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Sample records for making ends meet

  1. Hypothalamic glucose sensing: making ends meet

    Vanessa eRouth

    2014-12-01

    Full Text Available The neuroendocrine system governs essential survival and homeostatic functions. For example, growth is needed for development. Thermoregulation maintains optimal core temperature in a changing environment. Reproduction ensures species survival. Stress and immune responses enable an organism to overcome external and internal threats. The circadian system regulates arousal and sleep such that vegetative and active functions do not overlap. All of these functions require a significant portion of the body’s energy. As the integrator of the neuroendocrine system, the hypothalamus carefully assesses the energy status of the body in order to appropriately partition resources to provide for each system without compromising the others. While doing so the hypothalamus must ensure that adequate glucose levels are preserved for brain function since glucose is the primary fuel of the brain. To this end, the hypothalamus contains specialized glucose sensing neurons which are scattered throughout the nuclei controlling distinct neuroendocrine functions. We hypothesize that these neurons play a key role in enabling the hypothalamus to partition energy to meet these peripheral survival needs without endangering the brain’s glucose supply. The goal of this review is to describe the varied mechanisms underlying glucose sensing in neurons within discrete hypothalamic nuclei. We will then evaluate the way in which peripheral energy status regulates glucose sensitivity. For example, during energy deficit such as fasting specific hypothalamic glucose sensing neurons become sensitized to decreased glucose. This increases the gain of the information relay when glucose availability is a greater concern for the brain. Finally, changes in glucose sensitivity under pathological conditions (e.g., recurrent insulin-hypoglycemia, diabetes will be addressed. The overall goal of this review is to place glucose sensing neurons within the context of hypothalamic control of

  2. Making Ends Meet: Insufficiency and Work-Family Coordination in the New Economy

    Edgell, Penny; Ammons, Samantha K.; Dahlin, Eric C.

    2012-01-01

    The "New Economy" features 24/7 employment, varied work schedules, job insecurity, and lower benefits and wages, which lead to disparities in experiences of security and sufficiency. This study investigates sufficiency concerns in the New Economy; who is having trouble making ends meet? Sufficiency concerns are subjective perceptions that work is…

  3. Making ends meet. A synthesis of research on consumer behaviour and the environment

    Thøgersen, John

    1999-01-01

    litteratur. Især to diskussioner er mere udfoldede i denne sammenfatning end noget andet sted i disputatsen. Den ene er diskussionen om, hvordan mit teoretiske bidrag adskiller sig fra markante forgængere, især Icek Ajzens Theory of Planned Behaviour. Den anden er diskussionen af mine analysers...

  4. Making both ends meet

    Lancaster, C.|info:eu-repo/dai/nl/353782513

    2012-01-01

    Sustainability of global supply chains has gained increased attention during the last decade. Although the focus of sustainable development originally implied environmental efficient practices, this notion developed into an emphasis on sound business social practices. The phenomenon of addressing

  5. Community Based Flood Modeling in Southern and Baja California to Meet End User Needs for Decision-Making

    Sanders, B. F.

    2017-12-01

    Flooding of coastal and fluvial systems are the most significant natural hazards facing society, and damages have been escalating for decades globally and in the U.S. Almost all metropolitan areas are exposed to flood risk. The threat from river flooding is especially high in India and China, and coastal cities around the world are threatened by storm surge and rising sea levels. Several trends including rising sea levels, urbanization, deforestation, and rural-to-urban population shifts will increase flood exposure in the future. Flood impacts are escalating despite advances in hazards science and extensive effort to manage risks. The fundamental issue is not that flooding is becoming more severe, even though it is in some places, but rather that societies are become more vulnerable to flood impacts. A critical factor contributing to the escalation of flood impacts is that the most vulnerable sectors of communities are left out of processes to prepare for and respond to flooding. Furthermore, the translation of knowledge about flood hazards and vulnerabilities into actionable information for communities has not been effective. In Southern and Baja California, an interdisciplinary team of researchers has partnered with stakeholders in flood vulnerable communities to co-develop flood hazard information systems designed to meet end-user needs for decision-making. The initiative leveraged the power of advanced, fine-scale hydraulic models of flooding to craft intuitive visualizations of context-sensitive scenarios. This presentation will cover the ways by which the process of flood inundation modeling served as a focal point for knowledge development, as well as the unique visualizations that populate on-line information systems accessible here: http://floodrise.uci.edu/online-flood-hazard-viewers/

  6. East meets West: cross-cultural perspective in end-of-life decision making from Indian and German viewpoints.

    Chattopadhyay, Subrata; Simon, Alfred

    2008-06-01

    Culture creates the context within which individuals experience life and comprehend moral meaning of illness, suffering and death. The ways the patient, family and the physician communicate and make decisions in the end-of-life care are profoundly influenced by culture. What is considered as right or wrong in the healthcare setting may depend on the socio-cultural context. The present article is intended to delve into the cross-cultural perspectives in ethical decision making in the end-of-life scenario. We attempt to address the dynamics of the roles of patient, family and physician therein across two countries from East and West, namely, India and Germany. In India, where illness is more a shared family affair than an individual incident, a physician is likely to respect the family's wishes and may withhold the [Symbol: see text]naked truth' about the diagnosis of a fatal disease to the patient. In Germany, a physician is legally required to inform the patient about the disease. In India, advance directive being virtually non-existent, the family acts as the locus of the decision-making process, taking into account the economic cost of available medical care. In Germany, advance directive is regarded as mandatory and healthcare is covered by insurance. Family and the physician appear to play larger roles in ethical decision making for patients in India than for those in Germany, who place greater emphasis on autonomy of the individual patient. Our study explicates how culture matters in ethical decision-making and why the bioethical discourse is necessary in the concrete realities of the socio-cultural context. To explore the possibility of finding a common ground of morality across different cultures while acknowledging and respecting cultural diversity, thus remains a formidable challenge for the bioethicists.

  7. Opportunities for making ends meet and upward mobility: differences in organizational deprivation across urban and suburban poor neighborhoods.

    Murphy, Alexandra K; Wallace, Danielle

    2010-01-01

    Objectives. Given the recent rise of poverty in U.S. suburbs, this study asks: What poor neighborhoods are most disadvantageous, those in the city or those in the suburbs? Building on recent urban sociological work demonstrating the importance of neighborhood organizations for the poor, we are concerned with one aspect of disadvantage—the lack of availability of organizational resources oriented toward the poor. By breaking down organizations into those that promote mobility versus those that help individuals meet their daily subsistence needs, we seek to explore potential variations in the type of disadvantage that may exist.Methods. We test whether poor urban or suburban neighborhoods are more likely to be organizationally deprived by breaking down organizations into three types: hardship organizations, educational organizations, and employment organizations. We use data from the 2000 U.S. County Business Patterns and the 2000 U.S. Census and test neighborhood deprivation using logistic regression models.Results. We find that suburban poor neighborhoods are more likely to be organizationally deprived than are urban poor neighborhoods, especially with respect to organizations that promote upward mobility. Interesting racial and ethnic composition factors shape this more general finding.Conclusion. Our findings suggest that if a poor individual is to live in a poor neighborhood, with respect to access to organizational resources, he or she would be better off living in the central city. Suburban residence engenders isolation from organizations that will help meet one's daily needs and even more so from those offering opportunities for mobility.

  8. Making Meetings Work Better.

    Standke, Linda

    1978-01-01

    Focusing on the increased use by trainers of off-site facilities for employee training meetings, this article looks at some improvements and the expanding market in the meeting site industry. It also highlights emerging trends in the industry and covers the growth of meeting planning into a profession. (EM)

  9. End-of-life decision making in the ICU.

    Siegel, Mark D

    2009-03-01

    A large proportion of deaths, particularly in the developed world, follows admission to an ICU. Therefore, end-of life decision making is an essential facet of critical care practice. For intensivists, managing death in the critically ill has become a key professional skill. They must be thoroughly familiar with the ethical framework that guides end-of-life decision making. Decisions should generally be made collaboratively by clinicians partnering with patients' families. Treatment choices should be crafted to meet specific, achievable goals. A rational, empathic approach to working with families should encourage appropriate, mutually satisfactory outcomes.

  10. The art of grocery shopping on a food stamp budget: factors influencing the food choices of low-income women as they try to make ends meet.

    Wiig, Kristen; Smith, Chery

    2009-10-01

    Amidst a hunger-obesity paradox, the purpose of the present study was to examine the grocery shopping behaviour and food stamp usage of low-income women with children to identify factors influencing their food choices on a limited budget. Focus groups, which included questions based on Social Cognitive Theory constructs, examined food choice in the context of personal, behavioural and environmental factors. A quantitative grocery shopping activity required participants to prioritize food purchases from a 177-item list on a budget of $US 50 for a one-week period, an amount chosen based on the average household food stamp allotment in 2005. Ninety-two low-income women, with at least one child aged 9-13 years in their household, residing in the Twin Cities, Minnesota, USA. Participants' mean age was 37 years, and 76% were overweight or obese (BMI> or =25.0 kg/m2). Key findings suggest that their food choices and grocery shopping behaviour were shaped by not only individual and family preferences, but also their economic and environmental situation. Transportation and store accessibility were major determinants of shopping frequency, and they used various strategies to make their food dollars stretch (e.g. shopping based on prices, in-store specials). Generally, meat was the most important food group for purchase and consumption, according to both the qualitative and quantitative data. Efforts to improve food budgeting skills, increase nutrition knowledge, and develop meal preparation strategies involving less meat and more fruits and vegetables, could be valuable in helping low-income families nutritionally make the best use of their food dollars.

  11. The struggle to make ends meet.

    Bencheikh, T

    1988-01-01

    Morocco's severe financial problems have threatened its health-for-all goals. Restrictions have affected the recruitment and replacement of health personnel, the purchase and maintenance of equipment and buildings, hospital catering services and drug procurement. Several methods have been used to try and ease this crisis, rationalization and better deployment of resources, mobilization of national resources, and mobilization of external resources. In attaining the 1st, restrictions on the credits allocated to the Ministry of Public health have forced it to work out better ways of using its resources. These have included plans for better administrative and financial management of hospitals, improvements in drug procurement and distribution, new methods of personnel management, and efforts at improving information facilities and analytical capabilities at the central and local levels. To mobilize internal resources several steps were taken. These included revising too-low hospital charges, and charging people with social security coverage or those able to pay directly, raising funds through private charities, and the establishment of alternative, less expensive types of health centers. Morocco's continued need for funds to achieve health-for-all goals led it to also receive substantial assistance from international agencies (including the World Bank, UNICEF, UNFPA, and USAID) and friendly countries. External assistance cannot provide definitive solutions however, because of 1) the use of foreign experts and the payment of salaries abroad, 2) the purchase of products from the countries providing assistance, and 3) the unpredictability of external support and the danger programs may have to be abandoned. In times of financial crisis it is necessary to continue to budget adequately in order to reach health objectives.

  12. The role of the bioethicist in family meetings about end of life care.

    Watkins, Liza T; Sacajiu, Galit; Karasz, Alison

    2007-12-01

    There has been little study of the content of bioethicists' communication during family meeting consultations about end of life care. In the literature, two roles for bioethicists are usually described: the "consultant" role, in which bioethicists define and support ethical principles such as those enshrined in the "rational choice" model; and the "mediator" role, which focuses on the enhancement of communication in order to reduce conflict. In this study, we use observational data to explore how bioethicists support the practice of decision making during family meetings about end of life care. In a study conducted in the Bronx, New York, USA, researchers observed and recorded 24 decision-making meetings between hospital staff and family members of elderly patients identified as being in the last stages of illness, who were unable or unwilling to make the decision for themselves. Bioethics consultants were present during five of those meetings. Although bioethicists referred to the "rational choice" decision-making hierarchy, we did not see the systematic exploration described in the literature. Rather, our data show that bioethicists tended to employ elements of the rational model at particular turning points in the decision-making process in order to achieve pragmatic goals. As mediators, bioethicists worked to create consensus between family and staff and provided invaluable sympathy and comfort to distressed family members. We also found evidence of a context-dependent approach to mediation, with bioethicists' contributions generally supporting staff views about end of life care. Bioethicists' called to consult on family meetings about end of life care do not appear to adhere to a strict interpretation of the official guidelines. In order to negotiate the difficult terrain of end of life decision making, our data show that bioethicists often add a third role, "persuader", to official roles of "consultant" and "mediator".

  13. Issues surrounding end-of-life decision-making

    Tejwani V

    2013-08-01

    Full Text Available Vickram Tejwani,1,* YiFan Wu,1,* Sabrina Serrano,2 Luis Segura,2 Michael Bannon,3 Qi Qian1 1Department of Medicine, Division of Nephrology and Hypertension, 2Mayo Graduate School, 3Department of Trauma, Critical Care, and General Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA *These authors contributed equally to this work Abstract: End-of-life decision-making is a complex process that can be extremely challenging. We describe a 42-year-old woman in an irreversible coma without an advance directive. The case serves to illustrate the complications that can occur in end-of-life decision-making and challenges in resolving difficult futility disputes. We review the role of advance directives in planning end-of-life care, the responsibility and historical performance of patient surrogates, the genesis of futility disputes, and approaches to resolving disputes. Keywords: end-of-life care, advance directive, surrogate, futility dispute, conflict resolution

  14. Economic and Social Council ends meeting after considering poverty.

    1993-09-01

    An overview is provided of the recent meetings of the UN Economic and Social Council (UNESC) in Geneva during July 1993. The issues of the meetings focused on poverty alleviation and population issues and plans for the International Conference on Population and Development. More than 100 resolutions and decisions were approved by the UNESC Commissions. In the meeting held on June 29-30, 1993, Boutros Boutros-Ghali, Secretary General of the UN, addressed 15 ministers and 38 senior government officials and representatives of multilateral financial and trade institutions. He said that an unstable society undermines a stable economy and a stable political order. Social development must be the basis of all development. Social development has the goal of the alleviating poverty in the marginalization of populations, in discrimination in social relationship, in rootlessness of culture, and in vulnerability in ecology. The priority is in attacking poverty first. The World Summit to be held in March 1995 should enlist international cooperation in ending poverty. The UN marks its 50th anniversary also at that time, and the Summit would provide an opportunity to begin dealing with real and tangible issues such as poverty, social integration and employment. All countries are in need of formulating new directions in social policy and policies that accounting for the interrelationships globally in such a way as to put the best interests of all nations at the forefront. Development and international cooperation must "put people first." The meetings also addressed the issue of women's integration into society and the need to invest in women, as part of changing gender discrimination and contributing to their full participation in socioeconomic development. The Council requested an extension to meetings scheduled for April 1994 and the preparation of documentation by Dr. Nafis Sadik, Executive Director of the UN Population Fund that would include this Council meeting

  15. Ending War and Making Peace in Scandinavia, 1814–1848

    Ottosen, Morten Nordhagen

    2016-01-01

    The Napoleonic wars had a tremendous impact on the Scandinavian countries. Political and social upheaval and economic disruption ensured that ending war was no straightforward or rapid process. For traumatized veterans and those who had lost a husband or father, war never quite ended, to say...... nothing of those who remained under military occupation even after the nominal conclusion of peace. Still, the parallel process of making peace after 1815 was quite remarkable in Scandinavia, as 300 years of bitter rivalry, enmity, and perpetual conflict rapidly gave way to reconciliation to a point where...

  16. End-of-life decision making is more than rational.

    Eliott, Jaklin A; Olver, Ian N

    2005-01-01

    Most medical models of end-of-life decision making by patients assume a rational autonomous adult obtaining and deliberating over information to arrive at some conclusion. If the patient is deemed incapable of this, family members are often nominated as substitutes, with assumptions that the family are united and rational. These are problematic assumptions. We interviewed 23 outpatients with cancer about the decision not to resuscitate a patient following cardiopulmonary arrest and examined their accounts of decision making using discourse analytical techniques. Our analysis suggests that participants access two different interpretative repertoires regarding the construct of persons, invoking a 'modernist' repertoire to assert the appropriateness of someone, a patient or family, making a decision, and a 'romanticist' repertoire when identifying either a patient or family as ineligible to make the decision. In determining the appropriateness of an individual to make decisions, participants informally apply 'Sanity' and 'Stability' tests, assessing both an inherent ability to reason (modernist repertoire) and the presence of emotion (romanticist repertoire) which might impact on the decision making process. Failure to pass the tests respectively excludes or excuses individuals from decision making. The absence of the romanticist repertoire in dominant models of patient decision making has ethical implications for policy makers and medical practitioners dealing with dying patients and their families.

  17. The rational choice model in family decision making at the end of life.

    Karasz, Alison; Sacajiu, Galit; Kogan, Misha; Watkins, Liza

    2010-01-01

    Most end-of-life decisions are made by family members. Current ethical guidelines for family decision making are based on a hierarchical model that emphasizes the patient's wishes over his or her best interests. Evidence suggests that the model poorly reflects the strategies and priorities of many families. Researchers observed and recorded 26 decision-making meetings between hospital staff and family members. Semi-structured follow-up interviews were conducted. Transcriptions were analyzed using qualitative techniques. For both staff and families, consideration of a patient's best interests generally took priority over the patient's wishes. Staff generally introduced discussion of the patient's wishes for rhetorical purposes, such as persuasion. Competing moral frameworks, which de-emphasized the salience of patients' autonomy and "right to choose," played a role in family decision making. The priority given to the patients' wishes in the hierarchical model does not reflect the priorities of staff and families in making decisions about end-of-life care.

  18. Team Leadership and Cancer End-of-Life Decision Making.

    Waldfogel, Julie M; Battle, Dena J; Rosen, Michael; Knight, Louise; Saiki, Catherine B; Nesbit, Suzanne A; Cooper, Rhonda S; Browner, Ilene S; Hoofring, Laura H; Billing, Lynn S; Dy, Sydney M

    2016-11-01

    End-of-life decision making in cancer can be a complicated process. Patients and families encounter multiple providers throughout their cancer care. When the efforts of these providers are not well coordinated in teams, opportunities for high-quality, longitudinal goals of care discussions can be missed. This article reviews the case of a 55-year-old man with lung cancer, illustrating the barriers and missed opportunities for end-of-life decision making in his care through the lens of team leadership, a key principle in the science of teams. The challenges demonstrated in this case reflect the importance of the four functions of team leadership: information search and structuring, information use in problem solving, managing personnel resources, and managing material resources. Engaging in shared leadership of these four functions can help care providers improve their interactions with patients and families concerning end-of-life care decision making. This shared leadership can also produce a cohesive care plan that benefits from the expertise of the range of available providers while reflecting patient needs and preferences. Clinicians and researchers should consider the roles of team leadership functions and shared leadership in improving patient care when developing and studying models of cancer care delivery.

  19. Perceived risks around choice and decision making at end-of-life: a literature review.

    Wilson, F; Gott, M; Ingleton, C

    2013-01-01

    the World Health Organization identifies meeting patient choice for care as central to effective palliative care delivery. Little is known about how choice, which implies an objective balancing of options and risks, is understood and enacted through decision making at end-of-life. to explore how perceptions of 'risk' may inform decision-making processes at end-of-life. an integrative literature review was conducted between January and February 2010. Papers were reviewed using Hawker et al.'s criteria and evaluated according to clarity of methods, analysis and evidence of ethical consideration. All literature was retained as background data, but given the significant international heterogeneity the final analysis specifically focused on the UK context. the databases Medline, PsycINFO, Assia, British Nursing Index, High Wire Press and CINAHL were explored using the search terms decision*, risk, anxiety, hospice and palliative care, end-of-life care and publication date of 1998-2010. thematic analysis of 25 papers suggests that decision making at end-of-life is multifactorial, involving a balancing of risks related to caregiver support; service provider resources; health inequalities and access; challenges to information giving; and perceptions of self-identity. Overall there is a dissonance in understandings of choice and decision making between service providers and service users. the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families.

