castro, Carl

1999-01-01

.... In a recent study of U.S. Army units deployed to Kosovo in support of a multinational peacekeeping mission, soldier attitudes and health were surveyed on site, mid-way during a 6-month deployment...

Effectiveness of battlefield-ethics training during combat deployment: a programme assessment.

Science.gov (United States)

Warner, Christopher H; Appenzeller, George N; Mobbs, Angela; Parker, Jessica R; Warner, Carolynn M; Grieger, Thomas; Hoge, Charles W

2011-09-03

Breakdowns in the ethical conduct of soldiers towards non-combatants on the battlefield are of grave concern in war. Evidence-based training approaches to prevent unethical conduct are scarce. We assessed the effectiveness of battlefield-ethics training and factors associated with unethical battlefield conduct. The training package, based on movie vignettes and leader-led discussions, was administered 7 to 8 months into a 15-month high-intensity combat deployment in Iraq, between Dec 11, 2007, and Jan 30, 2008. Soldiers from an infantry brigade combat team (total population about 3500) were randomly selected, on the basis of company and the last four digits of each soldier's social security number, and invited to complete an anonymous survey 3 months after completion of the training. Reports of unethical behaviour and attitudes in this sample were compared with a randomly selected pre-training sample from the same brigade. The response patterns for ethical behaviour and reporting of ethical violations were analysed with chi-square analyses. We developed two logistic regression models using self-reported unethical behaviours as dependent variables. Factors associated with unethical conduct, including combat experiences and post-traumatic stress disorder (PTSD), were assessed with validated scales. Of 500 randomly selected soldiers 421 agreed to participate in the anonymous post-training survey. A total of 397 soldiers of the same brigade completed the pre-training survey. Training was associated with significantly lower rates of unethical conduct of soldiers and greater willingness to report and address misconduct than in those before training. For example, reports of unnecessary damage or destruction of private property decreased from 13·6% (54 of 397; 95% CI 10·2-17·0) before training to 5·0% (21 of 421; 2·9-7·1) after training (percent difference -63·2%; pethics training positively influenced soldiers' understanding of how to interact with and treat non

Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq.

Science.gov (United States)

Browne, Tess; Hull, Lisa; Horn, Oded; Jones, Margaret; Murphy, Dominic; Fear, Nicola T; Greenberg, Neil; French, Claire; Rona, Roberto J; Wessely, Simon; Hotopf, Matthew

2007-06-01

Deployment to the 2003 Iraq War was associated with ill health in reserve armed forces personnel. To investigate reasons for the excess of ill health in reservists. UK personnel who were deployed to the 2003 Iraq War completed a health survey about experiences on deployment to Iraq. Health status was measured using self-report of common mental disorders, post-traumatic stress disorder (PTSD), fatigue, physical symptoms and well-being. Reservists were older and of higher rank than the regular forces. They reported higher exposure to traumatic experiences, lower unit cohesion, more problems adjusting to homecoming and lower marital satisfaction. Most health outcomes could be explained by role, experience of traumatic events or unit cohesion in theatre. PTSD symptoms were the one exception and were paradoxically most powerfully affected by differences in problems at home rather than events in Iraq. The increased ill-health of reservists appears to be due to experiences on deployment and difficulties with homecoming.

Enabling affordable and efficiently deployed location based smart home systems.

Science.gov (United States)

Kelly, Damian; McLoone, Sean; Dishongh, Terry

2009-01-01

With the obvious eldercare capabilities of smart environments it is a question of "when", rather than "if", these technologies will be routinely integrated into the design of future houses. In the meantime, health monitoring applications must be integrated into already complete home environments. However, there is significant effort involved in installing the hardware necessary to monitor the movements of an elder throughout an environment. Our work seeks to address the high infrastructure requirements of traditional location-based smart home systems by developing an extremely low infrastructure localisation technique. A study of the most efficient method of obtaining calibration data for an environment is conducted and different mobile devices are compared for localisation accuracy and cost trade-off. It is believed that these developments will contribute towards more efficiently deployed location-based smart home systems.

Deciding the On-line Chromatic Number of a Graph with Pre-coloring is PSPACE-complete

DEFF Research Database (Denmark)

Kudahl, Christian

2015-01-01

In an on-line coloring, the vertices of a graph are revealed one by one. An algorithm assigns a color to each vertex after it is revealed. When a vertex is revealed, it is also revealed which of the previous vertices it is adjacent to. The on-line chromatic number of a graph, G, is the smallest...... number of colors an algorithm will need when on-line-coloring G. The algorithm may know G, but not the order in which the vertices are revealed. The problem of determining if the on-line chromatic number of a graph is less than or equal to k, given a pre-coloring, is shown to be PSPACE-complete....

Biomarkers of post-deployment resilience among military service members

Directory of Open Access Journals (Sweden)

Krista B. Highland

2015-01-01

Full Text Available The development of PTSD after military deployment is influenced by a combination of biopsychosocial risk and resilience factors. In particular, physiological factors may mark risk for symptom progression or resiliency. Research in civilian populations suggests elevated catecholamines after trauma are associated with PTSD months following the trauma. However, less is known regarding physiological markers of PTSD resilience among post-deployment service members (SM. We therefore assessed whether catecholamines obtained shortly after deployment were associated with combat-related PTSD symptoms three months later. Eighty-seven SMs completed the Clinician-Administered PTSD Scale for DSM-IV and blood draws within two months after return from deployment to Iraq or Afghanistan (“Time 1” or “T1” and three months later (“Time 2” or “T2”. Linear regression analyses demonstrated that lower norepinephrine at T1 was associated with lower PTSD symptoms at T2. In particular, T1 norepinephrine was positively associated with T2 symptom intensity and avoidance symptoms. The present findings represent a biologically-informed method of assessing PTSD resilience after deployment, which may aid clinicians in providing tailored treatments for those in the greatest need. Further research is needed to validate these findings and incorporate physiological measures within an assessment battery.

The Impact of Military Deployment and Reintegration on Children and Parenting: A Systematic Review

Science.gov (United States)

Creech, Suzannah K.; Hadley, Wendy; Borsari, Brian

2015-01-01

Hundreds of thousands of children have had at least 1 parent deploy as part of military operations in Iraq (Operation Iraqi Freedom; OIF; Operation New Dawn; OND) and Afghanistan (Operation Enduring Freedom; OEF). However, there is little knowledge of the impact of deployment on the relationship of parents and their children. This systematic review examines findings from 3 areas of relevant research: the impact of deployment separation on parenting, and children's emotional, behavioral, and health outcomes; the impact of parental mental health symptoms during and after reintegration; and current treatment approaches in veteran and military families. Several trends emerged. First, across all age groups, deployment of a parent may be related to increased emotional and behavioral difficulties for children, including higher rates of health-care visits for psychological problems during deployment. Second, symptoms of PTSD and depression may be related to increased symptomatology in children and problems with parenting during and well after reintegration. Third, although several treatments have been developed to address the needs of military families, most are untested or in the early stages of implementation and evaluation. This body of research suggests several promising avenues for future research. PMID:25844014

Comparing the Attitudes of Pre-Health Professional and Engineering Students in Introductory Physics Courses

Science.gov (United States)

McKinney, Meghan

2015-04-01

This talk will discuss using the Colorado Learning Attitudes about Science Survey (CLASS) to compare student attitudes towards the study of physics of two different groups. Northern Illinois University has two levels of introductory mechanics courses, one geared towards biology majors and pre-health professionals, and one for engineering and physics majors. The course for pre-health professionals is an algebra based course, while the course for engineering and physics majors is a calculus based course. We've adapted the CLASS into a twenty question survey that measures student attitudes towards the practice of and conceptions about physics. The survey is administered as a pre and post assessment to look at student attitudes before and after their first course in physics.

Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

Science.gov (United States)

Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

2017-03-01

Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

Associations of contextual risk and protective factors with fathers’ parenting practices in the post-deployment environment

Science.gov (United States)

Davis, Laurel; Hanson, Sheila K.; Zamir, Osnat; Gewirtz, Abigail H.; DeGarmo, David S.

2015-01-01

Deployment separation and reunifications are salient contexts that directly impact effective family functioning and parenting for military fathers. Yet, we know very little about determinants of post-deployed father involvement and effective parenting. The present study examined hypothesized risk and protective factors of observed parenting for 282 post-deployed fathers who served in the Army National Guard/Reserves. Pre-intervention data were employed from fathers participating in the After Deployment, Adaptive Parenting Tools (ADAPT) randomized control trial. Parenting practices were obtained from direct observation of father-child interaction and included measures of problem solving, harsh discipline, positive involvement, encouragement, and monitoring. Risk factors included combat exposure, negative life events, months deployed, and PTSD symptoms. Protective factors included education, income, dyadic adjustment, and social support. Results of a structural equation model predicting an effective parenting construct indicated that months deployed, income, and father age were most related to observed parenting, explaining 16% of the variance. We are aware of no other study utilizing direct parent-child observations of father’s parenting skills following overseas deployment. Implications for practice and preventive intervention are discussed. PMID:26213794

Electronic collaboration across organizational borders in the health care sector: Design and deployment from a national perspective

OpenAIRE

Heimly, Vigdis

2012-01-01

The purpose of this thesis is to make a contribution to the improvement of electronic collaboration across organizational borders in the health care sector. I have studied this problem from a sociotechnical1 point of view and have tried to find out what we can learn from the process and how lessons learned could potentially influence further development and deployment of collaboration systems at a national level. I have used electronic referrals as a case. Practice consultants are General Pra...

Book Review: Deployment Psychology: Evidence-based strategies ...

African Journals Online (AJOL)

Book Review: Deployment Psychology: Evidence-based strategies to promote mental health in the Military. AB Adler, PD Bliese, CA Castro. Abstract. Washington, DC: American Psychological Association 2011 294 pages ISBN-13: 978-1-4338-0881-4. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Advancing Pre-Health Humanities as Intensive Research Practice: Principles and Recommendations from a Cross-Divisional Baccalaureate Setting.

Science.gov (United States)

Singer, Sarah Ann; Weed, Kym; Edwell, Jennifer; Jack, Jordynn; Thrailkill, Jane F

2017-12-01

This essay argues that pre-health humanities programs should focus on intensive research practice for baccalaureate students and provides three guiding principles for implementing it. Although the interdisciplinary nature of health humanities permits baccalaureate students to use research methods from the natural sciences, social sciences, and humanities, pre-health humanities coursework tends to force students to adopt only one of many disciplinary identities. Alternatively, an intensive research approach invites students to critically select and combine methods from multiple (and seemingly opposing) disciplines to ask and answer questions about health problems more innovatively. Using the authors' experiences with implementing health humanities baccalaureate research initiatives at The University of North Carolina at Chapel Hill, the authors contend that pre-health humanities programs should teach and study multiple disciplinary research methods and their values; examine how health humanities research might transfer across disciplines; and focus on mentoring opportunities for funding, presenting, and publishing research. These recommendations have the potential to create unprecedented research experiences for baccalaureate students as they prepare to enter careers within and beyond the allied health professions.

Monitoring Exposure to Ebola and Health of U.S. Military Personnel Deployed in Support of Ebola Control Efforts - Liberia, October 25, 2014-February 27, 2015.

Science.gov (United States)

Cardile, Anthony P; Murray, Clinton K; Littell, Christopher T; Shah, Neel J; Fandre, Matthew N; Drinkwater, Dennis C; Markelz, Brian P; Vento, Todd J

2015-07-03

In response to the unprecedented Ebola virus disease (Ebola) outbreak in West Africa, the U.S. government deployed approximately 2,500 military personnel to support the government of Liberia. Their primary missions were to construct Ebola treatment units (ETUs), train health care workers to staff ETUs, and provide laboratory testing capacity for Ebola. Service members were explicitly prohibited from engaging in activities that could result in close contact with an Ebola-infected patient or coming in contact with the remains of persons who had died from unknown causes. Military units performed twice-daily monitoring of temperature and review of exposures and symptoms ("unit monitoring") on all persons throughout deployment, exit screening at the time of departure from Liberia, and post-deployment monitoring for 21 days at segregated, controlled monitoring areas on U.S. military installations. A total of 32 persons developed a fever during deployment from October 25, 2014, through February 27, 2015; none had a known Ebola exposure or developed Ebola infection. Monitoring of all deployed service members revealed no Ebola exposures or infections. Given their activity restrictions and comprehensive monitoring while deployed to Liberia, U.S. military personnel constitute a unique population with a lower risk for Ebola exposure compared with those working in the country without such measures.

Wind Energy Deployment Process and Siting Tools (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Tegen, S.

2015-02-01

Regardless of cost and performance, some wind projects cannot proceed to completion as a result of competing multiple uses or siting considerations. Wind energy siting issues must be better understood and quantified. DOE tasked NREL researchers with depicting the wind energy deployment process and researching development considerations. This presentation provides an overview of these findings and wind siting tools.

Mastering Windows 7 Deployment

CERN Document Server

Finn, Aidan; van Surksum, Kenneth

2011-01-01

Get professional-level instruction on Windows 7 deployment tools Enterprise-level operating system deployment is challenging and requires knowledge of specific tools. It is expected that Windows 7 will be extensively deployed in businesses worldwide. This comprehensive Sybex guide provides thorough coverage of the Microsoft deployment tools that were specifically created for Windows 7, preparing system administrators, MIS professionals, and corporate programmers to tackle the task effectively.Companies worldwide are expected to deploy Windows 7 as their enterprise operating system; system admi

Hearing Loss and Tinnitus in Military Personnel with Deployment-Related Mild Traumatic Brain Injury.

Science.gov (United States)

Karch, Stephanie J; Capó-Aponte, José E; McIlwain, D Scott; Lo, Michael; Krishnamurti, Sridhar; Staton, Roger N; Jorgensen-Wagers, Kendra

2016-01-01

The objective of this study was to analyze differences in incidence and epidemiologic risk factors for significant threshold shift (STS) and tinnitus in deployed military personnel diagnosed with mild traumatic brain injury (mTBI) due to either a blast exposure or nonblast head injury. A retrospective longitudinal cohort study of electronic health records of 500 military personnel (456 met inclusion criteria) diagnosed with deployment-related mTBI was completed. Chi-square tests and STS incidence rates were calculated to assess differences between blast-exposed and nonblast groups; relative risks and adjusted odds ratios of developing STS or tinnitus were calculated for risk factors. Risk factors included such characteristics as mechanism of injury, age, race, military occupational specialty, concurrent diagnosis of posttraumatic stress disorder (PTSD), and nicotine use. Among blast-exposed and nonblast patients, 67% and 58%, respectively, developed STS, (P=.06); 59% and 40%, respectively, developed tinnitus (Ptinnitus. Unprotected noise exposure was associated with both STS and tinnitus. This study highlights potential risk factors for STS and tinnitus among blast-exposed and nonblast mTBI patient groups.

The Urban Teaching Cohort: Pre-Service Training to Support Mental Health in Urban Schools

Science.gov (United States)

Schwartz, Tammy; Dinnen, Hannah; Smith-Millman, Marissa K.; Dixon, Maressa; Flaspohler, Paul D.

2017-01-01

Supporting students' mental health needs is critical in high-poverty urban school districts where many students are at risk for mental health problems. Although teacher-student relationships are at the core of student mental health promotion in the classroom, many teacher preparation programmes do not adequately prepare pre-service teachers…

Pre- and post-bronchodilator lung function as predictors of mortality in the Lung Health Study

Directory of Open Access Journals (Sweden)

Diaz-Guzman Enrique

2011-10-01

Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD is supposed to be classified on the basis of post-bronchodilator lung function. Most longitudinal studies of COPD, though, do not have post-bronchodilator lung function available. We used pre-and post bronchodilator lung function data from the Lung Health Study to determine whether these measures differ in their ability to predict mortality. Methods We limited our analysis to subjects who were of black or white race, on whom we had complete data, and who participated at either the 1 year or the 5 year follow-up visit. We classified subjects based on their baseline lung function, according to COPD Classification criteria using both pre- and post-bronchodilator lung function. We conducted a survival analysis and logistic regression predicting death and controlling for age, sex, race, treatment group, smoking status, and measures of lung function (either pre- or post-bronchodilator. We calculated hazard ratios (HR with 95% confidence intervals (CI and also calculated area under the curve for the logistic regression models. Results By year 15 of the study, 721 of the original 5,887 study subjects had died. In the year 1 sample survival models, a higher FEV1 % predicted lower mortality in both the pre-bronchodilator (HR 0.87, 95% CI 0.81, 0.94 per 10% increase and post-bronchodilator (HR 0.84, 95% CI 0.77, 0.90 models. The area under the curve for the respective models was 69.2% and 69.4%. Similarly, using categories, when compared to people with "normal" lung function, subjects with Stage 3 or 4 disease had similar mortality in both the pre- (HR 1.51, 95% CI 0.75, 3.03 and post-bronchodilator (HR 1.45, 95% CI 0.41, 5.15 models. In the year 5 sample, when a larger proportion of subjects had Stage 3 or 4 disease (6.4% in the pre-bronchodilator group, mortality was significantly increased in both the pre- (HR 2.68, 95% CI 1.51, 4.75 and post-bronchodilator (HR 2.46, 95% CI 1.63, 3

Pain education in pre-registration professional health courses: a protocol for a scoping review.

Science.gov (United States)

Thompson, Kate; Milligan, James; Johnson, Mark I; Briggs, Michelle

2016-07-18

Pain is a global health concern causing significant health and social problems with evidence that patients experiencing pain are receiving inadequate care. The content of pain education in pre-registration professional health courses is thought to be lacking both in the UK and internationally which is unacceptable considering the prevalence of pain. Evaluating the effect of education is complex in that the outcome (improved healthcare) is some distance from the educational approach. Best evidence medical education has been proposed as a continuum between 'opinion-based teaching' and 'evidence-based teaching'. Searching for evidence to inform best practice in health education is complex. A scoping review provides a practical and comprehensive strategy to locate and synthesise literature of varied methodology including reports from a variety of sources. The aim of this article is to describe a protocol for a scoping review that will locate, map and report research, guidelines and policies for pain education in pre-registration professional health courses. The extent, range and nature of reports will be examined, and where possible titles for potential systematic review will be identified. Reports will be included for review that are directly relevant to the development of the pain curriculum in pre-registration professional health courses, eg nursing, medicine, physiotherapy. The search strategy will identify reports that include [pain] AND [pre-registration education or curriculum] AND [health professionals] in the title or abstract. Two authors will independently screen retrieved studies against eligibility criteria. A numerical analysis regarding the extent, nature and distribution of reports will be given along with a narrative synthesis to describe characteristics of relevant reports. Formal ethical approval was not required to undertake this scoping review. Findings will be published in scientific peer-reviewed journals and via conference presentations

IPV6 Deployment - Mauritius to benefit from Opportunities and World ...

African Journals Online (AJOL)

user1

gaming, and many other new applications cost even higher to be deployed on IPv4 ... mitigate the effects of the imminent depletion of the IPv4 address space and .... The government of Korea plans to achieve complete IPv6 transition in the.

Completing the Link between Exposure Science and Toxicology for Improved Environmental Health Decision Making: The Aggregate Exposure Pathway Framework.

Science.gov (United States)

Teeguarden, Justin G; Tan, Yu-Mei; Edwards, Stephen W; Leonard, Jeremy A; Anderson, Kim A; Corley, Richard A; Kile, Molly L; Simonich, Staci M; Stone, David; Tanguay, Robert L; Waters, Katrina M; Harper, Stacey L; Williams, David E

2016-05-03

Driven by major scientific advances in analytical methods, biomonitoring, computation, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the "systems approaches" used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) concept in the toxicological sciences. Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more meaningful integration of exposure assessment and hazard identification. Together, the two frameworks form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making.

Deployment Plan for Small Roving Annulus Inspection Vehicle

International Nuclear Information System (INIS)

Minichan, R.

2002-01-01

The Small Roving Annulus Inspection Vehicle (SRAIV) is a modified commercially available wall crawler designed to supplement the In-Service Inspection (ISI) of Savannah River Site (SRS) Waste tanks. The SRAIV provides an improved capability to achieve a more complete inspection of the tank walls than existing methods. The SRAIV will be deployed through annulus risers in the tank to gain access to tank walls requiring inspection. The SRAIV will be deployed using a manually operated deployment pole and will be coupled to the wall using permanent magnet wheels. Navigation will be performed from the remote console where pictorial views can be displayed from the on-board cameras. The unit will incorporate multiple UT transducers for traditional weld examination. In addition, a specially developed Tandem Synthetic Aperture Focusing Technique (TSAFT) UT scanning bridge can be attached to provide further investigation of the knuckle region while the vehicle remains on the vertical surface of the tank wall. In summary, the SRAIV will provide features that enhance and expand the capability of the SRS ISI program

Deploying Healthcare Technology “in the wild”: Experiences from Deploying a Mobile Health Technology for Bipolar Disorder Treatment

DEFF Research Database (Denmark)

Frost, Mads; Houben, Steven

2014-01-01

In this case study, we report on experiences, situations, and lessons learned from working on the MONARCA research project, completed in close collaboration with patients and clinicians from the Affective Disorder Clinic at the University Hospital Copenhagen in Denmark. We discuss aspects...... of the design, implementation, and evaluation of MONARCA, and summarise some of the key issues and challenges that presented themselves during our work, including: • Recruiting and motivating mental health patients to participate in healthcare technology research; • Challenges that occur during data collection...

[Possible health effects associated with Pre-Columbian metallurgy].

Science.gov (United States)

Idrovo, Alvaro Javier

2005-09-01

In the Old World, several researchers have indicated that adverse health effects were associated with exposure to arsenic, and that this influenced a change in the use of copper-arsenic alloys to others less toxic. This hypothesis was evaluated for three Pre-Columbian metallurgy traditions: Central Andes, Intermediate Area, and West Mexico. The metal artifacts from the Central Andes showed arsenic concentrations similar to those in the Old World (0.5%-1.0%). In the Intermediate Area the values were smallest; however, in West Mexico the arsenic content was very high (7%-25%). In Central Andes arsenical bronze was used initially, but copper-tin alloys when introduced were preferred and distributed throughout the Inca Empire. Osteological and artistic evidences of foot amputations among Moche individuals from Central Andes support the presence of "black foot disease" (a condition associated with arsenic poisoning) among Pre-Columbian populations. In conclusion, the adverse effects of arsenic have been observed in the New World, and that these effects promoted a change toward the use of less toxic alloys.

Effects of changes in the pre-licensure education of health workers on health-worker supply.

Science.gov (United States)

Pariyo, George W; Kiwanuka, Suzanne N; Rutebemberwa, Elizeus; Okui, Olico; Ssengooba, Freddie

2009-04-15

The current and projected crisis because of a shortage of health workers in low and middle-income countries (LMICs) requires that effective strategies for expanding the numbers of health workers are quickly identified in order to inform action by policymakers, educators, and health managers. To assess the effect of changes in the pre-licensure education of health professionals on health-worker supply. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 3), EMBASE, Ovid (1980 to week 3, October 2007), MEDLINE, Ovid (1950 to week 3, October 2007), CINAHL (October 2007), LILACS (week 4, November 2007), ERIC (1966 to week 3, February 2008), and Sociological Abstracts (October 2007). We searched WHO (WHOLIS) (February 2008), World Bank, Google Scholar, and human resources on health-related websites to obtain grey literature. Key experts in human resources for health were contacted to identify unpublished studies. The reference lists of included studies were searched for additional articles. Randomised controlled trials, non-randomised controlled trials, controlled before and after studies, and interrupted time-series studies that measured increased numbers of health workers ultimately available for recruitment into the health workforce or improved patient to health professional ratios as their primary outcomes were considered. Although the focus of the review was on LMIC, we included studies regardless of where they were done. Heterogeneity between the two included studies precluded meta-analysis; therefore, data were presented separately for each study. Two studies of the 7880 identified from searching the electronic databases met the inclusion criteria. Both studies were controlled before and after studies, of moderate to high risk of bias, that explored the effects of interventions to improve retention of minority groups in health professional training institutions. These studies reported that an intervention

Verify Occulter Deployment Tolerances as Part of NASA's Technology Development for Exoplanet Missions

Science.gov (United States)

Kasdin, N. J.; Shaklan, S.; Lisman, D.; Thomson, M.; Webb, D.; Cady, E.; Marks, G. W.; Lo, A.

2013-01-01

In support of NASA's Exoplanet Exploration Program and the Technology Development for Exoplanet Missions (TDEM), we recently completed a 2 year study of the manufacturability and metrology of starshade petals. An external occult is a satellite employing a large screen, or starshade, that flies in formation with a spaceborne telescope to provide the starlight suppression needed for detecting and characterizing exoplanets. Among the advantages of using an occulter are the broadband allowed for characterization and the removal of light before entering the observatory, greatly relaxing the requirements on the telescope and instrument. This poster presents the results of our successful first TDEM that demonstrated an occulter petal could be built and measured to an accuracy consistent with close to 10^-10 contrast. We also present the progress in our second TDEM to demonstrate the next critical technology milestone: precision deployment of the central truss and petals to the necessary accuracy. We have completed manufacture of four sub-scale petals and a central hub to fit with an existing deployable truss. We show the plans for repeated stow and deploy tests of the assembly and the metrology to confirm that each deploy repeatably meets the absolute positioning requirements of the petals (better than 1.0 mm).

Clustering of obesity and dental health with lifestyle factors among Turkish and Finnish pre-adolescents

DEFF Research Database (Denmark)

Cinar, Basak; Murtomaa, Heikki

2008-01-01

This study aims to assess any clustering between obesity, number of decayed, missing, and filled teeth (DMFT), television (TV) viewing, and lifestyle factors among pre-adolescents living in 2 countries with different developmental status and oral health care systems - Turkey and Finland.......This study aims to assess any clustering between obesity, number of decayed, missing, and filled teeth (DMFT), television (TV) viewing, and lifestyle factors among pre-adolescents living in 2 countries with different developmental status and oral health care systems - Turkey and Finland....

An integrative review and evidence-based conceptual model of the essential components of pre-service education.

Science.gov (United States)

Johnson, Peter; Fogarty, Linda; Fullerton, Judith; Bluestone, Julia; Drake, Mary

2013-08-28

desired health outcomes. Professional regulation, deployment practices, workplace environment upon graduation and other service delivery contextual factors were analysed as influencing factors that affect educational outcomes and health impact. Our model for pre-service education reflects the investments that must be made by countries into programmes capable of leading to graduates who are competent for the health occupations and professions at the time of their entry into the workforce.

The relationship between parental religiosity and mental health of pre-adolescents in a community sample : The TRAILS study

NARCIS (Netherlands)

van der Jagt-Jelsma, Willeke; de Vries-Schot, Margreet; de Jong, Rint; Verhulst, Frank C.; Ormel, Johan; Veenstra, Rene; Swinkels, Sophie; Buitelaar, Jan

The purpose of this study is to examine the relationship between parental religiosity, parental harmony on the subject of religiosity, and the mental health of pre-adolescents. In a community-based sample of 2,230 pre-adolescents (10-12 years), mental health problems were assessed using self-report

[From Evidence to Health Policy Making: Pre-Exposure Prophylaxis for HIV Prevention].

Science.gov (United States)

Ko, Nai-Ying

2016-12-01

Pre-exposure prophylaxis (PrEP), in combination with traditional prevention strategies (such as condom use, voluntary HIV counseling and testing, and treatment for sexually transmitted infections), has been shown to effectively prevent HIV infection. As of September 2015, the World Health Organization recommends that people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention. This article introduces how to apply a systematic review using the methodology of Grading of Recommendations Assessment, Development and Evaluation (GRADE) to write clinical guidelines. With support from the Taiwan Centers for Disease Control, the Taiwan AIDS Society published clinical guidelines for oral pre-exposure prophylaxis in Taiwan. Nurses are responsible to apply evidence-based knowledge and to use their professional influence to shape health policies related to HIV prevention.

Pre-event trajectories of mental health and health-related disabilities, and post-event traumatic stress symptoms and health : A 7-wave population-based study

NARCIS (Netherlands)

van der Velden, Peter; Bosmans, Mark; van der Meulen, Erik; Vermunt, J.K.

2016-01-01

It is unknown to what extent classes of trajectories of pre-event mental health problems (MHP) and health-related disabilities (HRD), predict post-event traumatic stress symptoms (PTSS), MHP and HRD. Aim of the present 7-wave study was to assess the predictive values using a representative sample of

Operational Stress and Correlates of Mental Health Among Joint Task Force Guantanamo Bay Military Personnel.

Science.gov (United States)

Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L

2015-12-01

Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample. Copyright © 2015 International Society for Traumatic Stress Studies.

Pre-exercise screening and health coaching in CHD secondary prevention: a qualitative study of the patient experience.

Science.gov (United States)

Shaw, R; Gillies, M; Barber, J; MacIntyre, K; Harkins, C; Findlay, I N; McCloy, K; Gillie, A; Scoular, A; MacIntyre, P D

2012-06-01

Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly variable. In order to explore patients' experiences of a pre-exercise screening and health coaching programme (involving one-to-one consultations to support exercise behaviour change), semi-structured telephone interviews were undertaken with 84 CHD patients recruited from primary care. The interviews focused on patients' experiences of the intervention including referral and any recommendations for improvement. A thematic analysis of transcribed interviews showed that the majority of patients were positive about referral. However, patients also identified a number of barriers to attending and completing the programme, including a belief they were sufficiently active already, the existence of other health problems, feeling unsupported in community-based exercise classes and competing demands. Our findings highlight important issues around the choice of an appropriate point of intervention for programmes of this kind as well as the importance of appropriate patient selection, suggesting that the effectiveness of health coaching may be under-reported as a result of including patients who are not yet ready to change their behaviours.

The role of perceived threat in the emergence of PTSD and depression symptoms during warzone deployment.

Science.gov (United States)

Lancaster, Cynthia L; Cobb, Adam R; Lee, Han-Joo; Telch, Michael J

2016-07-01

Numerous studies have shown that level of exposure to combat-related stressors is a robust risk factor for posttraumatic stress disorder (PTSD) and depression among military personnel deployed to a warzone. Threat perception of warzone experiences assessed retrospectively has been consistently linked to increased risk for PTSD and depression months or even years after returning from deployment. However, little is known about concurrent relations between perceived threat, deployment stress, and stress-related symptoms during deployment. Using a novel in-theater web-based assessment system, we investigated the unique and joint contribution of threat perception and deployment stressors in predicting the emergence of PTSD and depression symptoms during deployment. Soldiers (N = 150) completed assessments of deployment stressors, perceived threat, PTSD symptoms, and depression symptoms throughout deployment to Iraq. Results revealed that perceived threat potentiated the increase in PTSD symptoms as a result of increases in deployment stressors. In contrast, perceived threat, but not warzone stressors, uniquely predicted depression symptoms. Results highlight the important role of threat perception as a risk marker for the acute experience of depression and PTSD symptoms during deployment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Effects of eHealth physical activity encouragement in adolescents with complex congenital heart disease: The PReVaiL randomized clinical trial.

