Improving advanced cardiovascular life support skills in medical students: simulation-based education approach

Directory of Open Access Journals (Sweden)

Hamidreza Reihani

2015-01-01

Full Text Available Objective: In this trial, we intend to assess the effect of simulation-based education approach on advanced cardiovascular life support skills among medical students. Methods: Through convenient sampling method, 40 interns of Mashhad University of Medical Sciences in their emergency medicine rotation (from September to December 2012 participated in this study. Advanced Cardiovascular Life Support (ACLS workshops with pretest and post-test exams were performed. Workshops and checklists for pretest and post-test exams were designed according to the latest American Heart Association (AHA guidelines. Results: The total score of the students increased significantly after workshops (24.6 out of 100 to 78.6 out of 100. This demonstrates 53.9% improvement in the skills after the simulation-based education (P< 0.001. Also the mean score of each station had a significant improvement (P< 0.001. Conclusion: Pretests showed that interns had poor performance in practical clinical matters while their scientific knowledge, such as ECG interpretation was acceptable. The overall results of the study highlights that Simulation based-education approach is highly effective in Improving ACLS skills among medical students.

Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support

OpenAIRE

Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

2017-01-01

Background Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians? experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mech...

Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support.

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Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

2017-01-01

Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians' experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mechanisms apply patterns from human thought processes, such as generalization, similarity and interpolation, based on attributional, hierarchical, and relational knowledge. Plausible reasoning mechanisms include inductive reasoning , which generalizes the commonalities among the data to induce new rules, and analogical reasoning , which is guided by data similarities to infer new facts. By further leveraging rich, biomedical Semantic Web ontologies to represent medical knowledge, both known and tentative, we increase the accuracy and expressivity of plausible reasoning, and cope with issues such as data heterogeneity, inconsistency and interoperability. In this paper, we present a Semantic Web-based, multi-strategy reasoning approach, which integrates deductive and plausible reasoning and exploits Semantic Web technology to solve complex clinical decision support queries. We evaluated our system using a real-world medical dataset of patients with hepatitis, from which we randomly removed different percentages of data (5%, 10%, 15%, and 20%) to reflect scenarios with increasing amounts of incomplete medical knowledge. To increase the reliability of the results, we generated 5 independent datasets for each percentage of missing values, which resulted in 20 experimental datasets (in addition to the original dataset). The results show that plausibly inferred knowledge extends the coverage of the knowledge base by, on average, 2%, 7%, 12%, and 16% for datasets with, respectively, 5%, 10%, 15

Education and Public Outreach for MSFC's Ground-Based Observations in Support of the HESSI Mission

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Adams, Mitzi L.; Hagyard, Mona J.; Newton, Elizabeth K.

1999-01-01

A primary focus of NASA is the advancement of science and the communication of these advances to a number of audiences, both within the science research community and outside it. The upcoming High Energy Solar Spectroscopic Imager (HESSI) mission and the MSFC ground-based observing program, provide an excellent opportunity to communicate our knowledge of the Sun, its cycle of activity, the role of magnetic fields in that activity, and its effect on our planet. In addition to ground-based support of the HESSI mission, MSFC's Solar Observatory, located in North Alabama, will involve students and the local education community in its day-to-day operations, an experience which is more immediate, personal, and challenging than their everyday educational experience. Further, by taking advantage of the Internet, our program can reach beyond the immediate community. By joining with Fernbank Science Center in Atlanta, Georgia, we will leverage their almost 30 years'experience in science program delivery in diverse situations to a distance learning opportunity which can encompass the entire Southeast and beyond. This poster will outline our education and public outreach plans in support of the HESSI mission in which we will target middle and high school students and their teachers.

Grounded theory in medical education research: AMEE Guide No. 70.

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Watling, Christopher J; Lingard, Lorelei

2012-01-01

Qualitative research in general and the grounded theory approach in particular, have become increasingly prominent in medical education research in recent years. In this Guide, we first provide a historical perspective on the origin and evolution of grounded theory. We then outline the principles underlying the grounded theory approach and the procedures for doing a grounded theory study, illustrating these elements with real examples. Next, we address key critiques of grounded theory, which continue to shape how the method is perceived and used. Finally, pitfalls and controversies in grounded theory research are examined to provide a balanced view of both the potential and the challenges of this approach. This Guide aims to assist researchers new to grounded theory to approach their studies in a disciplined and rigorous fashion, to challenge experienced researchers to reflect on their assumptions, and to arm readers of medical education research with an approach to critically appraising the quality of grounded theory studies.

Changing Medical School IT to Support Medical Education Transformation.

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Spickard, Anderson; Ahmed, Toufeeq; Lomis, Kimberly; Johnson, Kevin; Miller, Bonnie

2016-01-01

Many medical schools are modifying curricula to reflect the rapidly evolving health care environment, but schools struggle to provide the educational informatics technology (IT) support to make the necessary changes. Often a medical school's IT support for the education mission derives from isolated work units employing separate technologies that are not interoperable. We launched a redesigned, tightly integrated, and novel IT infrastructure to support a completely revamped curriculum at the Vanderbilt School of Medicine. This system uses coordinated and interoperable technologies to support new instructional methods, capture students' effort, and manage feedback, allowing the monitoring of students' progress toward specific competency goals across settings and programs. The new undergraduate medical education program at Vanderbilt, entitled Curriculum 2.0, is a competency-based curriculum in which the ultimate goal is medical student advancement based on performance outcomes and personal goals rather than a time-based sequence of courses. IT support was essential in the creation of Curriculum 2.0. In addition to typical learning and curriculum management functions, IT was needed to capture data in the learning workflow for analysis, as well as for informing individual and programmatic success. We aligned people, processes, and technology to provide the IT infrastructure for the organizational transformation. Educational IT personnel were successfully realigned to create the new IT system. The IT infrastructure enabled monitoring of student performance within each competency domain across settings and time via personal student electronic portfolios. Students use aggregated performance data, derived in real time from the portfolio, for mentor-guided performance assessment, and for creation of individual learning goals and plans. Poorly performing students were identified earlier through online communication systems that alert the appropriate instructor or coach of

Portable, space-saving medical patient support system

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Bzorgi,; Fariborz, [Knoxville, TN

2011-02-01

A support platform having a stowed configuration and a deployed configuration on a floor. The support platform is related to stretcher devices that are used for transporting, confining, or conducting medical procedures on medical patients in medical emergencies. The support platform typically includes a work surface that has a geometric extent. A base that typically includes a plurality of frame members is provided, and the frame members are disposed across the geometric extent of, and proximal to, the work surface in the stowed configuration. The frame members are typically disposed on the floor in the deployed configuration. There is a foldable bracing system engaged with the work surface and engaged with the base. At least a portion of the foldable bracing system is disposed substantially inside at least a portion of the plurality of frame members in the stowed configuration. Further, the foldable bracing system is configured for translocation of the work surface distal from the base in the deployed configuration.

A Clinical Decision Support Engine Based on a National Medication Repository for the Detection of Potential Duplicate Medications: Design and Evaluation.

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Yang, Cheng-Yi; Lo, Yu-Sheng; Chen, Ray-Jade; Liu, Chien-Tsai

2018-01-19

A computerized physician order entry (CPOE) system combined with a clinical decision support system can reduce duplication of medications and thus adverse drug reactions. However, without infrastructure that supports patients' integrated medication history across health care facilities nationwide, duplication of medication can still occur. In Taiwan, the National Health Insurance Administration has implemented a national medication repository and Web-based query system known as the PharmaCloud, which allows physicians to access their patients' medication records prescribed by different health care facilities across Taiwan. This study aimed to develop a scalable, flexible, and thematic design-based clinical decision support (CDS) engine, which integrates a national medication repository to support CPOE systems in the detection of potential duplication of medication across health care facilities, as well as to analyze its impact on clinical encounters. A CDS engine was developed that can download patients' up-to-date medication history from the PharmaCloud and support a CPOE system in the detection of potential duplicate medications. When prescribing a medication order using the CPOE system, a physician receives an alert if there is a potential duplicate medication. To investigate the impact of the CDS engine on clinical encounters in outpatient services, a clinical encounter log was created to collect information about time, prescribed drugs, and physicians' responses to handling the alerts for each encounter. The CDS engine was installed in a teaching affiliate hospital, and the clinical encounter log collected information for 3 months, during which a total of 178,300 prescriptions were prescribed in the outpatient departments. In all, 43,844/178,300 (24.59%) patients signed the PharmaCloud consent form allowing their physicians to access their medication history in the PharmaCloud. The rate of duplicate medication was 5.83% (1843/31,614) of prescriptions. When

Emergency medical support for a manned stratospheric balloon test program.

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Blue, Rebecca S; Norton, Sean C; Law, Jennifer; Pattarini, James M; Antonsen, Erik L; Garbino, Alejandro; Clark, Jonathan B; Turney, Matthew W

2014-10-01

Red Bull Stratos was a commercial program that brought a test parachutist, protected by a full-pressure suit, in a stratospheric balloon with pressurized capsule to over 127,582 ft (38,969 m), from which he free fell and subsequently parachuted to the ground. Given that the major risks to the parachutist included ebullism, negative Gz (toe-to-head) acceleration exposure from an uncontrolled flat spin, and trauma, a comprehensive plan was developed to recover the parachutist under nominal conditions and to respond to any medical contingencies that might have arisen. In this report, the project medical team describes the experience of providing emergency medical support and crew recovery for the manned balloon flights of the program. The phases of flight, associated risks, and available resources were systematically evaluated. Six distinct phases of flight from an Emergency Medical Services (EMS) standpoint were identified. A Medical Support Plan was developed to address the risks associated with each phase, encompassing personnel, equipment, procedures, and communications. Despite geographical, communications, and resource limitations, the medical team was able to implement the Medical Support Plan, enabling multiple successful manned balloon flights to 71,615 ft (21,828 m), 97,221 ft (29,610 m), and 127,582 ft (38,969 m). The experience allowed refinement of the EMS and crew recovery procedures for each successive flight and could be applied to other high altitude or commercial space ventures.

Ground Based Support for Exoplanet Space Missions

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Haukka, H.; Hentunen, V.-P.; Salmi, T.; Aartolahti, H.; Juutilainen, J.; Vilokki, H.; Nissinen, M.

2011-10-01

Taurus Hill Observatory (THO), observatory code A95, is an amateur observatory located in Varkaus, Finland. The observatory is maintained by the local astronomical association Warkauden Kassiopeia. THO research team has observed and measured various stellar objects and phenomena. Observatory has mainly focused to asteroid [1] and exoplanet light curve measurements, observing the gamma rays burst, supernova discoveries and monitoring [2] and long term monitoring projects [3]. In the early 2011 Europlanet NA1 and NA2 organized "Coordinated Observations of Exoplanets from Ground and Space"-workshop in Graz, Austria. The workshop gathered together proam astronomers who have the equipment to measure the light curves of the exoplanets. Also there were professional scientists working in the exoplanet field who attended to the workshop. The result of the workshop was to organize coordinated observation campaign for follow-up observations of exoplanets (e.g. CoRoT planets). Also coordinated observation campaign to observe stellar CME outbreaks was planned. THO has a lot of experience in field of exoplanet light curve measurements and therefore this campaign is very supported by the research team of the observatory. In next coming observing seasons THO will concentrate its efforts for this kind of campaigns.

Autonomy support for autonomous motivation in medical education.

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Kusurkar, Rashmi A; Croiset, Gerda

2015-01-01

Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

Why decision support systems are important for medical education.

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Konstantinidis, Stathis Th; Bamidis, Panagiotis D

2016-03-01

During the last decades, the inclusion of digital tools in health education has rapidly lead to a continuously enlarging digital era. All the online interactions between learners and tutors, the description, creation, reuse and sharing of educational digital resources and the interlinkage between them in conjunction with cheap storage technology has led to an enormous amount of educational data. Medical education is a unique type of education due to accuracy of information needed, continuous changing competences required and alternative methods of education used. Nowadays medical education standards provide the ground for organising the educational data and the paradata. Analysis of such education data through education data mining techniques is in its infancy, but decision support systems (DSSs) for medical education need further research. To the best of our knowledge, there is a gap and a clear need for identifying the challenges for DSSs in medical education in the era of medical education standards. Thus, in this Letter the role and the attributes of such a DSS for medical education are delineated and the challenges and vision for future actions are identified.

Autonomy support for autonomous motivation in medical education

Directory of Open Access Journals (Sweden)

Rashmi A. Kusurkar

2015-05-01

Full Text Available Background: Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Discussion: Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Conclusion: Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

Student identification of the need for complementary medicine education in Australian medical curricula: a constructivist grounded theory approach.

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Templeman, Kate; Robinson, Anske; McKenna, Lisa

2015-04-01

Across the Western world, including Australia, growing popularity of complementary medicines (CMs) mandates their implementation into medical education (ME). Medical students in international contexts have expressed a need to learn about CMs. In Australia, little is known about the student-specific need for CM education. The objective of this paper was to assess the self-reported need for CM education among Australian medical students. Thirty second-year to final-year medical students participated in semi-structured interviews. A constructivist grounded theory methodological approach was used to generate, construct and analyse data. Medical school education faculties in Australian universities. Medical students generally held favourable attitudes toward CMs but had knowledge deficits and did not feel adept at counselling patients about CMs. All students were supportive of CM education in ME, noting its importance in relation to the doctor-patient encounter, specifically with regard to interactions with medical management. As future practitioners, students recognised the need to be able to effectively communicate about CMs and advise patients regarding safe and effective CM use. Australian medical students expressed interest in, and the need for, CM education in ME regardless of their opinion of it, and were supportive of evidence-based CMs being part of their armamentarium. However, current levels of CM education in medical schools do not adequately enable this. This level of receptivity suggests the need for CM education with firm recommendations and competencies to assist CM education development required. Identifying this need may help medical educators to respond more effectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

How ground-based observations can support satellite greenhouse gas retrievals

Science.gov (United States)

Butler, J. H.; Tans, P. P.; Sweeney, C.; Dlugokencky, E. J.

2012-04-01

Global society will eventually accelerate efforts to reduce greenhouse gas emissions in a variety of ways. These would likely involve international treaties, national policies, and regional strategies that will affect a number of economic, social, and environmental sectors. Some strategies will work better than others and some will not work at all. Because trillions of dollars will be involved in pursuing greenhouse gas emission reductions - through realignment of energy production, improvement of efficiencies, institution of taxes, implementation of carbon trading markets, and use of offsets - it is imperative that society be given all the tools at its disposal to ensure the ultimate success of these efforts. Providing independent, globally coherent information on the success of these efforts will give considerable strength to treaties, policies, and strategies. Doing this will require greenhouse gas observations greatly expanded from what we have today. Satellite measurements may ultimately be indispensable in achieving global coverage, but the requirements for accuracy and continuity of measurements over time are demanding if the data are to be relevant. Issues such as those associated with sensor drift, aging electronics, and retrieval artifacts present challenges that can be addressed in part by close coordination with ground-based and in situ systems. This presentation identifies the information that ground-based systems provide very well, but it also looks at what would be deficient even in a greatly expanded surface system, where satellites can fill these gaps, and how on-going, ground and in situ measurements can aid in addressing issues associated with accuracy, long-term continuity, and retrieval artifacts.

Experiences of antidepressant medication and cognitive-behavioural therapy for depression: a grounded theory study.

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Bayliss, Paul; Holttum, Sue

2015-09-01

To develop a preliminary model of the experiences of people undergoing combined treatment with antidepressant medication and cognitive-behavioural therapy (CBT) for depression. The study used a qualitative methodology informed by grounded theory. Participants were 12 adults who had received treatment with antidepressant medication and CBT for depression. Participants engaged in a semistructured interview about their experiences. Interviews were transcribed and analysed using components of grounded theory methodology. Medication was often seen as an initial aid to surviving a crisis. Staying on medication longer term resulted in some participants feeling caught in a 'drug loop'. Feeling that medication was unhelpful or actively harmful could contribute to participants seeking CBT. Medics also offered information on CBT and acted as gatekeepers, meaning that negotiation was sometimes necessary. CBT was described as a process of being guided towards skilled self-management. Occasionally, participants felt that medication had facilitated CBT at one or more stages. Conversely, developing skilled self-management through CBT could reduce feelings of dependency on medication and affect several of the other elements maintaining the 'drug loop'. Antidepressant medication and CBT are perceived and experienced differently, with CBT often being seen as an alternative to medication, or even as a means to discontinue medication. Service users' experiences and beliefs about medication may thus affect their engagement and goals in CBT, and it may be important for therapists to consider this. Practitioners who prescribe medication should ensure that they also provide information on the availability and appropriateness of CBT, and engage in an open dialogue about treatment options. CBT practitioners should explore aspects of clients' experiences and beliefs about medication. This would particularly include clients' experiences of the effects of medication, their beliefs about

Student Affairs Professionals Supporting Students with Disabilities: A Grounded Theory Model

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Kimball, Ezekiel; Vaccaro, Annemarie; Vargas, Nadia

2016-01-01

In an action-based grounded theory project, the authors collected data from 31 student affairs professionals. During seven focus groups, practitioners described feeling unknowledgeable about disability law, accommodations, and diagnoses. However, they drew upon their core values and transferrable skills to support individual students. Participants…

The Implementation of Medical Informatics in the National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM).

Science.gov (United States)

Behrends, Marianne; Steffens, Sandra; Marschollek, Michael

2017-01-01

The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) describes medical skills and attitudes without being ordered by subjects or organs. Thus, the NKLM enables systematic curriculum mapping and supports curricular transparency. In this paper we describe where learning objectives related to Medical Informatics (MI) in Hannover coincide with other subjects and where they are taught exclusively in MI. An instance of the web-based MERLIN-database was used for the mapping process. In total 52 learning objectives overlapping with 38 other subjects could be allocated to MI. No overlap exists for six learning objectives describing explicitly topics of information technology or data management for scientific research. Most of the overlap was found for learning objectives relating to documentation and aspects of data privacy. The identification of numerous shared learning objectives with other subjects does not mean that other subjects teach the same content as MI. Identifying common learning objectives rather opens up the possibility for teaching cooperations which could lead to an important exchange and hopefully an improvement in medical education. Mapping of a whole medical curriculum offers the opportunity to identify common ground between MI and other medical subjects. Furthermore, in regard to MI, the interaction with other medical subjects can strengthen its role in medical education.

The ground based plan

International Nuclear Information System (INIS)

1989-01-01

The paper presents a report of ''The Ground Based Plan'' of the United Kingdom Science and Engineering Research Council. The ground based plan is a plan for research in astronomy and planetary science by ground based techniques. The contents of the report contains a description of:- the scientific objectives and technical requirements (the basis for the Plan), the present organisation and funding for the ground based programme, the Plan, the main scientific features and the further objectives of the Plan. (U.K.)

Supporting transitions in medical career pathways: the role of simulation-based education.

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Cleland, Jennifer; Patey, Rona; Thomas, Ian; Walker, Kenneth; O'Connor, Paul; Russ, Stephanie

2016-01-01

Transitions, or periods of change, in medical career pathways can be challenging episodes, requiring the transitioning clinician to take on new roles and responsibilities, adapt to new cultural dynamics, change behaviour patterns, and successfully manage uncertainty. These intensive learning periods present risks to patient safety. Simulation-based education (SBE) is a pedagogic approach that allows clinicians to practise their technical and non-technical skills in a safe environment to increase preparedness for practice. In this commentary, we present the potential uses, strengths, and limitations of SBE for supporting transitions across medical career pathways, discussing educational utility, outcome and process evaluation, and cost and value, and introduce a new perspective on considering the gains from SBE. We provide case-study examples of the application of SBE to illustrate these points and stimulate discussion.

Hispanic Medical Organizations' Support for LGBT Health Issues.

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Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

2014-09-01

Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.

Hanford Ground-Water Data Base management guide

International Nuclear Information System (INIS)

Rieger, J.T.; Mitchell, P.J.; Muffett, D.M.; Fruland, R.M.; Moore, S.B.; Marshall, S.M.

1990-02-01

This guide describes the Hanford Ground-Water Data Base (HGWDB), a computerized data base used to store hydraulic head, sample analytical, temperature, geologic, and well-structure information for ground-water monitoring wells on the Hanford Site. These data are stored for the purpose of data retrieval for report generation and also for historical purposes. This guide is intended as an aid to the data base manager and the various staff authorized to enter and verify data, maintain the data base, and maintain the supporting software. This guide focuses on the structure of the HGWDB, providing a fairly detailed description of the programs, files, and parameters. Data-retrieval instructions for the general user of the HGWDB will be found in the HGWDB User's Manual. 6 figs

Safety in numbers 7: Veni, vidi, duci: a grounded theory evaluation of nursing students' medication dosage calculation problem-solving schemata construction.

Science.gov (United States)

Weeks, Keith W; Higginson, Ray; Clochesy, John M; Coben, Diana

2013-03-01

This paper evaluates nursing students' transition through schemata construction and competence development in medication dosage calculation problem-solving (MDC-PS). We advance a grounded theory from interview data that reflects the experiences and perceptions of two groups of undergraduate pre-registration nursing students: eight students exposed to a prototype authentic MDC-PS environment and didactic transmission methods of education and 15 final year students exposed to the safeMedicate authentic MDC-PS environment. We advance a theory of how classroom-based 'chalk and talk' didactic transmission environments offered multiple barriers to accurate MDC-PS schemata construction among novice students. While conversely it was universally perceived by all students that authentic learning and assessment environments enabled MDC-PS schemata construction through facilitating: 'seeing' the authentic features of medication dosage problems; context-based and situational learning; learning within a scaffolded environment that supported construction of cognitive links between the concrete world of clinical MDC-PS and the abstract world of mathematics; and confidence-building in their cognitive and functional competence ability. Drawing on the principle of veni, vidi, duci (I came, I saw, I calculated), we combined the two sets of evaluations to offer a grounded theoretical basis for schemata construction and competence development within this critical domain of professional practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Aerospace Medical Support in Russia

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Castleberry, Tara; Chamberlin, Blake; Cole, Richard; Dowell, Gene; Savage, Scott

2011-01-01

This slide presentation reviews the role of the flight surgeon in support of aerospace medical support operations at the Gagarin Cosmonaut Training Center (GCTC), also known as Star City, in Russia. The flight surgeon in this role is the medical advocate for non-russian astronauts, and also provides medical care for illness and injury for astronauts, family members, and guests as well as civil servants and contractors. The flight surgeon also provides support for hazardous training. There are various photos of the area, and the office, and some of the equipment that is used.

Characterization of Jupiter's Atmosphere from Observation of Thermal Emission by Juno and Ground-Based Supporting Observations

Science.gov (United States)

Orton, G. S.; Momary, T.; Tabataba-Vakili, F.; Janssen, M. A.; Hansen, C. J.; Bolton, S. J.; Li, C.; Adriani, A.; Mura, A.; Grassi, D.; Fletcher, L. N.; Brown, S. T.; Fujiyoshi, T.; Greathouse, T. K.; Kasaba, Y.; Sato, T. M.; Stephens, A.; Donnelly, P.; Eichstädt, G.; Rogers, J.

2017-12-01

Ground-breaking measurements of thermal emission at very long wavelengths have been made by the Juno mission's Microwave Radiometer (MWR). We examine the relationship between these and other thermal emission measurements by the Jupiter Infrared Auroral Mapper (JIRAM) at 5 µm and ground-based supporting observations in the thermal infrared that cover the 5-25 µm range. The relevant ground-based observations of thermal emission are constituted from imaging and scanning spectroscopy obtained at the NASA Infrared Telescope Facility (IRTF), the Gemini North Telescope, the Subaru Telescope and the Very Large Telescope. A comparison of these results clarifies the physical properties responsible for the observed emissions, i.e. variability of the temperature field, the cloud field or the distribution of gaseous ammonia. Cross-references to the visible cloud field from Juno's JunoCam experiment and Earth-based images are also useful. This work continues an initial comparison by Orton et al. (2017, GRL 44, doi: 10.1002/2017GL073019) between MWR and JIRAM results, together with ancillary 5-µm IRTF imaging and with JunoCam and ground-based visible imaging. These showed a general agreement between MWR and JIRAM results for the 5-bar NH3 abundance in specific regions of low cloud opacity but only a partial correlation between MWR and 5-µm radiances emerging from the 0.5-5 bar levels of the atmosphere in general. Similar to the latter, there appears to be an inconsistent correlation between MWR channels sensitive to 0.5-10 bars and shorter-wavelength radiances in the "tails" of 5-µm hot spots , which may be the result of the greater sensitivity of the latter to particulate opacity that could depend on the evolution history of the particular features sampled. Of great importance is the interpretation of MWR radiances in terms of the variability of temperature vs. NH3 abundances in the 0.5-5 bar pressure range. This is particularly important to understand MWR results in

Integrating Parenting Support Within and Beyond the Pediatric Medical Home.

Science.gov (United States)

Linton, Julie M; Stockton, Maria Paz; Andrade, Berta; Daniel, Stephanie

2018-01-01

Positive parenting programs, developmental support services, and evidence-based home visiting programs can effectively provide parenting support and improve health and developmental outcomes for at-risk children. Few models, however, have integrated referrals for on-site support and home visiting programs into the provision of routine pediatric care within a medical home. This article describes an innovative approach, through partnership with a community-based organization, to deliver on-site and home visiting support services for children and families within and beyond the medical home. Our model offers a system of on-site services, including parenting, behavior, and/or development support, with optional intensive home visiting services. Assessment included description of the population served, delineation of services provided, and qualitative identification of key themes of the impact of services, illustrated by case examples. This replicable model describes untapped potential of the pediatric medical home as a springboard to mitigate risk and optimize children's health and development.

Organizational Creativity and IT-based Support

Directory of Open Access Journals (Sweden)

Celina M. Olszak

2016-05-01

Full Text Available The main aim of this paper is to provide a theoretically and empirically grounded discussion on IT-based organizational creativity support. This study attempts to answer the following questions: (1 what is the issue of organizational creativity and its IT-based support, (2 what is the demand for IT –based organizational creativity support; (3 what are the main determinants and barriers to IT-based organizational creativity support; and (4 what success factors are crucial for IT-based organizational creativity support. This paper presents the analysis results of a survey conducted in 25 selected organizations. The paper provides valuable information on the possibilities of IT applications in organizational creativity support as well as the associated success factors. It makes useful contribution to our better understanding of IT-based organizational creativity support issues.

Aircraft interrogation and display system: A ground support equipment for digital flight systems

Science.gov (United States)

Glover, R. D.

1982-01-01

A microprocessor-based general purpose ground support equipment for electronic systems was developed. The hardware and software are designed to permit diverse applications in support of aircraft flight systems and simulation facilities. The implementation of the hardware, the structure of the software, describes the application of the system to an ongoing research aircraft project are described.

Tactical emergency medical support programs: a comprehensive statewide survey.

Science.gov (United States)

Bozeman, William P; Morel, Benjamin M; Black, Timothy D; Winslow, James E

2012-01-01

Specially trained tactical emergency medical support (TEMS) personnel provide support to law enforcement special weapons and tactics (SWAT) teams. These programs benefit law enforcement agencies, officers, suspects, and citizens. TEMS programs are increasingly popular, but there are wide variations in their organization and operation and no recent data on their prevalence. We sought to measure the current prevalence and specific characteristics of TEMS programs in a comprehensive fashion in a single southeastern state. North Carolina emergency medical services (EMS) systems have county-based central EMS oversight; each system was surveyed by phone and e-mail. The presence and selected characteristics of TEMS programs were recorded. U.S. Census data were used to measure the population impact of the programs. All of the 101 EMS systems statewide were successfully contacted. Thirty-three counties (33%) have TEMS programs providing medical support to 56 local law enforcement agencies as well as state and federal agencies. TEMS programs tend to be located in more populated urban and suburban areas, serving a population base of 5.9 million people, or 64% of the state's population. Tactical medics in the majority of these programs (29/33; 88%) are not sworn law enforcement officers. Approximately one-third of county-based EMS systems in North Carolina have TEMS programs. These programs serve almost two-thirds of the state's population base, using primarily nonsworn tactical medics. Comparison with other regions of the country will be useful to demonstrate differences in prevalence and program characteristics. Serial surveillance will help track trends and measure the growth and impact of this growing subspecialty field.

Development and use of interactive displays in real-time ground support research facilities

Science.gov (United States)

Rhea, Donald C.; Hammons, Kvin R.; Malone, Jacqueline C.; Nesel, Michael C.

1989-01-01

The NASA Western Aeronautical Test Range (WATR) is one of the world's most advanced aeronautical research flight test support facilities. A variety of advanced and often unique real-time interactive displays has been developed for use in the mission control centers (MCC) to support research flight and ground testing. These dispalys consist of applications operating on systems described as real-time interactive graphics super workstations and real-time interactive PC/AT compatible workstations. This paper reviews these two types of workstations and the specific applications operating on each display system. The applications provide examples that demonstrate overall system capability applicable for use in other ground-based real-time research/test facilities.

QA CLASSIFICATION ANALYSIS OF GROUND SUPPORT SYSTEMS

International Nuclear Information System (INIS)

D. W. Gwyn

1996-01-01

The purpose and objective of this analysis is to determine if the permanent function Ground Support Systems (CI: BABEEOOOO) are quality-affecting items and if so, to establish the appropriate Quality Assurance (QA) classification

Free to become martyrs? The right to refuse medical treatment on religious grounds in a comparative perspective

Directory of Open Access Journals (Sweden)

Vincenzo Pacillo

2016-09-01

 ABSTRACT: This study focuses on the right of patients to refuse medical treatments on religious grounds and on the (supposed right to the parents to refuse medical treatments on behalf of their children, emphasizing the links and connections between the freedom of religion, the right to self-determination and the right to refuse medical treatment based on religious motivations. After a comparison between the norms devoted to rule the exercise of these rights in the English (and Welsh and Italian legal systems, the article suggests that the approach of medical staff towards a Refusal of Medical Treatment on Religious Grounds ought to start an intercultural process. This process ought to be a cross-cultural dialogue devoted not only to translate medical language in a language which can be fully understood by the patient, but also to create a reciprocal comprehension between the (mainstream ethnocultural communication codes and instances of the staff and the (nondominant ethnocultural (and religious communication codes and instances of the patient (or of his/her parents.

Supporting diagnosis and treatment in medical care based on Big Data processing.

Science.gov (United States)

Lupşe, Oana-Sorina; Crişan-Vida, Mihaela; Stoicu-Tivadar, Lăcrămioara; Bernard, Elena

2014-01-01

With information and data in all domains growing every day, it is difficult to manage and extract useful knowledge for specific situations. This paper presents an integrated system architecture to support the activity in the Ob-Gin departments with further developments in using new technology to manage Big Data processing - using Google BigQuery - in the medical domain. The data collected and processed with Google BigQuery results from different sources: two Obstetrics & Gynaecology Departments, the TreatSuggest application - an application for suggesting treatments, and a home foetal surveillance system. Data is uploaded in Google BigQuery from Bega Hospital Timişoara, Romania. The analysed data is useful for the medical staff, researchers and statisticians from public health domain. The current work describes the technological architecture and its processing possibilities that in the future will be proved based on quality criteria to lead to a better decision process in diagnosis and public health.

Supporting a Diverse Community of Undergraduate Researchers in Satellite and Ground-Based Remote Sensing

Science.gov (United States)

Blake, R.; Liou-Mark, J.

2012-12-01

The U.S. remains in grave danger of losing its global competitive edge in STEM. To find solutions to this problem, the Obama Administration proposed two new national initiatives: the Educate to Innovate Initiative and the $100 million government/private industry initiative to train 100,000 STEM teachers and graduate 1 million additional STEM students over the next decade. To assist in ameliorating the national STEM plight, the New York City College of Technology has designed its NSF Research Experience for Undergraduate (REU) program in satellite and ground-based remote sensing to target underrepresented minority students. Since the inception of the program in 2008, a total of 45 undergraduate students of which 38 (84%) are considered underrepresented minorities in STEM have finished or are continuing with their research or are pursuing their STEM endeavors. The program is comprised of the three primary components. The first component, Structured Learning Environments: Preparation and Mentorship, provides the REU Scholars with the skill sets necessary for proficiency in satellite and ground-based remote sensing research. The students are offered mini-courses in Geographic Information Systems, MATLAB, and Remote Sensing. They also participate in workshops on the Ethics of Research. Each REU student is a member of a team that consists of faculty mentors, post doctorate/graduate students, and high school students. The second component, Student Support and Safety Nets, provides undergraduates a learning environment that supports them in becoming successful researchers. Special networking and Brown Bag sessions, and an annual picnic with research scientists are organized so that REU Scholars are provided with opportunities to expand their professional community. Graduate school support is provided by offering free Graduate Record Examination preparation courses and workshops on the graduate school application process. Additionally, students are supported by college

The Earth Observing System (EOS) Ground System: Leveraging an Existing Operational Ground System Infrastructure to Support New Missions

Science.gov (United States)

Hardison, David; Medina, Johnny; Dell, Greg

2016-01-01

The Earth Observer System (EOS) was officially established in 1990 and went operational in December 1999 with the launch of its flagship spacecraft Terra. Aqua followed in 2002 and Aura in 2004. All three spacecraft are still operational and producing valuable scientific data. While all are beyond their original design lifetime, they are expected to remain viable well into the 2020s. The EOS Ground System is a multi-mission system based at NASA Goddard Space Flight Center that supports science and spacecraft operations for these three missions. Over its operational lifetime to date, the EOS Ground System has evolved as needed to accommodate mission requirements. With an eye towards the future, several updates are currently being deployed. Subsystem interconnects are being upgraded to reduce data latency and improve system performance. End-of-life hardware and operating systems are being replaced to mitigate security concerns and eliminate vendor support gaps. Subsystem hardware is being consolidated through the migration to Virtual Machine based platforms. While mission operations autonomy was not a design goal of the original system concept, there is an active effort to apply state-of-the-art products from the Goddard Mission Services Evolution Center (GMSEC) to facilitate automation where possible within the existing heritage architecture. This presentation will provide background information on the EOS ground system architecture and evolution, discuss latest improvements, and conclude with the results of a recent effort that investigated how the current system could accommodate a proposed new earth science mission.

Medication-overuse headache

DEFF Research Database (Denmark)

Westergaard, Maria Lurenda; Munksgaard, Signe Bruun; Bendtsen, Lars

2016-01-01

and nonmedical treatments, and limiting acute symptomatic medication. Stress reduction and lifestyle interventions may support the change towards rational pain medication use. Support, follow up, and education are needed to help patients through the detoxification period. There is fertile ground for research...

Using A Model-Based Systems Engineering Approach For Exploration Medical System Development

Science.gov (United States)

Hanson, A.; Mindock, J.; McGuire, K.; Reilly, J.; Cerro, J.; Othon, W.; Rubin, D.; Urbina, M.; Canga, M.

2017-01-01

NASA's Human Research Program's Exploration Medical Capabilities (ExMC) element is defining the medical system needs for exploration class missions. ExMC's Systems Engineering (SE) team will play a critical role in successful design and implementation of the medical system into exploration vehicles. The team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." Development of the medical system is being conducted in parallel with exploration mission architecture and vehicle design development. Successful implementation of the medical system in this environment will require a robust systems engineering approach to enable technical communication across communities to create a common mental model of the emergent engineering and medical systems. Model-Based Systems Engineering (MBSE) improves shared understanding of system needs and constraints between stakeholders and offers a common language for analysis. The ExMC SE team is using MBSE techniques to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. Systems Modeling Language (SysML) is the specific language the SE team is utilizing, within an MBSE approach, to model the medical system functional needs, requirements, and architecture. Modeling methods are being developed through the practice of MBSE within the team, and tools are being selected to support meta-data exchange as integration points to other system models are identified. Use of MBSE is supporting the development of relationships across disciplines and NASA Centers to build trust and enable teamwork, enhance visibility of team goals, foster a culture of unbiased learning and serving, and be responsive to customer needs. The MBSE approach to medical system design offers a paradigm shift toward greater integration between

[Medical treatment support to tuberculous patients--from the standpoint of community support].

Science.gov (United States)

2001-11-01

A symposium with "Medical Treatment Support to Tuberculous Patients--From the standpoint of community support" as its theme was held at the 76th Annual Meeting of the Japanese Society for Tuberculosis (April 20, 2001). "Once, It is infected with tuberculosis, one have to complete medication with a sensitive antituberculosis drug by observing the prescribed dose and duration for successful treatment". For this to be promoted community, it is necessary that (1) to manage patient's medication by medical facilities, (2) to support patient's medication by health center and (3) to support patient's living by welfare offices. Not that each facilities takes such responsibilities alone, but various community must fulfill them continuously in liaison with one another. On what measures should be taken to that end, reports based on practical examples from Nagoya City, Yokohama City and Kanagawa Prefecture have been compiled as follows. 1. It was in-office liaison by conference that supported the DOTS activities of health nurses. 2. It is cooperating, without health, medical treatment, and welfare going out, as follows. (1) A system for hospitals and clinics to carry out DOTS treatment consistently has been kept in good condition. (2) For a patient to take a drug in front of a nurse has become common, causing the patients to be motivated. (3) Assignment of MSW and nurses in charge of DOTS sent from hospitals has make it possible to offer or exchange information smoothly among those concerned. (4) A system for many persons concerned to support patients timely has been kept in good condition. This resulted in an increase in the cure rate of tuberculosis in the areas which have day laborers' lodgings. 3. By DOTS for in-patients, the number of self-discharges has decreased by 1/3, and the treatment completion rate was 94%. 4. In promotion of DOTS for the patients who have health problems other than tuberculosis, the role MSW plays is great. 5. As conditions for supporting DOTS

Constellation Program Electrical Ground Support Equipment Research and Development

Science.gov (United States)

McCoy, Keegan S.

2010-01-01

At the Kennedy Space Center, I engaged in the research and development of electrical ground support equipment for NASA's Constellation Program. Timing characteristics playa crucial role in ground support communications. Latency and jitter are two problems that must be understood so that communications are timely and consistent within the Kennedy Ground Control System (KGCS). I conducted latency and jitter tests using Alien-Bradley programmable logic controllers (PLCs) so that these two intrinsic network properties can be reduced. Time stamping and clock synchronization also play significant roles in launch processing and operations. Using RSLogix 5000 project files and Wireshark network protocol analyzing software, I verified master/slave PLC Ethernet module clock synchronization, master/slave IEEE 1588 communications, and time stamping capabilities. All of the timing and synchronization test results are useful in assessing the current KGCS operational level and determining improvements for the future.

CIMIDx: Prototype for a Cloud-Based System to Support Intelligent Medical Image Diagnosis With Efficiency.

Science.gov (United States)

Bhavani, Selvaraj Rani; Senthilkumar, Jagatheesan; Chilambuchelvan, Arul Gnanaprakasam; Manjula, Dhanabalachandran; Krishnamoorthy, Ramasamy; Kannan, Arputharaj

2015-03-27

The Internet has greatly enhanced health care, helping patients stay up-to-date on medical issues and general knowledge. Many cancer patients use the Internet for cancer diagnosis and related information. Recently, cloud computing has emerged as a new way of delivering health services but currently, there is no generic and fully automated cloud-based self-management intervention for breast cancer patients, as practical guidelines are lacking. We investigated the prevalence and predictors of cloud use for medical diagnosis among women with breast cancer to gain insight into meaningful usage parameters to evaluate the use of generic, fully automated cloud-based self-intervention, by assessing how breast cancer survivors use a generic self-management model. The goal of this study was implemented and evaluated with a new prototype called "CIMIDx", based on representative association rules that support the diagnosis of medical images (mammograms). The proposed Cloud-Based System Support Intelligent Medical Image Diagnosis (CIMIDx) prototype includes two modules. The first is the design and development of the CIMIDx training and test cloud services. Deployed in the cloud, the prototype can be used for diagnosis and screening mammography by assessing the cancers detected, tumor sizes, histology, and stage of classification accuracy. To analyze the prototype's classification accuracy, we conducted an experiment with data provided by clients. Second, by monitoring cloud server requests, the CIMIDx usage statistics were recorded for the cloud-based self-intervention groups. We conducted an evaluation of the CIMIDx cloud service usage, in which browsing functionalities were evaluated from the end-user's perspective. We performed several experiments to validate the CIMIDx prototype for breast health issues. The first set of experiments evaluated the diagnostic performance of the CIMIDx framework. We collected medical information from 150 breast cancer survivors from hospitals

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

Science.gov (United States)

Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

Grid-supported Medical Digital Library.

Science.gov (United States)

Kosiedowski, Michal; Mazurek, Cezary; Stroinski, Maciej; Weglarz, Jan

2007-01-01

Secure, flexible and efficient storing and accessing digital medical data is one of the key elements for delivering successful telemedical systems. To this end grid technologies designed and developed over the recent years and grid infrastructures deployed with their use seem to provide an excellent opportunity for the creation of a powerful environment capable of delivering tools and services for medical data storage, access and processing. In this paper we present the early results of our work towards establishing a Medical Digital Library supported by grid technologies and discuss future directions of its development. These works are part of the "Telemedycyna Wielkopolska" project aiming to develop a telemedical system for the support of the regional healthcare.

Home medication support for childhood cancer: family-centered design and testing.

Science.gov (United States)

Walsh, Kathleen E; Biggins, Colleen; Blasko, Deb; Christiansen, Steven M; Fischer, Shira H; Keuker, Christopher; Klugman, Robert; Mazor, Kathleen M

2014-11-01

Errors in the use of medications at home by children with cancer are common, and interventions to support correct use are needed. We sought to (1) engage stakeholders in the design and development of an intervention to prevent errors in home medication use, and (2) evaluate the acceptability and usefulness of the intervention. We convened a multidisciplinary team of parents, clinicians, technology experts, and researchers to develop an intervention using a two-step user-centered design process. First, parents and oncologists provided input on the design. Second, a parent panel and two oncology nurses refined draft materials. In a feasibility study, we used questionnaires to assess usefulness and acceptability. Medication error rates were assessed via monthly telephone interviews with parents. We successfully partnered with parents, clinicians, and IT experts to develop Home Medication Support (HoMeS), a family-centered Web-based intervention. HoMeS includes a medication calendar with decision support, a communication tool, adverse effect information, a metric conversion chart, and other information. The 15 families in the feasibility study gave HoMeS high ratings for acceptability and usefulness. Half recorded information on the calendar to indicate to other caregivers that doses were given; 34% brought it to the clinic to communicate with their clinician about home medication use. There was no change in the rate of medication errors in this feasibility study. We created and tested a stakeholder-designed, Web-based intervention to support home chemotherapy use, which parents rated highly. This tool may prevent serious medication errors in a larger study. Copyright © 2014 by American Society of Clinical Oncology.

Ground-based photo monitoring

Science.gov (United States)

Frederick C. Hall

2000-01-01

Ground-based photo monitoring is repeat photography using ground-based cameras to document change in vegetation or soil. Assume those installing the photo location will not be the ones re-photographing it. This requires a protocol that includes: (1) a map to locate the monitoring area, (2) another map diagramming the photographic layout, (3) type and make of film such...

Support for medical students with mental health problems: a conceptual model.