  20. Ethical decision-making near the end of life.

    Finucane, T E; Harper, M

    1996-05-01

    For ethical decision-making near the end of life, autonomy is the moral North Star. At the same time, for some treatments, the burdens so clearly outweigh benefits that physicians may make a judgment not to offer the treatment. This is often clearer in surgery. A person with colon cancer and metastases may not insist on resection of the metastases. For some reason, some treatments have escaped these logical constraints. Attempted resuscitation of a dying patient is a good example. The circumstances in which a physician may make choices on behalf of a competent, terminally-ill patient without consent, and even without notification, are hotly debated, but data suggest that physicians do so frequently. Patients who lack capacity present even more difficult challenges. Advance directives, when available, can be extremely helpful, but even with them difficult problems can remain. If advance directives have not been established, family and close friends are an obvious source of guidance. Their legal role varies in different jurisdictions; in practice, they are crucial in bedside decision-making. Guardianship and alternatives to it remain a poor last resort. Euthanasia is a very difficult problem. We believe it is semantically misleading to lump under the term "passive euthanasia" those circumstances where potentially life-sustaining treatment is withheld or withdrawn. The tension between patient autonomy and medical common sense remains unresolved within the "futility" controversy. The authors believe it serves no purpose to discuss carefully with dying patients propositions that are nonsense. At the same time, physicians must not confuse decisions about quality of life with judgements about treatment effectiveness. We believe that what many, although not all, dying patients want are physicians with intelligent compassion who can take care of them through the dying process.

  1. Determinantes sociales frente a estilos de vida en la diabetes mellitus de tipo 2 en Andalucía: ¿la dificultad para llegar a fin de mes o la obesidad? Social determinants vs. lifestyle in type 2 diabetes mellitus in Andalusia (Spain: difficulty in making ends meet or obesity?

    Antonio Escolar Pujolar

    2009-10-01

    Full Text Available Objetivo: Valorar las relaciones de la dificultad para llegar a fin de mes con la obesidad y la diabetes mellitus de tipo 2 en Andalucía. Métodos: Estudio transversal basado en los datos de la Encuesta de Salud de Andalucía-2003. Cálculo de prevalencias y odds ratio (OR de tener diabetes mellitus de tipo 2 según variables de estilo de vida, y de obesidad y diabetes mellitus de tipo 2 según la dificultad autopercibida para llegar a fin de mes. Resultados: La OR ajustada por edad de tener diabetes mellitus de tipo 2 en personas obesas respecto a las de peso normal fue de 2,52 (intervalo de confianza del 95% [IC95%]:1,63-3,88 y de 2,13 (IC95%:1,28-3,54 en las mujeres y los hombres, respectivamente. El sedentarismo no se asoció con un riesgo significativo de diabetes mellitus de tipo 2 en ninguno de los dos sexos. Para las mujeres con mayor dificultad económica para llegar a fin de mes, respecto a las que tienen más facilidades, la OR de ser obesa, ajustada por edad y ejercicio físico, fue de 3,03 (IC95%:1,96-4,66, y la de diabetes mellitus de tipo 2, ajustada por edad, ejercicio físico e índice de masa corporal, fue de 2,55 (IC95%:1,28-5,10. En los hombres ninguna de las OR fue estadísticamente significativa. Conclusión: En las mujeres, las dificultades para llegar a fin de mes reflejan un contexto socioeconómico favorecedor de obesidad y de diabetes mellitus de tipo 2. Las desigualdades de clase social y género identificadas pueden contribuir a ampliar el actual marco explicativo de los determinantes de la diabetes mellitus de tipo 2, excesivamente centrado en las conductas individuales. La dificultad autopercibida para llegar a fin de mes podría utilizarse como indicador de pobreza en los estudios de desigualdades en salud.Objective: To assess the relationship between difficulty in making ends meet and obesity and type 2 diabetes mellitus in Andalusia. Methods: We performed a cross-sectional survey based on the Andalusian Health

  2. Meeting Wise: Making the Most of Collaborative Time for Educators

    Boudett, Kathryn Parker; City, Elizabeth A.

    2014-01-01

    This book, by two editors of "Data Wise: A Step-by-Step Guide to Using Assessment Results to Improve Teaching and Learning," attempts to bring about a fundamental shift in how educators think about the meetings we attend. They make the case that these gatherings are potentially the most important venue where adult and organizational…

  3. Urban Biomining Meets Printable Electronics: End-To-End at Destination Biological Recycling and Reprinting

    Rothschild, Lynn J. (Principal Investigator); Koehne, Jessica; Gandhiraman, Ram; Navarrete, Jesica; Spangle, Dylan

    2017-01-01

    Space missions rely utterly on metallic components, from the spacecraft to electronics. Yet, metals add mass, and electronics have the additional problem of a limited lifespan. Thus, current mission architectures must compensate for replacement. In space, spent electronics are discarded; on earth, there is some recycling but current processes are toxic and environmentally hazardous. Imagine instead an end-to-end recycling of spent electronics at low mass, low cost, room temperature, and in a non-toxic manner. Here, we propose a solution that will not only enhance mission success by decreasing upmass and providing a fresh supply of electronics, but in addition has immediate applications to a serious environmental issue on the Earth. Spent electronics will be used as feedstock to make fresh electronic components, a process we will accomplish with so-called 'urban biomining' using synthetically enhanced microbes to bind metals with elemental specificity. To create new electronics, the microbes will be used as 'bioink' to print a new IC chip, using plasma jet electronics printing. The plasma jet electronics printing technology will have the potential to use martian atmospheric gas to print and to tailor the electronic and chemical properties of the materials. Our preliminary results have suggested that this process also serves as a purification step to enhance the proportion of metals in the 'bioink'. The presence of electric field and plasma can ensure printing in microgravity environment while also providing material morphology and electronic structure tunabiity and thus optimization. Here we propose to increase the TRL level of the concept by engineering microbes to dissolve the siliceous matrix in the IC, extract copper from a mixture of metals, and use the microbes as feedstock to print interconnects using mars gas simulant. To assess the ability of this concept to influence mission architecture, we will do an analysis of the infrastructure required to execute

  4. A survey of views and practice patterns of dialysis medical directors toward end-of-life decision making for patients with end-stage renal disease.

    Fung, Enrica; Slesnick, Nate; Kurella Tamura, Manjula; Schiller, Brigitte

    2016-07-01

    Patients with end-stage renal disease report infrequent end-of-life discussions, and nephrology trainees report feeling unprepared for end-of-life decision making, but the views of dialysis medical directors have not been studied. Our objective is to understand dialysis medical directors' views and practice patterns on end-of-life decision making for patients with ESRD. We administered questionnaires to dialysis medical directors during medical director meetings of three different dialysis organizations in 2013. Survey questions corresponded to recommendations from the Renal Physicians Association clinical practice guidelines on initiation and withdrawal of dialysis. There were 121 medical director respondents from 28 states. The majority of respondents felt "very prepared" (66%) or "somewhat prepared" (29%) to participate in end-of-life decisions and most (80%) endorsed a model of shared decision making. If asked to do so, 70% of the respondents provided prognostic information "often" or "nearly always." For patients with a poor prognosis, 36% of respondents would offer a time-limited trial of dialysis "often" or "nearly always", while 56% of respondents would suggest withdrawal from dialysis "often" or "nearly always" for those with a poor prognosis currently receiving dialysis therapy. Patient resistance and fear of taking away hope were the most commonly cited barriers to end-of-life discussions. Views and reported practice patterns of medical directors are consistent with clinical practice guidelines for end-of-life decision making for patients with end-stage renal disease but inconsistent with patient perceptions. © The Author(s) 2016.

  5. Eliciting regret improves decision making at the end of life.

    Djulbegovic, Benjamin; Tsalatsanis, Athanasios; Mhaskar, Rahul; Hozo, Iztok; Miladinovic, Branko; Tuch, Howard

    2016-11-01

    Management choices at the end of life are high-stake decisions fraught with emotions, chief among is regret. Our objective in this paper is to test the utility of a regret-based model to facilitate referral to hospice care while helping patients clarify their preferences on how they wish to spend the remaining days of their lives. A prospective cohort study that enrolled consecutive adult patients (n = 178) aware of the terminal nature of their disease. The patients were at the point in care where they had to decide between continuing potentially 'curative/life-prolonging' treatment (Rx) versus hospice care. Preferences were elicited using a Dual Visual Analog Scale regarding the level of regret of omission versus commission (RgO/RgC) towards hospice care and Rx. Each patient's RgO/RgC was contrasted against the predictive probability of death to suggest a management plan, which was then compared with the patient's actual choice. The probability of death was estimated using validated Palliative Performance Scale predictive model. Eighty-five percent (151/178) of patients agreed with the model's recommendations (p < 0.000001). Model predicted the actual choices for 72% (128/178) of patients (p < 0.00001). Logistic regression analysis showed that people who were initially inclined to be referred to hospice and were predicted to choose hospice over disease-directed treatment by the regret model have close to 98% probability of choosing hospice care at the end of their lives. No other factors (age, gender, race, educational status and pain level) affected their choice. Using regret to elicit choices in the end-of-life setting is both descriptively and prescriptively valid. People with terminal disease who are initially inclined to choose hospice and do not regret such a choice will select hospice care with high level of certainty. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. Making Money is not an End in Itself

    Svensson, Christian Franklin

    2014-01-01

    The different experiences, motivations and negotiations associated with the social and profit-making dimensions of money are of central concern to the employees of social enterprises. These negotiations become apparent because the social dimension plays a primary role within such organizations....... Consequently, it is important for employees that a balance should be achieved between the two. The meaningfulness of what social enterprises do in expression of their social relations introduces a broader discussion of employees as actors who are embedded within and act across several dimensions and traditions....

  7. Nurse involvement in end-of-life decision making: the ETHICUS Study

    Benbenishty, Julie; Ganz, Freda DeKeyser; Lippert, Anne

    2006-01-01

    The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making.......The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making....

  8. Putting the use of intuition for fuzzy front end decision making on the research agenda

    Eling, K.; Langerak, F.

    2011-01-01

    Decision making literature suggests that intuitive decision making is more appropriate than the established rational decision making approaches to handle the specific information processing needs of the fuzzy front end (FFE) of new product development. However, these earlier studies cannot be

  9. Health Care Decisions at the End of Life: Theological and Ethical Foundations for Decision Making.

    Allegretti, Joseph G.

    This paper provides a framework for making sense of perplexing problems surrounding issues of death and dying by exploring the theological and ethical background to health care decision making at the end of life. The paper first examines several of the basic principles that theologians and secular ethicists employ when analyzing such questions.…

  10. Using intuition in fuzzy front-end decision-making : a conceptual framework

    Eling, K.; Griffin, A.; Langerak, F.

    2014-01-01

    The goal of decision-making during the execution of the fuzzy front end (FFE) is to develop a creative new product concept. Although intuitive decision-making has been found to increase new product creativity, the theoretical knowledge base as to why and under which conditions intuition use during

  11. The enactment stage of end-of-life decision-making for children.

    Sullivan, Jane Elizabeth; Gillam, Lynn Heather; Monagle, Paul Terence

    2018-01-11

    Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process. A qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed. Twenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child's condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people's actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention. Significance of results A novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular

  12. Theories of Health Care Decision Making at the End of Life: A Meta-Ethnography.

    Kim, Kyounghae; Heinze, Katherine; Xu, Jiayun; Kurtz, Melissa; Park, Hyunjeong; Foradori, Megan; Nolan, Marie T

    2017-08-01

    The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015. Forty-three articles were included. The most common theories included decision-making models ( n = 14) followed by family-centered ( n = 11) and behavioral change models ( n = 7). A conceptual framework was developed using themes including context of decision making, communication and negotiation of decision making, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes. Future research should enhance and apply these theories to guide research to develop patient-centered decision-making programs that facilitate informed and shared decision making at the end of life among patients with advanced illness and their caregivers.

  13. End-of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making.

    Schüklenk, Udo; van Delden, Johannes J M; Downie, Jocelyn; McLean, Sheila A M; Upshur, Ross; Weinstock, Daniel

    2011-11-01

    This report on end-of-life decision-making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters. Chapter 1 reviews what is known about end-of-life care and opinions about assisted dying in Canada. Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death. Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order. Chapter 4 reviews the experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form. Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. © 2011 Blackwell Publishing Ltd.

  14. Preferences for autonomy in end-of-life decision making in modern Korean society.

    Kim, Su Hyun

    2015-03-01

    The demand for autonomy in medical decision making is increasing among Korean people, but it is not well known why some people prefer autonomy in decision making but others do not. The aim of this study was to determine the extent to which Korean adults wished to exercise autonomy in the process of decision making regarding end-of-life treatment and to determine whether economic issues and family functioning, in particular, were associated with preferences for participation in decision making in Korean people. This study was a cross-sectional correlational study using a survey. Data were collected using structured questionnaires from 354 patients or their families who visited ambulatory departments at two general hospitals in South Korea, recruited by the proportionate quota sampling method. Data analysis was performed using multinomial logistic regression analyses. The study was approved by the hospitals' directors and the ethics committee of Kyungpook National University Hospital. Written informed consent was given by all participants. A majority of Korean people wanted to make autonomous decisions regarding treatment at the end of life. Preferences for autonomous decision making regarding end-of-life treatment, rather than relying on family, showed a significant increase in association with poor family functioning and low income. Results of this study suggested the necessity for development of alternatives to a dominant traditional "family-centered" approach in Korean people, in order to enhance end-of-life decision making for people who wish to take an active role in the decision-making process. Healthcare providers need to examine not only patients' preferred decision-making style but also any reasons for their choice, in particular, family conflict and financial burden. © The Author(s) 2014.

  15. Communication and Decision-Making About End-of-Life Care in the Intensive Care Unit.

    Brooks, Laura Anne; Manias, Elizabeth; Nicholson, Patricia

    2017-07-01

    Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. The study was conducted in a 24-bed intensive care unit in Melbourne, Australia. An interpretative, qualitative inquiry was used, with focus groups as the data collection method. Intensive care nurses and physicians were recruited to participate in a discipline-specific focus group. Focus group discussions were audio-recorded, transcribed, and subjected to thematic data analysis. Five focus groups were conducted; 17 nurses and 11 physicians participated. The key aspects discussed included communication and shared decision-making. Themes related to communication included the timing of end-of-life care discussions and conducting difficult conversations. Implementation and multidisciplinary acceptance of end-of-life care plans and collaborative decisions involving patients and families were themes related to shared decision-making. Effective communication and decision-making practices regarding initiating end-of-life care in the intensive care unit are important. Multidisciplinary implementation and acceptance of end-of-life care plans in the intensive care unit need improvement. Clear organizational processes that support the introduction of nurse and physician end-of-life care leaders are essential to optimize outcomes for patients, family members, and clinicians. ©2017 American Association of Critical-Care Nurses.

  16. Family members' informal roles in end-of-life decision making in adult intensive care units.

    Quinn, Jill R; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A; Dombeck, Mary T; Sellers, Craig R

    2012-01-01

    To support the process of effective family decision making, it is important to recognize and understand informal roles that various family members may play in the end-of-life decision-making process. To describe some informal roles consistently enacted by family members involved in the process of end-of-life decision making in intensive care units. Ethnographic study. Data were collected via participant observation with field notes and semistructured interviews on 4 intensive care units in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical, a surgical, a burn and trauma, and a cardiovascular intensive care unit. Health care clinicians, patients, and family members. Informal roles for family members consistently observed were primary caregiver, primary decision maker, family spokesperson, out-of-towner, patient's wishes expert, protector, vulnerable member, and health care expert. The identified informal roles were part of families' decision-making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision making within the family system and between the family and health care domains. These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these informal roles of family members can help clinicians recognize and understand the functions of these roles in families' decision making at the end of life and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes.

  17. Medical futility in children's nursing: making end-of-life decisions.

    Brien, Irene O; Duffy, Anita; Shea, Ellen O

    Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of 'parental autonomy' and 'the child's best interests' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children's nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children's nursing.

  18. What parents want from doctors in end-of-life decision-making for children.

    Sullivan, J; Monagle, P; Gillam, L

    2014-03-01

    End-of-life decision-making is difficult for everyone involved, as many studies have shown. Within this complexity, there has been little information on how parents see the role of doctors in end-of-life decision-making for children. This study aimed to examine parents' views and experiences of end-of-life decision-making. A qualitative method with a semistructured interview design was used. Parent participants were living in the community. Twenty-five bereaved parents. Parents reported varying roles taken by doctors: being the provider of information without opinion; giving information and advice as to the decision that should be taken; and seemingly being the decision maker for the child. The majority of parents found their child's doctor enabled them to be the ultimate decision maker for their child, which was what they very clearly wanted to be, and consequently enabled them to exercise their parental autonomy. Parents found it problematic when doctors took over decision-making. A less frequently reported, yet significant role for doctors was to affirm decisions after they had been made by parents. Other important aspects of the doctor's role were to provide follow-up support and referral. Understanding the role that doctors take in end-of-life decisions, and the subsequent impact of that role from the perspective of parents can form the basis of better informed clinical practice.

  19. Factors That Impact End-of-Life Decision Making in African Americans With Advanced Cancer

    Campbell, Cathy L.; Williams, Ishan C.; Orr, Tamara

    2013-01-01

    Significance African Americans with cancer are less likely to use hospice services and more likely to die in the hospital than white patients with the same diagnosis. However, there is much that is not understood about the factors that lead African Americans to choose options for end-of-life care. Design A qualitative, descriptive design was used in this pilot study. Methods Interviews were conducted with two groups of African Americans with advanced-stage cancer (people enrolled in hospice and those who were not under hospice care). Findings End-of-life decisions were primarily guided by clinical factors, the patient-related physical, emotional, and cognitive symptoms that are sequelae of the underlying disease or medical treatments. The physician was the healthcare provider most likely to be involved in decision making with patients, family members, and caregivers. Individual factors, such as personal beliefs, influenced end-of-life decision making. Religion and spirituality were a topic in many interviews, but they did not consistently influence decision making. Discussion Future studies should include interviews with family members, caregivers, and healthcare professionals so that factors that impact end-of-life decision making can be fully described. Strategies to facilitate recruitment will need to be added to future protocols. PMID:23645999

  20. End-of-life decision-making for children with severe developmental disabilities: The parental perspective

    Zaal-Schuller, I. H.; de Vos, M. A.; Ewals, F. V. P. M.; van Goudoever, J. B.; Willems, D. L.