Science.gov (United States)

Klausen, Susanne Hwiid; Andersen, Lars L; Søndergaard, Lars; Jakobsen, Janus Christian; Zoffmann, Vibeke; Dideriksen, Kasper; Kruse, Anne; Mikkelsen, Ulla Ramer; Wetterslev, Jørn

2016-10-15

To assess benefit and harms of adding an eHealth intervention to health education and individual counseling in adolescents with congenital heart disease. Randomized clinical trial. Denmark. A total of 158 adolescents aged 13-16years with no physical activity restrictions after repaired complex congenital heart disease. PReVaiL consisted of individually tailored eHealth encouragement physical activity for 52weeks. All patients received 45min of group-based health education and 15min of individual counseling involving patients' parents. The primary outcome was maximal oxygen uptake (VO2 peak) at 52weeks after randomization. The secondary outcome was physical activity. Exploratory outcomes were generic and disease-specific questionnaires. In the intervention group, 58 patients (72%) completed the final test, but of those, only 46 (57%) fulfilled the compliance criteria of using the eHealth application for at least 2 consecutive weeks. In the control group, 61 patients (79%) completed both exercise tests. Adjusted for baseline values, the difference between the intervention group and the control group in mean VO2 peak at 1year was -0.65ml·kg(-1)·min(-1) (95% CI -2.66 to 1.36). Between-group differences at 1year in physical activity, generic health-related quality of life, and disease-specific quality of life were not statistically significant. Adding a tailored eHealth intervention to health education and individual counseling did not affect outcomes among adolescents with congenital heart disease. Our results do not support the use of this eHealth intervention in adolescents with complex congenital heart disease. Clinical trials.gov identifier: NCT01189981. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Influence of military component and deployment-related experiences on mental disorders among Canadian military personnel who deployed to Afghanistan: a cross-sectional survey

Science.gov (United States)

Boulos, David; Fikretoglu, Deniz

2018-01-01

Objective The primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder. Design Data came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were limited to those with an Afghanistan deployment (population n=35 311; sampled n=4854). Logistic regression compared MHP between RegF and ResF members. Covariate-adjusted prevalence differences were computed. Primary outcome measure The primary outcomes were MHP, past-year mental disorders, identified using the WHO’s Composite International Diagnostic Interview, and past-year suicide ideation. Results ResF personnel were less likely to be identified with a past-year anxiety disorder (adjusted OR (AOR)=0.72 (95% CI 0.58 to 0.90)), specifically both generalised anxiety disorder and panic disorder, but more likely to be identified with a past-year alcohol abuse disorder (AOR=1.63 (95% CI 1.04 to 2.58)). The magnitude of the covariate-adjusted disorder prevalence differences for component was highest for the any anxiety disorder outcome, 2.8% (95% CI 1.0 to 4.6); lower for ResF. All but one deployment-related experience variable had some association with MHP. The ‘ever felt responsible for the death of a Canadian or ally personnel’ experience had the strongest association with MHP; its estimated covariate-adjusted disorder prevalence difference was highest for the any (of the six measured) mental disorder outcome (11.2% (95% CI 6.6 to 15.9)). Additionally, ResF reported less past-year MHSU and more past-year civilian MHSU. Conclusions Past-year MHP differences were

Health worker and policy-maker perspectives on use of intramuscular artesunate for pre-referral and definitive treatment of severe malaria at health posts in Ethiopia

Directory of Open Access Journals (Sweden)

Takele Kefyalew

2016-10-01

Full Text Available Abstract Background The World Health Organization (WHO recommends injectable artesunate given either intravenously or by the intramuscular route for definitive treatment for severe malaria and recommends a single intramuscular dose of intramuscular artesunate or intramuscular artemether or intramuscular quinine, in that order of preference as pre-referral treatment when definitive treatment is not possible. Where intramuscular injections are not available, children under 6 years may be administered a single dose of rectal artesunate. Although the current malaria treatment guidelines in Ethiopia recommend intra-rectal artesunate or alternatively intramuscular artemether or intramuscular quinine as pre-referral treatment for severe malaria at the health posts, there are currently no WHO prequalified suppliers of intra-rectal artesunate and when available, its use is limited to children under 6 years of age leaving a gap for the older age groups. Intramuscular artesunate is not part of the drugs recommended for pre-referral treatment in Ethiopia. This study assessed the perspectives of health workers, and policy-makers on the use of intramuscular artesunate as a pre-referral and definitive treatment for severe malaria at the health post level. Methods In-depth interviews were held with 101 individuals including health workers, malaria focal persons, and Regional Health Bureaus from Oromia and southern nations, nationalities, and peoples’ region, as well as participants from the Federal Ministry of Health and development partners. An interview guide was used in the data collection and thematic content analysis was employed for analysis. Results Key findings from this study are: (1 provision of intramuscular artesunate as pre-referral and definitive treatment for severe malaria at health posts could be lifesaving; (2 with adequate training, and provision of facilities including beds, health posts can provide definitive treatment for severe

Effect of Deploying Trained Community Based Reproductive Health Nurses (CORN) on Long-Acting Reversible Contraception (LARC) Use in Rural Ethiopia: A Cluster Randomized Community Trial.

Science.gov (United States)

Zerfu, Taddese Alemu; Ayele, Henok Taddese; Bogale, Tariku Nigatu

2018-06-01

To investigate the effect of innovative means to distribute LARC on contraceptive use, we implemented a three arm, parallel groups, cluster randomized community trial design. The intervention consisted of placing trained community-based reproductive health nurses (CORN) within health centers or health posts. The nurses provided counseling to encourage women to use LARC and distributed all contraceptive methods. A total of 282 villages were randomly selected and assigned to a control arm (n = 94) or 1 of 2 treatment arms (n = 94 each). The treatment groups differed by where the new service providers were deployed, health post or health center. We calculated difference-in-difference (DID) estimates to assess program impacts on LARC use. After nine months of intervention, the use of LARC methods increased significantly by 72.3 percent, while the use of short acting methods declined by 19.6 percent. The proportion of women using LARC methods increased by 45.9 percent and 45.7 percent in the health post and health center based intervention arms, respectively. Compared to the control group, the DID estimates indicate that the use of LARC methods increased by 11.3 and 12.3 percentage points in the health post and health center based intervention arms. Given the low use of LARC methods in similar settings, deployment of contextually trained nurses at the grassroots level could substantially increase utilization of these methods. © 2018 The Population Council, Inc.

Evaluating PTSD on Reproductive Outcomes: Women Deployed in Iraq and Afghanistan

Science.gov (United States)

2009-10-01

Center attacks and its effect on pregnancy outcome . Paediatric and Perinatal Epidemiology, 2005. 19(5): p. 334-41. 6. Xiong, X., et al., Exposure ...health system. Thus, the effect of women’s military service on reproductive outcomes is a key concern. Due to the unique situation of women in the... exposure to PTSD as a consequence of deployment is one example of recent concern. A recent study found women who had deployed to Iraq/Afghanistan

Post-deployment family violence among UK military personnel.

Science.gov (United States)

Kwan, Jamie; Jones, Margaret; Somaini, Greta; Hull, Lisa; Wessely, Simon; Fear, Nicola T; MacManus, Deirdre

2017-12-19

Research into violence among military personnel has not differentiated between stranger- and family-directed violence. While military factors (combat exposure and post-deployment mental health problems) are risk factors for general violence, there has been limited research on their impact on violence within the family environment. This study aims to compare the prevalence of family-directed and stranger-directed violence among a deployed sample of UK military personnel and to explore risk factors associated with both family- and stranger-directed violence. This study utilised data from a large cohort study which collected information by questionnaire from a representative sample of randomly selected deployed UK military personnel (n = 6711). The prevalence of family violence immediately following return from deployment was 3.6% and 7.8% for stranger violence. Family violence was significantly associated with having left service, while stranger violence was associated with younger age, male gender, being single, having a history of antisocial behaviour as well as having left service. Deployment in a combat role was significantly associated with both family and stranger violence after adjustment for confounders [adjusted odds ratio (aOR) = 1.92 (1.25-2.94), p = 0.003 and aOR = 1.77 (1.31-2.40), p violence both inside and outside the family environment and should be considered in violence reduction programmes for military personnel. Further research using a validated measurement tool for family violence would improve comparability with other research.

Implementation factors affecting the large-scale deployment of digital health and well-being technologies: A qualitative study of the initial phases of the 'Living-It-Up' programme.

Science.gov (United States)

Agbakoba, Ruth; McGee-Lennon, Marilyn; Bouamrane, Matt-Mouley; Watson, Nicholas; Mair, Frances S

2016-12-01

Little is known about the factors which facilitate or impede the large-scale deployment of health and well-being consumer technologies. The Living-It-Up project is a large-scale digital intervention led by NHS 24, aiming to transform health and well-being services delivery throughout Scotland. We conducted a qualitative study of the factors affecting the implementation and deployment of the Living-It-Up services. We collected a range of data during the initial phase of deployment, including semi-structured interviews (N = 6); participant observation sessions (N = 5) and meetings with key stakeholders (N = 3). We used the Normalisation Process Theory as an explanatory framework to interpret the social processes at play during the initial phases of deployment.Initial findings illustrate that it is clear - and perhaps not surprising - that the size and diversity of the Living-It-Up consortium made implementation processes more complex within a 'multi-stakeholder' environment. To overcome these barriers, there is a need to clearly define roles, tasks and responsibilities among the consortium partners. Furthermore, varying levels of expectations and requirements, as well as diverse cultures and ways of working, must be effectively managed. Factors which facilitated implementation included extensive stakeholder engagement, such as co-design activities, which can contribute to an increased 'buy-in' from users in the long term. An important lesson from the Living-It-Up initiative is that attempting to co-design innovative digital services, but at the same time, recruiting large numbers of users is likely to generate conflicting implementation priorities which hinder - or at least substantially slow down - the effective rollout of services at scale.The deployment of Living-It-Up services is ongoing, but our results to date suggest that - in order to be successful - the roll-out of digital health and well-being technologies at scale requires a delicate and pragmatic trade

Deploying Electronic Health Record

African Journals Online (AJOL)

SOFTLINKS DIGITAL

[11] Verisign Whitepaper (2005) Managing Application Security in Business ... health record (EHR) and Information Technology and the subsequent impact of ... advancements, said that IT must play a ... and history of medical status and other.

Development of psychopathology in deployed armed forces in relation to plasma GABA levels.

Science.gov (United States)

Schür, Remmelt R; Boks, Marco P; Geuze, Elbert; Prinsen, Hubertus C; Verhoeven-Duif, Nanda M; Joëls, Marian; Kahn, René S; Vermetten, Eric; Vinkers, Christiaan H

2016-11-01

The GABA system is pivotal for an adequate response to a stressful environment but has remained largely unexplored in this context. The present study investigated the relationship of prospectively measured plasma GABA levels with psychopathology symptoms in military deployed to Afghanistan at risk for developing psychopathology following trauma exposure during deployment, including posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Plasma GABA levels were measured in military personnel (N=731) one month prior to deployment (T0), and one (T1) and six months (T2) after deployment using ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS). Mental health problems and depressive symptoms were measured with the Dutch revised Symptom Checklist (SCL-90) and PTSD symptoms with the Dutch Self-Rating Inventory for PTSD (SRIP). Six months after deployment increases in GABA concentrations were present in individuals who had developed mental health problems (T2: β=0.06, p=1.6×10 -2 , T1: β=4.7×10 -2 , p=0.13), depressive symptoms (T2: β=0.29, p=7.9×10 -3 , T1: β=0.23, p=0.072) and PTSD symptoms at T2 (T2: β=0.12, p=4.3×10 -2 , T1: β=0.11, p=0.13). Plasma GABA levels prior to and one month after deployment poorly predicted a high level of psychopathology symptoms either one or six months after deployment. The number of previous deployments, trauma experienced during deployment, childhood trauma, age and sex were not significantly associated with plasma GABA levels over time. Exclusion of subjects who either started or stopped smoking, alcohol or medication use between the three time points rendered the association of increasing GABA levels with the emergence of psychopathology symptoms more pronounced (mental health problems at T2: β=0.09, p=4.2×10 -3 ; depressive symptoms at T2: β=0.35, p=3.5×10 -3 , PTSD symptoms at T2: β=0.17, p=1.7×10 -2 ). To our knowledge, this is the first study to provide

Lab-on-a-Drone: Toward Pinpoint Deployment of Smartphone-Enabled Nucleic Acid-Based Diagnostics for Mobile Health Care.

Science.gov (United States)

Priye, Aashish; Wong, Season; Bi, Yuanpeng; Carpio, Miguel; Chang, Jamison; Coen, Mauricio; Cope, Danielle; Harris, Jacob; Johnson, James; Keller, Alexandra; Lim, Richard; Lu, Stanley; Millard, Alex; Pangelinan, Adriano; Patel, Neal; Smith, Luke; Chan, Kamfai; Ugaz, Victor M

2016-05-03

We introduce a portable biochemical analysis platform for rapid field deployment of nucleic acid-based diagnostics using consumer-class quadcopter drones. This approach exploits the ability to isothermally perform the polymerase chain reaction (PCR) with a single heater, enabling the system to be operated using standard 5 V USB sources that power mobile devices (via battery, solar, or hand crank action). Time-resolved fluorescence detection and quantification is achieved using a smartphone camera and integrated image analysis app. Standard sample preparation is enabled by leveraging the drone's motors as centrifuges via 3D printed snap-on attachments. These advancements make it possible to build a complete DNA/RNA analysis system at a cost of ∼$50 ($US). Our instrument is rugged and versatile, enabling pinpoint deployment of sophisticated diagnostics to distributed field sites. This capability is demonstrated by successful in-flight replication of Staphylococcus aureus and λ-phage DNA targets in under 20 min. The ability to perform rapid in-flight assays with smartphone connectivity eliminates delays between sample collection and analysis so that test results can be delivered in minutes, suggesting new possibilities for drone-based systems to function in broader and more sophisticated roles beyond cargo transport and imaging.

FY2000 Hanford Technology Deployment Accomplishments Fact Sheets

International Nuclear Information System (INIS)

WIBLE, R.A.

2001-01-01

Cleaning up the Hanford Site is one of the top priorities for the U. S. Department of Energy. The department is continually looking for ways to expedite cleanup and reduce costs. During Fiscal Year (FY) 2000. Hanford Site staff deployed 24 new technologies, which produced an estimated lifecycle cost savings of 479 million dollars. This is a clear indicator of the impacts new technology has had and will have on the cleanup efforts. The Hanford Site cleanup is focused on the following: Restoring the Columbia River Corridor; Building and operating the tank waste treatment complex to complete the cleanup of highly radioactive tank waste at Hanford; and Transitioning the Central Plateau. Applying innovative science and technology from national laboratories, universities, and private industry is critical to our complex cleanup mission. The 24 new technologies deployed in FY 2000 are significantly higher than our goal of 14 technological deployments. Eleven of these technologies supported restoring the Columbia River Corridor, and seven were involved with the remediation of radioactive tank waste. These deployments produced valuable information to determine the effectiveness of the new technologies in the field and the efficiencies gained over existing cleanup methods. In several cases, the technology deployed presented a solution to a problem where a clear path of remediation had not yet been determined. New and innovative technologies will play a significant role in the cleanup of the Hanford Site and enable remediation to be done more efficiently. Technology is being developed at a staggering pace. This requires excellent communication throughout the scientific and industry arenas. To effect this communication, we have implemented a technology needs process in conjunction with the multi-year work planning process. Through the combination of these two processes, technology developments and deployments address the near-term technology needs and enable us to plan for the

Has India's national rural health mission reduced inequities in maternal health services? A pre-post repeated cross-sectional study.

Science.gov (United States)

Vellakkal, Sukumar; Gupta, Adyya; Khan, Zaky; Stuckler, David; Reeves, Aaron; Ebrahim, Shah; Bowling, Ann; Doyle, Pat

2017-02-01

In 2005, India launched the National Rural Health Mission (NRHM) to strengthen the primary healthcare system. NRHM also aims to encourage pregnant women, particularly of low socioeconomic backgrounds, to use institutional maternal healthcare. We evaluated the impacts of NRHM on socioeconomic inequities in the uptake of institutional delivery and antenatal care (ANC) across high-focus (deprived) Indian states. Data from District Level Household and Facility Surveys (DLHS) Rounds 1 (1995-99) and 2 (2000-04) from the pre-NRHM period, and Round 3 (2007-08), Round 4 and Annual Health Survey (2011-12) from post-NRHM period were used. Wealth-related and education-related relative indexes of inequality, and pre-post difference-in-differences models for wealth and education tertiles, adjusted for maternal age, rural-urban, caste, parity and state-level fixed effects, were estimated. Inequities in institutional delivery declined between pre-NRHM Period 1 (1995-99) and pre-NRHM Period 2 (2000-04), but thereafter demonstrated steeper decline in post-NRHM periods. Uptake of institutional delivery increased among all socioeconomic groups, with (1) greater effects among the lowest and middle wealth and education tertiles than highest tertile, and (2) larger equity impacts in the late post-NRHM period 2011-12 than in the early post-NRHM period 2007-08. No positive impact on the uptake of ANC was found in the early post-NRHM period 2007-08; however, there was considerable increase in the uptake of, and decline in inequity, in uptake of ANC in most states in the late post-NRHM period 2011-12. In high-focus states, NRHM resulted in increased uptake of maternal healthcare, and decline in its socioeconomic inequity. Our study suggests that public health programs in developing country settings will have larger equity impacts after its almost full implementation and widest outreach. Targeting deprived populations and designing public health programs by linking maternal and child

Frequency of color blindness in pre-employment screening in a tertiary health care center in Pakistan.

Science.gov (United States)

Chhipa, Shaukat Ali; Hashmi, Farzeen K; Ali, Shehreen; Kamal, Mustafa; Ahmad, Khabir

2017-01-01

To describe the frequency of color vision deficiency among Pakistani adults presenting for pre-employment health screening in a tertiary care hospital. The cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, and the data was collected for color vision deficiency, age, gender, and job applied for from pre-employment examination during 2013-2014. IBM SPSS 20 was used for statistical analysis. Three thousand four hundred and thirty seven persons underwent pre-employment screening during 2013 and 2014; 1837 (53.44%) were males and 1600 (46.65%) females. The mean age was 29.01 (±6.53) years. A total of 0.9% (32/3437) persons had color vision deficiency with male being 1.4% and female 0.4%. Color vision deficiency was observed in 0.9% of candidates screened for pre-employment health check up in a tertiary care hospital. The color vision deficiency was predominantly present in male individuals.

A Pilot Study of a 6-Week Parenting Program for Mothers of Pre-school Children Attending Family Health Centers in Karachi, Pakistan

Directory of Open Access Journals (Sweden)

Yasmin Khowaja

2016-02-01

Full Text Available Background Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-school children attending family health centres (FHCs in Karachi, the largest metropolitan city of Pakistan. Methods A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 intervention; n = 27 control participated in this study. Mothers in the intervention group received SOS Help for parents module, while mothers in the control group received information about routine childcare. A parenting scale (PS was administered before the program was implemented and repeated 2 weeks after the program was completed in both groups. Statistical analysis was performed to compare participants’ attributes. Descriptive analysis was conducted to compare pre- and post-test mean scores along with standard deviation for parenting subscales in the intervention and control groups. Results A total of 50 mothers (n = 25 intervention; n = 25 control completed the 6-week program. Attrition was observed as 5/30 (17% in the intervention arm and 2/27 (2% in the control arm. Mothers commonly reported the burden of daily domestic and social responsibilities as the main reason for dropping out. Furthermore, the majority of participants in the control group recommended increasing the duration of weekly sessions from 1 to 1.5 hours, thereby decreasing the program period from 6 to 4 weeks. Mothers in intervention group reported substantial improvement in parenting skills as indicated by mean difference in their pre- and post-test scores for laxness and over

Predicting Athletes’ Pre-Exercise Fluid Intake: A Theoretical Integration Approach

Directory of Open Access Journals (Sweden)

Chunxiao Li

2018-05-01

Full Text Available Pre-exercise fluid intake is an important healthy behavior for maintaining athletes’ sports performances and health. However, athletes’ behavioral adherence to fluid intake and its underlying psychological mechanisms have not been investigated. This prospective study aimed to use a health psychology model that integrates the self-determination theory and the theory of planned behavior for understanding pre-exercise fluid intake among athletes. Participants (n = 179 were athletes from college sport teams who completed surveys at two time points. Baseline (Time 1 assessment comprised psychological variables of the integrated model (i.e., autonomous and controlled motivation, attitude, subjective norm, perceived behavioral control, and intention and fluid intake (i.e., behavior was measured prospectively at one month (Time 2. Path analysis showed that the positive association between autonomous motivation and intention was mediated by subjective norm and perceived behavioral control. Controlled motivation positively predicted the subjective norm. Intentions positively predicted pre-exercise fluid intake behavior. Overall, the pattern of results was generally consistent with the integrated model, and it was suggested that athletes’ pre-exercise fluid intake behaviors were associated with the motivational and social cognitive factors of the model. The research findings could be informative for coaches and sport scientists to promote athletes’ pre-exercise fluid intake behaviors.

Development and Deployment of the OpenMRS-Ebola Electronic Health Record System for an Ebola Treatment Center in Sierra Leone.

Science.gov (United States)

Oza, Shefali; Jazayeri, Darius; Teich, Jonathan M; Ball, Ellen; Nankubuge, Patricia Alexandra; Rwebembera, Job; Wing, Kevin; Sesay, Alieu Amara; Kanter, Andrew S; Ramos, Glauber D; Walton, David; Cummings, Rachael; Checchi, Francesco; Fraser, Hamish S

2017-08-21

Stringent infection control requirements at Ebola treatment centers (ETCs), which are specialized facilities for isolating and treating Ebola patients, create substantial challenges for recording and reviewing patient information. During the 2014-2016 West African Ebola epidemic, paper-based data collection systems at ETCs compromised the quality, quantity, and confidentiality of patient data. Electronic health record (EHR) systems have the potential to address such problems, with benefits for patient care, surveillance, and research. However, no suitable software was available for deployment when large-scale ETCs opened as the epidemic escalated in 2014. We present our work on rapidly developing and deploying OpenMRS-Ebola, an EHR system for the Kerry Town ETC in Sierra Leone. We describe our experience, lessons learned, and recommendations for future health emergencies. We used the OpenMRS platform and Agile software development approaches to build OpenMRS-Ebola. Key features of our work included daily communications between the development team and ground-based operations team, iterative processes, and phased development and implementation. We made design decisions based on the restrictions of the ETC environment and regular user feedback. To evaluate the system, we conducted predeployment user questionnaires and compared the EHR records with duplicate paper records. We successfully built OpenMRS-Ebola, a modular stand-alone EHR system with a tablet-based application for infectious patient wards and a desktop-based application for noninfectious areas. OpenMRS-Ebola supports patient tracking (registration, bed allocation, and discharge); recording of vital signs and symptoms; medication and intravenous fluid ordering and monitoring; laboratory results; clinician notes; and data export. It displays relevant patient information to clinicians in infectious and noninfectious zones. We implemented phase 1 (patient tracking; drug ordering and monitoring) after 2

The use of well completion efficiency in the assessment of formation damage in initial well completion and workover operations

Directory of Open Access Journals (Sweden)

Amieibibama JOSEPH

2016-07-01

Full Text Available The calculation of well completion efficiency is very important in comparing pre/post workover or re-entry completion efficiencies of wells to enable the quantification and ranking of the success of workover operations. However, the quantification of the success of an operation could be misleading if comparisons are wrongly placed on wells or fields basis by different operators. In this work, comparative analysis of pre and post well completion efficiencies for different completions types are evaluated for wells in different fields using averaging techniques. According with this, the aim is to quantify the success rate of workover operations. The average completion efficiencies were calculated using the arithmetic mean for wells in different reservoirs and fields having the same completion type. The analysis of the results from the workover operation showed that some operations were successful while others are not and no field had all operations completely successful. Those that were adjudged successful are fields were enhanced production due to the operations was able to offset low productions from failed operations. However, it was observed in some fields that there was complete failure in the operations as all post-operation productions are lower than the pre-operation productions. The operations where failure occurred are due to loss of completion fluids into the formations, resulting to formation damage. Hence, chemical consolidation treatments must be handled with caution as they seem to be more susceptible to damage than other completion types.

A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports

OpenAIRE

Heywood Anita E; Watkins Rochelle E; Iamsirithaworn Sopon; Nilvarangkul Kessarawan; MacIntyre C

2012-01-01

Abstract Background Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. Methods Cross-sectional surveys were conducted between July and De...

Mastering Hyper-V Deployment

CERN Document Server

Finn, Aidan

2010-01-01

The only book to take an in-depth look at deploying Hyper-V. Now in its second generation, the popular Hyper-V boasts technical advances that create even more dynamic systems than ever before. This unique resource serves an authoritative guide to deploying Windows Server 2008 R2 Hyper-V comprehensively. Step-by-step instructions demonstrate how to design a Hyper-V deployment, build a Hyper-V host environment, and design a management system with System Center Virtual Machine Manager 2008 R2.: Features real-world examples that show you how to design a Hyper-V deployment, build a Hyper-V host env

Open pre-schools at integrated health services - A program theory

Directory of Open Access Journals (Sweden)

Agneta Abrahamsson

2013-04-01

Full Text Available Introduction: Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres.Method: A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre.Findings: The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents. Conclusion: The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.

Open pre-schools at integrated health services - A program theory

Directory of Open Access Journals (Sweden)

Agneta Abrahamsson

2013-04-01

Full Text Available Introduction: Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres. Method: A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre. Findings: The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents. Conclusion: The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.

An integrated environmental and health performance quantification model for pre-occupancy phase of buildings in China

Energy Technology Data Exchange (ETDEWEB)

Li, Xiaodong, E-mail: eastdawn@tsinghua.edu.cn; Su, Shu, E-mail: sushuqh@163.com; Zhang, Zhihui, E-mail: zhzhg@tsinghua.edu.cn; Kong, Xiangqin, E-mail: kxlwq@126.com

2017-03-15

To comprehensively pre-evaluate the damages to both the environment and human health due to construction activities in China, this paper presents an integrated building environmental and health performance (EHP) assessment model based on the Building Environmental Performance Analysis System (BEPAS) and the Building Health Impact Analysis System (BHIAS) models and offers a new inventory data estimation method. The new model follows the life cycle assessment (LCA) framework and the inventory analysis step involves bill of quantity (BOQ) data collection, consumption data formation, and environmental profile transformation. The consumption data are derived from engineering drawings and quotas to conduct the assessment before construction for pre-evaluation. The new model classifies building impacts into three safeguard areas: ecosystems, natural resources and human health. Thus, this model considers environmental impacts as well as damage to human wellbeing. The monetization approach, distance-to-target method and panel method are considered as optional weighting approaches. Finally, nine residential buildings of different structural types are taken as case studies to test the operability of the integrated model through application. The results indicate that the new model can effectively pre-evaluate building EHP and the structure type significantly affects the performance of residential buildings.

An integrated environmental and health performance quantification model for pre-occupancy phase of buildings in China

International Nuclear Information System (INIS)

Li, Xiaodong; Su, Shu; Zhang, Zhihui; Kong, Xiangqin

2017-01-01

To comprehensively pre-evaluate the damages to both the environment and human health due to construction activities in China, this paper presents an integrated building environmental and health performance (EHP) assessment model based on the Building Environmental Performance Analysis System (BEPAS) and the Building Health Impact Analysis System (BHIAS) models and offers a new inventory data estimation method. The new model follows the life cycle assessment (LCA) framework and the inventory analysis step involves bill of quantity (BOQ) data collection, consumption data formation, and environmental profile transformation. The consumption data are derived from engineering drawings and quotas to conduct the assessment before construction for pre-evaluation. The new model classifies building impacts into three safeguard areas: ecosystems, natural resources and human health. Thus, this model considers environmental impacts as well as damage to human wellbeing. The monetization approach, distance-to-target method and panel method are considered as optional weighting approaches. Finally, nine residential buildings of different structural types are taken as case studies to test the operability of the integrated model through application. The results indicate that the new model can effectively pre-evaluate building EHP and the structure type significantly affects the performance of residential buildings.

Solar sail deployment experiment

OpenAIRE

Shimose, Shigeru; 下瀬　滋

2006-01-01

Solar Sail move by receiving momentum of photons in sunlight. This paper presents results of some Spin-Stabilized Solar Sail deployment experiment. ISAS has successfully deployed, for the first time in the world, the polyimide Solar Sail taking advantage of centrifugal force in space. Based on this result, the new deployment mechanism is being developed which retracts the 50 m diameter sail.

Color impact in visual attention deployment considering emotional images

Science.gov (United States)

Chamaret, C.

2012-03-01

Color is a predominant factor in the human visual attention system. Even if it cannot be sufficient to the global or complete understanding of a scene, it may impact the visual attention deployment. We propose to study the color impact as well as the emotion aspect of pictures regarding the visual attention deployment. An eye-tracking campaign has been conducted involving twenty people watching half pictures of database in full color and the other half of database in grey color. The eye fixations of color and black and white images were highly correlated leading to the question of the integration of such cues in the design of visual attention model. Indeed, the prediction of two state-of-the-art computational models shows similar results for the two color categories. Similarly, the study of saccade amplitude and fixation duration versus time viewing did not bring any significant differences between the two mentioned categories. In addition, spatial coordinates of eye fixations reveal an interesting indicator for investigating the differences of visual attention deployment over time and fixation number. The second factor related to emotion categories shows evidences of emotional inter-categories differences between color and grey eye fixations for passive and positive emotion. The particular aspect associated to this category induces a specific behavior, rather based on high frequencies, where the color components influence the visual attention deployment.