Science.gov (United States)

Grant, Andrew; Rix, Andrew; Winter, Peter; Mattick, Karen; Jones, Debbie

2015-02-01

Medical students experience higher prevalence of mental illness than age-matched controls and are less likely to access appropriate help when this happens. The aim of this study was to determine the range of strategies deployed by medical schools to support medical students with mental health concerns and to use this to identify distinct categories. Websites and documents relating to all 32 UK medical schools were looked at, as were reports for quality assurance visits carried out by the General Medical Council (UK). A structured telephone interview was carried out with medical schools. Support services were examined by tracing the path that might be taken by a hypothetical student with mental health concerns of varying severity, seeing what was required and what was available at each stage. A range of support strategies is available to most medical students both from their medical school and from generic services in the university. Medical students will usually first contact a personal tutor or a senior member of faculty or be contacted by them as a result of concerns raised either via performance issues or by another student. While individual support interventions are mostly based on evidence of effectiveness, there is no unifying theory in terms of what constitutes effective support. To enable analysis of support interventions and comparison across providers, a six-stage conceptual model of prevention was developed. The six stages are the following: prevention, identification, referral, escalation, treatment, and reintegration. The staged model, derived from analysis of existing interventions, provides a framework for evaluation of current provision and comparison of different methods of delivery. Moreover, it provides a framework for future research.

Optimal Medical Equipment Maintenance Service Proposal Decision Support System combining Activity Based Costing (ABC) and the Analytic Hierarchy Process (AHP).

Science.gov (United States)

da Rocha, Leticia; Sloane, Elliot; M Bassani, Jose

2005-01-01

This study describes a framework to support the choice of the maintenance service (in-house or third party contract) for each category of medical equipment based on: a) the real medical equipment maintenance management system currently used by the biomedical engineering group of the public health system of the Universidade Estadual de Campinas located in Brazil to control the medical equipment maintenance service, b) the Activity Based Costing (ABC) method, and c) the Analytic Hierarchy Process (AHP) method. Results show the cost and performance related to each type of maintenance service. Decision-makers can use these results to evaluate possible strategies for the categories of equipment.

Adaptive Magnetorheological Isolator for Ground Support Equipment, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — The minimization of vibration-induced damage has become a critical issue for rocket launch ground support electronics (GSE). In particular, the effect of high...

ESF GROUND SUPPORT - STRUCTURAL STEEL ANALYSIS

Energy Technology Data Exchange (ETDEWEB)

T. Misiak

1996-06-26

The purpose and objective of this analysis are to expand the level of detail and confirm member sizes for steel sets included in the Ground Support Design Analysis, Reference 5.20. This analysis also provides bounding values and details and defines critical design attributes for alternative configurations of the steel set. One possible configuration for the steel set is presented. This analysis covers the steel set design for the Exploratory Studies Facility (ESF) entire Main Loop 25-foot diameter tunnel.

Environmental control medical support team

Science.gov (United States)

Crump, William J.; Kilgore, Melvin V., Jr.

1988-01-01

The activities conducted in support of the Environmental Control and Life Support Team during December 7, 1987 through September 30, 1988 are summarized. The majority of the ongoing support has focused on the ECLSS area. Through a series of initial meetings with the ECLSS team and technical literature review, an initial list of critical topics was developed. Subtasks were then identified or additional related tasks received as action items from the ECLSS group meetings. Although most of the efforts focused on providing MSFC personnel with information regarding specific questions and problems related to ECLSS issues, other efforts regarding identifying an ECLSS Medical Support Team and constructing data bases of technical information were also initiated and completed. The specific tasks are as follows: (1) Provide support to the mechanical design and integration of test systems as related to microbiological concerns; (2) Assist with design of Human Subjects Test Protocols; (3) Interpretation and recommendations pertaining to air/water quality requirements; (4) Assist in determining the design specifications required as related to the Technical Demonstration Program; (5) Develop a data base of all microorganisms recovered from previous subsystem testing; (6) Estimates of health risk of individual microbes to test subjects; (7) Assist with setting limits for safety of test subjects; (8) Health monitoring of test subjects; (9) Assist in the preparation of test plans; (10) Assist in the development of a QA/QC program to assure the validity, accuracy and precision of the analyses; and (11) Assist in developing test plans required for future man in the loop testing.

Mathematical model of rolling an elastic wheel over deformable support base

Science.gov (United States)

Volskaia, V. N.; Zhileykin, M. M.; Zakharov, A. Y.

2018-02-01

One of the main direction of economic growth in Russia remains to be a speedy development of north and northeast regions that are the constituents of the 60 percent of the country territory. The further development of these territories requires new methods and technologies for solving transport and technological problems when off-road transportation of cargoes and people is conducting. One of the fundamental methods of patency prediction is imitation modeling of wheeled vehicles movement in different operating conditions. Both deformable properties of tires and physical and mechanical properties of the ground: normal tire deflection and gauge depth; variation of contact patch area depending on the load and pressure of air in the tire; existence of hysteresis losses in the tire material which are influencing on the rolling resistance due to friction processes between tire and ground in the contact patch; existence of the tangential reaction from the ground by entire contact area influence on the tractive patency. Nowadays there are two main trends in theoretical research of interaction wheeled propulsion device with ground: analytical method involving mathematical description of explored process and finite element method based on computational modeling. Mathematical models of interaction tire with the ground are used both in processes of interaction individual wheeled propulsion device with ground and researches of mobile vehicle dynamical models operated in specific road and climate conditions. One of the most significant imperfection of these models is the description of interaction wheel with flat deformable support base whereas profile of real support base surface has essential height of unevenness which is commensurate with radius of the wheel. The description of processes taking place in the ground under influence of the wheeled propulsion device using the finite element method is relatively new but most applicable lately. The application of this method allows

Exploration Medical System Technical Architecture Overview

Science.gov (United States)

Cerro, J.; Rubin, D.; Mindock, J.; Middour, C.; McGuire, K.; Hanson, A.; Reilly, J.; Burba, T.; Urbina, M.

2018-01-01

The Exploration Medical Capability (ExMC) Element Systems Engineering (SE) goals include defining the technical system needed to support medical capabilities for a Mars exploration mission. A draft medical system architecture was developed based on stakeholder needs, system goals, and system behaviors, as captured in an ExMC concept of operations document and a system model. This talk will discuss a high-level view of the medical system, as part of a larger crew health and performance system, both of which will support crew during Deep Space Transport missions. Other mission components, such as the flight system, ground system, caregiver, and patient, will be discussed as aspects of the context because the medical system will have important interactions with each. Additionally, important interactions with other aspects of the crew health and performance system are anticipated, such as health & wellness, mission task performance support, and environmental protection. This talk will highlight areas in which we are working with other disciplines to understand these interactions.

Protocol for SAMS (Support and Advice for Medication Study: A randomised controlled trial of an intervention to support patients with type 2 diabetes with adherence to medication

Directory of Open Access Journals (Sweden)

Sutton Stephen

2008-04-01

Full Text Available Abstract Background Although some interventions have been shown to improve adherence to medication for diabetes, results are not consistent. We have developed a theory-based intervention which we will evaluate in a well characterised population to test efficacy and guide future intervention development and trial design. Methods and Design The SAMS (Supported Adherence to Medication Study trial is a primary care based multi-centre randomised controlled trial among 200 patients with type 2 diabetes and an HbA1c of 7.5% or above. It is designed to evaluate the efficacy of a two-component motivational intervention based on the Theory of Planned Behaviour and volitional action planning to support medication adherence compared with standard care. The intervention is delivered by practice nurses. Nurses were trained using a workshop approach with role play and supervised using assessment of tape-recorded consultations. The trial has a two parallel groups design with an unbalanced three-to-two individual randomisation eight weeks after recruitment with twelve week follow-up. The primary outcome is medication adherence measured using an electronic medication monitor over 12 weeks and expressed as the difference between intervention and control in mean percentage of days on which the correct number of medication doses is taken. Subgroup analyses will explore impact of number of medications taken, age, HbA1c, and self-reported adherence at baseline on outcomes. The study also measures the effect of dispensing medication to trial participants packaged in the electronic medication-monitoring device compared with conventional medication packaging. This will be achieved through one-to-one randomisation at recruitment to these conditions with assessment of the difference between groups in self-report of medication adherence and change in mean HbA1c from baseline to eight weeks. Anonymised demographic data are collected on non-respondents. Central randomisation

Medical School Librarians Need More Training to Support their Involvement in Evidence Based Medicine Curricula

Directory of Open Access Journals (Sweden)

Aislinn Conway

2016-04-01

Full Text Available Objective – To describe the self-perceived role of librarians in developing evidence based medicine (EBM curricula and identify their current and desired level of training to support these activities. Design – Multi-institutional qualitative study. Setting – Nine medical schools in Canada and the United States of America. Subjects – Nine librarians identified by medical school faculty as central to the provision of EBM training for medical students at their institution. Methods – The researchers designed a semi-structured interview schedule based on a review of the literature and their own experiences as librarians teaching EBM. The topics covered were; librarians’ perceptions of their roles in relation to the curriculum, the training required to enable them to undertake these roles, and their professional development needs. The interviews were conducted by telephone and then audio-recorded and transcribed verbatim. The authors present five main themes; curricular design, curricular deployment, curricular assessment, educational training, and professional development. Profiles were developed for each participant based on the latter two themes and from this information common characteristics were identified. Main Results – The participants described the importance of collaboration with faculty and student bodies when designing a curriculum. Information literacy instruction and specifically literature searching and forming a research question were taught by all of the participants to facilitate curricular deployment. Some of the librarians were involved or partly involved in curricular assessment activities such as formulating exam questions or providing feedback on assignments. Educational training of participants varied from informal observation to formal workshops offered by higher education institutions. All librarians indicated a willingness to partake in professional development focused on teaching and EBM. The subjects�

Study on the action guidelines for medical support team for nuclear and radiological emergency

International Nuclear Information System (INIS)

Liu Chang'an; Liu Ying; Geng Xiusheng

2006-01-01

Objective: To study the action guidelines for medical support team for nuclear and radiological emergency. Methods: It is based on the experience and lessons learned in the course of meeting the emergencies preparedness and response of nuclear and radiological emergencies in China and abroad with the reference of the relevant reports of International Atomic Energy Agency. Results: Essential requirements and practical recommendations for the roles, responsibilities, emergency preparedness, principles and procedures of medical assistance at the scene, as well as the radiological protection of medical support team were provided. Conclusion: The document mentioned above can be applied to direct the establishment, effective medical preparedness and response of the medical support team for nuclear and radiological emergency. (authors)

Improving basic life support training for medical students

OpenAIRE

Lami, Mariam; Nair, Pooja; Gadhvi, Karishma

2016-01-01

Mariam Lami, Pooja Nair, Karishma GadhviFaculty of Medicine, Imperial College, London, London, UKAbstract: Questions have been raised about basic life support (BLS) training in medical education. This article addresses the research evidence behind why BLS training is inadequate and suggests recommendations for improving BLS training for medical students.Keywords: medical education, basic life support

Exploration Medical Cap Ability System Engineering Overview

Science.gov (United States)

McGuire, K.; Mindock, J.

2018-01-01

Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and

Silicon carbide optics for space and ground based astronomical telescopes

Science.gov (United States)

Robichaud, Joseph; Sampath, Deepak; Wainer, Chris; Schwartz, Jay; Peton, Craig; Mix, Steve; Heller, Court

2012-09-01

Silicon Carbide (SiC) optical materials are being applied widely for both space based and ground based optical telescopes. The material provides a superior weight to stiffness ratio, which is an important metric for the design and fabrication of lightweight space telescopes. The material also has superior thermal properties with a low coefficient of thermal expansion, and a high thermal conductivity. The thermal properties advantages are important for both space based and ground based systems, which typically need to operate under stressing thermal conditions. The paper will review L-3 Integrated Optical Systems - SSG’s (L-3 SSG) work in developing SiC optics and SiC optical systems for astronomical observing systems. L-3 SSG has been fielding SiC optical components and systems for over 25 years. Space systems described will emphasize the recently launched Long Range Reconnaissance Imager (LORRI) developed for JHU-APL and NASA-GSFC. Review of ground based applications of SiC will include supporting L-3 IOS-Brashear’s current contract to provide the 0.65 meter diameter, aspheric SiC secondary mirror for the Advanced Technology Solar Telescope (ATST).

A grounded theory of how social support influences physical activity in adolescent girls

Science.gov (United States)

Fawkner, Samantha

2018-01-01

ABSTRACT Purpose: Adolescent girls are not sufficiently active to achieve health benefits. Social support from friends and family has been positively associated with physical activity in adolescent girls; however it is unclear how social support influences physical activity behaviour. This study aimed to develop a grounded theory of how social support influences physical activity in adolescent girls. Methods: A qualitative, constructivist grounded theory approach was adopted. Individual interviews explored adolescent girls’ perspectives of how significant others’ influenced their physical activity through providing social support, and through modelling physical activity. Results: Participants perceived social support to influence physical activity behaviour through performance improvements, self-efficacy, enjoyment, motivation and by enabling physical activity. Improvements in performance and self-efficacy were also linked to motivation to be active. Girls perceived modelling to influence behaviour through providing opportunities for them to be physically active, and by inspiring them to be active. Conclusion: The grounded theory outlines adolescent girls’ perceptions of how significant others influence their physical activity and provides a framework for future research examining the role of social support on physical activity. PMID:29405881

A grounded theory of how social support influences physical activity in adolescent girls.

Science.gov (United States)

Laird, Yvonne; Fawkner, Samantha; Niven, Ailsa

2018-12-01

Adolescent girls are not sufficiently active to achieve health benefits. Social support from friends and family has been positively associated with physical activity in adolescent girls; however it is unclear how social support influences physical activity behaviour. This study aimed to develop a grounded theory of how social support influences physical activity in adolescent girls. A qualitative, constructivist grounded theory approach was adopted. Individual interviews explored adolescent girls' perspectives of how significant others' influenced their physical activity through providing social support, and through modelling physical activity. Participants perceived social support to influence physical activity behaviour through performance improvements, self-efficacy, enjoyment, motivation and by enabling physical activity. Improvements in performance and self-efficacy were also linked to motivation to be active. Girls perceived modelling to influence behaviour through providing opportunities for them to be physically active, and by inspiring them to be active. The grounded theory outlines adolescent girls' perceptions of how significant others influence their physical activity and provides a framework for future research examining the role of social support on physical activity.

Ground and Helicopter Emergency Medical Services Time Tradeoffs Assessed with Geographic Information.

Science.gov (United States)

Widener, Michael J; Ginsberg, Zac; Schleith, Daniel; Floccare, Douglas J; Hirshon, Jon Mark; Galvagno, Samuel

2015-07-01

We describe how geographic information systems (GIS) can be used to assess and compare estimated transport time for helicopter and ground emergency medical services. Recent research shows that while the odds of a trauma patient's survival increase with helicopter emergency medical services (HEMS), they may not increase to the extent necessary to make HEMS cost effective. This study offers an analytic tool to objectively quantify the patient travel time advantage that HEMS offers compared to ground emergency medical services (GEMS). Using helicopter dispatch data from the Maryland State Police from 2000-2011, we computed transport time estimates for HEMS and GEMS, compare these results to a reference transport time of 60 min, and use geospatial interpolation to extrapolate the total response times for each mode across the study region. Mapping the region's trauma incidents and modeling response times, our findings indicate the GIS framework for calculating transportation time tradeoffs is useful in identifying which areas can be better served by HEMS or GEMS. The use of GIS and the analytical methodology described in this study present a method to compare transportation by air and ground in the prehospital setting that accounts for how mode, distance, and road infrastructure impact total transport time. Whether used to generate regional maps in advance or applied real-time, the presented framework provides a tool to identify earlier incident locations that favor HEMS over GEMS transport modes.

Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.

Science.gov (United States)

Narayanan, Jaishree; Dobrin, Sofia; Choi, Janet; Rubin, Susan; Pham, Anna; Patel, Vimal; Frigerio, Roberta; Maurer, Darryck; Gupta, Payal; Link, Lourdes; Walters, Shaun; Wang, Chi; Ji, Yuan; Maraganore, Demetrius M

2017-01-01

Using the electronic medical record (EMR) to capture structured clinical data at the point of care would be a practical way to support quality improvement and practice-based research in epilepsy. We describe our stepwise process for building structured clinical documentation support tools in the EMR that define best practices in epilepsy, and we describe how we incorporated these toolkits into our clinical workflow. These tools write notes and capture hundreds of fields of data including several score tests: Generalized Anxiety Disorder-7 items, Neurological Disorders Depression Inventory for Epilepsy, Epworth Sleepiness Scale, Quality of Life in Epilepsy-10 items, Montreal Cognitive Assessment/Short Test of Mental Status, and Medical Research Council Prognostic Index. The tools summarize brain imaging, blood laboratory, and electroencephalography results, and document neuromodulation treatments. The tools provide Best Practices Advisories and other clinical decision support when appropriate. The tools prompt enrollment in a DNA biobanking study. We have thus far enrolled 231 patients for initial visits and are starting our first annual follow-up visits and provide a brief description of our cohort. We are sharing these EMR tools and captured data with other epilepsy clinics as part of a Neurology Practice Based Research Network, and are using the tools to conduct pragmatic trials using subgroup-based adaptive designs. © 2016 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

Personalized Medication Management: Towards a Design of Individualized Support for Elderly Citizens at Home

DEFF Research Database (Denmark)

Verdezoto, Nervo; Olsen, Jesper Wolff

2012-01-01

Several technologies have been developed to support people's medication management, including pillboxes, specialized software applications, reminders and paper-based medication lists. Several of these technologies were discovered in older adults' homes during user studies carried out with the main...... purpose to help them to manage their medications and recall challenges. We confirm that a considerable number of older adults integrate their medication treatments into their daily life routines, and that the lack of knowledge, caregiver's support, medicine outside the home, forgetting medication intake...... towards the design of a personalized medication management system. We further describe our initial stage in a participatory design process as part of the ongoing Lev Vel Consortium....

Experiments Using a Ground-Based Electrostatic Levitator and Numerical Modeling of Melt Convection for the Iron-Cobalt System in Support of Space Experiments

Science.gov (United States)

Lee, Jonghyun; SanSoucie, Michael P.

2017-08-01

Materials research is being conducted using an electromagnetic levitator installed in the International Space Station. Various metallic alloys were tested to elucidate unknown links among the structures, processes, and properties. To accomplish the mission of these space experiments, several ground-based activities have been carried out. This article presents some of our ground-based supporting experiments and numerical modeling efforts. Mass evaporation of Fe50Co50, one of flight compositions, was predicted numerically and validated by the tests using an electrostatic levitator (ESL). The density of various compositions within the Fe-Co system was measured with ESL. These results are being served as reference data for the space experiments. The convection inside a electromagnetically-levitated droplet was also modeled to predict the flow status, shear rate, and convection velocity under various process parameters, which is essential information for designing and analyzing the space experiments of some flight compositions influenced by convection.

An analysis model of the secondary tunnel lining considering ground-primary support-secondary lining interaction

Energy Technology Data Exchange (ETDEWEB)

Seo, Seong-Ho; Chang, Seok-Bue [Yooshin Engineering Corporation, Seoul(Korea); Lee, Sang-Duk [Ajou University, Suwon(Korea)

2002-06-30

It is the common practice to over design the reinforcement for the secondary tunnel lining due to the lack of rational insight into the ground loosening loads, and due to the conservative application of the empirical design methods. The main loads of the secondary lining are the ground loosening loads and the ground water pressure, and the ground load is critical in the reinforcement design of the secondary lining in the case of drained tunnel. If the external load is absent around a tunnel. the reasons of the load for secondary tunnel lining are the deterioration of the primary supports such as shotcrete, steel rib, and rock bolts. Accordingly, the analysis method considering the ground-primary supports-secondary lining interaction should be required for the rational design of the secondary tunnel lining. In this paper, the interaction was conceptually described by the simple mass-spring model and the load transfer from the ground and primary supports to the secondary lining is showed by the ground-primary supports-secondary lining reaction curves for the theoretical solution of a circular tunnel, And also, the application of this proposed model to numerical analysis is verified in order to check the potential for the tunnel with the complex analysis conditions. (author). 8 refs., 2 tabs., 7 figs.

Developing a Logistics Data Process for Support Equipment for NASA Ground Operations

Science.gov (United States)

Chakrabarti, Suman

2010-01-01

The United States NASA Space Shuttle has long been considered an extremely capable yet relatively expensive rocket. A great part of the roughly US $500 million per launch expense was the support footprint: refurbishment and maintenance of the space shuttle system, together with the long list of resources required to support it, including personnel, tools, facilities, transport and support equipment. NASA determined to make its next rocket system with a smaller logistics footprint, and thereby more cost-effective and quicker turnaround. The logical solution was to adopt a standard Logistics Support Analysis (LSA) process based on GEIA-STD-0007 http://www.logisticsengineers.org/may09pres/GEIASTD0007DEXShortIntro.pdf which is the successor of MIL-STD-1388-2B widely used by U.S., NATO, and other world military services and industries. This approach is unprecedented at NASA: it is the first time a major program of programs, Project Constellation, is factoring logistics and supportability into design at many levels. This paper will focus on one of those levels NASA ground support equipment for the next generation of NASA rockets and on building a Logistics Support Analysis Record (LSAR) for developing and documenting a support solution and inventory of resources for. This LSAR is actually a standards-based database, containing analyses of the time and tools, personnel, facilities and support equipment required to assemble and integrate the stages and umbilicals of a rocket. This paper will cover building this database from scratch: including creating and importing a hierarchical bill of materials (BOM) from legacy data; identifying line-replaceable units (LRUs) of a given piece of equipment; analyzing reliability and maintainability of said LRUs; and therefore making an assessment back to design whether the support solution for a piece of equipment is too much work, i.e., too resource-intensive. If one must replace or inspect an LRU too much, perhaps a modification of

Use of web based systems to support postgraduate medical education.

Science.gov (United States)

Tochel, C; Beggs, K; Haig, A; Roberts, J; Scott, H; Walker, K; Watson, M

2011-12-01

BACKGROUND To meet the demands of delivering the Foundation programme across a geographically diverse country, two web based systems (ePortfolio and eLearning) were developed to promote accessibility to training material and assessment tools on standardised platforms. This study evaluated the use of both tools throughout an entire academic year. METHODS All Scottish Foundation trainees' online learning and assessment data in 2007/08 were analysed, providing a national breakdown of post specialty, completion rates of mandatory assessments (including summary analysis of anonymised scores), and trainees' use of non-mandatory learning tools. Independent verification of competence data was sought from Deaneries. RESULTS There were high levels of engagement with both the ePortfolio (75-97% assessment completion) and eLearning systems (89-98% induction course completion), and the majority of trainees completed all required elements. There was extensive use of ePortfolio beyond mandatory levels for recording of learning events, including almost 20 000 personal learning records submitted by second year trainees. There was evidence that ePortfolio was used to record achievement of clinical competence rather than to track improvements towards competence (median workplace based assessment scores were 'high' or 'very high'). Online learning modules received positive feedback and its flexible format suited the trainees' working environment. External verification of formal assessment data revealed good correlation with locally stored outcomes, both indicating approximately 99% programme completion rates. CONCLUSIONS Core components of the Foundation programme have been delivered successfully to thousands of trainees across Scotland using web based systems to deliver and support education and assessment. There is great potential for further exploration of this carefully managed, rich dataset at individual, regional, and national levels to inform the future of medical education.

Software-Defined Ground Stations - Enhancing Multi-Mission Support, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — This SBIR Phase 1 proposal to NASA requests $99,055.69 to enhance multiple mission support in ground stations through the use of software defined radios and virtual...

Electric Ground Support Equipment at Airports

Energy Technology Data Exchange (ETDEWEB)

2017-12-12

Airport ground support equipment (GSE) is used to service airplanes between flights. Services include refueling, towing airplanes or luggage/freight carts, loading luggage/freight, transporting passengers, loading potable water, removing sewage, loading food, de-icing airplanes, and fire-fighting. Deploying new GSE technologies is a promising opportunity in part because the purchasers are generally large, technologically sophisticated airlines, contractors, or airports with centralized procurement and maintenance departments. Airlines could particularly benefit from fuel diversification since they are highly exposed to petroleum price volatility. GSE can be particularly well-suited for electrification because it benefits from low-end torque and has frequent idle time and short required ranges.

Ground-based observations of exoplanet atmospheres

NARCIS (Netherlands)

Mooij, Ernst Johan Walter de

2011-01-01

This thesis focuses on the properties of exoplanet atmospheres. The results for ground-based near-infrared secondary eclipse observations of three different exoplanets, TrES-3b, HAT-P-1b and WASP-33b, are presented which have been obtained with ground-based telescopes as part of the GROUSE project.

The Usability and Effectiveness of Mobile Health Technology–Based Lifestyle and Medical Intervention Apps Supporting Health Care During Pregnancy: Systematic Review

Science.gov (United States)

Rosman, Ageeth N; van Beukering, Monique DM; Kok, Marjolein

2018-01-01

Background A growing number of mobile health (mHealth) technology–based apps are being developed for personal lifestyle and medical health care support, of which several apps are related to pregnancy. Evidence on usability and effectiveness is limited but crucial for successful implementation. Objective This study aimed to evaluate the usability, that is, feasibility and acceptability, as well as effectiveness of mHealth lifestyle and medical apps to support health care during pregnancy in high-income countries. Feasibility was defined as the actual use, interest, intention, and continued use; perceived suitability; and ability of users to carry out the activities of the app. Acceptability was assessed by user satisfaction, appreciation, and the recommendation of the app to others. Methods We performed a systematic review searching the following electronic databases for studies on mHealth technology–based apps in maternal health care in developed countries: EMBASE, MEDLINE Epub (Ovid), Cochrane Library, Web of Science, and Google Scholar. All included studies were scored on quality, using the ErasmusAGE Quality Score or the consolidated criteria for reporting qualitative research. Main outcome measures were usability and effectiveness of mHealth lifestyle and medical health care support apps related to pregnancy. All studies were screened by 2 reviewers individually, and the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement were followed. Results Our search identified 4204 titles and abstracts, of which 2487 original studies remained after removing duplicates. We performed full-text screening of 217 studies, of which 29 were included in our study. In total, 19 out of 29 studies reported on mHealth apps to adopt healthy lifestyles and 10 out of 29 studies to support medical care. The lifestyle apps evaluated in 19 studies reported on usability and effectiveness: 10 studies reported positive on acceptability, and 14

How Iranian Medical Trainees Approach their Responsibilities in Clinical Settings; A Grounded Theory Research

Directory of Open Access Journals (Sweden)

Omid Asemani

2015-09-01

Full Text Available Background: It seems we are now experiencing “responsibility problems” among medical trainees (MTs and some of those recently graduated from medical schools in Iran. Training responsible professionals have always been one of the main concerns of medical educators. Nevertheless, there is a dearth of research in the literature on “responsibility” especially from the medical education point of view. Therefore, the present study was carried out with the aim of presenting a theoretical based framework for understanding how MTs approach their responsibilities in educational settings. Method: This qualitative study was conducted at Shiraz University of Medical Sciences (SUMS using the grounded theory methodology. 15 MTs and 10 clinical experts and professional nurses were purposefully chosen as participants. Data was analyzed using the methodology suggested by Corbin and Strauss, 1998. Results: “Try to find acceptance toward expectations”, “try to be committed to meet the expectations” and “try to cope with unacceptable expectations” were three main categories extracted based on the research data. Abstractly, the main objective for using these processes was “to preserve the integrity of student identity” which was the core category of this research too. Moreover, it was also found that practically, “responsibility” is considerably influenced by lots of positive and negative contextual and intervening conditions. Conclusion: “Acceptance” was the most decisive variable highly effective in MTs’ responsibility. Therefore, investigating the “process of acceptance” regarding the involved contextual and intervening conditions might help medical educators correctly identify and effectively control negative factors and reinforce the constructive ones that affect the concept of responsibility in MTs.

GEARS: An Enterprise Architecture Based On Common Ground Services

Science.gov (United States)

Petersen, S.

2014-12-01

Earth observation satellites collect a broad variety of data used in applications that range from weather forecasting to climate monitoring. Within NOAA the National Environmental Satellite Data and Information Service (NESDIS) supports these applications by operating satellites in both geosynchronous and polar orbits. Traditionally NESDIS has acquired and operated its satellites as stand-alone systems with their own command and control, mission management, processing, and distribution systems. As the volume, velocity, veracity, and variety of sensor data and products produced by these systems continues to increase, NESDIS is migrating to a new concept of operation in which it will operate and sustain the ground infrastructure as an integrated Enterprise. Based on a series of common ground services, the Ground Enterprise Architecture System (GEARS) approach promises greater agility, flexibility, and efficiency at reduced cost. This talk describes the new architecture and associated development activities, and presents the results of initial efforts to improve product processing and distribution.

A Social Accountable Model for Medical Education System in Iran: A Grounded-Theory

Directory of Open Access Journals (Sweden)

Mohammadreza Abdolmaleki

2017-10-01

Full Text Available Social accountability has been increasingly discussed over the past three decades in various fields providing service to the community and has been expressed as a goal for various areas. In medical education system, like other social accountability areas, it is considered as one of the main objectives globally. The aim of this study was to seek a social accountability theory in the medical education system that is capable of identifying all the standards, norms, and conditions within the country related to the study subject and recognize their relationship. In this study, a total of eight experts in the field of social accountability in medical education system with executive or study experience were interviewedpersonally. After analysis of interviews, 379 codes, 59 secondary categories, 16 subcategories, and 9 main categories were obtained. The resulting data was collected and analyzed at three levels of open coding, axial coding, and selective coding in the form of grounded theory study of “Accountability model of medical education in Iran”, which can be used in education system’s policies and planning for social accountability, given that almost all effective components of social accountability in highereducation health system with causal and facilitator associations were determined.Keywords: SOCIAL ACCOUNTABILITY, COMMUNITY–ORIENTED MEDICINE, COMMUNITY MEDICINE, EDUCATION SYSTEM, GROUNDED THEORY

Students' satisfaction to hybrid problem-based learning format for basic life support/advanced cardiac life support teaching.

Science.gov (United States)

Chilkoti, Geetanjali; Mohta, Medha; Wadhwa, Rachna; Saxena, Ashok Kumar; Sharma, Chhavi Sarabpreet; Shankar, Neelima

2016-11-01

Students are exposed to basic life support (BLS) and advanced cardiac life support (ACLS) training in the first semester in some medical colleges. The aim of this study was to compare students' satisfaction between lecture-based traditional method and hybrid problem-based learning (PBL) in BLS/ACLS teaching to undergraduate medical students. We conducted a questionnaire-based, cross-sectional survey among 118 1 st -year medical students from a university medical college in the city of New Delhi, India. We aimed to assess the students' satisfaction between lecture-based and hybrid-PBL method in BLS/ACLS teaching. Likert 5-point scale was used to assess students' satisfaction levels between the two teaching methods. Data were collected and scores regarding the students' satisfaction levels between these two teaching methods were analysed using a two-sided paired t -test. Most students preferred hybrid-PBL format over traditional lecture-based method in the following four aspects; learning and understanding, interest and motivation, training of personal abilities and being confident and satisfied with the teaching method ( P < 0.05). Implementation of hybrid-PBL format along with the lecture-based method in BLS/ACLS teaching provided high satisfaction among undergraduate medical students.

[Diagnosis and the technology for optimizing the medical support of a troop unit].

Science.gov (United States)

Korshever, N G; Polkovov, S V; Lavrinenko, O V; Krupnov, P A; Anastasov, K N

2000-05-01

The work is devoted to investigation of the system of military unit medical support with the use of principles and states of organizational diagnosis; development of the method allowing to assess its functional activity; and determination of optimization trends. Basing on the conducted organizational diagnosis and expert inquiry the informative criteria were determined which characterize the stages of functioning of the military unit medical support system. To evaluate the success of military unit medical support the complex multi-criteria pattern was developed and algorithm of this process optimization was substantiated. Using the results obtained, particularly realization of principles and states of decision taking theory in machine program it is possible to solve more complex problem of comparison between any number of military units: to dispose them according to priority decrease; to select the programmed number of the best and worst; to determine the trends of activity optimization in corresponding medical service personnel.

Penn State University ground software support for X-ray missions.

Science.gov (United States)

Townsley, L. K.; Nousek, J. A.; Corbet, R. H. D.

1995-03-01

The X-ray group at Penn State is charged with two software development efforts in support of X-ray satellite missions. As part of the ACIS instrument team for AXAF, the authors are developing part of the ground software to support the instrument's calibration. They are also designing a translation program for Ginga data, to change it from the non-standard FRF format, which closely parallels the original telemetry format, to FITS.

Innovative characterization techniques and decision support systems for ground water contamination projects

International Nuclear Information System (INIS)

Hoffman, F.

1992-07-01

Ground water contamination projects throughout the world must be approached as individual and unique problems. Many traditional investigation techniques require modification to meet the needs of site-specific situations. Because the age of the science of contaminant hydrogeology can be measured only in a few decades, the field is ripe for innovation. This paper describes the following new technologies: At Lawrence Livermore National Laboratory (LLNL), we have developed a new drilling and sampling method, which allows the evaluation of the vertical extent of contamination in a single borehole. We are also using new fiber-optic-based chemical analytical sensors that promise to greatly increase the case of obtaining chemical analyses in the subsurface while greatly reducing costs. Because ground water investigations are data intensive, we need the best decision support system information tools to proceed with investigation and cleanup. These tools have three components: a relational database, data analysis tools, and tools for data display

A web service system supporting three-dimensional post-processing of medical images based on WADO protocol.

Science.gov (United States)

He, Longjun; Xu, Lang; Ming, Xing; Liu, Qian

2015-02-01

Three-dimensional post-processing operations on the volume data generated by a series of CT or MR images had important significance on image reading and diagnosis. As a part of the DIOCM standard, WADO service defined how to access DICOM objects on the Web, but it didn't involve three-dimensional post-processing operations on the series images. This paper analyzed the technical features of three-dimensional post-processing operations on the volume data, and then designed and implemented a web service system for three-dimensional post-processing operations of medical images based on the WADO protocol. In order to improve the scalability of the proposed system, the business tasks and calculation operations were separated into two modules. As results, it was proved that the proposed system could support three-dimensional post-processing service of medical images for multiple clients at the same moment, which met the demand of accessing three-dimensional post-processing operations on the volume data on the web.

Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

Science.gov (United States)

Rohde, Emily; Domm, Elizabeth

2018-02-01

To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

Association Between Helicopter vs Ground Emergency Medical Services and Survival for Adults With Major Trauma

Science.gov (United States)

Galvagno, Samuel M.; Haut, Elliott R.; Zafar, S. Nabeel; Millin, Michael G.; Efron, David T.; Koenig, George J.; Baker, Susan P.; Bowman, Stephen M.; Pronovost, Peter J.; Haider, Adil H.

2012-01-01

Context Helicopter emergency medical services and their possible effect on outcomes for traumatically injured patients remain a subject of debate. Because helicopter services are a limited and expensive resource, a methodologically rigorous investigation of its effectiveness compared with ground emergency medical services is warranted. Objective To assess the association between the use of helicopter vs ground services and survival among adults with serious traumatic injuries. Design, Setting, and Participants Retrospective cohort study involving 223 475 patients older than 15 years, having an injury severity score higher than 15, and sustaining blunt or penetrating trauma that required transport to US level I or II trauma centers and whose data were recorded in the 2007–2009 versions of the American College of Surgeons National Trauma Data Bank. Interventions Transport by helicopter or ground emergency services to level I or level II trauma centers. Main Outcome Measures Survival to hospital discharge and discharge disposition. Results A total of 61 909 patients were transported by helicopter and 161 566 patients were transported by ground. Overall, 7813 patients (12.6%) transported by helicopter died compared with 17 775 patients (11%) transported by ground services. Before propensity score matching, patients transported by helicopter to level I and level II trauma centers had higher Injury Severity Scores. In the propensity score–matched multivariable regression model, for patients transported to level I trauma centers, helicopter transport was associated with an improved odds of survival compared with ground transport (odds ratio [OR], 1.16; 95% CI, 1.14–1.17; P<.001; absolute risk reduction [ARR], 1.5%). For patients transported to level II trauma centers, helicopter transport was associated with an improved odds of survival (OR, 1.15; 95% CI, 1.13–1.17; P < .001; ARR, 1.4%). A greater proportion (18.2%) of those transported to level I trauma centers

Canvas supports and grounds in paintings by C.W. Eckersberg

DEFF Research Database (Denmark)

Filtenborg, Troels; Andersen, Cecil Krarup

2017-01-01

The supports and grounds in 43 paintings on canvas by C.W. Eckersberg, dating from throughout his career, were investigated by visual examination, X-radiography, computer assisted automated thread counting and weave mapping, as well as by cross section analysis. The analytical data were complemen...

Solar Constant (SOLCON) Experiment: Ground Support Equipment (GSE) software development

Science.gov (United States)

Gibson, M. Alan; Thomas, Susan; Wilson, Robert

1991-01-01

The Solar Constant (SOLCON) Experiment, the objective of which is to determine the solar constant value and its variability, is scheduled for launch as part of the Space Shuttle/Atmospheric Laboratory for Application and Science (ATLAS) spacelab mission. The Ground Support Equipment (GSE) software was developed to monitor and analyze the SOLCON telemetry data during flight and to test the instrument on the ground. The design and development of the GSE software are discussed. The SOLCON instrument was tested during Davos International Solar Intercomparison, 1989 and the SOLCON data collected during the tests are analyzed to study the behavior of the instrument.

Parental social support as a moderator of self-medication in adolescents.

Science.gov (United States)

Reimuller, Alison; Shadur, Julia; Hussong, Andrea M

2011-03-01

We examined the moderating effects of parenting on the temporal relationship between negative affect and subsequent alcohol use in adolescents as an indicator of self-medication. Specifically, we tested whether youth are more likely to self-medicate if they receive less parental social support. We used a multi-method, multi-reporter strategy and an experience sampling paradigm to examine these mechanisms in an elevated-risk sample preparing for the transition to high school. Seventy-one adolescents and their parents completed home-based interviews and adolescents completed a 21-day experience sampling protocol in which they reported their alcohol use daily and their affect thrice daily. Parent-reported family communication, though no other parental support indicators, moderated the relation between daily negative affect and alcohol use. Plotting of interactions showed a greater likelihood of drinking on days characterized by greater negative affect only in adolescents with higher levels of parent-reported family communication. This study offers tentative support for parental support as a moderator of the relation between daily negative affect and alcohol use. Parental support may be a response to alcohol use and self-medication in teens such that parents become more involved and open in talking with their teens when they notice these patterns of behavior. Copyright © 2010 Elsevier Ltd. All rights reserved.

Log In to Experiential Learning Theory: Supporting Web-Based Faculty Development.

Science.gov (United States)

Omer, Selma; Choi, Sunhea; Brien, Sarah; Parry, Marcus

2017-09-27

For an increasingly busy and geographically dispersed faculty, the Faculty of Medicine at the University of Southampton, United Kingdom, developed a range of Web-based faculty development modules, based on Kolb's experiential learning cycle, to complement the faculty's face-to-face workshops. The objective of this study was to assess users' views and perceptions of the effectiveness of Web-based faculty development modules based on Kolb's experiential learning cycle. We explored (1) users' satisfaction with the modules, (2) whether Kolb's design framework supported users' learning, and (3) whether the design principle impacts their work as educators. We gathered data from users over a 3-year period using evaluation surveys built into each of the seven modules. Quantitative data were analyzed using descriptive statistics, and responses to open-ended questions were analyzed using content analysis. Out of the 409 module users, 283 completed the survey (69.1% response rate). Over 80% of the users reported being satisfied or very satisfied with seven individual aspects of the modules. The findings suggest a strong synergy between the design features that users rated most highly and the key stages of Kolb's learning cycle. The use of simulations and videos to give the users an initial experience as well as the opportunity to "Have a go" and receive feedback in a safe environment were both considered particularly useful. In addition to providing an opportunity for reflection, many participants considered that the modules would enhance their roles as educators through: increasing their knowledge on various education topics and the required standards for medical training, and improving their skills in teaching and assessing students through practice and feedback and ultimately increasing their confidence. Kolb's theory-based design principle used for Web-based faculty development can support faculty to improve their skills and has impact on their role as educators

Implementation and evaluation of a medical image management system with content-based retrieval support

International Nuclear Information System (INIS)

Carita, Edilson Carlos; Seraphim, Enzo; Honda, Marcelo Ossamu; Azevedo-Marques, Paulo Mazzoncini de

2008-01-01

Objective: the present paper describes the implementation and evaluation of a medical images management system with content-based retrieval support (PACS-CBIR) integrating modules focused on images acquisition, storage and distribution, and text retrieval by keyword and images retrieval by similarity. Materials and methods: internet-compatible technologies were utilized for the system implementation with free ware, and C ++ , PHP and Java languages on a Linux platform. There is a DICOM-compatible image management module and two query modules, one of them based on text and the other on similarity of image texture attributes. Results: results demonstrate an appropriate images management and storage, and that the images retrieval time, always < 15 sec, was found to be good by users. The evaluation of retrieval by similarity has demonstrated that the selected images extractor allowed the sorting of images according to anatomical areas. Conclusion: based on these results, one can conclude that the PACS-CBIR implementation is feasible. The system has demonstrated to be DICOM-compatible, and that it can be integrated with the local information system. The similar images retrieval functionality can be enhanced by the introduction of further descriptors. (author)

21 CFR 880.5780 - Medical support stocking.

Science.gov (United States)

2010-04-01

...) Classification. Class II (performance standards). (b) Medical support stocking for general medical purposes—(1... purposes other than the prevention of pooling of blood in the leg. (2) Classification. Class I. The device..., subject to the limitations in § 880.9. The device is also exempt from the current good manufacturing...

Complementary medicines in medicine: Conceptualising terminology among Australian medical students using a constructivist grounded theory approach.

Science.gov (United States)

Templeman, Kate; Robinson, Anske; McKenna, Lisa

2015-02-01

Terminology around the use of complementary medicines (CM) within medical discourse is ambiguous. Clear collective discourse within the medical context is required. This study reports the findings of a Constructivist Grounded Theory Method study used to explore medical students' conceptualisation of terminology and associated value components around CMs as evidenced within their discourse community. The results show that terminology surrounding CMs within medicine is politically charged and fraught with value judgements. Terms used to describe CMs were considered, many of which were deemed problematic. Categorisation of specific medicines was also deemed inappropriate in certain contexts. Conceptualisation of CM terminology, categorisation and value implications, discriminated between levels of evidence for CMs and provided insights into the social change of medicine towards emergence of an evidence-based integrative approach. The results show that terminology surrounding CM is a social construct consistent with fluid conceptualisation and operationalisation in different social contexts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving basic life support training for medical students.

Science.gov (United States)

Lami, Mariam; Nair, Pooja; Gadhvi, Karishma

2016-01-01

Questions have been raised about basic life support (BLS) training in medical education. This article addresses the research evidence behind why BLS training is inadequate and suggests recommendations for improving BLS training for medical students.

