Krista B. Highland
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.
Rohrbeck, Patricia; Hu, Zheng; Mallon, Col Timothy M
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.
Le, Tuan D; Gurney, Jennifer M; Nnamani, Nina S; Gross, Kirby R; Chung, Kevin K; Stockinger, Zsolt T; Nessen, Shawn C; Pusateri, Anthony E; Akers, Kevin S
Nonbattle injury (NBI) among deployed US service members increases the burden on medical systems and results in high rates of attrition, affecting the available force. The possible causes and trends of NBI in the Iraq and Afghanistan wars have, to date, not been comprehensively described. To describe NBI among service members deployed to Iraq and Afghanistan, quantify absolute numbers of NBIs and proportion of NBIs within the Department of Defense Trauma Registry, and document the characteristics of this injury category. In this retrospective cohort study, data from the Department of Defense Trauma Registry on 29 958 service members injured in Iraq and Afghanistan from January 1, 2003, through December 31, 2014, were obtained. Injury incidence, patterns, and severity were characterized by battle injury and NBI. Trends in NBI were modeled using time series analysis with autoregressive integrated moving average and the weighted moving average method. Statistical analysis was performed from January 1, 2003, to December 31, 2014. Primary outcomes were proportion of NBIs and the changes in NBI over time. Among 29 958 casualties (battle injury and NBI) analyzed, 29 003 were in men and 955 were in women; the median age at injury was 24 years (interquartile range, 21-29 years). Nonbattle injury caused 34.1% of total casualties (n = 10 203) and 11.5% of all deaths (206 of 1788). Rates of NBI were higher among women than among men (63.2% [604 of 955] vs 33.1% [9599 of 29 003]; P < .001) and in Operation New Dawn (71.0% [298 of 420]) and Operation Iraqi Freedom (36.3% [6655 of 18 334]) compared with Operation Enduring Freedom (29.0% [3250 of 11 204]) (P < .001). A higher proportion of NBIs occurred in members of the Air Force (66.3% [539 of 810]) and Navy (48.3% [394 of 815]) than in members of the Army (34.7% [7680 of 22 154]) and Marine Corps (25.7% [1584 of 6169]) (P < .001). Leading mechanisms of NBI included falls (2178 [21.3%]), motor vehicle crashes
findings highlight di f ferential child maltreatment risk across deployment periods and suggests possible points for interventions to fac i litate...successful reintegration and family stability across the deployment cycle. Our analyses characterizes risk for child maltreatment reports and medical...describe patterns of diagnoses leading up to an eventual PTSD diagnoses , and possibly child maltreatment episodes. 15. SUBJECT TERMS Family
Agimi, Yll; Regasa, Lemma Ebssa; Ivins, Brian; Malik, Saafan; Helmick, Katherine; Marion, Donald
To examine the role of Department of Defense policies in identifying theater-sustained traumatic brain injuries (TBIs). We conducted a retrospective study of 48 172 US military service members who sustained their first lifetime TBIs between 2001 and 2016 while deployed to Afghanistan or Iraq. We used multivariable negative binomial models to examine the changes in TBI incidence rates following the introduction of Department of Defense policies. Two Army policies encouraging TBI reporting were associated with an increase of 251% and 97% in TBIs identified following their implementation, respectively. Among airmen, the introduction of TBI-specific screening questions to the Post-Deployment Health Assessment was associated with a 78% increase in reported TBIs. The 2010 Department of Defense Directive Type Memorandum 09-033 was associated with another increase of 80% in the likelihood of being identified with a TBI among soldiers, a 51% increase among sailors, and a 124% increase among Marines. Department of Defense and service-specific policies introduced between 2006 and 2013 significantly increased the number of battlefield TBIs identified, successfully improving the longstanding problem of underreporting of TBIs.
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
Parry, Glenn; McLening, Marc; Caldwell, Nigel; Thompson, Rob
A pizza restaurant must provide product, in the form of the food and drink, and service in the way this is delivered to the customer. Providing this has distinct operational challenges, but what if the restaurant also provides a home delivery service? The service becomes deployed as the customer is no-longer co-located with the production area. The business challenge is complicated as service needs to be delivered within a geographic region, to time or the pizza will be cold, and within a cost that is not prohibitive. It must also be responsive to short term demand; needing to balance the number of staff it has available to undertake deliveries against a forecast of demand.
Turbyville, Joseph C; Dunford, James C; Nelson, Michael R
Insect venom hypersensitivity can pose a threat to personnel deployed to a combat zone but the exposure risk in Afghanistan is currently unknown. This study was designed to assess the threat of Hymenoptera stings and associated allergic reactions in Afghanistan. Hymenoptera species were collected during a deployment to southern Afghanistan from June 2010 through January 2011. The literature was also reviewed to determine species of medically important Hymenoptera recorded in the region. The U.S. Army theater electronic medical data system was mined for ICD-9 codes associated with insect stings to determine the number of theater medical clinic encounters addressing insect sting reactions. Three species of flying hymenoptera were commonly encountered during the study period: Vespa orientalis L., Polistes wattii Cameron, and Vespula germanica (F.). A literature review also confirms the presence of honeybees (Apidae), numerous velvet ant (Mutillidae) species, and various ant (Formicidae) species all capable of stinging. No evidence was identified to suggest that fire ants (Solenopsis ssp.) are a threat in the region. Based on electronic medical records from the U.S. Central Command area of operations over a 2-year period, roughly 1 in 500 clinic visits involved a patient with a diagnosis of insect bite or sting. Cross-reactive members of all five flying Hymenoptera species commonly assessed for in Hymenoptera allergy evaluations are present in Afghanistan. The review of in-theater medical records confirms that insect stings pose an environmental threat to deployed service members.
Full Text Available The purpose of this pilot study is 1 to develop an annotation schema and a training set of annotated notes to support the future development of a natural language processing (NLP system to automatically extract employment information, and 2 to determine if information about employment status, goals and work-related challenges reported by service members and Veterans with mild traumatic brain injury (mTBI and post-deployment stress can be identified in the Electronic Health Record (EHR.Retrospective cohort study using data from selected progress notes stored in the EHR.Post-deployment Rehabilitation and Evaluation Program (PREP, an in-patient rehabilitation program for Veterans with TBI at the James A. Haley Veterans' Hospital in Tampa, Florida.Service members and Veterans with TBI who participated in the PREP program (N = 60.Documentation of employment status, goals, and work-related challenges reported by service members and recorded in the EHR.Two hundred notes were examined and unique vocational information was found indicating a variety of self-reported employment challenges. Current employment status and future vocational goals along with information about cognitive, physical, and behavioral symptoms that may affect return-to-work were extracted from the EHR. The annotation schema developed for this study provides an excellent tool upon which NLP studies can be developed.Information related to employment status and vocational history is stored in text notes in the EHR system. Information stored in text does not lend itself to easy extraction or summarization for research and rehabilitation planning purposes. Development of NLP systems to automatically extract text-based employment information provides data that may improve the understanding and measurement of employment in this important cohort.
Kelly, Patricia J; Cheng, An-Lin; Berkel, LaVerne A; Nilsson, Johanna
Females currently make up 15% of U.S. military service members. Minimal attention has been paid to families of female National Guard members who have been deployed and their subsequent reintegration challenges. This cross-sectional Internet-based survey of female members of four National Guard units compared those who were and were not deployed. Instruments, guided by the variables of the Family Resilience Model, measured individual, family, and deployment-related factors. Bivariate analysis and ordinal logistic regression were done to assess differences between the groups. Of the 239 National Guard members surveyed, deployed women (n = 164) had significantly higher levels of posttraumatic stress disorder (PTSD; p family functioning were higher among deployed when compared with never deployed women. Results indicate community interventions that focus on strengthening coping skills of female Guard members would be useful for this population. © The Author(s) 2016.
ready force Deploy with and care for the warrior Care for all entrusted to our care Nursing Competencies and Practice: Patient outcomes...duties, physical activities, iron intake through diet ). This additional information would improve the ability to determine factors associated with
Rodrigues, Camila S; Renshaw, Keith D
Studies have identified coping processes as one potential factor influencing PTSD in veterans. This study examined the associations between coping, combat exposure, and PTSD among 218 National Guard veterans deployed overseas since 2001. Problem-focused coping was unrelated to combat exposure and PTSD symptoms. In contrast, increased levels of emotion focused coping (EFC) were found in veterans who reported higher levels of combat exposure. Moreover, the severity of combat was a curvilinear moderator of the relation between coping process and PTSD, such that EFC was unrelated to PTSD symptom severity at low levels of combat, associated with higher symptom severity at moderate levels of combat, and associated with lower symptom severity at high levels of combat. These findings indicate that the type and severity of trauma may moderate the association of coping and psychological outcomes, and that these associations might not be linear. Published by Elsevier Ltd.
through the Affordable Healthcare Act ( ACA ) and other sources. Most veterans are not seen in VA facilities. The Geisinger Clinic, the community partner...group practice, ten hospital campuses, a 467,000-member health plan, and is one of the largest employers in the state. The knowledge gained from...Complete Analyses for Study Aim 3 ( Effectiveness ) and for Aim 4 (Genetics), Prepare Final Manuscripts for Review and Submission, Convene Final Conferences
Akasaka, Fumiya; Ohno, Takehiko; Jensen, Mika Yasuoka
More and more companies are applying service design approaches to develop services and products. Not every project, however, has achieved its goals. In many cases, difficulties arise from organizational issues such as organization structure and evaluation system. In this research, we held workshops...... where success and failure factors of service design projects in organization are presented. By analysing the results, we construct a model that explains the “difficulties of deploying the service design approach in organization.” On the basis of the model, this paper discusses the challenges...... to the deployment of the service design approach in organizations....
Scherrer, Jeffrey F.; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi Kato
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
for these experiences is the transition of telecommunication (telephony) networks from circuit switched based systems towards packet based ones. The text of this monograph proceeds, unaltered for the most, from the author’s PhD thesis “Framework for Deployment of Advanced Telecommunication Services in Current......This monograph (Early Experiences related to Service Creation & Deployment in Converged Networks) presents different experiences related to architectures and mechanisms for deployment of telephony services, understood as especial features complementing the basic voice service. The context...... and Future Converged Networks”, carried out at the Technical University of Denmark in the period [April 2002-April 2005]. Even though the technologies presented in the text have evolved from that period until now, the presented scenarios and setups are still valid as interesting initial steps in the realm....
Molinaro, Marco; Cepparo, Francesco; De Marco, Marco; Knapic, Cristina; Apollo, Pietro; Smareglia, Riccardo
The International Virtual Observatory Alliance (IVOA) has produced many standards and recommendations whose aim is to generate an architecture that starts from astrophysical resources, in a general sense, and ends up in deployed consumable services (that are themselves astrophysical resources). Focusing on the Data Access Layer (DAL) system architecture, that these standards define, in the last years a web based application has been developed and maintained at INAF-OATs IA2 (Italian National institute for Astrophysics - Astronomical Observatory of Trieste, Italian center of Astronomical Archives) to try to deploy and manage multiple VO (Virtual Observatory) services in a uniform way: VO-Dance. However a set of criticalities have arisen since when the VO-Dance idea has been produced, plus some major changes underwent and are undergoing at the IVOA DAL layer (and related standards): this urged IA2 to identify a new solution for its own service layer. Keeping on the basic ideas from VO-Dance (simple service configuration, service instantiation at call time and modularity) while switching to different software technologies (e.g. dismissing Java Reflection in favour of Enterprise Java Bean, EJB, based solution), the new solution has been sketched out and tested for feasibility. Here we present the results originating from this test study. The main constraints for this new project come from various fields. A better homogenized solution rising from IVOA DAL standards: for example the new DALI (Data Access Layer Interface) specification that acts as a common interface system for previous and oncoming access protocols. The need for a modular system where each component is based upon a single VO specification allowing services to rely on common capabilities instead of homogenizing them inside service components directly. The search for a scalable system that takes advantage from distributed systems. The constraints find answer in the adopted solutions hereafter sketched. The
Alan L. Peterson
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.
Einspruch, E M; Omachonu, V K; Einspruch, N G
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.
Shiers, J D
This paper summarises the main lessons learnt from deploying WLCG production services, with a focus on Reliability, Scalability, Accountability, which lead to both manageability and usability. Each topic is analysed in turn. Techniques for zero-user-visible downtime for the main service interventions are described, together with pathological cases that need special treatment. The requirements in terms of scalability are analysed, calling for as much robustness and automation in the service as possible. The different aspects of accountability - which covers measuring/tracking/logging/monitoring what is going on - and has gone on - is examined, with the goal of attaining a manageable service. Finally, a simple analogy is drawn with the Web in terms of usability - what do we need to achieve to cross the chasm from small-scale adoption to ubiquity?
Danish, Steven J; Antonides, Bradley J
The ongoing wars in Afghanistan and Iraq have posed a number of reintegration challenges to service members. Much of the research focuses on those service members experiencing psychological problems and being treated at the VA. In this article, we contend that much of the distress service members experience occurs following deployment and is a consequence of the difficulties encountered during their efforts to successfully reintegrate into their families and communities. We propose a new conceptual framework for intervening in this reintegration distress that is psycho-educational in nature as well as a new delivery model for providing such services. An example of this new intervention framework is presented. © 2013 American Orthopsychiatric Association.
Madsen, T; Sadowa Vedtofte, M; Nordentoft, M
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...
Rodriguez, Aubrey J; Margolin, Gayla
Although military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members' reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member's absences. Two dimensions of parent absence--the extent to which absences coincide with important family events and cumulative time absent--were tested as potential risks to family members' mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member's absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers' symptoms were associated with the cumulative duration of the service members' time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members' lived experience during periods of service-member absence. (c) 2015 APA, all rights reserved).
Khalilia, Mohammed; Choi, Myung; Henderson, Amelia; Iyengar, Sneha; Braunstein, Mark; Sun, Jimeng
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.
different based on deployment status and exposure to an austere environment where antimalarial agents with MRSA/MSSA activity are used. However, the...adequate hygiene practices. Further, these deployments are often to geo- graphic regions that require antimalarial chemoprophy- laxis. The use of...genes. Methods Participants Two populations of healthy active duty service members (101 non-deployed personnel in San Antonio, Texas, USA and 100
Candido, Gonçalo; Barata, José; Jammes, François; Colombo, Armando W.
Service-oriented Architecture (SOA) is becoming a de facto paradigm for business and enterprise integration. SOA is expanding into several domains of application envisioning a unified solution suitable across all different layers of an enterprise infrastructure. The application of SOA based on open web standards can significantly enhance the interoperability and openness of those devices. By embedding a dynamical deployment service even into small field de- vices, it would be either possible to allow machine builders to place built- in services and still allow the integrator to deploy on-the-run the services that best fit his current application. This approach allows the developer to keep his own preferred development language, but still deliver a SOA- compliant application. A dynamic deployment service is envisaged as a fundamental framework to support more complex applications, reducing deployment delays, while increasing overall system agility. As use-case scenario, a dynamic deployment service was implemented over DPWS and WS-Management specifications allowing designing and programming an automation application using IEC61131 languages, and deploying these components as web services into devices.
The establishment of World Trade Organization is in line with the conclusion reached at the end of the Uruguay Round in April 1994 by the bulk of the world's trading nations. WTO is in charge of managing multilateral trading system. WTO's "General Agreement on Trade in Services" (GATS) requires member nations to comply with the following…
This CIGRE green book begins by addressing the specification and provision of communication services in the context of operational applications for electrical power utilities, before subsequently providing guidelines on the deployment or transformation of networks to deliver these specific communication services. Lastly, it demonstrates how these networks and their services can be monitored, operated, and maintained to ensure that the requisite high level of service quality is consistently achieved.
command, and degrades the morale of those still serving, as well as the American public.8 A shrinking number of qualified volunteers and reductions...to Sri Aurobindo’s Philosophy of Integral Non-Dualism,” in The Integral Philosophy of Sri Aurobindo, ed. Haridas Chaudhuri and Frederic Spiegelberg...potentially unsolvable problem should not prevent attempts to develop solutions. In a moral sense, service member suicide should elicit greater diligence
As partners of farmers' associations and small agri-businesses, financial cooperatives can play an important role in the adoption of agricultural innovations by providing relevant financial services. This project will test the ability of financial services to support the deployment and large-scale adoption of innovations ...
... Services, Inc., Currently Known as Ericsson, Inc., Service Assurance, Deployment and Integration, and... Known as Ericsson, Inc., Service Assurance, Deployment and Integration, and Engineering and IS/IT... Regarding Eligibility To Apply for Worker Adjustment Assistance In accordance with Section 223 of the Trade...
... NATIONAL CAPITAL PLANNING COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service... Senior Executive Service. The PRB established for the National Capital Planning Commission also makes...
... NATIONAL CAPITAL PLANNING COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service... Senior Executive Service. The PRB established for the National Capital Planning Commission also makes...
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.
Binh Minh Nguyen
Full Text Available In this paper, we will present an abstraction layer for cloud computing, which intends to simplify the manipulation with virtual machines in clouds for easy and controlled development and deployment of cloud services. It also ensures interoperability between diﬀerent cloud infrastructures and allows developers to create cloud appliances easily via inheritance mechanisms.
von Laszewski, G.; Blau, E.; Bletzinger, M.; Gawor, J.; Lane, P.; Martin, S.; Russell, M.
Grids comprise an infrastructure that enables scientists to use a diverse set of distributed remote services and resources as part of complex scientific problem-solving processes. We analyze some of the challenges involved in deploying software and components transparently in Grids. We report on three practical solutions used by the Globus Project. Lessons learned from this experience lead us to believe that it is necessary to support a variety of software and component deployment strategies. These strategies are based on the hosting environment
Webster, Steven; Miller, Gordon; Mayott, Gregory
Traditionally, military simulation has been problem domain specific. Executing an exercise currently requires multiple simulation software providers to specialize, deploy, and configure their respective implementations, integrate the collection of software to achieve a specific system behavior, and then execute for the purpose at hand. This approach leads to rigid system integrations which require simulation expertise for each deployment due to changes in location, hardware, and software. Our alternative is Software as a Service (SaaS) predicated on the virtualization of Night Vision Electronic Sensors (NVESD) sensor simulations as an exemplary case. Management middleware elements layer self provisioning, configuration, and integration services onto the virtualized sensors to present a system of services at run time. Given an Infrastructure as a Service (IaaS) environment, enabled and managed system of simulations yields a durable SaaS delivery without requiring user simulation expertise. Persistent SaaS simulations would provide on demand availability to connected users, decrease integration costs and timelines, and benefit the domain community from immediate deployment of lessons learned.
Steenkamp, Maria M.; Litz, Brett T.; Gray, Matt J.; Lebowitz, Leslie; Nash, William; Conoscenti, Lauren; Amidon, Amy; Lang, Ariel
The growing number of service members in need of mental health care requires that empirically based interventions be tailored to the unique demands and exigencies of this population. We discuss a 6-session intervention for combat-related PTSD designed to foster willingness to engage with and disclose difficult deployment memories through a…
Bravo, Adrian J; Kelley, Michelle L; Swinkels, Cindy M; Ulmer, Christi S
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.
Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi
Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives.
... COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA Senior Executive Service; Performance Review Board; Members AGENCY: Court Services and Offender Supervision Agency for the... agency's Senior Executive Service. The PRB established for the Court Services and Offender Supervision...
Mankowski, Mariann; Everett, Joyce E
The purpose of this paper is to highlight what we know now about female service members, veterans, and their families. The experiences of U.S. female service members and veterans are more complex than previous eras and significant demographic changes have taken place. U.S. female veterans are more likely to be younger, come from ethnic and racial minority groups, have children, and combat exposure. U.S. female service members report high rates of sexual violence and they are more vulnerable to homelessness and unemployment when compared to previous female military cohorts. U.S. female service members and veterans are also at higher risk for significant mental and health issues. Children and adolescents of women service members and veterans may also carry a heavy burden as a result of lengthy deployments. A majority of female service members and veterans will utilize community based healthcare and social services, therefore, it is essential that all healthcare providers understand the unique needs of this cohort of women. Practice implications at the micro, mezzo, and macro levels are discussed. Qualitative and quantitative studies that expand our understanding of women's experience in the military and as veterans are encouraged. Copyright © 2016 Elsevier Ltd. All rights reserved.
Benni , Benjamin; Mosser , Sébastien; Collet , Philippe; Riveill , Michel
International audience; The SOA ecosystem has drastically evolved since its childhood in the early 2000s. From monolithic services, micro–services now cooperate together in ultra-large scale systems. In this context, there is a tremendous need to deploy frequently new services, or new version of existing services. Container–based technologies (e.g., Docker) emerged recently to tool such deployments, promoting a black-box reuse mechanism to support off-the-shelf deployments. Unfortunately, fro...
Eckerlin, Denise M; Kovalesky, Andrea; Jakupcak, Matthew
: The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members as well as that of their family members, colleagues, and community members. Although a greater proportion of female than male service members are subjected to MST, the Department of Defense estimates that the absolute numbers of affected men and women, across all ranks and branches of military service, are nearly equal because roughly 85% of military members are men. Little research has explored the effects of MST on men. This article discusses the unique ways in which men may experience MST, and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man's interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care professionals.
... an advanced services loop technology. 51.230 Section 51.230 Telecommunication FEDERAL COMMUNICATIONS... Carriers § 51.230 Presumption of acceptability for deployment of an advanced services loop technology. (a) An advanced services loop technology is presumed acceptable for deployment under any one of the...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U. S. Small Business Administration. ACTION: Notice of Members for the FY 2014 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2011 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2012 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2010 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
Williamson, Randall B
.... DOD oversees the military services compliance with PDHRA requirements through its deployment health assessment quality assurance program and is required to report on the quality assurance program...
these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy
lifting of the bans – remains alive and well, with some LGBT service members experiencing interpersonal and institutional discrimination ...being among LGBT service members and improve unit cohesion. The military has always been a leader in understanding and implementing gender and...matters. These should be people that you know and who know you. These should be people you have had contact with in the past 3 months or so – either in
provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently...phases. In Phase I we (a) convened an expert panel to advise the study and (b) interview a diverse set of military service members (n=42) using a...have convened our expert panel of advisors and have completed 38 interviews with LGBT military service members. 15. SUBJECT TERMS Military, LGBT
through multiple rounds of internal testing and quality assurance procedures. Recruitment for the Phase II survey was initiated on August 25, 2017...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators...burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis
In 1964, in view of the increasingly important role of computers in atomic energy, the Nuclear Energy Agency of the Organization for Economic Co-operation and Development established a Computer Programme Library (CPL) at Ispra, Italy. The original purpose of this Library, then consisting chiefly of programmes for reactor calculations, was to improve communication between the originators of the computer programmes and the scientists and engineers in Member States of the OECD who used them, thus furthering the efficient and economic use of the many large and expensive computers in the countries concerned. During the first few years of the Library's operation, a growing interest in its activities became evident in countries which were not members of the OECD. The Director General of the International Atomic Energy Agency, aware that such countries which were Member States of the IAEA could benefit from the Library's services, concluded an agreement with the Nuclear Energy Agency in 1967 to the effect that these services would be extended to all IAEA Member States. In March 1968, the Director General announced by circular letter that these services were available, and requested the governments of Member States that were not members of OECD to nominate establishments to participate in the activities of the Computer Programme Library. By August 1973, 32 such establishments were regularly using the services of the CPL
Worthen, Miranda; Rathod, Sujit D; Cohen, Gregory; Sampson, Laura; Ursano, Robert; Gifford, Robert; Fullerton, Carol; Galea, Sandro; Ahern, Jennifer
Violent behavior is an important problem for military service members and veterans. A representative cohort of U.S. Reserve and National Guard personnel ( N = 1,293) were interviewed to assess self-reported problems controlling violent behavior, deployment traumas, posttraumatic stress disorder (PTSD), alcohol abuse, and social support. Poisson regression models were used to estimate the associations of violent behavior with risk and protective factors. Problems controlling violent behavior were uncommon among male (3.3%) and female (1.7%) service members. Adjusted prevalence ratios (aPR) showed associations between violent behavior and deployment traumas (aPR = 1.67, 95% confidence interval [CI] = [1.34, 2.08]), PTSD (aPR = 9.95, 95% CI = [5.09, 19.48]), and PTSD symptom severity (aPR for each additional PTSD symptom = 1.07, 95% CI = [1.06, 1.09]). Social support was associated with lower prevalence of violent behavior (aPR = 0.62, 95% CI = [0.52, 0.76]). The association between violent behavior and alcohol abuse was not statistically significant (aPR = 1.94, 95% CI = [0.92, 4.09]). Results were consistent when the population was restricted to personnel who had deployed to a war zone. Problems controlling violent behavior were less common in this cohort than has been documented in other studies. Associations of violent behavior with risk and protective factors are consistent with prior research.
DeVoe, Ellen R; Paris, Ruth; Emmert-Aronson, Ben; Ross, Abigail; Acker, Michelle
Parenting through the deployment cycle presents unique stressors for military families. To date, few evidence-based and military-specific parenting programs are available to support parenting through cycles of deployment separation and reintegration, especially for National Guard/Reserve members. The purpose of this research was to test the efficacy of a parenting program developed specifically to support military families during reintegration. Within 1 year of returning from deployment to Afghanistan or Iraq, 115 service members with very young children were randomly assigned to receive either the Strong Families Strong Forces Parenting Program at baseline or after a 12-week waiting period. Using a home-based modality, service members, at-home parents, and their young child were assessed at baseline, 3 months posttreatment/wait period, and 6 months from baseline. Service member parents in Strong Families evidenced greater reductions in parenting stress and mental health distress relative to those in the waitlist comparison group. Service members with more posttraumatic stress symptoms reported higher levels of perceived parental efficacy in the intervention group than service members in the comparison group. Intervention also resulted in enhanced parental reflective capacity, including increased curiosity and interest in the young child among those in the intervention group relative to comparison. Service member parents and their spouses demonstrated high interest in participating in a postdeployment parenting program targeting families with very young children. Findings point to the feasibility, appeal, and efficacy of Strong Families in this initial trial and suggest promise for implementation in broader military and community service systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Bush, Nigel E; Wheeler, William M
Although personal electronic devices, such as mobile phones, computers, and tablets, increasingly are being leveraged as vehicles for health in the civilian world, almost nothing is known about personal technology use in the U.S. military. In 2012 we conducted a unique survey of personal technologies used by U.S. military service members. However, with the rapidly growing sophistication of personal technology and changes in consumer habits, that knowledge must be continuously updated to be useful. Accordingly, we recently surveyed new samples of active duty service members, National Guard and Reserve, and veterans. We collected data by online surveys in 2013 from 239 active, inactive, and former service members. Online surveys were completed in-person via laptop computers at a large military installation and remotely via Web-based surveys posted on the Army Knowledge Online Web site and on a Defense Center Facebook social media channel. We measured high rates of personal technology use by service members at home across popular electronic media. The most dramatic change since our earlier survey was the tremendous increase in mobile phone use at home for a wide variety of purposes. Participants also reported moderate non-work uses of computers and tablets while on recent deployment to Iraq and Afghanistan, but almost no mobile phone use, ostensibly because of military restrictions in the war zone. These latest results will enable researchers and technology developers target their efforts on the most promising and popular technologies for psychological health in the military.
Sunburn is caused by acute overexposure to ultraviolet (UV) radiation directly from the sun or from artificial UV sources. Service members are at risk of excessive exposure to sunlight due to the nature of their military duties, which often involve working and training outdoors, and deployment to environments where UV radiation is more intense. From January 2002 through December 2013, a total of 19,172 incident cases of clinically significant sunburn were diagnosed among active component service members. Most of the cases (80.2%) were first degree sunburn. The incidence rates of sunburn diagnoses were higher among females, white non-Hispanics, younger age groups, individuals in the Marine Corps or Army, and among enlisted service members. Additionally, the rate among recruits was more than 3.5 times the rate for non-recruits. Sixty-one percent of all diagnosed cases occurred from May through July. Sunburn cases occurred in all areas of the U.S., particularly near major recruit and combat training locations. Service members are strongly advised to practice sun safety as a part of heat illness prevention, including properly using broad-spectrum sunscreen, finding or constructing shade during work and rest, wearing protective clothing and military combat eye protection items, and avoiding tanning booths and sun lamps.
Military, LGBT, health disparities, minority stress , social networks 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...physical and mental health needs of this community. This project includes LGBT service members from all four services, Army, Air Force, Navy and...acceptance and integration of sexual minorities into traditional heterosexual work environments. Further, the findings will address possible health
Jones, M; Sundin, J; Goodwin, L; Hull, L; Fear, N T; Wessely, S; Rona, R J
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.
Active competition in the telecommunications industry has caused a dramatic shift in focus for public network operators. Service designers need to be able to easily and rapidly create services according to the customer’s requirements. This is achievable by using Intelligent Networks (INs). Two primary goals of service development under the Intelligent Network paradigm are rapid service crcation using new software technologies and the minimisation of service development costs through switch ve...
Chu, Carol; Stanley, Ian H; Hom, Melanie A; Lim, Ingrid C; Joiner, Thomas E
Following deployment, soldiers may struggle to cope with the after-effects of combat service and experience increased suicidality. Therefore, connection to mental health services is vital. Research regarding the relationship between deployment, suicidality, and mental health connections has been equivocal, with some studies finding a link between deployment history and mental health outcomes, and others not. The purpose of this study was to examine the effects of military deployment on mental health and service utilization outcomes using a longitudinal design. Deployment history, mental health visits, symptoms of suicidality, and various mental health outcomes were assessed in a sample of 1,566 Army recruiters at study entry and 18-months follow-up. Deployment history was positively associated with mental health visits, number of major depressive episodes, and acquired capability for suicide at baseline; however, no significant relationship between deployment, mental health visits, and any other suicide or mental health-related outcomes emerged at baseline or follow-up. Findings suggest a disconnection from mental health services among military personnel. Implications for treatment and suicide prevention efforts among military personnel are discussed.
phone (including text message), mail or email, or online (e.g., through social media sites, such as Facebook, Twitter, Instagram, YouTube). You...0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202- 4302. Respondents should be aware that notwithstanding any other provision of...Ask, Don’t Tell (DADT); (b) describe the composition and structure of LGBT service members supportive social networks; (c) determine if there are
Nichols, Linda Olivia; Martindale-Adams, Jennifer; Graney, Marshall J; Zuber, Jeffrey; Burns, Robert
Spouses of returning Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) military service members report increased depression and anxiety post deployment as they work to reintegrate the family and service member. Reconnecting the family, renegotiating roles that have shifted, reestablishing communication patterns, and dealing with mental health concerns are all tasks that spouses must undertake as part of reintegration. We tested telephone support groups focusing on helping spouses with these basic reintegration tasks. Year-long telephone support groups focused on education, skills building (communication skills, problem solving training, cognitive behavioral techniques, stress management), and support. Spouse depression and anxiety were decreased and perceived social support was increased during the course of the study. In subgroup analyses, spouses with husbands whose injuries caused care difficulties had a positive response to the intervention. However, they were more likely to be depressed, be anxious, and have less social support compared to participants who had husbands who had no injury or whose injury did not cause care difficulty. Study findings suggest that this well-established, high-access intervention can help improve quality of life for military spouses who are struggling with reintegration of the service member and family.
Herrera, Catherine J; Owens, Gina P
Modern military missions place numerous demands on service members, including tactical, personal, and cultural challenges. The purpose of this study was to explore how domains of multicultural personality (cultural empathy, open-mindedness, social initiative, emotional stability, and flexibility) and combat exposure relate to posttraumatic stress disorder (PTSD) in service members. Participants (N = 163) completed the Multicultural Personality Questionnaire, Combat Exposure Scale, and PTSD Checklist-Military as part of an online survey. The majority of participants were Caucasian (87%), mean age was 33 years, and all were deployed at least once to Iraq or Afghanistan Regression results indicated that higher levels of combat exposure and open-mindedness and lower levels of flexibility and emotional stability were significant predictors of higher PTSD severity. The interactions between combat exposure and flexibility and combat exposure and openness were also significant. Higher levels of flexibility and emotional stability seem particularly important in their association with lower PTSD severity for service members. © 2014 Wiley Periodicals, Inc.
Bogner, Jennifer; French, Louis M; Lange, Rael T; Corrigan, John D
Explore relationships among traumatic brain injury (TBI), substance misuse and other mental health disorders in US service members and to identify risk factors for substance misuse. Service members (n = 93 in final sample) injured while deployed to Operation Enduring Freedom or Operation Iraqi Freedom. Longitudinal survey at 6 and 12 months post-intake. The following measures were used: problem substance use, Alcohol Expectancies Questionnaire-III, MINI International Neuropsychiatric Interview Substance Abuse Modules, Ohio State University TBI Identification Method, Neurobehavioural Symptom Inventory, Rivermead Post-Concussion Symptoms Questionnaire, Buss-Perry Aggression Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version, Beck Depression Inventory-II, Beck Anxiety Inventory. More severe TBI and post-traumatic stress disorder (PTSD) symptoms at 6 months post-enrolment were associated with decreased odds of substance misuse 12 months after study enrolment. Alcohol expectancies and incurring a TBI at a younger age increased the odds of substance misuse. While the ability to generalize the current findings to a larger population is limited, the results provide direction for future studies on the prevention and treatment of substance misuse following TBI. The unexpected protective effect of more severe TBI may result from prospective attention to the injury and its consequences. Greater preventive benefit may result from identifying more service members with elevated risk. Lifetime history of TBI and alcohol expectancies may be candidate indicators for greater attention.
Vento, Todd J; Calvano, Tatjana P; Cole, David W; Mende, Katrin; Rini, Elizabeth A; Tully, Charla C; Landrum, Michael L; Zera, Wendy; Guymon, Charles H; Yu, Xin; Beckius, Miriam L; Cheatle, Kristelle A; Murray, Clinton K
Staphylococcus aureus [methicillin-resistant and methicillin-susceptible (MRSA/MSSA)] is a leading cause of infections in military personnel, but there are limited data regarding baseline colonization of individuals while deployed. We conducted a pilot study to screen non-deployed and deployed healthy military service members for MRSA/MSSA colonization at various anatomic sites and assessed isolates for molecular differences. Colonization point-prevalence of 101 military personnel in the US and 100 in Afghanistan was determined by swabbing 7 anatomic sites. US-based individuals had received no antibiotics within 30 days, and Afghanistan-deployed personnel were taking doxycycline for malaria prophylaxis. Isolates underwent identification and testing for antimicrobial resistance, virulence factors, and pulsed-field type (PFT). 4 individuals in the US (4 isolates- 3 oropharynx, 1 perirectal) and 4 in Afghanistan (6 isolates- 2 oropharynx, 2 nare, 1 hand, 1 foot) were colonized with MRSA. Among US-based personnel, 3 had USA300 (1 PVL+) and 1 USA700. Among Afghanistan-based personnel, 1 had USA300 (PVL+), 1 USA800 and 2 USA1000. MSSA was present in 40 (71 isolates-25 oropharynx, 15 nare) of the US-based and 32 (65 isolates- 16 oropharynx, 24 nare) of the Afghanistan-based individuals. 56 (79%) US and 41(63%) Afghanistan-based individuals had MSSA isolates recovered from extra-nare sites. The most common MSSA PFTs were USA200 (9 isolates) in the US and USA800 (7 isolates) in Afghanistan. MRSA/MSSA isolates were susceptible to doxycycline in all but 3 personnel (1 US, 2 Afghanistan; all were MSSA isolates that carried tetM). MRSA and MSSA colonization of military personnel was not associated with deployment status or doxycycline exposure. Higher S. aureus oropharynx colonization rates were observed and may warrant changes in decolonization practices.