CMS software deployment on OSG

International Nuclear Information System (INIS)

Kim, B; Avery, P; Thomas, M; Wuerthwein, F

2008-01-01

A set of software deployment tools has been developed for the installation, verification, and removal of a CMS software release. The tools that are mainly targeted for the deployment on the OSG have the features of instant release deployment, corrective resubmission of the initial installation job, and an independent web-based deployment portal with Grid security infrastructure login mechanism. We have been deploying over 500 installations and found the tools are reliable and adaptable to cope with problems with changes in the Grid computing environment and the software releases. We present the design of the tools, statistics that we gathered during the operation of the tools, and our experience with the CMS software deployment on the OSG Grid computing environment

CMS software deployment on OSG

Energy Technology Data Exchange (ETDEWEB)

Kim, B; Avery, P [University of Florida, Gainesville, FL 32611 (United States); Thomas, M [California Institute of Technology, Pasadena, CA 91125 (United States); Wuerthwein, F [University of California at San Diego, La Jolla, CA 92093 (United States)], E-mail: bockjoo@phys.ufl.edu, E-mail: thomas@hep.caltech.edu, E-mail: avery@phys.ufl.edu, E-mail: fkw@fnal.gov

2008-07-15

A set of software deployment tools has been developed for the installation, verification, and removal of a CMS software release. The tools that are mainly targeted for the deployment on the OSG have the features of instant release deployment, corrective resubmission of the initial installation job, and an independent web-based deployment portal with Grid security infrastructure login mechanism. We have been deploying over 500 installations and found the tools are reliable and adaptable to cope with problems with changes in the Grid computing environment and the software releases. We present the design of the tools, statistics that we gathered during the operation of the tools, and our experience with the CMS software deployment on the OSG Grid computing environment.

Odors, Deployment Stress, and Health: A Conditioning Analysis of Gulf War Syndrome

National Research Council Canada - National Science Library

Dalton, Pamela

2004-01-01

Troops deployed in the Persian Gulf War were exposed to an unusually diverse mix of odorous chemicals at the same time that they were exposed to physiological and psychological stressors, a scenario...

Health Status of Gulf War and Era Veterans Serving in the US Military in 2000.

Science.gov (United States)

Porter, Ben; Long, Kyna; Rull, Rudolph P; Dursa, Erin K

2018-05-01

This research describes Gulf War and era veterans enrolled in the Millennium Cohort Study, who were sampled from US military personnel serving in 2000, and compares health characteristics of this sample to a Department of Veterans Affairs study sampled from the complete population. Demographics characteristics of this sample were described. Self-reported health characteristics were compared between the two studies. Gulf War and era veterans in the Millennium Cohort were generally healthier than in the VA study; they had fewer medical conditions and mental health disorders and better self-reported health. In both studies, Gulf War veterans had poorer health outcomes than era veterans. The Millennium Cohort Study is a unique resource for examining the long-term health effects of Gulf War deployment, particularly comparing deployed and nondeployed personnel and examining illnesses with long latencies.

Risk factors for not completing health interventions and the potential impact on health inequalities between educational groups

DEFF Research Database (Denmark)

Kure-Biegel, Nanna; Schnohr, Christina Warrer; Hindhede, Anette Lykke

2016-01-01

BACKGROUND: Individual-based interventions aim to improve patient self-management of chronic disease and to improve lifestyle among people at high risk, to reduce the prevalence of diseases contributing to health inequality. The present study investigates risk factors for uncompleted health...... interventions, via a combination of quantitative and qualitative methods. METHODS: From a health centre in Copenhagen, questionnaire data on educational level, gender, age, and cohabitation status from 104 participants in health interventions were used to examine risks for dropout. Qualitative telephone...... with low socioeconomic status will most likely have reduced opportunities for making healthy choices, in this case, completing the intervention, and this may increase health inequality....

Odors, Deployment Stress, and Health: A Conditioning Analysis of Gulf War Syndrome

National Research Council Canada - National Science Library

Dalton, Pamela

2005-01-01

Troops deployed in the Persian Gulf War were exposed to an unusually diverse mix of odorous chemicals at the same time as they were exposed to physiological and psychological stressors B a scenario...

Odors, Deployment Stress and Health: A Conditioning Analysis of Gulf War Syndrome

National Research Council Canada - National Science Library

Dalton, Pamela

2006-01-01

Troops deployed in the Persian Gulf War were exposed to an unusually diverse mix of odorous chemicals at the same time as they were exposed to physiological and psychological stressors B a scenario...

Odors, Deployment Stress, and Health: A Conditioning Analysis of Gulf War Syndrome

National Research Council Canada - National Science Library

Dalton, Pamela

2002-01-01

Troops deployed in the Persian Gulf War were exposed to an unusually diverse mix of odorous chemicals at the same time as they were exposed to physiological and psychological stressors B a scenario...

Online pre-race education improves test scores for volunteers at a marathon.

Science.gov (United States)

Maxwell, Shane; Renier, Colleen; Sikka, Robby; Widstrom, Luke; Paulson, William; Christensen, Trent; Olson, David; Nelson, Benjamin

2017-09-01

This study examined whether an online course would lead to increased knowledge about the medical issues volunteers encounter during a marathon. Health care professionals who volunteered to provide medical coverage for an annual marathon were eligible for the study. Demographic information about medical volunteers including profession, specialty, education level and number of marathons they had volunteered for was collected. A 15-question test about the most commonly encountered medical issues was created by the authors and administered before and after the volunteers took the online educational course and compared to a pilot study the previous year. Seventy-four subjects completed the pre-test. Those who participated in the pilot study last year (N = 15) had pre-test scores that were an average of 2.4 points higher than those who did not (mean ranks: pilot study = 51.6 vs. non-pilot = 33.9, p = 0.004). Of the 74 subjects who completed the pre-test, 54 also completed the post-test. The overall post-pre mean score difference was 3.8 ± 2.7 (t = 10.5 df = 53 p online education demonstrated a long-term (one-year) increase in test scores. Testing also continued to show short-term improvement in post-course test scores, compared to pre-course test scores. In general, marathon medical volunteers who had no volunteer experience demonstrated greater improvement than those who had prior volunteer experience.

Extending the lifetime of wireless sensor network with partial SDN deployment

Directory of Open Access Journals (Sweden)

S. Tomovic

2016-06-01

Full Text Available Energy efficiency is one of the key requirements in Wireless Sensor Networks (WSNs. In order to optimize energy usage at sensor nodes, this paper proposes a new network architecture that relies on concepts of Software Defined Networking (SDN. Since SDN is a relatively new technology, originally envisioned for wired networks, it cannot be expected to get immediately and completely adopted in WSN domain, regardless of potential benefits. For this reason, we consider incremental SDN deployment where SDN nodes coexist with traditional sensor nodes, and propose a new routing algorithm for SDN controller that prolongs the WSN lifetime even when a small percentage of SDN nodes is deployed.

Cultural competence education for health professionals from pre-graduation to licensure delivered using facebook: Twelve-month follow-up on a randomized control trial.

Science.gov (United States)

Chang, Li-Chun; Guo, Jong Long; Lin, Hui-Ling

2017-12-01

Cultural competence (CC) training is widely recognized as a crucial component of the professional development of healthcare providers. There is no study on the effect of Facebook (FB) as a strategy to promote continual learning to enhance CC among students in health professions. To test the effects of cultural competence education using FB as a delivery platform on knowledge, awareness, self-efficacy, and skill related to CC in health students from pre-graduation to licensed professional stages. A randomized controlled trial. We recruited students from professional nursing, pharmacy, and nutrition programs at six medical universities and randomly assigned them to study groups. Between T1 and T2 (months 1-3), the intervention group (IG) received pre-graduation education in CC while the control group (CG) received their regular educational program. Between T2 and T3 (months 6-9), IG received on-the-job education in CC while CG received the regular program. An online self-report questionnaire assessing CC knowledge, awareness, self-efficacy, and skill was analyzed at baseline, 6months, and 12months. Of 180 participants who completed the pretest, 120 (65 IG and 55 CG) completed both follow-ups. Changes over time were mixed; the only statistical difference between groups was an improvement in awareness in IG but not in CG. At 12months, intervention and control participants had different levels of awareness of CC (β=2.56, p<0.001), but other outcomes did not differ between groups. Health profession educators can adopt Facebook as an education delivery platform to offer personalized, social learning incorporating cultural competency curricula into ongoing education and training in rising awareness on CC. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gender differences in the risk and protective factors associated with PTSD: a prospective study of National Guard troops deployed to Iraq.

Science.gov (United States)

Kline, Anna; Ciccone, Donald S; Weiner, Marc; Interian, Alejandro; St Hill, Lauren; Falca-Dodson, Maria; Black, Christopher M; Losonczy, Miklos

2013-01-01

This study examines gender differences in post-traumatic stress symptoms (PTSS) and PTSS risk/protective factors among soldiers deployed to Iraq. We pay special attention to two potentially modifiable military factors, military preparedness and unit cohesion, which may buffer the deleterious psychological effects of combat. Longitudinal data were collected on 922 New Jersey National Guard soldiers (91 women) deployed to Iraq in 2008. Anonymous surveys administered at pre- and post-deployment included the PTSD Checklist (PCL), the Unit Support Scale, and a preparedness scale adapted from the Iowa Gulf War Study. Bivariate analyses and hierarchical multiple regression were used to identify predictors of PTSS and their explanatory effects on the relationship between gender and PTSS. Women had a higher prevalence of probable post-deployment PTSD than men (18.7% vs. 8.7%; OR = 2.45; CI [1.37, 4.37]) and significantly higher post-deployment PTSS (33.73 vs. 27.37; p = .001). While there were no gender differences in combat exposure, women scored higher on pre-deployment PTSS (26.9 vs. 23.1; p ≤ .001) and lower on military preparedness (1.65 vs. 2.41; p ≤ .001) and unit cohesion (32.5 vs. 38.1; p ≤ .001). In a multivariate model, controlling for all PTSS risk/resilience factors reduced the gender difference as measured by the unstandardized Beta (B) by 45%, with 18% uniquely attributable to low cohesion and low preparedness. In the fully controlled model, gender remained a significant predictor of PTSS but the effect size was small (d = .26). Modifiable military institutional factors may account for much of the increased vulnerability of women soldiers to PTSD.

Influence of military component and deployment-related experiences on mental disorders among Canadian military personnel who deployed to Afghanistan: a cross-sectional survey.

Science.gov (United States)

Boulos, David; Fikretoglu, Deniz

2018-03-12

The primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder. Data came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were limited to those with an Afghanistan deployment (population n=35 311; sampled n=4854). Logistic regression compared MHP between RegF and ResF members. Covariate-adjusted prevalence differences were computed. The primary outcomes were MHP, past-year mental disorders, identified using the WHO's Composite International Diagnostic Interview, and past-year suicide ideation. ResF personnel were less likely to be identified with a past-year anxiety disorder (adjusted OR (AOR)=0.72 (95% CI 0.58 to 0.90)), specifically both generalised anxiety disorder and panic disorder, but more likely to be identified with a past-year alcohol abuse disorder (AOR=1.63 (95% CI 1.04 to 2.58)). The magnitude of the covariate-adjusted disorder prevalence differences for component was highest for the any anxiety disorder outcome, 2.8% (95% CI 1.0 to 4.6); lower for ResF. All but one deployment-related experience variable had some association with MHP. The 'ever felt responsible for the death of a Canadian or ally personnel' experience had the strongest association with MHP; its estimated covariate-adjusted disorder prevalence difference was highest for the any (of the six measured) mental disorder outcome (11.2% (95% CI 6.6 to 15.9)). Additionally, ResF reported less past-year MHSU and more past-year civilian MHSU. Past-year MHP differences were identified between components. Our findings suggest that although

Combat deployment is associated with sexual harassment or sexual assault in a large, female military cohort.

Science.gov (United States)

Leardmann, Cynthia A; Pietrucha, Amanda; Magruder, Kathryn M; Smith, Besa; Murdoch, Maureen; Jacobson, Isabel G; Ryan, Margaret A K; Gackstetter, Gary; Smith, Tyler C

2013-01-01

Previous studies have examined the prevalence, risk factors, and health correlates of sexual stressors in the military, but have been limited to specific subpopulations. Furthermore, little is known about sexual stressors' occurrence and their correlates in relation to female troops deployed to the current operations in Iraq and Afghanistan. Using longitudinal data from Millennium Cohort participants, the associations of recent deployment as well as other individual and environmental factors with sexual harassment and sexual assault were assessed among U.S. female military personnel. Multivariable analyses were used to investigate the associations. Of 13,262 eligible participants, 1,362 (10.3%) reported at least one sexual stressor at follow-up. Women who deployed and reported combat experiences were significantly more likely to report sexual harassment (odds ratio [OR], 2.20; 95% confidence interval [CI], 1.84-2.64) or both sexual harassment and sexual assault (OR, 2.47; 95% CI, 1.61-3.78) compared with nondeployers. In addition, significant risk factors for sexual stressors included younger age, recent separation or divorce, service in the Marine Corps, positive screen for a baseline mental health condition, moderate/severe life stress, and prior sexual stressor experiences. Although deployment itself was not associated with sexual stressors, women who both deployed and reported combat were at a significantly increased odds for sexual stressors than other female service members who did not deploy. Understanding the factors associated with sexual stressors can inform future policy and prevention efforts to eliminate sexual stressors. Copyright © 2013 Jacobs Institute of Women's Health. All rights reserved.

Health risks due to pre-harvesting sugarcane burning in São Paulo State, Brazil

Directory of Open Access Journals (Sweden)

Maria Leticia de Souza Paraiso

2015-09-01

Full Text Available After 2003, a new period of expansion of the sugarcane culture began in Brazil. Pre-harvesting burning of sugarcane straw is an agricultural practice that, despite the nuisance for the population and pollution generated, still persisted in over 70% of the municipalities of São Paulo State in 2010. In order to study the distribution of this risk factor, an ecological epidemiological study was conducted associating the rates of deaths and hospital admissions for respiratory diseases, for each municipality in the State, with the exposure to the pre-harvesting burning of sugarcane straw. A Bayesian multivariate regression model, controlled for the possible effects of socioeconomic and climate (temperature, humidity, and rainfall variations, has been used. The effect on health was measured by the standardized mortality and morbidity ratio. The measures of exposure to the pre-harvesting burning used were: percentage of the area of sugarcane harvested with burning, average levels of aerosol, and number of outbreaks of burning. The autocorrelation between data was controlled using a neighborhood matrix. It was observed that the increase in the number of outbreaks of burning was significantly associated with higher rates of hospital admissions for respiratory disease in children under five years old. Pre-harvesting burning of sugarcane effectively imposes risk to population health and therefore it should be eliminated.

Tether Deployer And Brake

Science.gov (United States)

Carroll, Joseph A.; Alexander, Charles M.

1993-01-01

Design concept promises speed, control, and reliability. Scheme for deploying tether provides for fast, free, and snagless payout and fast, dependable braking. Developed for small, expendable tethers in outer space, scheme also useful in laying transoceanic cables, deploying guidance wires to torpedoes and missiles, paying out rescue lines from ship to ship via rockets, deploying antenna wires, releasing communication and power cables to sonobuoys and expendable bathythermographs, and in reeling out lines from fishing rods.

A Pre-Post Evaluation of OpenMinds: a Sustainable, Peer-Led Mental Health Literacy Programme in Universities and Secondary Schools.

Science.gov (United States)

Patalay, Praveetha; Annis, Jennifer; Sharpe, Helen; Newman, Robbie; Main, Dominic; Ragunathan, Thivvia; Parkes, Mary; Clarke, Kelly

2017-11-01

Engaging young people in the design and delivery of mental health education could lead to more effective interventions; however, few of these interventions have been evaluated. This study aimed to gain preliminary evidence with regards to the efficacy and acceptability of OpenMinds: a peer-designed and facilitated mental health literacy programme for university and secondary school students. The programme involves a structured programme of education and training for university medical students, who then deliver workshops in secondary schools. Pre- and post-surveys were completed by 234 school students who received two workshops and 40 university medical students who completed the OpenMinds programme and delivered the workshops. The main outcomes in both groups were components of mental health literacy (non-stigmatising attitudes, knowledge, social distance and helping attitudes). Perceived teaching efficacy and interest in mental health careers (university medical students) and workshop acceptability (school students) were also examined. University and school student participation in OpenMinds was associated with significant improvements in three of four mental health literacy elements in both samples. Knowledge and attitudes improved in both samples, social distance improved only in the university sample and knowledge of helping behaviours increased in the school sample. University students' perceived teaching efficacy improved but there was no change in their reported interest in pursuing psychiatry in their career. Acceptability was high; over 70% of the school students agreed that they enjoyed the workshops and liked being taught by a university student. This study provides preliminary evidence for the acceptability and efficacy of OpenMinds as a sustainable peer-led model of mental health education for young people. The OpenMinds programme is ready for efficacy testing in a randomised trial.

Law no. 111/1996 on the safe deployment of nuclear activities - A law central to the Romanian nuclear law system

International Nuclear Information System (INIS)

Chiripus, Vlad-Ionut

2004-01-01

Law no. 111/1996 on the safe deployment of nuclear activities was published in its original form in the Official Gazette of Romania, Part no. 267 of 29th October 1996. The complexity of this law prevents from performing a comprehensive analysis of the legal provisions thereof for which reason the author shall review only those aspects he consider to be relevant to the issues dealt with by this law. Furthermore, as the author intends his undertaking to be a comparative analysis of Law no. 111/1996 in its successive stages - from its issue till the present - he uses mostly the present tense even though the law has been amended and in some respects the changes are quite significant. The presentation contains the following three sections: 1. Passing of Law no. 111/1996 on the safe deployment of nuclear activities - a turning point in the development of the Romanian nuclear law; 2. The successive modifications of Law no. 111/1996 on safe deployment of nuclear activities; 3. Law no. 193/2003 for the modification and completion of Law no. 111/1996 on the safe deployment of nuclear activities - a key moment in the modernization of Romanian nuclear law and harmonization with the relevant international requirement. In conclusion, the issue of Law no. 111/1996 on safe deployment of nuclear activities represents a turning point in the development of Romanian nuclear law. From this moment on one may regard it as a modern area of the Romanian law, European in spirit. The pre-existent legal framework - namely the Law no. 61/1974 on the deployment of activities in the Romanian nuclear field - was no longer up to the existing standards and its replacement by a new, modern law, fully harmonized with the European and NATO accession requirements was a must. Such a new, European law was to fully guarantee the safe deployment of nuclear activities for exclusively peaceful purposes, so that the requirements regarding the nuclear safety, protection of professionally exposed personnel

Fusion Power Deployment

International Nuclear Information System (INIS)

Schmidt, J.A.; Ogden, J.M.

2002-01-01

Fusion power plants could be part of a future portfolio of non-carbon dioxide producing energy supplies such as wind, solar, biomass, advanced fission power, and fossil energy with carbon dioxide sequestration. In this paper, we discuss key issues that could impact fusion energy deployment during the last half of this century. These include geographic issues such as resource availability, scale issues, energy storage requirements, and waste issues. The resource needs and waste production associated with fusion deployment in the U.S. should not pose serious problems. One important feature of fusion power is the fact that a fusion power plant should be locatable within most local or regional electrical distribution systems. For this reason, fusion power plants should not increase the burden of long distance power transmission to our distribution system. In contrast to fusion power, regional factors could play an important role in the deployment of renewable resources such as wind, solar and biomass or fossil energy with CO2 sequestration. We examine the role of these regional factors and their implications for fusion power deployment

Health risks, travel preparation, and illness among public health professionals during international travel.

Science.gov (United States)

Balaban, Victor; Warnock, Eli; Ramana Dhara, V; Jean-Louis, Lee Ann; Sotir, Mark J; Kozarsky, Phyllis

2014-01-01

Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. Published by Elsevier Ltd.

Drivers Motivating Community Health Improvement Plan Completion by Local Public Health Agencies and Community Partners in the Rocky Mountain Region and Western Plains.

Science.gov (United States)

Hill, Anne; Wolf, Holly J; Scallan, Elaine; Case, Jenny; Kellar-Guenther, Yvonne

There are numerous drivers that motivate completion of community health improvement plans (CHIPs). Some are more obvious and include voluntary public health accreditation, state requirements, federal and state funding, and nonprofit hospital requirements through IRS regulations. Less is known about other drivers, including involvement of diverse partners and belief in best practices, that may motivate CHIP completion. This research investigated the drivers that motivated CHIP completion based on experiences of 51 local public health agencies (LPHAs). An explanatory mixed-methods design, including closed- and open-ended survey questions and key informant interviews, was used to understand the drivers that motivated CHIP completion. Analysis of survey data involved descriptive statistics. Classical content analysis was used for qualitative data to clarify survey findings. The surveys and key informant interviews were conducted in the Rocky Mountain Region and Western Plains among 51 medium and large LPHAs in Colorado, Kansas, Montana, Nebraska, North Dakota, South Dakota, Utah, and Wyoming. More than 50% of respondents were public health directors; the balance of the respondents were division/program directors, accreditation coordinators, and public health planners. CHIP completion. Most LPHAs in the Rocky Mountains and Western Plains have embraced developing and publishing a CHIP, with 80% having completed their plan and another 13% working on it. CHIP completion is motivated by a belief in best practices, with LPHAs and partners seeing the benefit of quality improvement activities linked to the CHIP and the investment of nonprofit hospitals in the process. Completing a CHIP is strengthened through engagement of diverse partners and a well-functioning partnership. The future of CHIP creation depends on LPHAs and partners investing in the CHIP as a best practice, dedicating personnel to CHIP activities, and enhancing leadership skills to contribute to a synergistic

Occupational health of miners at altitude: adverse health effects, toxic exposures, pre-placement screening, acclimatization, and worker surveillance.

Science.gov (United States)

Vearrier, David; Greenberg, Michael I

2011-08-01

Mining operations conducted at high altitudes provide health challenges for workers as well as for medical personnel. To review the literature regarding adverse health effects and toxic exposures that may be associated with mining operations conducted at altitude and to discuss pre-placement screening, acclimatization issues, and on-site surveillance strategies. We used the Ovid ( http://ovidsp.tx.ovid.com ) search engine to conduct a MEDLINE search for "coal mining" or "mining" and "altitude sickness" or "altitude" and a second MEDLINE search for "occupational diseases" and "altitude sickness" or "altitude." The search identified 97 articles of which 76 were relevant. In addition, the references of these 76 articles were manually reviewed for relevant articles. CARDIOVASCULAR EFFECTS: High altitude is associated with increased sympathetic tone that may result in elevated blood pressure, particularly in workers with pre-existing hypertension. Workers with a history of coronary artery disease experience ischemia at lower work rates at high altitude, while those with a history of congestive heart failure have decreased exercise tolerance at high altitude as compared to healthy controls and are at higher risk of suffering an exacerbation of their heart failure. PULMONARY EFFECTS: High altitude is associated with various adverse pulmonary effects, including high-altitude pulmonary edema, pulmonary hypertension, subacute mountain sickness, and chronic mountain sickness. Mining at altitude has been reported to accelerate silicosis and other pneumoconioses. Miners with pre-existing pneumoconioses may experience an exacerbation of their condition at altitude. Persons traveling to high altitude have a higher incidence of Cheyne-Stokes respiration while sleeping than do persons native to high altitude. Obesity increases the risk of pulmonary hypertension, acute mountain sickness, and sleep-disordered breathing. NEUROLOGICAL EFFECTS: The most common adverse neurological

Evaluating the data completeness in the Electronic Health Record after the Implementation of an Outpatient Electronic Health Record.

Science.gov (United States)

Soto, Mauricio; Capurro, Daniel; Catalán, Silvia

2015-01-01

Electronic health records (EHRs) present an opportunity for quality improvement in health organitations, particularly at the primary health level. However, EHR implementation impacts clinical workflows, and physicians frequently prefer to document in a non-structured way, which ultimately hinders the ability to measure quality indicators. We present an assessment of data completeness-a key data quality indicator-during the first 12 months after the implementation of an EHR at a teaching outpatient center in Santiago, Chile.

Severe Neuropsychiatric Reaction in a Deployed Military Member after Prophylactic Mefloquine

Directory of Open Access Journals (Sweden)

Alan L. Peterson

2011-01-01

Full Text Available Recent studies of military personnel who have deployed to Iraq and Afghanistan have reported a number of combat-related psychiatric disorders such as posttraumatic stress disorder, depression, and traumatic brain injury. This case report involves a 27-year-old male active-duty US military service member who developed severe depression, psychotic hallucinations, and neuropsychological sequelae following the prophylactic use of the antimalarial medication mefloquine hydrochloride. The patient had a recent history of depression and was taking antidepressant medications at the time of his deployment to the Middle East. Psychiatrists and other health care providers should be aware of the possible neuropsychiatric side effects of mefloquine in deployed military personnel and should consider the use of other medications for malaria prophylaxis in those individuals who may be at increased risk for side effects.

Effects of Combat Deployment on Anthropometrics and Physiological Status of U.S. Army Special Operations Forces Soldiers.

Science.gov (United States)

Farina, Emily K; Taylor, Jonathan C; Means, Gary E; Williams, Kelly W; Murphy, Nancy E; Margolis, Lee M; Pasiakos, Stefan M; Lieberman, Harris R; McClung, James P

2017-03-01

U.S. Army Special Operations Forces (SOF) soldiers deploy frequently and conduct military operations through special warfare and surgical strike capabilities. Tasks required to execute these capabilities may induce physical and mental stress and have the potential to degrade soldier physiological status. No investigations have longitudinally characterized whether combat deployment alters anthropometrics or biochemical markers of physiological status in a SOF population of frequent deployers. Effects of modern combat deployment on longitudinal changes in anthropometrics and physiological status of elite U.S. Army SOF soldiers (n = 50) were assessed. Changes in measures of body composition, grip strength, physiological status, and health behaviors from baseline to postdeployment were determined with paired t test and McNemar's statistic. Baseline measures were obtained between 4 and 8 weeks before deployment. Deployment length was a uniform duration of time between 3 and 6 months (all soldiers completed the same length of deployment). Post hoc analyses determined change in body mass within quartiles of baseline body mass with paired t test and associations between change in sex hormone-binding globulin (SHBG) and change in body mass with correlation coefficient. The study was approved by the Human Use Review Committee at the U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts. In response to deployment, increases in lean mass (77.1 ± 7.6 to 77.8 ± 7.5 kg), maximum grip strength (57.9 ± 7.2 to 61.6 ± 8.8 kg), and conduct of aerobic (156 ± 106 to 250 ± 182 minutes/week) and strength training (190 ± 101 to 336 ± 251 minutes/week) exercise were observed (p < 0.05). Increases in serum SHBG (35.42 ± 10.68 to 38.77 ± 12.26 nmol/L) and decreases in serum cortisol (443.2 ± 79.3 to 381.9 ± 111.6 nmol/L) were also observed (p < 0.05). Body mass changes were dependent on baseline body mass. Soldiers in the lowest quartile of baseline body

Evaluation of Methods for In-Situ Calibration of Field-Deployable Microphone Phased Arrays

Science.gov (United States)

Humphreys, William M.; Lockard, David P.; Khorrami, Mehdi R.; Culliton, William G.; McSwain, Robert G.

2017-01-01

Current field-deployable microphone phased arrays for aeroacoustic flight testing require the placement of hundreds of individual sensors over a large area. Depending on the duration of the test campaign, the microphones may be required to stay deployed at the testing site for weeks or even months. This presents a challenge in regards to tracking the response (i.e., sensitivity) of the individual sensors as a function of time in order to evaluate the health of the array. To address this challenge, two different methods for in-situ tracking of microphone responses are described. The first relies on the use of an aerial sound source attached as a payload on a hovering small Unmanned Aerial System (sUAS) vehicle. The second relies on the use of individually excited ground-based sound sources strategically placed throughout the array pattern. Testing of the two methods was performed in microphone array deployments conducted at Fort A.P. Hill in 2015 and at Edwards Air Force Base in 2016. The results indicate that the drift in individual sensor responses can be tracked reasonably well using both methods. Thus, in-situ response tracking methods are useful as a diagnostic tool for monitoring the health of a phased array during long duration deployments.

Deployment Health Centers Review, 2016-2017

Science.gov (United States)

2017-08-21

the short and long-term adverse effects of military service on the physical and mental health of veterans. We recommend that the DHB continue to...adverse effects of military service on the physical and mental health of veterans” by expanding on current clinical, surveillance, and research efforts...the ability to identify, treat, and minimize the short- and long-term adverse effects of military service on the mental and physical health of

The effects of pre-entry career maturity and support networks in workplace on newcomers' mental health.

Science.gov (United States)

Kawai, Kaoru; Yamazaki, Yoshihiko

2006-11-01

The present study examined the effects of pre-entry experiences (i.e. career maturity), as well as support networks (i.e. informational and friendship), on newcomers' mental health (i.e. depression, self-esteem, psychosomatic symptoms, and work motivation). We performed a longitudinal study of 890 men and women who first entered the workplace in 2003. Surveys were distributed at two time points: just prior to entering the workplace, and two months after entering. Results indicated that career maturity related positively to newcomers' mental health, and newcomers with high career maturity were more successful in establishing positive relationships with superiors and co-workers. Although, informational support networks positively related to work motivation, friendship networks did not show any direct effects on mental health. These results underscore the crucial roles of career maturity and informational networks in facilitating the transition to the workplace. The results also provide empirical support for an expanded view of the importance of pre-entry experiences to workplace newcomers' mental health.

Deployment of military mothers: supportive and nonsupportive military programs, processes, and policies.

Science.gov (United States)

Goodman, Petra; Turner, Annette; Agazio, Janice; Throop, Meryia; Padden, Diane; Greiner, Shawna; Hillier, Shannon L

2013-07-01

Military mothers and their children cope with unique issues when mothers are deployed. In this article, we present mothers' perspectives on how military resources affected them, their children, and their caregivers during deployment. Mothers described beneficial features of military programs such as family readiness groups and behavioral health care, processes such as unit support, and policies on length and timing of deployments. Aspects that were not supportive included inflexibility in family care plans, using personal leave time and funds for transporting children, denial of release to resolve caretaker issues, and limited time for reintegration. We offer recommendations for enhanced support to these families that the military could provide. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Part 8. Deployment considerations

International Nuclear Information System (INIS)

Dance, K.D.; Chang, Y.I.; Daly, T.A.

1980-01-01

This report addresses considerations of fast breeder reactor development and deployment from a national perspective. Nations vary greatly in their expertise and interest relative to nuclear power, and hence a single set of steps to be taken by a nation in decision-making on breeder development and deployment cannot be presented. The approach taken in this report is to present discussions on key factors influencing the breeder development and deployment decisions, especially in non-breeder nations, by drawing upon historical perspectives of the Light Water Reactor for comparison

Women at war: implications for mental health.