    2016-01-01

    The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and

  1. End-of-life decision-making for children with severe developmental disabilities: The parental perspective.

    Zaal-Schuller, I H; de Vos, M A; Ewals, F V P M; van Goudoever, J B; Willems, D L

    2016-01-01

    The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and PsycINFO. The search was limited to articles in English or Dutch published between January 2004 and August 2014. We included qualitative and quantitative original studies that directly investigated the experiences of parents of children aged 0-18 years with severe developmental disorders for whom an end-of-life decision had been considered or made. We identified nine studies that met all inclusion criteria. Reportedly, parental involvement in end-of-life decision-making varied widely, ranging from having no involvement to being the sole decision-maker. Most parents preferred to actively share in the decision-making process regardless of their child's specific diagnosis or comorbidity. The main factors that influenced parents in their decision-making were: their strong urge to advocate for their child's best interests and to make the best (possible) decision. In addition, parents felt influenced by their child's visible suffering, remaining quality of life and the will they perceived in their child to survive. Most parents of children with severe developmental disorders wish to actively share in the end-of-life decision-making process. An important emerging factor in this process is the parents' feeling that they have to stand up for their child's interests in conversations with the medical team. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Family communication and decision making at the end of life: a literature review.

    Wallace, Cara L

    2015-06-01

    Patients and families coping with a terminal illness are faced with a number of decisions over the course of their disease. The role that family communication plays in the process of decision making is an important one. The objectives for this review are to examine the current state of empirical literature on the relationship between family communication and decision making about end-of-life care, to identify gaps, and to discuss implications for policy, practice, and future research. Articles were identified using systematic keyword searches within the following relevant databases: Academic Search Complete, CINAHL Plus, Communications and Mass Media Complete, ERIC, PsychINFO, MEDLINE, SocINDEX, and ProQuest. The three bodies of relevant literature that emerged during this review include: (1) the importance of family communication at the end of life (EoL); (2) family decision making at the EoL; and (3) the interrelationship of communication (both within the family and with healthcare professionals) and decision making at the EoL. While the literature highlights the role of communication between medical professionals and the patient or family members, there is very little focus on the process of how family communication among the family members themselves contributes to decision making at the end of life. Barriers to end-of-life care are important considerations for helping patients to access timely and appropriate services. Understanding the pertinent role of family communication as it relates to the decision for EoL care is the first step in working to provide another avenue for overcoming these barriers.

  3. 77 FR 17001 - USDA Public Stakeholder Meeting: Match Making in the Biofuels Value Chain

    2012-03-23

    ... DEPARTMENT OF AGRICULTURE USDA Public Stakeholder Meeting: Match Making in the Biofuels Value... and representatives from the participating stakeholders will respond with short formal presentations... through USDA's security clearance. ADDRESSES: Patio, United States Department of Agriculture Whitten...

  4. Medical futility in children's nursing: making end-of-life decisions.

    Brien, Irene O

    2012-02-01

    Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts\\' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of \\'parental autonomy\\' and \\'the child\\'s best interests\\' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents\\' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children\\'s nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children\\'s nursing.

  5. A qualitative study of women's decision-making at the end of IVF treatment.

    Peddie, V L; van Teijlingen, E; Bhattacharya, S

    2005-07-01

    The decision not to pursue further in vitro fertilization (IVF) after one or more unsuccessful attempts is an important and often difficult one for couples. Relatively little is known about the woman's perception of this decision-making process. The aim of this study was to examine patients' perspectives of decision-making, including circumstances influencing it and satisfaction with the decision-making process. Semi-structured interviews were conducted with a purposive sample of 25 women who had decided to end treatment after unsuccessful IVF treatment. Interviews were tape-recorded and transcribed by means of thematic analysis using the open coding technique. Women experienced difficulty in accepting that their infertility would remain unresolved. Many felt that they had started with unrealistic expectations of treatment success and felt vulnerable to the pressures of both the media and society. Although the decision to end treatment was difficult, it offered many women a way out of the emotional distress caused by IVF; however, the process of decision-making created a sense of 'confrontation' for the women in which they had to address issues they had previously avoided. Adoptive parents perceived less societal pressure than those who remained childless. Efforts to improve the psychological preparation of couples who decide to end IVF treatment should be directed towards examination of the existing system of consultation, which has certain limitations in terms of the quality of communication and the provision of post-treatment support. Further efforts to develop strategies, which facilitate the decision-making process, should be considered.

  6. The End-to-end Demonstrator for improved decision making in the water sector in Europe (EDgE)

    Wood, Eric; Wanders, Niko; Pan, Ming; Sheffield, Justin; Samaniego, Luis; Thober, Stephan; Kumar, Rohinni; Prudhomme, Christel; Houghton-Carr, Helen

    2017-04-01

    High-resolution simulations of water resources from hydrological models are vital to supporting important climate services. Apart from a high level of detail, both spatially and temporally, it is important to provide simulations that consistently cover a range of timescales, from historical reanalysis to seasonal forecast and future projections. In the new EDgE project commissioned by the ECMWF (C3S) we try to fulfill these requirements. EDgE is a proof-of-concept project which combines climate data and state-of-the-art hydrological modelling to demonstrate a water-oriented information system implemented through a web application. EDgE is working with key European stakeholders representative of private and public sectors to jointly develop and tailor approaches and techniques. With these tools, stakeholders are assisted in using improved climate information in decision-making, and supported in the development of climate change adaptation and mitigation policies. Here, we present the first results of the EDgE modelling chain, which is divided into three main processes: 1) pre-processing and downscaling; 2) hydrological modelling; 3) post-processing. Consistent downscaling and bias corrections for historical simulations, seasonal forecasts and climate projections ensure that the results across scales are robust. The daily temporal resolution and 5km spatial resolution ensure locally relevant simulations. With the use of four hydrological models (PCR-GLOBWB, VIC, mHM, Noah-MP), uncertainty between models is properly addressed, while consistency is guaranteed by using identical input data for static land surface parameterizations. The forecast results are communicated to stakeholders via Sectoral Climate Impact Indicators (SCIIs) that have been created in collaboration with the end-user community of the EDgE project. The final product of this project is composed of 15 years of seasonal forecast and 10 climate change projections, all combined with four hydrological

  7. Meeting

    energy is becoming less important in shaping economic growth ... making more efficient use of energy, it becomes possible to ... speech that Professor Raman gave at the Science. Congress held at ... as free from technicalities as possible, a general account of the ..... end to end as in surface films of long-chain fatty acids.

  8. End-of-life decision-making and terminal sedation among very old patients.

    De Gendt, Cindy; Bilsen, Johan; Mortier, Freddy; Vander Stichele, Robert; Deliens, Luc

    2009-01-01

    About half of the persons who die in developed countries are very old (aged 80 years or older) and this proportion is still rising. In general, there is little information available concerning the circumstances and quality of the end of life of this group. This study aims (1) to describe the incidence and characteristics of medical end-of-life decisions with a possible or certain life-shortening effect (ELDs) and terminal sedation among very old patients who died nonsuddenly, (2) to describe the characteristics of the preceding decision-making process, and (3) to compare this with the deaths of younger patients. A sample of 5,005 death certificates was selected from all deaths in Flanders (Belgium) in the second half of 2001 (before euthanasia was legalized). Questionnaires were mailed to the certifying physicians. Response rate was 58.9%. An ELD was made for 53.6% very old (aged 80+) patients who died nonsuddenly (vs. 63.3% for the younger patients). Use of life-ending drugs occurred among 1.1% (six times less frequently than in younger patients), with no euthanasia cases, pain and symptom alleviation with a possible life-shortening effect among 27.3% (two times less frequently), and withholding or withdrawing life-prolonging treatments among 25.2% (slightly more frequently). Terminal sedation occurred among 6.9% of the cases, two times less frequently than for the younger patients. ELDs were not often discussed with very old patients. Among competent patients this was less than compared with younger patients. ELDs are less common for very old than for younger patients. Physicians seem to have a more reluctant attitude towards the use of lethal drugs, terminal sedation and participation in decision-making when dealing with very old patients. Advance care planning should increase the involvement of very old competent and noncompetent patients in end-of-life decision-making. (c) 2008 S. Karger AG, Basel.

  9. Transparency in Transcribing: Making Visible Theoretical Bases Impacting Knowledge Construction from Open-Ended Interview Records

    Audra Skukauskaite

    2012-01-01

    Full Text Available This article presents a reflexive analysis of two transcripts of an open-ended interview and argues for transparency in transcribing processes and outcomes. By analyzing ways in which a researcher's theories become consequential in producing and using transcripts of an open-ended interview, this paper makes visible the importance of examining and presenting theoretical bases of transcribing decisions. While scholars across disciplines have argued that transcribing is a theoretically laden process (GREEN, FRANQUIZ & DIXON, 1997; KVALE & BRINKMAN, 2009, few have engaged in reflexive analyses of the data history to demonstrate the consequences particular theoretical and methodological approaches pose in producing knowledge claims and inciting dialogues across traditions. The article demonstrates how theory-method-claim relationships in transcribing influence research transparency and warrantability. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1201146

  10. End of life care and decision making: Opinions and experiences of the general public, bereaved relatives, and professionals

    N.J.H. Raijmakers (Natasja)

    2013-01-01

    textabstractEnd-of-life care aims to improve quality of life of patients and their relatives facing problems associated with life-threatening illness in the last days of life. End-of-life decision-making is an important aspect of end-of-life care that can have a significant impact on the process of

  11. Making the case for talking to patients about the costs of end-of-life care.

    Donley, Greer; Danis, Marion

    2011-01-01

    Costs at the end of life disproportionately contribute to health care costs in the United States. Addressing these costs will therefore be an important component in making the U.S. health care system more financially sustainable. In this paper, we explore the moral justifications for having discussions of end-of-life costs in the doctor-patient encounter as part of an effort to control costs. As health care costs are partly shared through pooled resources, such as insurance and taxation, and partly borne by individuals through out-of-pocket expenses, we separate our defense for, and approach to, discussing both pooled and individual aspects of cost. We argue that there needs to be a shift away from formulating the options as a dichotomous choice of paying attention to end-of-life costs versus ignoring such costs. The question should be how personal costs will be managed and how societal expenditures should be allocated. These are issues that we believe patients care about and need to have addressed in a manner with which they are comfortable. Conversations about how money will be spent at the end of life should begin before the end is near. We propose discussing costs from the onset of chronic illness and incorporating financial issues in advance care planning. Through these approaches one can avoid abruptly and insensitively introducing financial issues at the very conclusion of a person's life when one would prefer to address the painful and important issues of spiritual and existential loss that are appropriately the focus when a person is dying. © 2011 American Society of Law, Medicine & Ethics, Inc.

  12. Making public ahead of print: Meetings and publications at the Royal Society, 1752?1892

    Fyfe, Aileen; Moxham, Noah

    2016-01-01

    This essay examines the interplay between the meetings and publications of learned scientific societies during the eighteenth and nineteenth centuries, when journals were an established but not yet dominant form of scholarly communication. The practice of ‘making public’ research at meetings, long before actual ‘publication’ in society periodicals, enabled a complex of more-or-less formal sites of communication and discussion ahead of print. Using two case studies from the Royal Society of Lo...

  13. Supporting End of Life Decision Making: Case Studies of Relational Closeness in Supported Decision Making for People with Severe or Profound Intellectual Disability

    Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

    2017-01-01

    Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…

  14. Evaluation of End-Products in Architecture Design Process: A Fuzzy Decision-Making Model

    Serkan PALABIYIK

    2012-06-01

    Full Text Available This paper presents a study on the development of a fuzzy multi-criteria decision-making model for the evaluation of end products of the architectural design process. Potentials of the developed model were investigated within the scope of architectural design education, specifically an international design studio titled “Design for Disassembly and Reuse: Design & Building Multipurpose Transformable Pavilions.” The studio work followed a design process that integrated systematic and heuristic thinking. The design objectives and assessment criteria were clearly set out at the beginning of the process by the studio coordinator with the aim of narrowing the design space and increasing awareness of the consequences of design decisions. At the end of the design process, designs produced in the studio were evaluated using the developed model to support decision making. The model facilitated the identification of positive and negative aspects of the designs and selection of the design alternative that best met the studio objectives set at the beginning.

  15. Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates.

    Jayanti, Anuradha; Neuvonen, Markus; Wearden, Alison; Morris, Julie; Foden, Philip; Brenchley, Paul; Mitra, Sandip

    2015-11-14

    Medical decision-making is critical to patient survival and well-being. Patients with end stage renal disease (ESRD) are faced with incrementally complex decision-making throughout their treatment journey. The extent to which patients seek involvement in the decision-making process and factors which influence these in ESRD need to be understood. 535 ESRD patients were enrolled into the cross-sectional study arm and 30 patients who started dialysis were prospectively evaluated. Patients were enrolled into 3 groups- 'predialysis' (group A), 'in-centre' haemodialysis (HD) (group B) and self-care HD (93 % at home-group C) from across five tertiary UK renal centres. The Autonomy Preference Index (API) has been employed to study patient preferences for information-seeking (IS) and decision-making (DM). Demographic, psychosocial and neuropsychometric assessments are considered for analyses. 458 complete responses were available. API items have high internal consistency in the study population (Cronbach's alpha > 0.70). Overall and across individual study groups, the scores for information-seeking and decision-making are significantly different indicating that although patients had a strong preference to be well informed, they were more neutral in their preference to participate in DM (p gender, marital status; higher API IS scores and white ethnicity background were significant predictors of preference for decision-making. DM scores were subdivided into tertiles to identify variables associated with high (DM > 70: and low DM (≤30) scores. This shows association of higher DM scores with lower age, lower comorbidity index score, higher executive brain function, belonging in the self-caring cohort and being unemployed. In the prospectively studied cohort of predialysis patients, there was no change in decision-making preference scores after commencement of dialysis. ESRD patients prefer to receive information, but this does not always imply active involvement in

  16. Mental competence and surrogate decision-making towards the end of life.

    Strätling, M; Scharf, V E; Schmucker, P

    2004-01-01

    German legislation demands that decisions about the treatment of mentally incompetent patients require an 'informed consent'. If this was not given by the patient him-/herself before he/she became incompetent, it has to be sought by the physician from a guardian, who has to be formally legitimized before. Additionally this surrogate has to seek the permission of a Court of Guardianship (Vormundschaftsgericht), if he/she intends to consent to interventions, which pose significant risks to the health or the life of the person under his/her care. This includes 'end-of-life decisions'. Deviations from this procedure are only allowed in acute emergencies or cases of 'medical futility'. On the basis of epidemiological and demographical data it can be shown that the vast majority of surrogate decisions on incompetent patients in Germany is not covered by legally valid consent. Moreover, the data suggests that if consent were to be requested according to the legal regulations, both the legal and medical system could realistically never cope with the practical consequences of this. Additionally, empiric research has revealed serious deficits concerning medical 'end of life-decisions' and practical performance in palliative care. As a consequence a multidisciplinary discussion has developed in Germany about the reform of present legislation with respect to key-issues like the assessment of mental competence, the options for exercising patient self-determination via advance directives and durable powers of attorney, the improvement of palliative care facilities, the clarification of formal procedures for surrogate decision-making in health care and towards the end of life and the possibilities and their limitations of controlling these decision-making processes 'externally' (e.g., by Guardianship Courts or committees). The authors discuss those proposals, which clearly dominate the present debate: They all aim to comply with the scientific basis of German law, jurisdiction

  17. A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers.

    Washington, Karla T; Oliver, Debra Parker; Gage, L Ashley; Albright, David L; Demiris, George

    2016-03-01

    Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. © The Author(s) 2015.

  18. The anatomy of clinical decision-making in multidisciplinary cancer meetings

    Soukup, Tayana; Petrides, Konstantinos V.; Lamb, Benjamin W.; Sarkar, Somita; Arora, Sonal; Shah, Sujay; Darzi, Ara; Green, James S. A.; Sevdalis, Nick

    2016-01-01

    Abstract In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable. The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision. This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons. We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis. The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = −0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001). Hawthorne effect is the main limitation of the study. The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core

  19. Influence of physicians' life stances on attitudes to end-of-life decisions and actual end-of-life decision-making in six countries

    Cohen, J; van Delden, J; Mortier, F

    2008-01-01

    AIM: To examine how physicians' life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making. METHODS: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland......) and Protestants (up to 20.4% in The Netherlands) reported ever having made such a decision. DISCUSSION: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients...... large life-stance groups in each country. RESULTS: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten...

  20. Decision Making Under Uncertainty - Bridging the Gap Between End User Needs and Science Capability

    Verdon-Kidd, D. C.; Kiem, A.; Austin, E. K.

    2012-12-01

    Successful adaptation outcomes depend on decision making based on the best available climate science information. However, a fundamental barrier exists, namely the 'gap' between information that climate science can currently provide and the information that is practically useful for end users and decision makers. This study identifies the major contributing factors to the 'gap' from an Australian perspective and provides recommendations as to ways in which the 'gap' may be narrowed. This was achieved via a literature review, online survey (targeted to providers of climate information and end users of that information), workshop (where both climate scientists and end users came together to discuss key issues) and focus group. The study confirmed that uncertainty in climate science is a key barrier to adaptation. The issue of uncertainty was found to be multi-faceted, with issues identified in terms of communication of uncertainty, misunderstanding of uncertainty and the lack of tools/methods to deal with uncertainty. There were also key differences in terms of expectations for the future - most end users were of the belief that uncertainty associated with future climate projections would reduce within the next five to 10 years, however producers of climate science information were well aware that this would most likely not be the case. This is a concerning finding as end users may delay taking action on adaptation and risk planning until the uncertainties are reduced - a situation which may never eventuate or may occur after the optimal time for action. Improved communication and packaging of climate information was another key theme that was highlighted in this study. Importantly, it was made clear that improved communication is not just about more glossy brochures and presentations by climate scientists, rather there is a role for a program or group to fill this role (coined a 'knowledge broker' during the workshop and focus group). The role of the 'knowledge

  1. Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.

    Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

    2016-11-01

    End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.

  2. Progress making the top end optical assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope

    Canzian, Blaise; Barentine, J.; Arendt, J.; Bader, S.; Danyo, G.; Heller, C.

    2012-09-01

    L-3 Integrated Optical Systems (IOS) Division has been selected by the National Solar Observatory (NSO) to design and produce the Top End Optical Assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope (ATST) to operate at Haleakal', Maui. ATST will perform to a very high optical performance level in a difficult thermal environment. The TEOA, containing the 0.65-meter silicon carbide secondary mirror and support, mirror thermal management system, mirror positioning and fast tip-tilt system, field stop with thermally managed heat dump, thermally managed Lyot stop, safety interlock and control system, and support frame, operates in the "hot spot" at the prime focus of the ATST and so presents special challenges. In this paper, we describe progress in the L-3 technical approach to meeting these challenges, including silicon carbide off-axis mirror design, fabrication, and high accuracy figuring and polishing all within L-3; mirror support design; the design for stray light control; subsystems for opto-mechanical positioning and high accuracy absolute mirror orientation sensing; Lyot stop design; and thermal management of all design elements to remain close to ambient temperature despite the imposed solar irradiance load.