Dynamic Behaviour and Seismic Response of Ground Supported Cylindrical Water Tanks

Science.gov (United States)

Asha, Joseph; Glory, Joseph

2018-05-01

Liquid storage tank such as in water distribution systems, petroleum plants etc., constitute a vital component of life line systems. Reducing earthquake effects on liquid storage tanks, to minimize the environmental and economic impact of these effects, have always been an important engineering concern. In this paper, the dynamic behavior of cylindrical ground supported concrete water tanks with different aspect ratios is investigated using finite element software ANSYS. The natural frequencies and modal responses are obtained for impulsive and convective modes of vibration. The natural frequency of vibration of the tank is observed to be the lowest at maximum water depth. The fundamental impulsive frequency increases as water level reduces and for water level less than 1/3 of tank height, there is significantly no change in impulsive frequency. The effect of wall flexibility on dynamic behavior of the tank is investigated by performing the modal analysis of flexible and rigid tanks. For a partially filled tank, the results of the present study are of significant relevance. The response of the tank to the transient loading as horizontal ground motion of El Centro earthquake is studied for various water heights. As the height of water on the tank increases, the ultimate maximum seismic response parameters are also observed to be increased. The location of maximum hoop stress varies in accordance with the variations in input ground motion and water fill condition whereas shear and bending moment are maximum at the base.

Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs.

Science.gov (United States)

Parmar, Jayesh R; Forrest, Benjamin D; Freeman, Robert A

2016-01-01

The purpose of this report is to present a review of the medical uses, efficacy, and adverse effects of the three approved cannabis-based medications and ingested marijuana. A literature review was conducted utilizing key search terms: dronabinol, nabilone, nabiximols, cannabis, marijuana, smoke, efficacy, toxicity, cancer, multiple sclerosis, nausea, vomiting, appetite, pain, glaucoma, and side effects. Abstracts of the included literature were reviewed, analyzed, and organized to identify the strength of evidence in medical use, efficacy, and adverse effects of the approved cannabis-based medications and medical marijuana. A total of 68 abstracts were included for review. Dronabinol's (Marinol) most common medical uses include weight gain, chemotherapy-induced nausea and vomiting (CINV), and neuropathic pain. Nabiximol's (Sativex) most common medical uses include spasticity in multiple sclerosis (MS) and neuropathic pain. Nabilone's (Cesamet) most common medical uses include CINV and neuropathic pain. Smoked marijuana's most common medical uses include neuropathic pain and glaucoma. Orally ingested marijuana's most common medical uses include improving sleep, reducing neuropathic pain, and seizure control in MS. In general, all of these agents share similar medical uses. The reported adverse effects of the three cannabis-based medications and marijuana show a major trend in central nervous system (CNS)-related adverse effects along with cardiovascular and respiratory related adverse effects. Marijuana shares similar medical uses with the approved cannabis-based medications dronabinol (Marinol), nabiximols (Sativex), and nabilone (Cesamet), but the efficacy of marijuana for these medical uses has not been fully determined due to limited and conflicting literature. Medical marijuana also has similar adverse effects as the FDA-approved cannabis-based medications mainly consisting of CNS related adverse effects but also including cardiovascular and respiratory

Effectively marketing prepaid medical care with decision support systems.

Science.gov (United States)

Forgionne, G A

1991-01-01

The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.

SCaN Network Ground Station Receiver Performance for Future Service Support

Science.gov (United States)

Estabrook, Polly; Lee, Dennis; Cheng, Michael; Lau, Chi-Wung

2012-01-01

Objectives: Examine the impact of providing the newly standardized CCSDS Low Density Parity Check (LDPC) codes to the SCaN return data service on the SCaN SN and DSN ground stations receivers: SN Current Receiver: Integrated Receiver (IR). DSN Current Receiver: Downlink Telemetry and Tracking (DTT) Receiver. Early Commercial-Off-The-Shelf (COTS) prototype of the SN User Service Subsystem Component Replacement (USS CR) Narrow Band Receiver. Motivate discussion of general issues of ground station hardware design to enable simple and cheap modifications for support of future services.

(Environmental investigation of ground water contamination at Wright- Patterson Air Force Base, Ohio)

Energy Technology Data Exchange (ETDEWEB)

1991-10-01

This Health and Safety Plan (HSP) was developed for the Environmental Investigation of Ground-water Contamination Investigation at Wright-Patterson Air Force Base near Dayton, Ohio, based on the projected scope of work for the Phase 1, Task 4 Field Investigation. The HSP describes hazards that may be encountered during the investigation, assesses the hazards, and indicates what type of personal protective equipment is to be used for each task performed. The HSP also addresses the medical monitoring program, decontamination procedures, air monitoring, training, site control, accident prevention, and emergency response.

Supporting medical students with learning disabilities in Asian medical schools

Directory of Open Access Journals (Sweden)

Md. Anwarul Azim Majumder

2010-10-01

Full Text Available Md. Anwarul Azim Majumder1, Sayeeda Rahman2, Urban JA D’Souza3, Gad Elbeheri4, Khalid Bin Abdulrahman5, M Muzaherul Huq61,2Department of Clinical Sciences, School of Life Sciences, University of Bradford, West Yorkshire, Bradford, UK; 3School of Medicine, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; 4Centre for Child Evaluation and Teaching, Kuwait; 5College of Medicine, Al-Imam University, Riyadh, Saudi Arabia; 6Centre for Medical Education (CME, Mohakhali, Dhaka, BangladeshAbstract: Learning disabilities (LDs represent the largest group of disabilities in higher education (HE institutes, including medical schools, and the numbers are continuing to rise. The worrying concern is that two-thirds to half of these students with LDs remain undiagnosed when they start their undergraduate education and may even graduate without having their disabilities diagnosed. These students struggle with their academic abilities, receive poor grades and, as a result, develop lower perceptions of their intellectual abilities than do those students without LDs. All these ultimately hamper their professional practice, employment, and career progression. Appropriate and adequate educational policies, provisions, and practices help students to progress satisfactorily. In Asian countries, public and professional awareness about LDs is low, supportive provisions are limited, legislations are inadequate, data are scarce, and equal-opportunity/widening-participation policies are not implemented effectively in the HE sector. This article discusses the issues related to LDs in medical education and draws policy, provision, and practice implications to identify, assess, and support students with LDs in medical schools, particularly in an Asian context.Keywords: medical education, learning disabilities, dyslexia, Asia

The ground support equipment for the LAUE project

Science.gov (United States)

Caroli, E.; Auricchio, N.; Basili, A.; Carassiti, V.; Cassese, F.; Del Sordo, S.; Frontera, F.; Pecora, M.; Recanatesi, L.; Schiavone, F.; Silvestri, S.; Squerzanti, S.; Stephen, J. B.; Virgilli, E.

2013-09-01

The development of wide band Laue lens imaging technology is challenging, but has important potential applications in hard X- and γ-ray space instrumentation for the coming decades. The Italian Space Agency has funded a project dedicated to the development of a reliable technology to assemble a wide band Laue lens for use in space. The ground support equipment (GSE) for this project was fundamental to its eventual success... The GSE was implemented in a hard X-ray beam line built at the University of Ferrara and had the main purpose of controlling the assembly of crystals onto the Laue lens petal and to verify its final performance. The GSE incorporates the management and control of all the movements of the beam line mechanical subsystems and of the precision positioner (based on a Hexapod tool) of crystals on the petal, as well as the acquisition, storing and analysis of data obtained from the focal plane detectors (an HPGe spectrometer and an X-ray flat panel imager). The GSE is based on two PC's connected through a local network: one, placed inside the beam line, to which all the movement subsystems and the detector I/O interface and on which all the management and acquisition S/W runs, the other in the control room allows the remote control and implements the offline analysis S/W of the data obtained from the detectors. Herein we report on the GSE structure with its interface with the beam line mechanical system, with the fine crystal positioner and with the focal plane detector. Furthermore we describe the SW developed for the handling of the mechanical movement subsystems and for the analysis of the detector data with the procedure adopted for the correct orientation of the crystals before their bonding on the lens petal support.

Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

Directory of Open Access Journals (Sweden)

Shane Scahill

2015-09-01

Full Text Available Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole.

Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy.

Science.gov (United States)

Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

2015-01-01

Mental health-related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole.

Overcoming barriers to development of cooperative medical decision support models.

Science.gov (United States)

Hudson, Donna L; Cohen, Maurice E

2012-01-01

Attempts to automate the medical decision making process have been underway for the at least fifty years, beginning with data-based approaches that relied chiefly on statistically-based methods. Approaches expanded to include knowledge-based systems, both linear and non-linear neural networks, agent-based systems, and hybrid methods. While some of these models produced excellent results none have been used extensively in medical practice. In order to move these methods forward into practical use, a number of obstacles must be overcome, including validation of existing systems on large data sets, development of methods for including new knowledge as it becomes available, construction of a broad range of decision models, and development of non-intrusive methods that allow the physician to use these decision aids in conjunction with, not instead of, his or her own medical knowledge. None of these four requirements will come easily. A cooperative effort among researchers, including practicing MDs, is vital, particularly as more information on diseases and their contributing factors continues to expand resulting in more parameters than the human decision maker can process effectively. In this article some of the basic structures that are necessary to facilitate the use of an automated decision support system are discussed, along with potential methods for overcoming existing barriers.

International medical students--a survey of perceived challenges and established support services at medical faculties.

Science.gov (United States)

Huhn, D; Junne, F; Zipfel, S; Duelli, R; Resch, F; Herzog, W; Nikendei, C

2015-01-01

Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties' perceived problems nor of the offered support exists. All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1.) The percentage of non-German students at the medical faculty; 2.) The perceived difficulties and problems of foreign students; 3.) The offers for non-German students; and 4.) The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis. Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology. Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential.

Ground-based Efforts to Support a Space-Based Experiment: the Latest LADEE Results

Science.gov (United States)

Cudnik, Brian; Rahman, Mahmudur

2014-05-01

The much anticipated launch of the Lunar Atmosphere and Dust Environment Explorer happened flawlessly last October and the satellite has been doing science (and sending a few images) since late November. [the LADEE mission ended with the crash-landing of the spacecraft on the lunar far side on April 17, 2014, capping a successful 140 day mission] .We also have launched our campaign to document lunar meteoroid impact flashes from the ground to supply ground truth to inform of any changes in dust concentration encountered by the spacecraft in orbit around the moon. To date I have received six reports of impact flashes or flash candidates from the group I am coordinating; other groups around the world may have more to add when all is said and done. In addition, plans are underway to prepare a program at Prairie View A&M University to involve our physics majors in lunar meteoroid, asteroid occultation, and other astronomical work through our Center for Astronomical Sciences and Technology. This facility will be a control center to not only involve physics majors, but also to include pre-service teachers and member of the outside community to promote pro-am collaborations.

[se-atlas - the health service information platform for people with rare diseases : Supporting research on medical care institutions and support groups].

Science.gov (United States)

Haase, Johanna; Wagner, Thomas O F; Storf, Holger

2017-05-01

se-atlas - the health service information platform for rare diseases - is part of the German National Action Plan for People with Rare Diseases and is funded by the German Federal Ministry of Health. The objective of se-atlas as a web-based platform is to illustrate those medical care institutions that are linked to rare diseases, in a transparent and user-friendly way. The website provides an overview of medical care institutions and support groups focusing on rare diseases in Germany. The primary target groups of se-atlas are affected patients, their relatives and physicians but can also include non-medical professionals and the general public. In order to make it easier to look up medical care institutions or support groups and optimize the search results displayed, various strategies are being developed and evaluated. Hence, the allocation of diseases to appropriate medical care institutions and support groups is currently a main focus. Since its launch in 2015, se-atlas has grown continuously and now incorporates five times more entries than were included 20 months prior. Among this data are the current rare diseases centres in Germany, which play a major role in providing patient-centred healthcare by acting as primary contact points for people with rare diseases. Further expansion and maintenance of the data base raises several organisational and software-related challenges. For one, the data should be completed by adding more high-quality information, while not neglecting the existing entries and maintaining their high level of quality in the long term.

Method of recovering deeply submerged support strings of a self-lifting floating unit from the ground

Energy Technology Data Exchange (ETDEWEB)

Dzhafarov, A M; Leybenzon, S R; Sarkisov, V G

1982-01-01

A method is proposed for recovering from the ground deeply submerged strings of self-lifting floating unit consisting of application of vertical forces through a lifter to the support string from surplus buoyancy of the housing submerged into the water. It is distinguished by the fact that in order to improve reliability and to expand the area of operation in water areas with deep occurrence of the bearing ground, submersion of the housing is done with its inclination. This applies to the support string or a group of support strings a permissible momentum, after which water ballast is used towards the housing opposite the inclined, with simultaneous preservation of the permissible moment applied to the support string or group of support strings, and the permissible momentum is determined from the formula-..mu.. = ..sqrt..theta/sup 2/ + /PSI//sup 2//A where M--momentum permitted according to the conditions of strength of the support string; /PSI/--angle of trim; /ETA/-- angle of list; A--coefficient of flexibility of the string submerged into the ground.

Illumination compensation in ground based hyperspectral imaging

Science.gov (United States)

Wendel, Alexander; Underwood, James

2017-07-01

Hyperspectral imaging has emerged as an important tool for analysing vegetation data in agricultural applications. Recently, low altitude and ground based hyperspectral imaging solutions have come to the fore, providing very high resolution data for mapping and studying large areas of crops in detail. However, these platforms introduce a unique set of challenges that need to be overcome to ensure consistent, accurate and timely acquisition of data. One particular problem is dealing with changes in environmental illumination while operating with natural light under cloud cover, which can have considerable effects on spectral shape. In the past this has been commonly achieved by imaging known reference targets at the time of data acquisition, direct measurement of irradiance, or atmospheric modelling. While capturing a reference panel continuously or very frequently allows accurate compensation for illumination changes, this is often not practical with ground based platforms, and impossible in aerial applications. This paper examines the use of an autonomous unmanned ground vehicle (UGV) to gather high resolution hyperspectral imaging data of crops under natural illumination. A process of illumination compensation is performed to extract the inherent reflectance properties of the crops, despite variable illumination. This work adapts a previously developed subspace model approach to reflectance and illumination recovery. Though tested on a ground vehicle in this paper, it is applicable to low altitude unmanned aerial hyperspectral imagery also. The method uses occasional observations of reference panel training data from within the same or other datasets, which enables a practical field protocol that minimises in-field manual labour. This paper tests the new approach, comparing it against traditional methods. Several illumination compensation protocols for high volume ground based data collection are presented based on the results. The findings in this paper are

Study of the unknown hemisphere of mercury by ground-based astronomical facilities

Science.gov (United States)

Ksanfomality, L. V.

2011-08-01

The short exposure method proved to be very productive in ground-based observations of Mercury. Telescopic observations with short exposures, together with computer codes for the processing of data arrays of many thousands of original electronic photos, make it possible to improve the resolution of images from ground-based instruments to almost the diffraction limit. The resulting composite images are comparable with images from spacecrafts approaching from a distance of about 1 million km. This paper presents images of the hemisphere of Mercury in longitude sectors 90°-180°W, 215°-350°W, and 50°-90°W, including, among others, areas not covered by spacecraft cameras. For the first time a giant S basin was discovered in the sector of longitudes 250°-290°W, which is the largest formation of this type on terrestrial planets. Mercury has a strong phase effects. As a result, the view of the surface changes completely with the change in the planetary phase. But the choice of the phase in the study using spacecrafts is limited by orbital characteristics of the mission. Thus, ground-based observations of the planet provide a valuable support.

IoTFLiP: IoT-based flipped learning platform for medical education

Directory of Open Access Journals (Sweden)

Maqbool Ali

2017-08-01

Full Text Available Case-Based Learning (CBL has become an effective pedagogy for student-centered learning in medical education, which is founded on persistent patient cases. Flippped learning and Internet of Things (IoTs concepts have gained significant attention in recent years. Using these concepts in conjunction with CBL can improve learning ability by providing real evolutionary medical cases. It also enables students to build confidence in their decision making, and efficiently enhances teamwork in the learing environment. We propose an IoT-based Flip Learning Platform, called IoTFLiP, where an IoT infrastructure is exploited to support flipped case-based learning in a cloud environment with state of the art security and privacy measures for personalized medical data. It also provides support for application delivery in private, public, and hybrid approaches. The proposed platform is an extension of our Interactive Case-Based Flipped Learning Tool (ICBFLT, which has been developed based on current CBL practices. ICBFLT formulates summaries of CBL cases through synergy between students' and medical expert knowledge. The low cost and reduced size of sensor device, support of IoTs, and recent flipped learning advancements can enhance medical students' academic and practical experiences. In order to demonstrate a working scenario for the proposed IoTFLiP platform, real-time data from IoTs gadgets is collected to generate a real-world case for a medical student using ICBFLT.

Product-based Safety Certification for Medical Devices Embedded Software.

Science.gov (United States)

Neto, José Augusto; Figueiredo Damásio, Jemerson; Monthaler, Paul; Morais, Misael

2015-01-01

Worldwide medical device embedded software certification practices are currently focused on manufacturing best practices. In Brazil, the national regulatory agency does not hold a local certification process for software-intensive medical devices and admits international certification (e.g. FDA and CE) from local and international industry to operate in the Brazilian health care market. We present here a product-based certification process as a candidate process to support the Brazilian regulatory agency ANVISA in medical device software regulation. Center of Strategic Technology for Healthcare (NUTES) medical device embedded software certification is based on a solid safety quality model and has been tested with reasonable success against the Class I risk device Generic Infusion Pump (GIP).

NATO Joint Medical Support - Reality and Vision

National Research Council Canada - National Science Library

Roedig, Erich

2004-01-01

.... Multinational solutions to medical support were not considered necessary or practical. The new NATO force structures and strategic concepts emphasise mobility, interoperability, sustainability, jointness and multinationality; i.e...

Systems Engineering for Space Exploration Medical Capabilities

Science.gov (United States)

Mindock, Jennifer; Reilly, Jeffrey; Rubin, David; Urbina, Michelle; Hailey, Melinda; Hanson, Andrea; Burba, Tyler; McGuire, Kerry; Cerro, Jeffrey; Middour, Chris;

On-the-Job Ethics – Proximity Morality Forming in Medical School: A grounded theory analysis using survey data

Directory of Open Access Journals (Sweden)

Hans O. Thulesius, MD, Ph.D.

2009-03-01

Full Text Available On-the-job-ethics exist in all businesses and can also be called proximity morality forming. In this paper we propose that medical students take a proximity morality stance towards ethics education at medical school. This means that they want to form physician morality “on the job” instead of being taught ethics like any other subject. On-the-job-ethics for medical students involves learning ethics that is used when practicing ethics. Learning ethics includes comprehensive ethics courses in which quality lectures provide ethics grammar useful for the ethics practicing in attitude exercises and vignette reflections in tutored group discussions. On-the-job-ethics develops professional identity, handles diversity of religious and existential worldviews, trains students described as ethically naive, processes difficult clinical experiences, and desists negative role modeling from physicians in clinical or teaching situations. This grounded theory analysis was made from a questionnaire survey on attitudes to ethics education with 409 Swedish medical students participating. We analyzed over 8000 words of open-ended responses and multiplechoice questions using classic grounded theory procedures, but also compared questionnaire data using statistics such as multiple regression models. The paper gives an example of how grounded theory can be used with a limited amount of survey data.

Reliability analysis of idealized tunnel support system using probability-based methods with case studies

NARCIS (Netherlands)

Gharouni-Nik, M.; Naeimi, M.; Ahadi, S.; Alimoradi, Z.

2014-01-01

In order to determine the overall safety of a tunnel support lining, a reliability-based approach is presented in this paper. Support elements in jointed rock tunnels are provided to control the ground movement caused by stress redistribution during the tunnel drive. Main support elements contribute

MINDS - Medical Information Network Decision Support System

National Research Council Canada - National Science Library

Armenian, H. K

2008-01-01

.... The increase in and complexity of medical data at various levels of resolution has increased the need for system level advancements in clinical decision support systems that provide computer-aided...

Perceived social support among students of medical sciences.

Science.gov (United States)

Zamani-Alavijeh, Freshteh; Dehkordi, Fatemeh Raeesi; Shahry, Parvin

2017-06-01

Social support is emotional and instrumental assistance from family, friends or neighbors, and has an important but different impact on individuals, mainly depending on contextual factors. To determine the status of perceived social support and related personal and family characteristics of medical sciences students in Ahvaz, Iran. In this cross-sectional study, the target population included the students of Ahvaz Jundishapur University of Medical Sciences in the second semester of 2013-2014, of whom 763 were selected by cluster random sampling method. The study tool was a two-part questionnaire containing 48 self-administered questions including 25 questions of measurements of personal and family characteristics and a Persian modified version of Vaux's social support scale (Cronbach's α=0.745). Data were analyzed with T test, ANOVA and chi-square and using SPSS version 16 and 0.05 was considered as the level of significance. The mean score of the perceived social support was 17.06±3.6 and 60.3% of them reported low social support. There was a significant relationship among the perceived social support and sex (p=0.02), faculty (psocial support and importance of social support in reducing stress and academic failure, the planners need to provide efficient supportive interventions for students.

Bayesian Analysis for Risk Assessment of Selected Medical Events in Support of the Integrated Medical Model Effort

Science.gov (United States)

Gilkey, Kelly M.; Myers, Jerry G.; McRae, Michael P.; Griffin, Elise A.; Kallrui, Aditya S.

2012-01-01

The Exploration Medical Capability project is creating a catalog of risk assessments using the Integrated Medical Model (IMM). The IMM is a software-based system intended to assist mission planners in preparing for spaceflight missions by helping them to make informed decisions about medical preparations and supplies needed for combating and treating various medical events using Probabilistic Risk Assessment. The objective is to use statistical analyses to inform the IMM decision tool with estimated probabilities of medical events occurring during an exploration mission. Because data regarding astronaut health are limited, Bayesian statistical analysis is used. Bayesian inference combines prior knowledge, such as data from the general U.S. population, the U.S. Submarine Force, or the analog astronaut population located at the NASA Johnson Space Center, with observed data for the medical condition of interest. The posterior results reflect the best evidence for specific medical events occurring in flight. Bayes theorem provides a formal mechanism for combining available observed data with data from similar studies to support the quantification process. The IMM team performed Bayesian updates on the following medical events: angina, appendicitis, atrial fibrillation, atrial flutter, dental abscess, dental caries, dental periodontal disease, gallstone disease, herpes zoster, renal stones, seizure, and stroke.

Assessment of NASA airborne laser altimetry data using ground-based GPS data near Summit Station, Greenland

Science.gov (United States)

Brunt, Kelly M.; Hawley, Robert L.; Lutz, Eric R.; Studinger, Michael; Sonntag, John G.; Hofton, Michelle A.; Andrews, Lauren C.; Neumann, Thomas A.

2017-03-01

A series of NASA airborne lidars have been used in support of satellite laser altimetry missions. These airborne laser altimeters have been deployed for satellite instrument development, for spaceborne data validation, and to bridge the data gap between satellite missions. We used data from ground-based Global Positioning System (GPS) surveys of an 11 km long track near Summit Station, Greenland, to assess the surface-elevation bias and measurement precision of three airborne laser altimeters including the Airborne Topographic Mapper (ATM), the Land, Vegetation, and Ice Sensor (LVIS), and the Multiple Altimeter Beam Experimental Lidar (MABEL). Ground-based GPS data from the monthly ground-based traverses, which commenced in 2006, allowed for the assessment of nine airborne lidar surveys associated with ATM and LVIS between 2007 and 2016. Surface-elevation biases for these altimeters - over the flat, ice-sheet interior - are less than 0.12 m, while assessments of measurement precision are 0.09 m or better. Ground-based GPS positions determined both with and without differential post-processing techniques provided internally consistent solutions. Results from the analyses of ground-based and airborne data provide validation strategy guidance for the Ice, Cloud, and land Elevation Satellite 2 (ICESat-2) elevation and elevation-change data products.

Clinical Assistant Diagnosis for Electronic Medical Record Based on Convolutional Neural Network.

Science.gov (United States)

Yang, Zhongliang; Huang, Yongfeng; Jiang, Yiran; Sun, Yuxi; Zhang, Yu-Jin; Luo, Pengcheng

2018-04-20

Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis without artificial construction of rules or knowledge bases. We use collected 18,590 copies of the real-world clinical electronic medical records to train and test the proposed model. Experimental results show that the proposed model can achieve 98.67% accuracy and 96.02% recall, which strongly supports that using convolutional neural network to automatically learn high-level semantic features of electronic medical records and then conduct assist diagnosis is feasible and effective.

International medical students – a survey of perceived challenges and established support services at medical faculties

Directory of Open Access Journals (Sweden)

Huhn, D.

2015-02-01

Full Text Available Introduction: Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties’ perceived problems nor of the offered support exists.Method: All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1. The percentage of non-German students at the medical faculty; 2. The perceived difficulties and problems of foreign students; 3. The offers for non-German students; and 4. The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis.Results: Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology.Discussion: Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential.

International medical students – a survey of perceived challenges and established support services at medical faculties

Science.gov (United States)

Huhn, D.; Junne, F.; Zipfel, S.; Duelli, R.; Resch, F.; Herzog, W.; Nikendei, C.

2015-01-01

Introduction: Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties’ perceived problems nor of the offered support exists. Method: All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1.) The percentage of non-German students at the medical faculty; 2.) The perceived difficulties and problems of foreign students; 3.) The offers for non-German students; and 4.) The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis. Results: Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology. Discussion: Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential. PMID:25699112

Medical Data Architecture Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Lindsey, A.; Marker, N.; Wolfe, S.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2017-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study.

Science.gov (United States)

Sigler, Brittany Erika

2017-03-21

Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. The aim of our study was to investigate care coordinators' perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients' agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change

Medical decision support and medical informatics education: roots, methods and applications in czechoslovakia and the czech republic.

Science.gov (United States)

Zvárová, Jana

2013-01-01

The paper describes the history of medical informatics in Czechoslovakia and the Czech Republic. It focuses on the topics of medical informatics education and decision support methods and systems. Several conferences held in Czechoslovakia and in the Czech Republic organized in cooperation with IMIA or EFMI are described. Support of European Union and Czech agencies in several European and national projects focused on medical informatics topics highly contributed to medical informatics development in Czechoslovakia and the Czech Republic and to the establishment of the European Center for Medical Informatics, Statistics and Epidemiology as the joint workplace of Charles University in Prague and Academy of Sciences of the Czech Republic in 1994.

Social support and common mental disorder among medical students

Directory of Open Access Journals (Sweden)

Adriano Gonçalves Silva

2014-03-01

Full Text Available INTRODUCTION: Different kinds of psychological distress have been identified for students in the health field, especially in the medical school. OBJECTIVE: To estimate the prevalence of mental suffering among medical students in the Southeastern Brazil and asses its association with social support. METHODS: It is a cross-sectional study. Structured questionnaires were applied for students from the 1st up to the 6th years of the medical school of Universidade Estadual Paulista "Júlio de Mesquita Filho", assessing demographic variables related to aspects of graduation and adaptation to the city. Psychological suffering was defined as a common mental disorder (CMD assessed by the Self Reporting Questionnaire (SRQ-20. Social support was assessed by the social support scale of the Medical Outcomes Study (MOS. The association between the outcome and explanatory variables was assessed by the χ2 test and Logistic Regression, for the multivariate analyses, using p < 0.05. RESULTS: The response rate was of 80.7%, with no differences between sample and the population regarding gender (p = 0.78. The average age was 22 years old (standard deviation - SD = 2.2, mainly women (58.2% and students who were living with friends (62%. The prevalence of CMD was 44.9% (95%CI 40.2 - 49.6. After the multivariate analyses, the explanatory variables that were associated with CMD were: feeling rejected in the past year (p < 0.001, thinking about leaving medical school (p < 0.001 and "interaction" in the MOS scale (p = 0.002. CONCLUSIONS: The prevalence of CMD among medical students was high and insufficient social support was an important risk factor. Our findings suggest that interventions to improve social interaction among those students could be beneficial, decreasing the prevalence of CMD in this group.

Social support and common mental disorder among medical students.

Science.gov (United States)

Silva, Adriano Gonçalves; Cerqueira, Ana Teresa de Abreu Ramos; Lima, Maria Cristina Pereira

2014-01-01

Different kinds of psychological distress have been identified for students in the health field, especially in the medical school. To estimate the prevalence of mental suffering among medical students in the Southeastern Brazil and asses its association with social support. It is a cross-sectional study. Structured questionnaires were applied for students from the 1st up to the 6th years of the medical school of Universidade Estadual Paulista "Júlio de Mesquita Filho", assessing demographic variables related to aspects of graduation and adaptation to the city. Psychological suffering was defined as a common mental disorder (CMD) assessed by the Self Reporting Questionnaire (SRQ-20). Social support was assessed by the social support scale of the Medical Outcomes Study (MOS). The association between the outcome and explanatory variables was assessed by the χ2 test and Logistic Regression, for the multivariate analyses, using p < 0.05. The response rate was of 80.7%, with no differences between sample and the population regarding gender (p = 0.78). The average age was 22 years old (standard deviation - SD = 2.2), mainly women (58.2%) and students who were living with friends (62%). The prevalence of CMD was 44.9% (95%CI 40.2 - 49.6). After the multivariate analyses, the explanatory variables that were associated with CMD were: feeling rejected in the past year (p < 0.001), thinking about leaving medical school (p < 0.001) and "interaction" in the MOS scale (p = 0.002). The prevalence of CMD among medical students was high and insufficient social support was an important risk factor. Our findings suggest that interventions to improve social interaction among those students could be beneficial, decreasing the prevalence of CMD in this group.

Doctors’ Support – An important part of medical therapy and quality of life

Directory of Open Access Journals (Sweden)

Mariusz Jaworski

2015-07-01

Full Text Available Introduction: The correct patient – doctor relationship is important in shaping the whole process of treatment. The scientific studies highlight the various irregularities in this relationship and its negative impact on the effectiveness of medical treatment. The purpose of this study was to assess the relationship between levels of doctors’ support and attitude to certain aspects of the treatment process and quality of life among patients with psoriasis. Material and Methods: The study was conducted on 50 patients with psoriasis aged from 21 to 78 who are treated in dermatological clinics. The Psoriasis Area and Severity Index (PASI was used to assess the severity of psoriatic skin changes. The patients completed a questionnaire for the assessment of receive doctors’ support, and its relationship with the attitude towards the disease. The research tool was developed based on literature review. Results: The level of doctors’ support had a direct impact on the patients’ attitude the disease, including attitudes towards the treatment and medical personnel, as well as adherence to medical recommendations; and indirectly on satisfaction with the treatment and the quality of life. Conclusions: Results of this study have shown clear evidence the importance of the level of doctors’ support in psoriasis which could help to improve the overall functioning of these patients. The level of doctors’ support indirectly affects the quality of life in patients with psoriasis.

An online community of practice to support evidence-based physiotherapy practice in manual therapy.

Science.gov (United States)

Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

2014-01-01

The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital

Context based support for Clinical Reasoning

DEFF Research Database (Denmark)

Vilstrup Pedersen, Klaus

2004-01-01

In many areas of the medical domain, the decision process i.e. reasoning, involving health care professionals is distributed, cooperative and complex. Computer based decision support systems has usually been focusing on the outcome of the decision making and treated it as a single task....... In this paper a framework for a Clinical Reasoning Knowledge Warehouse (CRKW) is presented, intended to support the reasoning process, by providing the decision participants with an analysis platform that captures and enhances information and knowledge. The CRKW mixes theories and models from Artificial...... Intelligence, Knowledge Management Systems and Business Intelligence to make context sensitive, patient case specific analysis and knowledge management. The knowledge base consists of patient health records, reasoning process information and clinical guidelines. Patient specific information and knowledge...

Modelling and simulation-based acquisition decision support: present & future

CSIR Research Space (South Africa)

Naidoo, S

2009-10-01

Full Text Available stream_source_info Naidoo1_2009.pdf.txt stream_content_type text/plain stream_size 24551 Content-Encoding UTF-8 stream_name Naidoo1_2009.pdf.txt Content-Type text/plain; charset=UTF-8 1 Modelling & Simulation...-Based Acquisition Decision Support: Present & Future Shahen Naidoo Abstract The Ground Based Air Defence System (GBADS) Programme, of the South African Army has been applying modelling and simulation (M&S) to provide acquisition decision and doctrine...

Considering "Nonlinearity" Across the Continuum in Medical Education Assessment: Supporting Theory, Practice, and Future Research Directions.

Science.gov (United States)

Durning, Steven J; Lubarsky, Stuart; Torre, Dario; Dory, Valérie; Holmboe, Eric

2015-01-01

The purpose of this article is to propose new approaches to assessment that are grounded in educational theory and the concept of "nonlinearity." The new approaches take into account related phenomena such as "uncertainty," "ambiguity," and "chaos." To illustrate these approaches, we will use the example of assessment of clinical reasoning, although the principles we outline may apply equally well to assessment of other constructs in medical education. Theoretical perspectives include a discussion of script theory, assimilation theory, self-regulated learning theory, and situated cognition. Assessment examples to include script concordance testing, concept maps, self-regulated learning microanalytic technique, and work-based assessment, which parallel the above-stated theories, respectively, are also highlighted. We conclude with some practical suggestions for approaching nonlinearity. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

[Analysis on composition and medication regularities of prescriptions treating hypochondriac pain based on traditional Chinese medicine inheritance support system inheritance support platform].

Science.gov (United States)

Zhao, Yan-qing; Teng, Jing

2015-03-01

To analyze the composition and medication regularities of prescriptions treating hypochondriac pain in Chinese journal full-text database (CNKI) based on the traditional Chinese medicine inheritance support system, in order to provide a reference for further research and development for new traditional Chinese medicines treating hypochondriac pain. The traditional Chinese medicine inheritance support platform software V2. 0 was used to build a prescription database of Chinese medicines treating hypochondriac pain. The software integration data mining method was used to distribute prescriptions according to "four odors", "five flavors" and "meridians" in the database and achieve frequency statistics, syndrome distribution, prescription regularity and new prescription analysis. An analysis were made for 192 prescriptions treating hypochondriac pain to determine the frequencies of medicines in prescriptions, commonly used medicine pairs and combinations and summarize 15 new prescriptions. This study indicated that the prescriptions treating hypochondriac pain in Chinese journal full-text database are mostly those for soothing liver-qi stagnation, promoting qi and activating blood, clearing heat and promoting dampness, and invigorating spleen and removing phlem, with a cold property and bitter taste, and reflect the principles of "distinguish deficiency and excess and relieving pain by smoothening meridians" in treating hypochondriac pain.

Teleworks: a CSCW application for remote medical diagnosis support and teleconsultation.

Science.gov (United States)

Makris, L; Kamilatos, I; Kopsacheilis, E V; Strintzis, M G

1998-06-01

The present paper describes methods for the design of both synchronous and asynchronous computer-supported cooperative work (CSCW) procedures suitable for the medical application area and specifically for the purpose of medical teleconsultation and remote diagnosis support. The experimental implementation of a CSCW system built upon a PC/Windows platform is detailed as an example of a low-cost system suitable for adoption in a wide range of medical teleconsultation applications.

TFTR grounding scheme and ground-monitor system

International Nuclear Information System (INIS)

Viola, M.

1983-01-01

The Tokamak Fusion Test Reactor (TFTR) grounding system utilizes a single-point ground. It is located directly under the machine, at the basement floor level, and is tied to the building perimeter ground. Wired to this single-point ground, via individual 500 MCM insulated cables, are: the vacuum vessel; four toroidal field coil cases/inner support structure quadrants; umbrella structure halves; the substructure ring girder; radial beams and columns; and the diagnostic systems. Prior to the first machine operation, a ground-loop removal program was initiated. It required insulation of all hangers and supports (within a 35-foot radius of the center of the machine) of the various piping, conduits, cable trays, and ventilation systems. A special ground-monitor system was designed and installed. It actively monitors each of the individual machine grounds to insure that there are no inadvertent ground loops within the machine structure or its ground and that the machine grounds are intact prior to each pulse. The TFTR grounding system has proven to be a very manageable system and one that is easy to maintain

Wilderness medicine: strategies for provision of medical support for adventure racing.

Science.gov (United States)

Townes, David A

2005-01-01

In adventure racing, or multisporting, athletes perform multiple disciplines over a course in rugged, often remote, wilderness terrain. Disciplines may include, but are not limited to, hiking, trail running, mountain biking, caving, technical climbing, fixed-line mountaineering, flat- and white-water boating, and orienteering. While sprint races may be as short as 6 hours, expedition-length adventure races last a minimum of 36 hours up to 10 days or more and may cover hundreds of kilometres. Over the past decade, adventure racing has grown in popularity throughout the world with increasing numbers of events and participants each year. The provision of on-site medical care during these events is essential to ensure the health and safety of the athletes and thus the success of the sport. At present, there are no formal guidelines and a relatively small amount of literature to assist in the development of medical support plans for these events. This article provides an introduction to the provision of medical support for adventure races. Since a wide variety of illness and injury occur during these events, the medical support plan should provide for proper personnel, equipment and supplies to provide care for a wide range of illness and injury. Foot-related problems are the most common reasons for athletes to require medical attention during these events. This article also highlights some of the controversies involved in the provision of medical support for these events. Suggested penalties for acceptance of medical care during the event and strategies for removal of an athlete from the event for medical reasons are offered. In addition, some of the challenges involved in the provision of medical support, including communication, logistics and liability are discussed. This information should prove useful for medical directors of future, similar events. Because of their extreme nature, expedition-length adventure races represent a new and unique area of wilderness and

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

NARCIS (Netherlands)

Gerritse, B.M.; Schalkwijk, A.; Pelzer, B.J.; Scheffer, G.J.; Draaisma, J.M.T.

2010-01-01

BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures

Ground-based Efforts to Support a Space-based Experiment: the Latest LADEE Results (Abstract)

Science.gov (United States)

Cudnik, B.; Rahman, M.

2014-12-01

(Abstract only) The much anticipated launch of NASA’s Lunar Atmosphere and Dust Environment Explorer happened flawlessly last October and the satellite has been doing science (and sending a few images) since late Novermber. [The LADEE mission ended with the crash-landing of the spacecraft on the lunar far side on April 17, 2014, capping a successful 140-day mission.] We also have launched our campaign to document lunar meteroid impact flashes from the ground to supply ground truth to inform of any changes in dust concentration encountered by the spacecraft in orbit around the moon. To date I have received six reports of impact flashes or flash candidates from the group I am coordinating; other groups around the world may have more to add when all is said and done. In addition, plans are underway to prepare a program at Prairie View A&M University to involve our physics majors in lunar meteoroid, asteroid occultation, and other astronomical work through our Center for Astronomical Sciences and Technology. This facility will be a control center to not only involve physics majors, but also to include pre-service teachers and members of the outside community to promote pro-am collaborations.

EMR-based medical knowledge representation and inference via Markov random fields and distributed representation learning.

Science.gov (United States)

Zhao, Chao; Jiang, Jingchi; Guan, Yi; Guo, Xitong; He, Bin

2018-05-01

Electronic medical records (EMRs) contain medical knowledge that can be used for clinical decision support (CDS). Our objective is to develop a general system that can extract and represent knowledge contained in EMRs to support three CDS tasks-test recommendation, initial diagnosis, and treatment plan recommendation-given the condition of a patient. We extracted four kinds of medical entities from records and constructed an EMR-based medical knowledge network (EMKN), in which nodes are entities and edges reflect their co-occurrence in a record. Three bipartite subgraphs (bigraphs) were extracted from the EMKN, one to support each task. One part of the bigraph was the given condition (e.g., symptoms), and the other was the condition to be inferred (e.g., diseases). Each bigraph was regarded as a Markov random field (MRF) to support the inference. We proposed three graph-based energy functions and three likelihood-based energy functions. Two of these functions are based on knowledge representation learning and can provide distributed representations of medical entities. Two EMR datasets and three metrics were utilized to evaluate the performance. As a whole, the evaluation results indicate that the proposed system outperformed the baseline methods. The distributed representation of medical entities does reflect similarity relationships with respect to knowledge level. Combining EMKN and MRF is an effective approach for general medical knowledge representation and inference. Different tasks, however, require individually designed energy functions. Copyright © 2018 Elsevier B.V. All rights reserved.

Hydrogeology, simulated ground-water flow, and ground-water quality, Wright-Patterson Air Force Base, Ohio

Science.gov (United States)

Dumouchelle, D.H.; Schalk, C.W.; Rowe, G.L.; De Roche, J.T.

1993-01-01

Ground water is the primary source of water in the Wright-Patterson Air Force Base area. The aquifer consists of glacial sands and gravels that fill a buried bedrock-valley system. Consolidated rocks in the area consist of poorly permeable Ordovician shale of the Richmondian stage, in the upland areas, the Brassfield Limestone of Silurian age. The valleys are filled with glacial sediments of Wisconsinan age consisting of clay-rich tills and coarse-grained outwash deposits. Estimates of hydraulic conductivity of the shales based on results of displacement/recovery tests range from 0.0016 to 12 feet per day; estimates for the glacial sediments range from less than 1 foot per day to more than 1,000 feet per day. Ground water flow from the uplands towards the valleys and the major rivers in the region, the Great Miami and the Mad Rivers. Hydraulic-head data indicate that ground water flows between the bedrock and unconsolidated deposits. Data from a gain/loss study of the Mad River System and hydrographs from nearby wells reveal that the reach of the river next to Wright-Patterson Air Force Base is a ground-water discharge area. A steady-state, three-dimensional ground-water-flow model was developed to simulate ground-water flow in the region. The model contains three layers and encompasses about 100 square miles centered on Wright-Patterson Air Force Base. Ground water enters the modeled area primarily by river leakage and underflow at the model boundary. Ground water exits the modeled area primarily by flow through the valleys at the model boundaries and through production wells. A model sensitivity analysis involving systematic changes in values of hydrologic parameters in the model indicates that the model is most sensitive to decreases in riverbed conductance and vertical conductance between the upper two layers. The analysis also indicates that the contribution of water to the buried-valley aquifer from the bedrock that forms the valley walls is about 2 to 4

An Evidence-based Guideline for the air medical transportation of prehospital trauma patients.

Science.gov (United States)

Thomas, Stephen H; Brown, Kathleen M; Oliver, Zoë J; Spaite, Daniel W; Lawner, Benjamin J; Sahni, Ritu; Weik, Tasmeen S; Falck-Ytter, Yngve; Wright, Joseph L; Lang, Eddy S

2014-01-01

Decisions about the transportation of trauma patients by helicopter are often not well informed by research assessing the risks, benefits, and costs of such transport. The objective of this evidence-based guideline (EBG) is to recommend a strategy for the selection of prehospital trauma patients who would benefit most from aeromedical transportation. A multidisciplinary panel was recruited consisting of experts in trauma, EBG development, and emergency medical services (EMS) outcomes research. Representatives of the Federal Interagency Committee on Emergency Medical Services (FICEMS), the National Highway Traffic Safety Administration (NHTSA) (funding agency), and the Children's National Medical Center (investigative team) also contributed to the process. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to guide question formulation, evidence retrieval, appraisal/synthesis, and formulate recommendations. The process followed the National Evidence-Based Guideline Model Process, which has been approved by the Federal Interagency Committee on EMS and the National EMS Advisory Council. Two strong and three weak recommendations emerged from the process, all supported only by low or very low quality evidence. The panel strongly recommended that the 2011 CDC Guideline for the Field Triage of Injured Patients be used as the initial step in the triage process, and that ground emergency medical services (GEMS) be used for patients not meeting CDC anatomic, physiologic, and situational high-acuity criteria. The panel issued a weak recommendation to use helicopter emergency medical services (HEMS) for higher-acuity patients if there is a time-savings versus GEMS, or if an appropriate hospital is not accessible by GEMS due to systemic/logistical factors. The panel strongly recommended that online medical direction should not be required for activating HEMS. Special consideration was given to the potential need for local

Modal-pushover-based ground-motion scaling procedure

Science.gov (United States)

Kalkan, Erol; Chopra, Anil K.