Science.gov (United States)

Dutra, Lissa; Grubbs, Kathleen; Greene, Carolyn; Trego, Lori L; McCartin, Tamarin L; Kloezeman, Karen; Morland, Leslie

2011-01-01

Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment posttraumatic stress disorder (PTSD) symptoms and depressive symptoms. Within 3 months of returning from deployment to Iraq, participants completed (a) the Combat Experiences Scale and the Sexual Harassment Scale of the Deployment Risk and Resilience Inventory, (b) the Primary Care PTSD Screen, and (c) an abbreviated version of the Center for Epidemiological Studies-Depression scale. Approximately three quarters of the sample endorsed exposure to combat experiences, and more than half of the sample reported experiencing deployment-related sexual harassment, with nearly half of the sample endorsing both stressors. Approximately one third of the sample endorsed clinical or subclinical levels of PTSD symptoms, with 11% screening positive for PTSD and 9% to 14% of the sample endorsing depressive symptoms. Regression analyses revealed that combat experiences and sexual harassment jointly accounted for significant variance in post-deployment PTSD symptoms, whereas military sexual harassment was identified as the only unique significant predictor of these symptoms. Findings from the present study lend support to research demonstrating that military sexual trauma may be more highly associated with post-deployment PTSD symptoms than combat exposure among female service members and veterans.

Prospective Assessment of Neurocognition in Future Gulf-deployed and Gulf-nondeployed Military Personnel: A Pilot Study

National Research Council Canada - National Science Library

Vasterling, Jennifer J; Proctor, Susan P

2007-01-01

Unexplained health symptoms appear to be ubiquitous to modern war. However, questions remain regarding linkages between military operational deployment and the development of physical or mental health symptoms...

Turbulent times: effects of turbulence and violence exposure in adolescence on high school completion, health risk behavior, and mental health in young adulthood.

Science.gov (United States)

Boynton-Jarrett, Renée; Hair, Elizabeth; Zuckerman, Barry

2013-10-01

Turbulent social environments are associated with health and developmental risk, yet mechanisms have been understudied. Guided by a life course framework and stress theory, this study examined the association between turbulent life transitions (including frequent residential mobility, school transitions, family structure disruptions, and homelessness) and exposure to violence during adolescence and high school completion, mental health, and health risk behaviors in young adulthood. Participants (n = 4834) from the U.S. National Longitudinal Survey of Youth, 1997 cohort were followed prospectively from age 12-14 years for 10 years. We used structural equation models to investigate pathways between turbulence and cumulative exposure to violence (CEV), and high school completion, mental health, and health risk behaviors, while accounting for early life socio-demographics, family processes, and individual characteristics. Results indicated that turbulence index was associated with cumulative exposure to violence in adolescence. Both turbulence index and cumulative exposure to violence were positively associated with higher health risk behavior, poorer mental health, and inversely associated with high school completion. These findings highlight the importance of considering the cumulative impact of turbulent and adverse social environments when developing interventions to optimize health and developmental trajectory for adolescents transitioning into adulthood. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Medical Humanities Effect: a Pilot Study of Pre-Health Professions Students at the University of Rochester.

Science.gov (United States)

Baker, Clayton J; Shaw, Margie Hodges; Mooney, Christopher J; Daiss, Susan Dodge-Peters; Clark, Stephanie Brown

2017-12-01

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students' responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches.

Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health.

Science.gov (United States)

Abalos, E; Cuesta, C; Carroli, G; Qureshi, Z; Widmer, M; Vogel, J P; Souza, J P

2014-03-01

To assess the incidence of hypertensive disorders of pregnancy and related severe complications, identify other associated factors and compare maternal and perinatal outcomes in women with and without these conditions. Secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health (WHOMCS) database. Cross-sectional study implemented at 357 health facilities conducting 1000 or more deliveries annually in 29 countries from Africa, Asia, Latin America and the Middle East. All women suffering from any hypertensive disorder during pregnancy, the intrapartum or early postpartum period in the participating hospitals during the study period. We calculated the proportion of the pre-specified outcomes in the study population and their distribution according to hypertensive disorders' severity. We estimated the association between them and maternal deaths, near-miss cases, and severe maternal complications using a multilevel logit model. Hypertensive disorders of pregnancy. Potentially life-threatening conditions among maternal near-miss cases, maternal deaths and cases without severe maternal outcomes. Overall, 8542 (2.73%) women suffered from hypertensive disorders. Incidences of pre-eclampsia, eclampsia and chronic hypertension were 2.16%, 0.28% and 0.29%, respectively. Maternal near-miss cases were eight times more frequent in women with pre-eclampsia, and increased to up to 60 times more frequent in women with eclampsia, when compared with women without these conditions. The analysis of this large database provides estimates of the global distribution of the incidence of hypertensive disorders of pregnancy. The information on the most frequent complications related to pre-eclampsia and eclampsia could be of interest to inform policies for health systems organisation. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?

Science.gov (United States)

Jones, M; Sundin, J; Goodwin, L; Hull, L; Fear, N T; Wessely, S; Rona, R J

2013-08-01

In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList-Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6-2.2] or elsewhere (OR 1.1, 95% CI 0.6-2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9-3.9). Childhood adversity (OR 3.3, 95% CI 2.1-5.0), having left service (OR 2.7, 95% CI 1.9-4.0) and serious accident (OR 2.1, 95% CI 1.4-3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12-0.76). For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.

Can Low-Cost Support Programmes with Coaching Accelerate Doctoral Completion in Health Science Faculty Academics?

Science.gov (United States)

Geber, Hilary; Bentley, Alison

2012-01-01

Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences…

Integrated care services: lessons learned from the deployment of the NEXES project.

Science.gov (United States)

Hernández, Carme; Alonso, Albert; Garcia-Aymerich, Judith; Grimsmo, Anders; Vontetsianos, Theodore; García Cuyàs, Francesc; Altes, Anna Garcia; Vogiatzis, Ioannis; Garåsen, Helge; Pellise, Laura; Wienhofen, Leendert; Cano, Isaac; Meya, Montserrat; Moharra, Montserrat; Martinez, Joan Ignasi; Escarrabill, Juan; Roca, Josep

2015-01-01

To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. One health care sector in Spain (Barcelona) (n = 11.382); six municipalities in Norway (Trondheim) (n = 450); and one hospital in Greece (Athens) (n = 388). The four services were: (i) Home-based long-term maintenance of rehabilitation effects (n = 337); (ii) Enhanced Care for frail patients, n = 1340); (iii) Home Hospitalization and Early Discharge (n = 2404); and Support for remote diagnosis (forced spirometry testing) in primary care (Support) (n = 8139). Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. The project demonstrated: (i) Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.

Impact of Deployment-Related Sexual Stressors on Psychiatric Symptoms After Accounting for Predeployment Stressors: Findings From a U.S. National Guard Cohort.

Science.gov (United States)

McCallum, Ethan B; Murdoch, Maureen; Erbes, Christopher R; Arbisi, Paul; Polusny, Melissa A

2015-08-01

This study used a longitudinal research design to examine the impact of predeployment stressors and deployment-related sexual stressors on self-reported psychiatric symptoms of U.S. National Guard soldiers returning from deployments to Iraq or Afghanistan. Prior to deployment, participants completed measures of depression and posttraumatic stress symptoms, along with an inventory of predeployment stressor experiences. At 3-months postdeployment, participants (468 men, 60 women) again completed self-report measures of psychiatric symptoms, along with an inventory of sexual stressors experienced during deployment. We compared a cross-sectional model of sexual stressors' impact on psychiatric symptoms, in which only postdeployment reports were considered, to a longitudinal model in which we adjusted for participants' predeployment stressors and psychiatric symptoms. No participants reported sexual assault during deployment, though sexual harassment was common. The cross-sectional model suggested that deployment-related sexual stressors were significantly associated with postdeployment depression (R(2) = .11) and posttraumatic stress symptoms (R(2) = .10). Once predeployment factors were taken into consideration, however, sexual stressors were no longer significant. The results did not support the notion of lasting negative impact for low-level sexual stressors (e.g., sexual harassment) during deployment after predeployment stressors are accounted for. Future studies of sexual stressors should consider longitudinal designs. © 2015 International Society for Traumatic Stress Studies.

Packing and deploying Soft Origami to and from cylindrical volumes with application to automotive airbags.

Science.gov (United States)

Bruton, Jared T; Nelson, Todd G; Zimmerman, Trent K; Fernelius, Janette D; Magleby, Spencer P; Howell, Larry L

2016-09-01

Packing soft-sheet materials of approximately zero bending stiffness using Soft Origami (origami patterns applied to soft-sheet materials) into cylindrical volumes and their deployment via mechanisms or internal pressure (inflation) is of interest in fields including automobile airbags, deployable heart stents, inflatable space habitats, and dirigible and parachute packing. This paper explores twofold patterns, the 'flasher' and the 'inverted-cone fold', for packing soft-sheet materials into cylindrical volumes. Two initial packing methods and mechanisms are examined for each of the flasher and inverted-cone fold patterns. An application to driver's side automobile airbags is performed, and deployment tests are completed to compare the influence of packing method and origami pattern on deployment performance. Following deployment tests, two additional packing methods for the inverted-cone fold pattern are explored and applied to automobile airbags. It is shown that modifying the packing method (using different methods to impose the same base pattern on the soft-sheet material) can lead to different deployment performance. In total, two origami patterns and six packing methods are examined, and the benefits of using Soft Origami patterns and packing methods are discussed. Soft Origami is presented as a viable method for efficiently packing soft-sheet materials into cylindrical volumes.

Ebola, fragile health systems and tuberculosis care: a call for pre-emptive action and operational research

NARCIS (Netherlands)

Zachariah, R.; Ortuno, N.; Hermans, V.; Desalegn, W.; Rust, S.; Reid, A.J.; Boeree, M.J.; Harries, A.D.

2015-01-01

The Ebola outbreak that started in late 2013 is by far the largest and most sustained in history. It occurred in a part of the world where pre-existing health systems were already fragile, and these deteriorated further during the epidemic due to a large number of health worker deaths; temporary or

EDITORIAL Wireless sensor networks: design for real-life deployment and deployment experiences Wireless sensor networks: design for real-life deployment and deployment experiences

Science.gov (United States)

Gaura, Elena; Roedig, Utz; Brusey, James

2010-12-01

Wireless sensor networks (WSNs) are among the most promising technologies of the new millennium. The opportunities afforded by being able to program networks of small, lightweight, low-power, computation- and bandwidth-limited nodes have attracted a large community of researchers and developers. However, the unique set of capabilities offered by the technology produces an exciting but complex design space, which is often difficult to negotiate in an application context. Deploying sensing physical environments produces its own set of challenges, and can push systems into failure modes, thus revealing problems that can be difficult to discover or reproduce in simulation or the laboratory. Sustained efforts in the area of wireless networked sensing over the last 15 years have resulted in a large number of theoretical developments, substantial practical achievements, and a wealth of lessons for the future. It is clear that in order to bridge the gap between (on the one hand) visions of very large scale, autonomous, randomly deployed networks and (on the other) the actual performance of fielded systems, we need to view deployment as an essential component in the process of developing sensor networks: a process that includes hardware and software solutions that serve specific applications and end-user needs. Incorporating deployment into the design process reveals a new and different set of requirements and considerations, whose solutions require innovative thinking, multidisciplinary teams and strong involvement from end-user communities. This special feature uncovers and documents some of the hurdles encountered and solutions offered by experimental scientists when deploying and evaluating wireless sensor networks in situ, in a variety of well specified application scenarios. The papers specifically address issues of generic importance for WSN system designers: (i) data quality, (ii) communications availability and quality, (iii) alternative, low-energy sensing

Academic Institutions' Critical Guidelines for Health Care Workers Who Deploy to West Africa for the Ebola Response and Future Crises.

Science.gov (United States)

Cranmer, Hilarie; Aschkenasy, Miriam; Wildes, Ryan; Kayden, Stephanie; Bangsberg, David; Niescierenko, Michelle; Kemen, Katie; Hsiao, Kai-Hsun; VanRooyen, Michael; Burkle, Frederick M; Biddinger, Paul D

2015-10-01

The unprecedented Ebola Virus Disease (EVD) outbreak in West Africa, with its first cases documented in March 2014, has claimed the lives of thousands of people, and it has devastated the health care infrastructure and workforce in affected countries. Throughout this outbreak, there has been a critical lack of health care workers (HCW), including physicians, nurses, and other essential non-clinical staff, who have been needed, in most of the affected countries, to support the medical response to EVD, to attend to the health care needs of the population overall, and to be trained effectively in infection protection and control. This lack of sufficient and qualified HCW is due in large part to three factors: 1) limited HCW staff prior to the outbreak, 2) disproportionate illness and death among HCWs caused by EVD directly, and 3) valid concerns about personal safety among international HCWs who are considering responding to the affected areas. These guidelines are meant to inform institutions who deploy professional HCWs.

Prospective longitudinal evaluation of the effect of deployment-acquired traumatic brain injury on posttraumatic stress and related disorders: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

Science.gov (United States)

Stein, Murray B; Kessler, Ronald C; Heeringa, Steven G; Jain, Sonia; Campbell-Sills, Laura; Colpe, Lisa J; Fullerton, Carol S; Nock, Matthew K; Sampson, Nancy A; Schoenbaum, Michael; Sun, Xiaoying; Thomas, Michael L; Ursano, Robert J

2015-11-01

Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel. A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms. Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance. The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.

PTSD in the military: special considerations for understanding prevalence, pathophysiology and treatment following deployment

Science.gov (United States)

Yehuda, Rachel; Vermetten, Eric; McFarlane, Alexander C.; Lehrner, Amy

2014-01-01

Given the unique context of warzone engagement, which may include chronic threat, multiple and lengthy deployments, and loss, there is a need to understand whether and to what extent knowledge about PTSD derived from studies of civilian trauma exposure is generalizeable to the military. This special issue on PTSD in the military addresses a range of issues and debates related to mental health in military personnel and combat veterans. This article provides an overview of the issues covered in selected contributions that have been assembled for a special volume to consider issues unique to the military. Several leading scholars and military experts have contributed papers regarding: 1) prevalence rates of PTSD and other post-deployment mental health problems in different NATO countries, 2) the search for biomarkers of PTSD and the potential applications of such findings, and 3) prevention and intervention approaches for service members and veterans. The volume includes studies that highlight the divergence in prevalence rates of PTSD and other post-deployment mental health problems across nations and that discuss potential causes and implications. Included studies also provide an overview of research conducted in military or Veteran's Affairs settings, and overarching reviews of military-wide approaches to research, promotion of resilience, and mental health interventions in the Unites States and across NATO and allied ISAF partners. PMID:25206950

'I felt a little bubbly in my tummy': eliciting pre-schoolers' accounts of their health visit using a computer-assisted interview method.

Science.gov (United States)

Bokström, P; Fängström, K; Calam, R; Lucas, S; Sarkadi, A

2016-01-01

In the health care services, children's rights to participate in all matters that concern them are considered important. However, in practice this can be challenging with young children. In My Shoes (IMS) is a computer-assisted interview tool developed to help children talk about their experiences. The aim of the study was to evaluate the IMS' ability to elicit pre-schoolers' subjective experiences and accurate accounts of a routine health visit as well as the children's engagement in the interview process. Interviews were conducted with 23 children aged 4-5 years, 2-4 weeks after their health visit. The interviews were transcribed verbatim and analysed using a method inspired by Content Analysis to evaluate IMS's ability to elicit accounts about subjective experiences. Accurate accounts were assessed by comparing the transcribed interviews with the filmed visits at the child health centre. The children's engagement was defined by the completion and length of the interviews, and the children's interaction with the software. All children gave accounts about their subjective experiences, such as their emotional state during the visit, available toys or rewards they received. All children related to the correct event, they all named at least one person who was present and 87% correctly named at least one examination procedure. The majority of children (91%) completed the interview, which lasted 17-39 min (M = 24), and 96% interacted with the IMS software. IMS was feasible to help children describe their health care experiences, in both detail and depth. The children interacted with the software and maintained their interest for an extended period of time. © 2015 John Wiley & Sons Ltd.

Pre-admission factors and utilization of tutoring services in health professions educational programs.

Science.gov (United States)

Olivares-Urueta, Mayra; Williamson, Jon W

2013-01-01

Pre-admission factors tend to serve as indicators of student success in health professions educational programs, but less is known about the effects that academic assistance programs have on student success. This study sought to determine whether specific pre-admission factors could help to identify students who may require academic support during their health professions education. This retrospective analysis aimed to identify differences in pre-admission variables between those students requiring tutoring and a matched sample of students who did not require tutoring. One-way ANOVA was used to assess differences for dependent variables-age, cumulative GPA (cGPA), science GPA (sGPA), verbal graduate record examination (GRE) score, quantitative GRE score, analytical GRE score and combined GRE score, community college hours, average credit hours per semester, and highest semester credit hour load-across three groups of students who received no tutoring (NT 0 hrs), some tutoring (ST tutoring (MT >8 hrs). Total GRE and average semester hours differentiated NT from ST from MT (ptutoring: quantitative GRE, sGPA, cGPA and average semester hours taken. The combination of lower GRE scores and lighter average semester course load were most predictive of the need for academic assistance as defined by hours of tutoring. While the value of the GRE in admissions processes is generally accepted, the average semester hour load in college can also provide important information regarding academic preparation and the need for tutoring services.

SMUD Community Renewable Energy Deployment Final Report

Energy Technology Data Exchange (ETDEWEB)

Sison-Lebrilla, Elaine [Sacramento Municipal Utility District, Sacramento, CA (United States); Tiangco, Valentino [Sacramento Municipal Utility District, Sacramento, CA (United States); Lemes, Marco [Sacramento Municipal Utility District, Sacramento, CA (United States); Ave, Kathleen [Sacramento Municipal Utility District, Sacramento, CA (United States)

2015-06-08

This report summarizes the completion of four renewable energy installations supported by California Energy Commission (CEC) grant number CEC Grant PIR-11-005, the US Department of Energy (DOE) Assistance Agreement, DE-EE0003070, and the Sacramento Municipal Utility District (SMUD) Community Renewable Energy Deployment (CRED) program. The funding from the DOE, combined with funding from the CEC, supported the construction of a solar power system, biogas generation from waste systems, and anaerobic digestion systems at dairy facilities, all for electricity generation and delivery to SMUD’s distribution system. The deployment of CRED projects shows that solar projects and anaerobic digesters can be successfully implemented under favorable economic conditions and business models and through collaborative partnerships. This work helps other communities learn how to assess, overcome barriers, utilize, and benefit from renewable resources for electricity generation in their region. In addition to reducing GHG emissions, the projects also demonstrate that solar projects and anaerobic digesters can be readily implemented through collaborative partnerships. This work helps other communities learn how to assess, overcome barriers, utilize, and benefit from renewable resources for electricity generation in their region.

Addressing medical absenteeism in pre-vocational secondary students : Effectiveness of a public health intervention, using a quasi-experimental design

NARCIS (Netherlands)

Vanneste-van Zandvoort, Y.T.M.; Mathijssen, J.J.P.; Van de Goor, L.A.M.; Rots – de Vries, C.M.; Feron, F.J.M.

2016-01-01

Background Students’ health and school absenteeism affect educational level, with adverse effects on their future health. This interdependence is reflected in medical absenteeism. In the Netherlands, a public health intervention has been developed to address medical absenteeism in pre-vocational

Deployment IPv6 over IPv4 network infrastructure

OpenAIRE

Hoang, Tien Dung

2015-01-01

The purpose of this thesis is doing the research about IPv6, concentrate in how to deploy an IPv6 network based on IPv4 network without making any interruption to IPv4 network. This thesis is made for Financing and Promoting Technology Corporation (FPT) in Vietnam. This thesis is completed in two main parts. The theoretical part is making research about IPv4 and IPv6 to have the point of view about IPv4 and IPv6 basically, and from those one, seeing the advantages of IPv6 comparing wit...

Does pre-operative psychological distress affect patient satisfaction after primary total hip arthroplasty?

Directory of Open Access Journals (Sweden)

Nolan John

2011-06-01

Full Text Available Abstract Background There are concerns that pre-operative psychological distress might be associated with reduced patient satisfaction after total hip replacement (THR. Methods We investigated this in a multi-centre prospective study between January 1999 and January 2002. We dichotomised the patients into the mentally distressed (MHS ≤ 56 and the not mentally distressed (MHS > 56 groups based on their pre-operative Mental Health Score (MHS of SF36. Results 448 patients (340 not distressed and 108 distressed completed the patient satisfaction survey. Patient satisfaction rate at five year was 96.66% (415/448. There was no difference in patient satisfaction or willingness to have the surgery between the two groups. None of pre-operative variables predicted five year patient satisfaction in logistic regression. Conclusions Patient satisfaction after surgery may not be adversely affected by pre-operative psychological distress.

A complete history of everything

Science.gov (United States)

Lanclos, Kyle; Deich, William T. S.

2012-09-01

This paper discusses Lick Observatory's local solution for retaining a complete history of everything. Leveraging our existing deployment of a publish/subscribe communications model that is used to broadcast the state of all systems at Lick Observatory, a monitoring daemon runs on a dedicated server that subscribes to and records all published messages. Our success with this system is a testament to the power of simple, straightforward approaches to complex problems. The solution itself is written in Python, and the initial version required about a week of development time; the data are stored in PostgreSQL database tables using a distinctly simple schema. Over time, we addressed scaling issues as the data set grew, which involved reworking the PostgreSQL database schema on the back-end. We also duplicate the data in flat files to enable recovery or migration of the data from one server to another. This paper will cover both the initial design as well as the solutions to the subsequent deployment issues, the trade-offs that motivated those choices, and the integration of this history database with existing client applications.

5-Beam ADCP Deployment Strategy Considerations

Science.gov (United States)

Moore, T.; Savidge, D. K.; Gargett, A.

2016-02-01

With the increasing availability of 5 beam ADCPs and expanding opportunities for their deployment within both observatory and dedicated process study settings, refinements in deployment strategies are needed.Measuring vertical velocities directly with a vertically oriented acoustic beam requires that the instrument be stably mounted and leveled within fractions of a degree. Leveled shallow water deployments to date have utilized divers to jet pipes into the sand for stability, manually mount the instruments on the pipes, and level them. Leveling has been guided by the deployed instrument's pitch and roll output, available in real-time because of the observatory settings in which the deployments occurred. To expand the range of feasible deployments to deeper, perhaps non-real-time capable settings, alternatives to diver deployment and leveling must be considered. To determine stability requirements, mooring motion (heading, pitch and roll) has been sampled at 1Hz by gimballed ADCPs at a range of instrument deployment depths, and in shrouded and unshrouded cages. Conditions under which ADCP cages resting on the bottom experience significant shifts in tilt, roll or heading are assessed using co-located wind and wave measurements. The accuracy of estimating vertical velocities using all five beams relative to a well leveled vertical single beam is assessed from archived high frequency five beam data, to explore whether easing the leveling requirement is feasible.

Changes to Workflow and Process Measures in the PICU During Transition From Semi to Full Electronic Health Record.

Science.gov (United States)

Salib, Mina; Hoffmann, Raymond G; Dasgupta, Mahua; Zimmerman, Haydee; Hanson, Sheila

2015-10-01

Studies showing the changes in workflow during transition from semi to full electronic medical records are lacking. This objective study is to identify the changes in workflow in the PICU during transition from semi to full electronic health record. Prospective observational study. Children's Hospital of Wisconsin Institutional Review Board waived the need for approval so this study was institutional review board exempt. This study measured clinical workflow variables at a 72-bed PICU during different phases of transition to a full electronic health record, which occurred on November 4, 2012. Phases of electronic health record transition were defined as follows: pre-electronic health record (baseline data prior to transition to full electronic health record), transition phase (3 wk after electronic health record), and stabilization (6 mo after electronic health record). Data were analyzed for the three phases using Mann-Whitney U test with a two-sided p value of less than 0.05 considered significant. Seventy-two bed PICU. All patients in the PICU were included during the study periods. Five hundred and sixty-four patients with 2,355 patient days were evaluated in the three phases. Duration of rounds decreased from a median of 9 minutes per patient pre--electronic health record to 7 minutes per patient post electronic health record. Time to final note decreased from 2.06 days pre--electronic health record to 0.5 days post electronic health record. Time to first medication administration after admission also decreased from 33 minutes pre--electronic health record and 7 minutes post electronic health record. Time to Time to medication reconciliation was significantly higher pre-electronic health record than post electronic health record and percent of medication reconciliation completion was significantly lower pre--electronic health record than post electronic health record and percent of medication reconciliation completion was significantly higher pre

Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia

Directory of Open Access Journals (Sweden)

Heywood Anita E

2012-02-01

Full Text Available Abstract Background Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. Methods In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. Results A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8. Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P Conclusions Our study highlights the need to educate students about the risk associated with travel and improve preventative

Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia.

Science.gov (United States)

Heywood, Anita E; Zhang, Meng; MacIntyre, C Raina; Seale, Holly

2012-02-17

Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8). Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P students reported low risk perception of travel threats and a low corresponding concern for these threats. Our study highlights the need to educate students about the risk

Rapid deployment intrusion detection system

International Nuclear Information System (INIS)

Graham, R.H.

1997-01-01

A rapidly deployable security system is one that provides intrusion detection, assessment, communications, and annunciation capabilities; is easy to install and configure; can be rapidly deployed, and is reusable. A rapidly deployable intrusion detection system (RADIDS) has many potential applications within the DOE Complex: back-up protection for failed zones in a perimeter intrusion detection and assessment system, intrusion detection and assessment capabilities in temporary locations, protection of assets during Complex reconfiguration, and protection in hazardous locations, protection of assets during Complex reconfiguration, and protection in hazardous locations. Many DOE user-need documents have indicated an interest in a rapidly deployable intrusion detection system. The purpose of the RADIDS project is to design, develop, and implement such a system. 2 figs

Child maltreatment among U.S. Air Force parents deployed in support of Operation Iraqi Freedom/Operation Enduring Freedom.

Science.gov (United States)

Rabenhorst, Mandy M; McCarthy, Randy J; Thomsen, Cynthia J; Milner, Joel S; Travis, Wendy J; Colasanti, Marie P

2015-02-01

This study examined child maltreatment perpetration among 99,697 active-duty U.S. Air Force parents who completed a combat deployment. Using the deploying parent as the unit of analysis, we analyzed whether child maltreatment rates increased postdeployement relative to predeployment. These analyses extend previous research that used aggregate data and extend our previous work that used data from the same period but used the victim as the unit of analysis and included only deploying parents who engaged in child maltreatment. In this study, 2% (n = 1,746) of deploying parents perpetrated child maltreatment during the study period. Although no overall differences were found in child maltreatment rates postdeployment compared to predeployment, several maltreatment-related characteristics qualified this finding. Rates for emotional abuse and mild maltreatment were lower following deployment, whereas child maltreatment rates for severe maltreatment were higher following deployment. The finding that rates of severe child maltreatment, including incidents involving alcohol use, were higher postdeployment suggests a need for additional support services for parents following their return from combat deployment, with a focus on returning parents who have an alcohol use problem. © The Author(s) 2014.

Out-of-pocket expenditure and catastrophic health spending on maternal care in public and private health centres in India: a comparative study of pre and post national health mission period.

Science.gov (United States)

Mohanty, Sanjay K; Kastor, Anshul

2017-09-18

The National Health Mission (NHM), one of the largest publicly funded maternal health programs worldwide was initiated in 2005 to reduce maternal, neo-natal and infant mortality and out-of-pocket expenditure (OOPE) on maternal care in India. Though evidence suggests improvement in maternal and child health, little is known on the change in OOPE and catastrophic health spending (CHS) since the launch of NHM. The aim of this paper is to provide a comprehensive estimate of OOPE and CHS on maternal care by public and private health providers in pre and post NHM periods. The unit data from the 60th and 71st rounds of National Sample Survey (NSS) is used in the analyses. Descriptive statistics is used to understand the differentials in OOPE and CHS. The CHS is estimated based on capacity to pay, derived from household consumption expenditure, the subsistence expenditure (based on state specific poverty line) and household OOPE on maternal care. Data of both rounds are pooled to understand the impact of NHM on OOPE and CHS. The log-linear regression model and the logit regression models adjusted for state fixed effect, clustering and socio-economic and demographic correlates are used in the analyses. Women availing themselves of ante natal, natal and post natal care (all three maternal care services) from public health centres have increased from 11% in 2004 to 31% by 2014 while that from private health centres had increased from 12% to 20% during the same period. The mean OOPE on all three maternal care services from public health centres was US$60 in pre-NHM and US$86 in post-NHM periods while that from private health center was US$170 and US$300 during the same period. Controlling for socioeconomic and demographic correlates, the OOPE on delivery care from public health center had not shown any significant increase in post NHM period. The OOPE on delivery care in private health center had increased by 5.6 times compared to that from public health centers in pre NHM

Department of Defense, Deployment Health Clinical Center

Science.gov (United States)

... general public of trends in mental health and mental health care within the Military Health System Get The Numbers Real Warriors Campaign Real Warriors Campaign A multimedia public awareness campaign designed to combat the stigma associated with ...

PRE-CONCEPTIONAL PREPARATION OF WOMEN AND ITS INFLUENCE TO THE FETUS AND CHILD HEALTH

Directory of Open Access Journals (Sweden)

L.L. Nisevich

2008-01-01

Full Text Available The authors presented the results of the medical history, monitoring of the pregnancy and outcome of the delivery among 260 women with obstetric gynecologic anamnesis record and high risk of the fetus contamination split into 3 groups. 106 women (group I underwent the pre con ceptional preparation 2 to 4 months prior to pregnancy and received both conventional therapy and metabolic medications prior to and during pregnancy. 82 women (group II were observed from 2nd to 3rd trimester of pregnancy and also received metabolic medications. 72 women (group III were observed from the first weeks of pregnancy and received only conventional therapy during their pregnancy. The researchers discovered that all the women had different chronic diseases. The laboratory examination proved there was a high rate of contamination by different viruses and agents of sexually transmitted diseases. They also found out that the metabolic therapy during the pre con ceptional preparation and pregnancy leads to a drastic drop of different complications during pregnancy, delivery and down lying period, improves placenta function and optimizes the fetus development conditions, sizably reduces any chances of the fetus and newborn intrauterine infection, enhances the newborn adaptation and leads to reductions in the perinatal and infant mortality. Ever deteriorating health of women and various complications during pregnancy and delivery registered among the women, who underwent pre con ceptional preparation by metabolic correction, clearly show the necessity to take steps to prevent the women's diseases and keep their reproductive health from adolescence on.Key words: pre-conceptional preparation, metabolic medications, pregnancy, act of delivery, newborns, fetal infection, perinatal death.