  3. Communication skills training for dialysis decision-making and end-of-life care in nephrology.

    Schell, Jane O; Green, Jamie A; Tulsky, James A; Arnold, Robert M

    2013-04-01

    Nephrology fellows often face difficult conversations about dialysis initiation or withdrawal but are frequently unprepared for these discussions. Despite evidence that communication skills are teachable, few fellowship programs include such training. A communication skills workshop for nephrology fellows (NephroTalk) focused on delivering bad news and helping patients define care goals, including end-of-life preferences. This 4-hour workshop, held in October and November 2011, included didactics and practice sessions with standardized patients. Participants were nephrology fellows at Duke University and the University of Pittsburgh (n=22). Pre- and post-workshop surveys evaluated efficacy of the curriculum and measured changes in perceived preparedness on the basis on workshop training. Overall, 14% of fellows were white and 50% were male. Less than one-third (6 of 22) reported prior palliative care training. Survey response rate varied between 86% and 100%. Only 36% (8 of 22) and 38% (8 of 21) of respondents had received structured training in discussions for dialysis initiation or withdrawal. Respondents (19 of 19) felt that communication skills were important to being a "great nephrologist." Mean level of preparedness as measured with a five-point Likert scale significantly increased for all skills (range, 0.5-1.14; Pdecision-making and end-of-life care.

  4. Roman concept of mental capacity to make end-of-life decisions.

    Mendelson, Danuta

    2007-01-01

    When assessing decisional competence of patients, psychiatrists have to balance the patients' right to personal autonomy, their condition and wishes against principles of medical ethics and professional discretion. This article explores the age-old legal and ethical dilemmas posed by refusal of vital medical treatment by patients and their mental capacity to make end-of-life decisions against the background of philosophical, legal and medical approaches to these issues in the time of the Younger Pliny (c62-c113 CE). Classical Roman discourse regarding mental competency and "voluntary death" formed an important theme of the vast corpus of Greco-Roman writings, which was moulded not only by legal permissibility of suicide but also by philosophical (in modern terms, moral or ethical) considerations. Indeed, the legal and ethical issues of evaluating the acceptability of end of life decisions discussed in the Letters are as pertinent today as they were 2000 years ago. We may gain valuable insights about our own methodologies and frames of reference in this area of the law and psychiatry by examining Classical Roman approaches to evaluating acceptability of death-choices as described in Pliny's Letters and the writings of some of his peers.

  5. Challenges and Approach for Making the Top End Optical Assembly for the 4-meter Advanced Technology Solar Telescope

    Canzian, Blaise; Barentine, J.; Hull, T.

    2012-01-01

    L-3 Integrated Optical Systems (IOS) Division has been selected by the National Solar Observatory (NSO) to make the Top End Optical Assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope (ATST) to operate at Haleakala, Maui. ATST will perform to a very high optical performance level in a difficult thermal environment. The TEOA, containing the 0.65-meter silicon carbide secondary mirror and support, mirror thermal management system, mirror positioning and fast tip-tilt system, field stop with thermally managed heat dump, thermally managed Lyot stop, safety interlock and control system, and support frame, operates in the "hot spot” at the prime focus of the ATST and so presents special challenges. In this paper, we will describe the L-3 IOS technical approach to meet these challenges, including subsystems for opto-mechanical positioning, rejected and stray light control, wavefront tip-tilt compensation, and thermal management. Key words: ATST, TEOA, L-3 IOS, thermal management, silicon carbide (SiC) mirrors, hexapods, solar astronomy

  6. Attitudes, experiences, and beliefs affecting end-of-life decision-making among homeless individuals.

    Tarzian, Anita J; Neal, Maggie T; O'Neil, J Anne

    2005-02-01

    Individuals who are homeless may encounter various barriers to obtaining quality end-of-life (EOL) care, including access barriers, multiple sources of discrimination, and lack of knowledge among health care providers (HCPs) of their preferences and decision-making practices. Planning for death with individuals who have spent so much energy surviving requires an understanding of their experiences and preferences. This study sought to increase HCPs' awareness and understanding of homeless or similarly marginalized individuals' EOL experiences and treatment preferences. Focus groups were conducted with homeless individuals using a semi-structured interview guide to elicit participants' EOL experiences, decision-making practices, and personal treatment preferences. Five focus groups were conducted with 20 inner-city homeless individuals (4 per group) at a free urban health care clinic for homeless individuals in the United States. Sixteen of the 20 participants were African American; 4 were Caucasian. None were actively psychotic. All had experienced multiple losses and drug addiction. Five main themes emerged: valuing an individual's wishes; acknowledging emotions; the primacy of religious beliefs and spiritual experience; seeking relationship-centered care; and reframing advance care planning. The narrative process of this qualitative study uncovered an approach to EOL decision-making in which participants' reasoning was influenced by emotions, religious beliefs, and spiritual experience. Relationship-centered care, characterized by compassion and respectful, two-way communication, was obvious by its described absence--reasons for this are discussed. Recommendations for reframing advance care planning include ways for HCPs to transform advance care planning from that of a legal document to a process of goal-setting that is grounded in human connection, respect, and understanding.

  7. Making Ends Meet: Hmong Socioeconomic Trends in the U.S.

    Chia Youyee Vang

    2012-01-01

    Full Text Available This article examines Hmong socioeconomic trends from 1990 to 2010. A review of economic indicators across states and in relation to the U.S. population reveals that on an aggregate level, the Hmong American population’s socioeconomic status has improved significantly. The increases in income and earnings have, however, been shortchanged by external factors brought about partially by the financial crisis and its aftermath. Consequently, this begs us to question the extent to which such developments contribute to the overall economic well-being of Hmong Americans.

  8. What Happens to Teacher Salaries during a Recession? Schools in Crisis: Making Ends Meet

    Simpkins, Jim; Roza, Marguerite; Simburg, Suzanne

    2012-01-01

    In many districts where budgets are tight and forcing cuts in services, are teacher incomes also falling behind? Is teaching becoming a less remunerative occupation relative to other local opportunities such that over time it may become less attractive? Or, do the automatic salary triggers shift wages up despite revenue constraints? This study…

  9. Making ends meet - when school leaders use data and feedback in the development of leadership practice

    Hansen, Pernille; Nørgaard, Camilla; Hornskov, Søren

    In the wake of a major school reform in Denmark, school leaders face a policy driven demand for developing leadership practices, which contributes to increasing learning outcomes for all students. The use of data, assessment and feedback are promoted as part and parcel of such leadership practices...... or with a reference to the formative use of data for development (Hornskov et al 2015). However, in our case study of how school leadership teams use and interpret data and feedback on their own leadership practices, the boundaries between accountability and development does not seem clear cut....

  10. From sea to shining sea. Making ends meet on European rivers

    Disco, Nil/Cornelis; Badenoch, Alexander; Fickers, Andreas

    2010-01-01

    This hopeful remark, written in 1920 by the German social critic Alfons Paquet, suggests that a ‘common spirit in Europe’ could ‘take the offensive’ in realizing waterways over both of Europe’s continental divides. As a German, Paquet conceived of these as extensions of the Rhine — via

  11. Decision-making on Population Return At the End of an Eruption

    Woo, G.

    2015-12-01

    If an eruption sequence is protracted and episodic, continuing for many months, or even a number of years, it can be very difficult for authorities to decide when an evacuated population might be allowed to return. A precautionary approach may be appropriate as a general principle, especially if the societal implications are deemed to be manageable. However, where the livelihoods of the evacuees are critically at stake, such as with farmers, and the economic costs of continuing evacuation are high, a risk-informed approach to supporting decision-making might be warranted. Such an approach has been developed, based on concepts drawn from cost-benefit analysis. On any given day during an extended volcanic crisis, a decision-maker may wish to consider whether to allow then for the return of evacuees. A delay of a decision by one day will increase the evacuation cost by one day's worth of accommodation and economic disruption. On the other hand, there is a small chance that there might be an onset to another eruption on this given day, so there would be a safety benefit in the delay. The task of quantifying this safety benefit requires a coherent synthesis of all the volcano monitoring data time series, together with an assessment of the medium and long-term historical and geological data, so that the probability of each of the alternative eruptive scenarios can be scientifically estimated. Bayesian belief networks provide a convenient framework for this synthesis. For each scenario, the potential casualty implications for returned evacuees need to be assessed. The application of this end of eruption methodology is illustrated and compared with the equivalent decision-making procedure at the start of an eruption.

  12. OA18 Population based end of life care - meeting the challenge of the ageing population.

    Thomas, Keri

    2015-04-01

    The key challenge for most developed countries is meeting the needs of our ageing population, in particular, those nearing the end of their lives - population-based end-of-life care. Building on a public health approach to meet needs of an area-wide population, and a practical approach of enabling generalist frontline staff care for all people in a variety of settings using the GSF Quality Improvement Programmes, we describe progress in a few GSF Cross-Boundary Care Foundation Sites taking a population-based view to meet the challenges of the ageing population. Taking a whole-system view, we explore ways to ensure all people receive quality care towards the final stages of life in line with their needs and wishes in a way that is cost-effective, responsive and compassionate. Expanding concepts of palliative/end-of-life care to include care for people with long-term conditions, dementia, and frailty. We describe practical progress in a number of GSF XBC Sites, enabling generalist frontline staff including: Identifying and prioritising people earlier Reducing 'diagnostic apartheid' Enabling more to live well and die well in the place and manner of their choosing Encouraging integrated person-centred care, reducing inappropriate over-Hospitalisation and prevention of over - medicalising. Use of GSF in various settings to enable generalist frontline staff is described, with key outcome measures and evaluations in the UK, and internationally. As the population ages, population-based end of life care will be one of the most significant developments to meet the challenges for a fit-for-purpose health service of the future. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Family factors in end-of-life decision-making: family conflict and proxy relationship.

    Parks, Susan Mockus; Winter, Laraine; Santana, Abbie J; Parker, Barbara; Diamond, James J; Rose, Molly; Myers, Ronald E

    2011-02-01

    Few studies have examined proxy decision-making regarding end-of-life treatment decisions. Proxy accuracy is defined as whether proxy treatment choices are consistent with the expressed wishes of their index elder. The purpose of this study was to examine proxy accuracy in relation to two family factors that may influence proxy accuracy: perceived family conflict and type of elder-proxy relationship. Telephone interviews with 202 community-dwelling elders and their proxy decision makers were conducted including the Life-Support Preferences Questionnaire (LSPQ), and a measure of family conflict, and sociodemographic characteristics, including type of relationship. Elder-proxy accuracy was associated with the type of elder-proxy relationship. Adult children demonstrated the lowest elder-proxy accuracy and spousal proxies the highest elder-proxy accuracy. Elder-proxy accuracy was associated with family conflict. Proxies reporting higher family conflict had lower elder-proxy accuracy. No interaction between family conflict and relationship type was revealed. Spousal proxies were more accurate in their substituted judgment than adult children, and proxies who perceive higher degree of family conflict tended to be less accurate than those with lower family conflict. Health care providers should be aware of these family factors when discussing advance care planning.

  14. End-Of-Life Care for Persons with Advanced Chronic Obstructive Pulmonary Disease: Report of a National Interdisciplinary Consensus Meeting

    DM Goodridge

    2009-01-01

    Full Text Available While systemic shortcomings in meeting the needs of individuals with progressive chronic illnesses at the end of life have been well documented, there is growing interest in improving both care and quality of life for persons with advanced chronic obstructive pulmonary disease (COPD. For instance, the American Thoracic Society has issued an official statement on palliative care for patients with respiratory diseases, affirming that the prevention, relief, reduction and soothing of symptoms “without affecting a cure” must become an integral component of standard care. A recent Medline search located 1015 articles related to palliative or end-of-life care for people with COPD published between 2001 and 2008, compared with only 336 articles published before 2001. To address the needs of Canadian patients, an interdisciplinary consensus meeting, funded by the Canadian Institutes of Health Research and supported by the Canadian Thoracic Society, the Canadian Respiratory Health Professionals and the Canadian Lung Association was convened in Toronto, Ontario, on November 22, 2008, to begin examining the quality of end-of-life care for individuals with COPD in Canada. The present report summarizes the background to and outcomes of this consensus meeting.

  15. Decision Making Among Older Adults at the End of Life: A Theoretical Perspective.

    Romo, Rafael D; Dawson-Rose, Carol S; Mayo, Ann M; Wallhagen, Margaret I

    Understanding changes in decision making among older adults across time is important for health care providers. We examined how older adults with a limited prognosis used their perception of prognosis and health in their decision-making processes and related these findings to prospect theory. The theme of decision making in the context of ambiguity emerged, reflecting how participants used both prognosis and health to value choices, a behavior not fully captured by prospect theory. We propose an extension of the theory that can be used to better visualize decision making at this unique time of life among older adults.

  16. Twitter as a place where people meet to make suicide pacts.

    Lee, S Y; Kwon, Y

    2018-06-01

    To examine how Twitter is used as a place where people seek others to make suicide pacts. This is an exploratory quantitative study. We used Twitter application programming interfaces to collect all Korean tweets containing the term 'suicide pact' between October 16, 2017 and November 30, 2017. A Python program and human coders were employed to further identify tweets that aimed to seek others to make a suicide pact and analyze the content of each tweet. Poisson regression analysis was used to examine the characteristics of the tweets that attracted more replies. During the data collection period comprising 43 days, 1702 tweets posted by 551 users were aimed to find others to make suicide pacts. Many of the tweets contained detailed information such as the name of city, gender and age of the user, preferred contact method, and preferred gender of a partner. The number of replies to a tweet seeking a suicide pact varied according to the types of the information contained in the tweet. The results of this study indicate that Twitter might be an attractive place where people try to meet others to make a suicide pact. Thus, the government should try to prevent cases of suicides caused by suicide pacts made via Twitter. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Trends in End-of-Life Decision Making in Patients With and Without Cancer

    Pardon, K.; Chambaere, K.; Pasman, H.R.W.; Deschepper, R.; Rietjens, J.; Deliens, L.

    2013-01-01

    Purpose: Because of cancer's high symptom burden and specific disease course, patients with cancer are more likely than other patients to face end-of-life decisions that have possible or certain life-shortening effects (ELDs). This study examines the incidence of ELDs in patients with cancer

  18. Negotiating end-of-life decision making: a comparison of Japanese and U.S. residents' approaches.

    Gabbay, Baback B; Matsumura, Shinji; Etzioni, Shiri; Asch, Steven M; Rosenfeld, Kenneth E; Shiojiri, Toshiaki; Balingit, Peter P; Lorenz, Karl A

    2005-07-01

    To compare Japanese and U.S. resident physicians' attitudes, clinical experiences, and emotional responses regarding making disclosures to patients facing incurable illnesses. From September 2003 to June 2004, the authors used a ten-item self-administered anonymous questionnaire in a cross-sectional survey of 103 internal medicine residents at two U.S. sites in Los Angeles, California, and 244 general medical practice residents at five Japanese sites in Central Honshu, Kyushu, Okinawa, Japan. The Japanese residents were more likely to favor including the family in disclosing diagnosis (95% versus 45%, pguilt about these behaviors. The residents' approaches to end-of-life decision making reflect known cultural preferences related to the role of patients and their families. Although Japanese trainees were more likely to endorse the role of the family, they expressed greater uncertainty about their approach. Difficulty and uncertainty in end-of-life decision making were common among both the Japanese and U.S. residents. Both groups would benefit from ethical training to negotiate diverse, changing norms regarding end-of-life decision making.

  19. Understanding Managers Decision Making Process for Tools Selection in the Core Front End of Innovation

    Appio, Francesco P.; Achiche, Sofiane; McAloone, Tim C.

    2011-01-01

    New product development (NPD) describes the process of bringing a new product or service to the market. The Fuzzy Front End (FFE) of Innovation is the term describing the activities happening before the product development phase of NPD. In the FFE of innovation, several tools are used to facilita...... hypotheses are tested. A preliminary version of a theoretical model depicting the decision process of managers during tools selection in the FFE is proposed. The theoretical model is built from the constructed hypotheses....

  20. Digital health for the End TB Strategy: developing priority products and making them work.

    Falzon, Dennis; Timimi, Hazim; Kurosinski, Pascal; Migliori, Giovanni Battista; Van Gemert, Wayne; Denkinger, Claudia; Isaacs, Chris; Story, Alistair; Garfein, Richard S; do Valle Bastos, Luis Gustavo; Yassin, Mohammed A; Rusovich, Valiantsin; Skrahina, Alena; Van Hoi, Le; Broger, Tobias; Abubakar, Ibrahim; Hayward, Andrew; Thomas, Bruce V; Temesgen, Zelalem; Quraishi, Subhi; von Delft, Dalene; Jaramillo, Ernesto; Weyer, Karin; Raviglione, Mario C

    2016-07-01

    In 2014, the World Health Organization (WHO) developed the End TB Strategy in response to a World Health Assembly Resolution requesting Member States to end the worldwide epidemic of tuberculosis (TB) by 2035. For the strategy's objectives to be realised, the next 20 years will need novel solutions to address the challenges posed by TB to health professionals, and to affected people and communities. Information and communication technology presents opportunities for innovative approaches to support TB efforts in patient care, surveillance, programme management and electronic learning. The effective application of digital health products at a large scale and their continued development need the engagement of TB patients and their caregivers, innovators, funders, policy-makers, advocacy groups, and affected communities.In April 2015, WHO established its Global Task Force on Digital Health for TB to advocate and support the development of digital health innovations in global efforts to improve TB care and prevention. We outline the group's approach to stewarding this process in alignment with the three pillars of the End TB Strategy. The supplementary material of this article includes target product profiles, as developed by early 2016, defining nine priority digital health concepts and products that are strategically positioned to enhance TB action at the country level. The content of this work is ©the authors or their employers. Design and branding are ©ERS 2016.

  1. Patient-centered family meetings in palliative care: a quality improvement project to explore a new model of family meetings with patients and families at the end of life.

    Sanderson, Christine R; Cahill, Philippa J; Phillips, Jane L; Johnson, Anne; Lobb, Elizabeth A

    2017-12-01

    Family meetings in palliative care can enhance communication with family members and identify unmet needs. However, the patient's voice may not be heard. This pre and post-test quality improvement project was conducted from 2013-2014 and investigated a patient-centered family meeting, which is a different approach to palliative care family meetings, to determine its feasibility and acceptability for patients, family and the palliative care team. Newly admitted patients to an Australian in-patient specialist palliative care unit were invited to ask anyone they wished to join them in a meeting with the palliative care team and to identify issues they wished to discuss. Consenting inpatients were interviewed shortly after admission; participated in a family meeting and re-interviewed 2-3 days after the meeting. Family members provided feedback at the end of the meeting. A focus group was held with staff for feedback on this new approach for family meetings. Meetings were observed, documented and thematically analyzed. Thirty-one newly admitted patients were approached to participate in a family meeting. Eighty-four percent had family meetings and the majority (96%) was attended by the patient. Thematic analysis revealed 69% of patient-centered meetings raised end-of-life concerns and 54% were "family-focused". Patient-centered family meetings in palliative care were shown to be feasible and acceptable for staff, patients and family members. Many patients and families spontaneously shared end-of-life concerns. A patient-centered approach to family meetings that includes active patient involvement may provide additional and valued opportunities for patients and families to: express mutual concerns, deliver messages of comfort and appreciation, and prepare for death. Further investigation of this approach, including families' bereavement outcomes, is warranted.