Full Text Available Given the importance and wide scope of Wi-Fi applications within academic environs in developed countries and its use in library services, its utilization within academic libraries in Iran is felt. While presenting Wi-Fi networks, the present study employed a survey of librarians and faculty members in Shiraz University to investigate their the outlook and viewpoints regarding the deployment of such networks in academic libraries. Findings demonstrated that librarians are very inclined to use Wi-Fi in library services such as listing, shelf-reading and OPAC and demand comprehensive network coverage throughout the entire library spaces. Meanwhile, faculty members expressed the necessity of increasing use of such networks all over the campus and remote access to library resources. Generally given the outcome of the present investigation, although Wi-Fi application in libraries is a novel and emerging phenomenon yet to catch on in Iran, librarians, researchers and professors are very keen about its use and application within academic environments.
Kontonatsios, Georgios; Korkontzelos, Ioannis; Kolluru, Balakrishna; Thompson, Paul; Ananiadou, Sophia
U-Compare is a text mining platform that allows the construction, evaluation and comparison of text mining workflows. U-Compare contains a large library of components that are tuned to the biomedical domain. Users can rapidly develop biomedical text mining workflows by mixing and matching U-Compare's components. Workflows developed using U-Compare can be exported and sent to other users who, in turn, can import and re-use them. However, the resulting workflows are standalone applications, i.e., software tools that run and are accessible only via a local machine, and that can only be run with the U-Compare platform. We address the above issues by extending U-Compare to convert standalone workflows into web services automatically, via a two-click process. The resulting web services can be registered on a central server and made publicly available. Alternatively, users can make web services available on their own servers, after installing the web application framework, which is part of the extension to U-Compare. We have performed a user-oriented evaluation of the proposed extension, by asking users who have tested the enhanced functionality of U-Compare to complete questionnaires that assess its functionality, reliability, usability, efficiency and maintainability. The results obtained reveal that the new functionality is well received by users. The web services produced by U-Compare are built on top of open standards, i.e., REST and SOAP protocols, and therefore, they are decoupled from the underlying platform. Exported workflows can be integrated with any application that supports these open standards. We demonstrate how the newly extended U-Compare enhances the cross-platform interoperability of workflows, by seamlessly importing a number of text mining workflow web services exported from U-Compare into Taverna, i.e., a generic scientific workflow construction platform.
Haider, Md. Rezzakul
In recent years container virtualization and container management emerged in the context of Cloud computing as a new paradigm in IT enterprises. It introduces new approaches that enable the IT industry to manage their application and services more effectively in the Cloud. With the rapid increase of usage of Cloud computing, IT companies introduce new tools to manage their applications in Cloud environments. However, each tool has its own kind of definitions and specifications on describing t...
Smoley, Brian A; Smith, Nicholas L; Runkle, Guy P
Hypertension is a common condition, but little is known about its prevalence in the Armed Forces. Our purpose was to provide an estimate of the prevalence of hypertension in a large population of US service members. We reviewed the screening records for service members who completed health risk assessments at Fort Lewis in Tacoma, WA, in 2004. The prevalence of hypertension and prehypertension were estimated from single recorded blood pressure readings and subjects' reported use of blood pressure medications. Study subject characteristics associated with hypertension and prehypertension were examined by chi(2) tests and multivariate logistic regression. Thirteen percent of the 15,391 subjects met the study definition for hypertension; 62% met the study definition for prehypertension. Increasing age and body mass index, male sex, black race/ethnicity, and senior rank were associated with hypertension; only body mass index, male sex, and senior rank were associated with prehypertension. Hypertension and prehypertension are more prevalent in the US Armed Forces than has been previously reported, and prehypertension may be more common in the US Armed forces than in the general population. The high prevalence of prehypertension found in this young, fit population suggests a need to better define the risks and benefits associated with the diagnosis and treatment of prehypertension in low-risk populations.
Bonar, Erin E.; Bohnert, Kipling M.; Walters, Heather M.; Ganoczy, Dara; Valenstein, Marcia
Objective To compare mental health symptoms and service utilization among returning student and nonstudent Service Members/Veterans (SM/Vs). Participants SM/Vs (N=1439) were predominately white (83%) men (92%); half were over age 30 (48%) and 24% were students. Methods SM/Vs completed surveys six months post-deployment (October 2011–July 2013). Results Students and nonstudent SM/Vs did not differ in positive screens for depression, anxiety, hazardous drinking, or Post-traumatic Stress Disorder (PTSD). Students (n=81) and nonstudents (n=265) with mental health symptoms had low levels of mental health service use (e.g., VA, civilian, or military facilities), at 47% and 57% respectively. Fewer students used VA mental health services. Common barriers to treatment-seeking included not wanting treatment on military records and embarrassment. Conclusions Like other returning SM/Vs, student SM/Vs have unmet mental health needs. The discrepancy between potential need and treatment-seeking suggests that colleges might be helpful in further facilitating mental health service use for student SM/Vs. PMID:25337770
Full Text Available Cloudlet recently was proposed to push data centers towards network edges for reducing the network latency of delivering cloud services to mobile devices. For the sake of user mobility, it is necessary to deploy and hand off services anytime anywhere for achieving the minimal network latency for users’ service requests. However, the cost of this solution usually is too high for service providers and is not effective for resource exploitation. To resolve this problem, we propose a location-aware service deployment algorithm based on K-means for cloudlets in this paper. Simply speaking, the proposed algorithm divides mobile devices into a number of device clusters according to the geographical location of mobile devices and then deploys service instances onto the edge cloud servers nearest to the centers of device clusters. Our performance evaluation has shown that the proposed algorithm can effectively reduce not only the network latency of edge cloud services but also the number of service instances used for satisfying the condition of tolerable network latency.
Adopting DevOps practices for model service development and deployment enables a community to engage in service-oriented modeling and data management. The Cloud Services Integration Platform (CSIP) developed the last 5 years at Colorado State University provides for collaborative integration of environmental models into scalable model and data services as a micro-services platform with API and deployment infrastructure. Originally developed to support USDA natural resource applications, it proved suitable for a wider range of applications in the environmental modeling domain. While extending its scope and visibility it became apparent community integration and adequate work flow support through the full model development and application cycle drove successful outcomes.DevOps provide best practices, tools, and organizational structures to optimize the transition from model service development to deployment by minimizing the (i) operational burden and (ii) turnaround time for modelers. We have developed and implemented a methodology to fully automate a suite of applications for application lifecycle management, version control, continuous integration, container management, and container scaling to enable model and data service developers in various institutions to collaboratively build, run, deploy, test, and scale services within minutes.To date more than 160 model and data services are available for applications in hydrology (PRMS, Hydrotools, CFA, ESP), water and wind erosion prediction (WEPP, WEPS, RUSLE2), soil quality trends (SCI, STIR), water quality analysis (SWAT-CP, WQM, CFA, AgES-W), stream degradation assessment (SWAT-DEG), hydraulics (cross-section), and grazing management (GRAS). In addition, supporting data services include soil (SSURGO), ecological site (ESIS), climate (CLIGEN, WINDGEN), land management and crop rotations (LMOD), and pesticides (WQM), developed using this workflow automation and decentralized governance.
The 62 staff members who are celebrating 25 years' service at CERN in 2009 were invited by the Director-General to a reception in their honour on 17 November. ARNAUDON Luca/BE BEL Jean-François/TE BERTINELLI Francesco/TE BLAND Alastair/BE BLOCH Philippe/PH BORCIER Luc/EN BRUNEL Xavier/PH BURKIMSHER Paul/EN CAMPI Domenico/PH CATTAI Ariella/PH DALIN Jean-Michel/EN DANGOISSE Claude/IT DAVIDS Daniel/EN DI MAIO Franck/BE FERRARI Claude/EN FISCHER Klaus/TE FOLLEY Adrian/PH FORMENTI Fabio/TE GATIGNON Laurentius/EN GIACHINO Rossano/BE GONIDEC Allain/PH GRAFSTROM Per/PH HANCOCK Steven/BE HATCH Mark/PH HEMMER Frederic/IT HOURICAN Michael/TE ...
Foko, Thato E
Full Text Available deployment of ICT Platforms in the rural areas. The contribution of ICT Platform adds to the important notion of access which enhances service delivery. This is seen through the Technology Acceptance Models used in this paper. The main research methodology...
Pokraev, S.; Koolwaaij, Johan; van Setten, Mark; Broens, Tom; Dockhorn Costa, Patrícia; Wibbels, Martin; Ebben, Peter; Strating, Patrick
In this paper we present a web services-based platform that facilitates and speeds up the development and deployment of context-aware, integrated mobile speech and data applications. The platform is capable of handling different types of context and offers sophisticated personalization mechanisms.
Woyte, Achim; Gardner, Paul; Snodin, Helen
The European Concerted Action for Offshore Wind Energy Deployment (COD) was carried out by eight sea-bordering European Union member states, with the objective to remove not explicitly technical barriers to offshore wind energy. Within the COD, an inventory of relevant aspects affecting the grid integration of offshore wind energy on a large scale in the eight countries has been made. Collected data items for this inventory are national plans and prospects for offshore wind energy, information about the transmission system, possibilities for grid connection, aspects of the grid codes, balancing, connection and energy pricing. The comprehensive COD reports were published and presented in October 2005 during the Copenhagen Offshore wind conference. This paper provides a short description of the situation for each country. Thereafter, country-specific information is grouped based on geography and membership in a synchronous zone. Additionally, a view is developed on the desirable facilities for the trans-European exchange of power from large wind farms. Finally, we elaborate overall conclusions in order to arrive at generalized observations, recommendations for policy makers and issues that will emerge in the near future. As a general conclusion, many things need to be done on a technical level in order to integrate large amounts of offshore wind power into our power systems. However, none of these measures is technically unknown. Therefore, the feasibility of integrating large amounts of offshore wind power is mainly a question of finance and hence based on political decisions. (Author)
Matsuda, L M; Evora, Y D; Boan, F S
"Focus on the client" is the posture that must be adopted in order to offer quality products. Based on the Total Quality Management approach, the Quality Function Deployment method (QFD) is a tool to achieve this goal. The purpose of this study is to create a proposal for planning the nursing services following the steps and actions of this methodology. The basic procedure was to survey the necessity of 106 hospitalized patients. Data were deployed using the seventeen steps proposed. Results showed that the interaction is more important than the technique according to the clients and also that this method enables the implementation of quality in nursing care.
Peliwe P. Mnguni
Research purpose: This article employs social defense theory to explore manifestations of anxiety and defense within South African public service organisations. Motivation for the study: Dominant discourse on public service institutions over-relies on political, sociological and public administration theories and tends to ignore psychosocial explanations. Further, whilst the psychodynamics of social service work are generally understood, the unconscious dynamics of generic public service work remain under-theorised. Research design, approach and method: This conceptual article draws on my personal observations as a reflective citizen and experiences as a consultant to government departments. Main findings: Herein, an argument is advanced that the deployment of ill-qualified party loyalists to key positions in the public service is perverse: it serves as a collective defense against the impossible aspects of the task at hand. The appointees, in turn, deploy organisational processes to defend against feelings of incompetence and the inevitability of failure. This practice, coupled with acute resource constraints, sets up front line staff for scapegoating. Practical/managerial implications: An appreciation of the multiple meanings of public service work and the defensive role played by public institutions stands to inform purposeful change towards sustainable public service organisational practice. Contribution/value-add: The discussion seeks to contribute to attempts that employ systems psychodynamics to make sense of anxiety and defense within organisations in general and public service institutions in particular.
The following staff members with 25 years' service in 2003 were invited by the Director-General to a reception in their honour on 20 November 2003: ALLIOD Patrick/ATGESCHONKE Gunther/AB AYMON Marcel/HRGLASER Maurice/EP BAUDET Serge/TISHUGOT Bernard/AB BENOIT-JEANNIN Brigitte/SPLJOUVE Christian/AT BERRY Peter/HRJULLIARD André/ST BIERI Catherine/STLAFAGE Patrice/ST BLANC Didier/STLAJUST Danièle/DSU BLANC Michel/ITLEGRAND Dominique/AT BOCH Guy/ITLONG Serge/EST BONZANO Roberto/STLYONNET André/EP BURCKHART Doris/EPMALOD-DOGNIN Jean-Pierre/ST BURNS Alan/ABMAURY Stephan/AC BURTIN Gérard/ABMILES John/AT CARENA Wisla/EPMONET René/EST CASTEL André/ESTMULLER André/TIS CLIFF Frank/HRPERREAL Pierre/AT CUCCURU Giovanni/ATPETERSEN Jørgen/EP DAMIANI Michel/ABPETIT Patrick/EP DELUCINGE Evelyne/ATPIERRE Patrice/AB DHOTE Patrick/SPLROUX Jacques/EP FLUCKIGER François/ITSAMYN Dirk/EP FORESTE Antonio/ESTSAVIOZ Jean Jacques/AB FRAIS...
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
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.
Kijl, Björn; Nieuwenhuis, Lambert J M; Huis in 't Veld, Rianne M H A; Hermens, Hermie J; Vollenbroek-Hutten, Miriam M R
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.
Francisco José Dias Junior
Full Text Available Training is important in preparing employees. The Quality Function Deployment (QFD is an effective method to systematically translate customer requirements into project specifications. This study presents the use of QFD method in development of training project. It is a qualitative research conducted in the industry services company. The results show that the use of QFD is an effective alternative for managers to develop or improve their training projects.
Horvitz, Eric J.; Apacible, Johnson; Sarin, Raman; Liao, Lin
We present research on developing models that forecast traffic flow and congestion in the Greater Seattle area. The research has led to the deployment of a service named JamBayes, that is being actively used by over 2,500 users via smartphones and desktop versions of the system. We review the modeling effort and describe experiments probing the predictive accuracy of the models. Finally, we present research on building models that can identify current and future surprises, via efforts on mode...
Bravo, Adrian J; Kelley, Michelle L; Hollis, Brittany F
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.
Dawson, Frances Trigg
A study was made to determine the relationships between (1) satisfaction of members with service club management processes and member's perception of management systems, (2) perception of service club management system to selected independent variables, and (3) satisfaction to perception of service club management systems with independent…
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.
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.
... vigilant to eliminate continuing, evolving predatory lending practices targeting service members and their... predatory marketing practices, and other abuses identified by consumer protection advocates, including the...
Tomoe Daniela Hamanaka Gusberti
Full Text Available This article discusses Organizational Capabilities as the basic components of business models that emerged under the New Product Development Process and Technological Management. In the context of the new Technology Based Companies Development, it adopts a qualitative research in order to identify, analyze and underpin the organizational capability deployment in a process of technology conversion into product and service. The analysis was carried out considering concepts from literature review, in a technology based enterprise started by an academic spin-off company. The analysis enabled the elicitation of a Business Model and the discussion of their components, and correspondent evolution hypothesis. The paper provides an example of capability deployment accordingly the established theory illustrated by a case study. The study not just enumerate the needed partners, resources, customer channels, it enabled the description of their connection, representing the logic behind the decision made to develop the conceptual model. This detailed representation of the model allows better addressed discussions.
... least three members. In the case of an appraisal of a career appointee, more than half the members shall consist of career appointees. The names and titles of the PRB members are as follows: Nani A. Coloretti... Management Service and Bureau of the Public Debt Cynthia Z. Springer, Deputy Commissioner, Accounting and...
Elnitsky, Christine A; Blevins, Cara L; Fisher, Michael P; Magruder, Kathryn
Returning military service members and veterans (MSMVs) experience a wide range of stress-related disorders in addition to social and occupational difficulties when reintegrating to the community. Facilitating reintegration of MSMVs following deployment is a societal priority. With an objective of identifying challenges and facilitators for reintegration of MSMVs of the current war era, we critically review and identify gaps in the literature. We searched 8 electronic databases and identified 1,764 articles. Screening of abstracts and full-text review based on our inclusion/exclusion criteria, yielded 186 articles for review. Two investigators evaluating relevant articles independently found a lack of clear definition or comprehensive theorizing about MSMV reintegration. To address these gaps, we linked the findings from the literature to provide a unified definition of reintegration and adapted the social ecological systems theory to guide research and practice aimed at MSMV reintegration. Furthermore, we identified individual, interpersonal, community, and societal challenges related to reintegration. The 186 studies published from 2001 (the start of the current war era) to 2015 included 6 experimental studies or clinical trials. Most studies do not adequately account for context or more than a narrow set of potential influences on MSMV reintegration. Little evidence was found that evaluated interventions for health conditions, rehabilitation, and employment, or effective models of integrated delivery systems. We recommend an ecological model of MSMV reintegration to advance research and practice processes and outcomes at 4 levels (individual, interpersonal, organizational, and societal). (PsycINFO Database Record (c) 2017 APA, all rights reserved).
... DEPARTMENT OF LABOR Office of the Secretary Senior Executive Service; Appointment of Members to the Performance Review Board Title 5 U.S.C. 4314(c)(4) provides that Notice of the Appointment of an individual to serve as a member of the Performance Review Board of the Senior Executive Service shall be...
Chang, Hyejung; Kim, Dohoon
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.
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
hour per response, including the time tor reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of...Member following SERE physical training. Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Capt Matthew A Pombo Se. TASK
The 38 staff members who are celebrating 25 years at CERN in 2010 were invited by the Director-General to a reception in their honour on 21 October. ASBURY David IT HEGARTY Seamus HR BAUDRENGHIEN Philippe BE ISNARD Christian IT BERGSMA Felix PH JONES Robert IT BERNAL Jean-Manuel TE JOUBERJEAN Franck IT BERRIG Olav Ejner BE LAGRANGE Thierry FP BONT Hillebrand GS MARIN Antonio BE BOURGEOIS Nicolas PH MESENGE Pascal EN BOURREL Thierry EN MISSIAEN Dominique BE ...
sexual abuse (995.53), neglect (995.52), emotional abuse (995.51), and unspecified abuse (995.50, 995.59). Children less than 2 years of age with an...The child’s age at the start of the episode was categorized as 0-2 years, 3-5 years, and 6 years or older . Episode characteristics included the...officer/warrant) or maltreatment type ( sexual , physical, or neglect/other). A final model explored whether age of the child modified the linkage results
of the lung 329 (17.5) 493 Asthma 297 (15.8) 486 Pneumonia, organism unspecified 209 (11.1) Digestive system diseases (codes 520–579) 540 Acute...fallopian tube, pelvic cellular tissue, and peritoneum 122 (6.2) Skin diseases (codes 680–709) 682 Other cellulitis and abscess 559 (53.5) 685...true measure of morbidity for categories such as mental health (31, 32). Further, the use of diagnostic coding for conditions such as cancer with a
Wells, Timothy S; Sato, Paul A; Smith, Tyler C; Wang, Linda Z; Reed, Robert J; Kappel Ryan, Margaret A
.... To determine if anthrax vaccination was associated with an increased risk of hospitalization, a historical cohort study utilizing pre- and post-anthrax-vaccination hospitalizations was undertaken...
personality disorder 301.7 Antisocial personality disorder 301.81 Narcissistic personality disorder 301.82 Avoidant personality disorder ...posttraumatic depression 4. Personality disorder diagnosis with V code V15.4 (History of psychological trauma) a. This may also capture soldiers with... personality disorders and/or childhood trauma (not necessarily recent trauma) Title: The Temporal Relationship Between Intrafamilial
Yount, Rick A; Olmert, Meg D; Lee, Mary R
In July 2008, social worker and certified service dog trainer Rick Yount created the first Warrior dog-training program designed to be a safe, effective, nonpharmaceutical intervention to treat the symptoms of posttraumatic stress disorder (PTSD) and traumatic brain injury in Veterans and service members undergoing treatment at a large Veterans Administration residential treatment facility. In 2009, Yount was asked to establish the program at a prominent Department of Defense medical center. In October 2010, Yount was invited to create a service dog training program to support the research and treatment mission at the new National Intrepid Center of Excellence (NICoE), in Bethesda, Maryland. This program, now being offered through the nonprofit foundation Warrior Canine Connection, continues to produce anecdotal evidence that training service dogs reduces the PTSD symptoms of Warrior-trainers and that the presence of the dogs enhances the sense of wellness in the NICoE staff and the families of our Wounded Warriors. Under the research leadership of the NICoE, the Warrior Canine Connection research team plans to systematically investigate the physiological, psychological, and behavioral benefits of this program.
reintegration. Communication and Generalized Anxiety The emotional cycle of deployment model provides a descrip- tive framework for understanding the...counseling. Thus, communication can have a reciprocal influence on the very appraisals and emotions that motivate interaction in the first place. Communication...of service members back into family life after deployment can be extremely challenging for military couples. Understanding the factors that
Beard, John D; Kamel, Freya
Rates of amyotrophic lateral sclerosis (ALS) have been reported to be higher among US military veterans, who currently number more than 21 million, but the causal factor(s) has not been identified. We conducted a review to examine the weight of evidence for associations between military service, deployments, and exposures and ALS etiology and survival. Thirty articles or abstracts published through 2013 were reviewed. Although the current evidence suggests a positive association with ALS etiology, it is too limited to draw firm conclusions regarding associations between military service and ALS etiology or survival. Some evidence suggests that deployment to the 1990-1991 Persian Gulf War may be associated with ALS etiology, but there is currently no strong evidence that any particular military exposure is associated with ALS etiology. Future studies should address the limitations of previous ones, such as reliance on mortality as a surrogate for incidence, a dearth of survival analyses, lack of clinical data, low statistical power, and limited exposure assessment. The Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis (GENEVA) Study is one such study, but additional research is needed to determine whether military-related factors are associated with ALS and to assess potential prevention strategies. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Vega-Barbas, Mario; Pau, Iván; Martín-Ruiz, María Luisa; Seoane, Fernando
Smart spaces foster the development of natural and appropriate forms of human-computer interaction by taking advantage of home customization. The interaction potential of the Smart Home, which is a special type of smart space, is of particular interest in fields in which the acceptance of new technologies is limited and restrictive. The integration of smart home design patterns with sensitive solutions can increase user acceptance. In this paper, we present the main challenges that have been identified in the literature for the successful deployment of sensitive services (e.g., telemedicine and assistive services) in smart spaces and a software architecture that models the functionalities of a Smart Home platform that are required to maintain and support such sensitive services. This architecture emphasizes user interaction as a key concept to facilitate the acceptance of sensitive services by end-users and utilizes activity theory to support its innovative design. The application of activity theory to the architecture eases the handling of novel concepts, such as understanding of the system by patients at home or the affordability of assistive services. Finally, we provide a proof-of-concept implementation of the architecture and compare the results with other architectures from the literature.
Vega-Barbas, Mario; Pau, Iván; Martín-Ruiz, María Luisa; Seoane, Fernando
Smart spaces foster the development of natural and appropriate forms of human-computer interaction by taking advantage of home customization. The interaction potential of the Smart Home, which is a special type of smart space, is of particular interest in fields in which the acceptance of new technologies is limited and restrictive. The integration of smart home design patterns with sensitive solutions can increase user acceptance. In this paper, we present the main challenges that have been identified in the literature for the successful deployment of sensitive services (e.g., telemedicine and assistive services) in smart spaces and a software architecture that models the functionalities of a Smart Home platform that are required to maintain and support such sensitive services. This architecture emphasizes user interaction as a key concept to facilitate the acceptance of sensitive services by end-users and utilizes activity theory to support its innovative design. The application of activity theory to the architecture eases the handling of novel concepts, such as understanding of the system by patients at home or the affordability of assistive services. Finally, we provide a proof-of-concept implementation of the architecture and compare the results with other architectures from the literature. PMID:25815449
The 34 staff members who have spent 25 years within CERN in 2006 were invited by the Director-General to a reception in their honour on 1st November. BELLEMAN Jeroen / AB BERTOLA Dominique / DSU BOLDI Armand / TS BOLLET André / AT BRANDT Daniel / DSU CACCIOPPOLI Michel /TS CALDERONE Antonino / TS CLARET René /TS COSSEY PUGET Françoise / PH DALEXANDRO Noël / AT DECOMBAZ Michel / TS DELLA NEGRA Michel / PH DINIUS Arend / AB FOSTER David / IT FROMM Christine / DSU GROS Daniel / TS GUDET Denis / TS LEWIS Julian / AB MAPELLI Livio / PH MASSON Albert / TS MOINE Catherine / PH MÜLLER Hans / PH ODIER Patrick / AB PANMAN Jaap / PH POOLE John / AB PROLA-TESSAUR Maureen / AT RAPHOZ Jean-Pierre / IT ROSTANT Jeanne / PH RUGO Erminio / AB VAN HERWIJNEN Eric / PH WERNER Per / PH WILDNER Elena / AT WILKINSON Jonathan / DSU WISZNIOWSKI Thierry / AB
The 27 staff members who have spent 25 years within CERN in 2012 were invited by the Director-General to a reception in their honour on 2 November. BARRIN Laurence - PH BILLEN Ronald - BE BOUCHÉ Jean-Marc - HR BURKHARDT Helmut - BE CARLIER Etienne - TE CASS Antony - IT CHAN KWOK CHEON Anne Belinda - IT CHARRUE Pierre - BE COLLIER Paul - BE CUENCA PEREZ Antonio - GS DE JONGHE Jurgen - GS DEFERT Philippe - IT ELSENER Konrad - PH FROIDEVAUX Daniel - PH GRIGGS Christopher - PH MATHEYS Jean-Pol - HR MEIJERS Franciscus - PH MERTENS Volker - TE METRAL Gabriel - BE NECCA Rene - EN PACE Alberto&...
The 30 staff members who have spent 25 years within CERN in 2015 were invited by the Director-General to a reception in their honour on 10 December. Renaud Barillere EN Edgar Birker DG Sergio Calatroni TE Paola Catapano DG Christophe Delamare GS Philippe Farthouat PH Roger Forty PH Yves Gaillard TE Clara Gaspar PH Jean-Christophe Gayde EN Hubert Gerwig PH Simone Giani PH Jean-Pierre Granchelli EN Juan Guijarro IT Helene Haller PH John Harvey PH Vincenzo Innocente PH ...
Kentis, Angelos Mimidis; Ollora Zaballa, Eder; Soler, José
5G standard emerges at a particular time in technology history when cloud transforms deeply almost all industries and services: it becomes obvious that innovations have to be made cloud-native for being successful. 5G must become the ubiquitous fabric blending universal connectivity (to humans, r...
The 24 staff members who have spent 25 years within CERN in 2007 were invited by the Director-General to a reception in their honour on 11 October. Mr.\tBLEUS Baudouin\tAB Mr.\tBRUNEL Bernard\tPH Mr.\tCAILLET Norbert\tHR Dr.\tCASPERS Friedhelm\tAB Mr.\tCHEVRET Thierry\tTS Mr.\tCUMER Gérard\tTS Mrs.\tDA COSTA Maryse\tIT Mrs.\tDELAMARE Catherine\tIT Mr.\tERIKSSON Tommy\tAB Mrs.\tFOFFANO Susan\tIT Mr.\tGONZALEZ José Luis\tAB Mr.\tHUTCHINS Stephen\tAB Dr.\tKLEMPT Wolfgang\tPH Mr.\tLEVRIER François\tTS Dr.\tMARCHIORO Alessandro\tPH Mr.\tNORMANN Lasse\tAB Dr.\tRAICH Ulrich\tAB Mr.\tREBUT Michel\tPH Mr.\tRUSSO Aniello\tAT Dr.\tSTAMPFLI Lorenz\tDSU Mrs.\tTUUVA Martine\tTS Dr.\tWEISZ Sylvain\tTS Mr.\tYVON Guy\tAB Mr.\tZIEGLER Patrice\tTS
The 74 staff members who have spent 25 years at CERN in 2005 were invited by the Director-General to a reception in their honour on 22 November. ADRIAN Gilbert / AB ALLIOD Marie-Noëlle / AB ANTOINET Gérard / SC AUBERT Marc / TS AUQUIER Christian / SC BAIRD Simon / AB BARRAS Suzanne / PH BAUD Richard / AT BELLONI Jean / SC BERTUOL Gilbert / SC BLANC Jean-Luc / AB BONVALLET Guy / SC BOSSUS Patrice / SC BROERE Johannes / AB BRU Yvon / TS BURDAIRON Alain / TS CANARD Philippe / AT CAVALLO Patrice / SC CHARRA Patrick / PH CHATAIGNEAU Marc / SC COLIN Gilles / SC DAHLEN Pierre / AB DE GROOT Johannes / PH DEDOBBELER Bernard / TS DELCAMBRE Jean Pierre / SC DELENCLOS Yves / TS DEROYER Patrick / SC DESBISSONS Christian / SC DRAPER Mick / AB DROUX Pascal / FI DUCASTEL Claude / TS DUMUR Alain / SC FOCKER Gerrit / AB FOFFANO Giuseppe / TS FORRAT Isabelle / IT FREI Marie-José / DSU FRESSARD Michel / TS GAGNIERE Daniel / TS GIUDICI Pierre-Ange / PH GOICOECHEA Bernard / TS GUEHO Alain / TS GUENEHEC François / SC JE...
Brickell, Tracey A; Lippa, Sara M; French, Louis M; Kennedy, Jan E; Bailie, Jason M; Lange, Rael T
Females are often excluded from military-related mild traumatic brain injury (mTBI) research because of its relatively low prevalence in this population. The purpose of this study was to focus on outcome from mTBI in female service members, compared with males. Participants were 172 United States military service members selected from a larger sample that had sustained an mTBI, and were evaluated within 24 months of injury (Age: mean = 28.9, SD = 8.1) at one of six military medical centers. Eighty-six women were matched to 86 men on nine key variables: TBI severity, mechanism of injury, bodily injury severity, days post-injury, age, number of deployments, theater where wounded, branch of service, and rank. Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C). There were no meaningful gender differences across all demographic and injury-related variables (p > 0.05). There were significant group differences and medium effect sizes for the NSI total score and all four NSI cluster scores. Symptoms most affected related to nausea, sensitivity to light, change in taste/smell, change in appetite, fatigue, and poor sleep. There were significant group differences and small-medium effect sizes for the PCL-C total score and two of the three PCL-C cluster scores. Symptoms most affected related to poor concentration, trouble remembering a stressful event, and disturbing memories/thoughts/images. Females consistently experienced more symptoms than males. As females become more active in combat-related deployments, it is critical that future studies place more emphasis on this important military population.
The 47 staff members who have spent 25 years within CERN in 2008 were invited by the Director-General to a reception in their honour on 24 October. Mr.\tAllen\tDavid John\tAB Dr.\tBailey\tRoger\tAB Mr.\tBlas\tAlfred\tAB Mr.\tBobbio\tPiero\tAB Dr.\tBona\tMaurizio\tSC Mr.\tBrachet\tJean-Pierre\tTS Dr.\tBurckhart\tHelfried\tPH Miss\tButtay\tCatherine\tFI Mr.\tCatherall\tRichard\tAB Mr.\tCoin\tAndré-Yvon\tTS Dr.\tCornelis\tKarel\tAB Dr.\tDavenport\tMartyn\tPH Mr.\tDehavay\tClaude\tAB Mr.\tDenblyden\tJean-Loup\tPH Mr.\tDenis\tBernard\tDSU Mr.\tDuret\tMax\tAT Mr.\tEvans\tJohn\tIT Mrs.\tFavrot\tVéronique\tIT Mr.\tFowler\tAntony\tAB Mrs.\tGalmant\tCatherine\tAB Mr.\tGuillaume\tJean-Claude\tTS Mrs.\tJerdelet\tJocelyne\tDSU Dr.\tKostro\tKrzysztof\tAB Mr.\tKuczerowski\tJoseph\tAB Mr.\tLappe\tJean-Pierre\tTS Mrs.\tLaverrière\tCatherine\tSC Mr.\tLeggiero\tLuigi\tTS Mr.\tManglunki\tDjango\tAB Mr.\tMartens\tReinoud\tIT Mr.\tMartinez\tGeorges\tSC Mr.\tMonchalin\tPhilippe\tSC Mr.\tMoret\tPhilippe\tDSU Mr.\tOlesen\tGert\tPH Mr.\tPasinelli\tSergi...
Full Text Available Purpose: The aims of this study are twofold: first, it attempts to investigate service attributes in a hospital front office; and second, to identify strategies to improve those service attributes. Design/methodology/approach: This study used integration of Quality Function Deployment and Kano Model. The research instrument, which takes the SERVQUAL model as its starting point, was developed using a comprehensive set of techniques, including a literature review of relevant topics, interviews and focus group discussions. Using a sample of 140 customers of an international hospital situated in Yogyakarta, Indonesia, 14 service attributes required by customers were identified. The attributes, which were further categorised into 5 attractive, 4 one-dimensional and 5 ‘must-be’ attributes, were analysed using the Kano Model. Findings: Using the integrated QFD and Kano Model, the service attributes needed for improvement were identified. The results are different from those when the company used either SERVQUAL or QFD alone. This study also reveals that benchmarking with competitor might produce misleading results. The results are different when the analysis combined a comprehensive method of QFD and Kano Model. Practical implications: Service providers will benefit from the findings of this study, as both the service attributes and technical requirements that require improvement as a priority are identified. Originality/value: It is the first time that front office quality of hospital is examined using integrated method of SERVQUAL, QFD and Kano Model. The recommendations proposed from this comprehensive method offer novel solution that has never been found in existing study.
Yildiz, Kadir; Polat, Ercan; Güzel, Pinar
The purpose of this study is to investigate sport center members' perceived service quality levels with a view to Kano customer expectations and requirements model. To that end, a descriptive approach and a correlational research design featuring survey method is adopted. Research group consists of 680 (300 women, 380 men) sport center members who…
Darby, Alexa; Newman, Gabrielle
This qualitative study provides a theoretical framework for understanding faculty members' motivation to persist in utilizing academic service-learning pedagogy. Twenty-four faculty members from a private liberal arts university in the southeastern United States were interviewed about the benefits and challenges of teaching academic…
External Relation, Clarity of Expression, Social Style, Subject Matter, and Aesthetics ). Each of these 10 subscales are rated on a scale of 0 to 5 where 0...Award Number: W81XWH-11-1-0635 TITLE: Treatment of Social Competence in Military Veterans, Service Members, and Civilians with Traumatic Brain...1Aug2014 - 31Jul2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Treatment of Social Competence in Military Veterans, Service Members, and Civilians with
This study applies quality function deployment (QFD) techniques to evaluate the quality of service of undergraduate nursing education in Taiwan from the perspective of nursing students. Survey data from 560 undergraduate nursing students at four Taiwanese universities were subjected to QFD analysis in order to identify the quality characteristics most highly valued by students, the elements of educational service they consider most important and least important, and relationships/discrepancies between student quality requirements and institutional service elements. Results show that students value traditional elements of nursing education - clinical practice and lectures - more highly than recent additions such as computer-aided instruction and multimedia teaching. Results also show that students are looking for quality primarily in the area of faculty characteristics. The implication is that institutions which provide nursing education should not neglect the importance of investing in faculty when they are seeking to upgrade the quality of their programs. Further QFD studies are recommended to evaluate the quality of nursing education from the perspective of preceptors and nurses who help to train students in clinical settings.
Edwards-Stewart, Amanda; Smolenski, Derek J; Reger, Greg M; Bush, Nigel; Workman, Don E
Personal technology use is ubiquitous in the United States today and technology, in general, continues to change the face of health care. However, little is known about the personal technology use of military service members and the behavioral health care providers that treat them. This study reports the technology use of 1,101 active duty service members and 45 behavioral health care providers at a large military installation. Participants reported Internet usage; ownership of smartphones, tablets, and e-readers; usage of mobile applications (apps); and basic demographic information. Compared with providers, service members reported higher rates of smartphone ownership, were more likely to own Android smartphones than iPhones, and spent more time gaming. Both groups spent a comparable amount of time using social media. With the exception of gaming, however, differences between service members and providers were not statistically significant when demographics were matched and controlled. Among service members, younger respondents (18-34) were statistically more likely than older respondents (35-58) to own smartphones, spend time gaming, and engage in social media. Our findings can help inform provider's technology-based education and intervention of their patients and guide the development of new technologies to support the psychological health of service members. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Falcó, Jorge L; Vaquerizo, Esteban; Lain, Luis; Artigas, Jose Ignacio; Ibarz, Alejandro
The MonAMI project aims to investigate the feasibility of the deployment of open platforms for Ambient Assisted Living (AAL) services provision based on Ambient Intelligence (AmI) and to test user acceptance and the usability of the services. Services were designed to provide support in the areas of environmental control, security, well-being and leisure. These services were installed and evaluated in a Spanish geriatric residence. The participants included elderly persons with disabilities, nursing home care givers and informal carers. The concept of the open platform proved to be satisfactory for the provision of the services in a context aware framework. Furthermore, the usability of the technology was viewed positively and the overall results indicate that this system has the potential to prolong independent living at home for elderly people with disabilities. Deployment was proven successful and awareness of open-platform AAL service delivery was raised in local communities throughout Europe.