Development and modeling of self-deployable structures

Science.gov (United States)

Neogi, Depankar

Deployable space structures are prefabricated structures which can be transformed from a closed, compact configuration to a predetermined expanded form in which they are stable and can bear loads. The present research effort investigates a new family of deployable structures, called the Self-Deployable Structures (SDS). Unlike other deployable structures, which have rigid members, the SDS members are flexible while the connecting joints are rigid. The joints store the predefined geometry of the deployed structure in the collapsed state. The SDS is stress-free in both deployed and collapsed configurations and results in a self-standing structure which acquires its structural properties after a chemical reaction. Reliability of deployment is one of the most important features of the SDS, since it does not rely on mechanisms that can lock during deployment. The unit building block of these structures is the self-deployable structural element (SDSE). Several SDSE members can be linked to generate a complex building block such as a triangular or a tetrahedral structure. Different SDSE and SDS concepts are investigated in the research work, and the performance of SDS's are experimentally and theoretically explored. Triangular and tetrahedral prototype SDS have been developed and presented. Theoretical efforts include modeling the behavior of 2-dimensional SDSs. Using this design tool, engineers can study the effects of different packing configurations and deployment sequence; and perform optimization on the collapsed state of a structure with different external constraints. The model also predicts if any lockup or entanglement occurs during deployment.

Modeling EERE Deployment Programs

Energy Technology Data Exchange (ETDEWEB)

Cort, K. A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hostick, D. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Belzer, D. B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Livingston, O. V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2007-11-01

This report compiles information and conclusions gathered as part of the “Modeling EERE Deployment Programs” project. The purpose of the project was to identify and characterize the modeling of deployment programs within the EERE Technology Development (TD) programs, address possible improvements to the modeling process, and note gaps in knowledge in which future research is needed.

Advantages of pre-production WLCG/EGEE services for VOs and users

CERN Document Server

Thackray, N; Fernandez Sanchez, C; Freire Garcia, E; Simon Garcia, A; Lopez Cacheiro, J

2008-01-01

The benefits that the Pre-Production Service (PPS) can offer to VOs and new users will be shown. Current PPS processes will be described so they have a better understanding of the PPS environment. PPS offers a proper place where VOs can test their applications and check their compatibility with upcoming middleware releases. PPS could help VOs improve their applications and at the same time, VOs would be helping PPS to produce better tested middleware releases that would go into Production (PROD) Currently a well-defined set of procedures is followed in PPS, beginning with the pre-deployment activity and finishing with the approval of a new middleware release that can go into PROD. The PPS Coordination Team takes care of supervising all these steps, mainly trying to spot possible bugs in the middleware before it goes into PROD. Unfortunately, VO contribution in this part of the deployment is currently very limited and the PPS team does not have a full feedback from these important groups. One of the problems i...

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

Directory of Open Access Journals (Sweden)

Dukers-Muijrers Nicole HTM

2012-12-01

Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

Advanced Deployable Structural Systems for Small Satellites

Science.gov (United States)

Belvin, W. Keith; Straubel, Marco; Wilkie, W. Keats; Zander, Martin E.; Fernandez, Juan M.; Hillebrandt, Martin F.

2016-01-01

One of the key challenges for small satellites is packaging and reliable deployment of structural booms and arrays used for power, communication, and scientific instruments. The lack of reliable and efficient boom and membrane deployment concepts for small satellites is addressed in this work through a collaborative project between NASA and DLR. The paper provides a state of the art overview on existing spacecraft deployable appendages, the special requirements for small satellites, and initial concepts for deployable booms and arrays needed for various small satellite applications. The goal is to enhance deployable boom predictability and ground testability, develop designs that are tolerant of manufacturing imperfections, and incorporate simple and reliable deployment systems.

Pre-event trajectories of mental health and health-related disabilities, and post-event traumatic stress symptoms and health: A 7-wave population-based study.

Science.gov (United States)

van der Velden, Peter G; Bosmans, Mark W G; van der Meulen, Erik; Vermunt, Jeroen K

2016-12-30

It is unknown to what extent classes of trajectories of pre-event mental health problems (MHP) and health-related disabilities (HRD), predict post-event traumatic stress symptoms (PTSS), MHP and HRD. Aim of the present 7-wave study was to assess the predictive values using a representative sample of adult Dutch (N=4052) participating in three health-surveys in November-December 2009 (T1), 2010 (T2), 2011 (T3). In total, 2988 out of 4052 also participated in trauma-surveys in April(T4), August(T5) and December(T6) 2012 and a fourth health-survey in November-December 2012 (T7). About 10% (N=314) was confronted with potentially traumatic events (PTE) in the 4 months before T4 or T5. Latent class analyses among 4052 respondents identified four classes of pre-event MHP and HRD. Series of multivariate logistic regression analyses with class membership, peri-traumatic stress, type of event, gender, age and education as predictors, showed that classes with high levels of MHP or HRD, were more at risk for high levels of PTSS at baseline and follow-ups at 4 and 8 months, than classes with low levels of MHP or HRD. These classes were very strong predictors for high levels of post-event MHP and HRD: no differences were found between non-affected and affected respondents with different levels of peri-traumatic stress. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

ISIS Child Soldiers in Syria: The Structural and Predatory Recruitment, Enlistment, Pre-Training Indoctrination, Training, and Deployment

OpenAIRE

Asaad Almohammad

2018-01-01

Research on the engagement of children with the so-called Islamic State (a.k.a. ISIS) relies heavily on the analysis of obtained ISIS documents and ISIS-disseminated propaganda, leaving major elements of the recruitment and deployment process uncovered. Such ambiguities hinder future efforts aimed at dealing with ISIS’ child soldiers. As such, an intensive effort to compile data using interviews and naturalistic observations across ISIS-held territories in Syria was made to exhaustively explo...

Implementing reflection: insights from pre-registration mental health students.

Science.gov (United States)

Donovan, Moira O

2007-08-01

Reflection and reflective practice continues to be contentious issues in nursing. The focus of this article is the use of reflection by pre-registration mental health students. The broad aim of this preliminary study was to discover student mental health nurses' perceptions of reflection as a learning strategy during clinical placement. Using a constructivist grounded theory methodology [Charmaz, K., 2000. Grounded theory: Objectivist and Constructivist Methods. In: Denzin, N., Lincoln, Y. (Eds.), Handbook of Qualitative Research, second ed. Sage, Thousand Oaks, California], five students were interviewed individually in their clinical placements. Data analysis revealed three major categories: understanding the process of reflection, using reflection in clinical practice, and needing support and guidance. Findings indicated that students were primarily using reflection-on-action, but to varying extents. Overall, students felt that reflection facilitated their learning. Factors were discovered that both helped and hindered students' use of reflection. These included level of preparation to reflect, a limited culture of reflection and the level of support from preceptors, clinical staff, clinical placement co-ordinators, and lecturers. In conclusion, it appears that a collaborative approach between students, Health Service Providers and institutes of nursing is vital for the successful development and implementation of reflective learning strategies in clinical placement. Suggestions are made as to how a collaborative approach may be developed to enhance this process.

Family Functioning Differences Across the Deployment Cycle in British Army Families: The Perceptions of Wives and Children.

Science.gov (United States)

Pye, Rachel E; Simpson, Leanne K

2017-09-01

Military deployment can have an adverse effect on a soldier's family, though little research has looked at these effects in a British sample. We investigated wives' of U.K.-serving soldiers perceptions of marital and family functioning, across three stages of the deployment cycle: currently deployed, postdeployment and predeployed, plus a nonmilitary comparison group. Uniquely, young (aged 3.5-11 years) children's perceptions of their family were also investigated, using the parent-child alliance (PCA) coding scheme of drawings of the family. Two hundred and twenty British military families of regular service personnel from the British Army's Royal Armoured Corps, were sent survey packs distributed with a monthly welfare office newsletter. Wives were asked to complete a series of self-report items, and the youngest child in the family between the ages of 3.5 and 11 years was asked to draw a picture of their family. Complete data were available for 78 military families, and an additional 34 nonmilitary families were recruited via opportunity sampling. Results indicated wives of currently deployed and recently returned personnel were less satisfied with their family and its communication, and children's pictures indicated higher levels of dysfunctional parent-child alliance, whereas predeployed families responded similarly to nonmilitary families. Marital satisfaction was similar across all groups except predeployed families who were significantly more satisfied. Nonmilitary and predeployed families showed balanced family functioning, and currently and recently deployed families demonstrated poor family functioning. In comparison to nonmilitary families, predeployed families showed a large "spike" in the rigidity subscale of the Family Adaptability and Cohesion Evaluation Scale IV. Wives' perceptions of family functioning, but not marital satisfaction, differed between the deployment groups. The results from the coded children's drawings correlated with the self

The microbiome in early life: self-completion and microbiota protection as health priorities.

Science.gov (United States)

Dietert, Rodney R

2014-08-01

This minireview considers the benefits of refocusing attention away from treating the patient as a mammalian human to managing the complete patient: a majority microbial superorganism. Under the "completed self" model for formation of the human-microbial superorganism, the single, most pivotal sign in distinguishing a life course of health versus that filled with disease is self-completion (i.e., seeding of the minority mammalian human by the majority microbial portion of the symbiont). From a disease prevention perspective, microbial seeding at birth and subsequent nurturing of the microbiota are significant steps to reduce the risk of both noncommunicable diseases (e.g., type 1 diabetes) and certain infectious diseases. Management of the microbiome during pregnancy, birth, and shortly thereafter appears to be the most significant critical window for healthy superorganism formation. However, the bolus for microbiota seeding at birth and the nurturing process are subject to environmental influences and disruption, such as exposure to toxic chemicals and drugs, infections, and other physical and psychological stressors. Additionally, childhood and adult corrective measures, such as fecal transplantation and administration of prebiotics and probiotics, while potentially useful, may have limitations that are yet to be fully defined. This minireview considers (1) basic features of management of the microbiome to facilitate self-completion, (2) protection of the microbiota from environmental hazards, and (3) the benefits of using a superorganism focus for health management beginning with pregnancy and extending throughout childhood and adult life. © 2014 Wiley Periodicals, Inc.

Dry ice blasting as a substitution for the conventional electroplating pre-treatments

Directory of Open Access Journals (Sweden)

Uhlmann Eckart

2016-01-01

Full Text Available For high quality electroplated products, surfaces must be thoroughly pre-treated. For this purpose electroplating currently needs a variety of chemical baths. The used chemicals are injurious to health and harmful to the environment. In addition, the conventional pre-treatment has a long process time which results in high costs. Dry ice blasting alone or in combination with other processes has the potential to completely substitute these conventional pre-treatment processes. Three process sequences as pre-treatment methods prior to electroplating were investigated on the aluminium alloys AlSi12 and AlMg3. The used processes are dry ice blasting, tempering during dry ice blasting and glass bead blasting followed by dry ice blasting. The influence of the parameters on the surface roughness, surface topography and surface tension of the workpieces was examined. A model to describe the correlation between the dry ice blasting parameters and surface parameters was developed. Finally, an adhesion test of electroplated specimen was conducted in order to determine the suitability of these alternative pre-treatment processes.

Pre-Feedback Risk Expectancies and Reception of Low-Risk Health Feedback: Absolute and Comparative Lack of Reassurance.

Science.gov (United States)

Gamp, Martina; Renner, Britta

2016-11-01

Personalised health-risk assessment is one of the most common components of health promotion programs. Previous research on responses to health risk feedback has commonly focused on the reception of bad news (high-risk feedback). The reception of low-risk feedback has been comparably neglected since it is assumed that good news is reassuring and readily received. However, field studies suggest mixed responses to low-risk health feedback. Accordingly, we examine whether pre-feedback risk expectancies can mitigate the reassuring effects of good news. In two studies (N = 187, N = 565), after assessing pre-feedback risk expectancies, participants received low-risk personalised feedback about their own risk of developing (the fictitious) Tucson Chronic Fatigue Syndrome (TCFS). Study 2 also included peer TCFS risk status feedback. Afterwards, self- and peer-related risk perception for TCFS was assessed. In both studies, participants who expected to be at high risk but received good news (unexpected low-risk feedback) showed absolute lack of reassurance. Specifically, they felt at significantly greater TCFS risk than participants who received expected good news. Moreover, the unexpected low-risk group even believed that their risk was as high as (Study 1) or higher (Study 2) than that of their peers (comparative lack of reassurance). Results support the notion that high pre-feedback risk expectancies can mitigate absolute and comparative reassuring effects of good news. © 2016 The International Association of Applied Psychology.

Impact of pharmacy worker training and deployment on access to essential medicines for children under five in Malawi: a cluster quasi-experimental evaluation.

Science.gov (United States)

Babigumira, Joseph B; Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy

2017-09-11

Poor access to essential medicines is common in many low- and middle-income countries, partly due to an insufficient and inadequately trained workforce to manage the medicines supply chain. We conducted a prospective impact evaluation of the training and deployment of pharmacy assistants (PAs) to rural health centers in Malawi. A quasi-experimental design was used to compare access to medicines in two districts where newly trained PAs were deployed to health centers (intervention) and two districts with no trained PAs at health centers (comparison). A baseline household survey and two annual post-intervention household surveys were conducted. We studied children under five years with a history of fever, cough and difficulty in breathing, and diarrhea in the previous two weeks. We collected data on access to antimalarials, antibiotics and oral rehydration salts (ORS) during the childrens' symptomatic periods. We used difference-in-differences regression models to estimate the impact of PA training and deployment on access to medicines. We included 3974 children across the three rounds of annual surveys: 1840 (46%) in the districts with PAs deployed at health centers and 2096 (53%) in districts with no PAs deployed at health centers. Approximately 80% of children had a fever, nearly 30% had a cough, and 43% had diarrhea in the previous two weeks. In the first year of the program, the presence of a PA led to a significant 74% increase in the odds of access to any antimalarial, and a significant 49% increase in the odds of access to artemisinin combination therapies. This effect was restricted to the first year post-intervention. There was no effect of presence of a PA on access to antibiotics or ORS. The training and deployment of pharmacy assistants to rural health centers in Malawi increased access to antimalarial medications over the first year, but the effect was attenuated over the second year. Pharmacy assistants training and deployment demonstrated no impact on

Non-traditional Infrasound Deployment

Science.gov (United States)

McKenna, M. H.; McComas, S.; Simpson, C. P.; Diaz-Alvarez, H.; Costley, R. D.; Hayward, C.; Golden, P.; Endress, A.

2017-12-01

Historically, infrasound arrays have been deployed in rural environments where anthropological noise sources are limited. As interest in monitoring low energy sources at local distances grows in the infrasound community, it will be vital to understand how to monitor infrasound sources in an urban environment. Arrays deployed in urban centers have to overcome the decreased signal-to-noise ratio and reduced amount of real estate available to deploy an array. To advance the understanding of monitoring infrasound sources in urban environments, local and regional infrasound arrays were deployed on building rooftops on the campus at Southern Methodist University (SMU), and data were collected for one seasonal cycle. The data were evaluated for structural source signals (continuous-wave packets), and when a signal was identified, the back azimuth to the source was determined through frequency-wavenumber analysis. This information was used to identify hypothesized structural sources; these sources were verified through direct measurement and dynamic structural analysis modeling. In addition to the rooftop arrays, a camouflaged infrasound sensor was installed on the SMU campus and evaluated to determine its effectiveness for wind noise reduction. Permission to publish was granted by Director, Geotechnical and Structures Laboratory.

Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis.

Science.gov (United States)

Frost, Rachael; Belk, Celia; Jovicic, Ana; Ricciardi, Federico; Kharicha, Kalpa; Gardner, Benjamin; Iliffe, Steve; Goodman, Claire; Manthorpe, Jill; Drennan, Vari M; Walters, Kate

2017-07-20

Mild or pre-frailty is common and associated with increased risks of hospitalisation, functional decline, moves to long-term care, and death. Little is known about the effectiveness of health promotion in reducing these risks. This systematic review aimed to synthesise randomised controlled trials (RCTs) evaluating home and community-based health promotion interventions for older people with mild/pre-frailty. We searched 20 bibliographic databases and 3 trials registers (January 1990 - May 2016) using mild/pre-frailty and associated terms. We included randomised controlled and crossover trials of health promotion interventions for community-dwelling older people (65+ years) with mild/pre-frailty and excluded studies focussing on populations in hospital, long term care facilities or with a specific condition. Risk of bias was assessed by two reviewers using the Cochrane Risk of Bias tool. We pooled study results using standardised mean differences (SMD) where possible and used narrative synthesis where insufficient outcome data were available. We included 10 articles reporting on seven trials (total n = 506 participants) and included five trials in a meta-analysis. Studies were predominantly small, of limited quality and six studies tested group exercise alone. One study additionally investigated a nutrition and exercise intervention and one evaluated telemonitoring. Interventions of exercise in groups showed mixed effects on functioning (no effects on self-reported functioning SMD 0.19 (95% CI -0.57 to 0.95) n = 3 studies; positive effects on performance-based functioning SMD 0.37 (95% CI 0.07 to 0.68) n = 3 studies). No studies assessed moves to long-term care or hospitalisations. Currently the evidence base is of insufficient size, quality and breadth to recommend specific health promotion interventions for older people with mild or pre- frailty. High quality studies of rigorously developed interventions are needed. CRD42014010370 (Review 2).

Outcome and Impact Evaluation of a Transgender Health Course for Health Profession Students.

Science.gov (United States)

Braun, Hannan M; Garcia-Grossman, Ilana R; Quiñones-Rivera, Andrea; Deutsch, Madeline B

2017-02-01

Being transgender is associated with numerous health disparities, and transgender individuals face mistreatment and discrimination in healthcare settings. At the same time, healthcare professionals report inadequate preparation to care for transgender people, and patients often have to teach their own medical providers about transgender care. Our study aimed to evaluate the impact of an elective course for health profession students in transgender health that was implemented to address these gaps in provider knowledge. Students participated in a 10-session, lunch-hour elective course during the spring of 2015. To evaluate impact, course participants completed pre-, immediately post-, and 3-month postcourse questionnaires, including a previously validated nine-item transphobia scale, to determine the course's effect on knowledge, attitudes, and beliefs about transgender health. Forty-six students completed the pre- and immediately postelective questionnaire (74% response rate). Compared with pre-elective surveys, immediately postelective scores demonstrated increased knowledge in most domains and reduced transphobia. Specific knowledge domains with improvements included terminology, best practices for collecting gender identity, awareness of the DSM-V gender dysphoria diagnosis, medications used for gender affirmation, and relevant federal policies. A previously validated transphobia scale was found to have good reliability in the current sample. This elective course led to positive short-term changes in measures of multiple knowledge domains and reduced measures of transphobia among health profession students. Further study is needed to assess the long-term impact. Our methods and findings, including the demonstration of reliability of a previously validated nine-item transphobia scale, serve as formative data for the future development of theory-based transgender medicine curricula and measures.

Completeness and accuracy of data transfer of routine maternal health services data in the greater Accra region

NARCIS (Netherlands)

Amoakoh-Coleman, Mary; Kayode, Gbenga A.; Brown-Davies, Charles; Agyepong, Irene Akua; Grobbee, DE; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K.

2015-01-01

Background: High quality routine health system data is essential for tracking progress towards attainment of the Millennium Development Goals 4 & 5. This study aimed to determine the completeness and accuracy of transfer of routine maternal health service data at health facility, district and

Deployable Brake for Spacecraft

Science.gov (United States)

Rausch, J. R.; Maloney, J. W.

1987-01-01

Aerodynamic shield that could be opened and closed proposed. Report presents concepts for deployable aerodynamic brake. Brake used by spacecraft returning from high orbit to low orbit around Earth. Spacecraft makes grazing passes through atmosphere to slow down by drag of brake. Brake flexible shield made of woven metal or ceramic withstanding high temperatures created by air friction. Stored until needed, then deployed by set of struts.

(AGA) Pre Term Babies

African Journals Online (AJOL)

Haematological Indices in Healthy Appropriate For-Gestational-Age (AGA) Pre Term Babies. ... International Journal of Medicine and Health Development. Journal Home ... Patient and Methods: All consecutive healthy pre-term new born babies delivered at UNTH and admitted into the hospital NBSCU were included.

Correlation among periodontal health status, maternal age and pre-term low birth weight.

Science.gov (United States)

Capasso, Francesca; Vozza, Iole; Capuccio, Veronica; Vestri, Anna Rita; Polimeni, Antonella; Ottolenghi, Livia

2016-08-01

To assess correlations between periodontal status, maternal age and adverse pregnancy outcomes, such as pre-term and low birth weight in a sample of pregnant women. Study population was represented by outpatient pregnant women, gestational age > 26 weeks. Medical history questionnaires were administered to all participants who underwent clinical evaluation; clinical obstetric outcome records were collected after delivery. A questionnaire was administered regarding personal information, socio-economic status, oral hygiene habits, and oral health conditions. A clinical oral examination was performed to collect Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI). Pregnancy outcome records included: delivery week, kind and causes of delivery, any relevant complications, and birth weight. Descriptive statistics were used to depict the data from the questionnaire while the relationship between delivery week, birth weight, maternal age and periodontal status was evaluated through multivariate tests of significance. 88 pregnant women were enrolled in the study. The results showed a statistically significant correlation (Pperiodontal disease and adverse pregnancy outcomes. No statistical correlation was found among pre-term and low birth weight, smoking, ethnicity and educational level of mothers. The results highlight the importance of including a routine oral and periodontal health examination in pregnant women older than 40 years of age. The correlation between periodontal status and adverse pregnancy outcomes in older mothers indicates the need for routine oral health examination and periodontal status assessment and care in pregnant women older than 40 years of age.

Blood-based gene-expression predictors of PTSD risk and resilience among deployed marines: a pilot study.

Science.gov (United States)

Glatt, Stephen J; Tylee, Daniel S; Chandler, Sharon D; Pazol, Joel; Nievergelt, Caroline M; Woelk, Christopher H; Baker, Dewleen G; Lohr, James B; Kremen, William S; Litz, Brett T; Tsuang, Ming T

2013-06-01

Susceptibility to PTSD is determined by both genes and environment. Similarly, gene-expression levels in peripheral blood are influenced by both genes and environment, and expression levels of many genes show good correspondence between peripheral blood and brain. Therefore, our objectives were to test the following hypotheses: (1) pre-trauma expression levels of a gene subset (particularly immune-system genes) in peripheral blood would differ between trauma-exposed Marines who later developed PTSD and those who did not; (2) a predictive biomarker panel of the eventual emergence of PTSD among high-risk individuals could be developed based on gene expression in readily assessable peripheral blood cells; and (3) a predictive panel based on expression of individual exons would surpass the accuracy of a model based on expression of full-length gene transcripts. Gene-expression levels were assayed in peripheral blood samples from 50 U.S. Marines (25 eventual PTSD cases and 25 non-PTSD comparison subjects) prior to their deployment overseas to war-zones in Iraq or Afghanistan. The panel of biomarkers dysregulated in peripheral blood cells of eventual PTSD cases prior to deployment was significantly enriched for immune genes, achieved 70% prediction accuracy in an independent sample based on the expression of 23 full-length transcripts, and attained 80% accuracy in an independent sample based on the expression of one exon from each of five genes. If the observed profiles of pre-deployment mRNA-expression in eventual PTSD cases can be further refined and replicated, they could suggest avenues for early intervention and prevention among individuals at high risk for trauma exposure. Copyright © 2013 Wiley Periodicals, Inc.

Decline in mortality with the Belize Integrated Patient-Centred Country Wide Health Information System (BHIS) with embedded program management.

Science.gov (United States)

Graven, Michael; Allen, Peter; Smith, Ian; MacDonald, Noni E

2013-10-01

Belize deployed a country-wide fully integrated patient centred health information system with eight embedded disease management algorithms and simple analytics in 2007 for $4 (Cad)/citizen. This study evaluated BHIS uptake by health care workers, and pre and post BHIS deployment mortality in selected areas and public health care expenditures. BHIS encounter data were compared to encounter data from required Ministry of Health reports from licensed health care entities. De-identified vital statistics death data for the eight BHIS protocol disease domains and three non-protocol domains were compared from 2005 to 2011. Belize population data came from the Statistical Institute of Belize (2005-2009) and from Belize census (2010) and estimate (2011). Public health system expenditures were compared by fiscal years (2000-2012). BHIS captured over 90% healthcare encounters by year one, 95% by year two. Mortality rates decreased in the eight BHIS protocol domains (each 2005 vs. 2011, all p<0.02) vs. an increase or little change in the three domains without protocols. Hypertension related deaths dropped from 1st cause of death in 2003 to 9th by 2010. Public expenditures on healthcare steadily rose until 2009 but then declined slightly for the next 3 years. For modest investment, BHIS was well accepted nationwide and following deployment, mortality in the eight BHIS disease management algorithm domains declined significantly and expenditures on public healthcare stabilized. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Prevalence of Airflow Limitation Defined by Pre- and Post-Bronchodilator Spirometry in a Community-Based Health Checkup: The Hisayama Study.

Science.gov (United States)

Fukuyama, Satoru; Matsumoto, Koichiro; Kaneko, Yasuko; Kan-o, Keiko; Noda, Naotaka; Tajiri-Asai, Yukari; Nakano, Takako; Ishii, Yumiko; Kiyohara, Yutaka; Nakanishi, Yoichi; Inoue, Hiromasa

2016-02-01

Spirometry in health checkup may contribute to early diagnosis of chronic obstructive pulmonary disease (COPD) and asthma. Although post-bronchodilator airflow limitation is essential for definite diagnosis of COPD and post-bronchodilator normalization of airflow is suggestive of asthma, this test has not been prevailed in health checkup. The objective of this study was to estimate the prevalence of airflow limitation defined by pre- and post-bronchodilator spirometry in health checkup. Post-bronchodilator spirometry was conducted for participants with airflow limitation in a town-wide health checkup for residents aged 40 years and older in Hisayama, a town in the western part of Japan. The prevalence of pre- and post-bronchodilator airway limitation defined by FEV1/FVC spirometry. In males, the age of current smokers was significantly younger than those of never smokers and former smokers. In females, the ages of current- and former smokers were significantly younger than never smokers. The values of %FEV1 and %FVC in current smokers were significantly lower than those in former smokers and never smokers. Two hundred sixty nine subjects, 85% of total subjects with a pre-bronchodilator FEV1/FVC spirometry. The prevalence of pre-bronchodilator airflow limitation was 14.6% in males and 13.7% in females, and the prevalence of post-bronchodilator airway limitation was 8.7% and 8.7%, respectively. Post-bronchodilator spirometry in health checkup would reduce the number of subjects with probable COPD to two-third. Recommendation for those examinees to take further evaluations may pave the way for early intervention.

Medical students help bridge the gap in sexual health education among middle school youth.

Science.gov (United States)

Adjei, Naomi; Yacovelli, Michael; Liu, Dorothy; Sindhu, Kunal; Roberts, Mary; Magee, Susanna

2017-01-06

School-based programs are important in addressing risky teenage sexual behavior. We implemented a sex education program using trained medical student volunteers. Medical students (n=30) implemented a seven-session curriculum, designed by medical students and faculty, to 7th and 8th grade students (n=310) at a local school. Middle school students completed pre- and post-assessments. Teachers and medical students completed questionnaires relating their perceptions of students' attitudes and understanding of sexual health. Students completing the curriculum scored 5% higher on post- versus pre-assessment (84% vs 78.7%, psexual decision making. Sixty percent of middle school teachers compared to only 16.7% of medical student volunteers reported discomfort teaching sexual health. Sexual education delivered by trained medical student volunteers may improve middle schoolers' understanding of sexual health. [Full article available at http://rimed.org/rimedicaljournal-2017-01.asp].

Poor periodontal health as a risk factor for development of pre-eclampsia in pregnant women

Directory of Open Access Journals (Sweden)

Shailesh Varshney

2014-01-01

Full Text Available Aims: Periodontal disease has been considered a systemic exposure implicated in a higher risk of adverse pregnancy outcomes. The aim of the present study was to determine whether maternal oral health is associated with an increased risk of pre-eclampsia. Subjects and Methods: A case-control study was conducted which included 40 pregnant women patients admitted to the Department of Obstetrics and Gynecology, J.N. Medical College, A.M.U, Aligarh. Pre-eclampsia was defined as classic triad of hypertension, proteinuria and symptoms such as swelling/edema esp. in hands and face, headache, visual changes etc., A periodontal examination was done during 48 h after child delivery. Maternal oral status was evaluated using gingival index by Loe and Silness, oral hygiene index (simplified by greene and vermillion and periodontal pockets and clinical attachment level (CAL. Statistical Analysis: Null hypothesis that no difference exist between the two groups (pre-eclamptic and non-pre-eclamptic Group was calculated using paired t-test, Chi-square and Mann-Whitney U statistical tests using SPSS 11.5 (Statistical Package for Social sciences, Chicago. P < 0.05 was considered to be statistically significant. Results: The amount of gingival inflammation, oral hygiene levels, pocket depth and CALs as measured by their respective indices were higher in the pre-eclamptic group when compared to non-pre-eclamptic group. Furthermore CAL was significantly increased in the test group. This study showed that pre-eclamptic cases were more likely to develop periodontal disease (P < 0.05. 30% of the test group and 65% of the case group had periodontal disease (P < 0.05 which had shown that pre-eclamptic cases were 4.33 times more likely to have periodontal disease (odds ratio = 4.33. Conclusions: Maternal oral status was determined to be associated with an increased risk of pre-eclampsia.

Accommodating Thickness in Origami-Based Deployable Arrays

Science.gov (United States)

Zirbel, Shannon A.; Magleby, Spencer P.; Howell, Larry L.; Lang, Robert J.; Thomson, Mark W.; Sigel, Deborah A.; Walkemeyer, Phillip E.; Trease, Brian P.

2013-01-01

The purpose of this work is to create deployment systems with a large ratio of stowed-to-deployed diameter. Deployment from a compact form to a final flat state can be achieved through origami-inspired folding of panels. There are many models capable of this motion when folded in a material with negligible thickness; however, when the application requires the folding of thick, rigid panels, attention must be paid to the effect of material thickness not only on the final folded state, but also during the folding motion (i.e., the panels must not be required to flex to attain the final folded form). The objective is to develop new methods for deployment from a compact folded form to a large circular array (or other final form). This paper describes a mathematical model for modifying the pattern to accommodate material thickness in the context of the design, modeling, and testing of a deployable system inspired by an origami six-sided flasher model. The model is demonstrated in hardware as a 1/20th scale prototype of a deployable solar array for space applications. The resulting prototype has a ratio of stowed-to-deployed diameter of 9.2 (or 1.25 m deployed outer diameter to 0.136 m stowed outer diameter).