  2. Voices of African American, Caucasian, and Hispanic surrogates on the burdens of end-of-life decision making.

    Braun, Ursula K; Beyth, Rebecca J; Ford, Marvella E; McCullough, Laurence B

    2008-03-01

    End-of-life decisions are frequently made by patients' surrogates. Race and ethnicity may affect such decision making. Few studies have described how different racial/ethnic groups experience end-of-life surrogate decision making. To describe the self-reported experience the self-reported experience of African-American, Caucasian, and Hispanic surrogate decision makers of seriously ill patients and to examine the relationship of race, ethnicity, and culture to that experience. Purposive sample to include racial/ethnic minorities in a qualitative study using focus group interviews. The participants of the study were 44 experienced, mostly female, surrogate decision makers for older veterans. Transcripts were qualitatively analyzed to identify major themes, with particular attention to themes that might be unique to each of the three groups. The experience of burden of end-of-life decision making was similar in all three groups. This burden in its medical, personal, and familial dimensions is compounded by uncertainty about prognosis and the patient's preferences. Racial/ethnic variations of responses to this burden concerned the physician-family relationship, religion and faith, and past experiences with race/ethnicity concordant versus non-concordant physicians. Regardless of race/ethnicity, surrogates for seriously ill patients appeared to experience increased significant, multidimensional burdens of decision making under conditions of uncertainty about a patient's preferences. This aspect of the burden of surrogate decision making may not be fully appreciated by physicians. Physicians should identify and be especially attentive to strategies used by surrogates, which may vary by race/ethnicity, to reduce the uncertainty about a patient's preferences and thus the burden of surrogate decision making to assist them in this difficult process.

  3. The impact of regional culture on intensive care end of life decision making: an Israeli perspective from the ETHICUS study.

    Ganz, F D; Benbenishty, J; Hersch, M; Fischer, A; Gurman, G; Sprung, C L

    2006-04-01

    Decisions of patients, families, and health care providers about medical care at the end of life depend on many factors, including the societal culture. A pan-European study was conducted to determine the frequency and types of end of life practices in European intensive care units (ICUs), including those in Israel. Several results of the Israeli subsample were different to those of the overall sample. The objective of this article was to explore these differences and provide a possible explanation based on the impact of culture on end of life decision making. All adult patients admitted consecutively to three Israeli ICUs (n = 2778) who died or underwent any limitation of life saving interventions between 1 January 1999 and 30 June 2000 were studied prospectively (n = 363). These patients were compared with a similar sample taken from the larger study (ethics in European intensive care units: ETHICUS) carried out in 37 European ICUs. Patients were followed until discharge, death, or 2 months from the decision to limit therapy. End of life decisions were prospectively organised into one of five mutually exclusive categories: cardiopulmonary resuscitation (CPR), brain death, withholding treatment, withdrawing treatment, and active shortening of the dying process (SDP). The data also included patient characteristics (gender, age, ICU admission diagnosis, chronic disorders, date of hospital admission, date and time of decision to limit therapy, date of hospital discharge, date and time of death in hospital), specific therapies limited, and the method of SDP. The majority of patients (n = 252, 69%) had treatment withheld, none underwent SDP, 62 received CPR (17%), 31 had brain death (9%), and 18 underwent withdrawal of treatment (5%). The primary reason given for limiting treatment was that the patient was unresponsive to therapy (n = 187). End of life discussions were held with 132 families (36%), the vast majority of which revolved around withholding treatment (91

  4. Decision-Making of Patients With Implantable Cardioverter-Defibrillators at End of Life: Family Members' Experiences.

    Lee, Mei Ching; Sulmasy, Daniel P; Gallo, Joseph; Kub, Joan; Hughes, Mark T; Russell, Stuart; Kellogg, Anela; Owens, Sharon G; Terry, Peter; Nolan, Marie T

    2017-07-01

    Many patients with advanced heart failure (HF) experience the life-extending benefits of implantable cardioverter-defibrillators (ICD), but at the end stage of HF, patients may experience shocks with increasing frequency and change the plan for end-of-life (EOL) care including the deactivation of the ICD. This report describes family members' experiences of patients with ICD making decisions at EOL. Understanding the decision-making of patients with ICD at EOL can promote informed decision-making and improve the quality of EOL care. This pilot study used a mixed methods approach to test the effects of a nurse-guided discussion in decision-making about ICD deactivation (turning off the defibrillation function) at the EOL. Interviews were conducted, audiotaped, and transcribed in 2012 to 2013 with 6 family members of patients with advanced HF and ICDs. Three researchers coded the data and identified themes in 2014. Three main themes described family members' experiences related to patients having HF with ICDs making health-care decision at EOL: decision-making preferences, patients' perception on ICD deactivation, and communication methods. Health-care providers need to have knowledge of patients' decision-making preferences. Preferences for decision-making include the allowing of appropriate people to involve and encourages direct conversation with family members even when advance directives is completed. Information of ICD function and the option of deactivation need to be clearly delivered to patients and family members. Education and guidelines will facilitate the communication of the preferences of EOL care.

  5. Older Adults Making End of Life Decisions: An Application of Roy's Adaptation Model

    Weihua Zhang

    2013-01-01

    Full Text Available Purpose. The purpose of this study was to identify variables that influenced completion of advanced directives in the context of adaptation from national data in older adults. Knowledge gained from this study would help us identify factors that might influence end of life discussions and shed light on strategies on effective communication on advance care planning. Design and Method. A model-testing design and path analysis were used to examine secondary data from 938 participants. Items were extracted from the data set to correspond to variables for this study. Scales were constructed and reliabilities were tested. Results. The final path model showed that physical impairment, self-rated health, continuing to work, and family structure had direct and indirect effects on completion of advanced directives. Five percent of the variance was accounted for by the path analysis. Conclusion. The variance accounted for by the model was small. This could have been due to the use of secondary data and limitations imposed for measurement. However, health care providers and families should explore patient’s perception of self-health as well as their family and work situation in order to strategize a motivational discussion on advance directive or end of life care planning.

  6. Decision Making Regarding the Place of End-of-Life Cancer Care: The Burden on Bereaved Families and Related Factors.

    Yamamoto, Sena; Arao, Harue; Masutani, Eiko; Aoki, Miwa; Kishino, Megumi; Morita, Tatsuya; Shima, Yasuo; Kizawa, Yoshiyuki; Tsuneto, Satoru; Aoyama, Maho; Miyashita, Mitsunori

    2017-05-01

    Decision making regarding the place of end-of-life (EOL) care is an important issue for patients with terminal cancer and their families. It often requires surrogate decision making, which can be a burden on families. To explore the burden on the family of patients dying from cancer related to the decisions they made about the place of EOL care and investigate the factors affecting this burden. This was a cross-sectional mail survey using a self-administered questionnaire. Participants were 700 bereaved family members of patients with cancer from 133 palliative care units in Japan. The questionnaire covered decisional burdens, depression, grief, and the decision-making process. Participants experienced emotional pressure as the highest burden. Participants with a high decisional burden reported significantly higher scores for depression and grief (both P decision making without knowing the patient's wishes and values (P making the decision because of a due date for discharge from a former facility or hospital (P = 0.005). Decision making regarding the place of EOL care was recalled as burdensome for family decision makers. An early decision-making process that incorporates sharing patients' and family members' values that are relevant to the desired place of EOL care is important. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Is Shared Decision Making for End-of-Life Decisions Associated With Better Outcomes as Compared to Other Forms of Decision Making? A Systematic Literature Review

    Negin Hajizadeh MD, MPH

    2016-07-01

    Full Text Available Background: Whether shared decision making (SDM has been evaluated for end-of-life (EOL decisions as compared to other forms of decision making has not been studied. Purpose: To summarize the evidence on SDM being associated with better outcomes for EOL decision making, as compared to other forms of decision making. Data Sources: PubMed, Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and CINAHL databases were searched through April 2014. Study Selection: Studies were selected that evaluated SDM, compared to any other decision making style, for an EOL decision. Data Extraction: Components of SDM tested, comparators to SDM, EOL decision being assessed, and outcomes measured. Data Synthesis: Seven studies met the inclusion criteria (three experimental and four observational studies. Results were analyzed using narrative synthesis. All three experimental studies compared SDM interventions to usual care. The four observational studies compared SDM to doctor-controlled decision making, or reported the correlation between level of SDM and outcomes. Components of SDM specified in each study differed widely, but the component most frequently included was presenting information on the risks/benefits of treatment choices (five of seven studies. The outcome most frequently measured was communication, although with different measurement tools. Other outcomes included decisional conflict, trust, satisfaction, and “quality of dying.” Limitations: We could not analyze the strength of evidence for a given outcome due to heterogeneity in the outcomes reported and measurement tools. Conclusions: There is insufficient evidence supporting SDM being associated with improved outcomes for EOL decisions as opposed to other forms of decision making. Future studies should describe which components of SDM are being tested, outline the comparator decision making style, and use validated tools to measure outcomes.

  8. Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals.

    Peicius, Eimantas; Blazeviciene, Aurelija; Kaminskas, Raimondas

    2017-06-05

    This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union (EU) where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health professionals' understanding and preferences related to advance directives. In addition, the study sought to explore the views of health care professionals of the application of Advance Directives (AD) in clinical practice in Lithuania. A cross-sectional survey was conducted by interviewing 478 health professionals based at major health care centers in Kaunas district, Lithuania. The design of the study included the use of a questionnaire developed for this study and validated by a pilot study. The collected data were analyzed using standard descriptive statistical methods. The analysis of knowledge about AD revealed some statistically significant differences when comparing the respondents' profession and gender. The analysis also indicated key emerging themes among respondents including tranquility of mind, the longest possible life expectancy and freedom of choice. Further, the study findings revealed that more than half of the study participants preferred to express their will while alive by using advance directives. The study findings revealed a low level of knowledge on advance directives among health professionals. Most health professionals agreed that AD's improved end-of-life decision making while the majority of physicians appreciated AD as the best tool for sharing responsibilities in clinical practice in Lithuania. More physicians than nurses preferred the presence of advance directives to support their decision making in end-of-life situations.

  9. Regenerative Medicine Will Make Orthopaedic Implants Obsolete In Our Time Orthopaedic Research Society First Annual Meeting Debate, San Diego, March 21st , 2017.

    Johnstone, Brian; Jacobs, Joshua J; Sandell, Linda J; Wilkinson, J Mark

    2018-05-10

    The mission of the Orthopaedic Research Society is to promote and advance musculoskeletal research worldwide. With this in mind, the Annual Meeting Program Committee sought to establish a debate as a key component of the meeting. Our purpose was to provoke discussion on topics that are core to our mission and to engage all constituencies within the society by examining questions of broad relevance. To this end, the topic "Regenerative medicine will make orthopaedic implants obsolete in our time" was selected as the title of the inaugural debate. The arguments for and against the motion are presented in this perspectives article. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Process quality of decision-making in multidisciplinary cancer team meetings: a structured observational study.

    Hahlweg, Pola; Didi, Sarah; Kriston, Levente; Härter, Martin; Nestoriuc, Yvonne; Scholl, Isabelle

    2017-11-17

    The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation. An adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) was used to assess the quality of the presented information and team processes in MDTMs. Data was analyzed using descriptive statistics and mixed logistic regression analysis. N = 249 cases were observed in N = 29 MDTMs. While cancer-specific medical information was judged to be of high quality, psychosocial information and information regarding patient views were considered to be of low quality. In 25% of the cases no, in 64% one, and in 10% more than one treatment recommendations were given (1% missing data). Giving no treatment recommendation was associated with duration of case discussion, duration of the MDTM session, quality of case history, quality of radiological information, and specialization of the MDTM. Higher levels of medical and treatment uncertainty during discussions were found to be associated with a higher probability for more than one treatment recommendation. The quality of different aspects of information was observed to differ greatly. In general, we did not find MDTMs to be in line with the principles of patient-centered care. Recommendation outcome varied substantially between different specializations of MDTMs. The quality of certain information was associated with the recommendation outcome. Uncertainty during discussions was related to more than one recommendation being considered. Time constraints

  11. The End of Theory? Does the Data Deluge Make the Scientific Method Obsolete?

    Kreinovich, Vladik; McClure, John; Symons, John

    2008-10-01

    Why do we need theory? One of the purposes of science is to predict: e.g., how a complex material behaves in different situations. There are a lot of records describing how different materials behave in different situations. In the past, it was not possible to find a similar record and simply recall what happened then. The only possibility was to extract, from the data, a simple dependence, and then use this dependence for predictions. For example, we can use Ohm's law V=I.R to predict the voltage V based on the current I and the resistance R. Nowadays, computer searches are so fast that there seems to be no need for any theoretical laws anymore: if we want to predict, we can simply search through all the records and find what happened in a similar situation. So maybe we do not need theory at all. This was the argument developed in a recent (June 2008) article in a popular Wired magazine. In our presentation, we will describe this argument in detail, and give our opinion on whether the computer progress will indeed lead to the end of the theory as we know it.

  12. [Thinking from the end - Does the diagnosis "cancer" make a difference to patients and carers?].

    Bausewein, Claudia

    2013-01-01

    The diagnosis of cancer is often associated with pain, suffering and dying. Many of these aspects also apply to patients dying from non-malignant disease. Being confronted with a malignancy posts an existential threat for many patients that is linked with loss of control, challenge of autonomy and fear of the future. In contrast, patients with non-malignant disease do not realise the scope of their diagnosis and the potentially life-limiting nature of their disease. The prognosis of patients with chronic organ failure is often shorter than that of some patients with malignancies. Patients with malignant and non-malignant disease suffer from pain and many other symptoms. Tumour-oriented therapies, side effects and changes of the body image add to the suffering of cancer patients. Although consequences of the disease and the therapies are often not visible in patients with non-malignant disease, the increasing functional decline, psychosocial burden, lack of co-ordination of care, and information needs burden patients. Wishes at the end of life are similar in cancer and non-cancer patients. Access to palliative care is much easier for cancer patients than for non-cancer patients. Copyright © 2013. Published by Elsevier GmbH.

  13. Making the End as Good as the Beginning: Financial Planning and Retirement for Women Plastic Surgeons.

    Johnson, Debra J; Shenaq, Deana; Thakor, Manisha

    2016-10-01

    Financial planning is critically important to ensure financial security both during a plastic surgical career and in retirement. Unfortunately, plastic surgery training includes very little in the way of financial planning. The information that is available in the literature is mostly geared toward men. Women, with longer lifespans and more family care responsibilities, have unique needs when it comes to financial planning. Adequate attention must also be paid to life after retirement. A plastic surgical career can be all-encompassing, and thus women need to carefully plan volunteer activities, new hobbies, and even a second career to make their retirement years fulfilling and enjoyable. Key points regarding financial planning during the various phases of a woman plastic surgeon's career are discussed. Options for retirement are presented.

  14. Signing at the beginning makes ethics salient and decreases dishonest self-reports in comparison to signing at the end.

    Shu, Lisa L; Mazar, Nina; Gino, Francesca; Ariely, Dan; Bazerman, Max H

    2012-09-18

    Many written forms required by businesses and governments rely on honest reporting. Proof of honest intent is typically provided through signature at the end of, e.g., tax returns or insurance policy forms. Still, people sometimes cheat to advance their financial self-interests-at great costs to society. We test an easy-to-implement method to discourage dishonesty: signing at the beginning rather than at the end of a self-report, thereby reversing the order of the current practice. Using laboratory and field experiments, we find that signing before-rather than after-the opportunity to cheat makes ethics salient when they are needed most and significantly reduces dishonesty.

  15. Signing at the beginning makes ethics salient and decreases dishonest self-reports in comparison to signing at the end

    Shu, Lisa L.; Mazar, Nina; Gino, Francesca; Ariely, Dan; Bazerman, Max H.

    2012-01-01

    Many written forms required by businesses and governments rely on honest reporting. Proof of honest intent is typically provided through signature at the end of, e.g., tax returns or insurance policy forms. Still, people sometimes cheat to advance their financial self-interests—at great costs to society. We test an easy-to-implement method to discourage dishonesty: signing at the beginning rather than at the end of a self-report, thereby reversing the order of the current practice. Using laboratory and field experiments, we find that signing before—rather than after—the opportunity to cheat makes ethics salient when they are needed most and significantly reduces dishonesty. PMID:22927408

  16. Influence of institutional culture and policies on do-not-resuscitate decision making at the end of life.

    Dzeng, Elizabeth; Colaianni, Alessandra; Roland, Martin; Chander, Geetanjali; Smith, Thomas J; Kelly, Michael P; Barclay, Stephen; Levine, David

    2015-05-01

    Controversy exists regarding whether the decision to pursue a do-not-resuscitate (DNR) order should be grounded in an ethic of patient autonomy or in the obligation to act in the patient's best interest (beneficence). To explore how physicians' approaches to DNR decision making at the end of life are shaped by institutional cultures and policies surrounding patient autonomy. We performed semistructured in-depth qualitative interviews of 58 internal medicine physicians from 4 academic medical centers (3 in the United States and 1 in the United Kingdom) by years of experience and medical subspecialty from March 7, 2013, through January 8, 2014. Hospitals were selected based on expected differences in hospital culture and variations in hospital policies regarding prioritization of autonomy vs best interest. This study identified the key influences of institutional culture and policies on physicians' attitudes toward patient autonomy in DNR decision making at the end of life. A hospital's prioritization of autonomy vs best interest as reflected in institutional culture and policy appeared to influence the way that physician trainees conceptualized patient autonomy. This finding may have influenced the degree of choice and recommendations physician trainees were willing to offer regarding DNR decision making. Trainees at hospitals where policies and culture prioritized autonomy-focused approaches appeared to have an unreflective deference to autonomy and felt compelled to offer the choice of resuscitation neutrally in all situations regardless of whether they believed resuscitation to be clinically appropriate. In contrast, trainees at hospitals where policies and culture prioritized best-interest-focused approaches appeared to be more comfortable recommending against resuscitation in situations where survival was unlikely. Experienced physicians at all sites similarly did not exclusively allow their actions to be defined by policies and institutional culture and were

  17. Seeking and Accepting: U.S. Clergy Theological and Moral Perspectives Informing Decision Making at the End of Life.

    Sanders, Justin J; Chow, Vinca; Enzinger, Andrea C; Lam, Tai-Chung; Smith, Patrick T; Quiñones, Rebecca; Baccari, Andrew; Philbrick, Sarah; White-Hammond, Gloria; Peteet, John; Balboni, Tracy A; Balboni, Michael J

    2017-10-01

    People with serious illness frequently rely on religion/spirituality to cope with their diagnosis, with potentially positive and negative consequences. Clergy are uniquely positioned to help patients consider medical decisions at or near the end of life within a religious/spiritual framework. We aimed to examine clergy knowledge of end-of-life (EOL) care and beliefs about the role of faith in EOL decision making for patients with serious illness. Key informant interviews, focus groups, and survey. A purposive sample of 35 active clergy in five U.S. states as part of the National Clergy End-of-Life Project. We assessed participant knowledge of and desire for further education about EOL care. We transcribed interviews and focus groups for the purpose of qualitative analysis. Clergy had poor knowledge of EOL care; 75% desired more EOL training. Qualitative analysis revealed a theological framework for decision making in serious illness that balances seeking life and accepting death. Clergy viewed comfort-focused treatments as consistent with their faith traditions' views of a good death. They employed a moral framework to determine the appropriateness of EOL decisions, which weighs the impact of multiple factors and upholds the importance of God-given free will. They viewed EOL care choices to be the primary prerogative of patients and families. Clergy described ambivalence about and a passive approach to counseling congregants about decision making despite having defined beliefs regarding EOL care. Poor knowledge of EOL care may lead clergy to passively enable congregants with serious illness to pursue potentially nonbeneficial treatments that are associated with increased suffering.