Full Text Available The MonAMI project aims to investigate the feasibility of the deployment of open platforms for Ambient Assisted Living (AAL services provision based on Ambient Intelligence (AmI and to test user acceptance and the usability of the services. Services were designed to provide support in the areas of environmental control, security, well-being and leisure. These services were installed and evaluated in a Spanish geriatric residence. The participants included elderly persons with disabilities, nursing home care givers and informal carers. The concept of the open platform proved to be satisfactory for the provision of the services in a context aware framework. Furthermore, the usability of the technology was viewed positively and the overall results indicate that this system has the potential to prolong independent living at home for elderly people with disabilities. Deployment was proven successful and awareness of open-platform AAL service delivery was raised in local communities throughout Europe.
Delahaij, R.; Kamphuis, W.; Berg, C.E. van den
This study investigated the importance of 2 resilience resources for service members’ ability to deal with threat during deployment. Military self-efficacy and family support were measured before deployment and related to work engagement and burnout levels of service members during deployment. We
Adopting a narrative approach with a dialogical framework, a longitudinal case study is presented that describes a service member's self in transition from active service into the civilian population. An analysis and interpretation of the case study leads to the hypothesis that if a dominant
Beard, John D; Engel, Lawrence S; Richardson, David B; Gammon, Marilie D; Baird, Coleen; Umbach, David M; Allen, Kelli D; Stanwyck, Catherine L; Keller, Jean; Sandler, Dale P; Schmidt, Silke; Kamel, Freya
Factors underlying a possible excess of amyotrophic lateral sclerosis (ALS) among military veterans remain unidentified. Limitations of previous studies on this topic include reliance on ALS mortality as a surrogate for ALS incidence, low statistical power, and sparse information on military-related factors. We evaluated associations between military-related factors and ALS using data from a case-control study of U.S. military veterans. From 2005 to 2010, we identified medical record-confirmed ALS cases via the National Registry of Veterans with ALS and controls via the Veterans Benefits Administration's Beneficiary Identification and Records Locator System database. In total, we enrolled 621 cases and 958 frequency-matched controls in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study. We collected information on military service and deployments and 39 related exposures. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). We used inverse probability weighting to adjust for potential bias from confounding, missing covariate data, and selection arising from a case group that disproportionately included long-term survivors and a control group that may or may not differ from U.S. military veterans at large. The odds of ALS did not differ for veterans of the Air Force, Army, Marines, and Navy. We found higher odds of ALS for veterans whose longest deployment was World War II or the Korean War and a positive trend with total years of all deployments (OR=1.27; 95% CI: 1.06, 1.52). ALS was positively associated with exposure to herbicides for military purposes, nasopharyngeal radium, personal pesticides, exhaust from heaters or generators, high-intensity radar waves, contaminated food, explosions within one mile, herbicides in the field, mixing and application of burning agents, burning agents in the field, and Agent Orange in the field, with ORs between 1.50 and 7
John D Beard
Full Text Available Military veterans may have higher rates of amyotrophic lateral sclerosis (ALS mortality than non-veterans. Few studies, with sparse exposure information and mixed results, have studied relationships between military-related factors and ALS survival. We evaluated associations between military-related factors and ALS survival among U.S. military veteran cases.We followed 616 medical record-confirmed cases from enrollment (2005-2010 in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study until death or July 25, 2013, whichever came first. We ascertained vital status information from several sources within the Department of Veterans Affairs. We obtained information regarding military service, deployments, and 39 related exposures via standardized telephone interviews. We used Cox proportional hazards regression models to estimate hazard ratios (HRs and 95% confidence intervals. We adjusted for potential confounding and missing covariate data biases via inverse probability weights. We also used inverse probability weights to adjust for potential selection bias among a case group that included a disproportionate number of long-term survivors at enrollment.We observed 446 deaths during 24,267 person-months of follow-up (median follow-up: 28 months. Survival was shorter for cases who served before 1950, were deployed to World War II, or mixed and applied burning agents, with HRs between 1.58 and 2.57. Longer survival was associated with exposure to: paint, solvents, or petrochemical substances; local food not provided by the Armed Forces; or burning agents or Agent Orange in the field with HRs between 0.56 and 0.73.Although most military-related factors were not associated with survival, associations we observed with shorter survival are potentially important because of the large number of military veterans.
Verey, Anna; Keeling, M; Thandi, G; Stevelink, S; Fear, N
When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach. 'Family member involvement' was the main theme under which four subthemes were situated: 'continuity of support', 'proactive signposting and initiating contact', 'psychoeducation and counselling' and 'higher risk groups'. Family members felt they might benefit from direct, consistent and continuous care regardless of the WIS person's injury or engagement type, and whether the WIS person was being treated in a hospital, rehabilitative centre or at home. The findings of this study suggest that family members of WIS personnel value proactive, direct and sustained communication from support service providers. We suggest that families of UK service personnel may benefit from family care coordinators, who could provide continuous and consistent care to family members of WIS personnel. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Rice, Valerie; Liu, Baoxia
U.S. military personnel face challenging situations including frequent deployments, family separations, and exposure to war. Identifying coping strategies used by the most resilient service members and veterans could positively influence military resiliency training programs. The purposes of this paper are to investigate the relationship between coping and resilience among U.S. military active service members and veterans, to identify the coping strategies used by those considered most resilient, and to discuss coping and resilience as they relate to the workplace. U.S. military active service members and veterans (N = 191) completed a demographic survey and two self-report questionnaires: The 14-Item Resilience Scale  and the Brief COPE . Active duty service members had higher resilience scores than veterans (p 0.05). Active service members' resilience was predicted by their use of positive reframing and less use of self-blame as coping strategies, accounting for 52.3% of the variance (R2 = 0.523, F(2, 60) = 32.92, p = 0.000). Veterans' resilience was predicted by longer time-in-service, greater use of humor, and less use of self-blame as coping strategies, explaining 44.8% of the variance (R2 = 0.448, F(3, 116) = 31.408, p = 0.000). This research identifies the positive coping strategies, and least-used negative coping strategies, of the U.S. service members and veterans in our study population with higher resilience scores. Incorporating this information into military- or veteran-based resilience training is likely to increase training effectiveness.
Rosenthal, Michael D; Ziemke, Gregg W; Bush, Matthew L; Halfpap, Joshua
Navy physical therapists (PTs) have been a part of ship's company aboard Aircraft Carriers since 2002 due to musculoskeletal injuries being the number one cause of lost duty time and disability. This article describes a decade of physical therapy services provided aboard aircraft carriers. A retrospective survey was conducted to evaluate the types of services provided, volume of workload, value of services provided, and impact of PTs on operational readiness for personnel aboard Naval aircraft carriers. Thirty-four reports documenting workload from PTs stationed onboard aircraft carriers were collected during the first decade of permanent PT assignment to aircraft carriers. This report quantifies a 10-yr period of physical therapy services (PT and PT Technician) in providing musculoskeletal care within the carrier strike group and adds to existing literature demonstrating a high demand for musculoskeletal care in operational platforms. A collective total of 144,211 encounters were reported during the 10-yr period. The number of initial evaluations performed by the PT averaged 1,448 per assigned tour. The average number of follow-up appointments performed by the PT per tour was 1,440. The average number of treatment appointments per tour provided by the PT and PT technician combined was 1,888. The average number of visits per patient, including the initial evaluation, was 3.3. Sixty-five percent (65%) of the workload occurred while deployed or out to sea during training periods. It was estimated that 213 medical evacuations were averted over the 10-yr period. There were no reports of adverse events or quality of care reviews related to the care provided by the PT and/or PT technician. Access to early PT intervention aboard aircraft carriers was associated with a better utilization ratio (lower average number of visits per condition) than has been reported in prior studies and suggests an effective utilization of medical personnel resources. The impact of Navy PTs
Pelts, Michael D; Albright, David L
Explore the mental health differences of student veterans by sexual orientation. Student service members/veterans (N = 702) from the Fall 2011 National College Health Assessment. Descriptive statistics and 2-sample proportion and mean tests were used to compare mental health characteristics. Student veterans who identify as lesbian, gay, bisexual, or unsure had higher levels of mental health symptoms and treatment. Results suggest a need for continued examination of student service members/veterans as related to disparities in mental health by sexual orientation.
Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying
Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members. PMID:28773347
Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying
Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members.
Claxton-Oldfield, Stephen; Gosselin, Natasha; Schmidt-Chamberlain, Kirsten; Claxton-Oldfield, Jane
A total of 22 family members, whose deceased loved ones had used the services of a hospice palliative care volunteer, responded to a brief survey designed to assess the importance of the different kinds of support offered to them (family members) by the volunteer, their impressions of the volunteers' personal qualities/characteristics, their general experiences with the volunteer, and their overall satisfaction with the volunteer services. The kind of support that received the highest importance rating from family members was the opportunity to take a much-needed break from the demands of caring for their loved one, closely followed by emotional support, the volunteer spending time with them, and the volunteer providing them with information. Family members rated volunteers highly on a list of qualities/characteristics that exemplify individuals who are effective in this role. In all, 85% of the family members felt that their volunteer was well trained and 95% did not feel that their or their loved one's privacy had been invaded by having a volunteer. Overall, family members were very satisfied with the volunteer support they received. Some limitations of the study are discussed.
Dillahunt-Aspillaga, Christina; Powell-Cope, Gail
Traumatic brain injury (TBI) has been called the signature injury of the post-9/11 wars in Iraq, Afghanistan, and neighboring countries. Although similarities exist between veterans and service members with TBI, levels of severity and different constellations of coexisting comorbid conditions affect them differently. These conditions affect physical, cognitive, and emotional function, which in turn can complicate community reintegration (CR), or the ability to return to family, vocational, and community life. This special supplement of the Archives of Physical Medicine and Rehabilitation consists of articles written by accomplished teams from multiple disciplines, including anthropology, neuropsychology, nursing, occupational therapy, psychology, and rehabilitation sciences. Each article brings a different perspective to bear on what CR means for veterans and service members from examination of predictors and perceptions of veterans and service members and others to measurement studies. Collectively, this group of articles represents current thinking about CR and lays the groundwork for testing interventions to improve CR outcomes for veterans and service members (eg, employment, living situation, family life). Published by Elsevier Inc.
Olson, Dustin; Gabriel-Olson, Kirsten
With the troop levels in Iraq decreasing and more service members being discharged, the number of veterans on campuses is steadily increasing. On average, these warriors-turning-college-students will be 24 or older, ethnic minorities, and first-generation college students. It is important to make sure that departments, campuses and communities are…
Research on the impact of mobility on children's academics has varied, although the majority indicated negative consequences. A gap in the current literature remains regarding how the mobility of children of service members, who attended public schools, relates to academic performance. The purpose of this study was to investigate the relationship…
Lewis, M. Jane; West, Bernadette; Bautista, Leyna; Greenberg, Alexandra M.; Done-Perez, Iris
This study examined perceptions regarding intimate partner abuse (IPV) in a largely Latino community in New Jersey through focus groups with Latino community members and key informant interviews with providers of services to this population. Questions examined definitions of partner abuse; perceptions of factors contributing to, or protecting…
Cleveland, Sandi D.; Branscum, Adam J.; Bovbjerg, Viktor E.; Thorburn, Sheryl
Objective: The aim of this study was to investigate if and to what extent student service members/veterans differ from civilian college students in the prevalence of self-reported symptoms of poor mental health. Participants: The Fall 2011 implementation of the American College Health Association-National College Health Assessment included 27,774…
Walker, Melissa S; Kaimal, Girija; Gonzaga, Adele M L; Myers-Coffman, Katherine A; DeGraba, Thomas J
Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery.
Huizinga, Eelco; Hoencamp, Rigo; Van Dongen, Thijs; Leenen, Luke
Background: A systematic analysis of the complete medical support organization of the Dutch Armed Forces regarding repatriated service members from Afghanistan has not been performed so far. Methods: All information were collated in a specifically designed electronic database and gathered from the
... or Air Force, when ordered to annual training duty for at least 14 days and while performing official... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Who is a member of a uniformed service. 404.1330 Section 404.1330 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND...
intervention improves attitudes toward behavioral health treatment and initiation of treatment. Advertisements are used to recruit service members...involve guns, cutting, car accidents, and carbon monoxide poisoning. We have had four participants die during the trial. One participant died from
... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Senior Executive Service (SES) Performance Review... Performance Review Boards. The Board shall review the initial appraisal of a senior executive's performance by... senior executive performance. The members of the Performance Review Board for the National Archives and...
Lande, R Gregory; Bahroo, Bhagwan A; Soumoff, Alyssa
To explore the characteristics of military service tattoos a descriptive study was conducted at Walter Reed Army Medical Center to collect information from a convenience sample. An investigator-developed questionnaire provided the data for this study. Over the ensuing 12 month-period the researchers collected 126 questionnaires. Typical respondents were enlisted men with at least one deployment to an area of combat operations. Among the respondents, 57% acquired their tattoos before their deployment. One-quarter of the respondents reported only one tattoo, leaving the majority with multiple tattoos. Men received their first tattoo at an earlier age than women. The most common tattoo listed a person's name. Respondents did not regret their tattoos and rarely acquired the body art under the influence of alcohol or drugs. Little evidence was found to support a connection between tattoos and deployment. Few regretted their decisions and most all approached the tattoo experience free of any mind-altering substance. All this seems to suggest that military tattoos are a well-accepted means of self-expression. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Susan M. Love
Full Text Available Now that the financial needs of post 9/11 student service members/veterans have begun to be addressed, the attention has shifted to disabilities and recovery strategies of student service members/veterans. Therefore, in a cross sectional design, this study electronically surveyed 189 enrolled student service members/veterans attending a large urban state university about their experiences of returning to school. Specifically, this study described the students’ rates of Post-Traumatic Stress Disorder (PTSD and alcohol abuse, perceived stress, adaptive and non-adaptive coping strategies, social support, participation in campus activities, and perceived campus climate. Moreover, correlates of recovery were examined. Although the majority of the returning students were doing well, 36.1% reported a high level of stress, 15.1% reported a high level of anger, 17.3% reported active symptoms of PTSD, and 27.1% screened positive for alcohol problems. Social networks were found to be the most salient factor in recovery. The study’s limitations are discussed and specific support strategies are presented that can be employed by disability services, counseling services and college administrators.
Ehiri, John E.; Gunn, Jayleen K.L.; Center, Katherine E.; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E.
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
John E. Ehiri
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
Ehiri, John E; Gunn, Jayleen K L; Center, Katherine E; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E
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
... develops formal arrangements with community-based providers, such as community mental health clinics... effectiveness of community partnerships in helping to meet the mental health needs of veterans in a timely way... networks that supports the use of community mental health services, including telehealth services and...
Staff Members with 25 years service in 2002 were invited by the Director-General to a reception in their honnor on the 20th November 2002 : Baulet Yves / ST, Bornand Michel / SL, Burdet Georges / ST, Carena Francesco / EP, Chanut Robert / LHC, Chauchaix Bruno / SL, Chevrier François / SL, Chohan Vinod / LHC, Dahlerup-Petersen Knud / LHC, De Gennaro Michele Silvano / IT, De Rujula Alvaro / TH, Dury Jean-Marie / SL, Ferrara Sergio / TH, Fraser Gordon / ETT, Kolly Michel / ST, Korda Gwendoline / DSU, Lager Michel / ST, Michelon Jean-Claude / SL, Montuelle Jean / IT, Naudi Andre John / FI, Seis Irene / IT, Vascotto Alessandro / EP, Vernamonte Donatino / ST, Von Rüden Wolfgang / IT, Vullierme Bruno / LHC. Staff members with 25 years service in 2001 were also invited: Datta-Cockerill Sudeshna / HR, Frost-Ainley Lio / IT, Laurent Moniek / HR, Saban Roberto / AC.
Staff Members with 25 years service in 2002 were invited by the Director-General to a reception in their honnor on the 20th November 2002 : Baulet Yves / ST Bornand Michel / SL Burdet Georges / ST Carena Francesco / EP Chanut Robert / LHC Chauchaix Bruno / SL Chevrier François / SL Chohan Vinod / LHC Dahlerup-Petersen Knud / LHC De Gennaro Michele Silvano / IT De Rujula Alvaro / TH Dury Jean-Marie / SL Ferrara Sergio / TH Fraser Gordon / ETT Kolly Michel / ST Korda Gwendoline / DSU Lager Michel / ST Michelon Jean-Claude / SL Montuelle Jean / IT Naudi Andre John / FI Seis Irene / IT Vascotto Alessandro / EP Vernamonte Donatino / ST Von Rüden Wolfgang / IT Vullierme Bruno / LHC Staff members with 25 years service in 2001 were also invited: Datta-Cockerill Sudeshna / HR Frost-Ainley Lio / IT Laurent Moniek / HR Saban Roberto / AC
Full Text Available The family’s role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric patients. This different mindset, which views the family as an alternative to institutionalization, leads to it being seen as an essential entity in the setting up of community service dynamics. We interviewed health professionals in order to understand obstacles of collaboration between family members and mental health care workers. The goal was to uncover actions that promote collaboration and help build alliances between families and psychiatric workers. Results showed that health professionals view the family as a therapeutic resource. Despite this view, family members were rarely included in patient treatment. The reasons is: the structures have a theoretical orientation of collaboration with the family but, for nurses not are organized a few meeting spaces with family members. Services should create moments, such as multi-family groups or groups of information, managed by nurses and not only by doctors. These occasions it might facilitate the knowledge between professionals and family members.
this study. Third, additional demographic criteria such as job type, specific location, and sexual orientation are omitted from these data. These and...perceptions. 31 Fourth, additional demographic criteria not included in the data may indicate perceptual differences based on age or other characteristics...For example, it can be assumed that rank and age are highly correlated, as higher rank service members often have spent more time in the military
sector had a defined benefit pension plan. However, in the 1980s, due to the high cost of funding defined benefit plans, corporations began to favor a...rate in February 2017 was 5.6%. Dave Ramsey (n.d.), a personal finance expert, recommends individuals save at least 15% of their income for retirement...is explicitly clear that “service members are responsible for their personal finances ” (DOD, 2012, p. 15). The FRS offers personal financial
video conferencing can help remote service members and dependents access needed care. These two promising avenues for improving access to care can...Corporation ISBN 978-0-8330-8872-7 www.rand.org Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are...RAND Corporation View document details Support RAND Browse Reports & Bookstore Make a charitable contribution Limited Electronic Distribution Rights
Bakalar, Jennifer L; Barmine, Marissa; Druskin, Lindsay; Olsen, Cara H; Quinlan, Jeffrey; Sbrocco, Tracy; Tanofsky-Kraff, Marian
US service members appear to be at high-risk for disordered eating. Further, the military is experiencing unprecedented prevalence of overweight and obesity. US service members also report a high prevalence of childhood adverse life event (ALE) exposure. Despite consistent links between early adversity with eating disorders and obesity, there is a dearth of research examining the association between ALE exposure and disordered eating and weight in military personnel. An online survey study was conducted in active duty personnel to examine childhood ALE history using the Life Stressor Checklist - Revised, disordered eating using the Eating Disorder Examination - Questionnaire total score, and self-reported body mass index (BMI, kg/m 2 ). Among 179 respondents, multiple indices of childhood ALE were positively associated with disordered eating. Traumatic childhood ALE and subjective impact of childhood ALE were associated with higher BMI and these associations were mediated by disordered eating. Findings support evaluating childhood ALE exposure among service members with disordered eating and weight concerns. Moreover, findings support the need for prospective research to elucidate these relationships. © 2018 Wiley Periodicals, Inc.
Full Text Available The purpose of this study is to investigate the governance questions that board members in public service organizations ask as they go about fulfilling their responsibilities for the oversight of executive compensation. The research uses 24 of the questions – as proposed by the Canadian Institute of Chartered Accountants - that directors should ask about executive compensation and investigates both their usage and perceived importance by board members. The study is based on a usable sample of 47 board members from public service organizations who were attending a Canadian director training program. The research finds that, insofar as public service organizations are concerned, not all of the recommended executive compensation governance questions were asked with the same frequency nor were they considered equally important. Additionally, the relationship between a question’s usage frequency and its perceived importance was not perfect. However, there appears to be a significantly positive relationship among the number of executive compensation governance questions asked and selected elements of a board’s governance structure.
Sundari, I. P.; Mariana, D.; Sjoraida, D. F.
This study examines the performance of the local representative members in serving and channeling people’s aspiration in Sumedang Regency, Indonesia. How the elected members serve their constituents and how they consider the people’s rights were the questions to be answered in this study. The study used a qualitative approach to get the natural settings in which there are many behaviors and events occurred. This study also uses an institutional theory (institutionalism), because the theory could lead the researchers to find the structure, regulation and institutional procedures which could have a significant impact on a public policy and cannot be ignored in policy analysis. This study found that to carry out their functions as elected representatives, the members of the provincial parliament always make themselves available for the community. In doing so, the members of the provincial parliament, among others, absorb and collect the constituents’ aspiration through regular working visits; accommodate and follow up the aspirations and complaints; morally and politically provide accountability to the constituencies. In addition, to receive complaints coming to the local parliament’s office, public aspiration was also obtained in working visits on a regular basis by the members of local parliament in Sumedang as their own region at recess time. In terms of rights, all the services were conducted to fulfill them. Even so, some people still doubt the veracity of such works.
Mirhaji, Parsa; Casscells, S Ward; Srinivasan, Arunkumar; Kunapareddy, Narendra; Byrne, Sean; Richards, David Mark; Arafat, Raouf
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.
5a. CONTRACT NUMBER N/A Families 5b. GRANT NUMBER HT9404-13-1-TS05 5c. PROGRAM ELEMENT NUMBER N/A 6. AUTHOR(S) 5d...Purpose: Many service members today are married, and many also have children; deployments affect all members of the military family . The purpose of this...conducted. Findings: As deployment factors increased, parenting stress increased for fathers in the reintegration period, with a potential mediation
Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N
Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.
Sadhukhan, Pampa; Sen, Rijurekha; Das, Pradip K.
Several methods for providing location based service (LBS) to mobile devices in indoor environment using wireless technologies like WLAN, RFID and Bluetooth have been proposed, implemented and evaluated. However, most of them do not focus on heterogeneity of mobile platforms, memory constraint of mobile devices, the adaptability of client or device to the new services it discovers whenever it reaches a new location. In this paper, we have proposed a Middleware based approach of LBS provision in the indoor environment, where a Bluetooth enabled Base Station (BS) detects Bluetooth enabled mobile devices and pushes a proper client application only to those devices that belong to some registered subscriber of LBS. This dynamic deployment enables the mobile clients to access any new service without having preinstalled interface to that service beforehand and thus the client's memory consumption is reduced. Our proposed work also addresses the other issues like authenticating the clients before providing them LBSs and introducing paid services. We have evaluated its performance in term of file transfer time with respect to file size and throughput with respect to distance. Experimental results on service consumption time by the mobile client for different services are also presented.
... REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED... official extended duty as a member of the Foreign Service of the United States in Brazil. In 2015 B sells... period of ownership and use during his 8-year period of service with the Foreign Service in Brazil. If B...
Scott, Julia K; Leary, Sam D; Ness, Andy R; Sandy, Jonathan R; Persson, Martin; Kilpatrick, Nicky; Waylen, Andrea E
Cleft care provision in the United Kingdom has been centralized over the past 15 years to improve outcomes for children born with cleft lip and palate. However, to date, there have been no investigations to examine how well these multidisciplinary teams are performing. In this pilot study, a cross-sectional questionnaire surveyed members of all health care specialties working to provide cleft care in 11 services across the United Kingdom. Team members were asked to complete the Team Work Assessment (TWA) to investigate perceptions of team working in cleft services. The TWA comprises 55 items measuring seven constructs: team foundation, function, performance and skills, team climate and atmosphere, team leadership, and team identity; individual constructs were also aggregated to provide an overall TWA score. Items were measured using five-point Likert-type scales and were converted into percentage agreement for analysis. Responses were received from members of every cleft team. Ninety-nine of 138 cleft team questionnaires (71.7%) were returned and analyzed. The median (interquartile range) percentage of maximum possible score across teams was 75.5% (70.8, 88.2) for the sum of all items. Team performance and team identity were viewed most positively, with 82.0% (75.0, 88.2) and 88.4% (82.2, 91.4), respectively. Team foundation and leadership were viewed least positively with 79.0% (72.6, 84.6) and 76.6% (70.6, 85.4), respectively. Cleft team members perceive that their teams work well, but there are variations in response according to construct.
Wortmann, Jennifer H; Jordan, Alexander H; Weathers, Frank W; Resick, Patricia A; Dondanville, Katherine A; Hall-Clark, Brittany; Foa, Edna B; Young-McCaughan, Stacey; Yarvis, Jeffrey S; Hembree, Elizabeth A; Mintz, Jim; Peterson, Alan L; Litz, Brett T
The Posttraumatic Stress Disorder Checklist (PCL-5; Weathers et al., 2013) was recently revised to reflect the changed diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). We investigated the psychometric properties of PCL-5 scores in a large cohort (N = 912) of military service members seeking PTSD treatment while stationed in garrison. We examined the internal consistency, convergent and discriminant validity, and DSM-5 factor structure of PCL-5 scores, their sensitivity to clinical change relative to PTSD Symptom Scale-Interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) scores, and their diagnostic utility for predicting a PTSD diagnosis based on various measures and scoring rules. PCL-5 scores exhibited high internal consistency. There was strong agreement between the order of hypothesized and observed correlations among PCL-5 and criterion measure scores. The best-fitting structural model was a 7-factor hybrid model (Armour et al., 2015), which demonstrated closer fit than all other models evaluated, including the DSM-5 model. The PCL-5's sensitivity to clinical change, pre- to posttreatment, was comparable with that of the PSS-I. Optimally efficient cut scores for predicting PTSD diagnosis were consistent with prior research with service members (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014). The results indicate that the PCL-5 is a psychometrically sound measure of DSM-5 PTSD symptoms that is useful for identifying provisional PTSD diagnostic status, quantifying PTSD symptom severity, and detecting clinical change over time in PTSD symptoms among service members seeking treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Osilla, Karen Chan; Pedersen, Eric R; Gore, Kristie; Trail, Thomas; Howard, Stefanie Stern
Alcohol misuse among military service members from the recent conflicts in Iraq and Afghanistan is over two times higher compared to misuse in the civilian population. Unfortunately, in addition to experiencing personal consequences from alcohol misuse, partners and family members of alcohol-misusing service members also suffer in negative ways from their loved one's drinking. These family members represent important catalysts for helping their loved ones identify problem drinking and overcoming the barriers to seeking care. This paper describes the protocol to a pilot study evaluating a 4-session, web-based intervention (WBI) for concerned partners (CPs) of service members with alcohol misuse. The WBI will be adapted from the Community Reinforcement and Family Training (CRAFT) intervention. In the first phase, we will develop and beta-test the WBI with 15-20 CPs. In the second phase, we will randomize CPs to WBI (n = 50) or to delayed-WBI (n = 50) and evaluate the impact of the WBI on CPs' perceptions of service member help-seeking and drinking, as well as the CP's well-being and relationship satisfaction 3 months after the intervention. In the third phase, we will recruit 15-20 service members whose partners have completed the study. We will interview the service members to learn how the CP-focused WBI affected them and to assess whether they would be receptive to a follow-on WBI module to help them. This project has the potential to benefit a large population of military service members who may be disproportionately affected by recent conflicts and whose drinking misuse would otherwise go undetected and untreated. It also develops a new prevention model that does not rely on service members or partners attending a hospital or clinical facility to access care. NCT02073825.
McGarity, Suzanne; Barnett, Scott D; Lamberty, Greg; Kretzmer, Tracy; Powell-Cope, Gail; Patel, Nitin; Nakase-Richardson, Risa
To examine community reintegration problems among Veterans and military service members with mild or moderate/severe traumatic brain injury (TBI) at 1 year postinjury and to identify unique predictors that may contribute to these difficulties. VA Polytrauma Rehabilitation Centers. Participants were 154 inpatients enrolled in the VA TBI Model Systems Program with available injury severity data (mild = 28.6%; moderate/severe = 71.4%) and 1-year postinjury outcome data. Prospective, longitudinal cohort. Community reintegration outcomes included independent driving, employability, and general community participation. Additional measures assessed depression, posttraumatic stress, and cognitive and motor functioning. In the mild TBI (mTBI) group, posttraumatic stress disorder and depressive symptoms were associated with lower levels of various community reintegration outcomes. In the moderate/severe TBI group, cognition and motor skills were significantly associated with lower levels of community participation, independent driving, and employability. Community reintegration is problematic for Veterans and active duty service members with a history of TBI. Unique comorbidities across injury severity groups inhibit full reintegration into the community. These findings highlight the ongoing rehabilitation needs of persons with TBI, specifically evidence-based mental healthcare, in comprehensive rehabilitation programs consistent with a chronic disease management model.
Lauro Soares de Freitas
Full Text Available Despite of the significant contribution of QFD for the construction of the theoretical framework for managing the development of new products and services, there is an embryonic implementation in the public sector. The purpose of this article is to analyze the application of the method in the context of public safety, and the study was delimited to the School Patrol in the Military Police of Minas Gerais. Action research was the research strategy chosen and qualitative and quantitative methods were used to collect and analyze data. The QFD method proved to be effective for: systematize a large set of internal and external corporate information, facilitating the subsequent planning of policing; promote a dynamic oriented and structured in encounters between police and the community; identify the needs of public school and prioritize activities policing which better fulfill these desires; and to understand the ability of service of a School Patrol Unit. Moreover, the police service has a unique set of characteristics that partially hindered planning service by QFD. This service does not have a specific market niche, being a service of law and not by purchase. Also relies on legal aspects and regulates behaviors, generating rejection. Although this particular nature, two factors favored the application of the method: the institutionalization of the philosophy of community policing in the organization and to familiarizing officers with management concepts and quality. The final conclusion is that the QFD method was presented as a promising tool for improving the quality of Brazilian public services.
Roč. 2, č. 80 (2009), s. 484-492 ISSN 0037-8720 Institutional research plan: CEZ:AV0Z10030501 Keywords : virtual observatory * GRID computing * web services Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics
This study was an attempt to describe the characteristics of U.S. Air Force (USAF) members with stepfamily and divorce conditions who had received services from USAF substance abuse treatment programs...
Goldbach, Jeremy T; Castro, Carl Andrew
Lesbian, gay, and bisexual service members can serve openly in the military with the repeal of the Don't Ask, Don't Tell policy. The fate of transgender service members remains uncertain as the policy preventing them from serving in the military remains under review. The health care needs of these populations remain for the most part unknown, with total acceptance and integration in the military yet to be achieved. In this paper, we review the literature on the health care needs of lesbian, gay, bisexual, and transgender (LGBT) service members, relying heavily on what is known about LGBT civilian and veteran populations. Significant research gaps about the health care needs of LGBT service members are identified, along with recommendations for closing those gaps. In addition, recommendations for improving LGBT acceptance and integration within the military are provided.
MDW/SGVU SUBJECT: Professional Presentation Approvai 11APR 20 17 1. Your paper, entitled The Influence of Medical Evaluation Board Status on... influence o f medical evaluation board status on symptom reporting among service members w ith traumatic brain injury 7. FUNDING RECEIVED FOR THIS STUDY? D...Page 3 of 3 Pages Title: The influence of medical evaluation board status on symptom reporting among service members with traumatic brain injury
The cloud is a fairly new concept in computer science, altough almost everyone has been or is in contact with it on a regular basis. As more and more systems and applications are migrating from the desktop and into the cloud, keeping a high availability in cloud services is becoming increasingly important. Seeing that the cloud users are dependant on the cloud services being online and accessable via the Internet, creating fault tolerant cloud systems is key to keeping the cloud stable and tr...
Kerns, Dannie J.
The qualitative phenomenological study explored the lived experiences of financial services industry change managers to understand the genesis of low data management information system project adoption rates. The goal of the study was to find methods to improve data management information system adoption rates. The participant pool consisted of 19…
Tekinerdogan, Bedir; Çelik, Turgay; Köksal, Ömer
Data distribution service (DDS) has been defined by the OMG to provide a standard data-centric publish-subscribe programming model and specification for distributed systems. DDS has been applied for the development of high performance distributed systems such as in the defense, finance, automotive,
Guina, Jeffrey; Welton, Randon S; Broderick, Pamela J; Correll, Terry L; Peirson, Ryan P
This review addresses how changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 posttraumatic stress disorder (PTSD) criteria has the potential to affect the care and careers of those who have served in the military, where the diagnosis often determines fitness for duty and veterans' benefits. PTSD criteria changes were intended to integrate new knowledge acquired since previous DSM editions. Many believe the changes will improve diagnosis and treatment, but some worry these could have negative clinical, occupational, and legal consequences. We analyze the changes in classification, trauma definition, symptoms, symptom clusters, and subtypes and possible impacts on the military (e.g., over- and under-diagnosis, "drone" video exposure, subthreshold PTSD, and secondary PTSD). We also discuss critiques and proposals for future changes. Our objectives are to improve the screening, diagnosis, and treatment of those service members who have survived trauma and to improve policies related to the military mental healthcare and disability systems.
Full Text Available Abstract We investigate the performance and coexistence techniques for worldwide interoperability for microwave access (WiMAX delivered from high altitude platforms (HAPs and terrestrial systems in shared 3.5 GHz frequency bands. The paper shows that it is possible to provide WiMAX services from individual HAP systems. The coexistence performance is evaluated by appropriate choice of parameters, which include the HAP deployment spacing radius, directive antenna beamwidths based on adopted antenna models for HAPs and receivers. Illustrations and comparisons of coexistence techniques, for example, varying the antenna pointing offset, transmitting and receiving antenna beamwidth, demonstrate efficient ways to enhance the HAP system performance while effectively coexisting with terrestrial WiMAX systems.
Full Text Available We investigate the performance and coexistence techniques for worldwide interoperability for microwave access (WiMAX delivered from high altitude platforms (HAPs and terrestrial systems in shared 3.5Ã¢Â€Â‰GHz frequency bands. The paper shows that it is possible to provide WiMAX services from individual HAP systems. The coexistence performance is evaluated by appropriate choice of parameters, which include the HAP deployment spacing radius, directive antenna beamwidths based on adopted antenna models for HAPs and receivers. Illustrations and comparisons of coexistence techniques, for example, varying the antenna pointing offset, transmitting and receiving antenna beamwidth, demonstrate efficient ways to enhance the HAP system performance while effectively coexisting with terrestrial WiMAX systems.