Supporting Knowledge Transfer in IS Deployment Projects

Science.gov (United States)

Schönström, Mikael

To deploy new information systems is an expensive and complex task, and does seldom result in successful usage where the system adds strategic value to the firm (e.g. Sharma et al. 2003). It has been argued that innovation diffusion is a knowledge integration problem (Newell et al. 2000). Knowledge about business processes, deployment processes, information systems and technology are needed in a large-scale deployment of a corporate IS. These deployments can therefore to a large extent be argued to be a knowledge management (KM) problem. An effective deployment requires that knowledge about the system is effectively transferred to the target organization (Ko et al. 2005).

The DevOps 2.0 toolkit automating the continuous deployment pipeline with containerized microservices

CERN Document Server

Farcic, Viktor

2016-01-01

This book is about different techniques that help us architect software in a better and more efficient way with microservices packed as immutable containers, tested and deployed continuously to servers that are automatically provisioned with configuration management tools. It's about fast, reliable and continuous deployments with zero-downtime and ability to roll-back. It's about scaling to any number of servers, design of self-healing systems capable of recuperation from both hardware and software failures and about centralized logging and monitoring of the cluster.In other words, this book envelops the whole microservices development and deployment lifecycle using some of the latest and greatest practices and tools. We'll use Docker, Kubernetes, Ansible, Ubuntu, Docker Swarm and Docker Compose, Consul, etcd, Registrator, confd, and so on. We'll go through many practices and even more tools. Finally, while there will be a lot of theory, this is a hands-on book. You won't be able to complete it by reading it ...

The Role of Social Support and Coping Strategies on Mental Health of a Group of Iranian Disabled War Veterans

Directory of Open Access Journals (Sweden)

Abdulaziz Aflakseir

2010-08-01

Full Text Available "n Objective: The purpose of this study was to examine the role of social support on the mental health of disabled war veterans alongside the role of physical disability and deployment type. The second aim of the study was to examine the relationship between coping strategies and mental health. "n Method: 85 disabled Iranian war veterans participated in this study. All of the participants were asked to complete the Medical Outcomes Study (MOS ,Social Support Survey, Impact of Event-Revised Scale (IES-R, Hospital Anxiety and Depression Scale (HADS, The Short Form (SF-36 Health Survey Questionnaire, and Brief COPE Scale. Results: The results showed that social support had a significant contribution on the mental health of the participants above and beyond the physical disability and deployment type. The physical disability also predicted the mental health of veterans, but deployment type did not have any significant contribution on mental health of the participants. The findings also showed that those veterans who used constructive coping strategies had better mental health status . "nConclusion: The findings suggest that after more than twenty years of war, social support still plays an important role in the life of Iranian disabled war veterans.

Developing Health-Based Pre-Planning Clearance Goals for Airport Remediation Following Chemical Terrorist Attack: Introduction and Key Assessment Considerations

Science.gov (United States)

Watson, Annetta; Hall, Linda; Raber, Ellen; Hauschild, Veronique D.; Dolislager, Fredrick; Love, Adam H.; Hanna, M. Leslie

2011-01-01

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility reuse and re-entry could require hours to multiple days. While restoration timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical terrorist release. What follows is the first of a two-part analysis identifying key considerations, critical information, and decision criteria to facilitate post-attack and post-decontamination consequence management activities. A conceptual site model and human health-based exposure guidelines are developed and reported as an aid to site-specific pre-planning in the current absence of U.S. state or Federal values designated as compound-specific remediation or re-entry concentrations, and to safely expedite facility recovery to full operational status. Chemicals of concern include chemical warfare nerve and vesicant agents and the toxic industrial compounds phosgene, hydrogen cyanide, and cyanogen chloride. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination. PMID:21390292

Developing Health-Based Pre-Planning Clearance Goals for Airport Remediation Following Chemical Terrorist Attack: Introduction and Key Assessment Considerations.

Science.gov (United States)

Watson, Annetta; Hall, Linda; Raber, Ellen; Hauschild, Veronique D; Dolislager, Fredrick; Love, Adam H; Hanna, M Leslie

2011-02-13

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility reuse and re-entry could require hours to multiple days. While restoration timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical terrorist release. What follows is the first of a two-part analysis identifying key considerations, critical information, and decision criteria to facilitate post-attack and post-decontamination consequence management activities. A conceptual site model and human health-based exposure guidelines are developed and reported as an aid to site-specific pre-planning in the current absence of U.S. state or Federal values designated as compound-specific remediation or re-entry concentrations, and to safely expedite facility recovery to full operational status. Chemicals of concern include chemical warfare nerve and vesicant agents and the toxic industrial compounds phosgene, hydrogen cyanide, and cyanogen chloride. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination.

Promoting School Mental Health Competencies: Exploring the Utility of Decision Cases for Pre-Service Learning

Science.gov (United States)

Iachini, Aidyn L.; Wolfer, Terry A.

2015-01-01

Preparation of the school mental health (SMH) workforce is an important priority. Significant gaps remain, however, in our understanding of which pre-service training strategies may be most effective for promoting essential cross-disciplinary SMH competencies. In response, this paper describes the case method of teaching and provides pilot…

Functional abdominal complaints in pre-school children: Parental reports of health-related quality of life

NARCIS (Netherlands)

R. Oostenbrink (Rianne); H.P. Jongman (Henri); J.M. Landgraf (Jeanne); H. Raat (Hein); H.A. Moll (Henriëtte)

2010-01-01

textabstractPurpose The aim of this study is to assess the influence of functional abdominal complaints (FAC) on health-related quality of life in a group of Dutch pre-school children. Methods Parents of children aged up to 6.0 visiting the outpatient pediatric department, Erasmus MC-Sophia,

Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience.

Science.gov (United States)

Schweitzer, Robert D; Brough, Mark; Vromans, Lyn; Asic-Kobe, Mary

2011-04-01

This study documents the mental health status of people from Burmese refugee backgrounds recently arrived in Australia, then examines the contributions of gender, pre-migration and post-migration factors in predicting mental health. Structured interviews, including a demographic questionnaire, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Checklist and Hopkins Symptom Checklist assessed pre-migration trauma, post-migration living difficulties, depression, anxiety, somatization and traumatization symptoms in a sample of 70 adults across five Burmese ethnic groups. Substantial proportions of participants reported psychological distress in symptomatic ranges including: post-traumatic stress disorder (9%), anxiety (20%) and depression (36%), as well as significant symptoms of somatization (37%). Participants reported multiple and severe pre-migration traumas. Post-migration living difficulties of greatest concern included communication problems and worry about family not in Australia. Gender did not predict mental health. Level of exposure to traumatic events and post-migration living difficulties each made unique and relatively equal contributions to traumatization symptoms. Post-migration living difficulties made unique contributions to depression, anxiety and somatization symptoms. While exposure to traumatic events impacted on participants' mental well-being, post-migration living difficulties had greater salience in predicting mental health outcomes of people from Burmese refugee backgrounds. Reported rates of post-traumatic stress disorder symptoms were consistent with a large review of adults across seven western countries. High levels of somatization point to a nuanced expression of distress. Findings have implications for service provision in terms of implementing appropriate interventions to effectively meet the needs of this newly arrived group in Australia.

Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers.

Science.gov (United States)

Yang, Li; Zhao, Qiuli; Zhu, Xuemei; Shen, Xiaoying; Zhu, Yulan; Yang, Liu; Gao, Wei; Li, Minghui

2017-08-01

Many factors influence pre-hospital delays in the event of stroke. This study aimed to develop and evaluate a comprehensive educational program for decreasing pre-hospital delays in high-risk stroke population. We enrolled 220 high-risk stroke population and caregivers from six urban communities in Harbin from May 2013 to May 2015, and randomly divided them into intervention and control groups. We implemented a comprehensive educational program (intervention group), comprising public lectures, instructional brochures, case videos, simulations, and role-playing from May 2013 to May 2015. We delivered conventional oral education in the control group. We compared stroke pre-hospital delay behavioral intention (SPDBI), pre-hospital stroke symptom coping test (PSSCT), and stroke pre-symptoms alert test (SPSAT) results between the groups before and 6, 12, and 18 months after health intervention. There were significant differences between before and after intervention (P educational program was significantly effective in decreasing SPDBI, improving knowledge, enhancing stroke pre-symptoms alert, and reducing the possibility of pre-hospital delays.

Verifying occulter deployment tolerances as part of NASA's technology development for exoplanet missions

Science.gov (United States)

Kasdin, N. J.; Lisman, D.; Shaklan, S.; Thomson, M.; Webb, D.; Cady, E.; Marks, G. W.; Lo, A.

2013-09-01

An external occulter is a satellite employing a large screen, or starshade, that flies in formation with a spaceborne telescope to provide the starlight suppression needed for detecting and characterizing exoplanets. Among the advantages of using an occulter are the broadband allowed for characterization and the removal of light before entering the observatory, greatly relaxing the requirements on the telescope and instrument. In support of NASA's Exoplanet Exploration Program and the Technology Development for Exoplanet Missions (TDEM), we recently completed a 2 year study of the manufacturability and metrology of starshade petals. In this paper we review the results of that successful first TDEM which demonstrated an occulter petal could be built and measured to an accuracy consistent with close to 10-10 contrast. We then present the results of our second TDEM to demonstrate the next critical technology milestone: precision deployment of the central truss and petals to the necessary accuracy. We show the deployment of an existing deployable truss outfitted with four sub-scale petals and a custom designed central hub.

Hydraulic Hybrid Parcel Delivery Truck Deployment, Testing & Demonstration

Energy Technology Data Exchange (ETDEWEB)

Gallo, Jean-Baptiste [Calstart Incorporated, Pasadena, CA (United States)

2014-03-07

Although hydraulic hybrid systems have shown promise over the last few years, commercial deployment of these systems has primarily been limited to Class 8 refuse trucks. In 2005, the Hybrid Truck Users Forum initiated the Parcel Delivery Working Group including the largest parcel delivery fleets in North America. The goal of the working group was to evaluate and accelerate commercialization of hydraulic hybrid technology for parcel delivery vehicles. FedEx Ground, Purolator and United Parcel Service (UPS) took delivery of the world’s first commercially available hydraulic hybrid parcel delivery trucks in early 2012. The vehicle chassis includes a Parker Hannifin hydraulic hybrid drive system, integrated and assembled by Freightliner Custom Chassis Corp., with a body installed by Morgan Olson. With funding from the U.S. Department of Energy, CALSTART and its project partners assessed the performance, reliability, maintainability and fleet acceptance of three pre-production Class 6 hydraulic hybrid parcel delivery vehicles using information and data from in-use data collection and on-road testing. This document reports on the deployment of these vehicles operated by FedEx Ground, Purolator and UPS. The results presented provide a comprehensive overview of the performance of commercial hydraulic hybrid vehicles in parcel delivery applications. This project also informs fleets and manufacturers on the overall performance of hydraulic hybrid vehicles, provides insights on how the technology can be both improved and more effectively used. The key findings and recommendations of this project fall into four major categories: -Performance, -Fleet deployment, -Maintenance, -Business case. Hydraulic hybrid technology is relatively new to the market, as commercial vehicles have been introduced only in the past few years in refuse and parcel delivery applications. Successful demonstration could pave the way for additional purchases of hydraulic hybrid vehicles throughout the

Breaking Health Insurance Knowledge Barriers Through Games: Pilot Test of Health Care America

Science.gov (United States)

James, Juli

2017-01-01

Background Having health insurance is associated with a number of beneficial health outcomes. However, previous research suggests that patients tend to avoid health insurance information and often misunderstand or lack knowledge about many health insurance terms. Health insurance knowledge is particularly low among young adults. Objective The purpose of this study was to design and test an interactive newsgame (newsgames are games that apply journalistic principles in their creation, for example, gathering stories to immerse the player in narratives) about health insurance. This game included entry-level information through scenarios and was designed through the collation of national news stories, local personal accounts, and health insurance company information. Methods A total of 72 (N=72) participants completed in-person, individual gaming sessions. Participants completed a survey before and after game play. Results Participants indicated a greater self-reported understanding of how to use health insurance from pre- (mean=3.38, SD=0.98) to postgame play (mean=3.76, SD=0.76); t71=−3.56, P=.001. For all health insurance terms, participants self-reported a greater understanding following game play. Finally, participants provided a greater number of correct definitions for terms after playing the game, (mean=3.91, SD=2.15) than they did before game play (mean=2.59, SD=1.68); t31=−3.61, P=.001. Significant differences from pre- to postgame play differed by health insurance term. Conclusions A game is a practical solution to a difficult health issue—the game can be played anywhere, including on a mobile device, is interactive and will thus engage an apathetic audience, and is cost-efficient in its execution. PMID:29146564

Design and end-to-end modelling of a deployable telescope

Science.gov (United States)

Dolkens, Dennis; Kuiper, Hans

2017-09-01

a closed-loop system based on measurements of the image sharpness as well as measurements obtained with edge sensors placed between the mirror segments. In addition, a phase diversity system will be used to recover residual wavefront aberrations. To aid the design of the deployable telescope, an end-to-end performance model was developed. The model is built around a dedicated ray-trace program written in Matlab. This program was built from the ground up for the purpose of modelling segmented telescope systems and allows for surface data computed with Finite Element Models (FEM) to be imported in the model. The program also contains modules which can simulate the closed-loop calibration of the telescope and it can use simulated images as an input for phase diversity and image processing algorithms. For a given thermo-mechanical state, the end-to-end model can predict the image quality that will be obtained after the calibration has been completed and the image has been processed. As such, the model is a powerful systems engineering tool, which can be used to optimize the in-orbit performance of a segmented, deployable telescope.

Deploying 5G-technologies in smart city and smart home wireless sensor networks with interferences

DEFF Research Database (Denmark)

Lynggaard, Per; Skouby, Knud Erik

2015-01-01

communication in an Internet of Things (5G) contexts. In this paper we discuss some of the key challenges that exist in the smart city and smart home networks in the light of possible 5G-solutions. Focus is on deploying cognitive radio technologies (5G) which enables the smart city networks to support......Deploying 5G technologies in a combination of smart homes and smart city opens for a new ecosystem with big potentials. The potentials lie in the creation of an advanced ICT infrastructure with support for connected and entangled services possibilities including technologies for efficient...... interconnected infrastructure elements, to handle big-data from the smart homes, and to be compatible with existing infrastructures. The considered cognitive radio technology is based on pre-coded OFDM which offers the needed flexibility to deal with the key challenges found in the smart home networks. Thus...

Pre-Travel Health Preparation of Pediatric International Travelers: Analysis From the Global TravEpiNet Consortium.

Science.gov (United States)

Hagmann, Stefan; LaRocque, Regina C; Rao, Sowmya R; Jentes, Emily S; Sotir, Mark J; Brunette, Gary; Ryan, Edward T

2013-12-01

Children frequently travel internationally. Health-related data on such children are limited. We sought to investigate the demographics, health characteristics, and preventive interventions of outbound US international pediatric travelers. We analyzed data from 32 099 travelers presenting for pre-travel healthcare at the Global TravEpiNet (GTEN), a national consortium of 19 travel clinics, from January 1, 2009 to June 6, 2012. A total of 3332 (10%) of all GTEN travelers were children (traveled mostly for leisure (36%) or to visit friends or relatives (VFR) (36%). Most popular destination regions were Africa (41%), Southeast Asia (16%), Central America (16%), and the Caribbean (16%). Compared with children traveling for leisure, VFR children were more likely to present travel consultation (44% vs 28%), intended to travel for 28 days or longer (70% vs 22%), and to travel to Africa (62% vs 32%). Nearly half of the pediatric travelers (46%) received at least 1 routine vaccine, and most (83%) received at least 1 travel-related vaccine. Parents or guardians of one third of the children (30%) refused at least 1 recommended travel-related vaccine. Most pediatric travelers visiting a malaria-endemic country (72%) received a prescription for malaria chemoprophylaxis. Ten percent of travelers seeking pre-travel healthcare at GTEN sites are children. VFR-travel, pre-travel consultation close to time of departure, and refusal of recommended vaccines may place children at risk for travel-associated illness. Strategies to engage pediatric travelers in timely, pre-travel care and improve acceptance of pre-travel healthcare interventions are needed. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Informing the scale-up of Kenya’s nursing workforce: a mixed methods study of factors affecting pre-service training capacity and production

Science.gov (United States)

2014-01-01

Background Given the global nursing shortage and investments to scale-up the workforce, this study evaluated trends in annual student nurse enrolment, pre-service attrition between enrolment and registration, and factors that influence nurse production in Kenya. Methods This study used a mixed methods approach with data from the Regulatory Human Resources Information System (tracks initial student enrolment through registration) and the Kenya Health Workforce Information System (tracks deployment and demographic information on licensed nurses) for the quantitative analyses and qualitative data from key informant interviews with nurse training institution educators and/or administrators. Trends in annual student nurse enrolment from 1999 to 2010 were analyzed using regulatory and demographic data. To assess pre-service attrition between training enrolment and registration with the nursing council, data for a cohort that enrolled in training from 1999 to 2004 and completed training by 2010 was analyzed. Multivariate logistic regression was used to test for factors that significantly affected attrition. To assess the capacity of nurse training institutions for scale-up, qualitative data was obtained through key informant interviews. Results From 1999 to 2010, 23,350 students enrolled in nurse training in Kenya. While annual new student enrolment doubled between 1999 (1,493) and 2010 (3,030), training institutions reported challenges in their capacity to accommodate the increased numbers. Key factors identified by the nursing faculty included congestion at clinical placement sites, limited clinical mentorship by qualified nurses, challenges with faculty recruitment and retention, and inadequate student housing, transportation and classroom space. Pre-service attrition among the cohort that enrolled between 1999 and 2004 and completed training by 2010 was found to be low (6%). Conclusion To scale-up the nursing workforce in Kenya, concurrent investments in expanding the

Effect of obesity and lifestyle on the oral health of pre adolescent children.

Science.gov (United States)

Anand, Nithya; Suresh, M; Chandrasekaran, S C

2014-02-01

Worldwide estimates of childhood obesity are as high as 43 million, and rates continue to increase each year. Childhood obesity is a growing problem in the present era and it causes serious consequences in the later years. In today's society, electronic media have been thoroughly integrated into the fabric of life, with television, video games, and computers being central to both work and play. While these media outlets can provide education and entertainment to children, many researches are concerned with the negative impact of electronic media on children. The current study aimed to evaluate the correlation, as to how oral hygiene and periodontal health were influenced by obesity and lifestyle factors, among pre-adolescents of ages of 9-12 years. This study was conducted in schools located around Velachery, Chennai, India. A total of 426 children of age group of 9-12 years were selected. Information on their socio-economic, dietary, oral health statuses and time spent in leisure activities were assessed by using a questionnaire, followed by BMI estimation and these variables were correlated with their oral hygiene statuses. The prevalence of poor oral hygiene and poor dietary habits was observed in children who spent more time in watching television, playing videogames and using computer. Good oral hygiene was observed in children who had visited dentists in the past. There is a strong association of lifestyle factors with oral hygiene in pre-adolescent children. Sedentary lifestyle, with more leisure activities, has a negative impact on the oral health of children.

Using quality function deployment to capture the voice of the customer and translate it into the voice of the provider.

Science.gov (United States)

Chaplin, E; Bailey, M; Crosby, R; Gorman, D; Holland, X; Hippe, C; Hoff, T; Nawrocki, D; Pichette, S; Thota, N

1999-06-01

Health care has a number of historical barriers to capturing the voice of the customer and to incorporating customer wants into health care services, whether the customer is a patient, an insurer, or a community. Quality function deployment (QFD) is a set of tools and practices that can help overcome these barriers to form a process for the planning and design or redesign of products and services. The goal of the project was to increase referral volume and to improve a rehabilitation hospital's capacity to provide comprehensive medical and/or legal evaluations for people with complex and catastrophic injuries or illnesses. HIGH-LEVEL VIEW OF QFD AS A PROCESS: The steps in QFD are as follows: capture of the voice of the customer, quality deployment, functions deployment, failure mode deployment, new process deployment, and task deployment. The output of each step becomes the input to a matrix tool or table of the next step of the process. In 3 1/2 months a nine-person project team at Continental Rehabilitation Hospital (San Diego) used QFD tools to capture the voice of the customer, use these data as the basis for a questionnaire on important qualities of service from the customer's perspective, obtain competitive data on how the organization was perceived to be meeting the demanded qualities, identify measurable dimensions and targets of these qualities, and incorporate the functions and tasks into the delivery of service which are necessary to meet the demanded qualities. The future of providing health care services will belong to organizations that can adapt to a rapidly changing environment and to demands for new products and services that are produced and delivered in new ways.

Social marketing meets health literacy: Innovative improvement of health care providers’ comfort with patient interaction

Science.gov (United States)

Primack, Brian A.; Bui, Thuy; Fertman, Carl I.

2010-01-01

Objective It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. Methods In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Results Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p marketing and health literacy can improve skills that improve medical students’ comfort with patients of diverse backgrounds. Practice implications Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers’ comfort with direct patient interaction. PMID:17418522

Structural design of the Large Deployable Reflector (LDR)

Science.gov (United States)

Satter, Celeste M.; Lou, Michael C.

1991-01-01

An integrated Large Deployable Reflector (LDR) analysis model was developed to enable studies of system responses to the mechanical and thermal disturbances anticipated during on-orbit operations. Functional requirements of the major subsystems of the LDR are investigated, design trades are conducted, and design options are proposed. System mass and inertia properties are computed in order to estimate environmental disturbances, and in the sizing of control system hardware. Scaled system characteristics are derived for use in evaluating launch capabilities and achievable orbits. It is concluded that a completely passive 20-m primary appears feasible for the LDR from the standpoint of both mechanical vibration and thermal distortions.

Structural design of the Large Deployable Reflector (LDR)

Science.gov (United States)

Satter, Celeste M.; Lou, Michael C.

1991-09-01

An integrated Large Deployable Reflector (LDR) analysis model was developed to enable studies of system responses to the mechanical and thermal disturbances anticipated during on-orbit operations. Functional requirements of the major subsystems of the LDR are investigated, design trades are conducted, and design options are proposed. System mass and inertia properties are computed in order to estimate environmental disturbances, and in the sizing of control system hardware. Scaled system characteristics are derived for use in evaluating launch capabilities and achievable orbits. It is concluded that a completely passive 20-m primary appears feasible for the LDR from the standpoint of both mechanical vibration and thermal distortions.

Completion Report for Multi-Site Incentive MRT 2779 Implement ASC Tripod Initiative by 30SEP08

Energy Technology Data Exchange (ETDEWEB)

East, D; Cerutti, J; Noe, J; Cupps, K; Loncaric, J; Sturtevant, J

2008-09-22

This report provides documentation and evidence for the completion of the deployment of the Tripod common operating system (TripodOS, also known as and generally referred to below as TOSS). Background documents for TOSS are provided in Appendices A and B, including the initial TOSS proposal accepted by ASC HQ and Executives in July 2007 and a Governance Model defined by a Tri-Lab working group in September 2007. Appendix C contains a document that clarifies the intent and requirements for the completion criteria associated with MRT 2779. The deployment of TOSS is a Multi-Site Incentive from the ASC FY08-09 Implementation Plan due at the end of Quarter 4 in FY08.

Pascua Yaqui Tribe Renewable Energy Development and Deployment Feasibility Study

Energy Technology Data Exchange (ETDEWEB)

Arvayo, Maria

2014-05-30

In 2012, PYT was awarded a grant from the Department of Energy Tribal Energy Program to conduct a Renewable Energy Development and Deployment Feasibility Study that would define the technical and economic viability of renewable energy on tribal lands. Red Mountain Energy Partners (RMEP) was hired by PYT to complete the study. Through this study, Red Mountain concluded that there are viable opportunities for solar at Tortuga Ranch, the Casino del Sol and a third site near the Justice Center on Camino de Oeste.

Newly reported lupus and rheumatoid arthritis in relation to deployment within proximity to a documented open-air burn pit in Iraq.

Science.gov (United States)

Jones, Kelly A; Smith, Besa; Granado, Nisara S; Boyko, Edward J; Gackstetter, Gary D; Ryan, Margaret A K; Phillips, Christopher J; Smith, Tyler C

2012-06-01

To assess the relationship between possible exposure to smoke from documented open-air burn pits and newly reported lupus and rheumatoid arthritis among Millennium Cohort participants who have deployed in support of operations in Iraq and Afghanistan. Prospectively assessed self-reported lupus and rheumatoid arthritis among deployers who completed both 2004-2006 and 2007-2008 questionnaires. After exclusions, more than 18,000 participants were deployed, including more than 3000 participants deployed within a 3-mile radius of a documented burn pit. After adjustment, proximity within 3 miles of a burn pit was not significantly associated with rheumatoid arthritis or lupus in general; however, one location was associated with lupus, although few cases were at this site (n = 2). Results indicate deployers potentially exposed to documented burn pits in the combined three-camp analysis were not at an elevated risk of lupus or rheumatoid arthritis.

Rover deployment system for lunar landing mission

Science.gov (United States)

Sutoh, Masataku; Hoshino, Takeshi; Wakabayashi, Sachiko

2017-09-01

For lunar surface exploration, a deployment system is necessary to allow a rover to leave the lander. The system should be as lightweight as possible and stored retracted when launched. In this paper, two types of retractable deployment systems for lunar landing missions, telescopic- and fold-type ramps, are discussed. In the telescopic-type system, a ramp is stored with the sections overlapping and slides out during deployment. In the fold-type system, it is stored folded and unfolds for the deployment. For the development of these ramps, a design concept study and structural analysis were conducted first. Subsequently, ramp deployment and rover release tests were performed using the developed ramp prototypes. Through these tests, the validity of their design concepts and functions have been confirmed. In the rover release test, it was observed that the developed lightweight ramp was sufficiently strong for a 50-kg rover to descend. This result suggests that this ramp system is suitable for the deployment of a 300-kg-class rover on the Moon, where the gravity is about one-sixth that on Earth. The lightweight and sturdy ramp developed in this study will contribute to both safe rover deployment and increase of lander/rover payload.

Completeness of malaria indicator data reporting via the District Health Information Software 2 in Kenya, 2011-2015.

Science.gov (United States)

Githinji, Sophie; Oyando, Robinson; Malinga, Josephine; Ejersa, Waqo; Soti, David; Rono, Josea; Snow, Robert W; Buff, Ann M; Noor, Abdisalan M

2017-08-17

Health facility-based data reported through routine health information systems form the primary data source for programmatic monitoring and evaluation in most developing countries. The adoption of District Health Information Software (DHIS2) has contributed to improved availability of routine health facility-based data in many low-income countries. An assessment of malaria indicators data reported by health facilities in Kenya during the first 5 years of implementation of DHIS2, from January 2011 to December 2015, was conducted. Data on 19 malaria indicators reported monthly by health facilities were extracted from the online Kenya DHIS2 database. Completeness of reporting was analysed for each of the 19 malaria indicators and expressed as the percentage of data values actually reported over the expected number; all health facilities were expected to report data for each indicator for all 12 months in a year. Malaria indicators data were analysed for 6235 public and 3143 private health facilities. Between 2011 and 2015, completeness of reporting in the public sector increased significantly for confirmed malaria cases across all age categories (26.5-41.9%, p performed and test results were not available in DHIS2 from 2011 to 2014. In 2015, sparse data on microscopy (11.5% for children aged performed were reported in DHIS2 from the private sector. There have been sustained improvements in the completeness of data reported for most key malaria indicators since the adoption of DHIS2 in Kenya in 2011. However, major data gaps were identified for the malaria-test indicator and overall low reporting across all indicators from private health facilities. A package of proven DHIS2 implementation interventions and performance-based incentives should be considered to improve private-sector data reporting.

The development of an integrated Indonesian health care model using Kano's model, quality function deployment and balanced scorecard

Science.gov (United States)

Jonny, Zagloed, Teuku Yuri M.

2017-11-01

This paper aims to present an integrated health care model for Indonesian health care industry. Based on previous researches, there are two health care models in the industry such as decease- and patient-centered care models. In their developments, the patient-centered care model is widely applied due to its capability in reducing cost and improving quality simultaneously. However, there is still no comprehensive model resulting in cost reduction, quality improvement, patient satisfaction and hospital profitability simultaneously. Therefore, this research is intended to develop that model. In doing so, first, a conceptual model using Kano's Model, Quality Function Deployment (QFD) and Balanced Scorecard (BSC) is developed to generate several important elements of the model as required by stakeholders. Then, a case study of an Indonesian hospital is presented to evaluate the validity of the model using correlation analysis. As a result, it can be concluded that the model is validated implying several managerial insights among its elements such as l) leadership (r=0.85) and context of the organization (r=0.77) improve operations; 2) planning (r=0.96), support process (r=0.87) and continual improvement (r=0.95) also improve operations; 3) operations improve customer satisfaction (r=0.89) and financial performance (r=0.93) and 4) customer satisfaction improves the financial performance (0.98).

Increased utilization of health care services after psychotherapy: a register based study

DEFF Research Database (Denmark)

Fenger, Morten Munthe; Poulsen, Stig Bernt; Mortensen, Erik Lykke

2012-01-01

services for patients referred to psychotherapeutic treatment in 2004 and 2005. Method The study was a matched control study, which included 716 consecutive patients and 15,220 matched controls. Data from a comprehensive set of health care services were collected from central registries for an observation...... period of four years before intake and four years after ended treatment. Changes in utilization of health care services in eight health parameters were analyzed with t-test and with ANCOVA one and four year pre-post treatment. Results Of the 761 patients, 216 patients did not show up for treatment, while...... 545 patients completed treatment; 228 responded and 201 did not respond to treatment. Data on treatment response was missing for the remaining 116 patients. Completer patients increased their use of all health care services with 296% (ES=0.58) in the four year pre-post comparison, while the control...

Quality function deployment: application to rehabilitation services.

Science.gov (United States)

Einspruch, E M; Omachonu, V K; Einspruch, N G

1996-01-01

Describes how the challenge of providing rehabilitative services at reasonable costs is beginning to mount. The management of quality in rehabilitative services is therefore gaining increasing attention in the health care arena. States that if a link is implied between the above stated goal and customer satisfaction, it is imperative to evaluate quality or customer satisfaction in the context of the patient's experience. Describes the quality function deployment (QFD) system and how it leads to a better understanding of the customer's needs and wants. Explores the process of applying the concept of QFD to physical therapy.