2011-01-01

Earthquake engineering is increasingly using nonlinear response history analysis (RHA) to demonstrate the performance of structures. This rigorous method of analysis requires selection and scaling of ground motions appropriate to design hazard levels. This paper presents a modal-pushover-based scaling (MPS) procedure to scale ground motions for use in a nonlinear RHA of buildings. In the MPS method, the ground motions are scaled to match to a specified tolerance, a target value of the inelastic deformation of the first-mode inelastic single-degree-of-freedom (SDF) system whose properties are determined by the first-mode pushover analysis. Appropriate for first-mode dominated structures, this approach is extended for structures with significant contributions of higher modes by considering elastic deformation of second-mode SDF systems in selecting a subset of the scaled ground motions. Based on results presented for three actual buildings-4, 6, and 13-story-the accuracy and efficiency of the MPS procedure are established and its superiority over the ASCE/SEI 7-05 scaling procedure is demonstrated.

Case-based medical informatics

Directory of Open Access Journals (Sweden)

Arocha José F

2004-11-01

Full Text Available Abstract Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences

The experience of medical training and expectations regarding future medical practice of medical students in the Cuban-supported Medical School in Timor-Leste.

Science.gov (United States)

Ferrinho, Paulo; Valdes, Ana C; Cabral, Jorge

2015-03-28

The purpose of this paper is to describe and analyse the professional expectations and profile of medical students at the Cuban-supported School of General Medicine, in the Faculty of Medicine and Health Sciences of the National University of Timor-Leste. A piloted, standardized questionnaire, with closed- and open-ended questions, was distributed to registered medical students attending classes on the day of the survey. All data were analysed using SPSS. The statistical analysis is mostly descriptive. Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor. The degree of feminization of the student population is high. Medical students are in general satisfied with the training received, though demanding improvements in terms of systems to support their studies and training (e.g. libraries, laboratories, access to computers and the Internet). Medical students know that they will be needed in the public sector and that it would represent their opportunity to contribute to the public's welfare. Nonetheless, they report that they expect to combine public sector practice with private work, probably, in order to improve their earnings. This may be explained by their expectations for salaries, which are much higher than the current level of public sector salaries. A significant proportion of students are unsure about their future area of specialization. Of those that have determined their desired specialization, most intend to train as hospital specialists and to follow a hospital-based career. For many, specialization is equated with migration to study abroad. There are important differences between students at the start of their training compared with more advanced students. This paper gives an overview of student expectations for alignment with stated national human resources for health priorities for Timor-Leste.

Evaluation of problem-based learning in medical students’ education

Directory of Open Access Journals (Sweden)

MOHAMMAD HADI IMANIEH

2014-01-01

concluded that problem-based learning method leads to a significant increase in learning and recalling output compared to the traditional method. Given the evolving medical education in the country’s medical schools toward problem-based learning, it is suggested that the grounds be laid so that this change will take place based on thought, principles and problem solving.

Real-time threat evaluation in a ground based air defence environment

Directory of Open Access Journals (Sweden)

JN Roux

2008-06-01

Full Text Available In a military environment a ground based air defence operator is required to evaluate the tactical situation in real-time and protect Defended Assets (DAs on the ground against aerial threats by assigning available Weapon Systems (WSs to engage enemy aircraft. Since this aerial environment requires rapid operational planning and decision making in stress situations, the associated responsibilities are typically divided between a number of operators and computerized systems that aid these operators during the decision making processes. One such a Decision Support System (DSS, a threat evaluation and weapon assignment system, assigns threat values to aircraft (with respect to DAs in real-time and uses these values to propose possible engagements of observed enemy aircraft by anti-aircraft WSs. In this paper a design of the threat evaluation part of such a DSS is put forward. The design follows the structured approach suggested in [Roux JN & van Vuuren JH, 2007, Threat evaluation and weapon assignment decision support: A review of the state of the art, ORiON, 23(2, pp. 151-187], phasing in a suite of increasingly complex qualitative and quantitative model components as more (reliable data become available.

Evaluation of RxNorm for Medication Clinical Decision Support.

Science.gov (United States)

Freimuth, Robert R; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G

2014-01-01

We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS.

Scaling earthquake ground motions for performance-based assessment of buildings

Science.gov (United States)

Huang, Y.-N.; Whittaker, A.S.; Luco, N.; Hamburger, R.O.

2011-01-01

The impact of alternate ground-motion scaling procedures on the distribution of displacement responses in simplified structural systems is investigated. Recommendations are provided for selecting and scaling ground motions for performance-based assessment of buildings. Four scaling methods are studied, namely, (1)geometric-mean scaling of pairs of ground motions, (2)spectrum matching of ground motions, (3)first-mode-period scaling to a target spectral acceleration, and (4)scaling of ground motions per the distribution of spectral demands. Data were developed by nonlinear response-history analysis of a large family of nonlinear single degree-of-freedom (SDOF) oscillators that could represent fixed-base and base-isolated structures. The advantages and disadvantages of each scaling method are discussed. The relationship between spectral shape and a ground-motion randomness parameter, is presented. A scaling procedure that explicitly considers spectral shape is proposed. ?? 2011 American Society of Civil Engineers.

Performance Evaluation of the Machine Learning Algorithms Used in Inference Mechanism of a Medical Decision Support System

Directory of Open Access Journals (Sweden)

Mert Bal

2014-01-01

Full Text Available The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.

Performance evaluation of the machine learning algorithms used in inference mechanism of a medical decision support system.

Science.gov (United States)

Bal, Mert; Amasyali, M Fatih; Sever, Hayri; Kose, Guven; Demirhan, Ayse

2014-01-01

The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.

Space and Ground-Based Infrastructures

Science.gov (United States)

Weems, Jon; Zell, Martin

This chapter deals first with the main characteristics of the space environment, outside and inside a spacecraft. Then the space and space-related (ground-based) infrastructures are described. The most important infrastructure is the International Space Station, which holds many European facilities (for instance the European Columbus Laboratory). Some of them, such as the Columbus External Payload Facility, are located outside the ISS to benefit from external space conditions. There is only one other example of orbital platforms, the Russian Foton/Bion Recoverable Orbital Capsule. In contrast, non-orbital weightless research platforms, although limited in experimental time, are more numerous: sounding rockets, parabolic flight aircraft, drop towers and high-altitude balloons. In addition to these facilities, there are a number of ground-based facilities and space simulators, for both life sciences (for instance: bed rest, clinostats) and physical sciences (for instance: magnetic compensation of gravity). Hypergravity can also be provided by human and non-human centrifuges.

Figure/Ground Segmentation via a Haptic Glance: Attributing Initial Finger Contacts to Objects or Their Supporting Surfaces.

Science.gov (United States)

Pawluk, D; Kitada, R; Abramowicz, A; Hamilton, C; Lederman, S J

2011-01-01

The current study addresses the well-known "figure/ground" problem in human perception, a fundamental topic that has received surprisingly little attention from touch scientists to date. Our approach is grounded in, and directly guided by, current knowledge concerning the nature of haptic processing. Given inherent figure/ground ambiguity in natural scenes and limited sensory inputs from first contact (a "haptic glance"), we consider first whether people are even capable of differentiating figure from ground (Experiments 1 and 2). Participants were required to estimate the strength of their subjective impression that they were feeling an object (i.e., figure) as opposed to just the supporting structure (i.e., ground). Second, we propose a tripartite factor classification scheme to further assess the influence of kinetic, geometric (Experiments 1 and 2), and material (Experiment 2) factors on haptic figure/ground segmentation, complemented by more open-ended subjective responses obtained at the end of the experiment. Collectively, the results indicate that under certain conditions it is possible to segment figure from ground via a single haptic glance with a reasonable degree of certainty, and that all three factor classes influence the estimated likelihood that brief, spatially distributed fingertip contacts represent contact with an object and/or its background supporting structure.

Generating Big Data Sets from Knowledge-based Decision Support Systems to Pursue Value-based Healthcare

Directory of Open Access Journals (Sweden)

Arturo González-Ferrer

2018-03-01

Full Text Available Talking about Big Data in healthcare we usually refer to how to use data collected from current electronic medical records, either structured or unstructured, to answer clinically relevant questions. This operation is typically carried out by means of analytics tools (e.g. machine learning or by extracting relevant data from patient summaries through natural language processing techniques. From other perspective of research in medical informatics, powerful initiatives have emerged to help physicians taking decisions, in both diagnostics and therapeutics, built from the existing medical evidence (i.e. knowledge-based decision support systems. Much of the problems these tools have shown, when used in real clinical settings, are related to their implementation and deployment, more than failing in its support, but, technology is slowly overcoming interoperability and integration issues. Beyond the point-of-care decision support these tools can provide, the data generated when using them, even in controlled trials, could be used to further analyze facts that are traditionally ignored in the current clinical practice. In this paper, we reflect on the technologies available to make the leap and how they could help driving healthcare organizations shifting to a value-based healthcare philosophy.

Building Employer Capacity to Support Meaningful Employment for Persons with Developmental Disabilities: A Grounded Theory Study of Employment Support Perspectives.

Science.gov (United States)

Rashid, Marghalara; Hodgetts, Sandra; Nicholas, David

2017-11-01

To explore strategies to build employer capacity to support people with DD in meaningful employment from perspective of employment support workers. A grounded theory study was conducted with 34 employment support individuals. A theoretical sampling approach was used to identify and recruit participants from multiple sites in Ontario and Alberta. Three main themes, with seven sub-themes, emerged: (1) experiences of supporting employment finding for people with DD, (2) institutional influences on employee experiences, and (3) attitudes, assumptions and stigma. Several recommendations related to building employer capacity were offered. Our findings provide insight on specific elements and strategies that can support building employer capacity for persons with DD.

Intercomparison of ground-based ozone and NO2 measurements during the MANTRA 2004 campaign

Directory of Open Access Journals (Sweden)

K. Strong

2007-11-01

Full Text Available The MANTRA (Middle Atmosphere Nitrogen TRend Assessment 2004 campaign took place in Vanscoy, Saskatchewan, Canada (52° N, 107° W from 3 August to 15 September, 2004. In support of the main balloon launch, a suite of five zenith-sky and direct-Sun-viewing UV-visible ground-based spectrometers was deployed, primarily measuring ozone and NO2 total columns. Three Fourier transform spectrometers (FTSs that were part of the balloon payload also performed ground-based measurements of several species, including ozone. Ground-based measurements of ozone and NO2 differential slant column densities from the zenith-viewing UV-visible instruments are presented herein. They are found to partially agree within NDACC (Network for the Detection of Atmospheric Composition Change standards for instruments certified for process studies and satellite validation. Vertical column densities of ozone from the zenith-sky UV-visible instruments, the FTSs, a Brewer spectrophotometer, and ozonesondes are compared, and found to agree within the combined error estimates of the instruments (15%. NO2 vertical column densities from two of the UV-visible instruments are compared, and are also found to agree within combined error (15%.

Supporting international medical graduates' transition to their host-country: realist synthesis.

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Kehoe, Amelia; McLachlan, John; Metcalf, Jane; Forrest, Simon; Carter, Madeline; Illing, Jan

2016-10-01

Many health services and systems rely on the contribution of international medical graduates (IMGs) to the workforce. However, concern has grown around their regulation and professional practice. There is a need, in the absence of strong evidence and a robust theoretical base, for a deeper understanding of the efficacy of interventions used to support IMGs' transition to their host countries. This study seeks to explore and synthesise evidence relating to interventions developed for IMGs. It aims to provide educators and policy makers with an understanding of how interventions should be developed to support IMGs in their transition to the workplace, particularly looking to identify how and why they are effective. The realist synthesis involved an initial systematic search of the literature for the period January 1990 to April 2015. Secondary searches were conducted throughout the review in order to inform and test the developing programme theory. The context, mechanism and outcome data were extracted from all sources meeting the inclusion criteria. Fourteen case studies were included to further aid theory refinement. Sixty-two articles were identified, describing diverse interventions of varying intensity. A further 26 articles were identified through a secondary search. The findings illustrate that, alongside a developed programme, ongoing support and cultural awareness at organisational and training levels are crucial. Individual differences must also be taken into consideration. This will ensure that IMGs engage in transformative learning, increase their levels of self-efficacy and cultural health capital, and reduce feelings of stress and anxiety. These factors will have an impact on work, interactions and cultural adjustment. Organisational, training and individual contexts all play a role in IMGs' adjustment during the transition process. Establishing ongoing support is critical. A list of recommendations for implementation is given. © 2016 The Authors

Organizational fidelity to a medication management evidence-based practice in the treatment of schizophrenia.

Science.gov (United States)

El-Mallakh, Peggy; Howard, Patricia B; Rayens, Mary Kay; Roque, Autumn P; Adkins, Sarah

2013-11-01

Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successful EBP implementation in practice settings. Copyright 2013, SLACK Incorporated.

Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

Science.gov (United States)

Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

2011-01-01

The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

Medical Trends: An Evaluation of Medical Support Given in Vietnam, Grenada, Panama and Vietnam

National Research Council Canada - National Science Library

Richards, Donn

1999-01-01

.... This paper reviews medical support given in four previous conflicts. Analysis includes predeployment, logistics, communication, patient evacuation, preventive medicine, veterinary services, civilian assistance and post-deployment...

Medical Data Architecture Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

MO-D-211-01: Medical Physics Practice Guidelines - The Minimum Level of Medical Physics Support in Clinical Practice Settings.

Science.gov (United States)

Chan, M; Fontenot, J; Halvorsen, P

2012-06-01

The American Association of Physicists in Medicine (AAPM) has long advocated a consistent level of medical physics practice, and has published many guidelines and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physicspractice. Despite these concerted and enduring efforts, the profession does not have a clear and concise statement of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. The AAPM will lead the development of MPPGs in collaboration with other professional societies. The MPPGs will be freely available to the general public. Accrediting organizations, regulatory agencies and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider to be prudent in all clinical practice settings. Support includes but is not limited to staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This course will describe the purpose and scope of MPPGs, the procedure for the development of a MPPG, as well as the progress of Therapy MPPG TG #1 on "Evaluation and quality assurance of x-ray based image guided radiotherapy systems" and Diagnostic MPPG TG #2 on "CT Protocol management

Medical teachers' perception towards simulation-based medical education: A multicenter study in Saudi Arabia.

Science.gov (United States)

Ahmed, Shabnam; Al-Mously, Najwa; Al-Senani, Fahmi; Zafar, Muhammad; Ahmed, Muhammad

2016-01-01

This study aims to evaluate the perception of medical teachers toward the integration of simulation-based medical education (SBME) in undergraduate curriculum and also identify contextual barriers faced by medical teachers. This cross-sectional observational study included medical teachers from three universities. A questionnaire was used to report teachers' perception. SBME was perceived by medical teachers (basic sciences/clinical, respectively) as enjoyable (71.1%/75.4%), effective assessment tool to evaluate students' learning (60%/73.9%) and can improve learning outcome (88.8%/79.7%). Similarly, (91.1%/71%) of teachers think that simulation should be part of the curriculum and not stand alone one time activity. Teachers' training for SBME has created a significant difference in perception (p medical curriculum are major perceived barriers for effective SBME. Results highlight the positive perception and attitude of medical teachers toward the integration of SBME in undergraduate curriculum. Prior formal training of teachers created a different perception. Top perceived barriers for effective SBME include teachers' formal training supported with time and resources and the early integration into the curriculum. These critical challenges need to be addressed by medical schools in order to enhance the integration SBME in undergraduate curricula.

Grid-enabled SEE++, A Grid-Based Medical Decision Support System for Eye Muscle Surgery Conference

CERN Document Server

Schreiner, W.; Buchberger, M.; Kaltofen, T.

2006-01-01

JKU/RISC currently develops in cooperation with Upper Austrian Research (UAR) the SEE-GRID software system. SEE-GRID is based on the SEE++ software for the biomechanical 3D simulation of the human eye and its muscles. SEE++ simulates the common eye muscle surgery techniques in a graphic interactive way that is familiar to an experienced surgeon. SEE++ is world-wide the most advanced software for this purpose; it is used by various hospitals and medical doctors for surgery training and planning, SEE++ deals with the support of diagnosis and treatment of strabismus, which is the common name given to usually persistent or regularly occuring misalignment of the eyes. Strabismus is a visual defect in which eyes point in different directions. A person suffering from it may see double images due to misaligned eyes. SEE++ is able to simulate the result of the Hess-Lancaster test, from which the pathological reason of strabismus can be estimated. The outcome of such an examination is two gaze patterns of blue points a...

ADDIS: A decision support system for evidence-based medicine

NARCIS (Netherlands)

G. van Valkenhoef (Gert); T. Tervonen (Tommi); T. Zwinkels (Tijs); B. de Brock (Bert); H.L. Hillege (Hans)

2013-01-01

textabstractClinical trials are the main source of information for the efficacy and safety evaluation of medical treatments. Although they are of pivotal importance in evidence-based medicine, there is a lack of usable information systems providing data-analysis and decision support capabilities for

Automating the SMAP Ground Data System to Support Lights-Out Operations

Science.gov (United States)

Sanders, Antonio

2014-01-01

The Soil Moisture Active Passive (SMAP) Mission is a first tier mission in NASA's Earth Science Decadal Survey. SMAP will provide a global mapping of soil moisture and its freeze/thaw states. This mapping will be used to enhance the understanding of processes that link the terrestrial water, energy, and carbon cycles, and to enhance weather and forecast capabilities. NASA's Jet Propulsion Laboratory has been selected as the lead center for the development and operation of SMAP. The Jet Propulsion Laboratory (JPL) has an extensive history of successful deep space exploration. JPL missions have typically been large scale Class A missions with significant budget and staffing. SMAP represents a new area of JPL focus towards low cost Earth science missions. Success in this new area requires changes to the way that JPL has traditionally provided the Mission Operations System (MOS)/Ground Data System (GDS) functions. The operation of SMAP requires more routine operations activities and support for higher data rates and data volumes than have been achieved in the past. These activities must be addressed by a reduced operations team and support staff. To meet this challenge, the SMAP ground data system provides automation that will perform unattended operations, including automated commanding of the SMAP spacecraft.

DoD Physical Security Technical Support at the 1980 Winter Olympics Village.

Science.gov (United States)

1980-09-02

support were provided to the 1980 Winter Olympic Games were: (1) Physical Security, (2) Communications- Electronics , and (3) Medical via the New York Army...vibration-based Fence Pro- tection System (FPS), manufactured by General Telephone and Electronics (GT& E ) and installed for the Federal Bureau of Prisons...CM (Mr. Woomert) DRSXY-GB (Mr. R. E . Cam) Aberdeen Proving Ground, MD 21005 Commander US Army Communications and Electronics Material Readiness

Foundation Investigation for Ground Based Radar Project-Kwajalein Island, Marshall Islands

Science.gov (United States)

1990-04-01

iL_ COPY MISCELLANEOUS PAPER GL-90-5 i iFOUNDATION INVESTIGATION FOR GROUND BASED RADAR PROJECT--KWAJALEIN ISLAND, MARSHALL ISLANDS by Donald E...C!assification) Foundatioa Investigation for Ground Based Radar Project -- Kwajalein Island, Marshall Islands 12. PERSONAL AUTHOR(S) Yule, Donald E...investigation for the Ground Based Radar Project -- Kwajalein Island, Marshall Islands , are presented.- eophysical tests comprised of surface refrac- tion

Strategies to improve medication adherence in patients with schizophrenia: the role of support services

Directory of Open Access Journals (Sweden)

El-Mallakh P

2015-04-01

Full Text Available Peggy El-Mallakh, Jan FindlayCollege of Nursing, University of Kentucky, Lexington, KY, USAAbstract: The purpose of this review is to describe research over the past 10 years on the role of support services in promoting medication adherence in mental health consumers diagnosed with schizophrenia. A literature search was conducted using the terms “medication adherence,” “schizophrenia,” and “support services,” using Medline, PubMed, and CINAHL. Reference lists from published studies were also reviewed to identify additional research studies. Twenty-two articles focused on support-service intervention studies, and these were selected for review. Available support-service interventions include adherence therapy, electronic reminders via text messages and telephones, cognitive–behavioral and motivational strategies, and financial incentives. Support-service intervention strategies need to be tailored to the specific needs of mental health consumers with schizophrenia. More research is needed to investigate effective support services to enhance long-term adherence and adherence to medications for medical illnesses in this population.Keywords: schizophrenia, medication adherence, support services, therapy, interventions

Towards meaningful medication-related clinical decision support: recommendations for an initial implementation.

Science.gov (United States)

Phansalkar, S; Wright, A; Kuperman, G J; Vaida, A J; Bobb, A M; Jenders, R A; Payne, T H; Halamka, J; Bloomrosen, M; Bates, D W

2011-01-01

Clinical decision support (CDS) can improve safety, quality, and cost-effectiveness of patient care, especially when implemented in computerized provider order entry (CPOE) applications. Medication-related decision support logic forms a large component of the CDS logic in any CPOE system. However, organizations wishing to implement CDS must either purchase the computable clinical content or develop it themselves. Content provided by vendors does not always meet local expectations. Most organizations lack the resources to customize the clinical content and the expertise to implement it effectively. In this paper, we describe the recommendations of a national expert panel on two basic medication-related CDS areas, specifically, drug-drug interaction (DDI) checking and duplicate therapy checking. The goals of this study were to define a starter set of medication-related alerts that healthcare organizations can implement in their clinical information systems. We also draw on the experiences of diverse institutions to highlight the realities of implementing medication decision support. These findings represent the experiences of institutions with a long history in the domain of medication decision support, and the hope is that this guidance may improve the feasibility and efficiency CDS adoption across healthcare settings.

Topographic gradient based site characterization in India complemented by strong ground-motion spectral attributes

KAUST Repository

Nath, Sankar Kumar; Thingbaijam, Kiran Kumar; Adhikari, M. D.; Nayak, Avinash; Devaraj, N.; Ghosh, Soumalya K.; Mahajan, Arun K.

2013-01-01

We appraise topographic-gradient approach for site classification that employs correlations between 30. m column averaged shear-wave velocity and topographic gradients. Assessments based on site classifications reported from cities across India indicate that the approach is reasonably viable at regional level. Additionally, we experiment three techniques for site classification based on strong ground-motion recordings, namely Horizontal-to-Vertical Spectral Ratio (HVSR), Response Spectra Shape (RSS), and Horizontal-to-Vertical Response Spectral Ratio (HVRSR) at the strong motion stations located across the Himalayas and northeast India. Statistical tests on the results indicate that these three techniques broadly differentiate soil and rock sites while RSS and HVRSR yield better signatures. The results also support the implemented site classification in the light of strong ground-motion spectral attributes observed in different parts of the globe. © 2013 Elsevier Ltd.

Topographic gradient based site characterization in India complemented by strong ground-motion spectral attributes

KAUST Repository

Nath, Sankar Kumar

2013-12-01

We appraise topographic-gradient approach for site classification that employs correlations between 30. m column averaged shear-wave velocity and topographic gradients. Assessments based on site classifications reported from cities across India indicate that the approach is reasonably viable at regional level. Additionally, we experiment three techniques for site classification based on strong ground-motion recordings, namely Horizontal-to-Vertical Spectral Ratio (HVSR), Response Spectra Shape (RSS), and Horizontal-to-Vertical Response Spectral Ratio (HVRSR) at the strong motion stations located across the Himalayas and northeast India. Statistical tests on the results indicate that these three techniques broadly differentiate soil and rock sites while RSS and HVRSR yield better signatures. The results also support the implemented site classification in the light of strong ground-motion spectral attributes observed in different parts of the globe. © 2013 Elsevier Ltd.

Ground Support Strategies at the Turquoise Ridge Joint Venture, Nevada

Science.gov (United States)

Sandbak, L. A.; Rai, A. R.

2013-05-01

Weak rock masses of high grade Carlin-trend gold mineralization are encountered in the Turquoise Ridge Joint Venture underground mine. The sediments consist of very weak and altered limestone, mudstone, and carbon-rich clays. The rock mass ratings are described as very poor to poor (Bieniawski in Proceedings of the symposium on exploration for rock engineering, Johannesburg, South Africa, pp. 97-106, 1976). The undercut and fill or boxes stoping mining methods are used because of the low dipping ore body geometry, complex geology, and weak rock mass. Design criteria are chosen to keep openings in weak rock as small as possible to prevent unraveling and to minimize supplementary support. Typical ground support for drifting includes the use of bolts, mesh, spiling, and shotcrete. Quality control of cemented rock fill (CRF) through sampling and aggregate sieve testing is necessary to insure high support strength. Specific support may include shotcrete arches with steel ring sets and CRF "arches" as a replacement of weak rock masses around long-term mine openings. Movement monitoring is utilized in problem areas and is needed to quantify and validate computer modeling.

Is being a medical educator a lonely business? The essence of social support.

Science.gov (United States)

van den Berg, Joost W; Verberg, Christel P M; Scherpbier, Albert J J A; Jaarsma, A Debbie C; Lombarts, Kiki M J M H

2017-03-01

Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study describes the essential elements of social support and their meaning for medical educators. We held interviews with medical educators purposefully sampled for diverse backgrounds and working circumstances and who spent a considerable amount of time on education. Both clinicians and basic scientists participated. The Pictor technique guided the interviews. Participants were invited to talk about the breadth of social support and elaborate on meaningful experiences. Template analysis was used for a descriptive phenomenological approach. Thirteen medical educators were interviewed. We identified four themes: (i) sources of support and their intent (e.g. a superior with the intent to stimulate personal growth); (ii) the materialisation of support (e.g. sought or offered); (iii) its manifestation (e.g. the act of providing protected time); and (iv) the overarching effect of social support, both in terms of practical effects and the meaning of support. We identified three sorts of meanings of social support for educators. Receiving support could lead to (i) feeling reassured and confident; (ii) feeling encouraged and determined and (iii) a sense of relatedness and acknowledgement of the educator role. Support for education comes from a wide range of sources because it is both sought and offered beyond the boundaries of the educational role. The resulting differences in support provided necessitate that educational leaders and policymakers consider the sources available to each educator, connecting educators where necessary. When facilitating or designing social support it is important that the need to feel reassured, encouraged or related is met. © 2017 John Wiley & Sons Ltd and The

Association of Social Support and Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus.

Science.gov (United States)

Gu, Linni; Wu, Shaomin; Zhao, Shuliang; Zhou, Huixuan; Zhang, Shengfa; Gao, Min; Qu, Zhiyong; Zhang, Weijun; Tian, Donghua

2017-12-06

The prevalence of diabetes is steadily increasing in China. When diabetes is uncontrolled, it generates dire consequences for health and well-being. Numerous studies have shown that health outcomes were associated with social support and medication adherence. Previous study confirmed that social support was associated with medication adherence in patients with heart failure, HIV diseases, and first-episode psychosis. However, the relationship between social support and medication adherence in patients with type 2 diabetes mellitus (T2DM) is remains unclear. This study aims to examine whether social support is associated with medication adherence in patients with T2DM. This study was conducted in the First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA). In Beijing, a systematic random sample of 412 patients with T2DM over 18 years was recruited at baseline, and demographic characteristics, clinical data and their assessment of social support were collected from medical records and self-reported questionnaires. 330 of these patients completed a self-report measure of medication adherence at the sixth month after baseline data collection. Regression analysis showed that social support presented a positive effect on medication adherence, additionally, support utilization and the subscale of social support exhibited a significantly strong influence on medication adherence in patients with T2DM. Although medication adherence was influenced by multiple factors, this finding confirmed that social support must be recognized as a core element in interventions aimed at improving in the management of patients with T2DM.

Exploration Medical System Demonstration

Science.gov (United States)

Rubin, D. A.; Watkins, S. D.

2014-01-01

BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

Constructing Benchmark Databases and Protocols for Medical Image Analysis: Diabetic Retinopathy

Directory of Open Access Journals (Sweden)

Tomi Kauppi

2013-01-01

Full Text Available We address the performance evaluation practices for developing medical image analysis methods, in particular, how to establish and share databases of medical images with verified ground truth and solid evaluation protocols. Such databases support the development of better algorithms, execution of profound method comparisons, and, consequently, technology transfer from research laboratories to clinical practice. For this purpose, we propose a framework consisting of reusable methods and tools for the laborious task of constructing a benchmark database. We provide a software tool for medical image annotation helping to collect class label, spatial span, and expert's confidence on lesions and a method to appropriately combine the manual segmentations from multiple experts. The tool and all necessary functionality for method evaluation are provided as public software packages. As a case study, we utilized the framework and tools to establish the DiaRetDB1 V2.1 database for benchmarking diabetic retinopathy detection algorithms. The database contains a set of retinal images, ground truth based on information from multiple experts, and a baseline algorithm for the detection of retinopathy lesions.

Human Factors in Training: Space Medical Proficiency Training

Science.gov (United States)

Byrne, Vicky E.; Barshi, I.; Arsintescu, L.; Connell, E.

2010-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and the International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to the ISS, medical equipment will be located on the ISS, and carried into CEV in the event of an emergency. Flight surgeons (FS) on the ground in Mission Control will be expected to direct the crew medical officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). This is a joint project consisting of human factors team from the Ames Research Center (ARC) with Immanuel Barshi as Principal Investigator and the Johnson Space Center (JSC). Human factors researchers at JSC have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. Work on medical training has been conducted in collaboration with the Medical Training Group at the Johnson Space Center (JSC) and with Wyle Laboratories that provides medical training to crew members, biomedical engineers (BMEs), and to flight surgeons under the Bioastronautics contract. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. A second area of research involves FS performance support tools. Information needed by the FS during the ISS mission

Adaptation of a web-based, open source electronic medical record system platform to support a large study of tuberculosis epidemiology

Directory of Open Access Journals (Sweden)

Fraser Hamish SF

2012-11-01

Full Text Available Abstract Background In 2006, we were funded by the US National Institutes of Health to implement a study of tuberculosis epidemiology in Peru. The study required a secure information system to manage data from a target goal of 16,000 subjects who needed to be followed for at least one year. With previous experience in the development and deployment of web-based medical record systems for TB treatment in Peru, we chose to use the OpenMRS open source electronic medical record system platform to develop the study information system. Supported by a core technical and management team and a large and growing worldwide community, OpenMRS is now being used in more than 40 developing countries. We adapted the OpenMRS platform to better support foreign languages. We added a new module to support double data entry, linkage to an existing laboratory information system, automatic upload of GPS data from handheld devices, and better security and auditing of data changes. We added new reports for study managers, and developed data extraction tools for research staff and statisticians. Further adaptation to handle direct entry of laboratory data occurred after the study was launched. Results Data collection in the OpenMRS system began in September 2009. By August 2011 a total of 9,256 participants had been enrolled, 102,274 forms and 13,829 laboratory results had been entered, and there were 208 users. The system is now entirely supported by the Peruvian study staff and programmers. Conclusions The information system served the study objectives well despite requiring some significant adaptations mid-stream. OpenMRS has more tools and capabilities than it did in 2008, and requires less adaptations for future projects. OpenMRS can be an effective research data system in resource poor environments, especially for organizations using or considering it for clinical care as well as research.

Log In to Experiential Learning Theory: Supporting Web-Based Faculty Development

Science.gov (United States)

Brien, Sarah; Parry, Marcus

2017-01-01

Background For an increasingly busy and geographically dispersed faculty, the Faculty of Medicine at the University of Southampton, United Kingdom, developed a range of Web-based faculty development modules, based on Kolb’s experiential learning cycle, to complement the faculty’s face-to-face workshops. Objective The objective of this study was to assess users’ views and perceptions of the effectiveness of Web-based faculty development modules based on Kolb’s experiential learning cycle. We explored (1) users’ satisfaction with the modules, (2) whether Kolb’s design framework supported users’ learning, and (3) whether the design principle impacts their work as educators. Methods We gathered data from users over a 3-year period using evaluation surveys built into each of the seven modules. Quantitative data were analyzed using descriptive statistics, and responses to open-ended questions were analyzed using content analysis. Results Out of the 409 module users, 283 completed the survey (69.1% response rate). Over 80% of the users reported being satisfied or very satisfied with seven individual aspects of the modules. The findings suggest a strong synergy between the design features that users rated most highly and the key stages of Kolb’s learning cycle. The use of simulations and videos to give the users an initial experience as well as the opportunity to “Have a go” and receive feedback in a safe environment were both considered particularly useful. In addition to providing an opportunity for reflection, many participants considered that the modules would enhance their roles as educators through: increasing their knowledge on various education topics and the required standards for medical training, and improving their skills in teaching and assessing students through practice and feedback and ultimately increasing their confidence. Conclusions Kolb’s theory-based design principle used for Web-based faculty development can support faculty to

International Space Station Sustaining Engineering: A Ground-Based Test Bed for Evaluating Integrated Environmental Control and Life Support System and Internal Thermal Control System Flight Performance

Science.gov (United States)

Ray, Charles D.; Perry, Jay L.; Callahan, David M.

2000-01-01

As the International Space Station's (ISS) various habitable modules are placed in service on orbit, the need to provide for sustaining engineering becomes increasingly important to ensure the proper function of critical onboard systems. Chief among these are the Environmental Control and Life Support System (ECLSS) and the Internal Thermal Control System (ITCS). Without either, life onboard the ISS would prove difficult or nearly impossible. For this reason, a ground-based ECLSS/ITCS hardware performance simulation capability has been developed at NASA's Marshall Space Flight Center. The ECLSS/ITCS Sustaining Engineering Test Bed will be used to assist the ISS Program in resolving hardware anomalies and performing periodic performance assessments. The ISS flight configuration being simulated by the test bed is described as well as ongoing activities related to its preparation for supporting ISS Mission 5A. Growth options for the test facility are presented whereby the current facility may be upgraded to enhance its capability for supporting future station operation well beyond Mission 5A. Test bed capabilities for demonstrating technology improvements of ECLSS hardware are also described.

Jung's equation of the ground of being with the ground of psyche.

Science.gov (United States)

Dourley, John

2011-09-01

The paper amplifies Jung's psychology of ground associated with the culmination of the alchemical process in the unus mundus. It argues that Jung and Dorn identify the experience of the ground with the experience of divinity as the common originary source of individual and totality. It notes the monistic and pantheistic implications of the experience and goes on to amplify the experience through Eckhart's mediaeval mysticism of ground and Paul Tillich's modern philosophical/theological understanding of ground. It concludes that the Jung/Dorn psychological understanding of ground supersedes monotheistic consciousness. Their vision supports the emergence of a societal myth based on the identification of the ground as the source of all divinities and faith in them. This source currently urges a mythic consciousness that would surpass its past and current concretions and so alleviate the threat that monotheistic consciousness in any domain now poses to human survival. © 2011, The Society of Analytical Psychology.

Perspectives on competency-based medical education from the learning sciences.

Science.gov (United States)

Swing, Susan R

2010-01-01

A central component of competency-based medical education is a framework of higher-order and more fundamental competencies whose purpose is to focus instruction and learning. In the language of the learning sciences, many of these competencies are complex cognitive-perceptual or cognitive-motor skills. Competency-based medical education has been criticized for being reductionistic, that is, for focusing on atomistic skills and failing to capture the essence of professional activities as manifested by complex, integrated capabilities. The value of identifying fundamental skill components is supported by theory and evidence from the learning sciences, however. Complex skills are constructed from fundamental, component skills. Proficient performance of the former is achieved as components are refined and integrated during repeated performance of the skill in a realistic context and as feedback on performance is provided. Competency-based medical education does not propose specific methods for teaching competencies. The learning and instructional sciences, however, posit a number of conditions for learning that support the acquisition of simple skills and their flexible integration into complex capabilities. Learners' motivation and self-regulation skills will also have an impact on the extent to which they engage in learning processes that result in the integration of knowledge and skills into complex competencies.

Determining spatio-temporal distribution of bee forage species of Al-Baha region based on ground inventorying supported with GIS applications and Remote Sensed Satellite Image analysis

Directory of Open Access Journals (Sweden)

Nuru Adgaba

2017-07-01

Full Text Available In arid zones, the shortage of bee forage is critical and usually compels beekeepers to move their colonies in search of better forages. Identifying and mapping the spatiotemporal distribution of the bee forages over given area is important for better management of bee colonies. In this study honey bee plants in the target areas were inventoried following, ground inventory work supported with GIS applications. The study was conducted on 85 large plots of 50 × 50 m each. At each plot, data on species name, height, base diameter, crown height, crown diameter has been taken for each plant with their respective geographical positions. The data were stored, and processed using Trimble GPS supported with ArcGIS10 software program. The data were used to estimate the relative frequency, density, abundance and species diversity, species important value index and apicultural value of the species. In addition, Remotely Sensed Satellite Image of the area was obtained and processed using Hopfield Artificial Neural Network techniques. During the study, 182 species from 49 plant families were identified as bee forages of the target area. From the total number of species; shrubs, herbs and trees were accounting for 61%, 27.67%, and 11.53% respectively. Of which Ziziphus spina-christi, Acacia tortilis, Acacia origina, Acacia asak, Lavandula dentata, and Hypoestes forskaolii were the major nectar source plants of the area in their degree of importance. The average vegetation cover values of the study areas were low (<30% with low Shannon’s species diversity indices (H′ of 0.5–1.52 for different sites. Based on the eco-climatological factors and the variations in their flowering period, these major bee forage species were found to form eight distinct spatiotemporal categories which allow beekeepers to migrate their colonies to exploit the resources at different seasons and place. The Remote Sensed Satellite Image analysis confirmed the spatial

BigBOSS: The Ground-Based Stage IV BAO Experiment

Energy Technology Data Exchange (ETDEWEB)

Schlegel, David; Bebek, Chris; Heetderks, Henry; Ho, Shirley; Lampton, Michael; Levi, Michael; Mostek, Nick; Padmanabhan, Nikhil; Perlmutter, Saul; Roe, Natalie; Sholl, Michael; Smoot, George; White, Martin; Dey, Arjun; Abraham, Tony; Jannuzi, Buell; Joyce, Dick; Liang, Ming; Merrill, Mike; Olsen, Knut; Salim, Samir

2009-04-01

The BigBOSS experiment is a proposed DOE-NSF Stage IV ground-based dark energy experiment to study baryon acoustic oscillations (BAO) and the growth of structure with an all-sky galaxy redshift survey. The project is designed to unlock the mystery of dark energy using existing ground-based facilities operated by NOAO. A new 4000-fiber R=5000 spectrograph covering a 3-degree diameter field will measure BAO and redshift space distortions in the distribution of galaxies and hydrogen gas spanning redshifts from 0.2< z< 3.5. The Dark Energy Task Force figure of merit (DETF FoM) for this experiment is expected to be equal to that of a JDEM mission for BAO with the lower risk and cost typical of a ground-based experiment.

Medical Data Architecture (MDA) Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

Interaction between stope support and ground motion in the hangingwall and footwall Project.

CSIR Research Space (South Africa)

Cichowicz, A

2002-07-01

Full Text Available and limitations were verified by detailed testing with the strong ground motion data. The support response may be simulated using SDOF model when PGA is in the range 18 - 100 m/s2 ; for this data model shows that the maximal value of the stiffness is 120,000 k...

Effect of vertical ground motion on earthquake-induced derailment of railway vehicles over simply-supported bridges

Science.gov (United States)

Jin, Zhibin; Pei, Shiling; Li, Xiaozhen; Liu, Hongyan; Qiang, Shizhong

2016-11-01

The running safety of railway vehicles on bridges can be negatively affected by earthquake events. This phenomenon has traditionally been investigated with only the lateral ground excitation component considered. This paper presented results from a numerical investigation on the contribution of vertical ground motion component to the derailment of vehicles on simply-supported bridges. A full nonlinear wheel-rail contact model was used in the investigation together with the Hertzian contact theory and nonlinear creepage theory, which allows the wheel to jump vertically and separate from the rail. The wheel-rail relative displacement was used as the criterion for derailment events. A total of 18 ground motion records were used in the analysis to account for the uncertainty of ground motions. The results showed that inclusion of vertical ground motion will likely increase the chance of derailment. It is recommended to include vertical ground motion component in earthquake induced derailment analysis to ensure conservative estimations. The derailment event on bridges was found to be more closely related to the deck acceleration rather than the ground acceleration.

Ground-water contamination at Wurtsmith Air Force Base, Michigan

Science.gov (United States)

Stark, J.R.; Cummings, T.R.; Twenter, F.R.

1983-01-01

A sand and gravel aquifer of glacial origin underlies Wurtsmith Air Force Base in northeastern lower Michigan. The aquifer overlies a thick clay layer at an average depth of 65 feet. The water table is about 10 feet below land surface in the western part of the Base and about 25 feet below land surface in the eastern part. A ground-water divide cuts diagonally across the Base from northwest to southeast. South of the divide, ground water flows to the Au Sable River; north of the divide, it flows to Van Etten Creek and Van Etten Lake. Mathematical models were used to aid in calculating rates of groundwater flow. Rates range from about 0.8 feet per day in the eastern part of the Base to about 0.3 feet per day in the western part. Models also were used as an aid in making decisions regarding purging of contaminated water from the aquifer. In 1977, trichloroethylene was detected in the Air Force Base water-supply system. It had leaked from a buried storage tank near Building 43 in the southeastern part of the Base and moved northeastward under the influence of the natural ground-water gradient and the pumping of Base water-supply wells. In the most highly contaminated part of the plume, concentrations are greater than 1,000 micrograms per liter. Current purge pumping is removing some of the trichloroethylene, and seems to have arrested its eastward movement. Pumping of additional purge wells could increase the rate of removal. Trichloroethylene has also been detected in ground water in the vicinity of the Base alert apron, where a plume from an unknown source extends northeastward off Base. A smaller, less well-defined area of contamination also occurs just north of the larger plume. Trichloroethylene, identified near the waste-treatment plant, seepage lagoons, and the northern landfill area, is related to activities and operations in these areas. Dichloroethylene and trichloroethylene occur in significant quantities westward of Building 43, upgradient from the major

Supporting smoking cessation in the medical specialist practice

NARCIS (Netherlands)

Schippers, G. M.

2004-01-01

Although smoking cessation reduces the cardiovascular risk of smoking, why this is so is still uncertain. Nevertheless, because they are strongly and authoritatively involved in much of the serious health damage caused by smoking, medical specialists should do all they can to support their patients

Decision Support Procedure for Medical Equipment Maintenance Management

NARCIS (Netherlands)

Masmoudi, Malek; Houria, Zeineb Ben; Al Hanbali, Ahmad; Masmoudi, Faouzi

2016-01-01

Hospitals outsource several activities of the service support in order to focus on the core healthcare production as maintenance service. Recently, faced to the sophistication and the costs of medical equipment that continue to escalate, governments have implemented new reforms to control costs and

A TOOL FOR EMOTIONAL USER EXPERIENCE ASSESSMENT OF WEB-BASED MEDICAL SERVICES

OpenAIRE

Alexander Nikov; Tramaine Alaina Gumaia

2016-01-01

Emotional User Experience Design (eUXD) has become increasingly important for web-based services. The primary objective of this study is to enable users to use websites that are easy to understand and operate and pleasing to use. A checklist tool for an emotional user experience (eUX) assessment that supports web-based medical services is proposed. This tool measures user moods while using medical services’ websites. The tool allocates emotive design-oriented problems and thus defines relevan...