  18. Chinese familial tradition and Western influence: a case study in Singapore on decision making at the end of life.

    Ho, Zheng Jie Marc; Radha Krishna, Lalit Kumar; Yee, Chung Pheng Alethea

    2010-12-01

    Decision making for an incompetent patient at the end of life is difficult for both family members and physicians alike. Often, palliative care teams are tasked with weaving through opinions, emotions, and goals in search for an amenable solution. Occasionally, these situations get challenging. We present the case of an elderly Chinese Singaporean with metastatic cancer, whose family and physicians had conflicting goals of care. The former was adamant on treating the patient's disease with an untested drug, whereas the latter aimed to treat his symptoms with more conventional medication. Drug-drug interactions prevented treatment with both. Beginning with a discussion of the patient's best interest, we delve into the Singaporean context to show how culture affects medical decision making. Confucianism and filial piety are the values on which this family's workings were based. In an analysis of what this entails, we attempt to explain the significant and assertive family involvement in the decision-making process and their insistence on using novel medications, having exhausted conventional interventions. Within this mix were Western influences, too. Through the Internet, family members have become more informed and empowered in decision making, wresting the traditional paternalistic role of physicians in favor of "patient autonomy." An understanding of such dynamic facets will help better tailor culturally appropriate approaches to such complex situations. Copyright © 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  19. Patients' preferences for participation in treatment decision-making at the end of life: qualitative interviews with advanced cancer patients.

    Brom, Linda; Pasman, H Roeline W; Widdershoven, Guy A M; van der Vorst, Maurice J D L; Reijneveld, Jaap C; Postma, Tjeerd J; Onwuteaka-Philipsen, Bregje D

    2014-01-01

    Patients are often encouraged to participate in treatment decision-making. Most studies on this subject focus on choosing between different curative treatment types. In the last phase of life treatment decisions differ as they often put more emphasis on weighing quantity against quality of life, such as whether or not to start treatment aimed at life prolongation but with the possibility of side effects. This study aimed to obtain insight into cancer patients' preferences and the reasons for patients' preferred role in treatment decision-making at the end of life. 28 advanced cancer patients were included at the start of their first line treatment. In-depth interviews were held prior to upcoming treatment decisions whether or not to start a life prolonging treatment. The Control Preference Scale was used to start discussing the extent and type of influence patients wanted to have concerning upcoming treatment decision-making. Interviews were audio taped and transcribed. All patients wanted their physician to participate in the treatment decision-making process. The extent to which patients themselves preferred to participate seemed to depend on how patients saw their own role or assessed their own capabilities for participating in treatment decision-making. Patients foresaw a shift in the preferred level of participation to a more active role depending in the later phase of illness when life prolongation would become more limited and quality of life would become more important. Patients vary in how much involvement they would like to have in upcoming treatment decision-making. Individual patients' preferences may change in the course of the illness, with a shift to more active participation in the later phases. Communication about patients' expectations, wishes and preferences for participation in upcoming treatment decisions is of great importance. An approach in which these topics are openly discussed would be beneficial.

  20. Fleeing from Frankenstein's Monster and Meeting Kafka on the Way: Algorithmic Decision-Making in Higher Education

    Prinsloo, Paul

    2017-01-01

    In the socio-technical imaginary of higher education, algorithmic decision-making offers huge potential, but we also cannot deny the risks and ethical concerns. In fleeing from Frankenstein's monster, there is a real possibility that we will meet Kafka on our path, and not find our way out of the maze of ethical considerations in the nexus between…

  1. Negotiated reorienting: a grounded theory of nurses' end-of-life decision-making in the intensive care unit.

    Gallagher, Ann; Bousso, Regina Szylit; McCarthy, Joan; Kohlen, Helen; Andrews, Tom; Paganini, Maria Cristina; Abu-El-Noor, Nasser Ibrahim; Cox, Anna; Haas, Margit; Arber, Anne; Abu-El-Noor, Mysoon Khalil; Baliza, Michelle Freire; Padilha, Katia Grillo

    2015-04-01

    Intensive care units (ICUs) focus on treatment for those who are critically ill and interventions to prolong life. Ethical issues arise when decisions have to be made regarding the withdrawal and withholding of life-sustaining treatment and the shift to comfort and palliative care. These issues are particularly challenging for nurses when there are varying degrees of uncertainty regarding prognosis. Little is known about nurses' end-of-life (EoL) decision-making practice across cultures. To understand nurses' EoL decision-making practices in ICUs in different cultural contexts. We collected and analysed qualitative data using Grounded Theory. Interviews were conducted with experienced ICU nurses in university or hospital premises in five countries: Brazil, England, Germany, Ireland and Palestine. Semi-structured interviews were conducted with 51 nurses (10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine). They were purposefully and theoretically selected to include nurses having a variety of characteristics and experiences concerning end-of-life (EoL) decision-making. The study used grounded theory to inform data collection and analysis. Interviews were facilitated by using key questions. The comparative analysis of the data within and across data generated by the different research teams enabled researchers to develop a deeper understanding of EoL decision-making practices in the ICU. Ethical approval was granted in each of the participating countries and voluntary informed consent obtained from each participant. The core category that emerged was 'negotiated reorienting'. Whilst nurses do not make the 'ultimate' EoL decisions, they engage in two core practices: consensus seeking (involving coaxing, information cuing and voice enabling); and emotional holding (creating time-space and comfort giving). There was consensus regarding the core concept and core practices employed by nurses in the ICUs in the five countries. However

  2. Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation.

    Benute, Gláucia R G; Nomura, Roseli M Y; Liao, Adolfo W; Brizot, Maria de Lourdes; de Lucia, Mara C S; Zugaib, M

    2012-08-01

    this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings. open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique. the study was carried out at a public university hospital in Brazil. 249 pregnant women who had received the diagnosis of a severe lethal fetal malformation. fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3%). Termination of pregnancy was decided by 172 (69.1%) patients and legally authorised by the judiciary (66%). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9%), the reasons were related to feelings of guilt (74%). the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Making Fieldwork Valuable: Designing fieldwork programmes to meet the needs of young geologists

    Thorne, Michael

    2016-04-01

    consolidator to abstract ideas in class and the importance of its role in team building exercises were also broadly held views. The strength of opinion demonstrated by students reinforces the importance of decisions made regarding fieldwork. Following the initial auditing stage potential field sites were then investigated by staff and assessed for their potential to meet the desired characteristics, where promise was shown these localities were then developed into individual courses where discrete skills could be developed. By assembling together the range of learning outcomes from each individual field trip a narrative 'learning journey' was developed with a clear end goal. Having been through this process and seeing the positive effects on student progress this work presents a toolkit to educators to provide assistance and framework in the development of further programmes of field study through equally considered design.

  4. Factors determining the long term back end nuclear fuel cycle strategy and future nuclear systems. Proceedings of a technical committee meeting

    2002-05-01

    The Technical Committee Meeting (TCM) was held in Vienna on 8-10 November 1999; it was organized by the International Atomic Energy Agency and attended by 26 participants from 16 Member States. The purpose of the meeting was to exchange information among experts on the back end fuel cycle strategies adopted by Member States; to identify key factors determining the long-term back end fuel cycle strategies; and to assess the applicability of these factors to future nuclear systems. Issues associated with the back end fuel cycle supporting a country's nuclear power programme are technical, economic, institutional and political. This TCM provided an opportunity to address these issues and their impacts to the back end fuel cycles, as well as to identify and assess factors affecting the back end fuel cycle strategies. The discussion was organized ib the following topical sessions: the nuclear fuel cycle; spent fuel management; waste management and repository; plutonium management. This document contains a summary of the meeting and 22 individual papers presented by participants. Each of the papers was indexed separately

  5. Factors determining the long term back end nuclear fuel cycle strategy and future nuclear systems. Proceedings of a technical committee meeting

    NONE

    2002-05-01

    The Technical Committee Meeting (TCM) was held in Vienna on 8-10 November 1999; it was organized by the International Atomic Energy Agency and attended by 26 participants from 16 Member States. The purpose of the meeting was to exchange information among experts on the back end fuel cycle strategies adopted by Member States; to identify key factors determining the long-term back end fuel cycle strategies; and to assess the applicability of these factors to future nuclear systems. Issues associated with the back end fuel cycle supporting a country's nuclear power programme are technical, economic, institutional and political. This TCM provided an opportunity to address these issues and their impacts to the back end fuel cycles, as well as to identify and assess factors affecting the back end fuel cycle strategies. The discussion was organized ib the following topical sessions: the nuclear fuel cycle; spent fuel management; waste management and repository; plutonium management. This document contains a summary of the meeting and 22 individual papers presented by participants. Each of the papers was indexed separately.

  6. Meeting

    July 1989 No.19 Newsletter of the Indian Academy of Sciences. 55th Annual. Meeting ... in the world, keeping alive atthe same time his research interests, abreast .... theory made a comeback with many new ideas and with the success of the ...

  7. Conceptualizing Surrogate Decision-Making at End of Life in the Intensive Care Unit using Cognitive Task Analysis

    Dionne-Odom, J. Nicholas; Willis, Danny G.; Bakitas, Marie; Crandall, Beth; Grace, Pamela J.

    2014-01-01

    Background Surrogate decision-makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. Purpose Identify and describe the underlying psychological processes of surrogate decision-making for adults at EOL in the ICU. Method Qualitative case study design using a cognitive task analysis (CTA) interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical center’s ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semi-structured CTA interviews. Discussion The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions: gist impressions, distressing emotions, and moral intuitions impact a SDM’s judgment about the acceptability of either the patient’s medical treatments or his or her condition. Conclusion The framework offers initial insights about the underlying psychological processes of surrogate decision-making and may facilitate enhanced decision support for SDMs. PMID:25982772

  8. Cardiopulmonary resuscitation knowledge and opinions on end of life decision making of older adults admitted to an acute medical service.

    Sharma, Rupali; Jayathissa, Sisira; Weatherall, Mark

    2016-01-08

    To determine the knowledge in cardiopulmonary resuscitation (CPR) process, preference for CPR, and desire to participate in end-of-life decision making amongst older hospitalised patients. We prospectively interviewed 100 participants above 65 years of age awaiting discharge from acute medical ward and collected demographics, knowledge of CPR and opinion on CPR in various clinical scenarios. Amongst the participants, 58% had good understanding of all components of CPR and 91% overestimated its success. Fifty-eight percent wished to have CPR in current health status, but this declined if they were presented a hypothetical scenario of critical illness (46%), functional impairment (17%), terminal illness (13%) and dementia (13%). Tertiary education, male gender and not living alone were associated with accepting CPR. Ninety-three percent were comfortable discussing CPR and 84% felt comfortable documenting their wishes in the medical notes. Seventy percent wished such discussion to include themselves and their family. Older inpatients have a reasonable understanding of the components of CPR and wish to be involved in CPR decision-making. Clinical scenarios with poor prognosis may lead to patients declining CPR. Discussion and documentation of resuscitation wishes is useful in routine assessment process among elderly hospitalised patients.

  9. The Terminology of Fault Zones in the Brittle Regime: Making Field Observations More Useful to the End User

    Shipton, Z.; Caine, J. S.; Lunn, R. J.

    2013-12-01

    Geologists are tiny creatures living on the 2-and-a-bit-D surface of a sphere who observe essentially 1D vanishingly small portions (boreholes, roadcuts, stream and beach sections) of complex, 4D tectonic-scale structures. Field observations of fault zones are essential to understand the processes of fault growth and to make predictions of fault zone mechanical and hydraulic properties at depth. Here, we argue that a failure of geologists to communicate their knowledge effectively to other scientists/engineers can lead to unrealistic assumptions being made about fault properties, and may result in poor economic performance and a lack of robustness in industrial safety cases. Fault zones are composed of many heterogeneously distributed deformation-related elements. Low permeability features include regions of intense grain-size reduction, pressure solution, cementation and shale smears. Other elements are likely to have enhanced permeability through fractures and breccias. Slip surfaces can have either enhanced or reduced permeability depending on whether they are open or closed, and the local stress state. The highly variable nature of 1) the architecture of faults and 2) the properties of deformation-related elements demonstrates that there are many factors controlling the evolution of fault zone internal structures (fault architecture). The aim of many field studies of faults is to provide data to constrain predictions at depth. For these data to be useful, pooling of data from multiple sites is usually necessary. This effort is frequently hampered by variability in the usage of fault terminologies. In addition, these terms are often used in ways as to make it easy for 'end-users' such as petroleum reservoir engineers, mining geologists, and seismologists to mis-interpret or over-simplify the implications of field studies. Field geologists are comfortable knowing that if you walk along strike or up dip of a fault zone you will find variations in fault rock type

  10. Family factors affect clinician attitudes in pediatric end-of-life decision making: a randomized vignette study.

    Ruppe, Michael D; Feudtner, Chris; Hexem, Kari R; Morrison, Wynne E

    2013-05-01

    Conflicts between families and clinicians in pediatric end-of-life (EOL) care cause distress for providers, dissatisfaction for patients' families, and potential suffering for terminally ill children. We hypothesized that family factors might influence clinician decision making in these circumstances. We presented vignettes concerning difficult EOL decision making, randomized for religious objection to therapy withdrawal and perceived level of family involvement, to clinicians working in three Children's Hospital intensive care units. Additionally, attitudes about EOL care were assessed. Three hundred sixty-four respondents completed the questionnaire, for an overall response rate of 54%. Respondents receiving the "involved family" vignette were more likely to agree to continue medical care indefinitely (Pfamilies had nonreligious objections to withdrawal (P=0.05). Respondents who thought that a fear of being sued affected decisions were less likely to pursue unilateral withdrawal (odds ratio 0.8, 95% CI=0.6-0.9). Those who felt personal distress as a result of difficult EOL decision making, thought they often provided "futile" care, or those who felt EOL care was effectively addressed at the institution were less likely to want to defer to the parents' wishes (range of odds ratios 0.7-1). In this randomized vignette study, we have shown that family factors, particularly how involved a family seems to be in a child's life, affect what clinicians think is ethically appropriate in challenging EOL cases. Knowledge of how a family's degree of involvement may affect clinicians should be helpful to the clinical ethics consultants and offer some degree of insight to the clinicians themselves. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  11. Ethics of End of Life Decisions in Pediatrics: A Narrative Review of the Roles of Caregivers, Shared Decision-Making, and Patient Centered Values

    Jonathan D. Santoro

    2018-04-01

    Full Text Available Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.

  12. Ethics of End of Life Decisions in Pediatrics: A Narrative Review of the Roles of Caregivers, Shared Decision-Making, and Patient Centered Values.

    Santoro, Jonathan D; Bennett, Mariko

    2018-04-26

    Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.

  13. The Mission Imperative for Sending Federal Scientists to Major Meetings: Making the Case (Invited)

    McNutt, M. K.; Kimball, S. M.

    2013-12-01

    In the spring of 2012, new guidelines from the Office of Management and Budget (OMB) made travel for government scientists to meetings suddenly much more difficult in the wake of a major scandal involving excessive spending for a Las Vegas conference by a certain government agency. Deputy-Secretary-level permission was instituted for meetings involving more than 15 government staff members, with detailed documentation on the purpose of the gathering, the costs, the rationale for the choice of venue, and the role of each participant. Any ancillary events such a field trips, social gatherings, or leisure activities, were discouraged even if paid for with personal funds as they were being supported on government travel at taxpayer's expense. Furthermore, Secretarial-level waivers were required if the total meeting expense exceeded $500,000, an easy threshold to reach for large meetings that attract more than 200 participants from any one Department. An additional challenge in addressing the new OMB requirements is that many Departments and their constitutive agencies prior to the new guidelines had no centralized system for tracking conference attendance from their numerous centers and offices across the landscape. I will review how the USGS rose to the challenge in 2012 of obtaining a Secretarial waiver in order to meet its mission objectives of communicating its science results to stakeholders, maintaining the quality of its working through conferring with colleagues, providing opportunities for professional growth for junior scientists, nucleating new projects, and other important needs.

  14. How to Make Poverty History: The central role of local organisations in meeting the Millennium Development Goals

    Bigg, Tom

    2006-02-15

    IIED's conference 'How to make poverty history: The central role of local organisations in meeting the MDGs' brought together 58 people from 23 countries for two days of lively debate in December 2005. Nine clear messages stem from the conference, with major implications for the actions and choices pursued by governments, donor agencies and a range of non-state actors, including the private sector.

  15. End-of-Life Decision Making in Palliative Care and Recommendations of the Council of Europe: Qualitative Secondary Analysis of Interviews and Observation Field Notes.

    Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo

    2018-05-01

    End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.

  16. Democratic Leadership by Managing Meetings for Effective Group Decision-Making.

    Stephens, Mary; Forest, Robert

    Instrumental to successful democratic leadership is the use of committees to solve management problems. In democratic leadership, a leader encourages participation and uses a guidance approach to direct a group toward consensus. This document offers leaders guidelines in effective democratic management of meetings. The authors first discuss the…

  17. Fight against fracking in rural Netherlands: from community meetings to decision-making

    Benneworth, Paul Stephen; Velderman, Willem-Jan

    2016-01-01

    In late 2014, in our home region of Twente, the Netherlands, the local newspaper reported that the Dutch National Oil Company (NAM) was meeting with local citizens to give them information about the injection of waste water from oil drilling operations (an extraction technique similar to fracking)

  18. "It's like playing with your destiny": Bosnian immigrants' views of advance directives and end-of-life decision-making.

    Searight, H Russell; Gafford, Jennifer

    2005-07-01

    Patient autonomy is a primary value in US health care. It is assumed that patients want to be fully and directly informed about serious health conditions and want to engage in advance planning about medical care at the end-of-life. Written advance directives and proxy decision-makers are vehicles to promote autonomy when patients are no longer able to represent their wishes. Cross-cultural studies have raised questions about the universal acceptance of these health care values among all ethnicities. In the current investigation, Bosnian immigrants were interviewed about their views of physician-patient communication, advance directives, and locus of decision-making in serious illness. Many of the respondents indicated that they did not want to be directly informed of a serious illness. There was an expressed preference for physician- or family-based health care decisions. Advance directives and formally appointed proxies were typically seen as unnecessary and inconsistent with many respondents' personal values. The findings suggest that the value of individual autonomy and control over the health care decisions may not be applicable to cultures with a collectivist orientation.

  19. Decision-making in end of life care. Are we really playing together in the same team?

    Lomero-Martínez, M M; Jiménez-Herrera, M F; Bodí-Saera, M A; Llauradó-Serra, M; Masnou-Burrallo, N; Oliver-Juan, E; Sandiumenge-Camps, A

    2018-05-18

    Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death. Cross-sectional study carried out in 13 Spanish hospitals by means of an ad hoc questionnaire. Contingency tables, Pearson's chi-squared test, Student's t-test and the Mann-Whitney u-test were used to carry out descriptive, bivariate and multivariate statistical analyses of responses. Although Limitation of life-sustaining treatment is a widespread practice, the survey revealed that nurses feel excluded from the development of protocols and the decision-making process, whilst the perception of physicians is that they have greater knowledge of the topic, and decisions are reached in consensus. Multi-disciplinary training programmes can help critical healthcare providers to work together with greater coordination, thus benefitting patients and their next of kin by providing excellent end-of-life care. Copyright © 2018 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. IOM and DHHS meeting on making clinical practice guidelines appropriate for patients with multiple chronic conditions.