Clare, I C H; Madden, E M; Holland, A J; Farrington, C J T; Whitson, S; Broughton, S; Lillywhite, A; Jones, E; Wade, K A; Redley, M; Wagner, A P
In the UK, the closure of 'long-stay' hospitals was accompanied by the development of community teams (CTs) to support people with intellectual disabilities (IDs) to live in community settings. The self-reported experiences of staff working in such teams have been neglected. Focusing on a single county-wide service, comprising five multi-disciplinary and inter-agency CTs, we measured perceptions among the health care and care management Team members of (1) their personal well-being; (2) the functioning of their team; and (3) the organisation's commitment to quality, and culture. Almost three-quarters of the questionnaires were returned (73/101; 72%). The scores of health care practitioners and care managers were very similar: (1) the MBI scores of more than half the respondents were 'of concern'; (2) similarly, almost four in ten respondents' scores on the Vision scale of the TCI were 'of concern'; (3) the perceived commitment to quality (QIIS-II Part 2) was uncertain; and (4) the organisational culture (QIIS-II, Part 1) was viewed as primarily hierarchical. The perceived absence of a vision for the service, combined with a dominant culture viewed by its members as strongly focussed on bureaucracy and process, potentially compromises the ability of these CTs to respond proactively to the needs of people with IDs. Given the changes in legislation, policy and practice that have taken place since CTs were established, it would be timely to revisit their role and purpose. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Villalba, Elena; Casas, Isabel; Abadie, Fabienne
conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... mechanisms, interoperable information systems, policy commitment, engaged professionals, national investments and funding programmes, and incentives and financing. Conclusion: In those cases which provided evidence of success beyond the pilot stage, we observed a promising trend: awareness and introduction...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Correction--Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF) The original date of publication for this Federal Register notice was March 28, 2012, Volume 77, Number 60, pages 18823...
Kaszeta, William J.
Five different types of public service photovoltaic power/load systems installed in the Gabonese Republic are discussed. The village settings, the systems, performance results and some problems encountered are described. Most of the systems performed well, but some of the systems had problems due to failure of components or installation errors. The project was reasonably successful in collecting and reporting data for system performance evaluation that will be useful for guiding officials and system designers involved in village power applications in developing countries.
Neuropsychological Performance and Subjective Symptom Reporting in Military Service Members With a History of Multiple Concussions: Comparison With a Single Concussion, Posttraumatic Stress Disorder, and Orthopedic Trauma.
Cooper, Douglas B; Curtiss, Glenn; Armistead-Jehle, Patrick; Belanger, Heather G; Tate, David F; Reid, Matthew; Bowles, Amy O; Velez, Carmen S; Kennedy, Jan E; Vanderploeg, Rodney D
To examine differences in objective neurocognitive performance and subjective cognitive symptoms in individuals with a history of a single concussion, multiple concussions, orthopedic injuries, and posttraumatic stress disorder (PTSD). Participants included 116 military service members who sustained a mild traumatic brain injury (mTBI) during combat deployment. Subjects were subdivided into groups based on concussion frequency: a single concussion (n = 42), 2 concussions (n = 21), and 3 or more concussions (n = 53). Eighty-one subjects sustained an orthopedic injury (n = 60) during deployment or were diagnosed with PTSD (n = 21), but had no history of mTBI. Subjects completed a battery of neuropsychological tests and self-report measures of postconcussive symptoms, PTSD symptoms, and psychopathology. No differences were found among the concussion groups on a composite neuropsychological measure. The PTSD group had the highest number of symptom complaints, with the 2-concussion and 3-plus-concussion groups being most similar to the PTSD group. The concussion groups showed a nonsignificant pattern of increasing distress with increasing number of concussions. The current findings are consistent with meta-analytic results showing no differential effect on neuropsychological functioning due to multiple concussions. Results also support the burden of adversity hypothesis suggesting increasing symptom levels with increasing psychological or physically traumatic exposures.
The US Department of Energy's Hanford Tank Farm Remediation System (TWRS) is responsible for the safe storage of waste in 177 underground waste storage tanks. TWRS is also responsible for the cleanup and final closure of these tanks. In the performance of this mission TWRS has historically designed its own equipment. The safety of the equipment for deployment in TWRS facilities has been assured through the development of detailed engineering specifications and close QA/QC monitoring during fabrication and testing. In order to address the complex and costly cleanup mission Hanford is looking for ways to apply private sector technologies to the cleanup mission. The Hanford Tanks Initiative (HTI) is a five year, EM 30/50 expense-funded project with a primary objective of demonstrating the extent to which the Hanford Tank Waste Remediation System (TWRS) tanks can be cleaned using commercially available technologies. To accomplish this objective, in August 1996 HTI issued a Request for Proposal (RFP) for services to remove the hard heel waste from tank 241-C-106, following retrieval of the majority of the waste by sluicing. While certain specification guidance was provided in the RFP such as, must be capable of operation in a flammable gas environment, the RFP was careful in avoiding language that would place limitations on the technologies that industry could provide. The challenge for HTI was to develop a licensing strategy that would provide maximum flexibility to the technology vendors while meeting the stringent documentation requirements of the US Department of Energy (DOE). This strategy must also provide assurance that the technology can be shown to be within the TWRS authorization basis and be safely deployed. A 35-step process (Figure 1) was developed by HTI to accomplish this objective
The US Department of Energy`s Hanford Tank Farm Remediation System (TWRS) is responsible for the safe storage of waste in 177 underground waste storage tanks. TWRS is also responsible for the cleanup and final closure of these tanks. In the performance of this mission TWRS has historically designed its own equipment. The safety of the equipment for deployment in TWRS facilities has been assured through the development of detailed engineering specifications and close QA/QC monitoring during fabrication and testing. In order to address the complex and costly cleanup mission Hanford is looking for ways to apply private sector technologies to the cleanup mission. The Hanford Tanks Initiative (HTI) is a five year, EM 30/50 expense-funded project with a primary objective of demonstrating the extent to which the Hanford Tank Waste Remediation System (TWRS) tanks can be cleaned using commercially available technologies. To accomplish this objective, in August 1996 HTI issued a Request for Proposal (RFP) for services to remove the hard heel waste from tank 241-C-106, following retrieval of the majority of the waste by sluicing. While certain specification guidance was provided in the RFP such as, must be capable of operation in a flammable gas environment, the RFP was careful in avoiding language that would place limitations on the technologies that industry could provide. The challenge for HTI was to develop a licensing strategy that would provide maximum flexibility to the technology vendors while meeting the stringent documentation requirements of the US Department of Energy (DOE). This strategy must also provide assurance that the technology can be shown to be within the TWRS authorization basis and be safely deployed. A 35-step process (Figure 1) was developed by HTI to accomplish this objective.
Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M; Bodzy, Mary; Swenson, Rebecca R; Spirito, Anthony
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.
The Department of Defense's (DOD) Exceptional Family Member Program (EFMP) is a mandatory enrollment program for active duty servicemembers who have family members with special medical needs. The Ronald W...
Forrest, Laura; Delatycki, Martin; Curnow, Lisette; Gen Couns, M; Skene, Loane; Aitken, Maryanne
The aim of this study was to investigate the uptake of genetic testing by at-risk family members for four genetic conditions: chromosomal translocations, fragile X syndrome, Huntington disease, and spinal muscular atrophy. A clinical audit was undertaken using genetics files from Genetic Health Services Victoria. Data were extracted from the files regarding the number of at-risk family members and the proportion tested. Information was also collected about whether discussion of at-risk family members and family communication during the genetic consultation was recorded. The proportion of at-risk family members who had genetic testing ranged from 11% to 18%. First-degree family members were most frequently tested and the proportion of testing decreased by degree of relatedness to the proband. Smaller families were significantly more likely to have genetic testing for all conditions except Huntington disease. Female at-risk family members were significantly more likely to have testing for fragile X syndrome. The majority of at-risk family members do not have genetic testing. Family communication is likely to influence the uptake of genetic testing by at-risk family members and therefore it is important that families are supported while communicating to ensure that at-risk family members are able to make informed decisions about genetic testing.
Lester, Patricia; Peterson, Kris; Reeves, James; Knauss, Larry; Glover, Dorie; Mogil, Catherine; Duan, Naihua; Saltzman, William; Pynoos, Robert; Wilt, Katherine; Beardslee, William
Objective: Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 through 12) of an active duty Army or Marine…
Moughrabieh, Anas; Weinert, Craig
The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country.
The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country. PMID:26788827
Rashid, Faisal M.; Dennis, Emily L.; Villalon-Reina, Julio E.; Jin, Yan; Lewis, Jeffrey D.; York, Gerald E.; Thompson, Paul M.; Tate, David F.
Mild traumatic brain injury (mTBI) is characterized clinically by a closed head injury involving differential or rotational movement of the brain inside the skull. Over 3 million mTBIs occur annually in the United States alone. Many of the individuals who sustain an mTBI go on to recover fully, but around 20% experience persistent symptoms. These symptoms often last for many weeks to several months. The thalamus, a structure known to serve as a global networking or relay system for the rest of the brain, may play a critical role in neurorehabiliation and its integrity and connectivity after injury may also affect cognitive outcomes. To examine the thalamus, conventional tractography methods to map corticothalamic pathways with diffusion-weighted MRI (DWI) lead to sparse reconstructions that may contain false positive fibers that are anatomically inaccurate. Using a specialized method to zero in on corticothalamic pathways with greater robustness, we noninvasively examined corticothalamic fiber projections using DWI, in 68 service members. We found significantly lower fractional anisotropy (FA), a measure of white matter microstructural integrity, in pathways projecting to the left pre- and postcentral gyri - consistent with sensorimotor deficits often found post-mTBI. Mapping of neural circuitry in mTBI may help to further our understanding of mechanisms underlying recovery post-TBI.
Haskell, Rebecca; Graham, Kathryn; Bernards, Sharon; Flynn, Andrea; Wells, Samantha
Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., "service users"), especially those with co-occurring issues, as well as their family members. We conducted structured interviews with 73 service users and 41 family members of service users in two Ontario communities (one urban, one rural) regarding their goals related to help-seeking, positive and negative experiences, and recommendations for improving systems of care. Overall, participants expressed a need for services that: (1) are respectful, nonjudgmental, and supportive, help service users to feel more 'normal' and include education to reduce stigma; (2) are accessible, varied and publicly funded, thereby meeting individual needs and addressing equity concerns at a systems level; and (3) are coordinated, holistic and inclusive of family members who often support service users. The findings provide a rich understanding of how service users and their families perceive services for MSD(V) issues and identify key ways to better meet their needs.
Reid, Matthew W; Cooper, Douglas B; Lu, Lisa H; Iverson, Grant L; Kennedy, Jan E
The objective of this study was to assess the associations between resilience, adversity, post-concussion symptoms, and post-traumatic stress symptom reporting after mild traumatic brain injury (mTBI). We hypothesized that resilience would be associated with less symptom reporting, and adversity would be associated with greater symptom reporting. This was a cross-sectional study of retrospective data collected for an ongoing TBI repository. United States military service members who screened positive for mTBI during a primary care visit completed the Trauma History Screen (THS), Connor-Davidson Resilience Scale (CD-RISC), Neurobehavioral Symptom Inventory (NSI), and post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C). Data collected from February 2015 to August 2016 were used for the present study. Only participants with complete data for the above measures were included, yielding a sample size of 165 participants. Adversity (THS) and resilience (CD-RISC) scores were each correlated significantly with post-concussion (NSI) and traumatic stress (PCL-C) total and subscale scores in the hypothesized direction. Interactions between adversity and resilience were absent for all measures except the NSI sensory subscale. Four traumatic event types were significantly associated positively with most NSI and PCL-C total and subscale scores, but the age at which traumatic events were first experienced showed few and mixed significant associations. In conclusion, resilience and adversity were significantly associated with symptom endorsement after mTBI. Screening for cumulative adversity may identify individuals at greater risk of developing persistent post-concussion symptoms and/or PTSD, and interventions that increase resilience may reduce symptom severity.
Seelig, Amber D; Rivera, Anna C; Powell, Teresa M; Williams, Emily C; Peterson, Arthur V; Littman, Alyson J; Maynard, Charles; Street, Amy E; Bricker, Jonathan B; Boyko, Edward J
In the first known longitudinal study of the topic, we examined whether experiencing sexual assault or sexual harassment while in the military was associated with increased risk for subsequent unhealthy alcohol use and smoking among U.S. service members in the Millennium Cohort Study (2001-2012). Adjusted complementary log-log models were fit to estimate the relative risk of (a) smoking relapse among former smokers (men: n = 4,610; women: n = 1,453); (b) initiation of unhealthy alcohol use (problem drinking and/or drinking over recommended limits) among those with no known history of unhealthy alcohol use (men: n = 8,459; women: n = 4,816); and (c) relapse among those previously reporting unhealthy alcohol use (men: n = 3,487; women: n = 1,318). Men who reported experiencing sexual assault while in the military had sixfold higher risk for smoking relapse: relative risk (RR) = 6.62; 95% confidence interval (CI) [2.34, 18.73], than men who did not. Women who reported experiencing sexual assault while in the military had almost twice the risk for alcohol relapse: RR = 1.73; 95% CI [1.06, 2.83]. There were no other significant associations. These findings suggest that men and women may respond differently following sexual trauma, and support future concerted policy efforts by military leadership to prevent, detect, and intervene on sexual assault. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
2. REPORT TYPE 10/07/2017 Presentation 4. TITLE AND SUBTITLE GENITOURINARY INJURIES SUSTAINED BY FEMALE U.S. SERVICE MEMBERS DURING OPERATION...for increased female GU injuries in future conflicts and the long-term sequelae from these injury patterns. Materials and Methods: The Department of
Whiteman, Shawn D; Barry, Adam E; Mroczek, Daniel K; Macdermid Wadsworth, Shelley
Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian counterparts and be at risk for social isolation. The present study compared the development and implications of emotional support from peers among 199 student service members/veterans and 181 civilian students through 3 distinct occasions over the course of 1 calendar year. Data were collected via electronic survey. Measured constructs included perceived emotional support from university friends, mental health, alcohol use, and academic functioning. A series of multilevel models revealed that student service members/veterans reported less emotional support from their peers compared with their civilian counterparts; yet, emotional support from peers increased similarly for both groups over time. Although, increasing peer emotional support was generally related to better academic and mental health outcomes for both groups, the links between emotional support and mental health were stronger for civilian students. Results suggest that mental health practitioners, particularly those on college campuses, should be prepared to deal with veteran-specific experiences that occur before and during college.
Stewart, Jamie C.
This study involved a one group pretest-posttest study to analyze the effectiveness of the Alpha Phi Omega leadership development course titled SERVE. This study focused on the collegiate members of this coeducational service fraternity. The Student Leadership Practices Inventory was administered as both a pretest and posttest; the posttest was…
... Force Reserve Officers Training Corps, when ordered to annual training duty for 14 days or more... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Work as a member of a uniformed service of the United States. 404.1019 Section 404.1019 Employees' Benefits SOCIAL SECURITY ADMINISTRATION...
McLay, Robert N; Webb-Murphy, Jennifer A; Fesperman, Susan F; Delaney, Eileen M; Gerard, Steven K; Roesch, Scott C; Nebeker, Bonnie J; Pandzic, Ines; Vishnyak, Elizabeth A; Johnston, Scott L
Eye movement desensitization and reprocessing (EMDR) is one of the therapy interventions recommended by the Veterans Affairs and Department of Defense Clinical Practice Guidelines. However, the literature concerning the effectiveness of this treatment modality in military service members is sparse. This study investigated the efficacy of EMDR in active-duty service members. We conducted an effectiveness study with a record review from active-duty military mental health clinics where clinical outcomes had been monitored over a 10-week period using self-report measures of posttraumatic stress and disability. Symptom scores were examined over time in 331 service members who met presumptive criteria for the disorder on the PTSD Checklist-Military Version (PCL-M), who were in psychotherapy, and who received (n = 46) or didn't receive (n = 285) EMDR. Results indicated that patients receiving EMDR had significantly fewer therapy sessions over 10 weeks but had significantly greater gains in their PCL-M scores than did individuals not receiving EMDR. Randomized, controlled trials are still needed, but these findings provide further support for the use of EMDR in service members with PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
... 32 National Defense 5 2010-07-01 2010-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services as...
Mota, Natalie P; Medved, Maria; Whitney, Debbie; Hiebert-Murphy, Diane; Sareen, Jitender
Although military interest in promoting psychological resilience is growing, resources protective against psychopathology have been understudied in female service members. Using a representative sample of Canadian Forces personnel, we investigated whether religious attendance, spirituality, coping, and social support were related to mental disorders and psychological distress in female service members, and whether sex differences occurred in these associations. Religious attendance and spirituality were self-reported. Coping items were taken from 3 scales and produced 3 factors (active, avoidance, and self-medication). Social support was assessed with the Medical Outcomes Study Social Support Survey. Past-year mental disorders were diagnosed with the World Mental Health Composite International Diagnostic Interview. The Kessler Psychological Distress Scale assessed distress. Multivariate regression models investigated links between correlates and psychological outcomes within each sex. For associations that were statistically significant in only one sex, sex by correlate interactions were computed. In female service members, inverse relations were found between social support and MDD, any MDD or anxiety disorder, suicidal ideation, and distress. No associations were found between religious attendance and outcomes, and spirituality was associated with an increased likelihood of some outcomes. Active coping was related to less psychological distress, while avoidance coping and self-medication were linked to a higher likelihood of most outcomes. Although several statistically significant associations were found in only one sex, only one sex by correlate interaction was statistically significant. Social support was found to be inversely related to several negative mental health outcomes in female service members. Few differences between men and women reached statistical significance. Future research should identify additional helpful resources for female service members.
Blais, Rebecca K; Renshaw, Keith D
Many U.S. Iraq/Afghanistan-era veterans return from deployment with posttraumatic stress (PTS) symptoms, but few veterans seek psychological help. Research on barriers to care is growing, but the link between stigma and help-seeking is understudied. The present study examined anticipated enacted stigma from military and nonmilitary sources, self-stigma, PTS, perceived likelihood of deploying again, marital status, and history of mental health care engagement as correlates of help-seeking intentions from a mental health professional or medical doctor/advance practice registered nurse (MD/APRN) in a sample of 165 combat veterans. Using structural equation modeling, results demonstrated that self-stigma was negatively associated with help-seeking intentions from a mental health professional and MD/APRN with small-to-medium effect sizes. Being married was positively associated with help-seeking intentions from a mental health professional and MD/APRN with small effect sizes. History of previous mental health care engagement was positively associated with help-seeking intentions from a mental health professional with a medium effect size, but unrelated to help-seeking intentions from a MD/APRN. Anticipated enacted stigma from any source, PTS, and greater perceived likelihood of deploying again were unrelated to help-seeking intentions from a mental health professional and MD/APRN. Implications for interventions aimed at decreasing self-stigma and increasing intention to seek help are discussed. Copyright © 2013 International Society for Traumatic Stress Studies.
As the cycle of deployments to war zones by military service members and other federal government employees continue, school psychologists likely have encountered or will encounter children in their schools who have been dealing with an absence of a parent for extended periods of time. While some school psychologists who live and work near major…
Manchester, Julianne; Eshel, Inbal; Marion, Donald W
Energy drinks (EDs) have become an integral part of the young adult, athletic, and military culture. Many athletes are convinced that EDs enhance performance, and service members as well as college students frequently use EDs as stimulants to counter sleep deprivation, or to improve academic performance. However, concerns have been raised by some military leaders about potential adverse effects of EDs. A needs assessment survey of a convenience sample of military health care providers was conducted and identified EDs as a top knowledge need for those providers working in the area of traumatic brain injury (TBI). The instrument demonstrated high interitem consistency (Cronbach's α > .80). To further explore the state of knowledge on EDs, and to prompt further discussion of ED use and how it may related to military treatment protocols and supporting educational products, we conducted a literature review of English language publications listed in the National Library of Medicine using the search term "energy drinks" and published during the last 5 years to determine what is known about EDs in terms of their potential benefits and health risks. The active ingredients in most EDs are caffeine, and to a lesser extent taurine and sugars. Several reports suggest that the combination of these ingredients is more active than the caffeine alone. Despite the positive attributes of EDs, there are increasing reports of serious and potentially life-threatening side effects. Most recently there also has been a dramatic increase in the use of ED/alcohol combination drinks, and there are preliminary studies that suggest important adverse effects with this combination. A 2013 National Institutes of Health expert workshop concluded that more clinical studies are needed to clearly define the health risks associated with ED use. The needs assessment points to a desire for more ED knowledge of health providers working with TBI patients. A few key themes emerged from the exploratory
Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura M J; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P
User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members from different backgrounds often
Polusny, Melissa A; Kumpula, Mandy J; Meis, Laura A; Erbes, Christopher R; Arbisi, Paul A; Murdoch, Maureen; Thuras, Paul; Kehle-Forbes, Shannon M; Johnson, Alexandria K
Although women in the military are exposed to combat and its aftermath, little is known about whether combat as well as pre-deployment risk/protective factors differentially predict post-deployment PTSD symptoms among women compared to men. The current study assesses the influence of combat-related stressors and pre-deployment risk/protective factors on women's risk of developing PTSD symptoms following deployment relative to men's risk. Participants were 801 US National Guard Soldiers (712 men, 89 women) deployed to Iraq or Afghanistan who completed measures of potential risk/protective factors and PTSD symptoms one month before deployment (Time 1) and measures of deployment-related stressors and PTSD symptoms about 2-3 months after returning from deployment (Time 2). Men reported greater exposure to combat situations than women, while women reported greater sexual stressors during deployment than men. Exposure to the aftermath of combat (e.g., witnessing injured/dying people) did not differ by gender. At Time 2, women reported more severe PTSD symptoms and higher rates of probable PTSD than did men. Gender remained a predictor of higher PTSD symptoms after accounting for pre-deployment symptoms, prior interpersonal victimization, and combat related stressors. Gender moderated the association between several risk factors (combat-related stressors, prior interpersonal victimization, lack of unit support and pre-deployment concerns about life/family disruptions) and post-deployment PTSD symptoms. Elevated PTSD symptoms among female service members were not explained simply by gender differences in pre-deployment or deployment-related risk factors. Combat related stressors, prior interpersonal victimization, and pre-deployment concerns about life and family disruptions during deployment were differentially associated with greater post-deployment PTSD symptoms for women than men. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
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
Lu, Lisa H; Cooper, Doug B; Reid, Matthew W; Khokhar, Bilal; Tsagaratos, Jennifer E; Kennedy, Jan E
To compare symptom reporting patterns of service members with a history of concussion based on work status: full duty, limited duty, or in the Medical Evaluation Board (MEB)/disability process. Retrospective analysis of 181 service members with a history of concussion (MEB n = 56; limited duty n = 62; full duty n = 63). Neurobehavioral Symptom Inventory (NSI) Validity-10 cutoff (>22) and Mild Brain Injury Atypical Symptoms Scale (mBIAS) cutoffs (≥10 and ≥8) were used to evaluate potential over-reporting of symptoms. The MEB group displayed significantly higher NSI scores and significantly higher proportion scored above the mBIAS ≥10 cutoff (MEB = 15%; limited duty = 3%; full duty = 5%). Validity-10 cutoff did not distinguish between groups. MEB but not limited duty status was associated with increased risk of over-reporting symptoms in service members with a history of concussion. Results support the use of screening measures for over-reporting in the MEB/disability samples.
Collins, H. E.; Gathers, R.; Halstead, R. J.
According to the 1999 Draft Environmental Impact Statement (DEIS) for the proposed Yucca Mountain repository site, members of the public along transportation routes by which spent nuclear fuel (SNF) and high-level radioactive waste (HLW) is shipped will receive annual radiation doses less than 100 mrem/yr, the international (ICRP) and national (Department of Energy, Nuclear Regulatory Commission) radiation limit for members of the public. For the ''Mostly Truck'' national transportation scenario, the DEIS specifically concludes that the maximally exposed member of the public, a service station attendant along the primary shipping route will receive no more than 100 mrem/yr, or 2.4 rem over 24 years. Based on the assumptions in the DEIS scenarios, however, it is highly likely that service station attendants along shipping routes will be called upon to fuel and service the rigs carrying SNF and HLW to Yucca Mountain. After reevaluating the DEIS, and making realistic alternative assumptions where necessary, the authors conclude that these attendants are likely to receive substantially more than 100 mrem/yr external dose, and perhaps several times that dose (up to 500 mrem/yr), unless mitigating measures are adopted. This is particularly true in Western states where refueling opportunities are limited, and the distances between fuel sources in rural areas may be up to 100 miles
Sapra, Katherine J; Crawford, Natalie D; Rudolph, Abby E; Jones, Kandice C; Benjamin, Ebele O; Fuller, Crystal M
Depression is more common among drug users (15-63 %) than the general population (5-16 %). Lack of social support network members may be associated with low mental health service (MHS) use rates observed among drug users. We investigated the relationship between social network members' roles and MHS use among frequent drug users using Social Ties Associated with Risk of Transition into Injection Drug Use data (NYC 2006-2009). Surveys assessed depression, MHS use, demographics, drug use and treatment, and social network members' roles. Participants reporting lifetime depressive episode with start/end dates and information on social/risk network members were included (n = 152). Adjusting for emotional support and HIV status, having one or more informational support network members remained associated with MHS use at last depressive episode (adjusted odds ratio (AOR) 3.37, 95 % confidence interval (CI) 1.38-8.19), as did history of drug treatment (AOR 2.75, 95 % CI 1.02-7.41) and no legal income (AOR 0.23, 95 % CI 0.08-0.64). These data suggest that informational support is associated with MHS utilization among depressed drug users.
... Secretary for Human Resources and Chief Human Capital Officer Bynum, Nicole, Chief of Management Operations... CONTACT: Mario R. Minor, Senior Human Resources Specialist, 1500 Pennsylvania Avenue NW., ATTN: Room 6W529... career appointee, more than half the members shall consist of career appointees. The names and titles of...
O'Haire, Marguerite E; Rodriguez, Kerri E
Psychiatric service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained service dog (n = 75). The primary outcome was longitudinal change on The PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), including data points from a cross-sectional assessment and a longitudinal record review. Secondary outcomes included cross-sectional differences in depression, quality of life, and social and work functioning. Mixed-model analyses revealed clinically significant reductions in PTSD symptoms from baseline following the receipt of a service dog, but not while receiving usual care alone. Though clinically meaningful, average reductions were not below the diagnostic cutoff on the PCL. Regression analyses revealed significant differences with medium to large effect sizes among those with service dogs compared with those on the waitlist, including lower depression, higher quality of life, and higher social functioning. There were no differences in employment status, but there was lower absenteeism because of health among those who were employed. The addition of trained service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology for military members and veterans with PTSD, though it does not appear to be associated with a loss of diagnosis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Full Text Available This paper deals with public service obligation, a form of state aid that applies to air services. The paper first provides general information on the European legislation applying to this form of state aid, and elaborates the legal framework and general principles. The second part is dedicated to a comparison of a similar subsidizing programme in the USA and Australia. An examination of current imposed public service obligation routes in Europe is provided in the following section. The coefficients defining the number of imposed PSO routes per various geo-economic variables have been defined.
Knight, Louise; Cooper, Rhonda S; Hypki, Cinder
Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.
Wallerstedt, Birgitta; Andershed, Birgitta; Benzein, Eva
To deepen the understanding of the variation of complexity in family members' caregiving situations, when the private home is the place for care, dying, and sitting service. Seven relatives to a deceased family member from four different families were interviewed twice. Data were analyzed by direct interpretation and categorical aggregation. Various patterns of becoming a caregiver were showed, but family members' willingness to become family caregivers was strongly related to fulfilling the dying persons' wishes to be cared for in their own homes. Important factors for coping with the caregiving situation were their needs of support, the possibility to prepare for death related to a need of communication and planning, the length and predictability of the illness trajectory, and experiences of losses and grief. Sitting service was experienced as supportive for family caregivers when they had possibility to hand over care responsibilities, but as non-supportive when expected help not was received. Family members' experiences of caregiving and their degree of vulnerability must be different, depending on whether it is a self-selected position or an imposed task. In general, family members in this study were willing to participate in caregiving for end-of life care, but subject to their own conditions. One way to decrease vulnerability is to assess the resources and competence in relation to the responsibility the person is expected to assume. The support and other efforts to help family caregivers must be related to their specific needs and reality, not only to what the care organization can offer as a standard solution.
their families. Nothing that I do as the Secretary of the Army is more important than this [emphasis added] ( Harvey , 2009). According to the Army...to address the physical, material, mental and spiritual needs of each member of the Total Army Family [emphasis added] ( Harvey and Schoomaker, 2006...Laurie Weinstein and Christie C. White, eds., Wives and Warriors: Women and the Military in the United States and Canada, Westport, Conn.: Greenwood
.... Reagan National Defense Authorization Act for Fiscal Year 2005 directed us to evaluate the effect of EFMP on health, support, and education services in selected civilian communities with a high...
and others. Voluntary separations include end of term of Service, retirement, pregnancy , and others. DoDI 1336.01, “Certificate of Release or...Completion of Required Active Service - Weight Control Failure - Pregnancy or Childbirth - Parenthood/Custody of Minor Children - Disability...Serious Offense) - Alcohol Rehabilitation Failure - File Not Found - SPD Codes Used Less Than 75 Times Introduction 6 │ DODIG-2016-088 NDMC Separations Of
help outside their chain of command. 41 Your family member may also: • feel depressed • begin to abuse alcohol or drugs • have problems with...P.O. Box 5715 Helena, MT 59604 P.O. Box 95083 301 Centennial Mall South, 6th Floor Lincoln, NE 68509 5460 Reno Corporation Dr. Reno, NV 89511 275...main.htm or call the toll-free line at 1-800-444-5445. DoD Mental Health Self Assessment Program Anonymous self-assessments are available for depression
Hoy, Janet M
Incorporating individuals' understandings and explanations of mental illness into service delivery offers benefits relating to increased service relevance and meaning. Existing research delineates explanatory models of mental illness held by individuals in home, outpatient, and hospital-based contexts; research on models held by those in peer-support contexts is notably absent. In this article, I describe themes identified within and across explanatory models of mental illness and recovery held by mental health consumers (N = 24) at one peer center, referred to as a consumer-operated service center (COSP). Participants held explanatory models inclusive of both developmental stressors and biomedical causes, consistent with a stress-diathesis model (although no participant explicitly referenced such). Explicit incorporation of stress-diathesis constructs into programming at this COSP offers the potential of increasing service meaning and relevance. Identifying and incorporating shared meanings across individuals' understandings of mental illness likewise can increase relevance and meaning for particular subgroups of service users. © The Author(s) 2014.
Porcari, Carole; Koch, Ellen I; Rauch, Sheila A M; Hoodin, Flora; Ellison, Grant; McSweeney, Lauren
Despite significant numbers of Afghanistan and Iraqi veterans and service members who report symptoms of posttraumatic stress disorder, depression, anxiety, and substance abuse, the majority do not seek help for these problems. A better understanding of the help-seeking process might aid providers and administrators in outreach and provision of services for those who need them. Past research has shown several variables that influence an individual's help-seeking behavior: demographic variables, the nature and severity of a mental health problem, and psychological variables. The three goals of the study were to determine which variables predicted help-seeking intentions from various sources for a psychological problem, identify barriers to help seeking, and identify sources of help sought in the past year. All Operation Enduring Freedom and Operation Iraqi Freedom veterans and service members registered with a Midwestern VA Healthcare System between 2001 and 2007 received a letter requesting participation in an Internet-based survey. Participants completed nine questionnaires regarding their current physical and psychological health, social support, self-efficacy, public and self-stigma, and barriers to seeking help for a psychological problem. In addition, patterns of help seeking from informal (i.e., partner/spouse, family, friends) and formal (i.e., physician, psychiatrist, or psychologist, either from Veterans Affairs [VA] or the private sector) sources of help were examined. Results from the linear regression model including all formal and informal sources of help indicated a significant model fit with attitudes toward psychotherapy, social support, and current mental health status as significant coefficients. Of note, attitudes toward psychotherapy were a significant coefficient in all help-seeking models; stigma was a significant coefficient with formal and VA sources, and social support was found to be a significant predictor with informal sources
Cook, Bryan J.; Kim, Young
This report offers a first-of-its-kind national snapshot of the programs, services, and policies that campuses have in place to serve veterans and military personnel. The partner organizations hope that it will prompt colleges and universities to follow California State University Chancellor Charlie Reed's advice and take a close look at their own…
Johnson, Clair; Viljoen, Nina
Background: Systemic approaches can be useful in working with people with learning disabilities and their network. The evidence base for these approaches within the field of learning disabilities, however, is currently limited. Materials and Methods: This article presents part of a service evaluation of systemic consultations in a Community…
..., Associate CIO, Strategy and Planning (IT) Julieta Garcia, Director, Customer Assistance, Relationships and...) Debra L. Nelson, Director, Management Services (IT) Nina E. Olson, National Taxpayer Advocate (TAS... Management Office (IT) David W. Stender, Associate CIO, Cybersecurity (IT) Peter J. Stipek, Director...
..., Specialty Programs (SB/SE); Robin DelRey Jenkins, Director, Office of Business Modernization (SB/ SE... (CI); David W. Stender, Associate CIO, Cybersecurity (MITS); Peter J. Stipek, Director, Customer Accounts Services (W&I); Keith V. Taylor, Director, Human Resources (SB/SE); Peter C. Wade, Business...
Mennan Selimi; Llorenç Cerdà-Alabern; Marc Sánchez-Artigas; Felix Freitag; Luís Veiga
Community networks (CNs) have gained momentum in the last few years with the increasing number of spontaneously deployed WiFi hotspots and home networks. These networks, owned and managed by volunteers, offer various services to their members and to the public. To reduce the complexity of service deployment, community micro-clouds have recently emerged as a promising enabler for the delivery of cloud services to community users. By putting services closer to consumers, micro-clouds pursue not...
Sousa, Valmi D; Williams, Janet K; Barnette, Jack J; Reed, David A
RATIONALE, AIMS, AND OBJECTIVES: Huntington disease (HD) is a progressive genetic brain disease leading to disruptive cognitive, behavioural and physical impairments. Persons with the condition and their caregivers need appropriate and accessible health care services to help them manage the disease adequately. The purpose of this study was to evaluate the psychometric properties of a new scale that measures family members' perception of community health care services (CHCS) for persons with HD. A methodological design was used to examine the initial reliability and dimensionality of the CHCS scale among 245 family members of persons with a diagnosis of HD. Data analysis consisted of computing Cronbach's alpha coefficients, calculating the 95% confidence interval for alpha and performing item-analysis and exploratory factor analysis. Reliability of the scale based on Cronbach's alpha was 0.83. Factor analysis using principal component analysis and varimax rotation suggested that three interpretable factors underlie the scale. Factor 1, HD knowledge, had alpha = 0.82, eigenvalue of 4.67 and explained 33.42% of the variance; factor 2, HD community resources, had alpha = 0.62, eigenvalue of 1.68 and explained 12.02% of the variance; factor 3, individualized HD management, had alpha = 0.77, eigenvalue of 1.45 and explained 10.39% of the variance. Findings from this study provide evidence of both construct validity and internal consistency reliability of the CHCS scale. Further psychometric testing of the scale in other samples of family caregivers of persons with HD is warranted.
Braverman, S E; Spector, J; Warden, D L; Wilson, B C; Ellis, T E; Bamdad, M J; Salazar, A M
To design and describe an effective rehabilitation programme for use in an ongoing trial on the efficacy of multidisciplinary brain injury rehabilitation for moderately head injury military service members. Treatment arm of a randomized control trial. US military tertiary care hospital inpatient rehabilitation programme. Sixty seven active duty military with moderate to severe TBI who were randomized to the treatment arm of the protocol. Eight week rehabilitation programme combining group and individual therapies with an inpatient milieu-oriented neuropsychological focus. Group therapies included fitness, planning and organization, cognitive skills, work skills, medication, and milieu groups, and community re-entry outings. Individual therapy included neuropsychology, work therapy, occupational therapy, and speech and language pathology. Successful return to work and return to duty. At 1 year follow-up, 64 patients returned to work (96%) and 66% (44/67) returned to duty. The described rehabilitation programme demonstrates one successful effort to rehabilitate active duty military service members with TBI who have the potential to return to duty.