Collaborative diagramming during problem based learning in medical education: Do computerized diagrams support basic science knowledge construction?

Science.gov (United States)

De Leng, Bas; Gijlers, Hannie

2015-05-01

To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning. Opinions and perceptions of students (n = 70) and tutors (n = 4) who used collaborative diagramming in tutorial groups were collected with a questionnaire and focus group discussions. A framework derived from the analysis of discourse in computer-supported collaborative leaning was used to construct the questionnaire. Video observations were used during the focus group discussions. Both students and tutors felt that collaborative diagramming positively affected discussion and knowledge construction. Students particularly appreciated that diagrams helped them to structure knowledge, to develop an overview of topics, and stimulated them to find relationships between topics. Tutors emphasized that diagramming increased interaction and enhanced the focus and detail of the discussion. Favourable conditions were the following: working with a shared whiteboard, using a diagram format that facilitated distribution, and applying half filled-in diagrams for non-content expert tutors and\\or for heterogeneous groups with low achieving students. The empirical findings in this study support the findings of earlier more descriptive studies that diagramming in a collaborative setting is valuable for learning complex knowledge in medicine.

Strength and durability tests of pipeline supports for the areas of above-ground routing under the influence of operational loads

Directory of Open Access Journals (Sweden)

Surikov Vitaliy Ivanovich

2014-03-01

Full Text Available The present article deals with integrated research works and tests of pipeline supports for the areas of above-ground routing of the pipeline system “Zapolyarye - Pur-pe” which is laid in the eternally frozen grounds. In order to ensure the above-ground routing method for the oil pipeline “Zapolyarye - Pur-pe” and in view of the lack of construction experience in case of above-ground routing of oil pipelines, the leading research institute of JSC “Transneft” - LLC “NII TNN” over the period of August, 2011 - September, 2012 performed a research and development work on the subject “Development and production of pipeline supports and pile foundation test specimens for the areas of above-ground routing of the pipeline system “Zapolyarye - Pur-pe”. In the course of the works, the test specimens of fixed support, linear-sliding and free-sliding pipeline supports DN1000 and DN800 were produced and examined. For ensuring the stable structural reliability of the supports constructions and operational integrity of the pipelines the complex research works and tests were performed: 1. Cyclic tests of structural elements of the fixed support on the test bed of JSC “Diascan” by means of internal pressure and bending moment with the application of specially prepared equipment for defining the pipeline supports strength and durability. 2. Tests of the fixed support under the influence of limit operating loads and by means of internal pressure for confirming the support’s integrity. On the test bed there were simulated all the maximum loads on the support (vertical, longitudinal, side loadings, bending moment including subsidence of the neighboring sliding support and, simultaneously, internal pressure of the carried medium. 3. Cyclic tests of endurance and stability of the displacements of sliding supports under the influence of limit operating loads for confirming their operation capacity. Relocation of the pipeline on the sliding

[Evaluation of organization of the military medical support in the peace time].

Science.gov (United States)

Korshever, N G

2001-09-01

The work is devoted to investigation of some theoretical and practical aspects of organizational diagnosis of troops medical support during the peace-time. The analysis of literature, the materials obtained during the practical training of the students of Saratov Military Medical Institute, the expert questioning of the teaching stuff (14 persons) allowed to characterize the difficulties in diagnosis of different objects as well as the qualities necessary for the diagnostician. It also permitted to determine the functions, methods, classification and stages of organizational diagnosis, to substantiate the requirements necessary for evaluation of troops medical support.

Competition-strength-dependent ground suppression in figure-ground perception.

Science.gov (United States)

Salvagio, Elizabeth; Cacciamani, Laura; Peterson, Mary A

2012-07-01

Figure-ground segregation is modeled as inhibitory competition between objects that might be perceived on opposite sides of borders. The winner is the figure; the loser is suppressed, and its location is perceived as shapeless ground. Evidence of ground suppression would support inhibitory competition models and would contribute to explaining why grounds are shapeless near borders shared with figures, yet such evidence is scarce. We manipulated whether competition from potential objects on the ground side of figures was high (i.e., portions of familiar objects were potentially present there) or low (novel objects were potentially present). We predicted that greater competition would produce more ground suppression. The results of two experiments in which suppression was assessed via judgments of the orientation of target bars confirmed this prediction; a third experiment showed that ground suppression is short-lived. Our findings support inhibitory competition models of figure assignment, in particular, and models of visual perception entailing feedback, in general.

Medication-indication knowledge bases: a systematic review and critical appraisal.

Science.gov (United States)

Salmasian, Hojjat; Tran, Tran H; Chase, Herbert S; Friedman, Carol

2015-11-01

Medication-indication information is a key part of the information needed for providing decision support for and promoting appropriate use of medications. However, this information is not readily available to end users, and a lot of the resources only contain this information in unstructured form (free text). A number of public knowledge bases (KBs) containing structured medication-indication information have been developed over the years, but a direct comparison of these resources has not yet been conducted. We conducted a systematic review of the literature to identify all medication-indication KBs and critically appraised these resources in terms of their scope as well as their support for complex indication information. We identified 7 KBs containing medication-indication data. They notably differed from each other in terms of their scope, coverage for on- or off-label indications, source of information, and choice of terminologies for representing the knowledge. The majority of KBs had issues with granularity of the indications as well as with representing duration of therapy, primary choice of treatment, and comedications or comorbidities. This is the first study directly comparing public KBs of medication indications. We identified several gaps in the existing resources, which can motivate future research. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) Model: An Integrated Model for Medical Student Success.

Science.gov (United States)

Stegers-Jager, Karen M; Cohen-Schotanus, Janke; Themmen, Axel P N

2017-11-01

Not all students cope successfully with the demands of medical school, and students' struggles may result in study delay or dropout. To prevent these outcomes, medical schools need to identify students who are experiencing academic difficul ties and provide them with timely interventions through access to support programs. Although the importance of early identification and intervention is well recognized, less is known about successful strategies for identifying and supporting struggling students.Building on the literature and their own empirical findings, the authors propose an integrated, school-wide model for medical student success comprising a continuum of academic and behavioral support. This Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) model focuses on improving both academic and behavioral outcomes by offering support for students at four levels, which range from adequate instruction for all, to targeted small-group interventions, to individualized support, and also include exit support for students who might be better off in another degree program. Additionally, medical schools should provide both academic and behavioral support; set high, yet realistic expectations and clearly communicate these to students; and intervene early, which requires timely identification of at-risk students who would benefit from the different types and tiers of support. Finally, interventions should be evidence based and fit the needs of the identified groups of students. The authors argue that adopting the core principles of the 4T-CABS model will enable medical schools to maximize academic engagement and performance for all students.

A study of EMR-based medical knowledge network and its applications.

Science.gov (United States)

Zhao, Chao; Jiang, Jingchi; Xu, Zhiming; Guan, Yi

2017-05-01

Electronic medical records (EMRs) contain an amount of medical knowledge which can be used for clinical decision support. We attempt to integrate this medical knowledge into a complex network, and then implement a diagnosis model based on this network. The dataset of our study contains 992 records which are uniformly sampled from different departments of the hospital. In order to integrate the knowledge of these records, an EMR-based medical knowledge network (EMKN) is constructed. This network takes medical entities as nodes, and co-occurrence relationships between the two entities as edges. Selected properties of this network are analyzed. To make use of this network, a basic diagnosis model is implemented. Seven hundred records are randomly selected to re-construct the network, and the remaining 292 records are used as test records. The vector space model is applied to illustrate the relationships between diseases and symptoms. Because there may exist more than one actual disease in a record, the recall rate of the first ten results, and the average precision are adopted as evaluation measures. Compared with a random network of the same size, this network has a similar average length but a much higher clustering coefficient. Additionally, it can be observed that there are direct correlations between the community structure and the real department classes in the hospital. For the diagnosis model, the vector space model using disease as a base obtains the best result. At least one accurate disease can be obtained in 73.27% of the records in the first ten results. We constructed an EMR-based medical knowledge network by extracting the medical entities. This network has the small-world and scale-free properties. Moreover, the community structure showed that entities in the same department have a tendency to be self-aggregated. Based on this network, a diagnosis model was proposed. This model uses only the symptoms as inputs and is not restricted to a specific

An Evidence Based Approach to Designing Medical Support for Long Duration, Interplanetary Missions

Science.gov (United States)

Watkins, S. D.; McGrath, T. L.; Bauman, D. K.; Wu, J. H.; Barsten, K. N.; Barr, Y. R.; Kerstman, E. L.

2011-01-01

The Exploration Medical Capability (ExMC) element is one of six elements under NASA's Human Research Program (HRP). The goal of the ExMC element is to address the risk of the "inability to adequately recognize or treat an ill or injured crewmember." This poster highlights the evidence-based approach that the ExMC element has taken to address this goal, and the ExMC element's current areas of interest.

Medical support for law enforcement-extended operations incidents.

Science.gov (United States)

Levy, Matthew J; Tang, Nelson

2014-01-01

As the complexity and frequency of law enforcement-extended operations incidents continue to increase, so do the opportunities for adverse health and well-being impacts on the responding officers. These types of clinical encounters have not been well characterized nor have the medical response strategies which have been developed to effectively manage these encounters been well described. The purpose of this article is to provide a descriptive epidemiology of the clinical encounters reported during extended law enforcement operations, as well as to describe a best practices approach for their effective management. This study retrospectively examined the clinical encounters of the Maryland State Police (MSP) Tactical Medical Unit (TMU) during law enforcement extended operations incidents lasting 8 or more hours. In addition, a qualitative analysis was performed on clinical data collected by federal law enforcement agencies during their extended operations. Forty-four percent of missions (455/1,047) supported by the MSP TMU lasted 8 or more hours. Twenty-six percent of these missions (117/455) resulted in at least one patient encounter. Nineteen percent of patient chief complaints (45/238) were related to heat illness/ dehydration. Fifteen percent of encounters (36/238) were for musculoskeletal injury/pain. Eight percent of patients (19/238) had nonspecific sick call (minor illness) complaints. The next most common occurring complaints were cold-related injuries, headache, sinus congestion, and wound/laceration, each of which accounted for 7 percent of patients (16/238), respectively. Analysis of federal law enforcement agencies' response to such events yielded similar clinical encounters. A wide range of health problems are reported by extended law enforcement operations personnel. Timely and effective treatment of these problems can help ensure that the broader operations mission is not compromised. An appropriate operational strategy for managing health complaints

ANSTO and CSIRO: supporting the medical devices and sensors industry in Australia

International Nuclear Information System (INIS)

Triani, Gerry; Doe, Simon

2005-01-01

The Australian Nuclear Science and Technology Organisation (ANSTO) and the Commonwealth Scientific and Industrial Research Organisation (CSIRO) have provided support to the Medical Devices and Sensors Industry in Australia for many years. In particular the Institute of Materials and Engineering Science at ANSTO and CSIRO Manufacturing and Infrastructure Technology have worked independently and jointly on a number of projects to provide technical services and support to small to medium sized companies. A recent venture to capture their capabilities in the WTIA's Medical Devices and Sensors Industry Sectoral Project, part of the WTIA National Diffusion Networks Project, has produced substantial technical and financial gains for its participants. The aim of this article is to highlight the infrastructure and capabilities that ANSTO and CSIRO can provide to component manufacturers and industry clusters that offer a range of manufacturing processes needed for medical devices and sensors. Several case studies illustrate how ANSTO and CSIRO have provided support to the medical devices industry

Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes.

Science.gov (United States)

Bernhard, Gerda; Ose, Dominik; Baudendistel, Ines; Seidling, Hanna M; Stützle, Marion; Szecsenyi, Joachim; Wensing, Michel; Mahler, Cornelia

2017-04-01

Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.

Solid waste burial grounds interim safety analysis

International Nuclear Information System (INIS)

Saito, G.H.

1994-01-01

This Interim Safety Analysis document supports the authorization basis for the interim operation and restrictions on interim operations for the near-surface land disposal of solid waste in the Solid Waste Burial Grounds. The Solid Waste Burial Grounds Interim Safety Basis supports the upgrade progress for the safety analysis report and the technical safety requirements for the operations in the Solid Waste Burial Grounds. Accident safety analysis scenarios have been analyzed based on the significant events identified in the preliminary hazards analysis. The interim safety analysis provides an evaluation of the operations in the Solid Waste Burial Grounds to determine if the radiological and hazardous material exposures will be acceptable from an overall health and safety standpoint to the worker, the onsite personnel, the public, and the environment

Solid waste burial grounds interim safety analysis

Energy Technology Data Exchange (ETDEWEB)

Saito, G.H.

1994-10-01

This Interim Safety Analysis document supports the authorization basis for the interim operation and restrictions on interim operations for the near-surface land disposal of solid waste in the Solid Waste Burial Grounds. The Solid Waste Burial Grounds Interim Safety Basis supports the upgrade progress for the safety analysis report and the technical safety requirements for the operations in the Solid Waste Burial Grounds. Accident safety analysis scenarios have been analyzed based on the significant events identified in the preliminary hazards analysis. The interim safety analysis provides an evaluation of the operations in the Solid Waste Burial Grounds to determine if the radiological and hazardous material exposures will be acceptable from an overall health and safety standpoint to the worker, the onsite personnel, the public, and the environment.

Determination of the ground state of an Au-supported FePc film based on the interpretation of Fe K - and L -edge x-ray magnetic circular dichroism measurements

Science.gov (United States)

Natoli, Calogero R.; Krüger, Peter; Bartolomé, Juan; Bartolomé, Fernando

2018-04-01

We determine the magnetic ground state of the FePc molecule on Au-supported thin films based on the observed values of orbital anisotropy and spectroscopic x-ray magnetic circular dichroism (XMCD) measurements at the Fe K and L edges. Starting from ab initio molecular orbital multiplet calculations for the isolated molecule, we diagonalize the spin-orbit interaction in the subspace spanned by the three lowest spin triplet states of 3A2 g and 3Eg symmetry in the presence of a saturating magnetic field at a polar angle θ with respect to the normal to the plane of the film, plus an external perturbation representing the effect of the molecules in the stack on the FePc molecule under consideration. We find that the orbital moment of the ground state strongly depends on the magnetic field direction in agreement with the sum rule analysis of the L23-edge XMCD data. We calculate integrals over the XMCD spectra at the Fe K and L23 edges as used in the sum rules and explicitly show that they agree with the expectation values of the orbital moment and effective spin moment of the ground state. On the basis of this analysis, we can rule out alternative candidates proposed in the literature.

Hospital Based Customization of a Medical Information System

Science.gov (United States)

Rath, Marilyn A.; Ferguson, Julie C.

1983-01-01

A Medical Information System must be current if it is to be a viable adjunct to patient care within a hospital setting. Hospital-based customization provides a means of achieving this timeliness with maximum user satisfaction. It, however, requires a major commitment in personnel time as well as additional software and training expenses. The enhanced control of system modifications and overall flexibility in planning the change process result in enthusiastic support of this approach by many hospitals. The key factors for success include careful selection of local personnel with adequate vendor support, extensive QA control, thorough auditing/validation and direct user involvement.

Calibration of Ground -based Lidar instrument

DEFF Research Database (Denmark)

Villanueva, Héctor; Yordanova, Ginka

This report presents the result of the lidar calibration performed for the given Ground-based Lidar at DTU’s test site for large wind turbines at Høvsøre, Denmark. Calibration is here understood as the establishment of a relation between the reference wind speed measurements with measurement...

A Selective Group Authentication Scheme for IoT-Based Medical Information System.

Science.gov (United States)

Park, YoHan; Park, YoungHo

2017-04-01

The technology of IoT combined with medical systems is expected to support advanced medical services. However, unsolved security problems, such as misuse of medical devices, illegal access to the medical server and so on, make IoT-based medical systems not be applied widely. In addition, users have a high burden of computation to access Things for the explosive growth of IoT devices. Because medical information is critical and important, but users have a restricted computing power, IoT-based medical systems are required to provide secure and efficient authentication for users. In this paper, we propose a selective group authentication scheme using Shamir's threshold technique. The property of selectivity gives the right of choice to users to form a group which consists of things users select and access. And users can get an access authority for those Things at a time. Thus, our scheme provides an efficient user authentication for multiple Things and conditional access authority for safe IoT-based medical information system. To the best of our knowledge, our proposed scheme is the first in which selectivity is combined with group authentication in IoT environments.

Ground Control for Emplacement Drifts for SR

International Nuclear Information System (INIS)

Y. Sun

2000-01-01

This analysis demonstrates that a satisfactory ground control system can be designed for the Yucca Mountain site, and provides the technical basis for the design of ground support systems to be used in repository emplacement and non-emplacement drifts. The repository ground support design was based on analytical methods using acquired computer codes, and focused on the final support systems. A literature review of case histories, including the lessons learned from the design and construction of the ESF, the studies on the seismic damages of underground openings, and the use of rock mass classification systems in the ground support design, was conducted (Sections 6.3.4 and 6.4). This review provided some basis for determining the inputs and methodologies used in this analysis. Stability of the supported and unsupported emplacement and non-emplacement drifts was evaluated in this analysis. The excavation effects (i.e., state of the stress change due to excavation), thermal effects (i.e., due to heat output from waste packages), and seismic effects (i.e., from potential earthquake events) were evaluated, and stress controlled modes of failure were examined for two in situ stress conditions (k 0 =0.3 and 1.0) using rock properties representing rock mass categories of 1 and 5. Variation of rock mass units such as the non-lithophysal (Tptpmn) and lithophysal (Tptpll) was considered in the analysis. The focus was on the non-lithophysal unit because this unit appears to be relatively weaker and has much smaller joint spacing. Therefore, the drift stability and ground support needs were considered to be controlled by the design for this rock unit. The ground support systems for both emplacement and non-emplacement drifts were incorporated into the models to assess their performance under in situ, thermal, and seismic loading conditions. Both continuum and discontinuum modeling approaches were employed in the analyses of the rock mass behavior and in the evaluation of the

Principles of medical ethics in supportive care: a reflection.

Science.gov (United States)

O'Hare, Daniel G

2004-02-01

The possibility of medical-moral controversy in contemporary health care delivery is occasioned by the interfacing of expanding technology with both professional and personal value systems, frequent and significant knowledge deficits on the part of health care consumers, and increased circumspection of and economic constraints experienced by health care providers. Particularly in an era of increasing regulatory mandates and the frequent and lamentable decrease in the availability of human, natural, and institutional resources, an understanding of the function of ethical analysis is indigenous to care, which is simultaneously medically appropriate and morally indicated. But while a familiarity with and an appreciation of the potential contribution of ethical reasoning is essential in all health care delivery, it assumes critical importance in supportive care. In that venue, where the rigors and demands of aggressively therapeutic interventions have ceased and the goal and the demeanor of care have shifted to the palliative mode, heightened attention to the principles of medical ethics is necessary for the balancing of rights and responsibilities for health care consumers and providers alike. This issue ultimately can be singularly salient in providing care that is patient centered and directed. Individuals acting as moral agents, suggesting what "ought" to be done in a given situation, either for themselves or as they are involved in rendering or supporting decisions proffered for or by other moral agents, particularly those in extremis, those in the throes of terminal illness following the collapse of the curative mode, need recourse to principles to facilitate their reasoning. Although the employment of each principle of medical ethics offers guidelines for reflection on the most comprehensive and appropriate care, it is attention to autonomy, informed consent, and beneficence that promotes the most effective supportive care. For even as the question of medical

Computer-based medical education in Benha University, Egypt: knowledge, attitude, limitations, and suggestions.

Science.gov (United States)

Bayomy, Hanaa; El Awadi, Mona; El Araby, Eman; Abed, Hala A

2016-12-01

Computer-assisted medical education has been developed to enhance learning and enable high-quality medical care. This study aimed to assess computer knowledge and attitude toward the inclusion of computers in medical education among second-year medical students in Benha Faculty of Medicine, Egypt, to identify limitations, and obtain suggestions for successful computer-based learning. This was a one-group pre-post-test study, which was carried out on second-year students in Benha Faculty of Medicine. A structured self-administered questionnaire was used to compare students' knowledge, attitude, limitations, and suggestions toward computer usage in medical education before and after the computer course to evaluate the change in students' responses. The majority of students were familiar with use of the mouse and keyboard, basic word processing, internet and web searching, and e-mail both before and after the computer course. The proportion of students who were familiar with software programs other than the word processing and trouble-shoot software/hardware was significantly higher after the course (Pcomputer (P=0.008), the inclusion of computer skills course in medical education, downloading lecture handouts, and computer-based exams (Pcomputers limited the inclusion of computer in medical education (Pcomputer labs, lack of Information Technology staff mentoring, large number of students, unclear course outline, and lack of internet access were more frequently reported before the course (Pcomputer labs, inviting Information Technology staff to support computer teaching, and the availability of free Wi-Fi internet access covering several areas in the university campus; all would support computer-assisted medical education. Medical students in Benha University are computer literate, which allows for computer-based medical education. Staff training, provision of computer labs, and internet access are essential requirements for enhancing computer usage in medical

Medical imaging in clinical applications algorithmic and computer-based approaches

CERN Document Server

Bhateja, Vikrant; Hassanien, Aboul

2016-01-01

This volume comprises of 21 selected chapters, including two overview chapters devoted to abdominal imaging in clinical applications supported computer aided diagnosis approaches as well as different techniques for solving the pectoral muscle extraction problem in the preprocessing part of the CAD systems for detecting breast cancer in its early stage using digital mammograms. The aim of this book is to stimulate further research in medical imaging applications based algorithmic and computer based approaches and utilize them in real-world clinical applications. The book is divided into four parts, Part-I: Clinical Applications of Medical Imaging, Part-II: Classification and clustering, Part-III: Computer Aided Diagnosis (CAD) Tools and Case Studies and Part-IV: Bio-inspiring based Computer Aided diagnosis techniques. .

A Study of the Competency of Third Year Medical Students to Interpret Biochemically Based Clinical Scenarios Using Knowledge and Skills Gained in Year 1 and 2

Science.gov (United States)

Gowda, Veena Bhaskar S.; Nagaiah, Bhaskar Hebbani; Sengodan, Bharathi

2016-01-01

Medical students build clinical knowledge on the grounds of previously obtained basic knowledge. The study aimed to evaluate the competency of third year medical students to interpret biochemically based clinical scenarios using knowledge and skills gained during year 1 and 2 of undergraduate medical training. Study was conducted on year 3 MBBS…

Anonymization of Electronic Medical Records to Support Clinical Analysis

CERN Document Server

Gkoulalas-Divanis, Aris

2013-01-01

Anonymization of Electronic Medical Records to Support Clinical Analysis closely examines the privacy threats that may arise from medical data sharing, and surveys the state-of-the-art methods developed to safeguard data against these threats. To motivate the need for computational methods, the book first explores the main challenges facing the privacy-protection of medical data using the existing policies, practices and regulations. Then, it takes an in-depth look at the popular computational privacy-preserving methods that have been developed for demographic, clinical and genomic data sharing, and closely analyzes the privacy principles behind these methods, as well as the optimization and algorithmic strategies that they employ. Finally, through a series of in-depth case studies that highlight data from the US Census as well as the Vanderbilt University Medical Center, the book outlines a new, innovative class of privacy-preserving methods designed to ensure the integrity of transferred medical data for su...

[Analysis on regularity of prescriptions in "a guide to clinical practice with medical record" for diarrhoea based on traditional Chinese medicine inheritance support system].

Science.gov (United States)

He, Lan-Juan; Zhu, Xiang-Dong

2016-06-01

To analyze the regularities of prescriptions in "a guide to clinical practice with medical record" (Ye Tianshi) for diarrhoea based on traditional Chinese medicine inheritance support system(V2.5), and provide a reference for further research and development of new traditional Chinese medicines in treating diarrhoea. Traditional Chinese medicine inheritance support system was used to build a prescription database of Chinese medicines for diarrhoea. The software integration data mining method was used to analyze the prescriptions according to "four natures", "five flavors" and "meridians" in the database and achieve frequency statistics, syndrome distribution, prescription regularity and new prescription analysis. An analysis on 94 prescriptions for diarrhoea was used to determine the frequencies of medicines in prescriptions, commonly used medicine pairs and combinations, and achieve 13 new prescriptions. This study indicated that the prescriptions for diarrhoea in "a guide to clinical practice with medical record" are mostly of eliminating dampness and tonifying deficienccy, with neutral drug property, sweet, bitter or hot in flavor, and reflecting the treatment principle of "activating spleen-energy and resolving dampness". Copyright© by the Chinese Pharmaceutical Association.

Overview of Boundary Layer Clouds Using Satellite and Ground-Based Measurements

Science.gov (United States)

Xi, B.; Dong, X.; Wu, P.; Qiu, S.

2017-12-01

A comprehensive summary of boundary layer clouds properties based on our few recently studies will be presented. The analyses include the global cloud fractions and cloud macro/micro- physical properties based on satellite measurements using both CERES-MODIS and CloudSat/Caliposo data products,; the annual/seasonal/diurnal variations of stratocumulus clouds over different climate regions (mid-latitude land, mid-latitude ocean, and Arctic region) using DOE ARM ground-based measurements over Southern great plain (SGP), Azores (GRW), and North slope of Alaska (NSA) sites; the impact of environmental conditions to the formation and dissipation process of marine boundary layer clouds over Azores site; characterizing Arctice mixed-phase cloud structure and favorable environmental conditions for the formation/maintainess of mixed-phase clouds over NSA site. Though the presentation has widely spread topics, we will focus on the representation of the ground-based measurements over different climate regions; evaluation of satellite retrieved cloud properties using these ground-based measurements, and understanding the uncertainties of both satellite and ground-based retrievals and measurements.

Public support for medical research in the 21st century.

Science.gov (United States)

Smith, P M

2000-01-01

Key public policies that have contributed to the rise of modern medical research in the 20th Century are reviewed, focusing especially on the United States and the post-World War II period. Drawing on this history, the question is posed: "Are these policies sufficient to insure vigorous medical research in the 21st Century?" Although radical policy changes are not needed, several proposals for policy and medical research portfolio redirection are offered, including a rebalancing of public supported research in all fields of science that contribute to medical advances. Medical research must also invest in a national and international information infrastructure that will allow the linking of researchers, clinical experimenters, practicing physicians, and the public in ways heretofore not imagined. Medical researchers must be leaders and advocates for the whole research enterprise in the 21st Century.

A hybrid approach to select features and classify diseases based on medical data

Science.gov (United States)

AbdelLatif, Hisham; Luo, Jiawei

2018-03-01

Feature selection is popular problem in the classification of diseases in clinical medicine. Here, we developing a hybrid methodology to classify diseases, based on three medical datasets, Arrhythmia, Breast cancer, and Hepatitis datasets. This methodology called k-means ANOVA Support Vector Machine (K-ANOVA-SVM) uses K-means cluster with ANOVA statistical to preprocessing data and selection the significant features, and Support Vector Machines in the classification process. To compare and evaluate the performance, we choice three classification algorithms, decision tree Naïve Bayes, Support Vector Machines and applied the medical datasets direct to these algorithms. Our methodology was a much better classification accuracy is given of 98% in Arrhythmia datasets, 92% in Breast cancer datasets and 88% in Hepatitis datasets, Compare to use the medical data directly with decision tree Naïve Bayes, and Support Vector Machines. Also, the ROC curve and precision with (K-ANOVA-SVM) Achieved best results than other algorithms

A multiobjective approach towards weapon assignment in a ground ...

African Journals Online (AJOL)

A typical ground-based air defence (GBAD) environment comprises defended assets on the ground which require protection from enemy aircraft entering the defended airspace. ... of computerised threat evaluation and weapon assignment (TEWA) decision support systems (DSSs) within the context of a GBAD system.

Hanford ground-water data base management guide and user's manual

International Nuclear Information System (INIS)

Mitchell, P.J.; Argo, R.S.; Bradymire, S.L.; Newbill, C.A.

1985-05-01

This management guide and user's manual is a working document for the computerized Hanford Ground-water Data Base maintained by the Geosciences Research and Engineering Department at Pacific Northwest Laboratory for the Hanford Ground-Water Surveillance Program. The program is managed by the Occupational and Environmental Protection Department for the US Department of Energy. The data base is maintained to provide rapid access to data that are rountinely collected from ground-water monitoring wells at the Hanford site. The data include water levels, sample analyses, geologic descriptions and well construction information of over 3000 existing or destroyed wells. These data are used to monitor water quality and for the evaluation of ground-water flow and pollutant transport problems. The management guide gives instructions for maintenance of the data base on the Digital Equipment Corporation PDP 11/70 Computer using the CIRMIS (Comprehensive Information Retrieval and Model Input Sequence) data base management software developed at Pacific Northwest Laboratory. Maintenance activities include inserting, modifying and deleting data, making back-up copies of the data base, and generating tables for annual monitoring reports. The user's guide includes instructions for running programs to retrieve the data in the form of listings of graphical plots. 3 refs

Engineering uses of physics-based ground motion simulations

Science.gov (United States)

Baker, Jack W.; Luco, Nicolas; Abrahamson, Norman A.; Graves, Robert W.; Maechling, Phillip J.; Olsen, Kim B.

2014-01-01

This paper summarizes validation methodologies focused on enabling ground motion simulations to be used with confidence in engineering applications such as seismic hazard analysis and dynmaic analysis of structural and geotechnical systems. Numberical simullation of ground motion from large erthquakes, utilizing physics-based models of earthquake rupture and wave propagation, is an area of active research in the earth science community. Refinement and validatoin of these models require collaboration between earthquake scientists and engineering users, and testing/rating methodolgies for simulated ground motions to be used with confidence in engineering applications. This paper provides an introduction to this field and an overview of current research activities being coordinated by the Souther California Earthquake Center (SCEC). These activities are related both to advancing the science and computational infrastructure needed to produce ground motion simulations, as well as to engineering validation procedures. Current research areas and anticipated future achievements are also discussed.

Principle and Design of a Single-phase Inverter-Based Grounding System for Neutral-to-ground Voltage Compensation in Distribution Networks

DEFF Research Database (Denmark)

Wang, Wen; Yan, Lingjie; Zeng, Xiangjun

2017-01-01

Neutral-to-ground overvoltage may occur in non-effectively grounded power systems because of the distributed parameters asymmetry and resonance between Petersen coil and distributed capacitances. Thus, the constraint of neutral-to-ground voltage is critical for the safety of distribution networks....... In this paper, an active grounding system based on single-phase inverter and its control parameter design method is proposed to achieve this objective. Relationship between its output current and neutral-to-ground voltage is derived to explain the principle of neutral-to-ground voltage compensation. Then...

A development framework for artificial intelligence based distributed operations support systems

Science.gov (United States)

Adler, Richard M.; Cottman, Bruce H.

1990-01-01

Advanced automation is required to reduce costly human operations support requirements for complex space-based and ground control systems. Existing knowledge based technologies have been used successfully to automate individual operations tasks. Considerably less progress has been made in integrating and coordinating multiple operations applications for unified intelligent support systems. To fill this gap, SOCIAL, a tool set for developing Distributed Artificial Intelligence (DAI) systems is being constructed. SOCIAL consists of three primary language based components defining: models of interprocess communication across heterogeneous platforms; models for interprocess coordination, concurrency control, and fault management; and for accessing heterogeneous information resources. DAI applications subsystems, either new or existing, will access these distributed services non-intrusively, via high-level message-based protocols. SOCIAL will reduce the complexity of distributed communications, control, and integration, enabling developers to concentrate on the design and functionality of the target DAI system itself.

Nonreference Medical Image Edge Map Measure

Directory of Open Access Journals (Sweden)

Karen Panetta

2014-01-01

Full Text Available Edge detection is a key step in medical image processing. It is widely used to extract features, perform segmentation, and further assist in diagnosis. A poor quality edge map can result in false alarms and misses in cancer detection algorithms. Therefore, it is necessary to have a reliable edge measure to assist in selecting the optimal edge map. Existing reference based edge measures require a ground truth edge map to evaluate the similarity between the generated edge map and the ground truth. However, the ground truth images are not available for medical images. Therefore, a nonreference edge measure is ideal for medical image processing applications. In this paper, a nonreference reconstruction based edge map evaluation (NREM is proposed. The theoretical basis is that a good edge map keeps the structure and details of the original image thus would yield a good reconstructed image. The NREM is based on comparing the similarity between the reconstructed image with the original image using this concept. The edge measure is used for selecting the optimal edge detection algorithm and optimal parameters for the algorithm. Experimental results show that the quantitative evaluations given by the edge measure have good correlations with human visual analysis.

Supporting Problem Solving with Case-Stories Learning Scenario and Video-based Collaborative Learning Technology

Directory of Open Access Journals (Sweden)

Chun Hu

2004-04-01

Full Text Available In this paper, we suggest that case-based resources, which are used for assisting cognition during problem solving, can be structured around the work of narratives in social cultural psychology. Theories and other research methods have proposed structures within narratives and stories which may be useful to the design of case-based resources. Moreover, embedded within cases are stories which are contextually rich, supporting the epistemological groundings of situated cognition. Therefore the purposes of this paper are to discuss possible frameworks of case-stories; derive design principles as to “what” constitutes a good case story or narrative; and suggest how technology can support story-based learning. We adopt video-based Computer-Supported Collaborative Learning (CSCL technology to support problem solving with case-stories learning scenarios. Our hypothesis in this paper is that well-designed case-based resources are able to aid in the cognitive processes undergirding problem solving and meaning making. We also suggest the use of an emerging video-based collaborative learning technology to support such an instructional strategy.

Space shuttle/food system study. Volume 2, Appendix G: Ground support system analysis. Appendix H: Galley functional details analysis

Science.gov (United States)

1974-01-01

The capabilities for preflight feeding of flight personnel and the supply and control of the space shuttle flight food system were investigated to determine ground support requirements; and the functional details of an onboard food system galley are shown in photographic mockups. The elements which were identified as necessary to the efficient accomplishment of ground support functions include the following: (1) administration; (2) dietetics; (3) analytical laboratories; (4) flight food warehouse; (5) stowage module assembly area; (6) launch site module storage area; (7) alert crew restaurant and disperse crew galleys; (8) ground food warehouse; (9) manufacturing facilities; (10) transport; and (11) computer support. Each element is discussed according to the design criteria of minimum cost, maximum flexibility, reliability, and efficiency consistent with space shuttle requirements. The galley mockup overview illustrates the initial operation configuration, food stowage locations, meal assembly and serving trays, meal preparation configuration, serving, trash management, and the logistics of handling and cleanup equipment.

Civil Support Operations

Science.gov (United States)

2010-08-01

marijuana eradication; linguist support; air and ground transportation; intelligence analysis; tunnel detection; engineering support; and...optical, infra-red and synthetic aperture radar imagery, as well as full motion video. Incident awareness and assessment requirements are based on the

Ground-Based Global Positioning System (GPS) Meteorology Integrated Precipitable Water Vapor (IPW)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Ground-Based Global Positioning System (GPS) Meteorology Integrated Precipitable Water Vapor (IPW) data set measures atmospheric water vapor using ground-based...

Kennedy Space Center: Constellation Program Electrical Ground Support Equipment Research and Development

Science.gov (United States)

McCoy, Keegan

2010-01-01

The Kennedy Space Center (KSC) is NASA's spaceport, launching rockets into space and leading important human spaceflight research. This spring semester, I worked at KSC on Constellation Program electrical ground support equipment through NASA's Undergraduate Student Research Program (USRP). This report includes a discussion of NASA, KSC, and my individual research project. An analysis of Penn State's preparation of me for an internship and my overall impressions of the Penn State and NASA internship experience conclude the report.

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

Directory of Open Access Journals (Sweden)

Scheffer Gert J

2010-03-01

Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

Medical marijuana: medical necessity versus political agenda.

Science.gov (United States)

Clark, Peter A; Capuzzi, Kevin; Fick, Cameron

2011-12-01

Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights.

Medical marijuana: Medical necessity versus political agenda

Science.gov (United States)

Clark, Peter A.; Capuzzi, Kevin; Fick, Cameron

2011-01-01

Summary Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government’s stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights. PMID:22129912

A critical review of simulation-based medical education research: 2003-2009.

Science.gov (United States)

McGaghie, William C; Issenberg, S Barry; Petrusa, Emil R; Scalese, Ross J

2010-01-01

This article reviews and critically evaluates historical and contemporary research on simulation-based medical education (SBME). It also presents and discusses 12 features and best practices of SBME that teachers should know in order to use medical simulation technology to maximum educational benefit. This qualitative synthesis of SBME research and scholarship was carried out in two stages. Firstly, we summarised the results of three SBME research reviews covering the years 1969-2003. Secondly, we performed a selective, critical review of SBME research and scholarship published during 2003-2009. The historical and contemporary research synthesis is reported to inform the medical education community about 12 features and best practices of SBME: (i) feedback; (ii) deliberate practice; (iii) curriculum integration; (iv) outcome measurement; (v) simulation fidelity; (vi) skill acquisition and maintenance; (vii) mastery learning; (viii) transfer to practice; (ix) team training; (x) high-stakes testing; (xi) instructor training, and (xii) educational and professional context. Each of these is discussed in the light of available evidence. The scientific quality of contemporary SBME research is much improved compared with the historical record. Development of and research into SBME have grown and matured over the past 40 years on substantive and methodological grounds. We believe the impact and educational utility of SBME are likely to increase in the future. More thematic programmes of research are needed. Simulation-based medical education is a complex service intervention that needs to be planned and practised with attention to organisational contexts.

Medical technology advances from space research

Science.gov (United States)

Pool, S. L.

1972-01-01

Details of medical research and development programs, particularly an integrated medical laboratory, as derived from space technology are given. The program covers digital biotelemetry systems, automatic visual field mapping equipment, sponge electrode caps for clinical electroencephalograms, and advanced respiratory analysis equipment. The possibility of using the medical laboratory in ground based remote areas and regional health care facilities, as well as long duration space missions is discussed.

Are medical educators following General Medical Council guidelines on obesity education: if not why not?

Science.gov (United States)

2013-01-01

Background Although the United Kingdom’s (UK’s) General Medical Council (GMC) recommends that graduating medical students are competent to discuss obesity and behaviour change with patients, it is difficult to integrate this education into existing curricula, and clinicians report being unprepared to support patients needing obesity management in practice. We therefore aimed to identify factors influencing the integration of obesity management education within medical schools. Methods Twenty-seven UK and Irish medical school educators participated in semi-structured interviews. Grounded theory principles informed data collection and analysis. Themes emerging directly from the dataset illustrated key challenges for educators and informed several suggested solutions. Results Factors influencing obesity management education included: 1) Diverse and opportunistic learning and teaching, 2) Variable support for including obesity education within undergraduate medical programmes, and 3) Student engagement in obesity management education. Findings suggest several practical solutions to identified challenges including clarifying recommended educational agendas; improving access to content-specific guidelines; and implementing student engagement strategies. Conclusions Students’ educational experiences differ due to diverse interpretations of GMC guidelines, educators’ perceptions of available support for, and student interest in obesity management education. Findings inform the development of potential solutions to these challenges which may be tested further empirically. PMID:23578257

Medical image computing for computer-supported diagnostics and therapy. Advances and perspectives.

Science.gov (United States)

Handels, H; Ehrhardt, J

2009-01-01

Medical image computing has become one of the most challenging fields in medical informatics. In image-based diagnostics of the future software assistance will become more and more important, and image analysis systems integrating advanced image computing methods are needed to extract quantitative image parameters to characterize the state and changes of image structures of interest (e.g. tumors, organs, vessels, bones etc.) in a reproducible and objective way. Furthermore, in the field of software-assisted and navigated surgery medical image computing methods play a key role and have opened up new perspectives for patient treatment. However, further developments are needed to increase the grade of automation, accuracy, reproducibility and robustness. Moreover, the systems developed have to be integrated into the clinical workflow. For the development of advanced image computing systems methods of different scientific fields have to be adapted and used in combination. The principal methodologies in medical image computing are the following: image segmentation, image registration, image analysis for quantification and computer assisted image interpretation, modeling and simulation as well as visualization and virtual reality. Especially, model-based image computing techniques open up new perspectives for prediction of organ changes and risk analysis of patients and will gain importance in diagnostic and therapy of the future. From a methodical point of view the authors identify the following future trends and perspectives in medical image computing: development of optimized application-specific systems and integration into the clinical workflow, enhanced computational models for image analysis and virtual reality training systems, integration of different image computing methods, further integration of multimodal image data and biosignals and advanced methods for 4D medical image computing. The development of image analysis systems for diagnostic support or

Why support a women's medical college? Philadelphia's early male medical pro-feminists.

Science.gov (United States)

Peitzman, Steven J

2003-01-01

The male founders and early faculty of Philadelphia's Woman's Medical College were mostly abolitionist physicians, zealous moralists for whom medical feminism formed only one of the cherished causes they could "manfully" and righteously defend. Male faculty of the late nineteenth century comprised "self-made" men, mostly new specialists, for whom strict sexism probably seemed inconsistent with progressive medicine. For some of these physicians-obviously a small minority-defending medical women and breaking the barriers of fraternity could be consistent with "manly" responsibility. The outcome of the collaboration of women and the dissident men physicians in nineteenth-century Philadelphia amounted to another seeming paradox: the majority of the male medical profession, both locally and nationally, tyrannically hindered women's entry into the profession, yet medicine opened its doors in advance of law and the clergy; and where this first occurred, such as in the community centered on Woman's Medical College, a novel gender rearrangement arose based on collaboration and friendship.

Post Cold War transformation of the medical function in support of the deployed soldier.

Science.gov (United States)

Vekerdi, Zoltan

2013-12-01

This article summarises the changes that resulted in, and still act towards, final implementation of a separate medical function in operational medical support. This article is not intended to represent an historical account, but to provide concise supplemental material for decision makers to position medical under the commander, which enables medical staff to support and care for the troops and which can be used in the best possible way as an image forming factor for the force. The aim of this article is to clearly articulate the necessity for independence of the medical and logistic functions, while recognising the need for continued close coordination.

Simulation of Ground-Water Flow and Effects of Ground-Water Irrigation on Base Flow in the Elkhorn and Loup River Basins, Nebraska

Science.gov (United States)

Peterson, Steven M.; Stanton, Jennifer S.; Saunders, Amanda T.; Bradley, Jesse R.