    Goodman, Richard A; Boyd, Cynthia; Tinetti, Mary E; Von Kohorn, Isabelle; Parekh, Anand K; McGinnis, J Michael

    2014-01-01

    The increasing prevalence of Americans with multiple (2 or more) chronic conditions raises concerns about the appropriateness and applicability of clinical practice guidelines for patient management. Most guidelines clinicians currently rely on have been designed with a single chronic condition in mind, and many such guidelines are inattentive to issues related to comorbidities. In response to the need for guideline developers to address comorbidities in guidelines, the Department of Health and Human Services convened a meeting in May 2012 in partnership with the Institute of Medicine to identify principles and action options. Eleven principles to improve guidelines' attentiveness to the population with multiple chronic conditions were identified during the meeting. They are grouped into 3 interrelated categories: (1) principles intended to improve the stakeholder technical process for developing guidelines; (2) principles intended to strengthen content of guidelines in terms of multiple chronic conditions; and (3) principles intended to increase focus on patient-centered care. This meeting built upon previously recommended actions by identifying additional principles and options for government, guideline developers, and others to use in strengthening the applicability of clinical practice guidelines to the growing population of people with multiple chronic conditions. The suggested principles are helping professional societies to improve guidelines' attentiveness to persons with multiple chronic conditions.

  1. Making IT ends meet. Susquehanna Health System outsources Siemens' prized product to nearby hospitals looking for an affordable alternative.

    Becker, Cinda

    2004-08-16

    Susquehanna Health System has been offering small, rural hospitals a more affordable information technology system through a unique outsourcing agreement. The system's CIO, Pamela Wirth, left, has advocated the provider-to-provider arrangement, which could draw the ire of some vendors.

  2. Making Ends (and Bytes) Meet: The Challenges of Teaching Multimedia at an Urban, Underfunded University (3-U)

    Shumow, Moses; Sheerin, Michael Scott

    2013-01-01

    In a time of dynamic changes in mass communication and the restructuring of communication programs, and in the face of shrinking education budgets, educators are being pushed to update their programs to include a new emphasis on multimedia production while sustaining traditional modes of mass communication. Through surveys (N = 121) and focus…

  3. The Opportunity Cost of Smaller Classes: A State-By-State Spending Analysis. Schools in Crisis: Making Ends Meet

    Roza, Marguerite; Ouijdani, Monica

    2012-01-01

    Two seemingly different threads are in play on the issue of class size. The first is manifested in media reports that tell readers that class sizes are rising to concerning levels. The second thread appears in the work of some researchers and education leaders and suggests that repurposing class-size reduction funds to pay for other reforms may…

  4. Making Connections: Where STEM Learning and Earth Science Data Services Meet

    Bugbee, Kaylin; Ramachandran, Rahul; Maskey, Manil; Gatlin, Patrick; Weigel, Amanda

    2016-01-01

    STEM (Science, Technology, Engineering, Mathematics) learning is most effective when students are encouraged to see the connections between science, technology and real world problems. Helping to make these connections has become an increasingly important aspect of Earth Science data research. The Global Hydrology Resource Center (GHRC), one of NASA's 12 EOSDIS (Earth Observing System Data Information System) data centers, has developed a new type of documentation called the micro article to facilitate making connections between data and Earth science research problems.

  5. Physicians' experiences with end-of-life decision-making: Survey in 6 European countries and Australia

    Mortier Freddy

    2008-02-01

    Full Text Available Abstract Background In this study we investigated (a to what extent physicians have experience with performing a range of end-of-life decisions (ELDs, (b if they have no experience with performing an ELD, would they be willing to do so under certain conditions and (c which background characteristics are associated with having experience with/or being willing to make such ELDs. Methods An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Results The response rate differed between countries (39–68%. The experience of foregoing life-sustaining treatment ranged between 37% and 86%: intensifying the alleviation of pain or other symptoms while taking into account possible hastening of death between 57% and 95%, and experience with deep sedation until death between 12% and 46%. Receiving a request for hastening death differed between 34% and 71%, and intentionally hastening death on the explicit request of a patient between 1% and 56%. Conclusion There are differences between countries in experiences with ELDs, in willingness to perform ELDs and in receiving requests for euthanasia or physician-assisted suicide. Foregoing treatment and intensifying alleviation of pain and symptoms are practiced and accepted by most physicians in all countries. Physicians with training in palliative care are more inclined to perform ELDs, as are those who attend to higher numbers of terminal patients. Thus, this seems not to be only a matter of opportunity, but also a matter of attitude.

  6. Private sector malaria RDT initiative in Nigeria: lessons from an end-of-project stakeholder engagement meeting.

    Odugbemi, Babatunde; Ezeudu, Chijioke; Ekanem, Anyiekere; Kolawole, Maxwell; Akanmu, Idowu; Olawole, Aderemi; Nglass, Nkabono; Nze, Chinwe; Idenu, Edward; Audu, Bala Mohammed; Ntadom, Godwin; Alemu, Wondimagegnehu; Mpazanje, Rex; Cunningham, Jane; Akubue, Augustine; Arowolo, Tolu; Babatunde, Seye

    2018-02-06

    The malaria rapid diagnosis testing (RDT) landscape is rapidly evolving in health care delivery in Nigeria with many stakeholders playing or having potential for critical roles. A recent UNITAID grant supported a pilot project on the deployment of quality-assured RDTs among formal and informal private service outlets in three states in Nigeria. This paper describes findings from a series of stakeholder engagement meetings held at the conclusion of the project. The agreed meeting structure was a combination of plenary presentations, structured facilitated discussions, and nominal group techniques to achieve consensus. Rapporteurs recorded the meeting proceeding and summaries of the major areas of discussion and consensus points through a retrospective thematic analysis of the submitted meeting reports. Key findings indicate that private providers were confident in the use of RDTs for malaria diagnosis and believed it has improved the quality of their services. However, concerns were raised about continued access to quality-assured RDT kits. Going forward, stakeholders recommended increasing client-driven demand, and continuous training and supervision of providers through integration with existing monitoring and supervision mechanisms.

  7. A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana.

    Edwin, Ama Kyerewaa; Johnson McGee, Summer; Opare-Lokko, Edwina Addo; Gyakobo, Mawuli Kotope

    2016-03-01

    To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana. A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group. A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying. © The Author(s) 2014.

  8. Juggling Roles and Making Changes: Suggestions for Meeting the Challenges of Being a Special Educator.

    Luckner, John L.

    1996-01-01

    Special educators experiencing stress are urged to take greater responsibility for their own well-being by maintaining a balanced lifestyle, planning for success, expanding their support network, creating a positive belief system, making learning a lifelong priority, and learning to cope with complexities and challenges. (DB)

  9. Challenges and Approaches to Make Multidisciplinary Team Meetings Interoperable - The KIMBo Project.

    Krauss, Oliver; Holzer, Karl; Schuler, Andreas; Egelkraut, Reinhard; Franz, Barbara

    2017-01-01

    Multidisciplinary team meetings (MDTMs) are already in use for certain areas in healthcare (e.g. treatment of cancer). Due to the lack of common standards and accessibility for the applied IT systems, their potential is not yet completely exploited. Common requirements for MDTMs shall be identified and aggregated into a process definition to be automated by an application architecture utilizing modern standards in electronic healthcare, e.g. HL7 FHIR. To identify requirements, an extensive literature review as well as semi-structured expert interviews were conducted. Results showed, that interoperability and flexibility in terms of the process are key requirements to be addressed. An architecture blueprint as well as an aggregated process definition were derived from the insights gained. To evaluate the feasibility of identified requirements, methods of explorative prototyping in software engineering were used. MDTMs will become an important part of modern and future healthcare but the need for standardization in terms of interoperability is imminent.

  10. Consultants’ Meeting (Preparatory Meeting) on the IAEA Coordinated Research Project (CRP) “PHENIX End-of-Life Tests”. Working Material

    2008-01-01

    The overall objective of the CRP is to improve/validate the Member States' analytical capabilities in the field of fast reactor simulation and design. A necessary condition towards achieving this objective is a wide international verification and validation effort of the analysis methodology and codes currently employed in the fields of fast reactor neutronics, thermal hydraulics and plant dynamics to achieve enhanced safety. Therefore, in providing the required wide international basis of interested Member States, each applying different methodologies, the CRP will contribute towards achieving the stated objective with the help of benchmark exercises focusing on the experimental results obtained during the planned PHENIX End-of-Life (EOL) Tests

  11. Making connections: Where STEM learning and Earth science data services meet

    Bugbee, K.; Ramachandran, R.; Maskey, M.; Gatlin, P. N.; Weigel, A. M.

    2016-12-01

    STEM learning is most effective when students are encouraged to see the connections between science, technology and real world problems. Helping to make these connections has become an increasingly important aspect of Earth science data research. The Global Hydrology Resource Center (GHRC), one of NASA's 12 EOSDIS data centers, has developed a new type of documentation called the micro article to facilitate making connections between data and Earth science research problems. Micro articles are short academic texts that enable a reader to quickly understand a scientific phenomena, a case study, or an instrument used to collect data. While originally designed to increase data discovery and usability, micro articles also serve as a reliable starting point for project-based learning, an educational approach in STEM education, for high school and higher education environments. This presentation will highlight micro articles at the Global Hydrology Resource Center data center and will demonstrate the potential applications of micro articles in project-based learning.

  12. Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

    Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

    2016-01-01

    The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients

  13. Educational Reform and Educational Research: New Challenges in Linking Research, Information and Decision Making. Final Report of the International Meeting (Tokyo, Japan, September 4-14, 1995).

    National Inst. for Educational Research, Tokyo (Japan).

    This document summarizes proceedings of a meeting held in September 1995. The purpose of the meeting was to gather educators and policymakers in order to establish criteria concerning links between educational research and decision making. Twenty participants from the following countries attended: Argentina, Australia, Bahrain, Botswana, Brazil,…

  14. Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making.

    Mathew, R; Davies, N; Manthorpe, J; Iliffe, S

    2016-07-19

    Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Shared decision-making in end-stage renal disease: a protocol for a multi-center study of a communication intervention to improve end-of-life care for dialysis patients.

    Eneanya, Nwamaka D; Goff, Sarah L; Martinez, Talaya; Gutierrez, Natalie; Klingensmith, Jamie; Griffith, John L; Garvey, Casey; Kitsen, Jenny; Germain, Michael J; Marr, Lisa; Berzoff, Joan; Unruh, Mark; Cohen, Lewis M

    2015-06-12

    End-stage renal disease carries a prognosis similar to cancer yet only 20 % of end-stage renal disease patients are referred to hospice. Furthermore, conversations between dialysis team members and patients about end-of-life planning are uncommon. Lack of provider training about how to communicate prognostic data may contribute to the limited number of end-of-life care discussions that take place with this chronically ill population. In this study, we will test the Shared Decision-Making Renal Supportive Care communication intervention to systematically elicit patient and caretaker preferences for end-of-life care so that care concordant with patients' goals can be provided. This multi-center study will deploy an intervention to improve end-of-life communication for hemodialysis patients who are at high risk of death in the ensuing six months. The intervention will be carried out as a prospective cohort with a retrospective cohort serving as the comparison group. Patients will be recruited from 16 dialysis units associated with two large academic centers in Springfield, Massachusetts and Albuquerque, New Mexico. Critical input from patient advisory boards, a stakeholder panel, and initial qualitative analysis of patient and caretaker experiences with advance care planning have informed the communication intervention. Rigorous communication training for hemodialysis social workers and providers will ensure that standardized study procedures are performed at each dialysis unit. Nephrologists and social workers will communicate prognosis and provide advance care planning in face-to-face encounters with patients and families using a social work-centered algorithm. Study outcomes including frequency and timing of hospice referrals, patient and caretaker satisfaction, quality of end-of-life discussions, and quality of death will be assessed over an 18 month period. The Shared Decision-Making Renal Supportive Care Communication intervention intends to improve discussions

  16. Environmental Decision Analysis: Meeting the Challenges of Making Good Decisions at CALFED

    Claire D Tomkins

    2006-09-01

    Full Text Available We present a methodology to support decision making at CALFED based on the principles of decision analysis, an analytical approach to decision making designed to handle complex decisions involving both uncertainty and multiple dimensions of value. The impetus for such an approach is a recognized need to enhance communication between scientists and management and between program elements within CALFED. In addition, the environmental decision analysis framework supports both the explicit representation of uncertainty in the decision problem and communication about risk, important elements of most environmental management decisions. The decision analysis cycle consists of four phases: 1 formulate, 2 evaluate, 3 appraise, and 4 decide. In phase one, we identify the objectives and also the alternatives, or possible actions. To facilitate inter-comparison between proposed actions, we recommend formulation of a set of common metrics for CALFED. In our pilot study, we introduced common metrics for salinity, winter-run Chinook salmon survival, and habitat health. The second phase focuses on quantifying possible impacts on the set of metrics, drawing on existing data, model runs, and expert opinions. For the evaluation phase, we employ tools such as decision trees to assess the system-wide impacts of a given action. In the final phase, tools such as expected cost-benefit analysis, value contribution diagrams, and 3-D tradeoff plots aid communication between various stakeholders, scientists, and managers. While decision analysis provides a spectrum of decision support tools, we emphasize that it does not dictate a solution but rather enhances communication about tradeoffs associated with different actions.

  17. A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-09-01

    Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to

  18. Physician medical decision-making at the end of life in newborns : Insight into implementation at 2 Dutch centers

    Verhagen, A. A. Eduard; van der Hoeven, Mark A. H.; van Meerveld, R. Corine; Sauer, Pieter J. J.

    OBJECTIVE. Decisions regarding end-of-life care in critically ill newborns in the Netherlands have received considerable criticism from the media and from the public. This might be because of a lack of proper information and knowledge. Our purpose was to provide detailed information about how and

  19. The Process of End-of-Life Decision-Making in Pediatrics: A National Survey in the Netherlands

    de Vos, Mirjam A.; van der Heide, Agnes; Maurice-Stam, Heleen; Brouwer, Oebele F.; Plötz, Frans B.; Schouten-van Meeteren, Antoinette Y. N.; Willems, Dick L.; Heymans, Hugo S. A.; Bos, Albert P.

    2011-01-01

    OBJECTIVE: The goal of this study was to investigate how Dutch pediatric specialists reach end-of-life decisions, how they involve parents, and how they address conflicts. METHODS: We conducted a national cross-sectional survey among pediatric intensivists, oncologists, neurologists, neurosurgeons,

  20. The Process of End-of-Life Decision-Making in Pediatrics : A National Survey in the Netherlands

    de Vos, Mirjam A.; van der Heide, Agnes; Maurice-Stam, Heleen; Brouwer, Oebele F.; Plotz, Frans B.; Schouten-van Meeteren, Antoinette Y. N.; Willems, Dick L.; Heymans, Hugo S. A.; Bos, Albert P.

    OBJECTIVE: The goal of this study was to investigate how Dutch pediatric specialists reach end-of-life decisions, how they involve parents, and how they address conflicts. METHODS: We conducted a national cross-sectional survey among pediatric intensivists, oncologists, neurologists, neurosurgeons,

  1. What makes end-user training successful? : a mixed method study of a business process management system implementation

    Benny de Waal; Ronald Batenburg

    2012-01-01

    Under what conditions is end-user training (EUT) as part of the implementation of a business process management (BPM) system successful? This question is addressed in this paper. Based on the literature on EUT and implementation success, we first argue that user involvement with, and attitude

  2. What makes end-user training successful? A mixed method study of a business process management system implementation.

    Waal, B.M.E. de; Batenburg, R.

    2012-01-01

    Under what conditions is end-user training (EUT) as part of the implementation of a business process management (BPM) system successful? This question is addressed in this paper. Based on the literature on EUT and implementation success, we first argue that user involvement with, and attitude

  3. Make

    Frauenfelder, Mark

    2012-01-01

    The first magazine devoted entirely to do-it-yourself technology projects presents its 29th quarterly edition for people who like to tweak, disassemble, recreate, and invent cool new uses for technology. MAKE Volume 29 takes bio-hacking to a new level. Get introduced to DIY tracking devices before they hit the consumer electronics marketplace. Learn how to build an EKG machine to study your heartbeat, and put together a DIY bio lab to study athletic motion using consumer grade hardware.

  4. Ethical Decision Making With End-of-Life Care: Palliative Sedation and Withholding or Withdrawing Life-Sustaining Treatments

    Olsen, Molly L.; Swetz, Keith M.; Mueller, Paul S.

    2010-01-01

    Palliative sedation (PS) is the use of medications to induce decreased or absent awareness in order to relieve otherwise intractable suffering at the end of life. Although uncommon, some patients undergoing aggressive symptom control measures still have severe suffering from underlying disease or therapy-related adverse effects. In these circumstances, use of PS is considered. Although the goal is to provide relief in an ethically acceptable way to the patient, family, and health care team, health care professionals often voice concerns whether such treatment is necessary or whether such treatment equates to physician-assisted suicide or euthanasia. In this review, we frame clinical scenarios in which PS may be considered, summarize the ethical underpinnings of the practice, and further differentiate PS from other forms of end-of-life care, including withholding and/or withdrawing life-sustaining therapy and physician-assisted suicide and euthanasia. PMID:20805544

  5. Outdoor brothel culture: the un/making of a transsexual stroll in Vancouver's West End, 1975–1984.

    Ross, Becki

    2012-01-01

    In the mid-1970s, following a series of police raids on prostitution inside downtown nightclubs, a community of approximately 200 sex workers moved into Vancouver's West End neighborhood, where a small stroll had operated since the early 1970s. This paper examines the contributions made by three male-to-female (MTF) transsexuals of color to the culture of on-street prostitution in the West End. The trans women's stories address themes of fashion, working conditions, money, community formation, violence, and resistance to well-organized anti-prostitution forces. These recollections enable me to bridge and enrich trans history and prostitution history – two fields of inquiry that have under-represented the participation of trans women in the sex industry across the urban West. Acutely familiar with the hazards inherent in a criminalized, stigmatized trade, trans sex workers in the West End manufactured efficacious strategies of harm reduction, income generation, safety planning, and community building. Eschewing the label of “victim”, they leveraged their physical size and style, charisma, contempt towards pimps, earning capacity, and seniority as the first workers on the stroll to assume leadership within the broader constituency of “hookers on Davie Street”. I discover that their short-lived outdoor brothel culture offered only a temporary bulwark against the inevitability of eviction via legal injunction in July 1984, and the subsequent rise in lethal violence against all prostitutes in Vancouver, including MTF transsexuals.

  6. [Decision-making processes in nursing and activities at the end of life in intensive care–An international comparative study].

    Kohlen, Helen; McCarthy, Joan; Szylit Buosso, Regina; Gallagher, Ann; Andrews, Tom

    2015-12-01

    Intensive care units (ICUs) are traditionally settings that offer high technologically advanced treatment for those who are in critical situations due to an illness or accident. Questions regarding the withdrawal and withholding as well as the ending of life sustaining treatment are related to ethical dilemmas. Nurses’ decision-making processes and nursing activities in different countries are scarcely studied. Which end-of-life decision-making processes and activities that are performed by nurses can be identified and described? The objective is the identification of a nursing terrain regarding decision-making and activities in patient end-of-life care on the intensive care unit. Semi-structured interviews were conducted with 51 experienced nurses in university or hospital premises: 10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine. The study used grounded theory to inform data collection and analysis. The finding of the study is the identification of a dynamic process in which activities with a focus on cure shift to activities with a focus on end-of-life care. The core category that emerged was ’negotiated reorienting’: The shift of activities implies negotiations between nurses and physicians, relatives as well as with oneself. Moreover the process is characterized by a constant re-orientation that is induced by changing patient data and the realisation of the whole situation. Nurses’ core practices are ’consensus seeking’ and ’emotional holding’ (sub-categories). In all countries a nursing terrain of activities in end-of-life care could be identified and described. However, it is unclear whether nursing activities connected to relatives of the patient are dominant in such a way that relations to dying patients and respect for their autonomy are put into the background. A field study could give answers to this question possible.