Varga, Colleen M; Haibach, Michael A; Rowan, Anderson B; Haibach, Jeffrey P
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
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
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).
Variations in the incidence and burden of illnesses and injuries among non-retiree service members in the earliest, middle, and last 6 months of their careers, active component, U.S. Armed Forces, 2000-2015.
Uptegraft, Colby C; Stahlman, Shauna
This report uses routinely collected data in the Defense Medical Surveillance System (DMSS) to characterize the incidence and burden of medical conditions throughout the careers of service members separating from the active component of the U.S. Armed Forces between 1 October 2014 and 30 September 2015. Three surveillance periods between 30 September 2000 and 30 September 2015 were defined by each individual's time in service: early (first 6 months), middle (middle 6 months), and late (last 6 months). Overall, separating service members were most often aged 25-34 years (59.4%), male (84.0%), non-Hispanic white (64.0%), junior enlisted (52.4%), in the Marine Corps (33.1%), serving in a repair/engineering occupation (33.0%), and had never deployed (52.5%). The top five burden of disease categories across surveillance periods by sex were remarkably similar, including mental health disorders, which exhibited similar upward trends across the three surveillance periods (males: 1.3%, 17.0%, and 35.6%; females: 1.8%, 15.1%, and 32.4%, respectively). The most common diagnoses exhibiting upward, downward, or bimodal trends by incidence rate differences were mental health disorders, respiratory infections/diseases, and musculoskeletal diseases, respectively.
Puri Ayu Margareta
There is an increasing competition in service industries, causing the service industry are competing in improving service quality to satisfaction to customers. In simple terms, satisfaction is a feeling or state of a person in which perceptions of a particular product or service in accordance with expectations. If the perception of a product or service was beyond what was expected of course, consumers are satisfied but if otherwise, consumers will feel dissatisfied. Training Centre is venue training skill in the shoe company. To analyse and improve employee satisfaction in the training , then provide technical service and response attributes, then using integration methods Servqual and Quality Function Deployment. Based on the analysis found the house of quality and service quality Training Centre still less satisfactory when compared with what is expected by its employee. Appropriate analysis of the priority needs of the customer based on raw weight value, the value of the interest, then unknown attributes to be considered on the terms of 3 (three top priority is condition of machines is good a priority value raw weight (8.932, a sufficient number of machine with a priority value raw weight (8.886, alacrity all trainer in helping trainees every time with a priority value raw weight (7.937. Priority services desperately need more attention from the company to immediately repaired by 3 (three priority technical response is to supervise the overall training with the value (0.184, improve skills trainers in the training program with the value (0.137, additional facilities with a value of ( 0.129.
large cohort of trials to spot unusual cases. However, deployment repeatability is inherently a nonlinear phenomenon, which makes modeling difficult...and GEMS tip position were both tracked during ground testing by a laser target tracking system. Earlier SAILMAST testing in 2005  used...recalls the strategy used by SRTM, where a constellation of lights was installed at the tip of the boom and a modified star tracker was used to track tip
Bricknell, Martin C M; Nadin, M
This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis ' the golden thread ' and eight ' silver bullets ' as themes to institutionalise the learning to deliver the golden thread. One additional theme, mentoring indigenous healthcare systems and providers, emerged as a completely new capability requirement. The DMS has established a programme of work to implement these lessons. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
sexual assault reporting. Such models would provide insight into the character- istics of the service members who experience these events ( age , pay grade...service members and who met Study Design and Analysis Approach 5 the study inclusion criteria requiring that they be age 18 or older , below the rank...to encour- age someone who experienced sexual assault both to report it (93.5 percent) and to seek counseling (93.9 percent). There were no service or
Balderrama-Durbin, Christina; Stanton, Kimberley; Snyder, Douglas K; Cigrang, Jeffrey A; Talcott, G Wayne; Smith Slep, Amy M; Heyman, Richard E; Cassidy, Daniel G
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).
Jen, Wen-Yuan; Hung, Ming-Chien
In an aging society, the issue of increased medical costs troubles both government agencies and families with aging parents. Many elderly people require long-term care, and the medical and financial problems associated with long-term care worry their entire family. Mobile healthcare service (MHS) has been widely applied by medical practitioners and researchers for years. Unfortunately, the elderly often fear both the technology and the cost its use incurs; hence, they seldom actively adopt MHS without the prompting and support of other family members. This study highlights this issue of long-term healthcare for the elderly and extracts the factors affecting their family's intentions in adopting MHS. Based on the integration of the Theory of Planned Behavior and the Technology Acceptance Model, the factors associated with the family's intention of the aging people toward MHS are explored. Data were collected from 200 students in the "Job Master" track in a local "Executive Master of Business Administration" program. Half of them had at least one immediate family member who was older than 65 years of age. A partial least squares (PLS) analysis shows that "attitude" significantly affected the behavioral intention of adopting MHS, and "perceived usefulness" and "perceived ease-of-use" had an indirect effect via "attitude." The PLS model explains the variance in intention (64.1%), attitude (58.1%), and perceived usefulness (33.8%). Overall, this study shows that attitude was an important determinant of MHS adoption. Gender also significantly affected the relationship between attitude and behavioral intention to adopt MHS.
Teyhen, Deydre S; Riebel, Mark A; McArthur, Derrick R; Savini, Matthew; Jones, Mackenzie J; Goffar, Stephen L; Kiesel, Kyle B; Plisky, Phillip J
Determine the influence of age and sex and describe normative data on field expedient tests associated with power, balance, trunk stability, mobility, and functional movement in a military population. Participants (n = 247) completed a series of clinical and functional tests, including closed-chain ankle dorsiflexion (DF), Functional Movement Screen (FMS), Y-Balance Test Lower Quarter (YBT-LQ), Y-Balance Test Upper Quarter (YBT-UQ), single leg vertical jump (SLVJ), 6-m timed hop (6-m timed), and triple hop. Descriptive statistics were calculated. Analysis of variance tests were performed to compare the results based on sex and age (30 years). Service members demonstrated DF of 34.2 ± 6.1°, FMS composite score of 16.2 ± 2.2, YBT-LQ normalized composite score of 96.9 ± 8.6%, YBT-UQ normalized composite score of 87.6 ± 9.6%, SLVJ of 26.9 ± 8.6 cm, 6-m hop of 2.4 ± 0.5 seconds, and a triple hop of 390.9 ± 110.8 cm. Men performed greater than women (p power, balance, and trunk stability tests, whereas younger individuals performed better on power, balance, mobility, and functional movement. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Welsh, Janet A; Olson, Jonathan; Perkins, Daniel F; Travis, Wendy J; Ormsby, LaJuana
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.
obstetric -gynecologic patients: the PRIME-MD Patient Health Questionnaire Obstetrics -Gynecology Study. Am J Obstet Gynecol. 2000;183(3): 759–769. 28...domestic violence exposure: a longitudinal study. J Trauma Stress. 2008;21(1):83–90. 69. Milliken CS, Auchterlonie JL, Hoge CW. Longitudinal assessment of
Other Physical and Psychological Health Problems," which was chosen as one of the top 5 posters submitted to the conference. In addition, a brief...mild traumatic brain injury (mTBI) in veterans from the Iraq and Afghanistan conflict in relation to other physical and psychological health ...associated with other physical and psychological health problems among veterans seen in clinical practice. Methods As part of a larger study involving
children’s psych health and development at pre- mid- and post-timepoints. Children participate through doll and puppet play interview. Teacher ratings...Regulation and Dysregulation: Development , Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of...Psychiatry, 127, 1653-1658. Shields, A.M., & Cicchetti, D. (1997). Emotion regulation among school-age children : The development and validation of a new
Ditchburn, Jae-Llane; Marshall, Alison
The Lancashire Teaching Hospitals NHS Trust in the UK has been providing renal care through video-as-a-service (VAAS) to patients since 2013, with support from the North West NHS Shared Infrastructure Service, a collaborative team that supports information and communication technology use in the UK National Health Service. Renal telemedicine offered remotely to patients on home dialysis supports renal care through the provision of a live high-quality video link directly to unsupported patients undergoing haemodialysis at home. Home haemodialysis is known to provide benefits to patients, particularly in making them more independent. The use of a telemedicine video-link in Lancashire and South Cumbria, UK, further reduces patient dependence on the professional team. The purpose of this paper is to present the perspectives of the renal care team members using the renal telemedicine service to understand the perceived benefits and issues with the service. Ten semi-structured interviews with members of the renal care team (two renal specialists, one matron, two renal nurses, one business manager, one renal technical services manager, two IT technicians and one hardware maintenance technician) were conducted. Thematic analysis was undertaken to analyse the qualitative data. A range of incremental benefits to the renal team members were reported, including more efficient use of staff time, reduced travel, peace of mind and a strong sense of job satisfaction. Healthcare staff believed that remote renal care through video was useful, encouraged concordance and could nurture confidence in patients. Key technological issues and adjustments which would improve the renal telemedicine service were also identified. The impact of renal telemedicine was positive on the renal team members. The use of telemedicine has been demonstrated to make home dialysis delivery more efficient and safe. The learning from staff feedback could inform development of services elsewhere. © 2017
diagnosed by a health care professional with PTSD, depression, manic-depressive disorder, or schizophre- nia or psychosis at baseline were indicated as...Wingard DL, Ryan MA, et al. Prior assault and posttraumatic stress disorder after combat deployment. Epidemiology 2008c;19(3): 505 –512. Smith TC. The US
Scully, Michael S; Wessman, Dylan E; McKee, James M; Francisco, Gregory M; Nayak, Keshav R; Kobashigawa, Jon A
Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant. A 47-year-old active duty male initially evaluated for atypical chest pain was found to have severe concentric left ventricular hypertrophy on echocardiogram but normal voltage on electrocardiogram. Cardiac magnetic resonance imaging, laboratory studies, and bone marrow biopsy established the diagnosis of cardiac amyloidosis. At the time of diagnosis, the patient's prognosis was very poor with a median survival of 5 months on the basis of the Mayo Clinic revised prognostic staging system for amyloidosis. The patient developed rapidly progressive left ventricular dysfunction and heart failure leading to cardiac arrest. The patient received a total artificial heart as a bridge to orthotopic heart and kidney transplantation and eventual stem cell transplant. He continues to be in remission and has a fair functional capacity without restriction in activities of daily living or moderate exercise. Amyloid CM is a rare and devastating disease. The natural course of the disease has made heart transplant in these patients controversial. Modern advancements in chemotherapies and advanced heart failure treatments have improved outcomes for select patients with AL amyloid CM undergoing heart transplantation. There is ongoing research seeking improvement in treatment options and outcomes for patients with this deadly disease. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
A previous MSMR report found that 42.8% of all incident (first-time) urinary tract infections (UTIs) in males, but only 0.4% of such UTIs in females, were diagnosed as "urethritis, unspecified" (ICD-9: 597.80). This study explored the possibility that many of the diagnoses of urethritis in males represented sexually transmitted infections (STIs), even though ICD-9: 597.80 is explicitly reserved for cases of urethritis that are deemed to not be sexually transmitted. Examined were relationships between diagnoses of urethritis, diagnoses of STIs, and recurrent diagnoses of UTIs. Male service members who received a diagnosis of "urethritis, unspecified" (ICD-9: 597.80) had an increased risk of a subsequent UTI diagnosis, especially of "urethritis, unspecified," compared to all male service members. Most service members who were diagnosed with "urethritis, unspecified" had no documented diagnoses of an STI in their Military Health System health records; however, recurrent UTIs were more common among service members who did have documented STIs. The most commonly diagnosed STIs in this study were "other non-gonococcal urethritis" (which includes that caused by Chlamydia trachomatis) and gonorrhea.
Ness, Bryan M.; Middleton, Michael J.; Hildebrandt, Michael J.
Objectives: To examine the relationships between self-reported posttraumatic stress disorder (PTSD) symptoms, perceived positive relations with others, self-regulation strategy use, and academic motivation among student service members/veterans (SSM/V) enrolled in postsecondary education. Participants: SSM/V (N = 214), defined as veterans, active…
Le Low, Lisa Pau; Lam, Lai Wah; Fan, Kim Pong
Caring and supporting older people with dementia have become a major public health priority. Recent reports have also revealed a diminishing number of family carers to provide dementia care in the future. Carers who are engaged in the caring role are known to bear significant psychological, practical and economic challenges as the disease advances over time. Seemingly, evidence indicates that the burden of care can be relieved by formal services. This study aims to explore decision-making experiences of family members of older adults with moderate dementia towards the use of community support (CS) and residential care home (RCH) services. A large multi-site constructivist grounded theory in a range of non-government organizations and a private aged home will frame this Hong Kong study. Purposive sampling will begin the recruitment of family members, followed by theoretical sampling. It is estimated that more than 100 family members using CS and RCH services will participate in an interview. The process of successive constant comparative analysis will be undertaken. The final product, a theory, will generate an integrated and comprehensive conceptual understanding which will explain the processes associated with decision-making of family members for dementia sufferers. Deeper understanding of issues including, but not exclusive to, service needs, expectations and hopes among family carers for improving service support to serve dementia sufferers in CS and RCH services will also be revealed. Importantly, this study seeks to illustrate the practical and strategic aspects of the theory and how it may be useful to transfer its applicability to various service settings to better support those who deliver formal and informal care to the dementia population.
Software-as-a-Service deployment model has become the way forward for many technology companies. Most companies with an established on-premise business are looking to adopt SaaS deployment model to incorporate SaaS offerings into their product portfolio. Gartner (2012) expects the SaaS enterprise application market to grow from $11.8 billion in 2012 to $26.5billion in 2016 generating a 17.4% compound annual growth rate. Perceptive Informatics is a leading eClinical solutions provider, loo...
Filgueira, R.; Ferreira da Silva, R.; Deelman, E.; Atkinson, M.
We present the Data-Intensive workflows as a Service (DIaaS) model for enabling easy data-intensive workflow composition and deployment on clouds using containers. DIaaS model backbone is Asterism, an integrated solution for running data-intensive stream-based applications on heterogeneous systems, which combines the benefits of dispel4py with Pegasus workflow systems. The stream-based executions of an Asterism workflow are managed by dispel4py, while the data movement between different e-Infrastructures, and the coordination of the application execution are automatically managed by Pegasus. DIaaS combines Asterism framework with Docker containers to provide an integrated, complete, easy-to-use, portable approach to run data-intensive workflows on distributed platforms. Three containers integrate the DIaaS model: a Pegasus node, and an MPI and an Apache Storm clusters. Container images are described as Dockerfiles (available online at http://github.com/dispel4py/pegasus_dispel4py), linked to Docker Hub for providing continuous integration (automated image builds), and image storing and sharing. In this model, all required software (workflow systems and execution engines) for running scientific applications are packed into the containers, which significantly reduces the effort (and possible human errors) required by scientists or VRE administrators to build such systems. The most common use of DIaaS will be to act as a backend of VREs or Scientific Gateways to run data-intensive applications, deploying cloud resources upon request. We have demonstrated the feasibility of DIaaS using the data-intensive seismic ambient noise cross-correlation application (Figure 1). The application preprocesses (Phase1) and cross-correlates (Phase2) traces from several seismic stations. The application is submitted via Pegasus (Container1), and Phase1 and Phase2 are executed in the MPI (Container2) and Storm (Container3) clusters respectively. Although both phases could be executed
Grieb, Suzanne M; Crawford, Amelia; Fields, Julie; Smith, Horace; Harris, Richard; Matson, Pamela
The role of incarceration and community reentry after incarceration has been studied extensively for individual and community health; however, little attention has been given to the experiences of individuals who provide support to those in reentry. Through a community-academic partnership, seven focus groups were conducted with 39 individuals supporting a family member in reentry in the summer of 2012. The primary objectives of the focus groups were to explore community experiences and perspectives regarding providing support during a family member's reentry from a period of incarceration and any desired support for themselves during this time. Five themes emerged under a metatheme of stress, indicating that family members experience acute stress as a result of family reentry that adds to the chronic stress they already endure. Programs that acknowledge the difficult role of family members as supporters during an individual's reentry and provide support to them are desperately needed.
Ioan – Franc Valeriu
Full Text Available The enterprises' offensive in various markets is focused on a. package of "services" that integrates - more than ever before - the observance of terms and vivid contacts between enterprises and customers. Metaphorically, we could say that services rendere
Gibbs, Deborah A; Clinton-Sherrod, A Monique; Johnson, Ruby E
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.
Clark, Malissa A; O'Neal, Catherine W; Conley, Kate M; Mancini, Jay A
Deployment affects not just the service members, but also their family members back home. Accordingly, this study examined how resilient family processes during a deployment (i.e., frequency of communication and household management) were related to the personal reintegration of each family member (i.e., how well each family member begins to "feel like oneself again" after a deployment), as well as several indicators of subjective well-being. Drawing from the family attachment network model (Riggs & Riggs, 2011), the present study collected survey data from 273 service members, their partners, and their adolescent children. Resilient family processes during the deployment itself (i.e., frequency of communication, household management), postdeployment positive and negative personal reintegration, and several indicators of well-being were assessed. Frequency of communication was related to personal reintegration for service members, while household management was related to personal reintegration for nondeployed partners; both factors were related to personal reintegration for adolescents. Negative and positive personal reintegration related to a variety of subjective well-being outcomes for each individual family member. Interindividual (i.e., crossover) effects were also found, particularly between adolescents and nondeployed partners. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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.
AWARD NUMBER: W81XWH-15-2-0072 TITLE: Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in...Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS 5b. GRANT NUMBER W81XWH-15...Figure 4. Mitochondrial activity is mostly preserved on the animals that were supported with ventilator devices and mesenchymal stem cells . Using a
amount of spending has produced a market that has driven the development of technological products that integrate with media devices, cell phones and...of muscle strengthening and activity are important to a service-wide fitness program that would be designed to increase mobility and stamina ...member would be able to participate in daily fitness routines with reduced physical injuries and increased cardiovascular stamina . These would then become
refer to as rape, including penetration of the mouth, anus, or vagina by a penis , body part, or object. We describe the measure as penetrative sexual...thigh, breast, groin, anus, vagina, penis , and testicles. Table 3.2 Estimated Percentage of Active-Component Coast Guard Service Members Who...reporting. The survey included a link to an image of the form to enhance recall. Fif- teen percent of women who were sexually assaulted in the past year
Messecar, Deborah C
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.
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
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
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
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.
Edwards, Joe; Vess, James; Reger, Greg; Cernich, Alison
Traumatic brain injury (TBI) is a common event in the current extended conflicts by American service members, with estimates that as many as 300,000 have sustained combat-related concussions during Operation Iraqi Freedom and Operation Enduring Freedom. The limited ecological validity of traditional neuropsychological assessment measures presents a challenge to effective postconcussion evaluation of service members in relation to fitness-for-duty decisions or rehabilitation needs. Virtual reality (VR) technology offers a promising opportunity to advance the field of functional assessment for TBI. This article reviews the current professional literature on VR applications for TBI assessment, with special emphasis on those that are particularly relevant to U.S. service members. VR affords several advantages for clinical use. These include assessment of complex sets of cognitive and behavioral functions rather than the isolated components assessed by traditional measures; more precise control over the standardized presentation of task stimuli and the recording of response data; and enhanced ecological validity that can lead to more useful assessment data in the applied contexts faced by the U.S. military.
resource noted that the program also assists veterans and their family members in purchasing food and clothes, explaining job application processes, and...of financial statements, and guidance on other such business-related activities as franchising and marketing. In addition to describing these
bruising. An MRI scan provides detailed images of the brain using magnetic energy rather than x-ray technology . Intracranial means within the...member/veteran is unable to swallow for many days to weeks, a per cutaneous gastronomy tube (PEG tube) will be placed directly into his or her
Declaration of income for 2006 Members of the personnel are invited to take note of the following information on the procedure for completing the 2006 declaration of income form, which must be returned by 31st May 2007 at the latest. Who is required to complete the form? Where can it be obtained? All members of the personnel1 residing in France, whether or not they are of French nationality2, are required to complete a declaration of income form for 2006 according to the following instructions and to return a signed copy to their local tax office by 31st May 2007 at the latest. Members of the personnel should receive a 2006 income declaration form at the end of April/ beginning of May. Failing this, they should procure one from their local tax office, public finance office ('Trésorerie') or town hall or download one from the Finance Ministry's website (www.finances.gouv.fr ). Completing the declaration form Members of the personnel must compete a HARD-COPY FORM only.It is not possible to make a decla...
Declaration of income for 2006 Members of the personnel are invited to take note of the following information on the procedure for completing the 2006 declaration of income form, which must be returned by 31st May 2007 at the latest. Who is required to complete the form? Where can it be obtained? All members of the personnel1 residing in France, whether or not they are of French nationality2, are required to complete a declaration of income form for 2006 according to the following instructions and to return a signed copy to their local tax office by 31st May 2007 at the latest. Members of the personnel should receive a 2006 income declaration form at the end of April/ beginning of May. Failing this, they should procure one from their local tax office, public finance office ('Trésorerie') or town hall or download one from the Finance Ministry's website (www.finances.gouv.fr ). Completing the declaration form Members of the personnel must compete a HARD-COPY FORM only.It is not possible to make a decla...
The speech, spatial and qualities of hearing scale (SSQ). International Journal of Audiology, 43(2), 85–99. 11 Quad Chart Diagnosing contributions... Service Members” PRINCIPAL INVESTIGATOR: Dr. Barbara Shinn-Cunningham CONTRACTING ORGANIZATION: Boston University Boston, MA 02215-1703 REPORT DATE...information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations
Kennedy, Norelee; Armstrong, Claire; Woodward, Oonagh; Cullen, Walter
Team working is an integral aspect of primary care, but barriers to effective team working can limit the effectiveness of a primary care team (PCT). The establishment of new PCTs in Ireland provides an excellent opportunity to explore team working in action. The aim of this qualitative study was to explore the experiences of team members working in a PCT. Team members (n = 19) from two PCTs were interviewed from May to June 2010 using a semi-structured interview guide. All interviews were audio-recorded and transcribed. Data were analysed using NVivo (version 8). Thematic analysis was used to explore the data. We identified five main themes that described the experiences of the team members. The themes were support for primary care, managing change, communication, evolution of roles and benefits of team working. Team members were generally supportive of primary care and had experienced benefits to their practice and to the care of their patients from participation in the team. Regular team meetings enabled communication and discussion of complex cases. Despite the significant scope for role conflict due to the varied employment arrangements of the team members, neither role nor interpersonal conflict was evident in the teams studied. In addition, despite the unusual team structure in Irish PCTs - where there is no formally appointed team leader or manager - general issues around team working and its benefits and challenges were very similar to those found in other international studies. This suggests, in contrast to some studies, that some aspects of the leadership role may not be as important in successful PCT functioning as previously thought. Nonetheless, team leadership was identified as an important issue in the further development of the teams. © 2014 John Wiley & Sons Ltd.
Jong, de A.; Ruyter, de J.C.; Lemmink, J.G.A.M.
Drawing from the organizational behaviour and services marketing literature, we develop a conceptual model of self-managing team (SMT) service climate, taking into account characteristics of the organizational context, the SMT, and the individual employee. In order to assess the impact of SMT
Bergmann, Jeffrey S; Renshaw, Keith D; Allen, Elizabeth S; Markman, Howard J; Stanley, Scott M
The vast numbers of military service members who have been deployed since 2001 highlights the need to better understand relationships of military couples. A unique consideration in military couples is the concept of meaningfulness of service, or the value service members and their partners place on military service in spite of the sacrifices it requires. In a sample of 606 Army couples, the authors used path analysis to examine how male service members' and female spouses' perceived meaningfulness of service added to the prediction of marital satisfaction in both members of the couple, when accounting for service members' PTSD symptoms. Spouses' perceived meaningfulness of service was linked with higher marital satisfaction in spouses, regardless of service member's perceived meaningfulness of service. Service members' perceived meaningfulness of service was also associated with increased marital satisfaction in service members, but only when their spouses also perceived higher meaningfulness. There were no significant interactions between service members' PTSD and either partner's perceived meaningfulness. Implications for enhanced attention to spousal perceptions of meaningfulness of service are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Lester, Patricia; Aralis, Hilary; Sinclair, Maegan; Kiff, Cara; Lee, Kyung-Hee; Mustillo, Sarah; Wadsworth, Shelley MacDermid
Since 9/11, military service in the United States has been characterized by wartime deployments and reintegration challenges that contribute to a context of stress for military families. Research indicates the negative impact of wartime deployment on the well being of service members, military spouses, and children. Yet, few studies have considered how parental deployments may affect adjustment in young children and their families. Using deployment records and parent-reported measures from primary caregiving (N = 680) and military (n = 310) parents, we examined the influence of deployment on adjustment in military families with children ages 0-10 years. Greater deployment exposure was related to impaired family functioning and marital instability. Parental depressive and posttraumatic stress symptoms were associated with impairments in social emotional adjustment in young children, increased anxiety in early childhood, and adjustment problems in school-age children. Conversely, parental sensitivity was associated with improved social and emotional outcomes across childhood. These findings provide guidance to developing preventive approaches for military families with young children.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Solicitation... policy Communication of scientific findings to multiple audiences including health care professionals, policy makers and the general public. Candidates with experience and skills in any of these areas should...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Solicitation... Application of science to health policy Communication of scientific findings to multiple audiences including health care professionals, policy makers and the general public. Candidates with experience and skills in...
Zhang Ruijin; Castel, Arnaud; Francois, Raoul
This paper deals with two corroded reinforcement concrete beams, which have been stored under sustained load in a chloride environment for 14 and 23 years respectively. The evolution of corrosion pattern of reinforcement and its influence on serviceability are studied. In chloride-induced corrosion process, corrosion cracking affects significantly the corrosion pattern. During the corrosion cracking initiation period, only local pitting corrosion occurs. At early stage of cracking propagation, localized pitting corrosion is still predominant as cracks widths are very small and cracks are not interconnected, but a general corrosion slowly develops as the cracks widen. At late cracking stage, interconnected cracking with wide width develops along large parts of the beam leading to a general corrosion pattern. Macrocells and microcells concepts are used for the interpretation of the results. Mechanical experiments and corrosion simulation tests are performed to clarify the influence of this corrosion pattern evolution on the serviceability of the beams (deflection increase). Experimental results show that, when the corrosion is localized (early cracking stage), the steel-concrete bond loss is the main factor affecting the beams serviceability. The local cross-section loss resulting from pitting attack does not significantly influence the deflection of the beam. When corrosion is generalized (late cracking stage), as the steel-concrete bond is already lost, the generalized steel cross-section reduction becomes the main factor affecting the beams serviceability. But, at this stage, the deflection increase is slower due to the low general corrosion rate.
... INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE Federal Insurance Contributions... 3121(r). N operates a seminary adjacent to a university. Students at the university obtain lodging and...
Runge, F. C.
Flight testing plans for a large deployable infrared reflector telescope to be tested on a space platform are discussed. Subsystem parts, subassemblies, and whole assemblies are discussed. Assurance of operational deployability, rigidization, alignment, and serviceability will be sought.
Stratton, Kelcey J; Clark, Shaunna L; Hawn, Sage E; Amstadter, Ananda B; Cifu, David X; Walker, William C
Military personnel returning from conflicts in Iraq and Afghanistan often endorse pain and posttraumatic stress disorder (PTSD) symptoms, either separately or concurrently. Associations between pain and PTSD symptoms may be further complicated by blast exposure from explosive munitions. Although many studies have reported on the prevalence and disability associated with polytraumatic injuries following combat, less is known about symptom maintenance over time. Accordingly, this study examined longitudinal interactive models of co-occurring pain and PTSD symptoms in a sample of 209 military personnel (mean age = 27.4 years, standard deviation = 7.6) who experienced combat-related blast exposure. Autoregressive cross-lagged analysis examined longitudinal associations between self-reported pain and PTSD symptoms over a 1-year period. The best-fitting covariate model indicated that pain and PTSD were significantly associated with one another across all assessment periods, χ² (3) = 3.66, P = .30, Tucker-Lewis index = .98, comparative fit index = 1.00, root mean squared error of approximation = .03. PTSD symptoms had a particularly strong influence on subsequent pain symptoms. The relationship between pain and PTSD symptoms is related to older age, race, and traumatic brain injury characteristics. Results further the understanding of complex injuries among military personnel and highlight the need for comprehensive assessment and rehabilitation efforts addressing the interdependence of pain and co-occurring mental health conditions. This longitudinal study demonstrates that pain and PTSD symptoms strongly influence one another and interact across time. These findings have the potential to inform the integrative assessment and treatment of military personnel with polytrauma injuries and who are at risk for persistent deployment-related disorders. Published by Elsevier Inc.
tobacco products, such as e-cigarettes, have not been studied as thoroughly as traditional cigarettes. Understanding the prevalence of e-cigarette...and METHODS Information on the prevalence, perception, and use of e-cigarettes, in addition to history of deployment, was obtained by using data from...the "Tobacco Use Among Service Members" survey sponsored by the Murtha Cancer Center and the Postgraduate Dental School of the Uniformed Services
Morales-Condea, M. J.
Full Text Available Drilling devices is used to get information about the cross-section properties and internal defects of structural members. Drill resistance is correlated with density which is often used to predict the mechanical properties of timber elements. However in situ a regression curve cannot be obtained and pre-existent curves provides unreliable predictions. The present paper proposes a procedure for in situ “calibration” of drill resistance data. The “calibration” is based on density values from wood cores taken in the close vicinity of drill holes. Two approaches were tested. One approach based on a regression curve built using wood cores density and drill resistance values obtained from a limited number of members. The other approach uses the information of one wood core to “calibrate” the drill resistance profile taken at the same member. Following this procedure a density prediction is obtained showing a low mean percentage error and a medium coefficient of determination.Los dispositivos de perforación se utilizan a menudo para obtener información sobre las propiedades de la sección transversal y defectos internos de los elementos estructurales de madera. La resistencia a la perforación se correlaciona con la densidad que, a menudo, se utiliza para obtener la predicción de las propiedades mecánicas de los elementos de madera. Sin embargo, una curva de regresión no puede ser obtenida in situ y las curvas de preexistentes proporcionan predicciones poco fiables. En el presente trabajo se propone un procedimiento de “calibración” in situ de los datos de resistencia de perforación obtenidos en cada caso. La “calibración” se basa en los valores de densidad de pequeñas probetas de madera tomadas en las inmediaciones de los taladros. Para ello se plantean 2 métodos: Un primer enfoque basado en obtener una curva de regresión a partir de los valores de densidad de pequeñas probetas de madera y los valores de resistencia a
Ross H. Miller
Full Text Available Background Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss. Methods Cross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW. Results Peak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s vs. controls (157% BW, 1,985% BW/s, with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters. Discussion Assuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.
Rantanen, Jorma; Lehtinen, Suvi; Valenti, Antonio; Iavicoli, Sergio
The United Nations General Assembly (UNGA), the International Labour Organization (ILO), the World Health Organization (WHO), the International Commission on Occupational Health (ICOH), and the European Union (EU) have encouraged countries to organize occupational health services (OHS) for all working people irrespective of the sector of economy, size of enterprise or mode of employment of the worker. The objective of this study was to survey the status of OHS in a sample of countries from all continents. A questionnaire focusing on the main aspects of OHS was developed on the basis of ILO Convention No. 161 and several other questionnaire surveys used in various target groups of OHS. The questionnaire was sent to 58 key informants: ICOH National Secretaries. A total of 49 National Secretaries responded (response rate 84.5%), from countries that employ 70% of the total world labour force. The majority of the respondent countries, 67%, had drawn up an OHS policy and implement it with the help of national occupational safety and health (OSH) authorities, institutes of occupational health or respective bodies, universities, and professional associations. Multidisciplinary expert OHS resources were available in the majority (82%) of countries, but varied widely in quantitative terms. The average OHS coverage of workers was 24.8%, with wide variation between countries. In over two thirds (69%) of the countries, the content of services was mixed, consisting of preventive and curative services, and in 29% preventive only. OHS financing was organized according to a mixed model among 63% and by employers only among 33% of the respondents. The majority of countries have drawn up policies, strategies and programmes for OHS. The infrastructures and institutional and human resources for the implementation of strategies, however, remain insufficient in the majority of countries (implementation gap). Qualitatively, the content and multidisciplinary nature of OHS corresponds to
Full Text Available The project aim was to establish an SDI (Selected Dissemination of Information service for the faculty members at University of Tehran, faculty of psychology and education. The project was carried out during the 2006-2007 period. First, a three stage survey was conducted to identify the information needs which were then served using a current awareness service over the period. Findings confirmed that the SDI project significantly impacted on the faculty information seeking behavior. Furthermore, there had been evidence supporting the fact that it has also influenced the quality of instruction by facilitating the overall efficacy of information sources collected. It was the intent of researchers to expand this project at later stages to include all humanities faculties in the university and if possible at a national level.
Shimose, Shigeru; 下瀬 滋
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.
Walter, Kristen H; Glassman, Lisa H; Michael Hunt, W; Otis, Nicholas P; Thomsen, Cynthia J
Posttraumatic stress disorder (PTSD) commonly co-occurs with major depressive disorder (MDD) in both civilian and military/veteran populations. Existing, evidence-based PTSD treatments, such as cognitive processing therapy (CPT), often reduce symptoms of both PTSD and depression; however, findings related to the influence of comorbid MDD on PTSD treatment outcomes are mixed, and few studies use samples of individuals with both conditions. Behavioral activation (BA), an approach that relies on behavioral principles, is an effective treatment for depression. We have integrated BA into CPT (BA+CPT), a more cognitive approach, to address depressive symptoms among active duty service members with both PTSD and comorbid MDD. We describe an ongoing randomized controlled trial investigating the efficacy of our innovative, integrated BA+CPT intervention, compared with standard CPT, for active duty service members with PTSD and comorbid MDD. We detail the development of this integrated treatment, as well as the design and implementation of the randomized controlled trial, to evaluate its effect on symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.
Lange, Rael T; Brickell, Tracey A; Bailie, Jason M; Tulsky, David S; French, Louis M
To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population. One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively). Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9). Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale. The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.
Finn, Aidan; van Surksum, Kenneth
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
Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE uniform health maintenance organization (HMO) benefit--Prime enrollment fee exemption for survivors of active duty deceased sponsors and medically retired uniformed services members and their dependents. Final rule.
This final rule creates an exception to the usual rule that TRICARE Prime enrollment fees are uniform for all retirees and their dependents and responds to public comments received to the proposed rule published in the Federal Register on June 7, 2013. Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents are part of the retiree group under TRICARE rules. In acknowledgment and appreciation of the sacrifices of these two beneficiary categories, the Secretary of Defense has elected to exercise his authority under the United States Code to exempt Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents enrolled in TRICARE Prime from paying future increases to the TRICARE Prime annual enrollment fees. The Prime beneficiaries in these categories have made significant sacrifices for our country and are entitled to special recognition and benefits for their sacrifices. Therefore, the beneficiaries in these two TRICARE beneficiary categories who enrolled in TRICARE Prime prior to 10/1/2013, and those since that date, will have their annual enrollment fee frozen at the appropriate fiscal year rate: FY2011 rate $230 per single or $460 per family, FY2012 rate $260 or $520, FY2013 rate $269.38 or $538.56, or the FY2014 rate $273.84 or $547.68. The future beneficiaries added to these categories will have their fee frozen at the rate in effect at the time they are classified in either category and enroll in TRICARE Prime or, if not enrolling, at the rate in effect at the time of enrollment. The fee remains frozen as long as at least one family member remains enrolled in TRICARE Prime and there is not a break in enrollment. The fee charged for the dependent(s) of a Medically Retired Uniformed Services Member would not change if the dependent(s) was later re-classified a Survivor.