2008-01-01

Irrigated agriculture is vital to the livelihood of communities in the Elkhorn and Loup River Basins in Nebraska, and ground water is used to irrigate most of the cropland. Concerns about the sustainability of ground-water and surface-water resources have prompted State and regional agencies to evaluate the cumulative effects of ground-water irrigation in this area. To facilitate understanding of the effects of ground-water irrigation, a numerical computer model was developed to simulate ground-water flow and assess the effects of ground-water irrigation (including ground-water withdrawals, hereinafter referred to as pumpage, and enhanced recharge) on stream base flow. The study area covers approximately 30,800 square miles, and includes the Elkhorn River Basin upstream from Norfolk, Nebraska, and the Loup River Basin upstream from Columbus, Nebraska. The water-table aquifer consists of Quaternary-age sands and gravels and Tertiary-age silts, sands, and gravels. The simulation was constructed using one layer with 2-mile by 2-mile cell size. Simulations were constructed to represent the ground-water system before 1940 and from 1940 through 2005, and to simulate hypothetical conditions from 2006 through 2045 or 2055. The first simulation represents steady-state conditions of the system before anthropogenic effects, and then simulates the effects of early surface-water development activities and recharge of water leaking from canals during 1895 to 1940. The first simulation ends at 1940 because before that time, very little pumpage for irrigation occurred, but after that time it became increasingly commonplace. The pre-1940 simulation was calibrated against measured water levels and estimated long-term base flow, and the 1940 through 2005 simulation was calibrated against measured water-level changes and estimated long-term base flow. The calibrated 1940 through 2005 simulation was used as the basis for analyzing hypothetical scenarios to evaluate the effects of

Exploration Medical System Demonstration Project

Science.gov (United States)

Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

2011-01-01

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

Preclosure radiological safety assessment for the ground support system in the exploratory studies facility

International Nuclear Information System (INIS)

Smith, A.J.; Tsai, F.C.

1995-01-01

An initial probabilistic safety assessment was performed for the exploratory studies facility underground opening to determine whether the ground support system should be classified as an item important to safety. The initiating event was taken to be a rock fall in an operational facility impacting a loaded waste transporter. Rock fall probability rates were estimated from data reported by commercial mining operations. This information was retrieved from the data base compiled by the Mining Safety and Health Administration from the mandatory reporting of incidents. The statistical distribution of the rock fall magnitude was estimated from the horizontal and vertical spacing fractures measured at the Yucca Mountain repository horizon. Simple models were developed to estimate container deformation and radionuclide releases arising from the projected distribution of impacts. Accepted techniques were used to calculate atmospheric dispersion and obtain the committed dose to individuals

An effective support system of emergency medical services with tablet computers.

Science.gov (United States)

Yamada, Kosuke C; Inoue, Satoshi; Sakamoto, Yuichiro

2015-02-27

There were over 5,000,000 ambulance dispatches during 2010 in Japan, and the time for transportation has been increasing, it took over 37 minutes from dispatch to the hospitals. A way to reduce transportation time by ambulance is to shorten the time of searching for an appropriate facility/hospital during the prehospital phase. Although the information system of medical institutions and emergency medical service (EMS) was established in 2003 in Saga Prefecture, Japan, it has not been utilized efficiently. The Saga Prefectural Government renewed the previous system in an effort to make it the real-time support system that can efficiently manage emergency demand and acceptance for the first time in Japan in April 2011. The objective of this study was to evaluate if the new system promotes efficient emergency transportation for critically ill patients and provides valuable epidemiological data. The new system has provided both emergency personnel in the ambulance, or at the scene, and the medical staff in each hospital to be able to share up-to-date information about available hospitals by means of cloud computing. All 55 ambulances in Saga are equipped with tablet computers through third generation/long term evolution networks. When the emergency personnel arrive on the scene and discern the type of patient's illness, they can search for an appropriate facility/hospital with their tablet computer based on the patient's symptoms and available medical specialists. Data were collected prospectively over a three-year period from April 1, 2011 to March 31, 2013. The transportation time by ambulance in Saga was shortened for the first time since the statistics were first kept in 1999; the mean time was 34.3 minutes in 2010 (based on administrative statistics) and 33.9 minutes (95% CI 33.6-34.1) in 2011. The ratio of transportation to the tertiary care facilities in Saga has decreased by 3.12% from the year before, 32.7% in 2010 (regional average) and 29.58% (9085

Ground-based Nuclear Detonation Detection (GNDD) Technology Roadmap

International Nuclear Information System (INIS)

Casey, Leslie A.

2014-01-01

This GNDD Technology Roadmap is intended to provide guidance to potential researchers and help management define research priorities to achieve technology advancements for ground-based nuclear explosion monitoring science being pursued by the Ground-based Nuclear Detonation Detection (GNDD) Team within the Office of Nuclear Detonation Detection in the National Nuclear Security Administration (NNSA) of the U.S. Department of Energy (DOE). Four science-based elements were selected to encompass the entire scope of nuclear monitoring research and development (R&D) necessary to facilitate breakthrough scientific results, as well as deliver impactful products. Promising future R&D is delineated including dual use associated with the Comprehensive Nuclear-Test-Ban Treaty (CTBT). Important research themes as well as associated metrics are identified along with a progression of accomplishments, represented by a selected bibliography, that are precursors to major improvements to nuclear explosion monitoring.

Ground-based Nuclear Detonation Detection (GNDD) Technology Roadmap

Energy Technology Data Exchange (ETDEWEB)

Casey, Leslie A.

2014-01-13

This GNDD Technology Roadmap is intended to provide guidance to potential researchers and help management define research priorities to achieve technology advancements for ground-based nuclear explosion monitoring science being pursued by the Ground-based Nuclear Detonation Detection (GNDD) Team within the Office of Nuclear Detonation Detection in the National Nuclear Security Administration (NNSA) of the U.S. Department of Energy (DOE). Four science-based elements were selected to encompass the entire scope of nuclear monitoring research and development (R&D) necessary to facilitate breakthrough scientific results, as well as deliver impactful products. Promising future R&D is delineated including dual use associated with the Comprehensive Nuclear-Test-Ban Treaty (CTBT). Important research themes as well as associated metrics are identified along with a progression of accomplishments, represented by a selected bibliography, that are precursors to major improvements to nuclear explosion monitoring.

The COROT ground-based archive and access system

Science.gov (United States)

Solano, E.; González-Riestra, R.; Catala, C.; Baglin, A.

2002-01-01

A prototype of the COROT ground-based archive and access system is presented here. The system has been developed at LAEFF and it is based on the experience gained at Laboratorio de Astrofisica Espacial y Fisica Fundamental (LAEFF) with the INES (IUE Newly Extracted System) Archive.

A detrimental soil disturbance prediction model for ground-based timber harvesting

Science.gov (United States)

Derrick A. Reeves; Matthew C. Reeves; Ann M. Abbott; Deborah S. Page-Dumroese; Mark D. Coleman

2012-01-01

Soil properties and forest productivity can be affected during ground-based harvest operations and site preparation. The degree of impact varies widely depending on topographic features and soil properties. Forest managers who understand site-specific limits to ground-based harvesting can alter harvest method or season to limit soil disturbance. To determine the...

Validation of GOME (ERS-2) NO2 vertical column data with ground-based measurements at Issyk-Kul (Kyrgyzstan)

Science.gov (United States)

Ionov, D.; Sinyakov, V.; Semenov, V.

Starting from 1995 the global monitoring of atmospheric nitrogen dioxide is carried out by the measurements of nadir-viewing GOME spectrometer aboard ERS-2 satellite. Continuous validation of that data by means of comparisons with well-controlled ground-based measurements is important to ensure the quality of GOME data products and improve related retrieval algorithms. At the station of Issyk-Kul (Kyrgyzstan) the ground-based spectroscopic observations of NO2 vertical column have been started since 1983. The station is located on the northern shore of Issyk-Kul lake, 1650 meters above the sea level (42.6 N, 77.0 E). The site is equipped with grating spectrometer for the twilight measurements of zenith-scattered solar radiation in the visible range, and applies the DOAS technique to retrieve NO2 vertical column. It is included in the list of NDSC stations as a complementary one. The present study is focused on validation of GOME NO2 vertical column data, based on 8-year comparison with correlative ground-based measurements at Issyk-Kul station in 1996-2003. Within the investigation, an agreement of both individual and monthly averaged GOME measurements with corresponding twilight ground-based observations is examined. Such agreement is analyzed with respect to different conditions (season, sun elevation), temporal/spatial criteria choice (actual overpass location, correction for diurnal variation) and data processing (GDP version 2.7, 3.0). In addition, NO2 vertical columns were integrated from simultaneous stratospheric profile measurements by NASA HALOE and SAGE-II/III satellite instruments and introduced to explain the differences with ground-based observations. In particular cases, NO2 vertical profiles retrieved from the twilight ground-based measurements at Issuk-Kul were also included into comparison. Overall, summertime GOME NO2 vertical columns were found to be systematicaly lower than ground-based data. This work was supported by International Association

A cloud medication safety support system using QR code and Web services for elderly outpatients.

Science.gov (United States)

Tseng, Ming-Hseng; Wu, Hui-Ching

2014-01-01

Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.

Coordinated Ground-Based Observations and the New Horizons Fly-by of Pluto

Science.gov (United States)

Young, Eliot; Young, Leslie; Parker, Joel; Binzel, Richard

2015-04-01

The New Horizons (NH) spacecraft is scheduled to make its closest approach to Pluto on July 14, 2015. NH carries seven scientific instruments, including separate UV and Visible-IR spectrographs, a long-focal-length imager, two plasma-sensing instruments and a dust counter. There are three arenas in particular in which ground-based observations should augment the NH instrument suite in synergistic ways: IR spectra at wavelengths longer than 2.5 µm (i.e., longer than the NH Ralph spectrograph), stellar occultation observations near the time of the fly-by, and thermal surface maps and atmospheric CO abundances based on ALMA observations - we discuss the first two of these. IR spectra in the 3 - 5 µm range cover the CH4 absorption band near 3.3 µm. This band can be an important constraint on the state and areal extent of nitrogen frost on Pluto's surface. If this band depth is close to zero (as was observed by Olkin et al. 2007), it limits the area of nitrogen frost, which is bright at that wavelength. Combined with the NH observations of nitrogen frost at 2.15 µm, the ground-based spectra will determine how much nitrogen frost is diluted with methane, which is a basic constraint on the seasonal cycle of sublimation and condensation that takes place on Pluto (and similar objects like Triton and Eris). There is a fortuitous stellar occultation by Pluto on 29-JUN-2015, only two weeks before the NH closest approach. The occulted star will be the brightest ever observed in a Pluto event, about 2 magnitudes brighter than Pluto itself. The track of the event is predicted to cover parts of Australia and New Zealand. Thanks to HST and ground based campaigns to find a TNO target reachable by NH, the position of the shadow path will be known at the +/-100 km level, allowing SOFIA and mobile ground-based observers to reliably cover the central flash region. Ground-based & SOFIA observations in visible and IR wavelengths will characterize the haze opacity and vertical

The ground support computer and in-orbit survey data analysis program for the SEEP experiment

International Nuclear Information System (INIS)

Voss, H.D.; Datlowe, D.W.; Mobilia, J.; Roselle, S.N.

1985-01-01

The ground support computer equipment (GSE) and production survey plot and analysis software are described for the Stimulated Emissions of Energetic Particles (SEEP) experiment on the S81-1 satellite. A general purpose satellite data acquisition circuit was developed based on a Z-80 portable microcomputer. By simply changing instrument control software and electrical connectors, automatic testing and control of the various SEEP instruments was accomplished. A new feature incorporated into the SEEP data analysis phase was the development of a correlative data base for all of the SEEP instruments. A CPU efficient survey plot program (with ephemeris) was developed to display the approximate 3100 hours of data, with a time resolution of 0.5 sec, from the ten instrument sensors. The details of the general purpose multigraph algorithms and plot formats are presented. For the first time new associations are being investigated of simultaneous particle, X-ray, optical and plasma density satellite measurements

Ground test facility for nuclear testing of space reactor subsystems

International Nuclear Information System (INIS)

Quapp, W.J.; Watts, K.D.

1985-01-01

Two major reactor facilities at the INEL have been identified as easily adaptable for supporting the nuclear testing of the SP-100 reactor subsystem. They are the Engineering Test Reactor (ETR) and the Loss of Fluid Test Reactor (LOFT). In addition, there are machine shops, analytical laboratories, hot cells, and the supporting services (fire protection, safety, security, medical, waste management, etc.) necessary to conducting a nuclear test program. This paper presents the conceptual approach for modifying these reactor facilities for the ground engineering test facility for the SP-100 nuclear subsystem. 4 figs

Description logic-based methods for auditing frame-based medical terminological systems.

Science.gov (United States)

Cornet, Ronald; Abu-Hanna, Ameen

2005-07-01

Medical terminological systems (TSs) play an increasingly important role in health care by supporting recording, retrieval and analysis of patient information. As the size and complexity of TSs are growing, the need arises for means to audit them, i.e. verify and maintain (logical) consistency and (semantic) correctness of their contents. This is not only important for the management of TSs but also for providing their users with confidence about the reliability of their contents. Formal methods have the potential to play an important role in the audit of TSs, although there are few empirical studies to assess the benefits of using these methods. In this paper we propose a method based on description logics (DLs) for the audit of TSs. This method is based on the migration of the medical TS from a frame-based representation to a DL-based one. Our method is characterized by a process in which initially stringent assumptions are made about concept definitions. The assumptions allow the detection of concepts and relations that might comprise a source of logical inconsistency. If the assumptions hold then definitions are to be altered to eliminate the inconsistency, otherwise the assumptions are revised. In order to demonstrate the utility of the approach in a real-world case study we audit a TS in the intensive care domain and discuss decisions pertaining to building DL-based representations. This case study demonstrates that certain types of inconsistencies can indeed be detected by applying the method to a medical terminological system. The added value of the method described in this paper is that it provides a means to evaluate the compliance to a number of common modeling principles in a formal manner. The proposed method reveals potential modeling inconsistencies, helping to audit and (if possible) improve the medical TS. In this way, it contributes to providing confidence in the contents of the terminological system.

A DBMS-based medical teleconferencing system.

Science.gov (United States)

Chun, J; Kim, H; Lee, S; Choi, J; Cho, H

2001-01-01

This article presents the design of a medical teleconferencing system that is integrated with a multimedia patient database and incorporates easy-to-use tools and functions to effectively support collaborative work between physicians in remote locations. The design provides a virtual workspace that allows physicians to collectively view various kinds of patient data. By integrating the teleconferencing function into this workspace, physicians are able to conduct conferences using the same interface and have real-time access to the database during conference sessions. The authors have implemented a prototype based on this design. The prototype uses a high-speed network test bed and a manually created substitute for the integrated patient database.

[The significance of the experience in organizing medical support for the troops during the war years for the development of the modern military medical infrastructure].

Science.gov (United States)

Pogodin, Iu I; Gurov, A N

1995-05-01

In the present period when combat activities are being carried out at the territory of Russia, namely in Chechnya, it is very important to solve the problem of the improvement of the infrastructure of medical service as a basis of territorial system of medical support of troops. That's why we are looking at the experience of medical support of troops in the period of the Great Patriotic war in order to determine the basic characteristic features of military medical infrastructure (MMI) of that time. Using the experience of medical support in the period of the Great Patriotic war it is necessary to draw the main attention on studying the medico-geographical aspects of the Armed Forces deployment over the whole territory of the country, state of health service system (taking into account its reformation), influence of natural, socio-economic and ecological factors of different regions upon the health of servicemen, organization of medical support of troops, proliferation of infectious and parasitic diseases, local resources and availability of medication materials, medical supplies, equipment and technique, as well as other indices which must be taken into consideration in routine situations or during disaster relief. All this information is very valuable for the process of the formation of an adequate MMF in the zone of responsibility of medical support of troops.

Professional medical writing support and the quality of randomised controlled trial reporting: a cross-sectional study.

Science.gov (United States)

Gattrell, William T; Hopewell, Sally; Young, Kate; Farrow, Paul; White, Richard; Wager, Elizabeth; Winchester, Christopher C

2016-02-21

Authors may choose to work with professional medical writers when writing up their research for publication. We examined the relationship between medical writing support and the quality and timeliness of reporting of the results of randomised controlled trials (RCTs). Cross-sectional study. Primary reports of RCTs published in BioMed Central journals from 2000 to 16 July 2014, subdivided into those with medical writing support (n=110) and those without medical writing support (n=123). Proportion of items that were completely reported from a predefined subset of the Consolidated Standards of Reporting Trials (CONSORT) checklist (12 items known to be commonly poorly reported), overall acceptance time (from manuscript submission to editorial acceptance) and quality of written English as assessed by peer reviewers. The effect of funding source and publication year was examined. The number of articles that completely reported at least 50% of the CONSORT items assessed was higher for those with declared medical writing support (39.1% (43/110 articles); 95% CI 29.9% to 48.9%) than for those without (21.1% (26/123 articles); 95% CI 14.3% to 29.4%). Articles with declared medical writing support were more likely than articles without such support to have acceptable written English (81.1% (43/53 articles); 95% CI 67.6% to 90.1% vs 47.9% (23/48 articles); 95% CI 33.5% to 62.7%). The median time of overall acceptance was longer for articles with declared medical writing support than for those without (167 days (IQR 114.5-231 days) vs 136 days (IQR 77-193 days)). In this sample of open-access journals, declared professional medical writing support was associated with more complete reporting of clinical trial results and higher quality of written English. Medical writing support may play an important role in raising the quality of clinical trial reporting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

Nurses' perspectives on supporting children during needle-related medical procedures.

Science.gov (United States)

Karlsson, Katarina; Rydström, Ingela; Enskär, Karin; Englund, Ann-Charlotte Dalheim

2014-01-01

Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents' ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as "balancing on a tightrope" in an unpredictable situation.

Experiences with establishing and implementing learning management system and computer-based test system in medical college.

Science.gov (United States)

Park, Joo Hyun; Son, Ji Young; Kim, Sun

2012-09-01

The purpose of this study was to establish an e-learning system to support learning in medical education and identify solutions for improving the system. A learning management system (LMS) and computer-based test (CBT) system were established to support e-learning for medical students. A survey of 219 first- and second-grade medical students was administered. The questionnaire included 9 forced choice questions about the usability of system and 2 open-ended questions about necessary improvements to the system. The LMS consisted of a class management, class evaluation, and class attendance system. CBT consisted of a test management, item bank, and authoring tool system. The results of the survey showed a high level of satisfaction in all system usability items except for stability. Further, the advantages of the e-learning system were ensuring information accessibility, providing constant feedback, and designing an intuitive interface. Necessary improvements to the system were stability, user control, readability, and diverse device usage. Based on the findings, suggestions for developing an e-learning system to improve usability by medical students and support learning effectively are recommended.

Ground-Based Telescope Parametric Cost Model

Science.gov (United States)

Stahl, H. Philip; Rowell, Ginger Holmes

2004-01-01

A parametric cost model for ground-based telescopes is developed using multi-variable statistical analysis, The model includes both engineering and performance parameters. While diameter continues to be the dominant cost driver, other significant factors include primary mirror radius of curvature and diffraction limited wavelength. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e.. multi-telescope phased-array systems). Additionally, single variable models based on aperture diameter are derived. This analysis indicates that recent mirror technology advances have indeed reduced the historical telescope cost curve.

Psychological distress and academic self-perception among international medical students: the role of peer social support.

Science.gov (United States)

Yamada, Yukari; Klugar, Miloslav; Ivanova, Katerina; Oborna, Ivana

2014-11-28

Psychological distress among medical students is commonly observed during medical education and is generally related to poor academic self-perception. We evaluated the role of peer social support at medical schools in the association between psychological distress and academic self-perception. An online survey was conducted in a medical degree program for 138 international students educated in English in the Czech Republic. The Medical Student Well-Being Index was used to define the students' psychological distress. Perceived peer social support was investigated with the Multidimensional Scale of Perceived Social Support. Poor academic self-perception was defined as the lowest 30% of a subscale score of the Dundee Ready Education Environment Measure. Analyses evaluated the presence of additive interactions between psychological distress and peer social support on poor academic self-perception, adjusted for possible confounders. Both psychological distress and low peer social support were negatively associated with poor academic self-perception, adjusted for local language proficiency and social support from family. Students with psychological distress and low peer social support had an odds ratio of 11.0 (95% confidence interval (CI): 2.1-56.6) for poor academic self-perception as compared with those without distress who had high peer social support. The presence of an additive interaction was confirmed in that the joint association was four times as large as what would have been expected to be on summing the individual risks of psychological distress and low peer social support (synergy index = 4.5, 95% CI: 1.3-14.9). Psychological distress and low peer social support may synergistically increase the probability of poor academic self-perception among international medical students. Promoting peer social relationships at medical school may interrupt the vicious cycle of psychological distress and poor academic performance.

Medication-overuse headache: a perspective review

Science.gov (United States)

Westergaard, Maria Lurenda; Munksgaard, Signe Bruun; Bendtsen, Lars; Jensen, Rigmor Højland

2016-01-01

Medication-overuse headache (MOH) is a debilitating condition in which frequent and prolonged use of medication for the acute treatment of pain results in the worsening of the headache. The purpose of this paper is to review the most recent literature on MOH and discuss future avenues for research. MOH accounts for a substantial share of the global burden of disease. Prevalence is often reported as 1–2% but can be as high as 7% overall, with higher proportions among women and in those with a low socioeconomic position. Management consists of withdrawing pain medication, focusing on prophylactic and nonmedical treatments, and limiting acute symptomatic medication. Stress reduction and lifestyle interventions may support the change towards rational pain medication use. Support, follow up, and education are needed to help patients through the detoxification period. There is fertile ground for research in MOH epidemiology, pathophysiology, and neuroimaging. Randomized and long-term follow-up studies on MOH treatment protocols are needed. Further focused research could be of major importance for global health. PMID:27493718

Evidence based medical imaging (EBMI)

International Nuclear Information System (INIS)

Smith, Tony

2008-01-01

Background: The evidence based paradigm was first described about a decade ago. Previous authors have described a framework for the application of evidence based medicine which can be readily adapted to medical imaging practice. Purpose: This paper promotes the application of the evidence based framework in both the justification of the choice of examination type and the optimisation of the imaging technique used. Methods: The framework includes five integrated steps: framing a concise clinical question; searching for evidence to answer that question; critically appraising the evidence; applying the evidence in clinical practice; and, evaluating the use of revised practices. Results: This paper illustrates the use of the evidence based framework in medical imaging (that is, evidence based medical imaging) using the examples of two clinically relevant case studies. In doing so, a range of information technology and other resources available to medical imaging practitioners are identified with the intention of encouraging the application of the evidence based paradigm in radiography and radiology. Conclusion: There is a perceived need for radiographers and radiologists to make greater use of valid research evidence from the literature to inform their clinical practice and thus provide better quality services

KSC ADVANCED GROUND BASED FIELD MILL V1

Data.gov (United States)

National Aeronautics and Space Administration — The Advanced Ground Based Field Mill (AGBFM) network consists of 34 (31 operational) field mills located at Kennedy Space Center (KSC), Florida. The field mills...

Multi-Feature Based Multiple Landmine Detection Using Ground Penetration Radar

Directory of Open Access Journals (Sweden)

S. Park

2014-06-01

Full Text Available This paper presents a novel method for detection of multiple landmines using a ground penetrating radar (GPR. Conventional algorithms mainly focus on detection of a single landmine, which cannot linearly extend to the multiple landmine case. The proposed algorithm is composed of four steps; estimation of the number of multiple objects buried in the ground, isolation of each object, feature extraction and detection of landmines. The number of objects in the GPR signal is estimated by using the energy projection method. Then signals for the objects are extracted by using the symmetry filtering method. Each signal is then processed for features, which are given as input to the support vector machine (SVM for landmine detection. Three landmines buried in various ground conditions are considered for the test of the proposed method. They demonstrate that the proposed method can successfully detect multiple landmines.

Biomass burning aerosols characterization from ground based and profiling measurements

Science.gov (United States)

Marin, Cristina; Vasilescu, Jeni; Marmureanu, Luminita; Ene, Dragos; Preda, Liliana; Mihailescu, Mona

2018-04-01

The study goal is to assess the chemical and optical properties of aerosols present in the lofted layers and at the ground. The biomass burning aerosols were evaluated in low level layers from multi-wavelength lidar measurements, while chemical composition at ground was assessed using an Aerosol Chemical Speciation Monitor (ACSM) and an Aethalometer. Classification of aerosol type and specific organic markers were used to explore the potential to sense the particles from the same origin at ground base and on profiles.

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Human Space Flight Missions

Science.gov (United States)

Kerstman, Eric L.; Minard, Charles; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

2011-01-01

This slide presentation reviews the Integrated Medical Model (IMM) and its use as a risk assessment and decision support tool for human space flight missions. The IMM is an integrated, quantified, evidence-based decision support tool useful to NASA crew health and mission planners. It is intended to assist in optimizing crew health, safety and mission success within the constraints of the space flight environment for in-flight operations. It uses ISS data to assist in planning for the Exploration Program and it is not intended to assist in post flight research. The IMM was used to update Probability Risk Assessment (PRA) for the purpose of updating forecasts for the conditions requiring evacuation (EVAC) or Loss of Crew Life (LOC) for the ISS. The IMM validation approach includes comparison with actual events and involves both qualitative and quantitaive approaches. The results of these comparisons are reviewed. Another use of the IMM is to optimize the medical kits taking into consideration the specific mission and the crew profile. An example of the use of the IMM to optimize the medical kits is reviewed.

Control Method of Single-phase Inverter Based Grounding System in Distribution Networks

DEFF Research Database (Denmark)

Wang, Wen; Yan, L.; Zeng, X.

2016-01-01

of neutral-to-ground voltage is critical for the safety of distribution networks. An active grounding system based on single-phase inverter is proposed to achieve this objective. Relationship between output current of the system and neutral-to-ground voltage is derived to explain the principle of neutral......The asymmetry of the inherent distributed capacitances causes the rise of neutral-to-ground voltage in ungrounded system or high resistance grounded system. Overvoltage may occur in resonant grounded system if Petersen coil is resonant with the distributed capacitances. Thus, the restraint...

The Study of Electronic Medical Record Adoption in a Medicare Certified Home Health Agency Using a Grounded Theory Approach

Science.gov (United States)

May, Joy L.

2013-01-01

The purpose of this qualitative grounded theory study was to examine the experiences of clinicians in the adoption of Electronic Medical Records in a Medicare certified Home Health Agency. An additional goal for this study was to triangulate qualitative research between describing, explaining, and exploring technology acceptance. The experiences…

Electronic ground support equipment for the Cluster Electric Field and Wave Experiment

International Nuclear Information System (INIS)

Sten, T.A.

1992-10-01

In a collaboration between ESA and NASA, ionosphere plasma structures will be studied by four indentical space probes to be launched in 1995 from French Guiana. The Electric Field and Wave (EFW) experiment will be designed to measure electric field and density fluctations by means of four sensors, each deployed on a 50 meter wire boom. In order to perform comprehensive tests and calibrations of the EFW experiment, computer controlled electronic ground support equipment has been developed. This report describes the hardware of the equipment, produced and assembled at the University of Oslo. 15 figs

A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care.

Science.gov (United States)

Vannoy, Steven D; Mauer, Barbara; Kern, John; Girn, Kamaljeet; Ingoglia, Charles; Campbell, Jeannie; Galbreath, Laura; Unützer, Jürgen

2011-07-01

Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and cross-agency communication. Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs.

Apps and Mobile Support Services in Canadian Academic Medical Libraries

Directory of Open Access Journals (Sweden)

Tess Grynoch

2016-12-01

Full Text Available Objective: To examine how Canadian academic medical libraries are supporting mobile apps, what apps are currently being provided by these libraries, and what types of promotion are being used. Methods: A survey of the library websites for the 17 medical schools in Canada was completed. For each library website surveyed, the medical apps listed on the website, any services mentioned through this medium, and any type of app promotion events were noted. When Facebook and Twitter accounts were evident, the tweets were searched and the past two years of Facebook posts scanned for mention of medical apps or mobile services/events. Results: All seventeen academic medical libraries had lists of mobile medical apps with a large range in the number of medical relevant apps (average=31, median= 23. A total of 275 different apps were noted and the apps covered a wide range of subjects. Five of the 14 Facebook accounts scanned had posts about medical apps in the past two years while 11 of the 15 Twitter accounts had tweets about medical apps. Social media was only one of the many promotional methods noted. Outside of the app lists and mobile resources guides, Canadian academic medical libraries are providing workshops, presentations, and drop-in sessions for mobile medical apps. Conclusion: While librarians cannot simply compare mobile services and resources between academic medical libraries without factoring in a number of other circumstances, librarians can learn from mobile resources strategies employed at other libraries, such as using research guides to increase medical app literacy.

Is being a medical educator a lonely business? The essence of social support

NARCIS (Netherlands)

van den Berg, Joost W.; Verberg, Christel P. M.; Scherpbier, Albert J. J. A.; Jaarsma, A. Debbie C.; Lombarts, Kiki M. J. M. H.

2017-01-01

Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study

Brain bases for auditory stimulus-driven figure-ground segregation.

Science.gov (United States)

Teki, Sundeep; Chait, Maria; Kumar, Sukhbinder; von Kriegstein, Katharina; Griffiths, Timothy D

2011-01-05

Auditory figure-ground segregation, listeners' ability to selectively hear out a sound of interest from a background of competing sounds, is a fundamental aspect of scene analysis. In contrast to the disordered acoustic environment we experience during everyday listening, most studies of auditory segregation have used relatively simple, temporally regular signals. We developed a new figure-ground stimulus that incorporates stochastic variation of the figure and background that captures the rich spectrotemporal complexity of natural acoustic scenes. Figure and background signals overlap in spectrotemporal space, but vary in the statistics of fluctuation, such that the only way to extract the figure is by integrating the patterns over time and frequency. Our behavioral results demonstrate that human listeners are remarkably sensitive to the appearance of such figures. In a functional magnetic resonance imaging experiment, aimed at investigating preattentive, stimulus-driven, auditory segregation mechanisms, naive subjects listened to these stimuli while performing an irrelevant task. Results demonstrate significant activations in the intraparietal sulcus (IPS) and the superior temporal sulcus related to bottom-up, stimulus-driven figure-ground decomposition. We did not observe any significant activation in the primary auditory cortex. Our results support a role for automatic, bottom-up mechanisms in the IPS in mediating stimulus-driven, auditory figure-ground segregation, which is consistent with accumulating evidence implicating the IPS in structuring sensory input and perceptual organization.

Using a smartphone-based self-management platform to support medication adherence and clinical consultation in Parkinson's disease.

Science.gov (United States)

Lakshminarayana, Rashmi; Wang, Duolao; Burn, David; Chaudhuri, K Ray; Galtrey, Clare; Guzman, Natalie Valle; Hellman, Bruce; Ben James; Pal, Suvankar; Stamford, Jon; Steiger, Malcolm; Stott, R W; Teo, James; Barker, Roger A; Wang, Emma; Bloem, Bastiaan R; van der Eijk, Martijn; Rochester, Lynn; Williams, Adrian

2017-01-01

The progressive nature of Parkinson's disease, its complex treatment regimens and the high rates of comorbid conditions make self-management and treatment adherence a challenge. Clinicians have limited face-to-face consultation time with Parkinson's disease patients, making it difficult to comprehensively address non-adherence. Here we share the results from a multi-centre (seven centres) randomised controlled trial conducted in England and Scotland to assess the impact of using a smartphone-based Parkinson's tracker app to promote patient self-management, enhance treatment adherence and quality of clinical consultation. Eligible Parkinson's disease patients were randomised using a 1:1 ratio according to a computer-generated random sequence, stratified by centre and using blocks of variable size, to intervention Parkinson's Tracker App or control (Treatment as Usual). Primary outcome was the self-reported score of adherence to treatment (Morisky medication adherence scale -8) at 16 weeks. Secondary outcomes were Quality of Life (Parkinson's disease questionnaire -39), quality of consultation for Parkinson's disease patients ( Patient-centred questionnaire for Parkinson's disease ), impact on non-motor symptoms (Non-motor symptoms questionnaire), depression and anxiety (Hospital anxiety and depression scale) and beliefs about medication (Beliefs about Medication Questionnaire) at 16 weeks. Primary and secondary endpoints were analysed using a generalised linear model with treatment as the fixed effect and baseline measurement as the covariate. 158 patients completed the study (Parkinson's tracker app = 68 and TAU = 90). At 16 weeks Parkinson's tracker app significantly improved adherence, compared to treatment as usual (mean difference: 0.39, 95%CI 0.04-0.74; p  = 0.0304) with no confounding effects of gender, number of comorbidities and age. Among secondary outcomes, Parkinson's tracker app significantly improved patients' perception of quality of

Nurses’ perspectives on supporting children during needle-related medical procedures

Directory of Open Access Journals (Sweden)

Katarina Karlsson

2014-03-01

Full Text Available Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents’ ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as “balancing on a tightrope” in an unpredictable situation.

Nurses’ perspectives on supporting children during needle-related medical procedures

Science.gov (United States)

Karlsson, Katarina; Rydström, Ingela; Enskär, Karin; Englund, Ann-Charlotte Dalheim

2014-01-01

Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents’ ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as “balancing on a tightrope” in an unpredictable situation. PMID:24646473

The impact of a person-centred community pharmacy mental health medication support service on consumer outcomes.

Science.gov (United States)

McMillan, Sara S; Kelly, Fiona; Hattingh, H Laetitia; Fowler, Jane L; Mihala, Gabor; Wheeler, Amanda J

2018-04-01

Mental illness is a worldwide health priority. As medication is commonly used to treat mental illness, community pharmacy staff is well placed to assist consumers. To evaluate the effectiveness of a multifaceted, community pharmacy medication support service for mental health consumers. Pharmacists and pharmacy support staff in three Australian states were trained to deliver a flexible, goal-oriented medication support service for adults with mental illness over 3-6 months. Consumer-related outcome measures included perceptions of illness and health-related quality of life, medication beliefs, treatment satisfaction and medication adherence. Fifty-five of 100 trained pharmacies completed the intervention with 295 of the 418 recruited consumers (70.6% completion rate); 51.2% of consumers received two or more follow-ups. Significant improvements were reported by consumers for overall perceptions of illness (p Consumers also reported an increase in medication adherence (p = 0.005). A community pharmacy mental health medication support service that is goal-oriented, flexible and individualised, improved consumer outcomes across various measures. While further research into the cost-effectiveness and sustainability of such a service is warranted, this intervention could easily be adapted to other contexts.

Medical Support for Aircraft Disaster Search and Recovery Operations at Sea: the RSN Experience.

Science.gov (United States)

Teo, Kok Ann Colin; Chong, Tse Feng Gabriel; Liow, Min Han Lincoln; Tang, Kong Choong

2016-06-01

The maritime environment presents a unique set of challenges to search and recovery (SAR) operations. There is a paucity of information available to guide provision of medical support for SAR operations for aircraft disasters at sea. The Republic of Singapore Navy (RSN) took part in two such SAR operations in 2014 which showcased the value of a military organization in these operations. Key considerations in medical support for similar operations include the resultant casualty profile and challenges specific to the maritime environment, such as large distances of area of operations from land, variable sea states, and space limitations. Medical support planning can be approached using well-established disaster management life cycle phases of preparedness, mitigation, response, and recovery, which all are described in detail. This includes key areas of dedicated training and exercises, force protection, availability of air assets and chamber support, psychological care, and the forensic handling of human remains. Relevant lessons learned by RSN from the Air Asia QZ8501 search operation are also included in the description of these key areas. Teo KAC , Chong TFG , Liow MHL , Tang KC . Medical support for aircraft disaster search and recovery operations at sea: the RSN experience. Prehosp Disaster Med. 2016; 31(3):294-299.

Rural Medicine Realities: The Impact of Immersion on Urban-Based Medical Students.

Science.gov (United States)

Crump, Allison M; Jeter, Karie; Mullins, Samantha; Shadoan, Amber; Ziegler, Craig; Crump, William J

2017-05-02

The purpose of our study was to determine what effect a rural-based 8-week surgical clerkship during the third year of medical school in a rural setting has on students' opinions about rural living and practice. Thirty-three third-year medical students completed a rural health opinion survey at the beginning and end of their 8-week rural rotation and a survey measuring their interest in rural practice after the rotation. The setting was a rural hospital with an average acute care census of 100 that is a regional referral center for 5 rural counties. Urban campus-based students had a statistically significant positive change in opinions about rural comfortable living, availability of quality services, community support, and medical resources. The urban campus-based students also showed a significantly increased interest in small town practice after the rotation. Our hypothesis that urban-based students would report an increased level of rural community support at the end of the rotation was confirmed. These urban-based students also reported positive opinions about rural living and practice. The students primarily based at the urban campus also showed a statistically significant more positive attitude toward pursuing a career in a small town after the 8-week experience. This suggests that brief rural immersion experiences may make the larger student pool at an urban campus available to address rural workforce challenges. Future studies at multiple rural sites with a larger sample size are needed to confirm this possibility. © 2017 National Rural Health Association.

Merging Problem-Based Learning with Simulation-Based Learning in the Medical Undergraduate Curriculum: The PAIRED Framework for Enhancing Lifelong Learning

Science.gov (United States)

Koh, Jansen

2016-01-01

Lifelong learning is an essential trait that is expected of every physician. The CanMeds 2005 Physician Competency Framework emphasizes lifelong learning as a key competency that physicians must achieve in becoming better physicians. However, many physicians are not competent at engaging in lifelong learning. The current medical education system is deficient in preparing medical students to develop and carry out their own lifelong learning curriculum upon graduation. Despite understanding how physicians learn at work, medical students are not trained to learn while working. Similarly, although barriers to lifelong learning are known, medical students are not adequately skilled in overcoming these barriers. Learning to learn is just as important, if not more, as acquiring the skills and knowledge required of a physician. The medical undergraduate curriculum lacks a specific learning strategy to prepare medical students in becoming an adept lifelong learner. In this article, we propose a learning strategy for lifelong learning at the undergraduate level. In developing this novel strategy, we paid particular attention to two parameters. First, this strategy should be grounded on literature describing a physician’s lifelong learning process. Second, the framework for implementing this strategy must be based on existing undergraduate learning strategies to obviate the need for additional resources, learner burden, and faculty time. In this paper, we propose a Problem, Analysis, Independent Research Reporting, Experimentation Debriefing (PAIRED) framework that follows the learning process of a physician and serves to synergize the components of problem-based learning and simulation-based learning in specifically targeting the barriers to lifelong learning. PMID:27446767

Is being a medical educator a lonely business? The essence of social support

NARCIS (Netherlands)

van den Berg, Joost W.; Verberg, Christel P. M.; Scherpbier, Albert J. J. A.; Jaarsma, A. Debbie C.; Lombarts, Kiki M. J. M. H.

CONTEXT Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study

From data mining rules to medical logical modules and medical advices.

Science.gov (United States)

Gomoi, Valentin; Vida, Mihaela; Robu, Raul; Stoicu-Tivadar, Vasile; Bernad, Elena; Lupşe, Oana

2013-01-01

Using data mining in collaboration with Clinical Decision Support Systems adds new knowledge as support for medical diagnosis. The current work presents a tool which translates data mining rules supporting generation of medical advices to Arden Syntax formalism. The developed system was tested with data related to 2326 births that took place in 2010 at the Bega Obstetrics - Gynaecology Hospital, Timişoara. Based on processing these data, 14 medical rules regarding the Apgar score were generated and then translated in Arden Syntax language.

Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies.

Science.gov (United States)

Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M

2015-11-03

Most Medicare patients seeking emergency medical transport are treated by ambulance providers trained in advanced life support (ALS). Evidence supporting the superiority of ALS over basic life support (BLS) is limited, but some studies suggest ALS may harm patients. To compare outcomes after ALS and BLS in out-of-hospital medical emergencies. Observational study with adjustment for propensity score weights and instrumental variable analyses based on county-level variations in ALS use. Traditional Medicare. 20% random sample of Medicare beneficiaries from nonrural counties between 2006 and 2011 with major trauma, stroke, acute myocardial infarction (AMI), or respiratory failure. Neurologic functioning and survival to 30 days, 90 days, 1 year, and 2 years. Except in cases of AMI, patients showed superior unadjusted outcomes with BLS despite being older and having more comorbidities. In propensity score analyses, survival to 90 days among patients with trauma, stroke, and respiratory failure was higher with BLS than ALS (6.1 percentage points [95% CI, 5.4 to 6.8 percentage points] for trauma; 7.0 percentage points [CI, 6.2 to 7.7 percentage points] for stroke; and 3.7 percentage points [CI, 2.5 to 4.8 percentage points] for respiratory failure). Patients with AMI did not exhibit differences in survival at 30 days but had better survival at 90 days with ALS (1.0 percentage point [CI, 0.1 to 1.9 percentage points]). Neurologic functioning favored BLS for all diagnoses. Results from instrumental variable analyses were broadly consistent with propensity score analyses for trauma and stroke, showed no survival differences between BLS and ALS for respiratory failure, and showed better survival at all time points with BLS than ALS for patients with AMI. Only Medicare beneficiaries from nonrural counties were studied. Advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS. National Science Foundation, Agency for

Advances in intelligent analysis of medical data and decision support systems

CERN Document Server

Iantovics, Barna

2013-01-01

This volume is a result of the fruitful and vivid discussions during the MedDecSup'2012 International Workshop bringing together a relevant body of knowledge, and new developments in the increasingly important field of medical informatics. This carefully edited book presents new ideas aimed at the development of intelligent processing of various kinds of medical information and the perfection of the contemporary computer systems for medical decision support. The book presents advances of the medical information systems for intelligent archiving, processing, analysis and search-by-content which will improve the quality of the medical services for every patient and of the global healthcare system. The book combines in a synergistic way theoretical developments with the practicability of the approaches developed and presents the last developments and achievements in  medical informatics to a broad range of readers: engineers, mathematicians, physicians, and PhD students.

Differentiation between anonymous paintings of the 17th and the early 18th century by composition of clay-based grounds

Czech Academy of Sciences Publication Activity Database

Hradil, David; Hradilová, J.; Bezdička, Petr; Švarcová, Silvie

2015-01-01

Roč. 118, DEC (2015), s. 8-20 ISSN 0169-1317 R&D Projects: GA ČR GA14-22984S Institutional support: RVO:61388980 Keywords : paintings * clay-based grounds * X-ray powder micro-diffraction * historical technology Subject RIV: CA - Inorganic Chemistry Impact factor: 2.586, year: 2015

The Future of Ground Magnetometer Arrays in Support of Space Weather Monitoring and Research

Science.gov (United States)

Engebretson, Mark; Zesta, Eftyhia

2017-11-01

A community workshop was held in Greenbelt, Maryland, on 5-6 May 2016 to discuss recommendations for the future of ground magnetometer array research in space physics. The community reviewed findings contained in the 2016 Geospace Portfolio Review of the Geospace Section of the Division of Atmospheric and Geospace Science of the National Science Foundation and discussed the present state of ground magnetometer arrays and possible pathways for a more optimal, robust, and effective organization and scientific use of these ground arrays. This paper summarizes the report of that workshop to the National Science Foundation (Engebretson & Zesta, as well as conclusions from two follow-up meetings. It describes the current state of U.S.-funded ground magnetometer arrays and summarizes community recommendations for changes in both organizational and funding structures. It also outlines a variety of new and/or augmented regional and global data products and visualizations that can be facilitated by increased collaboration among arrays. Such products will enhance the value of ground-based magnetometer data to the community's effort for understanding of Earth's space environment and space weather effects.