Security Support in Continuous Deployment Pipeline

DEFF Research Database (Denmark)

Ullah, Faheem; Raft, Adam Johannes; Shahin, Mojtaba

2017-01-01

Continuous Deployment (CD) has emerged as a new practice in the software industry to continuously and automatically deploy software changes into production. Continuous Deployment Pipeline (CDP) supports CD practice by transferring the changes from the repository to production. Since most of the CDP...... penetration tools. Our findings indicate that the applied tactics improve the security of the major components (i.e., repository, continuous integration server, main server) of a CDP by controlling access to the components and establishing secure connections....

Advanced OS deployment system

OpenAIRE

Galiano Molina, Sebastián

2007-01-01

The main project’s objective is to design and build an OS deployment system taking advantage of the Linux OS and the Open Source community developments. This means to use existing technologies that modularize the system. With this philosophy in mind, the number of developed code lines within the project is keeping as small as possible. As REMBO, the OS deployment system to develop has to be transparent to the user. This means a system with a friendly user interface and no te...

Renewable Energy: Policy Considerations for Deploying Renewables

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-07-01

This information paper accompanies the IEA publication Deploying Renewables 2011: Best and Future Policy Practice (IEA, 2011a). It provides more detailed data and analysis on policies for Deploying Renewables, and is intended to complement the main publication. It provides an account of the strategic drivers underpinning renewable energy (RE) technology deployment (energy security, economic development and environment protection) and assesses RE technologies with respect to these drivers, including an estimate of GHG emissions reductions due to RE technologies. The paper also explores the different barriers to deploying renewables at a given stage of market maturity and discusses what tools policy makers can avail of to succeed in removing deployment barriers. An additional topical highlight explores the challenges associated with accelerating the diffusion of RE technologies in developing countries.

Preventive effectiveness of pre-employment medical assessments

NARCIS (Netherlands)

de Kort, W.; van Dijk, F.

1997-01-01

Health gain, prevention of health loss, and avoidance of financial risk all seem to be driving forces for the use of pre-employment medical assessment. An attempt is made to measure the effect of implementing the pre-employment medical assessment on these end points. The anticipated maximum

Encouraging Pattern Language Development in a Pre-Service Inclusive Education Course: A Comparative Study

Science.gov (United States)

Lancaster, Julie; Auhl, Greg

2013-01-01

This study investigated the ability of students in a pre-service teacher education course to deploy pattern language (or professional lexicon) related to specific inclusive teaching strategies. The study sought to determine whether there were differential effects of two approaches to learning, one based on a field-based placement (Applied…

Preparation and procedures of pre-commissioning on DECY-13 cyclotron

International Nuclear Information System (INIS)

Silakhuddin

2016-01-01

A preparation and procedures for pre-commissioning of DECY-13 Cyclotron have been discussed and the steps for these have been arranged. Pre-commissioning is a testing stage of individual subsystems when all subsystems have been integrated into a cyclotron system. The discussion was taken from references, the next the readiness of devices was studied and then the preparation and procedures of the pre-commissioning were arranged. The results of the discussion are that for doing the pre-commissioning of the cyclotron DECY-13 still requires the completion of RF-dee subsystem and some components for testing are still to be completed. (author)

The pre-history of health psychology in the United Kingdom: From natural science and psychoanalysis to social science, social cognition and beyond.

Science.gov (United States)

Murray, Michael

2018-03-01

Health psychology formally came of age in the United Kingdom in the 1980s, but it was prefigured by much discussion about challenges to the dominance of biomedicine in healthcare and debates. This articles focuses on what could be termed the pre-history of health psychology in the UK. This was the period in the earlier 20th century when psychological approaches were dominated by psychoanalysis which was followed by behaviourism and then cognitivism. Review of this pre-history provides the backdrop for the rise of health psychology in the UK and also reveals the tensions between the different theoretical perspectives.

Pre- and post-displacement stressors and time of migration as related to self-rated health among Iraqi immigrants and refugees in Southeast Michigan.

Science.gov (United States)

Jamil, Hikmet; Nassar-McMillanb, Sylvia; Lambert, Richard; Wangd, Yun; Ager, Joel; Arnetz, Bengt

2010-01-01

The objective of this study was to determine whether perceived health status of Iraqi immigrants and refugees residing in the United States was related to pre-migration environmental stress, current unemployment, and if they had emigrated before or after the 1991 Gulf War. A random sample of Iraqis residing in Southeast Michigan, US, was interviewed using an Arab language structured survey. The main outcome measure was self-rated health (SRH). Major predictors included socioeconomics, employment status, pre-migration environmental stress, and health disorders. Path analysis was used to look at mediating effects between predictors and SRH. We found that SRH was significantly worse among participants that had left Iraq after the 1991 Gulf War. Unemployment and environmental stress exposure were inversely related to SRH. There was a direct path between Gulf War exposure and poor health. In addition, there were indirect paths mediated through psychosomatic and psychiatric disorders to SRH. Another path went from Gulf War exposure, via environmental stress and somatic health to poor health. Unemployment had a direct path, as well as indirect paths mediated through psychiatric and psychosomatic disorders, to poor self-rated health. In conclusion, these results suggest that pre- as well as post-migration factors, and period of migration, affect health.

The effects of exposure to documented open-air burn pits on respiratory health among deployers of the Millennium Cohort Study.

Science.gov (United States)

Smith, Besa; Wong, Charlene A; Boyko, Edward J; Phillips, Christopher J; Gackstetter, Gary D; Ryan, Margaret A K; Smith, Tyler C

2012-06-01

To investigate respiratory illnesses and potential open-air burn pit exposure among Millennium Cohort participants who deployed to Iraq or Afghanistan. Using multivariable logistic regression, newly reported chronic bronchitis or emphysema, newly reported asthma, and self-reported respiratory symptoms and possible burn pit exposure within 2, 3, or 5 miles were examined among Army and Air Force deployers surveyed in 2004 to 2006 and 2007 to 2008 (n = 22,844). Burn pit exposure within 3 or 5 miles was not associated with respiratory outcomes after statistical adjustment. Increased symptom reporting was observed among Air Force deployers located within 2 miles of Joint Base Balad; however, this finding was marginally significant with no evidence of trend. In general, these findings do not support an elevated risk for respiratory outcomes among personnel deployed within proximity of documented burn pits in Iraq.

Quality Function Deployment: Application to Chemotherapy Unit Services

Directory of Open Access Journals (Sweden)

Neda Hashemi

2015-10-01

Full Text Available Background: Today’s healthcare organizations are challenged by pressures to meet growing population demands and enhance community health through improving service quality. Quality function deployment is one of the widely-used customerdriven approaches for health services development. In the current study, quality function deployment is used to improve the quality of chemotherapy unit services. Methods: First, we identified chemotherapy outpatient unit patients as chemotherapy unit customers. Then, the Delphi technique and component factor analysis with orthogonal rotation was employed to determine their expectations. Thereafter, data envelopment analysis was performed to specify user priorities. We determined the relationships between patients’ expectations and service elements through expert group consensus using the Delphi method and the relationships between service elements by Pearson correlation. Finally, simple and compound priorities of the service elements were derived by matrix calculation. Results: Chemotherapy unit patients had four main expectations: access, suitable hotel services, satisfactory and effective relationships, and clinical services. The chemotherapy unit has six key service elements of equipment, materials, human resources, physical space, basic facilities, and communication and training. There were four-level relationships between the patients’ expectations and service elements, with mostly significant correlations between service elements. According to the findings, the functional group of basic facilities was the most critical factor, followed by materials. Conclusion: The findings of the current study can be a general guideline as well as a scientific, structured framework for chemotherapy unit decision makers in order to improve chemotherapy unit services.

The nutritional impact of the Pre-School Health Programme at three clinics in Central Province, Kenya

NARCIS (Netherlands)

Hoorweg, J.C.; Niemeijer, R.

1980-01-01

Abr. sum.: Contains an account of a study of the effects of the Pre-School Health Programme at three clinics in different ecological zones in Central Province, Kenya. Two groups of mothers were selected for interviewing: recent entrants and longtime participants. The study concentrates on the

Oral health-related quality of life of edentulous patients after complete dentures relining

Directory of Open Access Journals (Sweden)

Krunić Nebojša

2015-01-01

Full Text Available Background/Aim. Tooth loss affects oral health-related life quality. More than a third of edentulous patients are not fully satisfied with their complete dentures and mainly complain of insufficient stability, retention, and pain during mastication. Solving the problem may include relining by materials that are based on silicone or acrylic. The aim of this study was to determine the level of patients’ satisfaction before and after relining upper dentures with soft and rigid liners. Methods. The patients (n = 24 were divided into two study groups. Maxillary denture relining of the first group of patients was performed with hard acrylic based resins while in the second group of patients complete denture was relined with a silicone-based soft liner. They were asked the questions from the specifically adapted the Oral Health Impact Profile Questionnaire for edentulous patients before and three months after relining dentures. Results. After relining the patients showed a higher degree of satisfaction with their dentures in all the tested domains (masticatory function, psychological discomfort, social disability and retention and hygiene. The patients with soft denture relines were more satisfied. Conclusion. Relining of maxillary complete dentures significantly positively impacts the quality of life of patients in all the tested domains (masticatory function, psychological discomfort, social disability, pain and oral hygiene. Better results were achieved using a silicone-based soft liner, which recommends it as the material of choice for relining dentures.

Gestational trophoblastic disease following complete hydatidiform ...

African Journals Online (AJOL)

Gestational trophoblastic disease following complete hydatidiform mole in Mulago Hospital, Kampala, Uganda. ... The main outcome measures were pre- and post-evacuation serum hCG levels and complications associated with oral methotrexate use. Results : The prevalence of CHM was 3.42 per 1,000 deliveries.

Pre-notification letter type and response rate to a postal survey among women who have recently given birth.

Science.gov (United States)

Todd, Angela L; Porter, Maree; Williamson, Jennifer L; Patterson, Jillian A; Roberts, Christine L

2015-12-01

Surveys are commonly used in health research to assess patient satisfaction with hospital care. Achieving an adequate response rate, in the face of declining trends over time, threatens the quality and reliability of survey results. This paper evaluates a strategy to increase the response rate in a postal satisfaction survey with women who had recently given birth. A sample of 2048 Australian women who had recently given birth at seven maternity units in New South Wales were invited to participate in a postal survey about their recent experiences with maternity care. The study design included a randomised controlled trial that tested two types of pre-notification letter (with or without the option of opting out of the survey). The study also explored the acceptability of a request for consent to link survey data with existing routinely collected health data (omitting the latter data items from the survey reduced survey length and participant burden). This consent was requested of all women. The survey had an overall response rate of 46% (913 completed surveys returned, total sample 1989). Women receiving the pre-notification letter with the option of opting out of the survey were more likely to actively decline to participate than women receiving the letter without this option, although the overall numbers of women declining were small (27 versus 12). Letter type was not significantly associated with the return of a completed survey. Among women who completed the survey, 97% gave consent to link their survey data with existing health data. The two types of pre-notification letters used in our study did not influence the survey response rate. However, seeking consent for record linkage was highly acceptable to women who completed the survey, and represents an important strategy to add to the arsenal for designing and implementing effective surveys. In addition to aspects of survey design, future research should explore how to more effectively influence personal

On problems related to the deployment of depleted uranium weapons in the Balkans

International Nuclear Information System (INIS)

Mietelski, J. W.; Waligorski, M.P.R.; Zunic, Z.S.

2002-01-01

The likely long-term environmental and health effects of the deployment of weapons containing depleted uranium (DU) in the Balkans are discussed. To determine whether depleted uranium or spent reactor fuel was used in the weapons, knowledge is required of the 235 U to 238 U activity (or concentration) ratio in the measured samples. To this end, and to distinguish between uranium originating from natural and man-made sources, we discuss some of the methodology and metrology issues involved in performing alpha- and gamma- spectrometry of uranium in environmental and human samples. We present results of nuclear spectrometry performed on DU core deposits from the aluminium jacket of a PGU-14 bullet found in South Serbia. We draw attention to aspects involving ionising radiation, which are likely to be of importance when formulating a prognosis of the possible environmental and health impact of the deployment of DU weapons, indicating the importance of the inhalation pathway in children. (author)

Deploying Renewables - Best and Future Policy Practice

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-11-23

The global energy system faces urgent challenges. Concerns about energy security are growing, as highlighted by the recent political turmoil in Northern Africa and the nuclear incident in Fukushima. At the same time, the need to respond to climate change is more critical than ever. Against this background, many governments have increased efforts to promote deployment of renewable energy -- low-carbon sources that can strengthen energy security. This has stimulated unprecedented rise in deployment, and renewables are now the fastest growing sector of the energy mix. This 'coming of age' of renewable energy also brings challenges. Growth is focused on a few of the available technologies, and rapid deployment is confined to a relatively small number of countries. In more advanced markets, managing support costs and system integration of large shares of renewable energy in a time of economic weakness and budget austerity has sparked vigorous political debate. The IEA's new report, Deploying Renewables 2011: Best and Future Policy Practice: - Provides a comprehensive review and analysis of renewable energy policy and market trends; - Analyses in detail the dynamics of deployment and provides best-practice policy principles for different stages of market maturity; - Assesses the impact and cost-effectiveness of support policies using new methodological tools and indicators; - Investigates the strategic reasons underpinning the pursuit of RE deployment by different countries and the prospects for globalisation of RE. This new book builds on and extends a 2008 IEA publication, drawing on recent policy and deployment experience world-wide. It provides guidance for policy makers and other stakeholders to avoid past mistakes, overcome new challenges and reap the benefits of deploying renewables -- today and tomorrow.

Modeling EERE Deployment Programs

Energy Technology Data Exchange (ETDEWEB)

Cort, Katherine A.; Hostick, Donna J.; Belzer, David B.; Livingston, Olga V.

2007-11-08

The purpose of this report is to compile information and conclusions gathered as part of three separate tasks undertaken as part of the overall project, “Modeling EERE Deployment Programs,” sponsored by the Planning, Analysis, and Evaluation office within the Department of Energy’s Office of Energy Efficiency and Renewable Energy (EERE). The purpose of the project was to identify and characterize the modeling of deployment programs within the EERE Technology Development (TD) programs, address improvements to modeling in the near term, and note gaps in knowledge where future research is needed.

Effects of Soldiers’ Deployment on Children’s Academic Performance and Behavioral Health

Science.gov (United States)

2011-01-01

vector of indicators of parent deployment at time t, Xitk is a vector of student-level covariates, Pit is a vector of parent-level covariates, dkt are...school effect ( dkt ), alongside other necessary covariates, was often not pos- sible. When trying to estimate the models, we no longer had a nested

Characteristics of Hospitals Associated with Complete and Partial Implementation of Electronic Health Records.

Science.gov (United States)

Bhounsule, Prajakta; Peterson, Andrew M

2016-01-01

(1) To determine the proportion of hospitals with and without implementation of electronic health records (EHRs). (2) To examine characteristics of hospitals that report implementation of EHRs partially or completely versus those that report no implementation. (3) To identify hospital characteristics associated with nonimplementation to help devise future policy initiatives. This was a retrospective cross-sectional study using the 2012 American Hospital Association Annual Survey Database. The outcome variable was the implementation of EHRs completely or partially. Independent variables were hospital characteristics, such as staffing, organization structure, accreditations, ownership, and services and facilities provided at the hospitals. Descriptive frequencies were determined, and multinomial logistic regression was used to determine variables independently associated with complete or partial implementation of EHRs. In this study, 12.6 percent of hospitals reported no implementation of EHRs, while 43.9 percent of hospitals implemented EHRs partially and 43.5 percent implemented EHRs completely. Overall characteristics of hospitals with complete and partial implementation were similar. The multinomial regression model revealed a positive association between the number of licensed beds and complete implementation of EHRs. A positive association was found between children's general medical, surgical, and heart hospitals and complete implementation of EHRs. Conversely, psychiatric and rehabilitation hospitals, limited service hospitals, hospitals participating in a network, service hospitals, government nonfederal hospitals, and nongovernment not-for-profit hospitals showed less likelihood of complete implementation of EHRs. Study findings suggest a disparity of EHR implementation between larger, for-profit hospitals and smaller, not-for-profit hospitals. Low rates of implementation were observed with psychiatric and rehabilitation hospitals. EHR policy initiatives

Latent profile analysis of lifestyle characteristics and health risk behaviors among Koreans who have completed industrial accident care.

Science.gov (United States)

Choi, Wan-Suk; Moon, Ok-Kon; Yeum, Dong-Moon

2017-10-07

This study investigated the characteristics and health behavior profiles of 1,803 workers who had experienced industrial accidents. Average weekly exercise days, average number of cigarettes smoked per day, average daily sleep duration, and number of days of alcohol consumption were selected to investigate health behavior profiles. Specifically, latent profile analysis was applied to identify the health behavior profiles of people who had completed industrial accident care; the latent classes were the health-conscious type (n=240), the potential-risk type (n=850), and the high-risk type (n=713). Comparison of the health-conscious and potential-risk types indicated that younger subjects, the employed, and those with lower social status and life satisfaction were more likely to be the potential-risk type. Comparison of the health-conscious and high-risk types revealed that males, younger subjects, the employed, those without chronic illnesses, and those with lower social status and life satisfaction were more likely to be the high-risk type. The results suggest that industrial accident victims who have completed accident care have different health behaviors and it is necessary to improve health promotion based on health type characteristics.

Pre-migration Trauma Exposure and Psychological Distress for Asian American Immigrants: Linking the Pre- and Post-migration Contexts.

Science.gov (United States)

Li, Miao; Anderson, James G

2016-08-01

Drawing on the life course perspective and the assumptive world theory, this paper examines whether pre-migration trauma exposure is associated with psychological distress through post-migration perceived discrimination for Asian American immigrants. The study is based on cross-sectional data from the National Latino and Asian American Study (N = 1639). Structural equation model is used to estimate the relationship between pre-migration trauma, post-migration perceived discrimination, and psychological distress. Additional models are estimated to explore possible variations across ethnic groups as well as across different types of pre-migration trauma experience. Pre-migration trauma exposure is associated with higher levels of psychological distress, both directly and indirectly through higher level of perceived discrimination, even after controlling for demographic/acculturative factors and post-migration trauma exposure. This pattern holds for the following sub-types of pre-migration trauma: political trauma, crime victimization, physical violence, accidental trauma, and relational trauma. Multi-group analyses show that this pattern holds for all Asian immigrant subgroups except the Vietnamese. Studies of immigrant mental health primarily focus on post-migration stressors. Few studies have considered the link between pre- and post-migration contexts in assessing mental health outcomes. The study illustrates the usefulness of bridging the pre- and post-migration context in identifying the mental health risks along the immigrant life course.

Physics of Health Sciences

Science.gov (United States)

Baublitz, Millard; Goldberg, Bennett

A one-semester algebra-based physics course is being offered to Boston University students whose major fields of study are in allied health sciences: physical therapy, athletic training, and speech, language, and hearing sciences. The classroom instruction incorporates high-engagement learning techniques including worksheets, student response devices, small group discussions, and physics demonstrations instead of traditional lectures. The use of pre-session exercises and quizzes has been implemented. The course also requires weekly laboratory experiments in mechanics or electricity. We are using standard pre- and post-course concept inventories to compare this one-semester introductory physics course to ten years of pre- and post-course data collected on students in the same majors but who completed a two-semester course.

Deployment-related risk factors of low back pain

DEFF Research Database (Denmark)

Nissen, Lars Ravnborg; Marott, Jacob Louis; Gyntelberg, Finn

2014-01-01

Where much is known about the consequences of spinal and low back pain (LBP) during military deployments, there is lesser knowledge of risk factors for LBP among the deployed forces. The objective of this study was to identify deployment-related exposures associated with LBP. The study was a ques...... their subordinates and involve medical personnel, especially deployed physiotherapists, by giving advice to soldiers of different military occupational specialties on how to optimize ergonomics at work....

Tiny intracranial aneurysms: Endovascular treatment by coil embolisation or sole stent deployment

International Nuclear Information System (INIS)

Lu Jun; Liu Jiachun; Wang Lijun; Qi Peng; Wang Daming

2012-01-01

Purpose: Tiny intracranial aneurysms pose a significant therapeutic challenge for interventional neuroradiologists. The authors report their preliminary results of endovascular treatment of these aneurysms. Methods: Between January 2002 and December 2009, 52 tiny intracranial aneurysms (defined as ≤3 mm in maximum diameter) in 46 patients (22 men; mean age, 57.9 years) were treated by endosaccular coil embolisation or sole stent deployment in the parent artery. Of 52 aneurysms, 29 had ruptured and 23 remained unruptured. The initial angiographic results, procedural complications, and clinical outcomes were assessed at discharge. Imaging follow-up was performed with cerebral angiography. Results: One aneurysm coiling procedure failed because of unsuccessful micro-catheterization. Forty-three aneurysms were successfully coil embolized, of which complete occlusion was obtained in 14, subtotal occlusion in 18 and incomplete occlusion in 11. The other 8 aneurysms were treated by sole stent deployment in the parent artery. Procedural complications (2 intraprocedural ruptures and 3 thromboembolic events) occurred in 5 (9.6%) of 52 aneurysms, resulting in permanent morbidity in only 1 (2.2%, 1/46) patient. No rebleeding occurred during clinical follow-up (mean duration, 46.7 months). Of the 16 coiled aneurysms that receiving repetitive angiography, 6 initially completely and 3 subtotally occluded aneurysms remained unchanged, 4 initially subtotally and 3 incompletely occluded aneurysms progressed to total occlusion. Five sole stent deployed aneurysms received angiographic follow-up (mean duration, 10.0 months), of which 3 remained unchanged, 1 became smaller and 1 progressed to total occlusion. Conclusion: Endovascular treatment of tiny intracranial aneurysms is technical feasible and relatively safe. Coil embolisation seems to be effective in preventing early recanalisation, whereas sole stenting technique needs further investigation to determine its effectiveness.

Integrated care services: lessons learned from the deployment of the NEXES project

Directory of Open Access Journals (Sweden)

Carme Hernandez

2015-03-01

Full Text Available Objectives: To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. Setting: One health care sector in Spain (Barcelona (n = 11.382; six municipalities in Norway (Trondheim (n = 450; and one hospital in Greece (Athens (n = 388. Method: The four services were: (i Home-based long-term maintenance of rehabilitation effects (n = 337; (ii Enhanced Care for frail patients, n = 1340; (iii Home Hospitalization and Early Discharge (n = 2404; and Support for remote diagnosis (forced spirometry testing in primary care (Support (n = 8139. Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. Results: The project demonstrated: (i Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01; (ii Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05; (iii Reduced in-hospital days for all types of patients (p < 0.001 in Home Hospitalization/Early Discharge; and (iv Increased quality of testing (p < 0.01 for patients with respiratory symptoms in Support, with marked differences among sites. Conclusions: The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.

Integrated care services: lessons learned from the deployment of the NEXES project

Directory of Open Access Journals (Sweden)

Carme Hernandez

2015-03-01

Full Text Available Objectives: To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus.Setting: One health care sector in Spain (Barcelona (n = 11.382; six municipalities in Norway (Trondheim (n = 450; and one hospital in Greece (Athens (n = 388.Method: The four services were: (i Home-based long-term maintenance of rehabilitation effects (n = 337; (ii Enhanced Care for frail patients, n = 1340; (iii Home Hospitalization and Early Discharge (n = 2404; and Support for remote diagnosis (forced spirometry testing in primary care (Support (n = 8139. Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted.Results: The project demonstrated: (i Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01; (ii Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05; (iii Reduced in-hospital days for all types of patients (p < 0.001 in Home Hospitalization/Early Discharge; and (iv Increased quality of testing (p < 0.01 for patients with respiratory symptoms in Support, with marked differences among sites.Conclusions: The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.

Setting visual pre-placement testing in a technology manufacturing environment.

Science.gov (United States)

Gowan, Nancy J

2014-01-01

Every day we use our eyes to perform activities of daily living and work. Aging changes as well as health conditions can impact an individual's visual function, making it more difficult to accurately perform work activities. Occupational therapists work closely with optometrists and employers to develop ways to accommodate for these changes so that the employee can continue to perform the work tasks. This manuscript outlines a case study of systematically developing visual demands analyses and pre-placement vision screening assessment protocols for individuals completing quality inspection positions. When the vision screening was completed, it was discovered that over 20% of the employees had visual deficits that were correctable. This screening process yielded improved quality results but also identification of previously undetected visual deficits. Further development of vision screening in the workplace is supported.

The Assessment of Diet Quality and Its Effects on Health Outcomes Pre-pregnancy and during Pregnancy.

Science.gov (United States)

Martin, Julie C; Zhou, Shao J; Flynn, Angela C; Malek, Lenka; Greco, Rebecca; Moran, Lisa

2016-03-01

Overweight and obesity pre pregnancy or during pregnancy is associated with an increased risk for maternal obstetric and fetal complications. Diet is one modifiable risk factor that women may be motivated to improve. General healthy eating guidelines, micronutrient sufficiency and macronutrient quantity and quality are important nutrition considerations pre and during pregnancy. With regards to specific nutrients, health authorities have recommendations for folate and/or iodine supplementation; but not consistently for iron and omega-3 despite evidence for their association with health outcomes. There are modest additional requirements for energy and protein, but not fat or carbohydrate, in mid-late pregnancy. Diet indices and dietary pattern analysis are additional tools or methodologies used to assess diet quality. These tools have been used to determine dietary intakes and patterns and their association with pregnancy complications and birth outcomes pre or during pregnancy. Women who may unnecessarily resist foods due to fear of food contamination from listeriosis and methylmercury may limit their diet quality and a balanced approached is required. Dietary intake may also vary according to certain population characteristics. Additional support for women who are younger, less educated, overweight and obese, from socially disadvantaged areas, smokers and those who unnecessarily avoid healthy foods, is required to achieve a higher quality diet and optimal lifestyle peri conception. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Family Reintegration Following Guard Deployment

Science.gov (United States)

2010-09-20

Somalia Peacekeepers. Journal of Consulting and Clinical Psychology, 72(5), 909-913. Haas DM . Pazdernik LA. Olsen CH. A cross-sectional survey of the...relationship between partner deployment and stress in pregnancy during wartime. Haas DM . Pazdernik LA. Partner deployment and stress in pregnant...Identify 3-5 key words relating to the proposal. (Required) I used MESH Headings instead of the CRISP Thesaurus for key

Heterogeneous Deployment Analysis for Cost-Effective Mobile Network Evolution

DEFF Research Database (Denmark)

Coletti, Claudio

2013-01-01

network coverage and boosting network capacity in traffic hot-spot areas. The thesis deals with the deployment of both outdoor small cells and indoor femto cells. Amongst the outdoor solution, particular emphasis is put on relay base stations as backhaul costs can be reduced by utilizing LTE spectrum...... statistical models of deployment areas, the performance analysis is carried out in the form of operator case studies for large-scale deployment scenarios, including realistic macro network layouts and inhomogeneous spatial traffic distributions. Deployment of small cells is performed by means of proposed...... heuristic deployment algorithms, which combine network coverage and spatial user density information. As a secondary aspect, deployment solutions achieving the same coverage performance are compared in terms of Total Cost of Ownership (TCO), in order to investigate the viability of different deployment...

Barriers and facilitators associated with colonoscopy completion in individuals with multiple chronic conditions: a qualitative study

Directory of Open Access Journals (Sweden)

Sultan S

2017-05-01

Full Text Available Shahnaz Sultan,1–4 Melissa R Partin,1,2 Phalgoon Shah,5 Jennifer LeLaurin,4 Ivette Magaly Freytes,4 Chandylen L Nightingale,6 Susan F Fesperman,4 Barbara A Curbow,7 Rebecca J Beyth3,4,8 1Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, 2Department of Medicine, University of Minnesota, Minneapolis, MN, 3Department of Medicine, University of Florida College of Medicine, Gainesville, FL, 4Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System, Gainesville, FL, 5Department of Medicine, Tripler Army Medical Center, Honolulu, HI, 6Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem NC, 7Department of Community and Behavioral Health, University of Maryland, College Park, MD, 8Geriatric Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA Background: A recommendation to undergo a colonoscopy, an invasive procedure that requires commitment and motivation, planning (scheduling and finding a driver and preparation (diet restriction and laxative consumption, may be uniquely challenging for individuals with multiple chronic conditions (MCCs. This qualitative study aimed to describe the barriers and facilitators to colonoscopy experienced by such patients.Materials and methods: Semistructured focus groups were conducted with male Veterans who were scheduled for outpatient colonoscopy and either failed to complete the procedure or completed the examination. Focus group recordings were transcribed and analyzed by an inductive grounded approach using constant comparative analysis.Results: Forty-four individuals aged 51–83 years participated in this study (23 adherent and 21 nonadherent. Participants had an average of 7.4 chronic conditions (range 2–14. The five most common chronic conditions were hypertension (75%, hyperlipidemia (75

Pre-eclampsia: a life-threatening pregnancy syndrom

Directory of Open Access Journals (Sweden)

Andrea Brazdova

2014-10-01

Full Text Available Pre-eclampsia is a serious pathological state affecting 5-10% of pregnant women. Currently, it is diagnosed in the second half of pregnancy, particularly after the 20th week. Symptoms mostly correspond to the changes of blood vessels and kidneys. The severity of pre-eclampsia is proportional to symptomatic manifestations, thus the more symptoms present, the higher is of pre-eclampsia development. Although there are several studies dealing with pre-eclampsia pathology, the complete etiology is still unknown. In this review paper, several theories are presented and discussed.

Simplified Deployment of Health Informatics Applications by Providing Docker Images.

Science.gov (United States)

Löbe, Matthias; Ganslandt, Thomas; Lotzmann, Lydia; Mate, Sebastian; Christoph, Jan; Baum, Benjamin; Sariyar, Murat; Wu, Jie; Stäubert, Sebastian

2016-01-01

Due to the specific needs of biomedical researchers, in-house development of software is widespread. A common problem is to maintain and enhance software after the funded project has ended. Even if many tools are made open source, only a couple of projects manage to attract a user basis large enough to ensure sustainability. Reasons for this include complex installation and configuration of biomedical software as well as an ambiguous terminology of the features provided; all of which make evaluation of software laborious. Docker is a para-virtualization technology based on Linux containers that eases deployment of applications and facilitates evaluation. We investigated a suite of software developments funded by a large umbrella organization for networked medical research within the last 10 years and created Docker containers for a number of applications to support utilization and dissemination.