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.
members. Conclusion: This analysis demonstrated that in all five partners state-of-the-art preventative mental healthcare was included in the last deployment in Afghanistan, including a positive approach towards strengthening the mental resilience, a focus on self-regulatory skills and self-empowerment, and several initiatives that were well-integrated in a military context. These initiatives were partly/completely implemented by the military/colleagues/supervisors and applicable during several phases of the deployment cycle. Important new developments in operational mental health support are recognition of the role of social leadership and enhancement of operational peer support. This requires awareness of mental problems that will contribute to reduction of the barriers to care in case of problems. Finally, comparing mental health support services across countries can contribute to optimal preparation for the challenges of military deployment.
psychology , family, military, epidemiology, mental health, deployments Correspondence Nancy Crum-Cianflone, Deployment Health Research Department...American Psychological Association, 2007; Siegel et al., 2013; US Army Medical Research and Materiel Command, 2013). Although studies on military...functional health Modules on common types of mental disorders: depression, anxiety, panic syndrome, somatoform symptoms, alcohol abuse, bulimia nervosa
Little, Jeanette R; Pavliscsak, Holly H; Cooper, Mabel R; Goldstein, Lois A; Fonda, Stephanie J
Research has shown that mobile phones can help with management of numerous health problems. As an adjunct to care management provided to injured service members rehabilitating in their communities, particularly those with mild traumatic brain injury (mTBI), post-traumatic stress (PTS), and/or behavioral health problems, the Army developed a mobile phone application called "mCare." This study examined whether service members who received mCare had higher well-being, were more satisfied with their care, and viewed mCare as a valuable part of their care management as compared with their counterparts who received standard care management alone, and whether those with mTBI, PTS, and/or behavioral health problems benefited differently from mCare. In-processing service members at four community-based warrior transition units were recruited for participation in a 36-wk, randomized, controlled trial and allocated to receive standard care management plus mCare (n = 95) or standard care management alone (n = 87). Participants in the mCare group received daily questionnaires, tips, and appointment reminders. All participants were asked to complete the General Well-being Schedule (GWS) at baseline, 12, 24, and 36 wk, and the Case Management Quality Questionnaire (CMQQ) at 12, 24, and 36 wk. All participants and care managers were approached to complete interviews about the usability/likeability of mCare or standard care management. The analyses tested for group differences in completion of the intervention, graphed means for the GWS and CMQQ by group/subgroup, and statistically compared the longitudinal trends in these outcomes using mixed models in which group, time, and group*time were included as regression variables. The analyses also tallied interview responses and identified thematic quotes. The study protocol was reviewed and approved by the Walter Reed National Military Medical Center's Institutional Review Board. Estimated rate of change in GWS scores was -2
Armistead-Jehle, Patrick; Cooper, Douglas B; Grills, Chad E; Cole, Wesley R; Lippa, Sara M; Stegman, Robert L; Lange, Rael T
Self-report measures are commonly relied upon in military healthcare environments to assess service members following a mild traumatic brain injury (mTBI). However, such instruments are susceptible to over-reporting and rarely include validity scales. This study evaluated the utility of the mild Brain Injury Atypical Symptoms scale (mBIAS) and the Neurobehavioral Symptom Inventory Validity-10 scale to detect symptom over-reporting. A total of 359 service members with a reported history of mTBI were separated into two symptom reporting groups based on MMPI-2-RF validity scales (i.e., non-over-reporting versus symptom over-reporting). The clinical utility of the mBIAS and Validity-10 as diagnostic indicators and screens of symptom over-reporting were evaluated by calculating sensitivity, specificity, positive test rate, positive predictive power (PPP), and negative predictive power (NPP) values. An mBIAS cut score of ≥10 was optimal as a diagnostic indicator, which resulted in high specificity and PPP; however, sensitivity was low. The utility of the mBIAS as a screening instrument was limited. A Validity-10 cut score of ≥33 was optimal as a diagnostic indicator. This resulted in very high specificity and PPP, but low sensitivity. A Validity-10 cut score of ≥7 was considered optimal as a screener, which resulted in moderate sensitivity, specificity, NPP, but relatively low PPP. Owing to low sensitivity, the current data suggests that both the mBIAS and Validity-10 are insufficient as stand-alone measures of symptom over-reporting. However, Validity-10 scores above the identified cut-off of ≥7should be taken as an indication that further evaluation to rule out symptom over-reporting is necessary.
Carroll, Joseph A.; Alexander, Charles M.
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.
Ganz, Michael L; Tendulkar, Shalini A
To estimate the prevalence and correlates of unmet needs for mental health care services for children with special health care needs and their families. We use the National Survey of Children With Special Health Care Needs to estimate the prevalence of unmet mental health care needs among children with special health care needs (1-17 years old) and their families. Using logistic-regression models, we also assess the independent impact of child and family factors on unmet needs. Substantial numbers of children with special health care needs and members of their families have unmet needs for mental health care services. Children with special health care needs who were poor, uninsured, and were without a usual source of care were statistically significantly more likely to report that their mental health care needs were unmet. More severely affected children and those with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet. Families of severely affected children or of children with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet. Our results indicate that children with special health care needs and their families are at risk for not receiving needed mental health care services. Furthermore, we find that children in families of lower socioeconomic status are disproportionately reporting higher rates of unmet needs. These data suggest that broader policies to identify and connect families with needed services are warranted but that child- and family-centered approaches alone will not meet the needs of these children and their families. Other interventions such as anti-poverty and insurance expansion efforts may be needed as well.
This study uses The Theory Of Constraints (TOC) management methodology and recent military missions to show that RSOI operations are generally the limiting constraint to force deployment operations...
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...
DeNicola, Anthony D
.... Gulf War health questions have resulted in controversy over potentially hazardous exposures during the deployment, the possibility of adverse affects from preventive health measures, and the role...
Lyk-Jensen, Stéphanie; Weatherall, Cecilie Dohlmann; W. Jepsen, Peter
for the non-deployed eligible men, and our results hold to various robustness checks. Our administrative records provide objective measures of mental health service use in the form of psychiatric diagnoses and purchase of mental health-related medication. The very rich data makes it possible to control......In this paper we estimate the causal effect of military deployment on soldiers’ mental health. To handle the selection bias problem, we use longitudinal data for deployed and non-deployed eligible men in a difference-in-differences setting. Using pair-wise matching, we impute deployment dates...... for important variables like intelligence tests and family background. We find significant adverse effects of military deployment on soldiers’ mental health service use. Highlights: - Causal effect of military deployment on soldiers’ use of mental health service - Using a difference-in-differences approach...
Frisch, Noreen; Atherton, Pat; Borycki, Elizabeth; Mickelson, Grace; Cordeiro, Jennifer; Novak Lauscher, Helen; Black, Agnes
Use of Web 2.0 and social media technologies has become a new area of research among health professionals. Much of this work has focused on the use of technologies for health self-management and the ways technologies support communication between care providers and consumers. This paper addresses a new use of technology in providing a platform for health professionals to support professional development, increase knowledge utilization, and promote formal/informal professional communication. Specifically, we report on factors necessary to attract and sustain health professionals' use of a network designed to increase nurses' interest in and use of health services research and to support knowledge utilization activities in British Columbia, Canada. "InspireNet", a virtual professional network for health professionals, is a living laboratory permitting documentation of when and how professionals take up Web 2.0 and social media. Ongoing evaluation documents our experiences in establishing, operating, and evaluating this network. Overall evaluation methods included (1) tracking website use, (2) conducting two member surveys, and (3) soliciting member feedback through focus groups and interviews with those who participated in electronic communities of practice (eCoPs) and other stakeholders. These data have been used to learn about the types of support that seem relevant to network growth. Network growth exceeded all expectations. Members engaged with varying aspects of the network's virtual technologies, such as teams of professionals sharing a common interest, research teams conducting their work, and instructional webinars open to network members. Members used wikis, blogs, and discussion groups to support professional work, as well as a members' database with contact information and areas of interest. The database is accessed approximately 10 times per day. InspireNet public blog posts are accessed roughly 500 times each. At the time of writing, 21 research teams
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)
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.
Fritz, Heather Ann; Lysack, Cathy; Luborsky, Mark R; Messinger, Seth D
Despite growing knowledge about medical and functional recovery in clinical settings, the long-term issue of community reintegration with a spinal cord injury (SCI) in the military context remains virtually unexamined. Thus, the U.S. Department of Defense created the SCI Qualitative Research Program to advance knowledge about service members' reintegration into civilian life. The purpose of this paper is to better characterize the long-term outcomes related to the community participation experienced and desired vis-à-vis a case study of a military veteran who suffered a service-related traumatic SCI. An in-depth anthropological interview was used with Jake, a 28-year old marine with a service-related C5/C6 SCI. Data were analyzed using content analysis. Three significant themes were identified: opportunities for better engaging socially meaningful others may not be adequately included in so-called "client-centered" interventions; how management of the social self in inter-personal interactions and public spaces is critical to gaining broader societal acceptance; and how meaningful age normative relationships and activities are essential to establish lasting inclusive social connections. Jake's case challenges existing models of rehabilitation predominantly focused on physical capacity building. Study findings point to the need for rehabilitation to invest more resources in efforts to address the existential and social elements of long-term social reintegration. Implications for Rehabilitation Both the veteran with SCI and their meaningful support network face challenges socially reintegrating after injury and rehabilitation. Empowering clients to envision future possibilities in terms of family, intimate relationships, and meaningful work are important to successful long-term social reintegration. Addressing the existential desires and social capacities of the individual may be as important as addressing physical functioning skills after SCI.
Cardile, Anthony P; Murray, Clinton K; Littell, Christopher T; Shah, Neel J; Fandre, Matthew N; Drinkwater, Dennis C; Markelz, Brian P; Vento, Todd J
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.
Johnson, S. R
.... The increased rate of deployments, coupled with the reduction in resources, has military leaders concerned that these changing demands will cause undue strain, adversely affecting the military member's quality of life...
Dance, K.D.; Chang, Y.I.; Daly, T.A.
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
Scherrer, Jeffrey F; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi K
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 postdeployment 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 avenues for help, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed information delivery on education being met (76.8% and 78.2%, respectively) and were least likely to endorse legal information delivery (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 to 4 months after a deployment. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Wolf, Erika J; Lunney, Carole A; Schnurr, Paula P
A dissociative subtype of posttraumatic stress disorder (PTSD) was recently added to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) and is thought to be associated with poor PTSD treatment response. We used latent growth curve modeling to examine data from a randomized controlled trial of prolonged exposure and present-centered therapy for PTSD in a sample of 284 female veterans and active duty service members with PTSD to test the association between the dissociative subtype and treatment response. Individuals with the dissociative subtype (defined using latent profile analysis) had a flatter slope (p = .008) compared with those with high PTSD symptoms and no dissociation, such that the former group showed, on average, a 9.75 (95% confidence interval [-16.94, -2.57]) lesser decrease in PTSD severity scores on the Clinician Administered PTSD Scale (Blake et al., 1995) over the course of the trial. However, this effect was small in magnitude. Dissociative symptoms decreased markedly among those with the subtype, though neither treatment explicitly addressed such symptoms. There were no differences as a function of treatment type. Results raise doubt about the common clinical perception that exposure therapy is not effective or appropriate for individuals who have PTSD and dissociation, and provide empirical support for the use of exposure treatment for individuals with the dissociative subtype of PTSD. (c) 2015 APA, all rights reserved).
Pape, Marcy M; Williams, Kathy; Kodosky, Paula N; Dretsch, Michael
To compare the capacity of the Community Balance and Mobility Scale (CB&M) to identify balance and mobility deficits in Service Members (SMs) with mild traumatic brain injury and comorbid psychological health conditions (mTBI/PH) to other commonly used balance assessments. A clinical research institute that provides a 4-week, outpatient, interdisciplinary program for active-duty SMs with mTBI/PH. A nonrandomized, cross-sectional design that compared multiple measures between 2 groups-active duty SMs with (n = 8) and without (n = 8) the dual diagnosis of mTBI/PH. Gait speed, Activities-specific Balance Confidence scale (ABC), Functional Gait Assessment (FGA), and CB&M to assess functional balance among the community-dwelling, TBI population. Across all measures, the mTBI/PH group performed significantly worse (P ≤ .01) with the exception of the FGA. The abilities of all objective measures to distinguish participants with mTBI/PH from healthy controls ranged from fair to excellent (area under the curve [AUC] = 0.66-0.94). However, the CB&M showed the largest group differences in effect size (d = 2.6) and had the highest discriminate ability (AUC = 0.98; sensitivity 100%; specificity 88%). The CB&M appears to have higher sensitivity and specificity than other measures of balance in SMs with mTBI/PH. A higher cut score for the CB&M is needed for this population.
DeNicola, Anthony D
... of stress in causing chronic illness. The lack of comprehensive deployment health surveillance has made it difficult to determine possible causes of adverse health effects reported by Gulf War veterans...
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)
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 for future research.
.... This runs counter to the popular belief that strategic lift is the limiting constraint. The study begins by highlighting the genesis of the military's current force projection strategy and the resulting importance of rapid force deployments...
Rausch, J. R.; Maloney, J. W.
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.
... service on a Team. 270.106 Section 270.106 Commerce and Foreign Trade Regulations Relating to Commerce and... SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.106 Conflicts of interest related to service on a Team. (a) Team members who are not Federal employees will be...
Fink, David S; Keyes, Katherine M; Calabrese, Joseph R; Liberzon, Israel; Tamburrino, Marijo B; Cohen, Gregory H; Sampson, Laura; Galea, Sandro
Studies have shown that combat-area deployment is associated with increases in alcohol use; however, studying the influence of deployment on alcohol use faces 2 complications. First, the military considers a confluence of factors before determining whether to deploy a service member, creating a nonignorable exposure and unbalanced comparison groups that inevitably complicate inference about the role of deployment itself. Second, regression analysis assumes that a single effect estimate can approximate the population's change in postdeployment alcohol use, which ignores previous studies that have documented that respondents tend to exhibit heterogeneous postdeployment drinking behaviors. Therefore, we used propensity score matching to balance baseline covariates for the 2 comparison groups (deployed and nondeployed), followed by a variable-oriented difference-in-differences approach to account for the confounding and a person-oriented approach using a latent growth mixture model to account for the heterogeneous response to deployment in this prospective cohort study of the US Army National Guard (2009-2014). We observed a nonsignificant increase in estimated monthly drinks in the first year after deployment that regressed to predeployment drinking levels 2 years after deployment. We found a 4-class model that fit these data best, suggesting that common regression analyses likely conceal substantial interindividual heterogeneity in postdeployment alcohol-use behaviors. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Titaley, Christiana R; Hunter, Cynthia L; Heywood, Peter; Dibley, Michael J
Antenatal, delivery and postnatal care services are amongst the recommended interventions aimed at preventing maternal and newborn deaths worldwide. West Java is one of the provinces of Java Island in Indonesia with a high proportion of home deliveries, a low attendance of four antenatal services and a low postnatal care uptake. This paper aims to explore community members' perspectives on antenatal and postnatal care services, including reasons for using or not using these services, the services received during antenatal and postnatal care, and cultural practices during antenatal and postnatal periods in Garut, Sukabumi and Ciamis districts of West Java province. A qualitative study was conducted from March to July 2009 in six villages in three districts of West Java province. Twenty focus group discussions (FGDs) and 165 in-depth interviews were carried out involving a total of 295 respondents. The guidelines for FGDs and in-depth interviews included the topics of community experiences with antenatal and postnatal care services, reasons for not attending the services, and cultural practices during antenatal and postnatal periods. Our study found that the main reason women attended antenatal and postnatal care services was to ensure the safe health of both mother and infant. Financial difficulty emerged as the major issue among women who did not fulfil the minimum requirements of four antenatal care services or two postnatal care services within the first month after delivery. This was related to the cost of health services, transportation costs, or both. In remote areas, the limited availability of health services was also a problem, especially if the village midwife frequently travelled out of the village. The distances from health facilities, in addition to poor road conditions were major concerns, particularly for those living in remote areas. Lack of community awareness about the importance of these services was also found, as some community members perceived
Leardmann, Cynthia A; Pietrucha, Amanda; Magruder, Kathryn M; Smith, Besa; Murdoch, Maureen; Jacobson, Isabel G; Ryan, Margaret A K; Gackstetter, Gary; Smith, Tyler C
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.
Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A
For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.
Armistead-Jehle, Patrick; Cole, Wesley R; Stegman, Robert L
The study was designed to replicate and extend pervious findings demonstrating the high rates of invalid neuropsychological testing in military service members (SMs) with a history of mild traumatic brain injury (mTBI) assessed in the context of a medical evaluation board (MEB). Two hundred thirty-one active duty SMs (61 of which were undergoing an MEB) underwent neuropsychological assessment. Performance validity (Word Memory Test) and symptom validity (MMPI-2-RF) test data were compared across those evaluated within disability (MEB) and clinical contexts. As with previous studies, there were significantly more individuals in an MEB context that failed performance (MEB = 57%, non-MEB = 31%) and symptom validity testing (MEB = 57%, non-MEB = 22%) and performance validity testing had a notable affect on cognitive test scores. Performance and symptom validity test failure rates did not vary as a function of the reason for disability evaluation when divided into behavioral versus physical health conditions. These data are consistent with past studies, and extends those studies by including symptom validity testing and investigating the effect of reason for MEB. This and previous studies demonstrate that more than 50% of SMs seen in the context of an MEB will fail performance validity tests and over-report on symptom validity measures. These results emphasize the importance of using both performance and symptom validity testing when evaluating SMs with a history of mTBI, especially if they are being seen for disability evaluations, in order to ensure the accuracy of cognitive and psychological test data. Published by Oxford University Press 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Lange, Rael T; Brickell, Tracey A; French, Louis M
The purpose of this study was to examine the clinical utility of two validity scales designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist-Civilian Version (PCL-C); the Mild Brain Injury Atypical Symptoms Scale (mBIAS) and Validity-10 scale. Participants were 63 U.S. military service members (age: M = 31.9 years, SD = 12.5; 90.5% male) who sustained a mild traumatic brain injury (MTBI) and were prospectively enrolled from Walter Reed National Military Medical Center. Participants were divided into two groups based on the validity scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF): (a) symptom validity test (SVT)-Fail (n = 24) and (b) SVT-Pass (n = 39). Participants were evaluated on average 19.4 months postinjury (SD = 27.6). Participants in the SVT-Fail group had significantly higher scores (p scales (d = 0.69 to d = 2.47). Sensitivity, specificity, and predictive power values were calculated across the range of mBIAS and Validity-10 scores to determine the optimal cutoff to detect symptom exaggeration. For the mBIAS, a cutoff score of ≥8 was considered optimal, which resulted in low sensitivity (.17), high specificity (1.0), high positive predictive power (1.0), and moderate negative predictive power (.69). For the Validity-10 scale, a cutoff score of ≥13 was considered optimal, which resulted in moderate-high sensitivity (.63), high specificity (.97), and high positive (.93) and negative predictive power (.83). These findings provide strong support for the use of the Validity-10 as a tool to screen for symptom exaggeration when administering the NSI and PCL-C. The mBIAS, however, was not a reliable tool for this purpose and failed to identify the vast majority of people who exaggerated symptoms.
VA Education Benefits: Actions Taken, but Outreach and Oversight Could Be Improved. Report to the Ranking Member, Subcommittee on Military Personnel, Committee on Armed Services, House of Representatives. GAO-11-256
The U.S. Department of Veterans Affairs (VA) provided $9 billion in education benefits to service-members and veterans in fiscal year 2010, mostly through the new Post-9/11 GI Bill. In providing education benefits, VA relies on State Approving Agencies (SAA) to approve schools; and on schools to report students' enrollment status. US Government…
Galiano Molina, Sebastián
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...
Cort, Katherine A.; Hostick, Donna J.; Belzer, David B.; Livingston, Olga V.
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.
Bailey, Sharon A.; Baker, Carl P.; Valdez, Patrick LJ
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.
Kaplow, Julie B; Layne, Christopher M; Saltzman, William R; Cozza, Stephen J; Pynoos, Robert S
To date, the US military has made major strides in acknowledging and therapeutically addressing trauma and post-traumatic stress disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (multidimensional grief theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death--especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD.
Kaplow, Julie B.; Layne, Christopher M.; Saltzman, William R.; Cozza, Stephen J.; Pynoos, Robert S.
To date, the U.S. military has made major strides in acknowledging and therapeutically addressing trauma and Posttraumatic Stress Disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (Multidimensional Grief Theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death—especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD. PMID:23760905
Ward, Jonathan Stuart; Barker, Adam David
Infrastructure as a Service computing exhibits a number of properties, which are not found in conventional server deployments. Elasticity is among the most significant of these properties which has wide reaching implications for applications deployed in cloud hosted VMs. Among the applications affected by elasticity is monitoring. In this paper we investigate the challenges of monitoring large cloud deployments and how these challenges differ from previous monitoring problems. In order to mee...
If you are an intermediate or advanced developer deploying your Node.js applications, then this book is for you. If you have already built a Node application or module and want to take your knowledge to the next level, this book will help you find your way.
Koenders, E.; Velt, R. in 't
After the successful demonstrations of cooperative technology by the CVIS and Safespot projects the question remains how this technology can be successfully deployed. This question is explored by the Field Operational Test project FREILOT, which aims to provide fuel economy applications that must be
Schmidt, J.A.; Ogden, J.M.
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
Riggs, Shelley A; Riggs, David S
Deployment separation constitutes a significant stressor for U.S. military men and women and their families. Many military personnel return home struggling with physical and/or psychological injuries that challenge their ability to reintegrate and contribute to marital problems, family dysfunction, and emotional or behavioral disturbance in spouses and children. Yet research examining the psychological health and functioning of military families is scarce and rarely driven by developmental theory. The primary purpose of this theoretical paper is to describe a family attachment network model of military families during deployment and reintegration that is grounded in attachment theory and family systems theory. This integrative perspective provides a solid empirical foundation and a comprehensive account of individual and family risk and resilience during military-related separations and reunions. The proposed family attachment network model will inform future research and intervention efforts with service members and their families.
O'Connor, Kathryn L; Dain Allred, C; Cameron, Kenneth L; Campbell, Darren E; D'Lauro, Christopher J; Houston, Megan N; Johnson, Brian R; Kelly, Tim F; McGinty, Gerald; O'Donnell, Patrick G; Peck, Karen Y; Svoboda, Steven J; Pasquina, Paul; McAllister, Thomas; McCrea, Michael; Broglio, Steven P
The prevalence and possible long-term consequences of concussion remain an increasing concern to the U.S. military, particularly as it pertains to maintaining a medically ready force. Baseline testing is being used both in the civilian and military domains to assess concussion injury and recovery. Accurate interpretation of these baseline assessments requires one to consider other influencing factors not related to concussion. To date, there is limited understanding, especially within the military, of what factors influence normative test performance. Given the significant physical and mental demands placed on service academy members (SAM), and their relatively high risk for concussion, it is important to describe demographics and normative profile of SAMs. Furthermore, the absence of available baseline normative data on female and non-varsity SAMs makes interpretation of post-injury assessments challenging. Understanding how individuals perform at baseline, given their unique individual characteristics (e.g., concussion history, sex, competition level), will inform post-concussion assessment and management. Thus, the primary aim of this manuscript is to characterize the SAM population and determine normative values on a concussion baseline testing battery. All data were collected as part of the Concussion Assessment, Research and Education (CARE) Consortium. The baseline test battery included a post-concussion symptom checklist (Sport Concussion Assessment Tool (SCAT), psychological health screening inventory (Brief Symptom Inventory (BSI-18) and neurocognitive evaluation (ImPACT), Balance Error Scoring System (BESS), and Standardized Assessment of Concussion (SAC). Linear regression models were used to examine differences across sexes, competition levels, and varsity contact levels while controlling for academy, freshman status, race, and previous concussion. Zero inflated negative binomial models estimated symptom scores due to the high frequency of zero scores
behavioral problems in children, a higher risk of divorce, and higher rates of suicide . Not surprisingly, service members and spouses regularly name...areas: marriage, family, psychological and behavioral health, child and teen well-being, and military integration BRIEF 1. What happens to... depressive symptoms among service members and spouses, increased posttraumatic stress disorder and anxiety symptoms among spouses, elevated
.... The purpose of the investigation was to make a comparative study of a number of approximate methods for the design of members under combined loads to ascertain their relative degrees of conservatism...
Footdale, Joseph N.; Murphey, Thomas W.
The detailed mechanical design of a novel deployable support structure that positions and tensions a membrane optic for space imagining applications is presented. This is a complex three-dimensional deployment using freely deploying rollable composite tape spring booms that become load bearing structural members at full deployment. The deployment tests successfully demonstrate a new architecture based on rolled and freely deployed composite tape spring members that achieve simultaneous deployment without mechanical synchronization. Proper design of the flexible component mounting interface and constraint systems, which were critical in achieving a functioning unit, are described. These flexible composite components have much potential for advancing the state of the art in deployable structures, but have yet to be widely adopted. This paper demonstrates the feasibility and advantages of implementing flexible composite components, including the design details on how to integrate with required traditional mechanisms.
Bergmann, Jeffrey S.; Renshaw, Keith D.; Allen, Elizabeth S.; Markman, Howard J.; Stanley, Scott M.
The vast numbers of military service members who have been deployed since 2001 highlights the need to better understand relationships of military couples. A unique consideration in military couples is the concept of meaningfulness of service, or the value service members and their partners place on military service in spite of the sacrifices it requires. In a sample of 606 Army couples, we used path analysis to examine how male service members’ and female spouses’ perceived meaningfulness of service added to the prediction of marital satisfaction in both members of the couple, when accounting for service members’ PTSD symptoms. Spouses’ perceived meaningfulness of service was linked with higher marital satisfaction in spouses, regardless of service member’s perceived meaningfulness of service. Service members’ perceived meaningfulness of service was also associated with increased marital satisfaction in service members, but only when their spouses also perceived higher meaningfulness. There were no significant interactions between service members’ PTSD and either partner’s perceived meaningfulness. Implications for enhanced attention to spousal perceptions of meaningfulness of service are discussed. PMID:25046347
Alff, W. H.
The feasibility and costs were determined for a 1 m to 30 m diameter ambient temperature, infrared to submillimeter orbiting astronomical telescope which is to be shuttle-deployed, free-flying, and have a 10 year orbital life. Baseline concepts, constraints on delivery and deployment, and the sunshield required are examined. Reflector concepts, the optical configuration, alignment and pointing, and materials are also discussed. Technology studies show that a 10 m to 30 m diameter system which is background and diffraction limited at 30 micron m is feasible within the stated time frame. A 10 m system is feasible with current mirror technology, while a 30 m system requires technology still in development.
Meinel, A. B.; Meinel, M. P.; Woolf, N. J.
Both the theoretical reasons for considering a non-circular format for the Large Deployable Reflector, and a potentially realizable concept for such a device, are discussed. The optimum systems for diffraction limited telescopes with incoherent detection have either a single filled aperture, or two such apertures as an interferometer to synthesize a larger aperture. For a single aperture of limited area, a reflector in the form of a slot can be used to give increased angular resolution. It is shown how a 20 x 8 meter telescope can be configured to fit the Space Shuttle bay, and deployed with relatively simple operations. The relationship between the sunshield design and the inclination of the orbit is discussed. The possible use of the LDR as a basic module to permit the construction of supergiant space telescopes and interferometers both for IR/submm studies and for the entire ultraviolet through mm wave spectral region is discussed.
Aiftimiei, D. C.; Fattibene, E.; Gargana, R.; Panella, M.; Salomoni, D.
Deploying a complex application on a Cloud-based infrastructure can be a challenging task. In this contribution we present an approach for Cloud-based deployment of applications and its present or future implementation in the framework of several projects, such as “!CHAOS: a cloud of controls” , a project funded by MIUR (Italian Ministry of Research and Education) to create a Cloud-based deployment of a control system and data acquisition framework, “INDIGO-DataCloud” , an EC H2020 project targeting among other things high-level deployment of applications on hybrid Clouds, and “Open City Platform”, an Italian project aiming to provide open Cloud solutions for Italian Public Administrations. We considered to use an orchestration service to hide the complex deployment of the application components, and to build an abstraction layer on top of the orchestration one. Through Heat  orchestration service, we prototyped a dynamic, on-demand, scalable platform of software components, based on OpenStack infrastructures. On top of the orchestration service we developed a prototype of a web interface exploiting the Heat APIs. The user can start an instance of the application without having knowledge about the underlying Cloud infrastructure and services. Moreover, the platform instance can be customized by choosing parameters related to the application such as the size of a File System or the number of instances of a NoSQL DB cluster. As soon as the desired platform is running, the web interface offers the possibility to scale some infrastructure components. In this contribution we describe the solution design and implementation, based on the application requirements, the details of the development of both the Heat templates and of the web interface, together with possible exploitation strategies of this work in Cloud data centers.
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
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.
Donoho, Carrie J; Bonanno, George A; Porter, Ben; Kearney, Lauren; Powell, Teresa M
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.
M. A. Rynearson; M. M. Plum
The U.S. Department of Energy (DOE) is responsible for the final disposition of legacy spent nuclear fuel (SNF). As a response, DOE's National Spent Nuclear Fuel Program (NSNFP) has been given the responsibility for the disposition of DOE-owned SNF. Many treatment technologies have been identified to treat some forms of SNF so that the resulting treated product is acceptable by the disposition site. One of these promising treatment processes is the electrometallurgical treatment (EMT) currently in development; a second is an Acid Wash Decladding process. The NSNFP has been tasked with identifying possible strategies for the deployment of these treatment processes in the event that a treatment path is deemed necessary. To support the siting studies of these strategies, economic evaluations are being performed to identify the least-cost deployment path. This model (tool) was developed to consider the full scope of costs, technical feasibility, process material disposition, and schedule attributes over the life of each deployment alternative. Using standard personal computer (PC) software, the model was developed as a comprehensive technology economic assessment tool using a Life-Cycle Cost (LCC) analysis methodology. Model development was planned as a systematic, iterative process of identifying and bounding the required activities to dispose of SNF. To support the evaluation process, activities are decomposed into lower level, easier to estimate activities. Sensitivity studies can then be performed on these activities, defining cost issues and testing results against the originally stated problem
Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel
Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, this study was designed to evaluate Australian DMAT experience in relation to the human resources issues associated with deployment. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. The response rate for this survey was 50% (59/118). Most personnel had deployed to the Asian Tsunami affected areas with DMAT members having significant clinical and international experience. While all except one respondent stated they received a full orientation prior to deployment, only 34% of respondents (20/59) felt their role was clearly defined pre deployment. Approximately 56% (33/59) felt their actual role matched their intended role and that their clinical background was well suited to their tasks. Most respondents were prepared to be available for deployment for 1 month (34%, 20/59). The most common period of notice needed to deploy was 6-12 hours for 29% (17/59) followed by 12-24 hours for 24% (14/59). The preferred period of overseas deployment was 14-21 days (46%, 27/59) followed by 1 month (25%, 15/59) and the optimum shift period was felt to be 12 hours by 66% (39/59). The majority felt that there was both adequate pay (71%, 42/59) and adequate indemnity (66%, 39/59). Almost half (49%, 29/59) stated it was better to work with people from the same hospital and, while most felt their deployment could be easily covered by staff from their workplace (56%, 33/59) and caused an inconvenience to their colleagues (51%, 30/59), it was less likely to interrupt service delivery in their workplace (10%, 6/59) or cause an inconvenience to patients (9%, 5/59). Deployment was felt to benefit the affected community by nearly all
Nelson, C Beau; Zivin, Kara; Walters, Heather; Ganoczy, Dara; MacDermid Wadsworth, Shelley; Valenstein, Marcia
Employment is a vital part of the postdeployment return to civilian life. This study investigated factors associated with employment-related outcomes (employment status, self-reported work performance, and self-reported work satisfaction) among National Guard members returning from Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn deployments. The sample consisted of 1,151 National Guard service members who had returned from overseas deployments approximately six months earlier. Bivariate and multivariable analyses were performed to examine associations between predictors and employment-related outcome variables. Higher-risk alcohol use was associated with reduced odds of being employed as well as with lower ratings of work satisfaction, whereas psychiatric symptom load was associated with lower self-reported work performance and work satisfaction ratings. Perceived social resources were associated with higher self-reported work performance and work satisfaction, whereas better physical functioning was associated with better self-reported work performance. Policy makers and clinicians may need to consider and assess alcohol use among unemployed National Guard members. They may also need to consider psychiatric symptom load and physical functioning among employed service members who perceive poor work performance and have low work satisfaction. Further research is needed on causal links between these predictors and employment outcomes.
This report analyses costs and benefits of Intelligent Transportation Systems (ITS) deployed by : the Michigan Department of Transportation (MDOT). MDOT ITS focuses on traffic incident : management and also provide Freeway Courtesy Patrol services. A...
Arenstein, Stacy J.
Approved for public release; distribution is unlimited. The primary goal of this research is to investigate whether the length and frequency of deployments affect the likelihood of divorce. The study uses data from the Contingency Tracking System (CTS) and the Active Duty Military Personnel file. The sample includes all active duty Navy and Marine Corps members from 2000 to 2009. Three models of divorce are estimated, each with a different control for the stress of deployment on the f...
Preliminary examination of the impact of traumatic brain injury and posttraumatic stress disorder on self-regulated learning and academic achievement among military service members enrolled in postsecondary education.
Ness, Bryan M; Vroman, Kerryellen
Delineate the effects of self-reported traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) on self-regulated learning and academic achievement for university-enrolled military Service members. Students (N = 192) from 8 regionally diverse universities, representing an estimated 6% of Service members enrolled across schools. Public universities that are members of the Servicemember Opportunity College consortium. Cross-sectional study evaluating the relationships between self-reported TBI, PTSD, and self-regulated learning variables and their contribution to academic achievement. Self-report of military service; symptoms of TBI and PTSD; self-regulation strategies including effort, time/environment regulation, and academic self-efficacy; and grade point average (GPA). There was no effect of self-reported TBI or PTSD on GPA, effort regulation, or time/environment regulation strategies; however, participants with TBI or PTSD reported significantly lower academic self-efficacy. Multiple regression analysis revealed self-efficacy was the strongest predictor of GPA among all participants, followed by military rank. The sample consisted of high achieving students responsive to a university administrator, which raises the possibility of sampling bias. Because of the low recruitment rate for this study and lack of published research on this subject, replicating the results is necessary before drawing generalizable conclusions about the population.
Understanding health-related quality of life in caregivers of civilians and service members/veterans with traumatic brain injury: Establishing the reliability and validity of PROMIS Fatigue and Sleep Disturbance item banks.
Carlozzi, Noelle E; Ianni, Phillip A; Tulsky, David S; Brickell, Tracey A; Lange, Rael T; French, Louis M; Cella, David; Kallen, Michael A; Miner, Jennifer A; Kratz, Anna L
To examine the reliability and validity of Patient Reported Outcomes Measurement Information System (PROMIS) measures of sleep disturbance and fatigue in TBI caregivers and to determine the severity of fatigue and sleep disturbance in these caregivers. Cross-sectional survey data collected through an online data capture platform. Four rehabilitation hospitals and Walter Reed National Military Medical Center. Caregivers (N=560) of civilians (n=344) and service member/veterans (n=216) with TBI. Not Applicable MAIN OUTCOME MEASURES: PROMIS sleep and fatigue measures administered as both computerized adaptive tests (CATs) and 4-item short forms (SFs). For both samples, floor and ceiling effects for the PROMIS measures were low (internal consistency was very good (all alphas ≥0.80), and test-retest reliability was acceptable (all r≥0.70 except for the fatigue CAT in the service member/veteran sample r=0.63). Convergent validity was supported by moderate correlations between the PROMIS and related measures. Discriminant validity was supported by low correlations between PROMIS measures and measures of dissimilar constructs. PROMIS scores indicated significantly worse sleep and fatigue for those caring for someone with high levels versus low levels of impairment. Findings support the reliability and validity of the PROMIS CAT and SF measures of sleep disturbance and fatigue in caregivers of civilians and service members/veterans with TBI. Copyright © 2018. Published by Elsevier Inc.