Advanced ESPI-based medical instruments for otolaryngology

Science.gov (United States)

Castracane, James; Conerty, M.; Cacace, Anthony T.; Gardner, Glendon M.; Miller, Mitchell B.; Parnes, Steven M.

1993-05-01

Optical fibers have long been used for visual inspection inside the human body for medical diagnoses and treatment. By making use of sophisticated optical interferometric and ultra- small imaging techniques, combined with automated image processing, it is possible to extract significantly increased information for more accurate medical diagnoses. With support from NIH under the SBIR program, we have been developing a range of such instruments. One of these supported by the NIDCD is capable of providing detailed spatial information on the vibratory response of the tympanic membrane (TM). This instrument involves the examination of the TM by means of high speed electronic speckle pattern interferometry (ESPI). This provides a real time view of the vibration patterns of the TM for clinical diagnosis. This Interferometric Otoscope consists of mode conserving fiber optics, miniature diode lasers and high speed solid state detector arrays. We present the current status of the research including holography and ESPI of TM models and excised temporal bone preparations. A second instrument, also developed with support from NIDCD, is for application to the larynx. This system is also ESPI based but will incorporate features for direct vocal cord (VC) examination. By careful examination of the vibratory response of the VC during phonation, the characteristics of the mucosal wave may be examined. Adynamic regions of the cords can signal the start of lesions or cysts. Results of surgery can be evaluated in a quantitative manner. The design of a clinical prototype and preliminary electro-optic experiments on excised larynges and VC models will be presented.

Estimation of High-Frequency Earth-Space Radio Wave Signals via Ground-Based Polarimetric Radar Observations

Science.gov (United States)

Bolen, Steve; Chandrasekar, V.

2002-01-01

Expanding human presence in space, and enabling the commercialization of this frontier, is part of the strategic goals for NASA's Human Exploration and Development of Space (HEDS) enterprise. Future near-Earth and planetary missions will support the use of high-frequency Earth-space communication systems. Additionally, increased commercial demand on low-frequency Earth-space links in the S- and C-band spectra have led to increased interest in the use of higher frequencies in regions like Ku and Ka-band. Attenuation of high-frequency signals, due to a precipitating medium, can be quite severe and can cause considerable disruptions in a communications link that traverses such a medium. Previously, ground radar measurements were made along the Earth-space path and compared to satellite beacon data that was transmitted to a ground station. In this paper, quantitative estimation of the attenuation along the propagation path is made via inter-comparisons of radar data taken from the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) and ground-based polarimetric radar observations. Theoretical relationships between the expected specific attenuation (k) of spaceborne measurements with ground-based measurements of reflectivity (Zh) and differential propagation phase shift (Kdp) are developed for various hydrometeors that could be present along the propagation path, which are used to estimate the two-way path-integrated attenuation (PIA) on the PR return echo. Resolution volume matching and alignment of the radar systems is performed, and a direct comparison of PR return echo with ground radar attenuation estimates is made directly on a beam-by-beam basis. The technique is validated using data collected from the TExas and Florida UNderflights (TEFLUN-B) experiment and the TRMM large Biosphere-Atmosphere experiment in Amazonia (LBA) campaign. Attenuation estimation derived from this method can be used for strategiC planning of communication systems for

Ground-truth aerosol lidar observations: can the Klett solutions obtained from ground and space be equal for the same aerosol case?

International Nuclear Information System (INIS)

Ansmann, Albert

2006-01-01

Upcoming multiyear satellite lidar aerosol observations need strong support by a worldwide ground-truth lidar network. In this context the question arises as to whether the ground stations can deliver the same results as obtained from space when the Klett formalism is applied to elastic backscatter lidar data for the same aerosol case. This question is investigated based on simulations of observed cases of simple and complex aerosol layering. The results show that the differences between spaceborne and ground-based observations can be as large as20% for the backscatter and extinction coefficients and the optimum estimates of the column lidar ratios. In cases with complex aerosol layering, the application of the two-layer approach can lead to similar results (space, ground) and accurate products provided that horizontally homogeneous aerosol conditions are given

A similarity-based data warehousing environment for medical images.

Science.gov (United States)

Teixeira, Jefferson William; Annibal, Luana Peixoto; Felipe, Joaquim Cezar; Ciferri, Ricardo Rodrigues; Ciferri, Cristina Dutra de Aguiar

2015-11-01

A core issue of the decision-making process in the medical field is to support the execution of analytical (OLAP) similarity queries over images in data warehousing environments. In this paper, we focus on this issue. We propose imageDWE, a non-conventional data warehousing environment that enables the storage of intrinsic features taken from medical images in a data warehouse and supports OLAP similarity queries over them. To comply with this goal, we introduce the concept of perceptual layer, which is an abstraction used to represent an image dataset according to a given feature descriptor in order to enable similarity search. Based on this concept, we propose the imageDW, an extended data warehouse with dimension tables specifically designed to support one or more perceptual layers. We also detail how to build an imageDW and how to load image data into it. Furthermore, we show how to process OLAP similarity queries composed of a conventional predicate and a similarity search predicate that encompasses the specification of one or more perceptual layers. Moreover, we introduce an index technique to improve the OLAP query processing over images. We carried out performance tests over a data warehouse environment that consolidated medical images from exams of several modalities. The results demonstrated the feasibility and efficiency of our proposed imageDWE to manage images and to process OLAP similarity queries. The results also demonstrated that the use of the proposed index technique guaranteed a great improvement in query processing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ground-water flow and ground- and surface-water interaction at the Weldon Spring quarry, St. Charles County, Missouri

International Nuclear Information System (INIS)

Imes, J.L.; Kleeschulte, M.J.

1997-01-01

Ground-water-level measurements to support remedial actions were made in 37 piezometers and 19 monitoring wells during a 19-month period to assess the potential for ground-water flow from an abandoned quarry to the nearby St. Charles County well field, which withdraws water from the base of the alluvial aquifer. From 1957 to 1966, low-level radioactive waste products from the Weldon Spring chemical plant were placed in the quarry a few hundred feet north of the Missouri River alluvial plain. Uranium-based contaminants subsequently were detected in alluvial ground water south of the quarry. During all but flood conditions, lateral ground-water flow in the bedrock from the quarry, as interpreted from water-table maps, generally is southwest toward Little Femme Osage Creek or south into the alluvial aquifer. After entering the alluvial aquifer, the ground water flows southeast to east toward a ground-water depression presumably produced by pumping at the St. Charles County well field. The depression position varies depending on the Missouri River stage and probably the number and location of active wells in the St. Charles County well field

High energy astrophysics with ground-based gamma ray detectors

International Nuclear Information System (INIS)

Aharonian, F; Buckley, J; Kifune, T; Sinnis, G

2008-01-01

Recent advances in ground-based gamma ray astronomy have led to the discovery of more than 70 sources of very high energy (E γ ≥ 100 GeV) gamma rays, falling into a number of source populations including pulsar wind nebulae, shell type supernova remnants, Wolf-Rayet stars, giant molecular clouds, binary systems, the Galactic Center, active galactic nuclei and 'dark' (yet unidentified) galactic objects. We summarize the history of TeV gamma ray astronomy up to the current status of the field including a description of experimental techniques and highlight recent astrophysical results. We also discuss the potential of ground-based gamma ray astronomy for future discoveries and describe possible directions for future instrumental developments

Basic life support: knowledge and attitude of medical/paramedical professionals.

Science.gov (United States)

Roshana, Shrestha; Kh, Batajoo; Rm, Piryani; Mw, Sharma

2012-01-01

Basic life support (BLS), a key component of the chain of survival decreases the arrest - cardiopulmonary resuscitation interval and increases the rate of hospital discharge. The study aimed to explore the knowledge of and attitude towards basic life support (BLS) among medical/paramedical professionals. An observational study was conducted by assessing response to self prepared questionnaire consisting of the demographic information of the medical/paramedical staff, their personnel experience/attitude and knowledge of BLS based on the 2005 BLS Guidelines of European Resuscitation Council. After excluding incomplete questionnaires, the data from 121 responders (27 clinical faculty members, 21 dental and basic sciences faculty members, 29 house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4%) of the 121 responders answered ≥11, 53 (43%) answered 7-10, and 58 (48%) answered basic sciences faculty members attained a least mean score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary resuscitation (CPR) training within 5 years obtained a highest mean score of 8.62±2.49, whereas those who had the training more than 5 years back or no training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001). Those who were involved in resuscitation frequently had a higher median score of 8 in comparison to those who were seldom involved or not involved at all (P<0.001). The average health personnel in our hospital lack adequate knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of these personnel. Thus standard of CPR/BLS training and assessment are recommended at our hospital.

Modeling a ground-coupled heat pump system by a support vector machine

Energy Technology Data Exchange (ETDEWEB)

Esen, Hikmet; Esen, Mehmet [Department of Mechanical Education, Faculty of Technical Education, Firat University, 23119 Elazig (Turkey); Inalli, Mustafa [Department of Mechanical Engineering, Faculty of Engineering, Firat University, 23279 Elazig (Turkey); Sengur, Abdulkadir [Department of Electronic and Computer Science, Faculty of Technical Education, Firat University, 23119 Elazig (Turkey)

2008-08-15

This paper reports on a modeling study of ground coupled heat pump (GCHP) system performance (COP) by using a support vector machine (SVM) method. A GCHP system is a multi-variable system that is hard to model by conventional methods. As regards the SVM, it has a superior capability for generalization, and this capability is independent of the dimensionality of the input data. In this study, a SVM based method was intended to adopt GCHP system for efficient modeling. The Lin-kernel SVM method was quite efficient in modeling purposes and did not require a pre-knowledge about the system. The performance of the proposed methodology was evaluated by using several statistical validation parameters. It is found that the root-mean squared (RMS) value is 0.002722, the coefficient of multiple determinations (R{sup 2}) value is 0.999999, coefficient of variation (cov) value is 0.077295, and mean error function (MEF) value is 0.507437 for the proposed Lin-kernel SVM method. The optimum parameters of the SVM method were determined by using a greedy search algorithm. This search algorithm was effective for obtaining the optimum parameters. The simulation results show that the SVM is a good method for prediction of the COP of the GCHP system. The computation of SVM model is faster compared with other machine learning techniques (artificial neural networks (ANN) and adaptive neuro-fuzzy inference system (ANFIS)); because there are fewer free parameters and only support vectors (only a fraction of all data) are used in the generalization process. (author)

Medical support during an Ironman 70.3 triathlon race [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Hae-Rang Yang

2017-08-01

Full Text Available Background: The Ironman 70.3 race is also called a half Ironman, and consists of 1.9 km of swimming, 90.1 km of cycling, and 21.1 km of running. The authors provide practical insights that may be useful for medical support in future events by summarizing the process and results of on-scene medical care. Methods: The medical post was established at the transition area between the cycling and running courses, which was close to the finish line, and staffed with the headquarters team comprised of an emergency physician, an EMT, two nurses, and an ambulance with a driver. The other five ambulances were located throughout the course. The medical staff identified participants according to their numbers when providing medical support, and described complaints, treatment provided, and disposition. When treating non-participants, gender and age were recorded instead of numbers. The treatment records were analyzed after the race. Results: The medical team treated a total of 187 participants. One suffered cramps in the calf muscles during the swimming part of the course. Nineteen were treated for injuries suffered during the cycling race. A total of 159 were treated for injuries on the running course. Five casualties, all of which occurred during the cycling race, required transport to hospital. Conclusions: Medical directors preparing medical support during a triathlon event should expect severe injuries in the cycling course. In hot climates, staff may also suffer from heat injuries as well as runners, and proper attention should be paid to these risks.

Medical Certification System -

Data.gov (United States)

Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

SCIENTIFIC EFFICIENCY OF GROUND-BASED TELESCOPES

International Nuclear Information System (INIS)

Abt, Helmut A.

2012-01-01

I scanned the six major astronomical journals of 2008 for all 1589 papers that are based on new data obtained from ground-based optical/IR telescopes worldwide. Then I collected data on numbers of papers, citations to them in 3+ years, the most-cited papers, and annual operating costs. These data are assigned to four groups by telescope aperture. For instance, while the papers from telescopes with an aperture >7 m average 1.29 more citations than those with an aperture of 2 to 7 m) telescopes. I wonder why the large telescopes do so relatively poorly and suggest possible reasons. I also found that papers based on archival data, such as the Sloan Digital Sky Survey, produce 10.6% as many papers and 20.6% as many citations as those based on new data. Also, the 577.2 papers based on radio data produced 36.3% as many papers and 33.6% as many citations as the 1589 papers based on optical/IR telescopes.

Ground-Based VIS/NIR Reflectance Spectra of 25143 Itokawa: What Hayabusa will See and How Ground-Based Data can Augment Analyses

Science.gov (United States)

Vilas, Faith; Abell, P. A.; Jarvis, K. S.

2004-01-01

Planning for the arrival of the Hayabusa spacecraft at asteroid 25143 Itokawa includes consideration of the expected spectral information to be obtained using the AMICA and NIRS instruments. The rotationally-resolved spatial coverage the asteroid we have obtained with ground-based telescopic spectrophotometry in the visible and near-infrared can be utilized here to address expected spacecraft data. We use spectrophotometry to simulate the types of data that Hayabusa will receive with the NIRS and AMICA instruments, and will demonstrate them here. The NIRS will cover a wavelength range from 0.85 m, and have a dispersion per element of 250 Angstroms. Thus, we are limited in coverage of the 1.0 micrometer and 2.0 micrometer mafic silicate absorption features. The ground-based reflectance spectra of Itokawa show a large component of olivine in its surface material, and the 2.0 micrometer feature is shallow. Determining the olivine to pyroxene abundance ratio is critically dependent on the attributes of the 1.0- and 2.0 micrometer features. With a cut-off near 2,1 micrometer the longer edge of the 2.0- feature will not be obtained by NIRS. Reflectance spectra obtained using ground-based telescopes can be used to determine the regional composition around space-based spectral observations, and possibly augment the longer wavelength spectral attributes. Similarly, the shorter wavelength end of the 1.0 micrometer absorption feature will be partially lost to the NIRS. The AMICA filters mimic the ECAS filters, and have wavelength coverage overlapping with the NIRS spectral range. We demonstrate how merging photometry from AMICA will extend the spectral coverage of the NIRS. Lessons learned from earlier spacecraft to asteroids should be considered.

Performance Based Criteria for Ship Collision and Grounding

DEFF Research Database (Denmark)

Pedersen, Preben Terndrup

2009-01-01

The paper outlines a probabilistic procedure whereby the maritime industry can develop performance based rules to reduce the risk associated with human, environmental and economic costs of collision and grounding events and identify the most economic risk control options associated with prevention...

Awareness of basic life support among medical, dental, nursing students and doctors

Directory of Open Access Journals (Sweden)

Shanta Chandrasekaran

2010-01-01

Full Text Available To study the awareness of Basic Life Support (BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. A cross-sectional study was conducted by assessing responses to 20 selected basic questions regarding BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. After excluding the incomplete response forms the data was analysed on 1,054 responders. The results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual. Out of 1,054 responders 345 were medical students, 75 were medical interns, 19 were dental students, 59 were dental interns, 105 were homeopathy interns, 319 were nursing students, 72 were doctors, 29 were dentists, 25 were nursing faculty and six were homeopathy doctors. No one among them had complete knowledge of BLS. Only two out of 1054 (0.19% had secured 80 - 89% marks, 10 out of 1054 (0.95% had secured 70 - 79% marks, 40 of 1054 (4.08% had secured 60 - 69% marks and 105 of 1054 (9.96% had secured 50 - 59% marks. A majority of them, that is, 894 (84.82% had secured less than 50% marks. Awareness of BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges is very poor.

Design of decision support interventions for medication prescribing.

Science.gov (United States)

Horsky, Jan; Phansalkar, Shobha; Desai, Amrita; Bell, Douglas; Middleton, Blackford

2013-06-01

Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety. Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort. Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks. Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians

[Organization of anesthesia management and advanced life support at military medical evacuation levels].

Science.gov (United States)

Shchegolev, A V; Petrakov, V A; Savchenko, I F

2014-07-01

Anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels in armed conflict (local war) is time-consuming and resource-requiring task. One of the mathematical modeling methods was used to evaluate capabilities of anesthesia and intensive care units at tactical level. Obtained result allows us to tell that there is a need to make several system changes of the existing system of anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels. In addition to increasing number of staff of anesthesiology-critical care during the given period of time another solution should be the creation of an early evacuation to a specialized medical care level by special means while conducting intensive monitoring and treatment.

Ground Control Point - Wireless System Network for UAV-based environmental monitoring applications

Science.gov (United States)

Mejia-Aguilar, Abraham

2016-04-01

In recent years, Unmanned Aerial Vehicles (UAV) have seen widespread civil applications including usage for survey and monitoring services in areas such as agriculture, construction and civil engineering, private surveillance and reconnaissance services and cultural heritage management. Most aerial monitoring services require the integration of information acquired during the flight (such as imagery) with ground-based information (such as GPS information or others) for improved ground truth validation. For example, to obtain an accurate 3D and Digital Elevation Model based on aerial imagery, it is necessary to include ground-based information of coordinate points, which are normally acquired with surveying methods based on Global Position Systems (GPS). However, GPS surveys are very time consuming and especially for longer time series of monitoring data repeated GPS surveys are necessary. In order to improve speed of data collection and integration, this work presents an autonomous system based on Waspmote technologies build on single nodes interlinked in a Wireless Sensor Network (WSN) star-topology for ground based information collection and later integration with surveying data obtained by UAV. Nodes are designed to be visible from the air, to resist extreme weather conditions with low-power consumption. Besides, nodes are equipped with GPS as well as Inertial Measurement Unit (IMU), accelerometer, temperature and soil moisture sensors and thus provide significant advantages in a broad range of applications for environmental monitoring. For our purpose, the WSN transmits the environmental data with 3G/GPRS to a database on a regular time basis. This project provides a detailed case study and implementation of a Ground Control Point System Network for UAV-based vegetation monitoring of dry mountain grassland in the Matsch valley, Italy.

A novel technique for extracting clouds base height using ground based imaging

Directory of Open Access Journals (Sweden)

E. Hirsch

2011-01-01

Full Text Available The height of a cloud in the atmospheric column is a key parameter in its characterization. Several remote sensing techniques (passive and active, either ground-based or on space-borne platforms and in-situ measurements are routinely used in order to estimate top and base heights of clouds. In this article we present a novel method that combines thermal imaging from the ground and sounded wind profile in order to derive the cloud base height. This method is independent of cloud types, making it efficient for both low boundary layer and high clouds. In addition, using thermal imaging ensures extraction of clouds' features during daytime as well as at nighttime. The proposed technique was validated by comparison to active sounding by ceilometers (which is a standard ground based method, to lifted condensation level (LCL calculations, and to MODIS products obtained from space. As all passive remote sensing techniques, the proposed method extracts only the height of the lowest cloud layer, thus upper cloud layers are not detected. Nevertheless, the information derived from this method can be complementary to space-borne cloud top measurements when deep-convective clouds are present. Unlike techniques such as LCL, this method is not limited to boundary layer clouds, and can extract the cloud base height at any level, as long as sufficient thermal contrast exists between the radiative temperatures of the cloud and its surrounding air parcel. Another advantage of the proposed method is its simplicity and modest power needs, making it particularly suitable for field measurements and deployment at remote locations. Our method can be further simplified for use with visible CCD or CMOS camera (although nighttime clouds will not be observed.

The relationship between autonomous motivation and autonomy support in medical students' academic achievement.

Science.gov (United States)

Feri, Rose; Soemantri, Diantha; Jusuf, Anwar

2016-12-29

This study applied self-determination theory (SDT) to investigate the relationship between students' autonomous motivation and tutors' autonomy support in medical students' academic achievement. This was a cross-sectional study. Out of 204 students in a fundamental medical science course, 199 participated in the study. Data was collected using two questionnaires: the Learning Self-Regulation and Learning Climate Questionnaires. The score of the course assessment was the measure of academic achievement. Data was analyzed and reported with descriptive and inferential statistics (mean, standard deviation and multiple regression analysis). Mean score (±standard deviation) of the autonomous motivation, tutors' autonomy support, and academic achievement were 5.48±0.89, 5.22±0.92, and 5.22±0.92. Multiple regression results reported students' autonomous motivation was associated with improvement of students' academic achievement (β=15.2, p=0.004). However, augmentation of tutors' autonomy support was not reflected in the improvement of students' academic achievement (β = -12.6, p = 0.019). Both students' autonomous motivation and tutors' autonomy support had a contribution of about 4.2% students' academic achievement (F = 4.343, p = 0.014, R 2 = 0.042). Due to the unique characteristic of our medical students' educational background, our study shows that tutors' autonomy support is inconsistent with students' academic achievement. However, both autonomous motivation and support are essential to students' academic achievement. Further study is needed to explore students' educational background and self-regulated learning competence to improve students' academic achievement.

21 CFR 225.120 - Buildings and grounds.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Buildings and grounds. 225.120 Section 225.120... Buildings and grounds. Buildings used for production of medicated feed shall provide adequate space for... routine maintenance and cleaning of equipment. Buildings and grounds shall be constructed and maintained...

ProFUSO: Business process and ontology-based framework to develop ubiquitous computing support systems for chronic patients' management.

Science.gov (United States)

Jimenez-Molina, Angel; Gaete-Villegas, Jorge; Fuentes, Javier

2018-06-01

New advances in telemedicine, ubiquitous computing, and artificial intelligence have supported the emergence of more advanced applications and support systems for chronic patients. This trend addresses the important problem of chronic illnesses, highlighted by multiple international organizations as a core issue in future healthcare. Despite the myriad of exciting new developments, each application and system is designed and implemented for specific purposes and lacks the flexibility to support different healthcare concerns. Some of the known problems of such developments are the integration issues between applications and existing healthcare systems, the reusability of technical knowledge in the creation of new and more sophisticated systems and the usage of data gathered from multiple sources in the generation of new knowledge. This paper proposes a framework for the development of chronic disease support systems and applications as an answer to these shortcomings. Through this framework our pursuit is to create a common ground methodology upon which new developments can be created and easily integrated to provide better support to chronic patients, medical staff and other relevant participants. General requirements are inferred for any support system from the primary attention process of chronic patients by the Business Process Management Notation. Numerous technical approaches are proposed to design a general architecture that considers the medical organizational requirements in the treatment of a patient. A framework is presented for any application in support of chronic patients and evaluated by a case study to test the applicability and pertinence of the solution. Copyright © 2018 Elsevier Inc. All rights reserved.

Collaborative diagramming during problem based learning in medical education: Do computerized diagrams support basic science knowledge construction?

NARCIS (Netherlands)

de Leng, Bas; Gijlers, Aaltje H.

2015-01-01

Aim: To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning. Methods: Opinions and perceptions of students (n = 70) and

The potential for intelligent decision support systems to improve the quality and consistency of medication reviews.

Science.gov (United States)

Bindoff, I; Stafford, A; Peterson, G; Kang, B H; Tenni, P

2012-08-01

Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided. The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into

Improving Agricultural Water Resources Management Using Ground-based Infrared Thermometry

Science.gov (United States)

Taghvaeian, S.

2014-12-01

Irrigated agriculture is the largest user of freshwater resources in arid/semi-arid parts of the world. Meeting rapidly growing demands in food, feed, fiber, and fuel while minimizing environmental pollution under a changing climate requires significant improvements in agricultural water management and irrigation scheduling. Although recent advances in remote sensing techniques and hydrological modeling has provided valuable information on agricultural water resources and their management, real improvements will only occur if farmers, the decision makers on the ground, are provided with simple, affordable, and practical tools to schedule irrigation events. This presentation reviews efforts in developing methods based on ground-based infrared thermometry and thermography for day-to-day management of irrigation systems. The results of research studies conducted in Colorado and Oklahoma show that ground-based remote sensing methods can be used effectively in quantifying water stress and consequently triggering irrigation events. Crop water use estimates based on stress indices have also showed to be in good agreement with estimates based on other methods (e.g. surface energy balance, root zone soil water balance, etc.). Major challenges toward the adoption of this approach by agricultural producers include the reduced accuracy under cloudy and humid conditions and its inability to forecast irrigation date, which is a critical knowledge since many irrigators need to decide about irrigations a few days in advance.

Virtual patient design: exploring what works and why. A grounded theory study.

Science.gov (United States)

Bateman, James; Allen, Maggie; Samani, Dipti; Kidd, Jane; Davies, David

2013-06-01

Virtual patients (VPs) are online representations of clinical cases used in medical education. Widely adopted, they are well placed to teach clinical reasoning skills. International technology standards mean VPs can be created, shared and repurposed between institutions. A systematic review has highlighted the lack of evidence to support which of the numerous VP designs may be effective, and why. We set out to research the influence of VP design on medical undergraduates. This is a grounded theory study into the influence of VP design on undergraduate medical students. Following a review of the literature and publicly available VP cases, we identified important design properties. We integrated them into two substantial VPs produced for this research. Using purposeful iterative sampling, 46 medical undergraduates were recruited to participate in six focus groups. Participants completed both VPs, an evaluation and a 1-hour focus group discussion. These were digitally recorded, transcribed and analysed using grounded theory, supported by computer-assisted analysis. Following open, axial and selective coding, we produced a theoretical model describing how students learn from VPs. We identified a central core phenomenon designated 'learning from the VP'. This had four categories: VP Construction; External Preconditions; Student-VP Interaction, and Consequences. From these, we constructed a three-layer model describing the interactions of students with VPs. The inner layer consists of the student's cognitive and behavioural preconditions prior to sitting a case. The middle layer considers the VP as an 'encoded object', an e-learning artefact and as a 'constructed activity', with associated pedagogic and organisational elements. The outer layer describes cognitive and behavioural change. This is the first grounded theory study to explore VP design. This original research has produced a model which enhances understanding of how and why the delivery and design of VPs

Testing a ground-based canopy model using the wind river canopy crane

Science.gov (United States)

Robert Van Pelt; Malcolm P. North

1999-01-01

A ground-based canopy model that estimates the volume of occupied space in forest canopies was tested using the Wind River Canopy Crane. A total of 126 trees in a 0.25 ha area were measured from the ground and directly from a gondola suspended from the crane. The trees were located in a low elevation, old-growth forest in the southern Washington Cascades. The ground-...

Space weather effects on ground based technology

Science.gov (United States)

Clark, T.

Space weather can affect a variety of forms of ground-based technology, usually as a result of either the direct effects of the varying geomagnetic field, or as a result of the induced electric field that accompanies such variations. Technologies affected directly by geomagnetic variations include magnetic measurements made d ringu geophysical surveys, and navigation relying on the geomagnetic field as a direction reference, a method that is particularly common in the surveying of well-bores in the oil industry. The most obvious technology affected by induced electric fields during magnetic storms is electric power transmission, where the example of the blackout in Quebec during the March 1989 magnetic storm is widely known. Additionally, space weather effects must be taken into account in the design of active cathodic protection systems on pipelines to protect them against corrosion. Long-distance telecommunication cables may also have to be designed to cope with space weather related effects. This paper reviews the effects of space weather in these different areas of ground-based technology, and provides examples of how mitigation against hazards may be achieved. (The paper does not include the effects of space weather on radio communication or satellite navigation systems).

Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study.

Science.gov (United States)

Yang, Shujuan; Liu, Danping; Liu, Hongbo; Zhang, Juying; Duan, Zhanqi

2017-01-01

Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China. This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers. We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, Pfamily conflict, self-reported social support, and job satisfaction accounted for 2.6% (F = 5.93, Pfamily conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China.

Support technologies to cater for rockbursts and falls of ground in the immediate face area, volume 1.

CSIR Research Space (South Africa)

Daehnk, A

2000-03-01

Full Text Available Final Project Report Support technologies to cater for rockbursts and falls of ground in the immediate face area Volume I A. Daehnke, E. Acheampong, N. Reddy, K.B. Le Bron and A.T. Haile Research agency: CSIR Mining Technology Project number: GAP...

Examining the Process of Change in an Evidence-Based Parent Training Intervention: A Qualitative Study Grounded in the Experiences of Parents

Science.gov (United States)

Holtrop, Kendal N.

2011-01-01

The evidence-based parent training intervention known as Parent Management Training-the Oregon Model (PMTO) is one particularly well-supported treatment approach for addressing child behavioral problems. Yet, there remains a need to further examine how this intervention promotes change. The purpose of this study was to develop a grounded theory…

[Nutritional support response in critically ill patients; differences between medical and surgical patients].

Science.gov (United States)

Zamora Elson, M; Serón Arbeloa, C; Labarta Monzón, L; Garrido Ramírez de Arellano, I; Lander Azcona, A; Marquina Lacueva, M I; López Claver, J C; Escós Orta, J

2012-01-01

To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients. One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections. Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels. We have observed higher usage of PN among surgical patients, which showed worse

OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records.

Science.gov (United States)

Chen, Jonathan H; Podchiyska, Tanya; Altman, Russ B

2016-03-01

To answer a "grand challenge" in clinical decision support, the authors produced a recommender system that automatically data-mines inpatient decision support from electronic medical records (EMR), analogous to Netflix or Amazon.com's product recommender. EMR data were extracted from 1 year of hospitalizations (>18K patients with >5.4M structured items including clinical orders, lab results, and diagnosis codes). Association statistics were counted for the ∼1.5K most common items to drive an order recommender. The authors assessed the recommender's ability to predict hospital admission orders and outcomes based on initial encounter data from separate validation patients. Compared to a reference benchmark of using the overall most common orders, the recommender using temporal relationships improves precision at 10 recommendations from 33% to 38% (P < 10(-10)) for hospital admission orders. Relative risk-based association methods improve inverse frequency weighted recall from 4% to 16% (P < 10(-16)). The framework yields a prediction receiver operating characteristic area under curve (c-statistic) of 0.84 for 30 day mortality, 0.84 for 1 week need for ICU life support, 0.80 for 1 week hospital discharge, and 0.68 for 30-day readmission. Recommender results quantitatively improve on reference benchmarks and qualitatively appear clinically reasonable. The method assumes that aggregate decision making converges appropriately, but ongoing evaluation is necessary to discern common behaviors from "correct" ones. Collaborative filtering recommender algorithms generate clinical decision support that is predictive of real practice patterns and clinical outcomes. Incorporating temporal relationships improves accuracy. Different evaluation metrics satisfy different goals (predicting likely events vs. "interesting" suggestions). Published by Oxford University Press on behalf of the American Medical Informatics Association 2015. This work is written by US Government

Effects of the addition of functional electrical stimulation to ground level gait training with body weight support after chronic stroke.

Science.gov (United States)

Prado-Medeiros, Christiane L; Sousa, Catarina O; Souza, Andréa S; Soares, Márcio R; Barela, Ana M F; Salvini, Tania F

2011-01-01

The addition of functional electrical stimulation (FES) to treadmill gait training with partial body weight support (BWS) has been proposed as a strategy to facilitate gait training in people with hemiparesis. However, there is a lack of studies that evaluate the effectiveness of FES addition on ground level gait training with BWS, which is the most common locomotion surface. To investigate the additional effects of commum peroneal nerve FES combined with gait training and BWS on ground level, on spatial-temporal gait parameters, segmental angles, and motor function. Twelve people with chronic hemiparesis participated in the study. An A1-B-A2 design was applied. A1 and A2 corresponded to ground level gait training using BWS, and B corresponded to the same training with the addition of FES. The assessments were performed using the Modified Ashworth Scale (MAS), Functional Ambulation Category (FAC), Rivermead Motor Assessment (RMA), and filming. The kinematics analyzed variables were mean walking speed of locomotion; step length; stride length, speed and duration; initial and final double support duration; single-limb support duration; swing period; range of motion (ROM), maximum and minimum angles of foot, leg, thigh, and trunk segments. There were not changes between phases for the functional assessment of RMA, for the spatial-temporal gait variables and segmental angles, no changes were observed after the addition of FES. The use of FES on ground level gait training with BWS did not provide additional benefits for all assessed parameters.

Quality of Basic Life Support - A Comparison between Medical Students and Paramedics.

Science.gov (United States)

Körber, Maria Isabel; Köhler, Thomas; Weiss, Verena; Pfister, Roman; Michels, Guido

2016-07-01

Poor survival rates after cardiac arrest can partly be explained by poor basic life support skills in medical professionals. This study aimed to assess quality of basic life support in medical students and paramedics. We conducted a prospective observational study with 100 early medical students (group A), 100 late medical students (group B) and 100 paramedics (group C), performing a 20-minute basic life support simulation in teams of two. Average frequency and absolute number of chest compressions per minute (mean (±SD)), chest decompression (millimetres of compression remaining, mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching positions between ventilation and chest compression (per 20 minutes) and rate of sufficient compressions (depth ≥50mm) were assessed as quality parameters of CPR. In groups A, B and C the rates of sufficiently deep chest compressions were 56%, 42% and 52%, respectively, without significant differences. Male gender and real-life CPR experience were significantly associated with deeper chest compression. Frequency and number of chest compressions were within recommended goals in at least 96% of all groups. Remaining chest compressions were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and 4s/min (±1), which was significantly different across all three groups. Overall, paramedics tended to show better quality of CPR compared to medical students. Though, chest compression depth as an important quality characteristic of CPR was insufficient in almost 50% of participants, even in well trained paramedics. Therefore, we suggest that an effort should be made to find better ways to educate health care professionals in BLS.

The effects of problem-based learning during medical school on physician competency: a systematic review.

Science.gov (United States)

Koh, Gerald Choon-Huat; Khoo, Hoon Eng; Wong, Mee Lian; Koh, David

2008-01-01

Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.

Mixed-field GCR Simulations for Radiobiological Research using Ground Based Accelerators

Science.gov (United States)

Kim, Myung-Hee Y.; Rusek, Adam; Cucinotta, Francis

Space radiation is comprised of a large number of particle types and energies, which have differential ionization power from high energy protons to high charge and energy (HZE) particles and secondary neutrons produced by galactic cosmic rays (GCR). Ground based accelerators such as the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory (BNL) are used to simulate space radiation for radiobiology research and dosimetry, electronics parts, and shielding testing using mono-energetic beams for single ion species. As a tool to support research on new risk assessment models, we have developed a stochastic model of heavy ion beams and space radiation effects, the GCR Event-based Risk Model computer code (GERMcode). For radiobiological research on mixed-field space radiation, a new GCR simulator at NSRL is proposed. The NSRL-GCR simulator, which implements the rapid switching mode and the higher energy beam extraction to 1.5 GeV/u, can integrate multiple ions into a single simulation to create GCR Z-spectrum in major energy bins. After considering the GCR environment and energy limitations of NSRL, a GCR reference field is proposed after extensive simulation studies using the GERMcode. The GCR reference field is shown to reproduce the Z and LET spectra of GCR behind shielding within 20 percents accuracy compared to simulated full GCR environments behind shielding. A major challenge for space radiobiology research is to consider chronic GCR exposure of up to 3-years in relation to simulations with cell and animal models of human risks. We discuss possible approaches to map important biological time scales in experimental models using ground-based simulation with extended exposure of up to a few weeks and fractionation approaches at a GCR simulator.

Identifying medication-related needs of HIV patients: foundation for community pharmacist-based services

Directory of Open Access Journals (Sweden)

Yardlee Kauffman

2014-01-01

Full Text Available Background: Patients living with HIV/AIDS have complex medication regimens. Pharmacists within community pharmacy settings can have a role managing patients living with HIV/AIDS. Patients' perspectives surrounding implementation about community pharmacist-based services is needed as limited information is available. Objective: To identify medication-related needs of HIV-infected patients who receive prescriptions from a community pharmacy. To determine patient perspectives and knowledge of community pharmacist-based services. Methods: A qualitative research study involving in-depth, semi-structured interviews with patients was conducted. Inclusion criteria included: HIV positive men and women at least 18 years of age who receive care at a HIV clinic, currently take medication(s and use a community pharmacy for all prescription fills. Patients were recruited from one urban and one rural health center. Patients answered questions about their perceptions and knowledge about the role and value of pharmacy services and completed a demographic survey. The recordings of the interviews were transcribed verbatim and were analyzed using principles of Grounded Theory. Results: Twenty-nine interviews were conducted: 15 participants from the urban site and 14 from the rural site. Five main themes emerged including: patients experience ongoing and varying medication-related needs; patients desire a pharmacist who is caring, knowledgeable and integrated with health care providers; patients expect ready access to drug therapy; patients value an individualized patient encounter, and patients need to be informed that a pharmacist-service exists. Conclusion: Patients with HIV value individualized and personal encounters with pharmacists at time intervals that are convenient for the patient. Patients felt that a one-on-one encounter with a pharmacist would be most valuable when initiating or modifying medication therapy. These patient perspectives can be useful for

Virtual reality-based medical training and assessment

DEFF Research Database (Denmark)

Aboulafia, Annette Løw T.; Lövquist, Erik; Shorten, George Declan

2012-01-01

The current focus on patient safety and evidence-based medical education has led to an increased interest in utilising virtual reality (VR) for medical training. The development of VR-based systems require experts from different disciplines to collaborate with shared and agreed objectives...... to develop useful and usable VR-based medical training systems. Methods: This article reports a case study of two research projects that developed and evaluated a VR-based training system for spinal anaesthesia. Results: The case study illustrates how close relationships can be established by champion...

Integration between ground based and satellite SAR data in landslide mapping: The San Fratello case study

Science.gov (United States)

Bardi, Federica; Frodella, William; Ciampalini, Andrea; Bianchini, Silvia; Del Ventisette, Chiara; Gigli, Giovanni; Fanti, Riccardo; Moretti, Sandro; Basile, Giuseppe; Casagli, Nicola

2014-10-01

The potential use of the integration of PSI (Persistent Scatterer Interferometry) and GB-InSAR (Ground-based Synthetic Aperture Radar Interferometry) for landslide hazard mitigation was evaluated for mapping and monitoring activities of the San Fratello landslide (Sicily, Italy). Intense and exceptional rainfall events are the main factors that triggered several slope movements in the study area, which is susceptible to landslides, because of its steep slopes and silty-clayey sedimentary cover. In the last three centuries, the town of San Fratello was affected by three large landslides, developed in different periods: the oldest one occurred in 1754, damaging the northeastern sector of the town; in 1922 a large landslide completely destroyed a wide area in the western hillside of the town. In this paper, the attention is focussed on the most recent landslide that occurred on 14 February 2010: in this case, the phenomenon produced the failure of a large sector of the eastern hillside, causing severe damages to buildings and infrastructures. In particular, several slow-moving rotational and translational slides occurred in the area, making it suitable to monitor ground instability through different InSAR techniques. PS-InSAR™ (permanent scatterers SAR interferometry) techniques, using ERS-1/ERS-2, ENVISAT, RADARSAT-1, and COSMO-SkyMed SAR images, were applied to analyze ground displacements during pre- and post-event phases. Moreover, during the post-event phase in March 2010, a GB-InSAR system, able to acquire data continuously every 14 min, was installed collecting ground displacement maps for a period of about three years, until March 2013. Through the integration of space-borne and ground-based data sets, ground deformation velocity maps were obtained, providing a more accurate delimitation of the February 2010 landslide boundary, with respect to the carried out traditional geomorphological field survey. The integration of GB-InSAR and PSI techniques proved to

The relationship between autonomous motivation and autonomy support in medical students’ academic achievement

Science.gov (United States)

Soemantri, Diantha; Jusuf, Anwar

2016-01-01

Objectives This study applied self-determination theory (SDT) to investigate the relationship between students’ autonomous motivation and tutors’ autonomy support in medical students’ academic achievement. Methods This was a cross-sectional study. Out of 204 students in a fundamental medical science course, 199 participated in the study. Data was collected using two questionnaires: the Learning Self-Regulation and Learning Climate Questionnaires. The score of the course assessment was the measure of academic achievement. Data was analyzed and reported with descriptive and inferential statistics (mean, standard deviation and multiple regression analysis).  Results Mean score (±standard deviation) of the autonomous motivation, tutors’ autonomy support, and academic achievement were 5.48±0.89, 5.22±0.92, and 5.22±0.92. Multiple regression results reported students’ autonomous motivation was associated with improvement of students’ academic achievement (β=15.2, p=0.004). However, augmentation of tutors’ autonomy support was not reflected in the improvement of students’ academic achievement (β = -12.6, p = 0.019). Both students’ autonomous motivation and tutors’ autonomy support had a contribution of about 4.2% students’ academic achievement (F = 4.343, p = 0.014, R2 = 0.042). Conclusions Due to the unique characteristic of our medical students’ educational background, our study shows that tutors’ autonomy support is inconsistent with students’ academic achievement. However, both autonomous motivation and support are essential to students’ academic achievement. Further study is needed to explore students’ educational background and self-regulated learning competence to improve students’ academic achievement.               PMID:28035054

Use of and attitudes to a hospital information system by medical secretaries, nurses and physicians deprived of the paper-based medical record: a case report

Directory of Open Access Journals (Sweden)

Karlsen Tom H

2004-10-01

Full Text Available Abstract Background Most hospitals keep and update their paper-based medical records after introducing an electronic medical record or a hospital information system (HIS. This case report describes a HIS in a hospital where the paper-based medical records are scanned and eliminated. To evaluate the HIS comprehensively, the perspectives of medical secretaries and nurses are described as well as that of physicians. Methods We have used questionnaires and interviews to assess and compare frequency of use of the HIS for essential tasks, task performance and user satisfaction among medical secretaries, nurses and physicians. Results The medical secretaries use the HIS much more than the nurses and the physicians, and they consider that the electronic HIS greatly has simplified their work. The work of nurses and physicians has also become simplified, but they find less satisfaction with the system, particularly with the use of scanned document images. Conclusions Although the basis for reference is limited, the results support the assertion that replacing the paper-based medical record primarily benefits the medical secretaries, and to a lesser degree the nurses and the physicians. The varying results in the different employee groups emphasize the need for a multidisciplinary approach when evaluating a HIS.

[Modern approaches to the planning of the medical material support in conditions of daily activities].

Science.gov (United States)

Miroshnichenko, Iu V; Goriachev, A B; Krasavin, K D; Tikhonov, A V

2012-07-01

There are requirements producing to the planning in modem social and economic conditions: solidarity, participation, continuity, flexibility, accuracy. The authors made a conclusion that the main target of the planning of the medical material support is creating of conditions for highly effective function of the system of medical material support on the basis of long-time forecast of status and development of inner and outer factors.

Mycological evaluation of a ground cocoa-based beverage ...

African Journals Online (AJOL)

Cocoa beans (Theobroma cacao) are processed into cocoa beverage through fermentation, drying, roasting and grounding of the seed to powder. The mycological quality of 39 samples of different brand of these cocoa – based beverage referred to as 'eruku oshodi' collected from 3 different markets in south – west Nigeria ...

Implementing competency-based medical education: What changes in curricular structure and processes are needed?