A regulations’ survey for the wireless telecommunications deployment in Colombia

Directory of Open Access Journals (Sweden)

José Gustavo Morales-Guarín

2016-01-01

Full Text Available This paper describes the current wireless telecommunications infrastructure deployment regulations in Colombia. It also refers to the possible effects that this infrastructure could cause to the country`s health and environment. similarly, the results obtained show a comparison between the Argentina’s current regulations, one of the most relevant researches carried out and the Colombian case. finally, some recommendations are proposed that can be considered in the project of regulations applicable in Colombia for the ensuring purpose that the non-ionizing radiation generated by wireless communications systems do not have effects on health and the environment.

A Movement-Assisted Deployment of Collaborating Autonomous Sensors for Indoor and Outdoor Environment Monitoring.

Science.gov (United States)

Niewiadomska-Szynkiewicz, Ewa; Sikora, Andrzej; Marks, Michał

2016-09-14

Using mobile robots or unmanned vehicles to assist optimal wireless sensors deployment in a working space can significantly enhance the capability to investigate unknown environments. This paper addresses the issues of the application of numerical optimization and computer simulation techniques to on-line calculation of a wireless sensor network topology for monitoring and tracking purposes. We focus on the design of a self-organizing and collaborative mobile network that enables a continuous data transmission to the data sink (base station) and automatically adapts its behavior to changes in the environment to achieve a common goal. The pre-defined and self-configuring approaches to the mobile-based deployment of sensors are compared and discussed. A family of novel algorithms for the optimal placement of mobile wireless devices for permanent monitoring of indoor and outdoor dynamic environments is described. They employ a network connectivity-maintaining mobility model utilizing the concept of the virtual potential function for calculating the motion trajectories of platforms carrying sensors. Their quality and utility have been justified through simulation experiments and are discussed in the final part of the paper.

Pre-cementation of deep shaft

Science.gov (United States)

Heinz, W. F.

1988-12-01

Pre-cementation or pre-grouting of deep shafts in South Africa is an established technique to improve safety and reduce water ingress during shaft sinking. The recent completion of several pre-cementation projects for shafts deeper than 1000m has once again highlighted the effectiveness of pre-grouting of shafts utilizing deep slimline boreholes and incorporating wireline technique for drilling and conventional deep borehole grouting techniques for pre-cementation. Pre-cementation of deep shaft will: (i) Increase the safety of shaft sinking operation (ii) Minimize water and gas inflow during shaft sinking (iii) Minimize the time lost due to additional grouting operations during sinking of the shaft and hence minimize costly delays and standing time of shaft sinking crews and equipment. (iv) Provide detailed information of the geology of the proposed shaft site. Informations on anomalies, dykes, faults as well as reef (gold bearing conglomerates) intersections can be obtained from the evaluation of cores of the pre-cementation boreholes. (v) Provide improved rock strength for excavations in the immediate vicinity of the shaft area. The paper describes pre-cementation techniques recently applied successfully from surface and some conclusions drawn for further considerations.

Primeval health economics in Britain: a personal retrospect of the pre-HESG (Health Economists' Study Group) period.

Science.gov (United States)

Williams, A

1998-08-01

There is a danger that the history of health economics in Britain comes to be regarded as roughly co-terminous with the history of the Health Economists' Study Group (HESG). As one of the founders of that Group, I would take some pride from that, if it were true. But it is not. Just as primitive human societies existed before recorded history, so there was primeval health economics in Britain prior to 1972. There is probably more of this primeval health economics than even I know about, but as one of the ancient relics of that period I have been offered the opportunity to reminisce about what I saw during those dark ages! When one reaches the advanced age of 70, there is no escaping the fact that your past is bound to be more extensive (and probably more enjoyable) than your future, which is why the old enjoy looking back more than they enjoy looking forward! I am no exception. Hence this essay, which may either be seen as a rather self-indulgent bout of nostalgia concerning the early days of health economics in Britain, or as an archaeological enterprise, exhibiting, for all to wonder at, the treasures to be found at carefully selected ancient (i.e., pre-HESG) sites in Britain. Either way, my purpose is to suggest that most of the fundamental issues with which health economists have grappled in the last 25 years had already been identified and addressed in a careful way during the decade preceding the formation of the HESG.

Examining the links between therapeutic jurisprudence and mental health court completion.

Science.gov (United States)

Redlich, Allison D; Han, Woojae

2014-04-01

Research demonstrates that mental health courts (MHCs) lead to improved outcomes compared to traditional criminal court processes. An underlying premise of MHCs is therapeutic jurisprudence (TJ). However, no research, to our knowledge, has examined whether MHC outcomes are predicted by TJ principles as theorized. In the present study, we examined whether principles measured at the onset of MHC enrollment (knowledge, perceived voluntariness, and procedural justice) predicted MHC completion (graduation). Using structural equation modeling with MHC participants from four courts, a significant, direct relationship between TJ and MHC completion was found, such that higher levels of TJ were associated with higher rates of success. Although this direct effect became nonsignificant when mediator variables were included, a significant indirect path remained, such that increased levels of initial perceived voluntariness and procedural justice, and MHC knowledge, led to decreased rates of new arrests, prison, MHC bench warrants, and increased court compliance, which, in turn, led to a higher likelihood of MHC graduation. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A Prospective Study of Lupus and Rheumatoid Arthritis in Relation to Deployment in Support of Iraq and Afghanistan: The Millennium Cohort Study

Directory of Open Access Journals (Sweden)

Kelly A. Jones

2011-01-01

Full Text Available The objective of this study was to prospectively assess the association between deployment in support of the operations in Iraq and Afghanistan and newly reported lupus and rheumatoid arthritis while also considering the effects of demographic, behavioral, and occupational characteristics. A total of 77,047 (2001–2003 and 31,110 (2004–2006 participants completed the baseline Millennium Cohort questionnaire and were resurveyed approximately every 3 years. Longitudinal analyses were used to assess the adjusted association between deployment to Iraq and Afghanistan with and without combat exposures and newly reported disease. After adjusting, deployment was not significantly associated with newly reported lupus compared with nondeployers. However, compared with nondeployers, deployers with and without combat exposures were significantly less likely to newly report rheumatoid arthritis. Women, non-Hispanic black, and Hispanic participants had a significantly elevated risk for both diseases. Overall, deployment was not associated with an increased risk of newly reported lupus or rheumatoid arthritis.

A Wireless Sensor Network for Structural Health Monitoring: Performance and Experience

OpenAIRE

Paek, Jeongyeup; Chintalapudi, Krishna; Caffrey, John; Govindan, Ramesh; Masri, Sami

2005-01-01

While sensor network research has made significant strides in the past few years, the literature has relatively few examples of papers that have evaluated and validated a complete experimental system. In this paper we discuss our deployment experiences and evaluate the performance of a multi-hop wireless data acquisition system (called Wisden) for structural health monitoring (SHM) on a large seismic test structure used by civil engineers. Our experiments indicate that, with the latest sensor...

Developing Health-Based Pre-Planning Clearance Goals for Airport Remediation Following a Chemical Terrorist Attack: Decision Criteria for Multipathway Exposure Routes

Science.gov (United States)

Watson, Annetta; Dolislager, Fredrick; Hall, Linda; Raber, Ellen; Hauschild, Veronique D.; Love, Adam H.

2011-01-01

In the event of a chemical terrorist attack on a transportation hub, post-event remediation and restoration activities necessary to attain unrestricted facility re-use and re-entry could require hours to multiple days. While timeframes are dependent on numerous variables, a primary controlling factor is the level of pre-planning and decision-making completed prior to chemical release. What follows is the second of a two-part analysis identifying key considerations, critical information and decision criteria to facilitate post-attack and post-decontamination consequence management activities. Decision criteria analysis presented here provides first-time, open-literature documentation of multi-pathway, health-based remediation exposure guidelines for selected toxic industrial compounds, chemical warfare agents, and agent degradation products for pre-planning application in anticipation of a chemical terrorist attack. Guideline values are provided for inhalation and direct ocular vapor exposure routes as well as percutaneous vapor, surface contact, and ingestion. Target populations include various employees as well as transit passengers. This work has been performed as a national case study conducted in partnership with the Los Angeles International Airport and The Bradley International Terminal. All recommended guidelines have been selected for consistency with airport scenario release parameters of a one-time, short-duration, finite airborne release from a single source followed by compound-specific decontamination. PMID:21399674

The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study.

Science.gov (United States)

Van Son, M A C; De Vries, J; Roukema, J A; Gosens, T; Verhofstad, M H J; Den Oudsten, B L

2016-05-01

The aim of this prospective study was to describe the course of health status (HS), health-related quality of life, and quality of life (QOL) in patients with lower extremity fractures (LEF) up to 6 months post-fracture. Patients (n = 171; age range 18-100 years) completed the World Health Organization Quality of Life assessment instrument-Bref (WHOQOL-Bref) and the Short Musculoskeletal Function Assessment questionnaire (SMFA) at time of diagnosis (i.e., pre-injury status), 1 week, and 6 months post-fracture. Linear mixed modeling was performed. Interaction effects of time with treatment were detected for the WHOQOL-Bref facet Overall QOL and General health (p = .002) and Physical health (p = .003). Patients did not return to their pre-injury Physical health, Psychological health, and Environment 6 months post-fracture (p choice of the questionnaire influences the derived conclusions. LEF did not affect satisfaction with social relationships.

Does gender matter? Exploring mental health recovery court legal and health outcomes.

Science.gov (United States)

Kothari, Catherine L; Butkiewicz, Robert; Williams, Emily R; Jacobson, Caron; Morse, Diane S; Cerulli, Catherine

2014-12-05

Based upon therapeutic justice principles, mental health courts use legal leverage to improve access and compliance to treatment for defendants who are mentally ill. Justice-involved women have a higher prevalence of mental illness than men, and it plays a greater role in their criminal behavior. Despite this, studies examining whether women respond differently than men to mental health courts are lacking. Study goals were to examine gender-related differences in mental health court participation, and in criminal justice, psychiatric and health-related outcomes. This study utilized a quasi-experimental pre-posttest design without a control group. The data were abstracted from administrative records of Kalamazoo Community Mental Health and Substance Abuse agency, the county jail and both county hospitals, 2008 through 2011. Generalized estimating equation regression was used to assess gender-differences in pre-post program outcomes (jail days, psychiatric and medical hospitalization days, emergency department visits) for the 30 women and 63 men with a final mental health court disposition. Program-eligible females were more likely than males to become enrolled in mental health court. Otherwise they were similar on all measured program-participation characteristics: treatment compliance, WRAP participation and graduation rate. All participants showed significant reductions in emergency department visits, but women-completers had significantly steeper drops than males: from 6.7 emergency department visits to 1.3 for women, and from 4.1 to 2.4 for men. A similar gender pattern emerged with medical-hospitalization-days: from 2.2 medical hospital days down to 0.1 for women, and from 0.9 days up to 1.8 for men. While women had fewer psychiatric hospitalization days than men regardless of program involvement (2.5 and 4.6, respectively), both genders experienced fewer days after MHRC compared to before. Women and men showed equal gains from successful program completion in

28 CFR 345.81 - Pre-industrial training.

Science.gov (United States)

2010-07-01

... training is available and the worker has not completed both the skill training and orientation phases of... pre-industrial training is not available, new FPI assignees will receive on-the-job training in pre-industrial pay status for a period of at least 30 days before being promoted into available fourth grade jobs. ...

The Health and Safety Benefits of New Technologies in Mining: A Review and Strategy for Designing and Deploying Effective User-Centred Systems

Directory of Open Access Journals (Sweden)

Tim Horberry

2012-10-01

Full Text Available Mining is currently experiencing a rapid growth in the development and uptake of automation and other new technologies (such as collision detection systems; however, they are often developed from a technology-centred perspective that does not explicitly consider the end-user. This paper first presents a review of the technologies currently available (or near-market and the likely human factors issues associated with them. The second part of the paper presents a potential long term strategy for research and development that aims to maximise the safety and health benefits for operators of such new technologies. The strategy includes a four stage research and development process, this covers: better understanding the needs for technology, user requirements and risk/cost analysis; human element design, procurement and deployment processes; evaluation and verification of the strategy; and dissemination of it to relevant stakeholders (including equipment manufacturers, mine site purchasers and regulators. The paper concludes by stressing the importance of considering the human element with respect to new mining technologies and the likely benefits of adopting the type of strategy proposed here. The overall vision is for mining to become safer and healthier through effective user-centred design and deployment of new technologies that serve both operator needs and the demands of the workplace.

Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands.

Science.gov (United States)

Bruggink, Jan-Willem; de Goeij, Moniek C M; Otten, Ferdy; Kunst, Anton E

2016-10-01

International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health, and alcohol and tobacco use changed after the recession started. We used data from the Dutch Health Interview Surveys: 2006-2008 (pre-crisis period) and 2009-2013 (crisis period). Respondents aged 25-64 were divided into socioeconomic groups based on labour status, income level and income change. Inequalities in health and stimulant use among these socioeconomic groups were described by period and changes between the pre-crisis and crisis period were investigated using logistic regression models. Most inequalities did not change, with some exceptions. For perceived general health, inequalities between employed persons and persons not in the labour force were larger in the crisis period (unfavourable trends for those not in the labour force). For smoking, inequalities between unemployed and employed persons were larger in the crisis period (decreasing smoking rates only for those employed), as did inequalities between persons with low and high income levels (decreasing smoking rates for those with higher income levels). Excessive drinking decreased among employed persons and persons with a decrease in income, while it remained stable among persons not in the labour force and among persons with an increase in income. The widening of some socioeconomic inequalities in health and stimulant use might suggest an enhanced vulnerability of lower socioeconomic groups to the post-2008 crisis. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Pre-1989 epidemiological surveys of low-level dose pre-conception irradiation

International Nuclear Information System (INIS)

Rose, K.S.B.

1990-01-01

Information from 59 pre-1989 epidemiological surveys concerning pre-conception irradiation at doses less than 0.1 Gy has been collated to determine whether any consistent patterns of health effects emerge. The surveys are considered in three groups: childhood malignancies, Down's syndrome and indicators of reproductive damage. Although a pattern is observed for Down's syndrome, no reliable associations are apparent for childhood malignancies (where all surveys pre-date the Gardner survey at Sellafield) or indications of reproductive damage. The twelve surveys of Down's syndrome in relation to maternal pre-conception irradiation received for medical reasons show a pattern consistent with a doubling dose of about 20 mGy. This doubling dose value is, however, not based on individual measurements of ovarian dose and is inconsistent with results from high-level dose surveys. There is no association between paternal irradiation and Down's syndrome. (author)

The impact of completing upper secondary education - a multi-state model for work, education and health in young men.

Science.gov (United States)

Hoff, Rune; Corbett, Karina; Mehlum, Ingrid S; Mohn, Ferdinand A; Kristensen, Petter; Hanvold, Therese N; Gran, Jon M

2018-04-27

Completing upper secondary education is associated with higher work participation and less health-related absence from work. Although these outcomes are closely interrelated, most studies focus on single outcomes, using cross-sectional designs or short follow-up periods. As such, there is limited knowledge of the long-term outcomes, and how paths for completers and non-completers unfold over time. In this paper, we use multi-state models for time-to-event data to assess the long-term effects of completing upper secondary education on employment, tertiary education, sick leave, and disability pension over twelve and a half years for young men. Baseline covariates and twelve and a half years of follow-up data on employment, tertiary education, sick leave and disability pension were obtained from national registries for all males born in Norway between 1971 and 1976 (n =184951). The effects of completing upper secondary education (by age 23) were analysed in a multi-state framework, adjusting for both individual and family level confounders. All analyses were done separately for general studies and vocational tracks. Completers do better on a range of outcomes compared to non-completers, for both fields of upper secondary education, but effects of completion change over time. The largest changes are for tertiary education and work, with the probability of work increasing reciprocally to the probability of education. Vocational students are quicker to transfer to the labour market, but tend to have more unemployment, sick leave and disability, and the absolute effects of completion on these outcomes are largest for vocational tracks. However, the relative effects of completion are larger for general studies. Completing upper secondary education increases long-term work participation and lowers health-related absence for young men, but effects diminish over time. Studies that have used shorter follow-up periods could be overstating the negative effects of dropout on

Economic assessment of the IRIS reactor for deployment in Brazil using INPRO methodology

International Nuclear Information System (INIS)

Goncalves Filho, Orlando Joao Agostinho

2009-01-01

This paper presents the main results of the evaluation of the economic competitiveness of the International Reactor Innovative and Secure (IRIS) for deployment in Brazil using the assessment methodology developed under the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO), co-ordinated by the International Atomic Energy Agency (IAEA). INPRO was initiated in 2001 and has the main objective of helping to ensure that nuclear energy will be available to contribute in a sustainable manner to the energy needs of the 21st century. Among its missions are the development of a methodology to assess innovative nuclear energy systems (INS) on a global, regional and national basis, and to facilitate the co-operation among IAEA Member States for planning the development and deployment of INS. Brazil joined INPRO since its beginning and in 2005 submitted a proposal for the screening assessment of two small-sized integral-type PWR reactors as alternative components of an INS completed with a conventional open nuclear fuel cycle based on enriched uranium. This paper outlines the rationale and the main results of the economic assessment of the IRIS-based INS completed in August 2008. The study concluded that IRIS reference design satisfies most of INPRO criteria in the area of economics. (author)

Reintegration Difficulty of Military Couples Following Deployment

Science.gov (United States)

2016-07-01

Response rate for Wave 8 = 88% Our final sample contained 554 men and 556 women (n = 554 cross- sex couples, 1 same- sex couple). Individuals were...story in the Killeen Daily Herald (10 April 2016) http://kdhnews.com/news/local/ kids -deployments-when-a-parent-deploys-children-face- tough...years old), and (c) “Me getting sick and having to go to sick call.” (deployed Army husband, 25 years old). Sex and fidelity. Comments fell into

Market and Policy Barriers to Energy Storage Deployment

Energy Technology Data Exchange (ETDEWEB)

Bhatnagar, Dhruv [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Currier, Aileen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hernandez, Jacquelynne [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ma, Ookie [Dept. of Energy (DOE), Washington DC (United States) Office of Energy Efficiency and Renewable Energy; Kirby, Brendan [Consultant

2013-09-01

Electric energy storage technologies can provide numerous grid services; there are a number of factors that restrict their current deployment. The most significant barrier to deployment is high capital costs, though several recent deployments indicate that capital costs are decreasing and energy storage may be the preferred economic alternative in certain situations. However, a number of other market and regulatory barriers persist, limiting further deployment. These barriers can be categorized into regulatory barriers, market (economic) barriers, utility and developer business model barriers, cross-cutting barriers and technology barriers.

A Remotely Deployable Wind Sonic Anemometer

Directory of Open Access Journals (Sweden)

Muhammad Awais

2017-12-01

Full Text Available Communication and computing shape up base for explosion of Internet of Things (IoT era. Humans can efficiently control the devices around their environment as per requirements because of IoT, the communication between different devices brings more flexibility in surrounding. Useful data is also gathered from some of these devices to create Big Data; where, further analysis assist in making life easier by developing good business models corresponding to user needs, enhance scientific research, formulating weather prediction or monitoring systems and contributing in other relative fields as well. Thus, in this research a remotely deployable IoT enabled Wind Sonic Anemometer has been designed and deployed to calculate average wind speed, direction, and gust. The proposed design is remotely deployable, user-friendly, power efficient and cost-effective because of opted modules i.e., ultrasonic sensors, GSM module, and solar panel. The testbed was also deployed at the roof of Computer & Information Systems Engineering (CIS department, NED UET. Further, its calibration has been carried out by using long short-term memory (LSTM, a deep learning technique; where ground truth data has been gathered from mechanical wind speed sensor (NRG-40 H deployed at top of Industrial & Manufacturing (IM department of NED UET. The obtained results are satisfactory and the performance of designed sensor is also good under various weather conditions.

Reedsport PB150 Deployment and Ocean Test Project

Energy Technology Data Exchange (ETDEWEB)

Hart, Phil [Ocean Power Technologies Inc., Pennington, NJ (United States)

2016-06-03

As the first utility scale wave power project in the US, the Wave Power Demonstration Project at Reedsport (OR) was planned to consist of 10 PowerBuoys (Phase II)1, located 2.5 miles off the coast. U.S. Department of Energy (DOE) funding under a prior DOE Grant (DE-FG36-08GO88017) along with funding from PNGC Power, an Oregon-based electric power cooperative, was utilized for the design completion, fabrication, assembly and factory testing of the first PowerBuoy for the Reedsport project. The design and fabrication of the first PowerBuoy and factory testing of the power take-off subsystem were completed, and the power take-off subsystem was successfully integrated into the spar at the fabricator’s facility in Oregon. The objectives of this follow-on grant were: advance PB150B design from TRL 5/6 to TRL 7/8; deploy a single PB150 and operate autonomously for 2 years; establish O&M costs; collect environmental information; and establish manufacturing methodologies.

Environmental issues affecting clean coal technology deployment

Energy Technology Data Exchange (ETDEWEB)

Miller, M.J. [Electric Power Research Inst., Palo Alto, CA (United States)

1997-12-31

The author outlines what he considers to be the key environmental issues affecting Clean Coal Technology (CCT) deployment both in the US and internationally. Since the international issues are difficult to characterize given different environmental drivers in various countries and regions, the primary focus of his remarks is on US deployment. However, he makes some general remarks, particularly regarding the environmental issues in developing vs. developed countries and how these issues may affect CCT deployment. Further, how environment affects deployment depends on which particular type of clean coal technology one is addressing. It is not the author`s intention to mention many specific technologies other than to use them for the purposes of example. He generally categorizes CCTs into four groups since environment is likely to affect deployment for each category somewhat differently. These four categories are: Precombustion technologies such as coal cleaning; Combustion technologies such as low NOx burners; Postcombustion technologies such as FGD systems and postcombustion NOx control; and New generation technologies such as gasification and fluidized bed combustion.

An innovative deployable solar panel system for Cubesats

Science.gov (United States)

Santoni, Fabio; Piergentili, Fabrizio; Donati, Serena; Perelli, Massimo; Negri, Andrea; Marino, Michele

2014-02-01

One of the main Cubesat bus limitations is the available on-board power. The maximum power obtained using body mounted solar panels and advanced triple junction solar cells on a triple unit Cubesat is typically less than 10 W. The Cubesat performance and the mission scenario opened to these small satellite systems could be greatly enhanced by an increase of the available power. This paper describes the design and realization of a modular deployable solar panel system for Cubesats, consisting of a modular hinge and spring system that can be potentially used on-board single (1U), double(2U), triple (3U) and six units (6U) Cubesats. The size of each solar panels is the size of a lateral Cubesat surface. The system developed is the basis for a SADA (Solar Array Drive Assembly), in which a maneuvering capability is added to the deployed solar array in order to follow the apparent motion of the sun. The system design trade-off is discussed, comparing different deployment concepts and architectures, leading to the final selection for the modular design. A prototype of the system has been realized for a 3U Cubesat, consisting of two deployable solar panel systems, made of three solar panels each, for a total of six deployed solar panels. The deployment system is based on a plastic fiber wire and thermal cutters, guaranteeing a suitable level of reliability. A test-bed for the solar panel deployment testing has been developed, supporting the solar array during deployment reproducing the dynamical situation in orbit. The results of the deployment system testing are discussed, including the design and realization of the test-bed, the mechanical stress given to the solar cells by the deployment accelerations and the overall system performance. The maximum power delivered by the system is about 50.4 W BOL, greatly enhancing the present Cubesat solar array performance.

Forehearing words: Pre-activation of word endings at word onset.

Science.gov (United States)

Roll, Mikael; Söderström, Pelle; Frid, Johan; Mannfolk, Peter; Horne, Merle

2017-09-29

Occurring at rates up to 6-7 syllables per second, speech perception and understanding involves rapid identification of speech sounds and pre-activation of morphemes and words. Using event-related potentials (ERPs) and functional magnetic resonance imaging (fMRI), we investigated the time-course and neural sources of pre-activation of word endings as participants heard the beginning of unfolding words. ERPs showed a pre-activation negativity (PrAN) for word beginnings (first two segmental phonemes) with few possible completions. PrAN increased gradually as the number of possible completions of word onsets decreased and the lexical frequency of the completions increased. The early brain potential effect for few possible word completions was associated with a blood-oxygen-level-dependent (BOLD) contrast increase in Broca's area (pars opercularis of the left inferior frontal gyrus) and angular gyrus of the left parietal lobe. We suggest early involvement of the left prefrontal cortex in inhibiting irrelevant left parietal activation during lexical selection. The results further our understanding of the importance of Broca's area in rapid online pre-activation of words. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

The DUNDRUM Quartet: validation of structured professional judgement instruments DUNDRUM-3 assessment of programme completion and DUNDRUM-4 assessment of recovery in forensic mental health services.

LENUS (Irish Health Repository)

O'Dwyer, Sarah

2011-07-03

Abstract Background Moving a forensic mental health patient from one level of therapeutic security to a lower level or to the community is influenced by more than risk assessment and risk management. We set out to construct and validate structured professional judgement instruments for consistency and transparency in decision making Methods Two instruments were developed, the seven-item DUNDRUM-3 programme completion instrument and the six item DUNDRUM-4 recovery instrument. These were assessed for all 95 forensic patients at Ireland\\'s only forensic mental health hospital. Results The two instruments had good internal consistency (Cronbach\\'s alpha 0.911 and 0.887). Scores distinguished those allowed no leave or accompanied leave from those with unaccompanied leave (ANOVA F = 38.1 and 50.3 respectively, p < 0.001). Scores also distinguished those in acute\\/high security units from those in medium or in low secure\\/pre-discharge units. Each individual item distinguished these levels of need significantly. The DUNDRUM-3 and DUNDRUM-4 correlated moderately with measures of dynamic risk and with the CANFOR staff rated unmet need (Spearman r = 0.5, p < 0.001). Conclusions The DUNDRUM-3 programme completion items distinguished significantly between levels of therapeutic security while the DUNDRUM-4 recovery items consistently distinguished those given unaccompanied leave outside the hospital and those in the lowest levels of therapeutic security. This data forms the basis for a prospective study of outcomes now underway.

Gender differences among veterans deployed in support of the wars in Afghanistan and Iraq.

Science.gov (United States)

Street, Amy E; Gradus, Jaimie L; Giasson, Hannah L; Vogt, Dawne; Resick, Patricia A

2013-07-01

The changing scope of women's roles in combat operations has led to growing interest in women's deployment experiences and post-deployment adjustment. To quantify the gender-specific frequency of deployment stressors, including sexual and non-sexual harassment, lack of social support and combat exposure. To quantify gender-specific post-deployment mental health conditions and associations between deployment stressors and posttraumatic stress disorder (PTSD), to inform the care of Veterans returning from the current conflicts. National mail survey of OEF/OIF Veterans randomly sampled within gender, with women oversampled. The community. In total, 1,207 female and 1,137 male Veterans from a roster of all Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans. Response rate was 48.6 %. Deployment stressors (including combat and harassment stress), PTSD, depression, anxiety and alcohol use, all measured via self-report. Women were more likely to report sexual harassment (OR = 8.7, 95% CI: 6.9, 11) but less likely to report combat (OR = 0.62, 95 % CI: 0.50, 0.76). Women and men were equally likely to report symptoms consistent with probable PTSD (OR = 0.87, 95 % CI: 0.70, 1.1) and symptomatic anxiety (OR = 1.1, 9 5% CI: 0.86, 1.3). Women were more likely to report probable depression (OR = 1.3, 95 % CI: 1.1, 1.6) and less likely to report problematic alcohol use (OR = 0.59, 9 5% CI: 0.47, 0.72). With a five-point change in harassment stress, adjusted odds ratios for PTSD were 1.36 (95 % CI: 1.23, 1.52) for women and 1.38 (95 % CI: 1.19, 1.61) for men. The analogous associations between combat stress and PTSD were 1.31 (95 % CI: 1.24, 1.39) and 1.31 (95 % CI: 1.26, 1.36), respectively. Although there are important gender differences in deployment stressors-including women's increased risk of interpersonal stressors-and post-deployment adjustment, there are also significant similarities. The post-deployment adjustment of our nation's growing population of

Health Outcomes among Infants Born to Women Deployed to US Military Operations during Pregnancy

Science.gov (United States)

2011-01-01

electronic inpa- tient and outpatient medical records from the following sources: Standard Inpatient Data Record, which contains one record for each...Deployment dates to military opera- tions between September 2001 and March 2008 were determined using military electronic data from the Defense... plasms requiring hospitalization in the first year of life among this cohort. Although multivariable statistical modeling was not performed for

Mental health consequences of overstretch in the UK Armed Forces, 2007-09: a population-based cohort study.

Science.gov (United States)

Rona, Roberto J; Jones, Margaret; Keeling, Mary; Hull, Lisa; Wessely, Simon; Fear, Nicola T

2014-12-01

Concerns have been raised about the effect of tour length on the mental health of the UK armed forces. In 2007, we reported that cumulative length of deployment was associated with mental illness in military personnel. Our findings provided empirical evidence to support the UK advisory policy for tour length, known as the Harmony Guidelines. If fully implemented, these guidelines could aid prevention of mental illnesses. We aimed to reassess the association between cumulative length of deployment and number of deployments with mental illness in the UK forces. Our analysis was based on data from a representative study of the military for UK regular personnel who had completed a questionnaire between Nov 2, 2007, and Sept 24, 2009, and were deployed in the 3 years before questionnaire completion. Study outcomes were presence of possible post-traumatic stress disorder (PTSD), psychological distress, multiple physical symptoms, alcohol misuse, problems at home during and after deployment, and relationship or family problems. The key independent factors were deployment for 13 months or more, and months and number of deployments in the past 3 years. 8278 regulars responded to the questionnaire, of whom 3982 (48%) had been deployed in the 3 years before questionnaire completion. Deployment for 13 months or more decreased from 22% in March, 2005, (median March 8, 2005 [IQR Oct 10, 2004 to April 28, 2005]), to 12% in May, 2008, (May 17, 2008, [Feb 14, 2008, to Dec 5, 2008]). We noted an association between cumulative time deployed as a continuous variable and a score of 40 or more on the PTSD checklist (p=0·002), presence of psychological distress (p=0·018), and multiple physical symptoms (p=0·030; table 2). Furthermore, 13 months or more of deployment was associated with multiple physical symptoms (adjusted odds ratio [OR] 2·15, 95% CI 1·39-3·32), a PTSD checklist score of 40 or more (2·02, 1·31-3·12), and problems at home, but not a PTSD checklist score of 50 or