8217, Psychological Medicine, vol. 38, no. 4, pp. 511-522. Jacobson IG, Ryan MAK, Hooper TI, Smith TC, Amoroso PJ, Boyko EJ, Gackstetter GD, Wells TS...Instruments Embedded within the Survey Construct Inventory Physical, mental, and functional health Short-Form 36 Psychological assessment...including symptoms of Patient Health Questionnaire depression, anxiety, panic syndrome, binge-eating, bulimia (PHQ) nervosa, and alcohol abuse Post
Dandeker, Christopher; French, Claire; Birtles, Catherine; Wessely, S
Introduction and Aims: During deployments, Service wives have to adapt to being alone and taking sole responsibility for their families and house-holds whilst dealing with the additional stress about whether their loved ones will return...
Bordy, J.M.; Stadtmann, H.; Ambrosi, P.
of the dosimetry of routine services. It was assumed that each service would have already done a type test before performing routine dosimetry: the radiation fields were chosen to simulate, as far as possible, workplace radiation fields by mixing combining energies and incident angles. The results of photon...... for External Radiation. The other two papers are included in this issue of Radiation Protection Dosimetry....
waking up in between. Some things are triggers for seizures. These include: • Stress • Overuse of alcohol and/or other drugs • Being overworked and/or...weight gain. In severe cases, both men and women may experience thoughts of suicide . If you suspect that your family member is depressed, ask your...personal appearance • Thoughts of suicide , suicide attempts. How you can help: • Offer emotional support, understanding, patience, and encouragement
Delene, J.G.; Fuller, L.C.; Hudson, C.R.
The Advanced Liquid Metal Reactor (ALMR) has the potential to extend the economic life of the nuclear option and of reducing the number of high level waste repositories which will eventually be needed in an expanding nuclear economy. This paper reports on an analysis which models and evaluates the economics of the use of ALMRs as a component of this country's future electricity generation mix. The ALMR concept has the ability to utilize as fuel the fissile material contained in previously irradiated nuclear fuel (i.e., spent fuel) or from surplus weapons grade material. While not a requirement for the successful deployment of ALMR power plant technology, the reprocessing of spent fuel from light water reactors (LWR) is necessary for any rapid introduction of ALMR power plants. In addition, the reprocessing of LWR spent fuel may reduce the number of high level waste repositories needed in the future by burning the long-lived actinides produced in the fission process. With this study, the relative economics of a number of potential scenarios related to these issues are evaluated. While not encompassing the full range of all possibilities, the cases reported here provide an indication of the potential costs, timings, and relative economic attractiveness of ALMR deployment
Delene, J.G.; Fuller, L.C.; Hudson, C.R.
This analysis seeks to model and evaluate the economics of the use of Advanced Liquid Metal Reactors (ALMR) as a component of this country's future electricity generation mix. The ALMR concept has the ability to utilize as fuel the fissile material contained in previously irradiated nuclear fuel (i.e., spent fuel). While not a requirement for the successful deployment of ALMR power plant technology, the reprocessing of spent fuel from light water reactors (LWR) is necessary for any rapid introduction of ALMR power plants. In addition, the reprocessing of LWR spent fuel may reduce the number of high level waste repositories needed in the future by burning the long-lived actinides produced in the fission process. With this study, the relative economics of a number of potential scenarios related to these issues are evaluated. While not encompassing the full range of all possibilities, the cases reported here provide an indication of the potential costs, timings, and relative economic attractiveness of ALMR deployment
... and application as is given to the term for income tax purposes. (3) (i) If a minister is performing..., is engaged by N University to teach history and mathematics. He performs no other service for N...
... term “religious organization” has the same meaning and application as is given to the term for income... minister, is engaged by N University to teach history and mathematics. He performs no other service for N...
Kennedy, Timothy F. (Inventor); Fink, Patrick W. (Inventor); Chu, Andrew W. (Inventor); Lin, Gregory Y. (Inventor)
Apparatus and methods for enhancing the gain of a wireless signal are provided. In at least one specific embodiment, the apparatus can include a screen comprised of one or more electrically conductive regions for reflecting electromagnetic radiation and one or more non-conductive regions for permitting electromagnetic radiation therethrough. The one or more electrically conductive regions can be disposed adjacent to at least one of the one or more non-conductive regions. The apparatus can also include a support member disposed about at least a portion of the screen. The screen can be capable of collapsing by twisting the support member in opposite screw senses to form interleaved concentric sections.
McCarthy, Michael D; Thompson, Sanna J; Knox, Kerry L
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.
The deployment of Clean Coal Technologies (CCT) is discussed by asserting that in the case of commercializing CCT, the government's involvement should not stop at the demonstration gate. Two areas in this regard are described. First, the need for the domestic DOE CCT Program to focus on the domestic deployment of demonstrated technologies, and second, the need to recognize that to participate in the phenomenal growth of international power markets through use of clean coal or advanced coal technologies an aggressive partnering between the government and industry to demonstrate technologies abroad will be required. The Clean Coal Technology Coalition's (CCT) primary mission has been to promote the development and use of CCTs. The CCT is a strong advocate for the DOE CCT Program and applauds the Department's and industry's success at developing many coal-based technologies. By current design, the DOE program is said to go no further than the initial demonstration of a technology. Since the inception of CCT in 1986, the Coalition has advocated the need to pursue a partnership with government in which more than one demonstration of the same or similar technology is supported by the clean coal program. Only in this way can one be assured of widespread acceptance of any given technology. There exists a gap (call it a open-quotes risk gapclose quotes) between CCTs that have been successfully demonstrated (and presumably available for commercial use) and their widespread commercial use. A technology matrix has been developed in which the developmental status of a variety of clean coal technologies is demonstrated. While still too early to pass judgment, it appears that while success is being achieved in demonstrating advanced coal technologies, the market place - for several reasons - is not, indeed may have no plans, to adopt these technologies
Kim, B; Avery, P; Thomas, M; Wuerthwein, F
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
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: email@example.com, E-mail: firstname.lastname@example.org, E-mail: email@example.com, E-mail: firstname.lastname@example.org
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.
Long, Larry D.
Fraternities and sororities promote the ideals of scholarship, leadership, service, and friendship. Little or no research, however, has demonstrated that college students who join fraternal organizations actually grow in these areas as a result of their fraternal experience. The purpose of this descriptive study was to assess the extent to which…
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
Federal Laboratory Consortium — Volpe's Infrastructure Engineering and Deployment Division advances transportation innovation by being leaders in infrastructure technology, including vehicles and...
Wilcox, Sherrie L; Oh, Hyunsung; Redmond, Sarah A; Chicas, Joseph; Hassan, Anthony M; Lee, Pey-Jiuan; Ell, Kathleen
More Reserve and Guard members have been activated in the past few years than in any other time in history. In addition to the high rates of psychological and behavioral challenges among military personnel, there are other equally important post-deployment reintegration challenges. Post-deployment reintegration challenges are particularly important to Reserve and Guard members, who transition rapidly from civilian-military-civilian. This study aims to describe the scope of challenges that a battalion of National Guard members (NGM) report experiencing after returning from a one-year deployment to Iraq. This article reports data from a sample of 126 NGM who recently returned from a one-year deployment to Iraq. The scope of post-deployment problems at baseline, 3- and 6-month post-deployment are presented. Overall, the rates of post-deployment psychological and behavioral problems were elevated upon returning from deployment and remained fairly constant for up to 6 months post-deployment. Approximately 30% of respondents were unsatisfied with their relationship and upwards of 30% reported family reintegration challenges. Comparisons with similar research and implications for prevention and improvement of post-deployment quality of life are addressed.
Walsh, Tova B; Dayton, Carolyn J; Erwin, Michael S; Muzik, Maria; Busuito, Alexandra; Rosenblum, Katherine L
Although often eagerly anticipated, reunification after deployment poses challenges for families, including adjusting to the parent-soldier's return, re-establishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological effects. Fourteen male service members, previously deployed to a combat zone, parent to at least one child under seven years of age, were interviewed about their relationships with their young children. Principles of grounded theory guided data analysis to identify key themes related to parenting young children after deployment. Participants reported significant levels of parenting stress and identified specific challenges, including difficulty reconnecting with children, adapting expectations from military to family life, and coparenting. Fathers acknowledged regret about missing an important period in their child's development and indicated a strong desire to improve their parenting skills. They described a need for support in expressing emotions, nurturing, and managing their tempers. Results affirm the need for support to military families during reintegration and demonstrate that military fathers are receptive to opportunities to engage in parenting interventions. Helping fathers understand their children's behavior in the context of age-typical responses to separation and reunion may help them to renew parent-child relationships and reengage in optimal parenting of their young children.
Yehuda, Rachel; Vermetten, Eric; McFarlane, Alexander C.; Lehrner, Amy
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
hyperactivity SdQ (Goodman, 1997) x x x x Child peer relationships SdQ (Goodman, 1997) x x x x Child prosocial behavior SdQ (Goodman, 1997) x x x x...2 Th e d ep lo ym en t Life Stu d y: M eth o d o lo g ical O verview an d B aselin e Sam p le d escrip tio n Table A.1 List of Constructs and...Life Study x x List o f C o n stru cts an d M easu res fo r th e d ep lo ym en t Life Stu d y 3 Survey Topic Measure Source Service Member Spouse
Zhao, Gansen; Chunming, Rong; Jaatun, Martin Gilje; Sandnes, Frode Eika
Cloud computing has become a popular choice as an alternative to investing new IT systems. When making decisions on adopting cloud computing related solutions, security has always been a major concern. This article summarizes security concerns in cloud computing and proposes five service deployment models to ease these concerns. The proposed models provide different security related features to address different requirements and scenarios and can serve as reference models for deployment. D...
Woodruff, Susan I; Galarneau, Michael R; Luu, Bethi N; Sack, Daniel; Han, Peggy
There is a need for more work to understand the quality of life (QOL) outcomes of survivors of Operations Enduring Freedom and Iraqi Freedom combat injury to improve care and treatment, and prevent poor physical, psychological, and social outcomes. We describe the study design and methods of the Wounded Warrior Recovery Project, a study supported by the Department of Defense that will track close to 10,000 military personnel wounded in Operations Enduring Freedom and Iraqi Freedom. The overall objective of the 6-year longitudinal study is to track changes in QOL and describe variations in those changes as they relate to sociodemographic factors, injury characteristics, service-related factors, clinical/diagnostic measures including traumatic brain injury and posttraumatic stress disorder, and medical procedures and services. The Wounded Warrior Recovery Project study will be among the first longitudinal population-based investigations of QOL outcomes after combat injury and will provide a basis upon which large-scale epidemiological studies can be conducted. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Understanding Health-related Quality of Life in Caregivers of Civilians and Service Members/Veterans with Traumatic Brain Injury: Establishing the Reliability and Validity of PROMIS Mental Health Measures.
Carlozzi, Noelle E; Hanks, Robin; Lange, Rael T; Brickell D Psych, Tracey A; Ianni, Phillip A; Miner, Jennifer A; French Psy D, Louis M; Kallen, Michael A; Sander, Angelle M
To provide important reliability and validity data to support the use of the PROMIS Mental Health measures in caregivers of civilians or service members/veterans with traumatic brain injury (TBI). Patient-reported outcomes surveys administered through an electronic data collection platform. Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. 560 caregivers of individuals with a documented TBI (344 civilians and 216 military) INTERVENTION: Not Applicable MAIN OUTCOME MEASURES: PROMIS Anxiety, Depression, and Anger Item Banks RESULTS: Internal consistency for all of the PROMIS Mental Health item banks was very good (all α > .86) and three-week test retest reliability was good to adequate (ranged from .65 to .85). Convergent validity and discriminant validity of the PROMIS measures was also supported. Caregivers of individuals that were low functioning had worse emotional HRQOL (as measured by the three PROMIS measures) than caregivers of high functioning individuals, supporting known groups validity. Finally, levels of distress, as measured by the PROMIS measures, were elevated for those caring for low-functioning individuals in both samples (rates ranged from 26.2% to 43.6% for caregivers of low-functioning individuals). Results support the reliability and validity of the PROMIS Anxiety, Depression, and Anger item banks in caregivers of civilians and service members/veterans with TBI. Ultimately, these measures can be used to provide a standardized assessment of HRQOL as it relates to mental health in these caregivers. Copyright © 2018. Published by Elsevier Inc.
Beaumont, Steven P; Allan, Helen T
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
Sairsingh, Holly; Solomon, Phyllis; Helstrom, Amy; Treglia, Dan
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
In field settings, female service members may not have adequate access to bathrooms, showers, laundry, or sanitary products necessary to maintain adequate feminine hygiene; therefore, service women may be at risk for vaginal yeast infections while deployed. During the 6-year surveillance period, nearly 3,000 U.S. military service women were diagnosed with at least one clinically significant yeast infection while supporting combat operations in Southwest/Central Asia. The crude overall incidence rate was 35.1 per 1,000 person-years (p-yrs). Overall incidence rates were higher among black, non-Hispanic service women, and among those in the Army and Air Force, in enlisted grades, and in communications/intelligence and motor transport occupations. The yearly rate of yeast infections was relatively stable from 2008 through 2010, then decreased in 2011 through 2013. Prior to deploying to austere operational settings, female service members should be provided practical and useful information, realistic training, and material support to decrease the risk of acquiring and increase the effectiveness of treating clinically and military operationally significant yeast infections.
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.63) is Palau which deposited its Instrument of Acceptance of the Statute on 2 March 2007. The Attachment hereto shows the dates on which the present 144 Member States became Members [fr
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.63) is Palau which deposited its Instrument of Acceptance of the Statute on 2 March 2007. The Attachment hereto shows the dates on which the present 144 Member States became Members [es
Romaní-Romaní, Franco; Curisinche-Rojas, Maricela; Arteaga, Norka Rojas; Lopez, Pedro Riega; Cabezas, César
There is a gap between human resources and technical-operational education that limits the Peruvian health system's ability to implement public health interventions. The Peruvian Ministry of Health, through the National Health Institute and the Ministry of Defense, implemented a Public Health Training Program addressed to young full-time military servicemen, on the basis of the competency profile of a public health technician. The program consists of seven thematic units given in 390 hours, 200 of which correspond to classroom and field practices. Between July 2014 and December 2015, the program has been carried out in 10 venues of the three armed forces, training and certifying 405 young servicemen. The intervention provides the military service with an additional educational benefit, making it more appealing as a chance for development and opens up a line of work in the public health sector for young people in more remote areas. This experience seeks to increase public health-trained human resources to a technical-operational level. In collaboration with regional governments, graduates are expected to be welcomed and included in the public health system.
Thandi, G; Greenberg, N; Fear, N T; Jones, N
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: email@example.com
The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described
Thomsen, Cynthia J; Stander, Valerie A; McWhorter, Stephanie K; Rabenhorst, Mandy M; Milner, Joel S
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.
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
The proposed method of analysis for concrete members subjected to temperature changes is consistent with the requirements of ultimate strength design. This also facilitates the provision of the same safety margin as for other loads. Due to cracks and creep in concrete, thermal stresses are nonlinear; they are dependent on the effective member stiffness, which in turn vary with the magnitude of loading. Therefore it is inconsistent to have an ultimate strength design in conjunction with an analysis based on the linear elastic theory. It is proposed that when the requirements of serviceability are met, the neutral axis corresponding to the ultimate load capacity conditions be considered for temperature-induced loadings. This conforms with the fact that the thermal load, because of creep and formation of cracks in the member, can be self-relieving as the failure load condition or ultimate capacity is approached. The maximum thermal load that can develop in dependent on the effective cross section of the member. Recommendations are made for determining the average effective member stiffness, which lies between the stiffness corresponding to the cracked (at ultimate condition) and the uncracked sections. In the proposed method, thermal stresses are not considered completely self-relieving. The stresses are considered simultaneously with stresses resulting from other causes. A step-by-step approach is presented for analysis and design of concrete members subjected to temperature changes
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
Full Text Available Many clouds and network testbeds use disk images to initialize local storage on their compute devices. Large facilities must manage thousands or more images, requiring significant amounts of storage. At the same time, to provide a good user experience, they must be able to deploy those images quickly. Driven by our experience in operating the Emulab site at the University of Utah---a long-lived and heavily-used testbed---we have created a new service for efficiently storing and deploying disk images. This service exploits the redundant data found in similar images, using deduplication to greatly reduce the amount of physical storage required. In addition to space savings, our system is also designed for highly efficient image deployment---it integrates with an existing highly-optimized disk image deployment system, Frisbee, without significantly increasing the time required to distribute and install images. In this paper, we explain the design of our system and discuss the trade-offs we made to strike a balance between efficient storage and fast disk image deployment. We also propose a new chunking algorithm, called AFC, which enables fixed-size chunking for deduplicating allocated disk sectors. Experimental results show that our system reduces storage requirements by up to 3x while imposing only a negligible runtime overhead on the end-to-end disk-deployment process.
Boulos, David; Fikretoglu, Deniz
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
Boulos, David; Fikretoglu, Deniz
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
Sandoz, Emily K; Moyer, Danielle N; Armelie, Aaron P
Postdeployment reintegration may present an exceptional challenge to service members and their families; yet, overcoming this challenge seems to strengthen family relationships through a shared sense of purpose. Navigating family reintegration may be an important determinant of long-term psychological well-being. If the needs of military families are to be answered effectively, it is of critical importance to identify the skills that facilitate positive reintegration following deployment. This article proposes psychological flexibility as a group of interrelated skills that could be directly intervened on to facilitate not only resilience but also positive growth and development. This paper focuses on the conceptualization of family reintegration in terms of psychological flexibility, including common deficits observed in this population and potential goals of treatment. Video Abstract. © 2014 American Association for Marriage and Family Therapy.
Full Text Available The institutionally powered Personal Learning Environment (iPLE constitutes our vision of how Web 2.0 technologies, people arrangement and data sharing could be applied for delivering open, flexible, distributed and learner-centred learning environments to university members. Based on the iPLE, this paper explores a strategy approach that universities could follow in order to deploy eLearning 2.0 tools and services. With that aim in mind, we review the patterns that Web 2.0 has successfully applied, and have been proved to encourage people to interact and to share information. Then, we present an eLearning 2.0 provisioning strategy based on iPLEs. Finally, we explain how this strategy can help translating Web 2.0 patterns to learning, and positioning universities as eLearning 2.0 providers.
Marnay, Chris; Blanco, Raquel; Hamachi, Kristina S.; Kawaan, Cornelia P.; Osborn, Julie G.; Rubio, F. Javier
The goal of this work is to create an integrated framework for forecasting the adoption of distributed energy resources (DER), both by electricity customers and by the various institutions within the industry itself, and for evaluating the effect of this adoption on the power system, particularly on the overall reliability and quality of electrical service to the end user. This effort and follow on contributions are intended to anticipate and explore possible patterns of DER deployment, thereby guiding technical work on microgrids towards the key technical problems. An early example of this process addressed is the question of possible DER adopting customer disconnection. A deployment scenario in which many customers disconnect from their distribution company (disco) entirely leads to a quite different set of technical problems than a scenario in which customers self generate a significant share or all of their on-site electricity requirements and additionally buy and sell energy and ancillary services (AS) locally and/or into wider markets. The exploratory work in this study suggests that the economics under which customers disconnect entirely are unlikely.
Dorsey, J. T.
An analytical study was made to evaluate changes in the fundamental frequency of a two dimensional cantilevered truss boom at various stages of deployment. The truss could be axially deployed or retracted and undergo a variety of controlled geometry changes by shortening or lengthening the telescoping diagonal members in each bay. Both untapered and tapered versions of the truss boom were modeled and analyzed by using the finite element method. Large reductions in fundamental frequency occurred for both the untapered and tapered trusses when they were uniformly retracted or maneuvered laterally from their fully deployed position. These frequency reductions can be minimized, however, if truss geometries are selected which maintain cantilever root stiffness during truss maneuvers.
Carl Andrew Castro
Full Text Available This paper reviews the psychological health research conducted in the United States in support of combat veterans from Iraq and Afghanistan, using the Military Psychological Health Research Continuum, which includes foundational science, epidemiology, etiology, prevention and screening, treatment, follow-up care, and services research. The review is limited to those studies involving combat veterans and military families. This review discusses perplexing issues regarding the impact of combat on the mental health of service members such as risk and resilience factors of mental health, biomarkers of posttraumatic stress syndrome (PTSD, mental health training, psychological screening, psychological debriefing, third location decompression, combat and suicide, the usefulness of psychotherapy and drug therapy for treating PTSD, role of advanced technology, telemedicine and virtual reality, methods to reduce stigma and barriers to care, and best approaches to the dissemination of evidence-based interventions. The mental health research of special populations such as women, National Guardsmen and reservists, and military families is also presented. The review concludes by identifying future areas of research.
...: To investigate the perceived psychological support requirements for service personnel on peacekeeping deployments when they return home from operations and examine their views on the requirement...
Düşünce Tarzlarına Dayalı Kalite Fonksiyon Göçerimi Aracılığıyla Hizmet İşletmelerine Yönelik Bir İş Değerleme Uygulaması (An Application of Job Evaluation for Service Businesses Through Thinking Styles-Based Quality Function Deployment
Full Text Available Efficiency and fairness in the payment and incentive systems is known to be effective on the job outcomes such as employee satisfaction, loyalty and performance. The main purpose of this study is to search for the applicability of job evaluation techniques, which has the philosophy of equal pay for equal work, in service industry influentially, then to propose a job evaluation technique for service organizations. With this purpose, a five star hotel case is used to illustrate to discuss the advantages of the propoed approach. At the end of evaluation of ten different jobs through the combination of quality function deployment and thinking styles of employees, jobs that require legislative, executive and hierarchic thinking styles were determined as the most valuable jobs relaive to the compared ones. The relative weights in the house of quality were mentioned to be used as ratio when determining the payments and intentives
A guide for understanding, deploying, and managing Internet Protocol version 6 The growth of the Internet has created a need for more addresses than are available with Internet Protocol version 4 (IPv4)-the protocol currently used to direct almost all Internet traffic. Internet Protocol version 6 (IPv6)-the new IP version intended to ultimately succeed IPv4-will expand the addressing capacity of the Internet to support the explosive growth of users and devices on the Internet as well as add flexibility to allocating addresses and efficiency for routing traffic. IPv6 Deploy
Chang, Victor; Walters, Robert John; Wills, Gary
This paper describes service portability for a private cloud deployment, including a detailed case study about Cloud Storage and bioinformatics services developed as part of the Cloud Computing Adoption Framework (CCAF). Our Cloud Storage design and deployment is based on Storage Area Network (SAN) technologies, details of which include functionalities, technical implementation, architecture and user support. Experiments for data services (backup automation, data recovery and data migration) ...
Deployment of Ahmadu Bello University Zaria, Nigeria Institutional Digital Repository. ... that repositories are very important to universities in helping them showcase, manage and capture their intellectual assets as a part of their information service strategy and contribution to universal access to knowledge and information.
E-commerce firms are increasingly adopting recommendation systems to effectively target customers with products and services. The first essay examines the impact that improving a recommender system has on firms that deploy such systems. A market with customers heterogeneous in their search costs is considered. We find that in a monopoly, a firm…
qualitative case study approach was used with the deployment of ... QFD appears to supersede most models, where it compounds the market, social ... valuable strategy by means of which to align business, industry and ... business models' adoption in the services sector, ..... quality concepts are not effectively translated into.
Kwan, Jamie; Jones, Margaret; Somaini, Greta; Hull, Lisa; Wessely, Simon; Fear, Nicola T; MacManus, Deirdre
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.
... different from hearing about conflicts and violence that break out in the world during our own time. If someone you care about is in the military and is deployed for duty, it's natural to worry about their safety. That's especially true if the person is going ...
McKenna, M. H.; McComas, S.; Simpson, C. P.; Diaz-Alvarez, H.; Costley, R. D.; Hayward, C.; Golden, P.; Endress, A.
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.
The initiative of this work is to develop a cooperative process for continual evolution of an integrated, time phased avionics technology plan that involves customers, technologists, developers, and managers. This will be accomplished by demonstrating a computer network technology to augment the Quality Function Deployment (QFD). All results are presented in viewgraph format.
Morris-Butler, R; Jones, N; Greenberg, N; Campion, B; Wessely, S
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.
Pierce, Penny F; Lewandowski-Romps, Lisa; Silverschanz, Perry
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.
Yablonsky, Abigail M; Barbero, Edie Devers; Richardson, Jeanita W
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.
Avlonitis, Viktor; Hsuan, Juliana
the effects of modularity and integrality on a range of different analytical levels in service architectures. Taking a holistic approach, the authors synthesize and empirically deploy a framework comprised of the three most prevalent themes in modularity and service design literature: Offering (service...... insights on the mirroring hypothesis of modularity theory to services. Originality/value The paper provides a conceptualization of service architectures drawing on service design, modularity, and market relationships. The study enriches service design literature with elements from modularity theory...
Adler, Amy B; Adrian, Amanda L; Hemphill, Marla; Scaro, Nicole H; Sipos, Maurice L; Thomas, Jeffrey L
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
Short, W.; Sullivan, P.; Mai, T.; Mowers, M.; Uriarte, C.; Blair, N.; Heimiller, D.; Martinez, A.
The Regional Energy Deployment System (ReEDS) is a deterministic optimization model of the deployment of electric power generation technologies and transmission infrastructure throughout the contiguous United States into the future. The model, developed by the National Renewable Energy Laboratory's Strategic Energy Analysis Center, is designed to analyze the critical energy issues in the electric sector, especially with respect to potential energy policies, such as clean energy and renewable energy standards or carbon restrictions. ReEDS provides a detailed treatment of electricity-generating and electrical storage technologies and specifically addresses a variety of issues related to renewable energy technologies, including accessibility and cost of transmission, regional quality of renewable resources, seasonal and diurnal generation profiles, variability of wind and solar power, and the influence of variability on the reliability of the electrical grid. ReEDS addresses these issues through a highly discretized regional structure, explicit statistical treatment of the variability in wind and solar output over time, and consideration of ancillary services' requirements and costs.
Amendolia, S R; Frate, C; Gálvez, J; Hassan, W; Hauer, T; Manset, D; McClatchey, R; Odeh, M; Rogulin, D; Solomonides, T; Warren, R
The MammoGrid project has deployed its Service-Oriented Architecture (SOA)-based Grid application in a real environment comprising actual participating hospitals. The resultant setup is currently being exploited to conduct rigorous in-house tests in the first phase before handing over the setup to the actual clinicians to get their feedback. This paper elaborates the deployment details and the experiences acquired during this phase of the project. Finally the strategy regarding migration to an upcoming middleware from EGEE project will be described. This paper concludes by highlighting some of the potential areas of future work.
Tri-Service Nursing Research Program (TSNRP); Defense Medical Research & Development Program (DMRDP): NIH; Congressionally Directed Medical Research ...Medics - Mission Ready- Patient Focused +Past and Current Research +Parent Reported + Quantitative vs. Qualitative +Combat vs. Peacetime Deployments...Base Deployments presented at/published to TSNRP Research /EBP Dissemination Course, Ellicott City, MD, 25-26 April 2017 in accordance with MDWI 41
It is U.S. policy that medical and personnel information systems be designed, integrated, and utilized with military medical surveillance to protect the physical and mental health of Service members throughout...
Schrader, Andrew J; Tribble, David R; Riddle, Mark S
To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD will seek medical care earlier in the disease course compared with current patterns; the second strategy aimed to optimize provider treatment practices through the implementation of a Department of Defense Clinical Practice Guideline. Outcome measures selected to compare management strategies were duty days lost averted (DDL-averted) and a cost effectiveness ratio (CER) of cost per DDL-averted (USD/DDL-averted). Increasing health care and by seeking it more often and earlier in the disease course as a stand-alone management strategy produced more DDL (worse) than the base case (up to 8,898 DDL-gained per year) at an increased cost to the Department of Defense (CER $193). Increasing provider use of an optimal evidence-based treatment algorithm through Clinical Practice Guidelines prevented 5,299 DDL per year with overall cost savings (CER -$74). A combination of both strategies produced the greatest gain in DDL-averted (6,887) with a modest cost increase (CER $118). The application of this model demonstrates that changes in TD management during deployment can be implemented to reduce DDL with likely favorable impacts on mission capability and individual health readiness. The hypothetical combination strategy evaluated prevents the most DDL compared with current practice and is associated with a modest cost increase.
Belvin, W. Keith; Straubel, Marco; Wilkie, W. Keats; Zander, Martin E.; Fernandez, Juan M.; Hillebrandt, Martin F.
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.
Elisabeth (Liesbeth M. Taal
Full Text Available Background: Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment. Objective: We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS of military deployed to Afghanistan to that of non-deployed military personnel. Method: We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems. Results: The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed, who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR, adjusted for sex, military branch and time in service, 1.84 [95% CI 1.61–2.11] in the first and 1.28 [1.09–1.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.02–3.32] and 1.74 [1.30–2.32] and of anxiety disorders (2.22 [1.52–3.25] and 2.28 [1.50–3.45] including posttraumatic stress disorder (5.15 [2.55–10.40] and 5.28 [2.42–11.50], but not of mood disorders (1.33 [0.90–1.97] and 1.11 [0.68–1.82], was observed in deployed personnel in the first- and second-year post-deployment, respectively. Military personnel deployed in a unit with a higher risk of confrontation with potentially traumatic events had a higher HR (2.13 [1.84–2.47] and 1.40 [1.18–1.67]. Conclusions: Though absolute risk was low, in the first and second year following deployment to Afghanistan there was an 80 and 30% higher risk for mental health problems resulting in a consultation with the Dutch MMHS compared to military never
Taal, Elisabeth (Liesbeth) M.; Vermetten, Eric; van Schaik, Digna (Anneke) J. F.; Leenstra, Tjalling
Background Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment. Objective We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS) of military deployed to Afghanistan to that of non-deployed military personnel. Method We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems. Results The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed), who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR), adjusted for sex, military branch and time in service, 1.84 [95% CI 1.61–2.11] in the first and 1.28 [1.09–1.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.02–3.32] and 1.74 [1.30–2.32]) and of anxiety disorders (2.22 [1.52–3.25] and 2.28 [1.50–3.45]) including posttraumatic stress disorder (5.15 [2.55–10.40] and 5.28 [2.42–11.50]), but not of mood disorders (1.33 [0.90–1.97] and 1.11 [0.68–1.82]), was observed in deployed personnel in the first- and second-year post-deployment, respectively. Military personnel deployed in a unit with a higher risk of confrontation with potentially traumatic events had a higher HR (2.13 [1.84–2.47] and 1.40 [1.18–1.67]). Conclusions Though absolute risk was low, in the first and second year following deployment to Afghanistan there was an 80 and 30% higher risk for mental health problems resulting in a consultation with the Dutch MMHS compared to military never deployed to
Burcu DEVRİM İÇTENBAŞ
Full Text Available Quality Function Deployment (QFD uses a house of quality to translate customerrequirements into engineering specifications. QFD has been widely used as a toolto develop new products. It has been adopted in thefields of education quality,service quality, software development and marketingplanning. The tool hasrecently been applied in strategic planning .In this study authors reviewed currentresearch which uses QFD as a strategic planning tool and described how QFDmethods can be used as a robust tool in strategic planning. This study provides aninsight for strategic planners to utilize a QFD- based philosophy and the methodsare useful tools for the design of a customer-driven strategy and show how itsystematically translates vision into action, targeting opportunities and creatinginnovative strategies.
This document provides a description of Babcock and Wilcox's deployment strategy for the mPower™ Small Modular Reactor from the perspective of Supply Chain and Manufacturing. A desirable future state of readiness is described as one which leverages and revitalizes an existing supply chain and manufacturing infrastructure, as well as leveraging an existing workforce of engineering, construction, and project management employees. B and W's mPower™ SMR value proposition offers many desired design and operating advantages to the SMR market. (author)
Service oriented architectures allow modelling engines to be hosted over the Internet abstracting physical hardware configuration and software deployments from model users. Many existing environmental models are deployed as desktop applications running on user's personal computers (PCs). Migration ...
Abdelhamid Salma R.
Full Text Available The immense growth in wireless network applications has encouraged the researchers to enhance and propose new approaches that facilitate the deployment of the widely used services, protocols, and applications of the wired networking area in the wireless networks. Among which, the Session Initiation Protocol (SIP is a signaling protocol that allows the establishment of multimedia sessions and calls between different parties. SIP functionality totally depends on a centralized infrastructure, and complexity arises when deploying such a protocol in a special type of wireless networks, namely Mobile Ad-hoc Networks (MANET, due to the absence of a centralized infrastructure, and the dynamic topology of the later. This paper highlights the the challenges arising when deploying SIP in MANETs and presents an overview of different proposed approaches to overcome these challenges.
...) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF... alternate is selected shall serve in place of that member on the committee, and shall have and be able to... members of the committee shall serve for terms of two years: Provided, That four of the initially selected...
Smith, Tyler C; Powell, Teresa M; Jacobson, Isabel G; Smith, Besa; Hooper, Tomoko I; Boyko, Edward J; Gackstetter, Gary D
Symptoms and illnesses reported by veterans of the 1991 Gulf War era are a cause of potential concern for those military members who have deployed to the Gulf region in support of more recent contingency operations in Iraq and Afghanistan. In the present study, we quantified self-reported symptoms from participants in the Millennium Cohort Study, a prospective study representing all US service branches, including both active duty and Reserve/National Guard components (2001-2008). Self-reported symptoms were uniquely compared with those in a cohort of subjects from the 1991 Gulf War to gain context for the present report. Symptoms were then aggregated to identify cases of chronic multisymptom illness (CMI) based on the case definition from the Centers for Disease Control and Prevention. The prevalence of self-reported CMI symptoms was compared with that collected in 1997-1999 from a study population of US Seabees from the 1991 Gulf War, as well as from deployed and nondeployed subgroups. Although overall symptom reporting was much less in the Millennium Cohort than in the 1991 Gulf War cohort, a higher prevalence of reported CMI was noted among deployed compared with nondeployed contemporary cohort members. An increased understanding of coping skills and resilience and development of well-designed screening instruments, along with appropriate clinical and psychological follow-up for returning veterans, might help to focus resources on early identification of potential long-term chronic disease manifestations. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
95 B.2. Percentage of members who experienced sexual quid pro quo in the past year...Volume 3 B.2. Percentage of members who experienced sexual quid pro quo in the past year Table B.2 Percentage of members who experienced sexual quid ... SEXUAL ASSAULT AND SEXUAL HARASSMENT IN THE U.S. MILITARY Annex to Volume 3. Tabular Results from the 2014 RAND Military Workplace Study for
Shickman, Kurt [Trust for Conservation Innovation, San Francisco, CA (United States). Global Cool Cities Alliance (GCCA)
Purpose of the project was to accelerate the deployment of energy efficient and renewable energy technologies in South Africa. Activities were undertaken to reduce barriers to deployment by improving product awareness for the South African market; market and policy intelligence for U.S. manufacturers; product/service availability; local technical capacity at the workforce, policymaker and expert levels; and ease of conducting business for these technologies/services in the South African market.
Owsley, Stanley L.; Dodson, Michael G.; Hatchell, Brian K.; Seim, Thomas A.; Alexander, David L.; Hawthorne, Woodrow T.
The RSG deployment case design is centered on taking the RSG system and producing a transport case that houses the RSG in a safe and controlled manner for transport. The transport case was driven by two conflicting constraints, first that the case be as light as possible, and second that it meet a stringent list of Military Specified requirements. The design team worked to extract every bit of weight from the design while striving to meet the rigorous Mil-Spec constraints. In the end compromises were made primarily on the specification side to control the overall weight of the transport case. This report outlines the case testing results.