Science.gov (United States)

Nousiainen, Markku T; Caverzagie, Kelly J; Ferguson, Peter C; Frank, Jason R

2017-06-01

Medical educators must prepare for a number of challenges when they decide to implement a competency-based curriculum. Many of these challenges will pertain to three key aspects of implementation: organizing the structural changes that will be necessary to deliver new curricula and methods of assessment; modifying the processes of teaching and evaluation; and helping to change the culture of education so that the CBME paradigm gains acceptance. This paper focuses on nine key considerations that will support positive change in first two of these areas. Key considerations include: ensuring that educational continuity exists amongst all levels of medical education, altering how time is used in medical education, involving CBME in human health resources planning, ensuring that competent doctors work in competent health care systems, ensuring that information technology supports CBME, ensuring that faculty development is supported, ensuring that the rights and responsibilities of the learner are appropriately balanced in the workplace, preparing for the costs of change, and having appropriate leadership in order to achieve success in implementation.

Retention of first aid and basic life support skills in undergraduate medical students

OpenAIRE

Pim A. de Ruijter; Heleen A. Biersteker; Jan Biert; Harry van Goor; Edward C. Tan

2014-01-01

Background: Undergraduate medical students follow a compulsory first aid (FA) and basic life support (BLS) course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in undergraduate medical students.Methods: One hundred and twenty students were randomly selected from first year (n=349) medical students who successfully followed a compulsory FA and BLS course. From thes...

In Support of the Medical Apology: The Nonlegal Arguments.

Science.gov (United States)

Heaton, Heather A; Campbell, Ronna L; Thompson, Kristine M; Sadosty, Annie T

2016-11-01

More than 30 million people are affected annually by medical errors. Apologies can heal patients, families, and providers and, if deployed and structured appropriately, can enrich clinical encounters-yet they rarely occur. This article will address the nonlegal arguments in favor of the medical apology and discuss a structure for delivering a meaningful apology. In addition, we will review reasons why some providers feel compelled to apologize while others faced with similar circumstances do not. Medical apologies bring value to both patients and providers. Apologies can preserve therapeutic relationships and save careers for professionals by restoring their self-respect and dignity. The four R's of the ideal apology-recognition, responsibility, regret, and remedy-provide a framework to help providers apologize for unintended outcomes. When deployed and structured appropriately, apologies can heal patients, families, and providers and can enrich clinical encounters. For providers, forgiving one's self is key to professional wellbeing and continued effective practice. For patients, apologies are desirable and also serve as a conduit for often wanted emotional support from their physician. Copyright © 2016 Elsevier Inc. All rights reserved.

[Desirable medical technologists in a community support hospital].

Science.gov (United States)

Takeda, Kyoko

2008-07-01

Recently, there have been marked advances in the technological strategies employed in medical examinations. The educational concept to nurture highly capable medical technologists is considered to be a priority issue by not only educators but also employers, even though the medical educational levels have markedly improved in every college and university. It is commonly acknowledged that the results of any examination in the clinical laboratory should be accurate and fed back to medical doctors as soon as possible. The business outline of medical technologists in our hospital is becoming more extensive because we act as a core hospital in the area, and so knowledge regarding many kinds of chemical and transfusion examinations is required in operations performed around the clock. Furthermore, medical doctors, clerical workers, nurses, and volunteers comprise a team of sophisticated workers in our hospital. To accomplish our daily work, character traits such as accuracy, honesty, perseverance, and ability to follow instruction manuals, are the most fundamental and valuable. To nurture a highly career-oriented medical technologist, we propose that the following should be focused on: self-responsibility, reduction of malpractices, economic profitability, brainstorming, education of subsequent generations, and the spirit of cooperativeness and reconciliation. Additionally, it is another basic requirement of competent medical technologists to learn to adapt to laboratory-based changes in their work throughout their career. In conclusion, how to adapt to any social demand and learn strategies in any era should be taught in college or university as well as after graduation because each hospital and institute has a different philosophy and requirements of newcomers. It is important for medical technologists and doctors to develop flexible ways of thinking, although we sometimes might accede to traditional ways.

Awareness and behavior of oncologists and support measures in medical institutions related to ongoing employment of cancer patients in Japan.

Science.gov (United States)

Wada, Koji; Ohtsu, Mayumi; Aizawa, Yoshiharu; Tanaka, Hiroshi; Tagaya, Nobumi; Takahashi, Miyako

2012-04-01

Improved outcomes of cancer treatment allow patients to undergo treatment while working. However, support from oncologists and medical institutions is essential for patients to continue working. This study aimed to clarify oncologists' awareness and behavior regarding patients who work during treatment, support in medical institutions and their association. A questionnaire was mailed to all 453 diplomates and faculty of the subspecialty board of medical oncology in the Japanese Society of Medical Oncology and all 1016 surgeons certified by the Japanese Board of Cancer Therapy living in the Kanto area. The questionnaire assessed demographics, oncologist awareness and behavior regarding patient employment and support measures at their medical institutions. Logistic regression analysis was used to examine the association of awareness and behavior of oncologists with support measures at their institutions. A total of 668 individuals participated. The overall response rate was 45.5%. Only 53.6% of respondents advised patients to tell their supervisors about prospects for treatment and ask for understanding. For medical institutions, 28.8% had a nurse-involved counseling program and adjustments in radiation therapy (28.0%) and chemotherapy (41.9%) schedules to accommodate patients' work. There was a significant correlation between awareness and behavior of oncologists and medical institutions' measures to support employed cancer patients. There is room for improvement in awareness and behavior of oncologists and support in medical institutions for cancer patients continuing to work. Oncologists could support working patients by exerting influence on their medical institutions. Conversely, proactive development of support measures by medical institutions could alter the awareness and behavior of oncologists.

Awareness and behavior of oncologists and support measures in medical institutions related to ongoing employment of cancer patients in Japan

International Nuclear Information System (INIS)

Wada, Koji; Aizawa, Yoshiharu; Ohtsu, Mayumi; Tanaka, Hiroshi; Tagaya, Nobumi; Takahashi, Miyako

2012-01-01

Improved outcomes of cancer treatment allow patients to undergo treatment while working. However, support from oncologists and medical institutions is essential for patients to continue working. This study aimed to clarify oncologists' awareness and behavior regarding patients who work during treatment, support in medical institutions and their association. A questionnaire was mailed to all 453 diplomates and faculty of the subspecialty board of medical oncology in the Japanese Society of Medical Oncology and all 1016 surgeons certified by the Japanese Board of Cancer Therapy living in the Kanto area. The questionnaire assessed demographics, oncologist awareness and behavior regarding patient employment and support measures at their medical institutions. Logistic regression analysis was used to examine the association of awareness and behavior of oncologists with support measures at their institutions. A total of 668 individuals participated. The overall response rate was 45.5%. Only 53.6% of respondents advised patients to tell their supervisors about prospects for treatment and ask for understanding. For medical institutions, 28.8% had a nurse-involved counseling program and adjustments in radiation therapy (28.0%) and chemotherapy (41.9%) schedules to accommodate patients' work. There was a significant correlation between awareness and behavior of oncologists and medical institutions' measures to support employed cancer patients. There is room for improvement in awareness and behavior of oncologists and support in medical institutions for cancer patients continuing to work. Oncologists could support working patients by exerting influence on their medical institutions. Conversely, proactive development of support measures by medical institutions could alter the awareness and behavior of oncologists. (author)

Medical Device Integrated Vital Signs Monitoring Application with Real-Time Clinical Decision Support.

Science.gov (United States)

Moqeem, Aasia; Baig, Mirza; Gholamhosseini, Hamid; Mirza, Farhaan; Lindén, Maria

2018-01-01

This research involves the design and development of a novel Android smartphone application for real-time vital signs monitoring and decision support. The proposed application integrates market available, wireless and Bluetooth connected medical devices for collecting vital signs. The medical device data collected by the app includes heart rate, oxygen saturation and electrocardiograph (ECG). The collated data is streamed/displayed on the smartphone in real-time. This application was designed by adopting six screens approach (6S) mobile development framework and focused on user-centered approach and considered clinicians-as-a-user. The clinical engagement, consultations, feedback and usability of the application in the everyday practices were considered critical from the initial phase of the design and development. Furthermore, the proposed application is capable to deliver rich clinical decision support in real-time using the integrated medical device data.

Asteroseismology of solar-type stars with Kepler: III. Ground-based data

DEFF Research Database (Denmark)

Karoff, Christoffer; Molenda-Żakowicz , J.

2010-01-01

We report on the ground-based follow-up program of spectroscopic and photometric observations of solar-like asteroseismic targets for the Kepler space mission. These stars constitute a large group of more than a thousand objects which are the subject of an intensive study by the Kepler Asteroseis......We report on the ground-based follow-up program of spectroscopic and photometric observations of solar-like asteroseismic targets for the Kepler space mission. These stars constitute a large group of more than a thousand objects which are the subject of an intensive study by the Kepler...

Calibration of Ground-based Lidar instrument

DEFF Research Database (Denmark)

Yordanova, Ginka; Gómez Arranz, Paula

This report presents the result of the lidar calibration performed for the given Ground-based Lidar at DTU’s test site for large wind turbines at Høvsøre, Denmark. Calibration is here understood as the establishment of a relation between the reference wind speed measurements with measurement...... uncertainties provided by measurement standard and corresponding lidar wind speed indications with associated measurement uncertainties. The lidar calibration concerns the 10 minute mean wind speed measurements. The comparison of the lidar measurements of the wind direction with that from wind vanes...

First aid and basic life support: a questionnaire survey of medical schools in the Netherlands.

NARCIS (Netherlands)

Tan, E.C.T.H.; Hekkert, K.D.; Vugt, A.B. van; Biert, J.

2010-01-01

PURPOSE: Adequate education in first aid and basic life support (BLS) should be considered as an essential aspect of the medical curriculum. The objective of this study was to investigate the current medical training in first aid and BLS at all 8 medical schools in the Netherlands. SUMMARY: An

New fuzzy support vector machine for the class imbalance problem in medical datasets classification.

Science.gov (United States)

Gu, Xiaoqing; Ni, Tongguang; Wang, Hongyuan

2014-01-01

In medical datasets classification, support vector machine (SVM) is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM) for the class imbalance problem (called FSVM-CIP) is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

New Fuzzy Support Vector Machine for the Class Imbalance Problem in Medical Datasets Classification

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Xiaoqing Gu

2014-01-01

Full Text Available In medical datasets classification, support vector machine (SVM is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM for the class imbalance problem (called FSVM-CIP is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

Physician roles in tactical emergency medical support: the first 20 years.

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Young, Jason B; Sena, Matthew J; Galante, Joseph M

2014-01-01

The benefits of Tactical Emergency Medical Support (TEMS) elements are providing injury prevention, immediate care of injuries, and medical augmentation of the success of dangerous law enforcement operations. TEMS is recognized by civilian Special Weapons and Tactics (SWAT) and various other law enforcement agencies around the country as a vital addition to such SWAT teams. The integration of specially trained TEMS personnel has become a key component of law enforcement special operations. Our aim was to review the published literature to identify if there is a role for physicians within TEMS elements with regard to its establishment and progression, and to characterize the level of physician-specific support provided in the tactical environment for civilian tactical law enforcement teams. Physician presence as part of TEMS elements is increasing in number and popularity as the realization of the benefits provided by such physicians has become more apparent. The inclusion of physicians as active and participating members of TEMS elements is a critical measure to be taken for tactical law enforcement units. Physicians provide an added level of medical expertise to TEMS elements in rural and urban settings compared with law enforcement personnel with medic training. Physician involvement is an essential element of a successful TEMS program. There is a need for more physicians to become involved as TEMS personnel for specialized tactical teams to spread the time commitment and increase their availability to tactical units on a daily basis. Copyright © 2014 Elsevier Inc. All rights reserved.

A Simulation-Based Program to Train Medical Residents to Lead and Perform Advanced Cardiovascular Life Support

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Stefan, Mihaela S.; Belforti, Raquel K.; Langlois, Gerard; Rothberg, Michael B.

2014-01-01

Background Medical residents are often responsible for leading and performing cardiopulmonary resuscitation; however, their levels of expertise and comfort as leaders of advanced cardiovascular life support (ACLS) teams vary widely. While the current American Heart Association ACLS course provides education in recommended resuscitative protocols, training in leadership skills is insufficient. In this article, we describe the design and implementation in our institution of a formative curriculum aimed at improving residents’ readiness for being leaders of ACLS teams using human patient simulation. Human patient simulation refers to a variety of technologies using mannequins with realistic features, which allows learners to practice through scenarios without putting patients at risk. We discuss the limitations of the program and the challenges encountered in implementation. We also provide a description of the initiation and organization of the program. Case scenarios and assessment tools are provided. Description of the Institutional Training Program Our simulation-based training curriculum consists of 8 simulated patient scenarios during four 1-hour sessions. Postgraduate year–2 and 3 internal medicine residents participate in this program in teams of 4. Assessment tools are utilized only for formative evaluation. Debriefing is used as a teaching strategy for the individual resident leader of the ACLS team to facilitate learning and improve performance. To evaluate the impact of the curriculum, we administered a survey before and after the intervention. The survey consisted of 10 questions answered on a 5-point Likert scale, which addressed residents’ confidence in leading ACLS teams, management of the equipment, and management of cardiac rhythms. Respondents’ mean presimulation (ie, baseline) and postsimulation (outcome) scores were compared using a 2-sample t test. Residents’ overall confidence score improved from 2.8 to 3.9 (P simulation-based training

Knowledge, attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City, India.

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Somaraj, Vinej; Shenoy, Rekha P; Panchmal, Ganesh Shenoy; Jodalli, Praveen S; Sonde, Laxminarayan; Karkal, Ravichandra

2017-01-01

This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences ( P <0.05) between assessed knowledge and anxiety. Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant ( P =0.983). There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Ground-based grasslands data to support remote sensing and ecosystem modeling of terrestrial primary production

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Olson, R. J.; Scurlock, J. M. O.; Turner, R. S.; Jennings, S. V.

1995-01-01

Estimating terrestrial net primary production (NPP) using remote-sensing tools and ecosystem models requires adequate ground-based measurements for calibration, parameterization, and validation. These data needs were strongly endorsed at a recent meeting of ecosystem modelers organized by the International Geosphere-Biosphere Program's (IGBP's) Data and Information System (DIS) and its Global Analysis, Interpretation, and Modelling (GAIM) Task Force. To meet these needs, a multinational, multiagency project is being coordinated by the IGBP DIS to compile existing NPP data from field sites and to regionalize NPP point estimates to various-sized grid cells. Progress at Oak Ridge National Laboratory (ORNL) on compiling NPP data for grasslands as part of the IGBP DIS data initiative is described. Site data and associated documentation from diverse field studies are being acquired for selected grasslands and are being reviewed for completeness, consistency, and adequacy of documentation, including a description of sampling methods. Data are being compiled in a database with spatial, temporal, and thematic characteristics relevant to remote sensing and global modeling. NPP data are available from the ORNL Distributed Active Archive Center (DAAC) for biogeochemical dynamics. The ORNL DAAC is part of the Earth Observing System Data and Information System, of the US National Aeronautics and Space Administration.

Ground-based grasslands data to support remote sensing and ecosystem modeling of terrestrial primary production

Energy Technology Data Exchange (ETDEWEB)

Olson, R.J.; Turner, R.S. [Oak Ridge National Lab., TN (United States); Scurlock, J.M.O. [King`s College London, (England); Jennings, S.V. [Tennessee Univ., Knoxville, TN (United States)

1995-12-31

Estimating terrestrial net primary production (NPP) using remote- sensing tools and ecosystem models requires adequate ground-based measurements for calibration, parameterization, and validation. These data needs were strongly endorsed at a recent meeting of ecosystem modelers organized by the International Geosphere-Biosphere Programme`s (IGBP`s) Data and Information System (DIS) and its Global Analysis, Interpretation, and Modelling (GAIM) Task Force. To meet these needs, a multinational, multiagency project is being coordinated by the IGBP DIS to compile existing NPP data from field sites and to regionalize NPP point estimates to various-sized grid cells. Progress at Oak Ridge National Laboratory (ORNL) on compiling NPP data for grasslands as part of the IGBP DIS data initiative is described. Site data and associated documentation from diverse field studies are being acquired for selected grasslands and are being reviewed for completeness, consistency, and adequacy of documentation, including a description of sampling methods. Data are being compiled in a database with spatial, temporal, and thematic characteristics relevant to remote sensing and global modeling. NPP data are available from the ORNL Distributed Active Archive Center (DAAC) for biogeochemical dynamics. The ORNL DAAC is part of the Earth Observing System Data and Information System, of the US National Aeronautics and Space Administration.

Methods for the performance enhancement and the error characterization of large diameter ground-based diffractive telescopes.

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Zhang, Haolin; Liu, Hua; Lizana, Angel; Xu, Wenbin; Caompos, Juan; Lu, Zhenwu

2017-10-30

This paper is devoted to the improvement of ground-based telescopes based on diffractive primary lenses, which provide larger aperture and relaxed surface tolerance compared to non-diffractive telescopes. We performed two different studies devised to thoroughly characterize and improve the performance of ground-based diffractive telescopes. On the one hand, we experimentally validated the suitability of the stitching error theory, useful to characterize the error performance of subaperture diffractive telescopes. On the other hand, we proposed a novel ground-based telescope incorporated in a Cassegrain architecture, leading to a telescope with enhanced performance. To test the stitching error theory, a 300 mm diameter, 2000 mm focal length transmissive stitching diffractive telescope, based on a three-belt subaperture primary lens, was designed and implemented. The telescope achieves a 78 cy/mm resolution within 0.15 degree field of view while the working wavelength ranges from 582.8 nm to 682.8 nm without any stitching error. However, the long optical track (35.49 m) introduces air turbulence that reduces the final images contrast in the ground-based test. To enhance this result, a same diameter compacted Cassegrain ground-based diffractive (CGD) telescope with the total track distance of 1.267 m, was implemented within the same wavelength. The ground-based CGD telescope provides higher resolution and better contrast than the transmissive configuration. Star and resolution tests were experimentally performed to compare the CGD and the transmissive configurations, providing the suitability of the proposed ground-based CGD telescope.

Improving medication adherence: a framework for community pharmacy-based interventions

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Pringle J

2015-11-01

Full Text Available Janice Pringle,1 Kim C Coley2 1Program Evaluation and Research Unit, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; 2Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Abstract: Evidence supports that patient medication adherence is suboptimal with patients typically taking less than half of their prescribed doses. Medication nonadherence is associated with poor health outcomes and higher downstream health care costs. Results of studies evaluating pharmacist-led models in a community pharmacy setting and their impact on medication adherence have been mixed. Community pharmacists are ideally situated to provide medication adherence interventions, and effective strategies for how they can consistently improve patient medication adherence are necessary. This article suggests a framework to use in the community pharmacy setting that will significantly improve patient adherence and provides a strategy for how to apply this framework to develop and test new medication adherence innovations. The proposed framework is composed of the following elements: 1 defining the program's pharmacy service vision, 2 using evidence-based, patient-centered communication and intervention strategies, 3 using specific implementation approaches that ensure fidelity, and 4 applying continuous evaluation strategies. Within this framework, pharmacist interventions should include those services that capitalize on their specific skill sets. It is also essential that the organization's leadership effectively communicates the pharmacy service vision. Medication adherence strategies that are evidence-based and individualized to each patient's adherence problems are most desirable. Ideally, interventions would be delivered repeatedly over time and adjusted when patient's adherence circumstances change. Motivational interviewing principles are particularly well

EAC training and medical support for International Space Station astronauts.

Science.gov (United States)

Messerschmid, E; Haignere, J P; Damian, K; Damann, V

2000-11-01

The operation of the International Space Station (ISS) will be a global multilateral endeavour. Each International Partner will be responsible for the operation of its elements and for providing a crew complement proportional to its share of the overall resources. The preparations of the European Astronaut Centre to furnish training and medical support for the ISS astronauts are described.

Support of a Problem-Based Learning Curriculum by Basic Science Faculty

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William L. Anderson

2002-11-01

Full Text Available Although published reports describe benefits to students of learning in a problem-based, student-centered environment, questions have persisted about the excessive faculty time commitments associated with the implementation of PBL pedagogy. The argument has been put forward that the excessive faculty costs of such a curriculum cannot be justified based upon the potential benefits to students. However, the magnitude of the faculty time commitment to a PBL curriculum to support the aforementioned argument is not clear to us and we suspect that it is also equally unclear to individuals charged with making resource decisions supporting the educational efforts of the institution. Therefore, to evaluate this cost - benefit question, we analyzed the actual basic science faculty time commitment in a hybrid PBL curriculum during the first phase 18 months of undergraduate medical education. The results of this analysis do demonstrate an increase in faculty time commitments but do not support the argument that PBL pedagogy is excessively costly in terms of faculty time. For the year analyzed in this report, basic science faculty members contributed on average of 27.4 hours to the instruction of medical students. The results of the analysis did show significant contributions (57% of instructional time by the clinical faculty during the initial 18 months of medical school. In addition, the data revealed a four-fold difference between time commitments of the four basic science departments. We conclude that a PBL curriculum does not place unreasonable demands on the time of basic science faculty. The demands on clinical faculty, in the context of their other commitments, could not be evaluated. Moreover, this type of analysis provides a tool that can be used to make faculty resource allocation decisions fairly.

The Haiti Medical Education Project: development and analysis of a competency based continuing medical education course in Haiti through distance learning.

Science.gov (United States)

Battat, Robert; Jhonson, Marc; Wiseblatt, Lorne; Renard, Cruff; Habib, Laura; Normil, Manouchka; Remillard, Brian; Brewer, Timothy F; Sacajiu, Galit

2016-10-19

Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti. Real time lectures from local and international institutions were teleconferenced to physicians in remote Haitian sites using VidyoConferencing™ technology. With American Academy of Family Physicians (AAFP) and College of Family Physicians Canada (CFPC) guidelines as references, a competency-derived syllabus was created for a Haitian continuing medical education program. The resulting educational goals were reviewed by a committee of Haitian and North American physician/medical education practitioners to reflect local needs. All authors reviewed lectures and then conferred to establish agreement on competencies presented for each lecture. Sixty-seven lectures were delivered. Human immunodeficiency virus/Acquired Immunodeficiency Syndrome, ophthalmologic, infectious diseases, renal and endocrine competencies were well-represented, with more than 50 % of the joint AAFP and CFPC recommended competencies outlined. Areas under-represented included allergy and immunology, cardiology, surgery, pain management, gastroenterology, neurology, pulmonology, men's health and rheumatology; these topics accounted for less than 25 % of AAFP/CFPC recommended competencies. Areas not covered included geriatrics, nutrition, occupational health and women's health. Within practice-based lectures, only disaster medicine, health promotion and information management were included, but only partially

Population Health and Tailored Medical Care in the Home: the Roles of Home-Based Primary Care and Home-Based Palliative Care.

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Ritchie, Christine S; Leff, Bruce

2018-03-01

With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care (HBPC) and home-based palliative care (HBPalC). Although the type of services provided by HBPC and HBPalC (together termed "home-based medical care") overlap, HBPC tends to encompass longitudinal and preventive care, while HBPalC often provides services for shorter durations focused more on distress management and goals of care clarification. Given workforce constraints and growing demand, both HBPC and HBPalC will benefit from working together within a population health framework-where HBPC provides care to all patients who have trouble accessing traditional office practices and where HBPalC offers adjunctive care to patients with high symptom burden and those who need assistance with goals clarification. Policy changes that support provision of medical care in the home, population health strategies that tailor home-based medical care to the specific needs of the patients and their caregivers, and educational initiatives to assure basic palliative care competence for all home-based medical providers will improve access and reduce illness burden to this important and underrecognized population. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A demanding web-based PACS supported by web services technology

Science.gov (United States)

Costa, Carlos M. A.; Silva, Augusto; Oliveira, José L.; Ribeiro, Vasco G.; Ribeiro, José

2006-03-01

During the last years, the ubiquity of web interfaces have pushed practically all PACS suppliers to develop client applications in which clinical practitioners can receive and analyze medical images, using conventional personal computers and Web browsers. However, due to security and performance issues, the utilization of these software packages has been restricted to Intranets. Paradigmatically, one of the most important advantages of digital image systems is to simplify the widespread sharing and remote access of medical data between healthcare institutions. This paper analyses the traditional PACS drawbacks that contribute to their reduced usage in the Internet and describes a PACS based on Web Services technology that supports a customized DICOM encoding syntax and a specific compression scheme providing all historical patient data in a unique Web interface.

Sequential Ground Motion Effects on the Behavior of a Base-Isolated RCC Building

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Zhi Zheng

2017-01-01

Full Text Available The sequential ground motion effects on the dynamic responses of reinforced concrete containment (RCC buildings with typical isolators are studied in this paper. Although the base isolation technique is developed to guarantee the security and integrity of RCC buildings under single earthquakes, seismic behavior of base-isolated RCC buildings under sequential ground motions is deficient. Hence, an ensemble of as-recorded sequential ground motions is employed to study the effect of including aftershocks on the seismic evaluation of base-isolated RCC buildings. The results indicate that base isolation can significantly attenuate the earthquake shaking of the RCC building under not only single earthquakes but also seismic sequences. It is also found that the adverse aftershock effect on the RCC can be reduced due to the base isolation applied to the RCC. More importantly, the study indicates that disregarding aftershocks can induce significant underestimation of the isolator displacement for base-isolated RCC buildings.

Biodosimetry: Medicine, Science, and Systems to Support the Medical Decision-Maker Following a Large Scale Nuclear or Radiation Incident

International Nuclear Information System (INIS)

Coleman, C. Norman; Koerner, John F.

2016-01-01

The public health and medical response to a radiological or nuclear incident requires the capability to sort, assess, treat, triage and to ultimately discharge, refer or transport people to their next step in medical care. The size of the incident and scarcity of resources at the location of each medical decision point will determine how patients are triaged and treated. This will be a rapidly evolving situation impacting medical responders at regional, national and international levels. As capabilities, diagnostics and medical countermeasures improve, a dynamic system-based approach is needed to plan for and manage the incident, and to adapt effectively in real time. In that the concepts and terms can be unfamiliar and possibly confusing, resources and a concept of operations must be considered well in advance. An essential underlying tenet is that medical evaluation and care will be managed by health-care professionals with biodosimetry assays providing critical supporting data. (authors)

Development of Patient Status-Based Dynamic Access System for Medical Information Systems

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Chang Won Jeong

2015-06-01

Full Text Available Recently, the hospital information system environment using IT communication technology and utilization of medical information has been increasing. In the medical field, the medical information system only supports the transfer of patient information to medical staff through an electronic health record, without information about patient status. Hence, it needs a method of real-time monitoring for the patient. Also, in this environment, a secure method in approaching healthcare through various smart devices is required. Therefore, in this paper, in order to classify the status of the patients, we propose a dynamic approach of the medical information system in a hospital information environment using the dynamic access control method. Also, we applied the symmetric method of AES (Advanced Encryption Standard. This was the best encryption algorithm for sending and receiving biological information. We can define usefulness as the dynamic access application service based on the final result of the proposed system. The proposed system is expected to provide a new solution for a convenient medical information system.

"Slow-scanning" in Ground-based Mid-infrared Observations

Science.gov (United States)

Ohsawa, Ryou; Sako, Shigeyuki; Miyata, Takashi; Kamizuka, Takafumi; Okada, Kazushi; Mori, Kiyoshi; Uchiyama, Masahito S.; Yamaguchi, Junpei; Fujiyoshi, Takuya; Morii, Mikio; Ikeda, Shiro

2018-04-01

Chopping observations with a tip-tilt secondary mirror have conventionally been used in ground-based mid-infrared observations. However, it is not practical for next generation large telescopes to have a large tip-tilt mirror that moves at a frequency larger than a few hertz. We propose an alternative observing method, a "slow-scanning" observation. Images are continuously captured as movie data, while the field of view is slowly moved. The signal from an astronomical object is extracted from the movie data by a low-rank and sparse matrix decomposition. The performance of the "slow-scanning" observation was tested in an experimental observation with Subaru/COMICS. The quality of a resultant image in the "slow-scanning" observation was as good as in a conventional chopping observation with COMICS, at least for a bright point-source object. The observational efficiency in the "slow-scanning" observation was better than that in the chopping observation. The results suggest that the "slow-scanning" observation can be a competitive method for the Subaru telescope and be of potential interest to other ground-based facilities to avoid chopping.

A Ground-based validation of GOSAT-observed atmospheric CO2 in Inner-Mongolian grasslands

International Nuclear Information System (INIS)

Qin, X; Lei, L; Zeng, Z; Kawasaki, M; Oohasi, M

2014-01-01

Atmospheric carbon dioxide (CO 2 ) is a long-lived greenhouse gas that significantly contributes to global warming. Long-term and continuous measurements of atmospheric CO 2 to investigate its global distribution and concentration variations are important for accurately understanding its potential climatic effects. Satellite measurements from space can offer atmospheric CO 2 data for climate change research. For that, ground-based measurements are required for validation and improving the precision of satellite-measured CO 2 . We implemented observation experiment of CO 2 column densities in the Xilinguole grasslands in Inner Mongolia, China, using a ground-based measurement system, which mainly consists of an optical spectrum analyzer (OSA), a sun tracker and a notebook controller. Measurements from our ground-based system were analyzed and compared with those from the Greenhouse gas Observation SATellite (GOSAT). The ground-based measurements had an average value of 389.46 ppm, which was 2.4 ppm larger than from GOSAT, with a standard deviation of 3.4 ppm. This result is slightly larger than the difference between GOSAT and the Total Carbon Column Observing Network (TCCON). This study highlights the usefulness of the ground-based OSA measurement system for analyzing atmospheric CO 2 column densities, which is expected to supplement the current TCCON network

Human Walking Pattern Recognition Based on KPCA and SVM with Ground Reflex Pressure Signal

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Zhaoqin Peng

2013-01-01

Full Text Available Algorithms based on the ground reflex pressure (GRF signal obtained from a pair of sensing shoes for human walking pattern recognition were investigated. The dimensionality reduction algorithms based on principal component analysis (PCA and kernel principal component analysis (KPCA for walking pattern data compression were studied in order to obtain higher recognition speed. Classifiers based on support vector machine (SVM, SVM-PCA, and SVM-KPCA were designed, and the classification performances of these three kinds of algorithms were compared using data collected from a person who was wearing the sensing shoes. Experimental results showed that the algorithm fusing SVM and KPCA had better recognition performance than the other two methods. Experimental outcomes also confirmed that the sensing shoes developed in this paper can be employed for automatically recognizing human walking pattern in unlimited environments which demonstrated the potential application in the control of exoskeleton robots.

Refugee Policy Implications of U.S. Immigration Medical Screenings: A New Era of Inadmissibility on Health-Related Grounds.

Science.gov (United States)

Hong, Mi-Kyung; Varghese, Reshma E; Jindal, Charulata; Efird, Jimmy T

2017-09-24

Refugees frequently face extended delays in their efforts to enter the United States (U.S.) and those who are successful, in many cases, encounter overwhelming obstacles, inadequate resources, and a complex system of legal barriers. Travel restrictions based on equivocal health concerns and a drop in refugee admittance ceilings have complicated the situation. The authors retrieved and analyzed peer-reviewed journal articles, government agency press releases, media postings, epidemiologic factsheets, and relevant lay publications to critically assess U.S. policy regarding refugee resettlement based on health-related grounds. While refugees arguably exhibit an increased incidence of measles and tuberculosis compared with the U.S. population, the legitimacy of the medical examination will be undermined if other diseases that are endemic to refugee populations, yet currently deemed admissible, are used to restrict refugees from entering the U.S. This paper addressees the historic refugee policy of the U.S. and its consequent effect on the health of this vulnerable population. The needs of refugees should be carefully considered in the context of increased disease burden and the associated health care challenges of the country as a whole.

Development of national competency-based learning objectives "Medical Informatics" for undergraduate medical education.

Science.gov (United States)

Röhrig, R; Stausberg, J; Dugas, M

2013-01-01

The aim of this project is to develop a catalogue of competency-based learning objectives "Medical Informatics" for undergraduate medical education (abbreviated NKLM-MI in German). The development followed a multi-level annotation and consensus process. For each learning objective a reason why a physician needs this competence was required. In addition, each objective was categorized according to the competence context (A = covered by medical informatics, B = core subject of medical informatics, C = optional subject of medical informatics), the competence level (1 = referenced knowledge, 2 = applied knowledge, 3 = routine knowledge) and a CanMEDS competence role (medical expert, communicator, collaborator, manager, health advocate, professional, scholar). Overall 42 objectives in seven areas (medical documentation and information processing, medical classifications and terminologies, information systems in healthcare, health telematics and telemedicine, data protection and security, access to medical knowledge and medical signal-/image processing) were identified, defined and consented. With the NKLM-MI the competences in the field of medical informatics vital to a first year resident physician are identified, defined and operationalized. These competencies are consistent with the recommendations of the International Medical Informatics Association (IMIA). The NKLM-MI will be submitted to the National Competence-Based Learning Objectives for Undergraduate Medical Education. The next step is implementation of these objectives by the faculties.

A transit timing analysis with combined ground- and space-based photometry

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Raetz St.

2015-01-01

The CoRoT satellite looks back on six years of high precision photometry of a very high number of stars. Thousands of transiting events are detected from which 27 were confirmed to be transiting planets so far. In my research I search and analyze TTVs in the CoRoT sample and combine the unprecedented precision of the light curves with ground-based follow-up photometry. Because CoRoT can observe transiting planets only for a maximum duration of 150 days the ground-based follow-up can help to refine the ephemeris. Here we present first examples.

Status of advanced ground-based laser interferometers for gravitational-wave detection

Science.gov (United States)

Dooley, K. L.; Akutsu, T.; Dwyer, S.; Puppo, P.

2015-05-01

Ground-based laser interferometers for gravitational-wave (GW) detection were first constructed starting 20 years ago and as of 2010 collection of several years’ worth of science data at initial design sensitivities was completed. Upgrades to the initial detectors together with construction of brand new detectors are ongoing and feature advanced technologies to improve the sensitivity to GWs. This conference proceeding provides an overview of the common design features of ground-based laser interferometric GW detectors and establishes the context for the status updates of each of the four gravitational-wave detectors around the world: Advanced LIGO, Advanced Virgo, GEO 600 and KAGRA.

Making Sense of Grounded Theory Approach: Implications for Medial Education Research

OpenAIRE

Mohsen Tavokol; S Torabi; AA Zeialoo

2009-01-01

This article first gives a definition of grounded theory and its development and use in medicine and medical education. The fundamental differences of grounded theory with quantitative methods are discussed along a full discussion of the steps required to use a grounded theory approach. At the end the questions in the area of medical education which can best addressed with this approach are provided. 

Effect of ionizing radiation on advanced life support medications

International Nuclear Information System (INIS)

Sullivan, D.J.; Hubbard, L.B.; Broadbent, M.V.; Stewart, P.; Jaeger, M.

1987-01-01

Advanced life support medications stored in emergency department stretcher areas, diagnostic radiology rooms, and radiotherapy suites are exposed to ionizing radiation. We hypothesized that radiation may decrease the potency and thus the shelf life of medications stored in these areas. Atropine, dopamine, epinephrine, and isoproterenol were exposed to a wide range of ionizing radiation. The potency of the four drugs was unaffected by levels of radiation found in ED stretcher areas and high-volume diagnostic radiograph rooms (eg, chest radiograph, computed tomography, fluoroscopy). The potency of atropine may be reduced by gamma radiation in high-use radiotherapy suites. However, dopamine, epinephrine, and isoproterenol were unaffected by high doses of gamma radiation. Atropine, dopamine, epinephrine, and isoproterenol may be safely kept in ED stretcher areas and diagnostic radiology rooms without loss of potency over the shelf life of the drugs

Detection of cyst using image segmentation and building knowledge-based intelligent decision support system as an aid to telemedicine

Science.gov (United States)

Janet, J.; Natesan, T. R.; Santhosh, Ramamurthy; Ibramsha, Mohideen

2005-02-01

An intelligent decision support tool to the Radiologist in telemedicine is described. Medical prescriptions are given based on the images of cyst that has been transmitted over computer networks to the remote medical center. The digital image, acquired by sonography, is converted into an intensity image. This image is then subjected to image preprocessing which involves correction methods to eliminate specific artifacts. The image is resized into a 256 x 256 matrix by using bilinear interpolation method. The background area is detected using distinct block operation. The area of the cyst is calculated by removing the background area from the original image. Boundary enhancement and morphological operations are done to remove unrelated pixels. This gives us the cyst volume. This segmented image of the cyst is sent to the remote medical center for analysis by Knowledge based artificial Intelligent Decision Support System (KIDSS). The type of cyst is detected and reported to the control mechanism of KIDSS. Then the inference engine compares this with the knowledge base and gives appropriate medical prescriptions or treatment recommendations by applying reasoning mechanisms at the remote medical center.

Perceived Social Support as a Determinant of Quality of Life Among Medical Students: 6-Month Follow-up Study.

Science.gov (United States)

Hwang, In Cheol; Park, Kwi Hwa; Kim, Jin Joo; Yim, Jun; Ko, Kwang Pil; Bae, Seung Min; Kyung, Sun Young

2017-04-01

This longitudinal study aimed to identify the relevant factors related to quality of life (QoL) changes in medical students. For this 6-month follow-up study, we enrolled 109 students from a Korean medical school. To assess students' QoL, we used the World Health Organization QoL scale. Possible determinants of student QoL included demographics, fatigue, and social support. A stepwise multivariate analysis identified factors associated with changes of student QoL. Among sources of support, the "friends" category was the main position affecting their overall QoL, and "significant other" had the strongest influence on psychological and social domains. The impact of support from friends on QoL was confirmed in the longitudinal analysis. Final regression models revealed that providing students with more social support and promoting fatigue reduction best improved medical student sense of well-being. Creating stronger student support programs to prevent social detachment and implementing strategies to reduce fatigue can improve QoL in medical students.

Experiential Knowledge Complements an LCA-Based Decision Support Framework

Directory of Open Access Journals (Sweden)

Heng Yi Teah

2015-09-01

Full Text Available A shrimp farmer in Taiwan practices innovation through trial-and-error for better income and a better environment, but such farmer-based innovation sometimes fails because the biological mechanism is unclear. Systematic field experimentation and laboratory research are often too costly, and simulating ground conditions is often too challenging. To solve this dilemma, we propose a decision support framework that explicitly utilizes farmer experiential knowledge through a participatory approach to alternatively estimate prospective change in shrimp farming productivity, and to co-design options for improvement. Data obtained from the farmer enable us to quantitatively analyze the production cost and greenhouse gas (GHG emission with a life cycle assessment (LCA methodology. We used semi-quantitative graphical representations of indifference curves and mixing triangles to compare and show better options for the farmer. Our results empower the farmer to make decisions more systematically and reliably based on the frequency of heterotrophic bacteria application and the revision of feed input. We argue that experiential knowledge may be less accurate due to its dependence on varying levels of farmer experience, but this knowledge is a reasonable alternative for immediate decision-making. More importantly, our developed framework advances the scope of LCA application to support practically important yet scientifically uncertain cases.

Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm.

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Friedli, Natalie; Stanga, Zeno; Culkin, Alison; Crook, Martin; Laviano, Alessandro; Sobotka, Lubos; Kressig, Reto W; Kondrup, Jens; Mueller, Beat; Schuetz, Philipp

2018-03-01

Refeeding syndrome (RFS) can be a life-threatening metabolic condition after nutritional replenishment if not recognized early and treated adequately. There is a lack of evidence-based treatment and monitoring algorithm for daily clinical practice. The aim of the study was to propose an expert consensus guideline for RFS for the medical inpatient (not including anorexic patients) regarding risk factors, diagnostic criteria, and preventive and therapeutic measures based on a previous systematic literature search. Based on a recent qualitative systematic review on the topic, we developed clinically relevant recommendations as well as a treatment and monitoring algorithm for the clinical management of inpatients regarding RFS. With international experts, these recommendations were discussed and agreement with the recommendation was rated. Upon hospital admission, we recommend the use of specific screening criteria (i.e., low body mass index, large unintentional weight loss, little or no nutritional intake, history of alcohol or drug abuse) for risk assessment regarding the occurrence of RFS. According to the patient's individual risk for RFS, a careful start of nutritional therapy with a stepwise increase in energy and fluids goals and supplementation of electrolyte and vitamins, as well as close clinical monitoring, is recommended. We also propose criteria for the diagnosis of imminent and manifest RFS with practical treatment recommendations with adoption of the nutritional therapy. Based on the available evidence, we developed a practical algorithm for risk assessment, treatment, and monitoring of RFS in medical inpatients. In daily routine clinical care, this may help to optimize and standardize the management of this vulnerable patient population. We encourage future quality studies to further refine these recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

Simulation-based medical teaching and learning

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Abdulmohsen H Al-Elq

2010-01-01

Full Text Available One of the most important steps in curriculum development is the introduction of simulation- based medical teaching and learning. Simulation is a generic term that refers to an artificial representation of a real world process to achieve educational goals through experiential learning. Simulation based medical education is defined as any educational activity that utilizes simulation aides to replicate clinical scenarios. Although medical simulation is relatively new, simulation has been used for a long time in other high risk professions such as aviation. Medical simulation allows the acquisition of clinical skills through deliberate practice rather than an apprentice style of learning. Simulation tools serve as an alternative to real patients. A trainee can make mistakes and learn from them without the fear of harming the patient. There are different types and classification of simulators and their cost vary according to the degree of their resemblance to the reality, or ′fidelity′. Simulation- based learning is expensive. However, it is cost-effective if utilized properly. Medical simulation has been found to enhance clinical competence at the undergraduate and postgraduate levels. It has also been found to have many advantages that can improve patient safety and reduce health care costs through the improvement of the medical provider′s competencies. The objective of this narrative review article is to highlight the importance of simulation as a new teaching method in undergraduate and postgraduate education.

Biomedical visual data analysis to build an intelligent diagnostic decision support system in medical genetics.

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Kuru, Kaya; Niranjan, Mahesan; Tunca, Yusuf; Osvank, Erhan; Azim, Tayyaba

2014-10-01

In general, medical geneticists aim to pre-diagnose underlying syndromes based on facial features before performing cytological or molecular analyses where a genotype-phenotype interrelation is possible. However, determining correct genotype-phenotype interrelationships among many syndromes is tedious and labor-intensive, especially for extremely rare syndromes. Thus, a computer-aided system for pre-diagnosis can facilitate effective and efficient decision support, particularly when few similar cases are available, or in remote rural districts where diagnostic knowledge of syndromes is not readily available. The proposed methodology, visual diagnostic decision support system (visual diagnostic DSS), employs machine learning (ML) algorithms and digital image processing techniques in a hybrid approach for automated diagnosis in medical genetics. This approach uses facial features in reference images of disorders to identify visual genotype-phenotype interrelationships. Our statistical method describes facial image data as principal component features and diagnoses syndromes using these features. The proposed system was trained using a real dataset of previously published face images of subjects with syndromes, which provided accurate diagnostic information. The method was tested using a leave-one-out cross-validation scheme with 15 different syndromes, each of comprised 5-9 cases, i.e., 92 cases in total. An accuracy rate of 83% was achieved using this automated diagnosis technique, which was statistically significant (pbenefits of using hybrid image processing and ML-based computer-aided diagnostics for identifying facial phenotypes. Copyright © 2014. Published by Elsevier B.V.

Academic Primer Series: Key Papers About Competency-Based Medical Education