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).
... 29 Labor 4 2010-07-01 2010-07-01 false Influencing Members of Congress. 1400.735-19 Section 1400... Responsibilities § 1400.735-19 Influencing Members of Congress. No money appropriated to the Service shall be used... devices intended to influence any Member of Congress regarding any legislation or appropriation before the...
DEVRİM İÇTENBAŞ, Burcu; ERYILMAZ, Hande
Quality Function Deployment (QFD) uses a house of quality to translate customer requirements into engineering specifications. QFD has been widely used as a tool to develop new products. It has been adopted in the fields of education quality, service quality, software development and marketing planning. The tool has recently been applied in strategic planning .In this study authors reviewed current research which uses QFD as a strategic planning tool and described how QFD methods can be ...
Fazila Said; Mohd Amirul Shafiq Shafiee; Nurul Hasanah Mohd Abd Basir
This study aims to measure service quality performance and identify critical service quality characteristics as perceived by the customers. An integrated results survey that conducted by seven service centers that certified with Quality Management System (QMS) in Nuclear Malaysia are analysed. This is followed by constructing House of Quality (HoQ) and identifying other parameters for the Quality Function Deployment (QFD) matrix. HoQ is a simple and attractive service innovation tool which can be used to directly show comprehensive information which contained the voice of customer (VOC), technical response, technical correlation and matrix relationship. This study revealed that the information's from HoQ with further discussion on planning part which can be used to assist management in knowing the overall detail information of service center achievement and recognizes the solution for unsatisfied customer through priority improvement activity to enhance the customer satisfaction in future. (author)
Russell C. Moody; Jen Y. Liu
Glued structural members are manufactured in a variety of configurations. Structural composite lumber (SCL) products consist of small pieces of wood glued together into sizes common for solid-sawn lumber. Glued-laminated timber (glulam) is an engineered stress-rated product that consists of two or more layers of lumber in which the grain of all layers is oriented...
Lithuania is on course to become an associate member of CERN, pending final approval by the Lithuanian parliament. Associate membership will allow representatives of the Baltic nation to take part in meetings of the CERN Council, which oversees the Geneva-based physics lab.
The political upheaval in what was the Soviet Union was reflected in an Extraordinary Plenipotentiaries Committee of Joint Institute for Nuclear Research (JINR) Member States, held in Dubna, near Moscow, on 10-13 December, with representatives of eleven sovereign republics of the former Soviet State taking part
Radin, Jennifer M; Hawksworth, Anthony W; Ortiguerra, Ryan G; Brice, Gary T
In 2011, a new variant of influenza A(H3N2) emerged that contained a recombination of genes from swine H3N2 viruses and the matrix (M) gene of influenza A(H1N1)pdm09 virus. New combinations and variants of pre-existing influenza viruses are worrisome if there is low or nonexistent immunity in a population, which increases chances for an outbreak or pandemic. Sera collected in 2011 were obtained from US Department of Defense service members in three age groups: 19-21 years, 32-33 years, and 47-48 years. Pre- and post-vaccination samples were available for the youngest age group, and postvaccination samples for the two older groups. Specimens were tested using microneutralization assays for antibody titers against H3N2v (A/Indiana/10/2011) and seasonal H3N2 virus (A/Perth/16/2009). The youngest age group had significantly (p<0.05) higher geometric mean titers for H3N2v with 165 (95% confidence interval [CI]: 105-225) compared with the two older groups, aged 32-33 and 47-48 years, who had geometric mean titers of 68 (95% CI: 55-82) and 46 (95% CI: 24-65), respectively. Similarly, the youngest age group also had the highest geometric mean titers for seasonal H3N2. In the youngest age group, the proportion of patients who seroconverted after vaccination was 12% for H3N2v and 27% for seasonal H3N2. Our results were similar to previous studies that found highest seroprotection among young adults and decreasing titers among older adults. The proportion of 19- to 21-year-olds who seroconverted after seasonal vaccination was low and similar to previous findings. Improving our understanding of H3N2v immunity among different age groups in the United States can help inform vaccination plans if H3N2v becomes more transmissible in the future.
Gelareh, Shahin; Pisinger, David
A mixed integer linear programming formulation is proposed for the simultaneous design of network and fleet deployment of a liner service providers for deep-sea shipping. The underlying network design problem is based on a 4-index (5-index by considering capacity type) formulation of the hub...... location problem which are known for their tightness. The demand is considered to be elastic in the sense that the service provider can accept any fraction of the origin-destination demand. We then propose a primal decomposition method to solve instances of the problem to optimality. Numerical results...... confirm superiority of our approach in comparison with a general-purpose mixed integer programming solver....
Aiftimiei, C.; Costantini, A.; Bucchi, R.; Italiano, A.; Michelotto, D.; Panella, M.; Pergolesi, M.; Saletta, M.; Traldi, S.; Vistoli, C.; Zizzi, G.; Salomoni, D.
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 , 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.
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
Ullah, Faheem; Raft, Adam Johannes; Shahin, Mojtaba
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....
Bhatnagar, Dhruv; Currier, Aileen B.; Hernandez, Jacquelynne; Ma, Ookie; Kirby, Brendan
Electric energy storage technologies have recently been in the spotlight, discussed as essential grid assets that can provide services to increase the reliability and resiliency of the grid, including furthering the integration of variable renewable energy resources. Though they 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, crosscutting barriers and technology barriers. This report, through interviews with stakeholders and review of regulatory filings in four regions roughly representative of the United States, identifies the key barriers restricting further energy storage development in the country. The report also includes a discussion of possible solutions to address these barriers and a review of initiatives around the country at the federal, regional and state levels that are addressing some of these issues. Energy storage could have a key role to play in the future grid, but market and regulatory issues have to be addressed to allow storage resources open market access and compensation for the services they are capable of providing. Progress has been made in this effort, but much remains to be done and will require continued engagement from regulators, policy makers, market operators, utilities, developers and manufacturers.
Thank you! Over the past year, AGU has received 12,104 gifts, both large and small, from members and friends. The Union has also received corporate contributions, National Science Foundation grants, and support from the National Oceanographic Partnership Program and National Association of Geoscience Teachers. Together their generosity has benefited AGU non revenue producing programs that are critical to our science and the future health of the Union. The following list gratefully acknowledges annual gifts of $100 or more and cumulative giving of $5,000 or more. The 1919 Society ($100,000 or more) and Benefactors ($5,000-$99,999) recognize single major gifts and cumulative contributions. Three circles acknowledge annual giving: President's Circle ($1,000 or more), Leadership Circle ($200-$999), and Supporters Circle ($100-$199). Supporting Life Members, who contribute a one-time gift of $1,200 in addition to lifetime dues, are among our most loyal Supporters.
National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) will develop new shape memory polymer (SMP) deployment mechanisms for actuating thermal protective systems (TPS) panels to...
National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) will develop new shape memory polymer (SMP) deployment mechanisms for actuating thermal protection system (TPS) panels to...
Summer is coming, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 25 € instead of 31 €. Access to Aqualibi: 5 € instead of 8 € on presentation of your Staff Association member ticket. Free for children under 100 cm. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 24 € instead of 30 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children under 100 cm. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is coming, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 24 € instead of 30 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children under 100 cm. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Richman, Barbara T.
The new Board on Ocean Science and Policy (BOSP) (Eos, June 7, 1983, p. 402) met for the first time on May 4. John B. Slaughter, former director of the National Science Foundation and now chancellor of the University of Maryland in College Park, is the board's chairman. Other board members are D. James Baker, Jr. (University of Washington, Seattle); Kirk Bryan (Geophysical Fluid Dynamics Laboratory, Princeton University); John P. Craven (University of Hawaii); Charles L. Drake (Dartmouth College); Paul M. Fye (Woods Hole Oceanographic Institution); Edward D. Goldberg (Scripps Institution of Oceanography); G. Ross Heath (Oregon State University); Judith T. Kildow (Massachusetts Institute of Technology); John A. Knauss (University of Rhode Island); James J. McCarthy (Museum of Comparative Zoology, Harvard University); H. William Menard (Scripps Institution of Oceanography); C. Barry Raleigh (Lamont-Doherty Geological Observatory); Roger Revelle (University of California, San Diego); David A. Ross (Woods Hole Oceanographic Institution); Brian J. Rothschild (University of Maryland); William M. Sackett (University of South Florida); John H. Steele (Woods Hole Oceanographic Institution); and Carl Wunsch (MIT). Wallace Broecker (Lamont-Doherty Geological Observatory), an original board member, resigned after the first meeting. Broecker told Eos that combining the science and policy boards resulted in a new board whose mission is too broad. A new board member will be appointed in Broecker's place
... three. Similarly, the financial services sector of an economy facilitates the efficient deployment of capital and minimizes business risks functions upon which all other industry sectors vitally depend...
Vaniachine, A. V.; von der Schmitt, J. G.
In preparation for ATLAS data taking, a coordinated shift from development towards operations has occurred in ATLAS database activities. In addition to development and commissioning activities in databases, ATLAS is active in the development and deployment (in collaboration with the WLCG 3D project) of the tools that allow the worldwide distribution and installation of databases and related datasets, as well as the actual operation of this system on ATLAS multi-grid infrastructure. We describe development and commissioning of major ATLAS database applications for online and offline. We present the first scalability test results and ramp-up schedule over the initial LHC years of operations towards the nominal year of ATLAS running, when the database storage volumes are expected to reach 6.1 TB for the Tag DB and 1.0 TB for the Conditions DB. ATLAS database applications require robust operational infrastructure for data replication between online and offline at Tier-0, and for the distribution of the offline data to Tier-1 and Tier-2 computing centers. We describe ATLAS experience with Oracle Streams and other technologies for coordinated replication of databases in the framework of the WLCG 3D services
Mitsubishi Heavy Industries, Ltd. (MHI) has been the total engineering and manufacturing company of pressurized water reactors (PWRs) in Japan since the commencement of commercial operations of Mihama Unit 1 of the Kansai Electric Power Company in 1970. Over these decades, MHI has endeavored to develop a broad spread of nuclear technology, from design, manufacturing, and construction, to plant maintenance services. More recently, with the ever rising need for nuclear power generation around the world to prevent global warming and to cope with surging oil prices, MHI is striving to expand its nuclear power business in the world market, such as US-APWR (Advanced Pressurized Water Reactor) in the U.S., as well as to develop technology for advanced reactors and nuclear fuel cycles to ensure energy security in the future. This paper introduces these approaches, especially focused on new technologies deployment for the global needs, and clarifies the current status and future prospects of MHI as the world's leading nuclear company. (author)
Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C
To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Graves, S.; Ramachandran, R.; Keiser, K.; Maskey, M.; Lynnes, C.; Pham, L.
The maturation of web services standards and technologies sets the stage for a distributed "Service-Oriented Architecture" (SOA) for NASA's next generation science data processing. This architecture will allow members of the scientific community to create and combine persistent distributed data processing services and make them available to other users over the Internet. NASA has initiated a project to create a suite of specialized data mining web services designed specifically for science data. The project leverages the Algorithm Development and Mining (ADaM) toolkit as its basis. The ADaM toolkit is a robust, mature and freely available science data mining toolkit that is being used by several research organizations and educational institutions worldwide. These mining services will give the scientific community a powerful and versatile data mining capability that can be used to create higher order products such as thematic maps from current and future NASA satellite data records with methods that are not currently available. The package of mining and related services are being developed using Web Services standards so that community-based measurement processing systems can access and interoperate with them. These standards-based services allow users different options for utilizing them, from direct remote invocation by a client application to deployment of a Business Process Execution Language (BPEL) solutions package where a complex data mining workflow is exposed to others as a single service. The ability to deploy and operate these services at a data archive allows the data mining algorithms to be run where the data are stored, a more efficient scenario than moving large amounts of data over the network. This will be demonstrated in a scenario in which a user uses a remote Web-Service-enabled clustering algorithm to create cloud masks from satellite imagery at the Goddard Earth Sciences Data and Information Services Center (GES DISC).
Full Text Available This paper provides a comprehensive insight into current trends and developments in Concurrent Engineering for integrated development of products and processes with the goal of completing the entire cycle in a shorter time, at lower overall cost and with fewer engineering design changes after product release. The evolution and definition of Concurrent Engineering are addressed first, followed by a concise review of the following elements of the concurrent engineering approach to product development: Concept Development: The Front-End Process, identifying Customer Needs and Quality Function Deployment, Establishing Product Specifications, Concept Selection, Product Architecture, Design for Manufacturing, Effective Rapid Prototyping, and The Economics of Product Development. An outline of a computer-based tutorial developed by the authors and other graduate students funded by NASA ( accessible via the world-wide-web . is provided in this paper. A brief discussion of teamwork for successful concurrent engineering is included, t'ase histories of concurrent engineering implementation at North American and European companies are outlined with references to textbooks authored by Professor Menon and other writers. A comprehensive bibliography on concurrent engineering is included in the paper.
Lassnig, Mario; The ATLAS collaboration; Barisits, Martin-Stefan; Beermann, Thomas Alfons; Serfon, Cedric; Garonne, Vincent
This contribution details the deployment of Rucio, the ATLAS Distributed Data Management system. The main complication is that Rucio interacts with a wide variety of external services, and connects globally distributed data centres under different technological and administrative control, at an unprecedented data volume. It is therefore not possibly to create a duplicate instance of Rucio for testing or integration. Every software upgrade or configuration change is thus potentially disruptive and requires fail-safe software and automatic error recovery. Rucio uses a three-layer scaling and mitigation strategy based on quasi-realtime monitoring. This strategy mainly employs independent stateless services, automatic failover, and service migration. The technologies used for deployment and mitigation include OpenStack, Puppet, Graphite, HAProxy, Apache, and nginx. In this contribution, the reasons and design decisions for the deployment, the actual implementation, and an evaluation of all involved services and c...
Razumnikov, S.; Prankevich, D.
Developing an IT-strategy of cloud deployment is a complex issue since even the stage of its formation necessitates revealing what applications will be the best possible to meet the requirements of a company business-strategy, evaluate reliability and safety of cloud providers and analyze staff satisfaction. A system of criteria, as well an integrated model to assess cloud deployment effectiveness is offered. The model makes it possible to identify what applications being at the disposal of a company, as well as new tools to be deployed are reliable and safe enough for implementation in the cloud environment. The data on practical use of the procedure to assess cloud deployment effectiveness by a provider of telecommunication services is presented. The model was used to calculate values of integral indexes of services to be assessed, then, ones, meeting the criteria and answering the business-strategy of a company, were selected.
Full Text Available on the university) to complete a proposal which had to be accepted by their respective research committees. • Students had to get their own ethical approval at their universities. Any other ethical approval which was gained before the ICT4RED initiative... Infrastructure Library which is a set of practices for IT service management or ITSM that focuses on aligning IT services with the needs of the business). The four main areas of focus for this deliverable were: • People: A multi-tiered approach was followed...
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.63) is Palau which deposited its Instrument of Acceptance of the Statute on 2 March 2007. The Attachment hereto shows the dates on which the present 144 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.64) is Nepal which deposited its Instrument of Acceptance of the Statute on 8 July 2008. The Attachment hereto shows the dates on which the present 145 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.61) are Belize, Mozambique and Malawi, which deposited their Instruments of Acceptance of the Statute on 31 March 2006, 18 September 2006 and 2 October 2006 respectively. The Attachment hereto shows the dates on which the present 142 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.62) is Montenegro which deposited its Instrument of Acceptance of the Statute on 30 October 2006. The Attachment hereto shows the dates on which the present 143 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members [ru
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members [fr
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.61) are Belize, Mozambique and Malawi, which deposited their Instruments of Acceptance of the Statute on 31 March 2006, 18 September 2006 and 2 October 2006 respectively. The Attachment hereto shows the dates on which the present 142 Member States became Members [fr
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members [fr
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.65) is the Sultanate of Oman which deposited its Instrument of Acceptance of the Statute on 5 February 2009. The Attachment hereto shows the dates on which the present 146 Member States became Members [fr
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.59) is the Islamic Republic of Mauritania, which deposited the instrument of acceptance of the Statute on 23 November 2004. The Attachment hereto shows the dates on which the present 138 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members [es
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members [es
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.60) is Chad, which deposited the instrument of acceptance of the Statute on 2 November 2005. The Attachment hereto shows the dates on which the present 139 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.65) is the Sultanate of Oman which deposited its Instrument of Acceptance of the Statute on 5 February 2009. The Attachment hereto shows the dates on which the present 146 Member States became Members [es
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.58) is Kyrgyzstan, which deposited the instrument of acceptance of the Statute on 10 September 2003. The list shows the dates on which the present 137 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.65) is the Sultanate of Oman which deposited its Instrument of Acceptance of the Statute on 5 February 2009. The Attachment hereto shows the dates on which the present 146 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members [ru
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 21 € instead of 26 €. Access to Aqualibi: 5 € instead of 8 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 30 CHF instead of 39 CHF – Adults : 36 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 21,50 € instead of 27 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12:00 p.m. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 23 € instead of 29 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12:00 p.m. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Niemann, R.C.; Gonczy, J.D.; Nicol, T.H.
A cryogenic support member is described for restraining a cryogenic system comprising; a rod having a depression at a first end. The rod is made of non-metallic material. The non-metallic material has an effectively low thermal conductivity; a metallic plug; and a metallic sleeve. The plug and the sleeve are shrink-fitted to the depression in the rod and assembled thereto such that the plug is disposed inside the depression of the rod. The sleeve is disposed over the depression in the rod and the rod is clamped therebetween. The shrink-fit clamping the rod is generated between the metallic plug and the metallic sleeve
Moore, T.; Savidge, D. K.; Gargett, A.
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.
doet onderzoek om de ontwikkeling v’an PSYOPS in Nederland te ondersteunen. Een eerste stap, in het goed voorbereiden en uitvoeren van PSYOPS is het...bezit. De focus van het huidige project ligt op de selectiemethode van mensen die PSYOPS functies gaan vervullen. Naast Nederland zijn er ook andere NAVO...deze interviews kwam naar voren dat verschillende landen kampen met dezelfde problemen als Nederland wat betreft de selectie van het PSYOPS personeel
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
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.
When subjected to temperature changes and restrained from free movement, a member develops stresses. Restrained members are sometimes assumed to act independently of other members. A method of analysis and design for thermal stresses in such members is provided. The method of analysis, based on the ultimate strength concept, greatly reduces the computational efforts for determining thermal effects in concrete members. Available charts and tables and the recommendations given herein simplify the design. (Auth.)
Choi, Chang-Hwan, E-mail: Chang-Hwan.CHOI@iter.org [ITER Organization, Route de Vinon-sur-Verdon, 13115 St Paul lez Durance (France); Tesini, Alessandro; Subramanian, Rajendran [ITER Organization, Route de Vinon-sur-Verdon, 13115 St Paul lez Durance (France); Rolfe, Alan; Mills, Simon; Scott, Robin; Froud, Tim; Haist, Bernhard; McCarron, Eddie [Oxford Technologies Ltd., 7 Nuffield Way, Abingdon, OXON (United Kingdom)
Highlights: • ITER RH system called as the multi-purpose deployer (MPD) is introduced. • The MPD performs dust and tritium inventory control, in-service inspection. • The MPD performs leak localization, in-vessel diagnostics maintenance. • The MPD has nine degrees of freedom with a payload capacity up to 2 tons. - Abstract: The multi-purpose deployer (MPD) is a general purpose in-vessel remote handling (RH) system in the ITER RH system. The MPD provides the means for deployment and handling of in-vessel tools or components inside the vacuum vessel (VV) for dust and tritium inventory control, in-service inspection, leak localization, and in-vessel diagnostics. It also supports the operation of blanket first wall maintenance and neutral beam duct liner module maintenance operations. This paper describes the concept design of the MPD. The MPD is a cask based system, i.e. it stays in the hot cell building during the machine operation, and is deployed to the VV using the cask system for the in-vessel operations. The main part of the MPD is the articulated transporter which provides transportation and positioning of the in-vessel tools or components. The articulated transporter has nine degrees of freedom with a payload capacity up to 2 tons. The articulated transporter can cover the whole internal surface of the VV by switching between the four equatorial RH ports. Additionally it can use two non-RH equatorial ports to transfer large tools or components. A concept for in-cask tool exchange is developed which minimizes the cask transportation by allowing the MPD to stay in the VV during the tool exchange.
Babik, M.; Chudoba, J.; Dewhurst, A.; Finnern, T.; Froy, T.; Grigoras, C.; Hafeez, K.; Hoeft, B.; Idiculla, T.; Kelsey, D. P.; López Muñoz, F.; Martelli, E.; Nandakumar, R.; Ohrenberg, K.; Prelz, F.; Rand, D.; Sciabà, A.; Tigerstedt, U.; Traynor, D.
The fraction of Internet traffic carried over IPv6 continues to grow rapidly. IPv6 support from network hardware vendors and carriers is pervasive and becoming mature. A network infrastructure upgrade often offers sites an excellent window of opportunity to configure and enable IPv6. There is a significant overhead when setting up and maintaining dual-stack machines, so where possible sites would like to upgrade their services directly to IPv6 only. In doing so, they are also expediting the transition process towards its desired completion. While the LHC experiments accept there is a need to move to IPv6, it is currently not directly affecting their work. Sites are unwilling to upgrade if they will be unable to run LHC experiment workflows. This has resulted in a very slow uptake of IPv6 from WLCG sites. For several years the HEPiX IPv6 Working Group has been testing a range of WLCG services to ensure they are IPv6 compliant. Several sites are now running many of their services as dual-stack. The working group, driven by the requirements of the LHC VOs to be able to use IPv6-only opportunistic resources, continues to encourage wider deployment of dual-stack services to make the use of such IPv6-only clients viable. This paper presents the working group’s plan and progress so far to allow sites to deploy IPv6-only CPU resources. This includes making experiment central services dual-stack as well as a number of storage services. The monitoring, accounting and information services that are used by jobs also need to be upgraded. Finally the VO testing that has taken place on hosts connected via IPv6-only is reported.
O método desdobramento da função qualidade - QFD - no planejamento do serviço de enfermagem O método desdoblamiento de la función calidad - QFD - en la planeación del servicio de enfermería Quality function deployment method - QFD - in the planning of nursing service
Laura Misue Matsuda
Full Text Available "Foco no Cliente" postura a ser adotada na obtenção de produtos de qualidade. Alicerçada na abordagem da Gestão pela Qualidade Total, o Desdobramento da Função Qualidade é a ferramenta que operacionaliza essa perspectiva. Este estudo objetivou criar uma proposta de planejamento para o Serviço de Enfermagem, seguindo as etapas e ações desta metodologia, que iniciou com o levantamento das necessidades de 106 clientes hospitalizados. Através de matrizes e diagramas, os dados foram desdobrados e priorizados perfazendo as dezessete etapas propostas. O resultado mostrou que no atendimento de enfermagem, o cliente valoriza a interação à técnica e que este método possibilita implementar a qualidade."El cliente es lo primero" posición a ser adoptada en la obtención de productos de calidad. Estructurada en el abordaje de la Gestión por la Calidad Total, el Desdoblamiento de la Función Calidad, es la herramienta que operacionaliza esa perspectiva. Este estudio tuvo como objetivo crear una propuesta de planeación para el servicio de enfermería siguiendo etapas y acciones de esta metodología, que comenzó con el levantamiento de las necesidades de 106 clientes hospitalizados. A través de matrices y diagramas, los datos fueron organizados y priorizados siguiendo las 17 etapas propuestas. El resultado mostró que en la atención de enfermería, el cliente valoriza la interacción mas que la técnica y que este método posibilita la implementación de la calidad."Focus on the client" is the posture that must be adopted in order to offer quality products. Based on the Total Quality Management approach, the Quality Function Deployment method (QFD is a tool to achieve this goal. The purpose of this study is to create a proposal for planning the nursing services following the steps and actions of this methodology. The basic procedure was to survey the necessity of 106 hospitalized patients. Data were deployed using the seventeen steps
2002. Sister services, the Navy and the Air Force, are constructed around their modes of transportation. They take themselves to the battle around...The vessels returned to Diego Garcia in the Indian Ocean and transloaded all of the equipment to vessels small enough to be received at Mogadishu ...of their response time, though. Marines and Navy Seals were in Mogadishu before a port assessment had ever been done. Forces were committed without
Fu, Linyun; Arko, Robert; Leadbetter, Adam
The Ocean Data Interoperability Platform (ODIP) seeks to increase data sharing across scientific domains and international boundaries, by providing a forum to harmonize diverse regional data systems. ODIP participants from the US include the Rolling Deck to Repository (R2R) program, whose mission is to capture, catalog, and describe the underway/environmental sensor data from US oceanographic research vessels and submit the data to public long-term archives. R2R publishes information online as Linked Open Data, making it widely available using Semantic Web standards. Each vessel, sensor, cruise, dataset, person, organization, funding award, log, report, etc, has a Uniform Resource Identifier (URI). Complex queries that federate results from other data providers are supported, using the SPARQL query language. To facilitate interoperability, R2R uses controlled vocabularies developed collaboratively by the science community (eg. SeaDataNet device categories) and published online by the NERC Vocabulary Server (NVS). In response to user feedback, we are developing a standard programming interface (API) and Web portal for R2R's Linked Open Data. The API provides a set of simple REST-type URLs that are translated on-the-fly into SPARQL queries, and supports common output formats (eg. JSON). We will demonstrate an implementation based on the Epimorphics Linked Data API (ELDA) open-source Java package. Our experience shows that constructing a simple portal with limited schema elements in this way can significantly reduce development time and maintenance complexity.
Questionnaires are commonly used to collect data, to learn people's opinions and determine customer's satisfaction or identify employee's needs. More often they are used when it is difficult to obtain data directly. Typically what is more important is the subject matter under investigation and the statistical analysis of collected ...
The Courir shops propose the following offer: 15% discount on all articles (not on sales) in the Courir shops (Val Thoiry, Annemasse and Neydens) and 5% discount on sales upon presentation of your Staff Association membership card and an identity card before payment. Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 21 € instead of 26 €. Access to Aqualibi: 5 € instead of 8 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 30 CHF instead of 39 CHF – Adults : 36 CHF instead of 49 CHF Bonus! Free for children under 5.
Association du personnel
La banque LCL propose aux membres de l’Association du personnel les avantages suivants : – Un barème Privilège sur le Prêt immobilier – Des avantages tarifaires sur l’épargne, notamment l’assurance-vie. – Un taux préférentiel de prêt à la consommation. En outre, jusqu’au 30 septembre 2013, elle offre 50€ à tous les nouveaux clients, membres de l'Association du personnel. Summer is here, enjoy our offers for the aquatic parcs! Tickets "Zone terrestre" : 21 € instead of de 26 €. Access to Aqualibi : 5 euros instead of 8 euros on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Free car park. * * * * * * * Full day ticket: – Children : 30 CHF instead of 39 CHF &...
The warm weather arrives, it's time to take advantage of our offers Walibi and Aquapark! Walibi : Tickets "Zone terrestre": 21 € instead of 26 € Access to Aqualibi: 5 € instead of 8 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Half-day ticket (5 hours): – Children: 26 CHF instead of 35 CHF – Adults : 32 CHF instead of 43 CHF Day ticket: – Children: 30 CHF instead of 39 CHF – Adults : 36 CHF instead of 49 CHF Free for children under 5.
Hendrix, Val; Yao Yushu; Benjamin, Doug
Deployment, maintenance and recovery of a scientific cluster, which has complex, specialized services, can be a time consuming task requiring the assistance of Linux system administrators, network engineers as well as domain experts. Universities and small institutions that have a part-time FTE with limited time for and knowledge of the administration of such clusters can be strained by such maintenance tasks. This current work is the result of an effort to maintain a data analysis cluster (DAC) with minimal effort by a local system administrator. The realized benefit is the scientist, who is the local system administrator, is able to focus on the data analysis instead of the intricacies of managing a cluster. Our work provides a cluster deployment and recovery process (CDRP) based on the puppet configuration engine allowing a part-time FTE to easily deploy and recover entire clusters with minimal effort. Puppet is a configuration management system (CMS) used widely in computing centers for the automatic management of resources. Domain experts use Puppet's declarative language to define reusable modules for service configuration and deployment. Our CDRP has three actors: domain experts, a cluster designer and a cluster manager. The domain experts first write the puppet modules for the cluster services. A cluster designer would then define a cluster. This includes the creation of cluster roles, mapping the services to those roles and determining the relationships between the services. Finally, a cluster manager would acquire the resources (machines, networking), enter the cluster input parameters (hostnames, IP addresses) and automatically generate deployment scripts used by puppet to configure it to act as a designated role. In the event of a machine failure, the originally generated deployment scripts along with puppet can be used to easily reconfigure a new machine. The cluster definition produced in our CDRP is an integral part of automating cluster deployment
Hendrix, Val; Benjamin, Doug; Yao, Yushu
Deployment, maintenance and recovery of a scientific cluster, which has complex, specialized services, can be a time consuming task requiring the assistance of Linux system administrators, network engineers as well as domain experts. Universities and small institutions that have a part-time FTE with limited time for and knowledge of the administration of such clusters can be strained by such maintenance tasks. This current work is the result of an effort to maintain a data analysis cluster (DAC) with minimal effort by a local system administrator. The realized benefit is the scientist, who is the local system administrator, is able to focus on the data analysis instead of the intricacies of managing a cluster. Our work provides a cluster deployment and recovery process (CDRP) based on the puppet configuration engine allowing a part-time FTE to easily deploy and recover entire clusters with minimal effort. Puppet is a configuration management system (CMS) used widely in computing centers for the automatic management of resources. Domain experts use Puppet's declarative language to define reusable modules for service configuration and deployment. Our CDRP has three actors: domain experts, a cluster designer and a cluster manager. The domain experts first write the puppet modules for the cluster services. A cluster designer would then define a cluster. This includes the creation of cluster roles, mapping the services to those roles and determining the relationships between the services. Finally, a cluster manager would acquire the resources (machines, networking), enter the cluster input parameters (hostnames, IP addresses) and automatically generate deployment scripts used by puppet to configure it to act as a designated role. In the event of a machine failure, the originally generated deployment scripts along with puppet can be used to easily reconfigure a new machine. The cluster definition produced in our CDRP is an integral part of automating cluster deployment
Sutoh, Masataku; Hoshino, Takeshi; Wakabayashi, Sachiko
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.
Hinojosa, Ramon; Hinojosa, Melanie Sberna; Högnäs, Robin S
Twenty Reserve component (Army and Marines) and Army National Guard male veterans of Operational Enduring Freedom/Operation Iraqi Freedom discuss their deployment and postdeployment family reintegration experiences. A Grounded Theory approach is used to highlight some of the ways in which family miscommunication during deployment can occur. Communication with civilian family members is affected by the needs of operational security, technical problems with communication tools, miscommunication between family members, or because veterans have "nothing new to say" to family back home. These communication difficulties may lead to an initial gulf of understanding between veterans and family members that can cause family strain during postdeployment family reintegration. We end with a discussion of veteran family reintegration difficulties.
Mayes, Mark G.
Developments in terahertz sources include compacted electron beam systems, optical mixing techniques, and multiplication of microwave frequencies. Although significant advances in THz science have been achieved, efforts continue to obtain source technologies that are more mobile and suitable for field deployment. Strategies in source development have approached generation from either end of the THz spectrum, from up-conversion of high-frequency microwave to down-conversion of optical frequencies. In this paper, we present the design of a THz source which employs an up-conversion method in an assembly that integrates power supply, electronics, and radiative component into a man-portable unit for situations in which a lab system is not feasible. This unit will ultimately evolve into a ruggedized package suitable for use in extreme conditions, e.g. temporary security check points or emergency response teams, in conditions where THz diagnostics are needed with minimal planning or logistical support. In order to meet design goals of reduced size and complexity, the inner workings of the unit ideally would be condensed into a monolithic active element, with ancillary systems, e.g. user interface and power, coupled to the element. To attain these goals, the fundamental component of our design is a THz source and lens array that may be fabricated with either printed circuit board or wafer substrate. To reduce the volume occupied by the source array, the design employs a metamaterial composed of a periodic lattice of resonant elements. Each resonant element is an LC oscillator, or tank circuit, with inductance, capacitance, and center frequency determined by dimensioning and material parameters. The source array and supporting electronics are designed so that the radiative elements are driven in-phase to yield THz radiation with a high degree of partial coherence. Simulation indicates that the spectral width of operation may be controlled by detuning of critical dimensions
One of the IAEA's statutory objectives is to 'seek to accelerate and enlarge the contribution of atomic energy to peace, health and prosperity throughout the world.' One way this objective is achieved is through the publication of a range of technical series. Two of these are the IAEA Nuclear Energy Series and the IAEA Safety Standards Series. According to Article III.A.6 of the IAEA Statute, the safety standards establish 'standards of safety for protection of health and minimization of danger to life and property'. The safety standards include the Safety Fundamentals, Safety Requirements and Safety Guides. These standards are written primarily in a regulatory style, and are binding on the IAEA for its own programmes. The principal users are the regulatory bodies in Member States and other national authorities. The IAEA Nuclear Energy Series comprises reports designed to encourage and assist R and D on, and application of, nuclear energy for peaceful uses. This includes practical examples to be used by owners and operators of utilities in Member States, implementing organizations, academia, and government officials, among others. This information is presented in guides, reports on technology status and advances, and best practices for peaceful uses of nuclear energy based on inputs from international experts. The IAEA Nuclear Energy Series complements the IAEA Safety Standards Series. Several IAEA Member States have embarked recently on initiatives to establish or reinvigorate nuclear power programmes. In response, the IAEA has developed several guidance and technical publications to identify with Member States the complex tasks associated with such an undertaking and to recommend the processes that can be used in the performance of this work. A major challenge in this undertaking, especially for newcomer Member States, is the process associated with reactor technology assessment (RTA) for near term deployment. RTA permits the evaluation, selection and deployment
Bernier, J.; Campana, S.; Chadwick, K.; Chudoba, J.; Dewhurst, A.; Eliáš, M.; Fayer, S.; Finnern, T.; Grigoras, C.; Hartmann, T.; Hoeft, B.; Idiculla, T.; Kelsey, D. P.; López Muñoz, F.; Macmahon, E.; Martelli, E.; Millar, A. P.; Nandakumar, R.; Ohrenberg, K.; Prelz, F.; Rand, D.; Sciabà, A.; Tigerstedt, U.; Voicu, R.; Walker, C. J.; Wildish, T.
The world is rapidly running out of IPv4 addresses; the number of IPv6 end systems connected to the internet is increasing; WLCG and the LHC experiments may soon have access to worker nodes and/or virtual machines (VMs) possessing only an IPv6 routable address. The HEPiX IPv6 Working Group has been investigating, testing and planning for dual-stack services on WLCG for several years. Following feedback from our working group, many of the storage technologies in use on WLCG have recently been made IPv6-capable. This paper presents the IPv6 requirements, tests and plans of the LHC experiments together with the tests performed on the group's IPv6 test-bed. This is primarily aimed at IPv6-only worker nodes or VMs accessing several different implementations of a global dual-stack federated storage service. Finally the plans for deployment of production dual-stack WLCG services are presented.
Full Text Available Cloud Computing represents the new method of delivering hardware and software resources to the users, Internet of Things (IoT is currently one of the most popular ICT paradigms. Both concepts can have a major impact on how we build smart or/and smarter cities. Cloud computing represents the delivery of hardware and software resources on-demand over the Internet as a Service. At the same time, the IoT concept envisions a new generation of devices (sensors, both virtual and physical that are connected to the Internet and provide different services for value-added applications. In this paper we present our view on how to deploy Cloud computing and IoT for smart or/and smarter cities. We demonstrate that data gathered from heterogeneous and distributed IoT devices can be automatically managed, handled and reused with decentralized cloud services.