  7. Approaches to end-of-life decision-making in the NICU: insights from Dostoevsky's The Grand Inquisitor.

    Paris, J J; Graham, N; Schreiber, M D; Goodwin, M

    2006-07-01

    For many parents stopping life-sustaining medical treatment on their dying infant is psychologically impossible. Dostoevsky's insights into human behavior, particularly the fact that individuals do not want the anxiety and guilt associated with responsibility for making difficult decisions, might change the way physicians approach parents for permission to withdraw life-prolonging medical interventions on dying infants.

  8. Physicians' experiences with end-of-life decision-making: survey in 6 European countries and Australia

    Löfmark, Rurik; Nilstun, Tore; Cartwright, Colleen

    2008-01-01

    are associated with having experience with/or being willing to make such ELDs. METHODS: An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. RESULTS: The response rate differed between...

  9. Pressure during decision making of continuous sedation in end-of-life situations in Dutch general practice

    Blanker, M.H.; Koerhuis-Roessink, M.; Swart, S.J.; Zuurmond, W.W.A.; van der Heide, A.; Perez, R.S.G.M.; Rietjens, J.A.C.

    2012-01-01

    Background: Little is known about pressure from patients or relatives on physician's decision making of continuous palliative sedation. We aim to describe experienced pressure by general practitioners (GPs) in cases of continuous sedation after the introduction of the Dutch practice guideline, using

  10. An inquiry on managers use of decision-making tools in the core front end of the innovation process

    Appio, Francesco P.; Achiche, Sofiane; McAloone, Tim C.

    2013-01-01

    This paper focuses on the Core Front End (CFE) activities of the innovation process to say, Opportunity Identification and Opportunity Analysis. In the CFE of innovation, several tools are used to facilitate and optimise decisions. To select them, managers of the product development team have...... is chosen and how those tools impact specific performance metrics. From the analyses and hypotheses testing performed, it clearly emerges that there is no link between being aware of basic requirements (inputs/outputs) to appropriately use a certain tool and dimensions such as tools’ effectiveness...

  11. Medical end-of-life decisions in Switzerland 2001 and 2013: Who is involved and how does the decision-making capacity of the patient impact?

    Schmid, Margareta; Zellweger, Ueli; Bosshard, Georg; Bopp, Matthias

    2016-01-01

    In Switzerland, the prevalence of medical end-of-life practices had been assessed on a population level only once - in 2001 - until in 2013/14 an identical study was conducted. We aimed to compare the results of the 2001 and 2013 studies with a special focus on shared decision-making and patients' decision-making capacity. Our study encompassed a 21.3% sample of deaths among residents of the German-speaking part of Switzerland aged 1 year or older. From 4998 mailed questionnaires, 3173 (63.5%) were returned. All data were weighted to adjust for age- and sex-specific differences in response rates. Cases with at least one reported end-of-life practice significantly increased from 74.5% (2001) to 82.3% (2013) of all deaths eligible for an end-of-life decision (p Switzerland, there remains potential for further improvement in shared decision-making. Efforts to motivate physicians to involve patients and relatives may be a win-win situation.

  12. Sustainability assessment of alternative end-uses for disused areas based on multi-criteria decision-making method.

    De Feo, Giovanni; De Gisi, Sabino; De Vita, Sabato; Notarnicola, Michele

    2018-08-01

    The main aim of this study was to define and apply a multidisciplinary and multi-criteria approach to sustainability in evaluating alternative end-uses for disused areas. Taking into account the three pillars of sustainability (social, economic and environmental dimension) as well as the need for stakeholders to have new practical instruments, the innovative approach consists of four modules stated (i) sociological, (ii) economic, (iii) environmental and (iv) multi-criteria assessment. By means of a case study on a small Municipality in Southern Italy, three end-uses alternatives, representing three essential services for citizens, were selected: Municipal gym; Market area; Municipal Solid Waste (MSW) separate collection centre. The sociological module was useful to select the most socially sound alternative by means of a consultative referendum, simulated with the use of a structured questionnaire administered to a sample of the population. The economic evaluation was conducted defining the bill of quantities with regarding to six main items (soil handling, landfill disposal tax, public services, structure and services, completion work, equipment and furnishings). The environmental evaluation was performed applying the Delphi method with local technicians who were involved in a qualitative-quantitative evaluation of the three alternatives with regarding to eight possible environmental impacts (landscape impact, soil handling, odour, traffic, noise, atmospheric pollution, wastewater, waste). Finally, the Simple Additive Weighting was used as multi-criteria technique to define alternatives priorities. The obtained results showed how the multi-criteria analysis is a useful decision support tool able to identify transparently and efficiently the most sustainable solutions to a complex social problem. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Advance care planning and end-of-life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates.

    Song, Mi-Kyung; Ward, Sandra E; Fine, Jason P; Hanson, Laura C; Lin, Feng-Chang; Hladik, Gerald A; Hamilton, Jill B; Bridgman, Jessica C

    2015-11-01

    Few trials have examined long-term outcomes of advance care planning (ACP) interventions. We examined the efficacy of an ACP intervention on preparation for end-of-life decision making for dialysis patients and surrogates and for surrogates' bereavement outcomes. A randomized trial compared an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) to usual care alone, with blinded outcome assessments. 420 participants (210 dyads of prevalent dialysis patients and their surrogates) from 20 dialysis centers. Every dyad received usual care. Those randomly assigned to SPIRIT had an in-depth ACP discussion at the center and a follow-up session at home 2 weeks later. preparation for end-of-life decision making, assessed for 12 months, included dyad congruence on goals of care at end of life, patient decisional conflict, surrogate decision-making confidence, and a composite of congruence and surrogate decision-making confidence. bereavement outcomes, assessed for 6 months, included anxiety, depression, and posttraumatic distress symptoms completed by surrogates after patient death. adjusting for time and baseline values, dyad congruence (OR, 1.89; 95% CI, 1.1-3.3), surrogate decision-making confidence (β=0.13; 95% CI, 0.01-0.24), and the composite (OR, 1.82; 95% CI, 1.0-3.2) were better in SPIRIT than controls, but patient decisional conflict did not differ between groups (β=-0.01; 95% CI, -0.12 to 0.10). 45 patients died during the study. Surrogates in SPIRIT had less anxiety (β=-1.13; 95% CI, -2.23 to -0.03), depression (β=-2.54; 95% CI, -4.34 to -0.74), and posttraumatic distress (β=-5.75; 95% CI, -10.9 to -0.64) than controls. Study was conducted in a single US region. SPIRIT was associated with improvements in dyad preparation for end-of-life decision making and surrogate bereavement outcomes. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Audition of Professor Jean-Marie Chevalier (Paris 9 univ. Dauphine) at the end of the FNCCR board meeting of July 9, 2003

    2003-12-01

    This document presents the economic analysis made by a university specialist, J.M. Chevalier, about the evolution of the energy systems in France and abroad. This analysis was made at the end of the July 9, 2003 board meeting of the National federation of granted organizations and public corporations (FNCCR). In his analysis, J.M. Chevalier presents: the un-bundling between energy generation and transportation (separation between network manager and network user, separation between transport functions (natural monopoly) and commercial functions), the advantages and drawbacks of energy markets opening, the role of a regulation authority, the public utility aspect, the security of supplies with the lack of new investments and the manipulation of prices. At the end of his presentation, J.M. Chevalier answers a series of questions about the volatility of the electricity market, the balance between monopoly and competition, the lack of a real European energy policy, the public acceptance with respect to new project of power line, the development of decentralized power generation and wind energy in the context of market deregulation, the opening of Electricite de France (EdF) and Gaz de France (GdF) capital, and the impact of deregulation on small consumers. (J.S.)

  15. Strategies for the back end of the nuclear fuel cycle. Proceedings of a technical committee meeting held in Vienna, 1-4 June 1993

    NONE

    1995-11-01

    The selection of an option for the back end of the nuclear fuel cycle is an important decision for all countries with nuclear power programmes. Likewise, the process for making that option selection is also important. Some countries have begun utilizing nuclear energy for electricity generation without formally determining what would be done with the spent nuclear fuel and radioactive wastes. In a number of those countries the inventories of spent fuel are approaching their storage capacity - and an option selection must soon be made. This report provides an analysis of both the policies chosen by a number of Member States and the process that led to those selections. The intent of this analysis and this publication is to assist other countries in their deliberations on this subject. This publication presents conclusions concerning the factors that were considered important by different countries and the processes which they followed in making their determination of the policy for disposal of nuclear waste. Refs, figs, tabs.

  16. Strategies for the back end of the nuclear fuel cycle. Proceedings of a technical committee meeting held in Vienna, 1-4 June 1993

    1995-11-01

    The selection of an option for the back end of the nuclear fuel cycle is an important decision for all countries with nuclear power programmes. Likewise, the process for making that option selection is also important. Some countries have begun utilizing nuclear energy for electricity generation without formally determining what would be done with the spent nuclear fuel and radioactive wastes. In a number of those countries the inventories of spent fuel are approaching their storage capacity - and an option selection must soon be made. This report provides an analysis of both the policies chosen by a number of Member States and the process that led to those selections. The intent of this analysis and this publication is to assist other countries in their deliberations on this subject. This publication presents conclusions concerning the factors that were considered important by different countries and the processes which they followed in making their determination of the policy for disposal of nuclear waste. Refs, figs, tabs

  17. End-of-treatment and serial PET imaging in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R: A paradigm shift in clinical decision making.

    Melani, Christopher; Advani, Ranjana; Roschewski, Mark; Walters, Kelsey M; Chen, Clara C; Baratto, Lucia; Ahlman, Mark A; Miljkovic, Milos D; Steinberg, Seth M; Lam, Jessica; Shovlin, Margaret; Dunleavy, Kieron; Pittaluga, Stefania; Jaffe, Elaine S; Wilson, Wyndham H

    2018-05-10

    Dose-adjusted-EPOCH-R obviates the need for radiotherapy in most patients with primary mediastinal B-cell lymphoma. End-of-treatment PET, however, does not accurately identify patients at risk of treatment failure, thereby confounding clinical decision making. To define the role of PET in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R, we extended enrollment and follow-up on our published phase II trial and independent series. Ninety-three patients received dose-adjusted-EPOCH-R without radiotherapy. End-of-treatment PET was performed in 80 patients, of whom 57 received 144 serial scans. One nuclear medicine physician from each institution blindly reviewed all scans from their respective institution. End-of-treatment PET was negative (Deauville 1-3) in 55 (69%) patients with one treatment failure (8-year event-free and overall survival of 96.0% and 97.7%). Among 25 (31%) patients with a positive (Deauville 4-5) end-of-treatment PET, there were 5 (20%) treatment failures (8-year event-free and overall survival of 71.1% and 84.3%). Linear regression analysis of serial scans showed a significant decrease in SUVmax in positive end-of-treatment PET non-progressors compared to an increase in treatment failures. Among 6 treatment failures, the median end-of-treatment SUVmax was 15.4 (range, 1.9-21.3) and 4 achieved long-term remission with salvage therapy. Virtually all patients with a negative end-of-treatment PET following dose-adjusted-EPOCH-R achieved durable remissions and should not receive radiotherapy. Among patients with a positive end-of-treatment PET, only 5/25 (20%) had treatment-failure. Serial PET imaging distinguished end-of-treatment PET positive patients without treatment failure, thereby reducing unnecessary radiotherapy by 80%, and should be considered in all patients with an initial positive PET following dose-adjusted-EPOCH-R (NCT00001337). Copyright © 2018, Ferrata Storti Foundation.

  18. How Did the Universe Make People? A Brief History of the Universe from the Beginning to the End

    Mather, John C.

    2009-01-01

    Astronomers are beginning to know the easy part: How did the Big Bang make stars and galaxies and the chemical elements? How did solar systems form and evolve? How did the Earth and the Moon form, and how did water and carbon come to the Earth? Geologists are piecing together the history of the Earth, and biologists are coming to know the history and process of life from the earliest times. But is our planet the only life-supporting place in the universe, or are there many? Astronomers are working on that too. I will tell the story of the discovery of the Big Bang by Edwin Hubble, and how the primordial heat radiation tells the details of that universal explosion. I will tell how the James Webb Space Telescope will extend the discoveries of the Hubble Space Telescope to ever greater distances, will look inside dust clouds to see stars being born today, will measure planets around other stars, and examine the dwarf planets in the outer Solar System. I will show concepts for great new space telescopes to follow the JWST and how they could use future moon rockets to hunt for signs of life on planets around other stars.

  19. Pressure during decision making of continuous sedation in end-of-life situations in Dutch general practice

    Blanker Marco H

    2012-07-01

    Full Text Available Abstract Background Little is known about pressure from patients or relatives on physician’s decision making of continuous palliative sedation. We aim to describe experienced pressure by general practitioners (GPs in cases of continuous sedation after the introduction of the Dutch practice guideline, using a questionnaire survey. Methods A sample of 918 Dutch GPs were invited to fill out a questionnaire about their last patient under continuous sedation. Cases in which GPs experienced pressure from the patient, relatives or other persons were compared to those without pressure. Results 399 of 918 invite GPs (43% returned the questionnaire and 250 provided detailed information about their most recent case of continuous sedation. Forty-one GPs (16% indicated to have experienced pressure from the patient, relatives or colleagues. In GPs younger than 50, guideline knowledge was not related to experienced pressure, whereas in older GPs, 15% with and 36% without guideline knowledge reported pressure. GPs experienced pressure more often when patients had psychological symptoms (compared to physical symptoms only and when patients had a longer estimated life expectancy. A euthanasia request of the patient coincided with a higher prevalence of pressure for GPs without, but not for GPs with previous experience with euthanasia. GPs who experienced pressure had consulted a palliative consultation team more often than GPs who did not experience pressure. Conclusion One in six GPs felt pressure from patients or relatives to start sedation. This pressure was related to guideline knowledge, especially in older GPs, longer life expectancy and the presence of a euthanasia request, especially for GPs without previous experience of euthanasia.

  20. Pressure during decision making of continuous sedation in end-of-life situations in Dutch general practice

    2012-01-01

    Background Little is known about pressure from patients or relatives on physician’s decision making of continuous palliative sedation. We aim to describe experienced pressure by general practitioners (GPs) in cases of continuous sedation after the introduction of the Dutch practice guideline, using a questionnaire survey. Methods A sample of 918 Dutch GPs were invited to fill out a questionnaire about their last patient under continuous sedation. Cases in which GPs experienced pressure from the patient, relatives or other persons were compared to those without pressure. Results 399 of 918 invite GPs (43%) returned the questionnaire and 250 provided detailed information about their most recent case of continuous sedation. Forty-one GPs (16%) indicated to have experienced pressure from the patient, relatives or colleagues. In GPs younger than 50, guideline knowledge was not related to experienced pressure, whereas in older GPs, 15% with and 36% without guideline knowledge reported pressure. GPs experienced pressure more often when patients had psychological symptoms (compared to physical symptoms only) and when patients had a longer estimated life expectancy. A euthanasia request of the patient coincided with a higher prevalence of pressure for GPs without, but not for GPs with previous experience with euthanasia. GPs who experienced pressure had consulted a palliative consultation team more often than GPs who did not experience pressure. Conclusion One in six GPs felt pressure from patients or relatives to start sedation. This pressure was related to guideline knowledge, especially in older GPs, longer life expectancy and the presence of a euthanasia request, especially for GPs without previous experience of euthanasia. PMID:22759834

  1. Beyond cultural stereotyping: views on end-of-life decision making among religious and secular persons in the USA, Germany, and Israel.

    Schweda, Mark; Schicktanz, Silke; Raz, Aviad; Silvers, Anita

    2017-02-17

    End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes. The paper is based on a qualitative study comprising 12 focus group discussions with religious and secular persons in the USA, Germany, and Israel (n = 82). Considering the respective socio-political and legal frameworks, the thematic analysis focuses on moral attitudes towards end-of-life decision making and explores the complex interplay between individual preferences, culture, and religion. Our findings draw attention to the variety and complexity of cultural and religious aspects of end-of-life decision making. Although there is local consensus that goes beyond radical individualism, positions are not neatly matched with national cultures or religious denominations. Instead, the relevance of the specific situatedness of religious beliefs and cultural communities becomes visible: Their status and role in individual situations, for example, as consensual or conflicting on the level of personal perspectives, family relationships, or broader social contexts, e.g., as a majority or minority culture within a political system. As the group discussions indicate, there are no clear-cut positions anchored in "nationality," "culture," or "religion." Instead, attitudes are personally decided on as part of a negotiated context representing the political, social and existential situatedness of the individual. Therefore, more complex theoretical and practical approaches to cultural diversity have to be developed.

  2. Physician-related barriers to communication and patient- and family-centred decision-making towards the end of life in intensive care: a systematic review.

    Visser, Mieke; Deliens, Luc; Houttekier, Dirk

    2014-11-18

    Although many terminally ill people are admitted to an intensive care unit (ICU) at the end of life, their care is often inadequate because of poor communication by physicians and lack of patient- and family-centred care. The aim of this systematic literature review was to describe physician-related barriers to adequate communication within the team and with patients and families, as well as barriers to patient- and family-centred decision-making, towards the end of life in the ICU. We base our discussion and evaluation on the quality indicators for end-of-life care in the ICU developed by the Robert Wood Johnson Foundation Critical Care End-of-Life Peer Workgroup. Four electronic databases (MEDLINE, Embase, CINAHL and PsycINFO) were searched, using controlled vocabulary and free text words, for potentially relevant records published between 2003 and 2013 in English or Dutch. Studies were included if the authors reported on physician-related and physician-reported barriers to adequate communication and decision-making. Barriers were categorized as being related to physicians' knowledge, physicians' attitudes or physicians' practice. Study quality was assessed using design-specific tools. Evidence for barriers was graded according to the quantity and quality of studies in which the barriers were reported. Of 2,191 potentially relevant records, 36 studies were withheld for data synthesis. We determined 90 barriers, of which 46 were related to physicians' attitudes, 24 to physicians' knowledge and 20 to physicians' practice. Stronger evidence was found for physicians' lack of communication training and skills, their attitudes towards death in the ICU, their focus on clinical parameters and their lack of confidence in their own judgment of their patient's true condition. We conclude that many physician-related barriers hinder adequate communication and shared decision-making in ICUs. Better physician education and palliative care guidelines are needed to enhance

  3. End-of-life care communications and shared decision-making in Norwegian nursing homes--experiences and perspectives of patients and relatives.

    Gjerberg, Elisabeth; Lillemoen, Lillian; Førde, Reidun; Pedersen, Reidar

    2015-08-19

    Involving nursing home patients and their relatives in end-of-life care conversations and treatment decisions has recently gained increased importance in several Western countries. However, there is little knowledge about how the patients themselves and their next-of-kin look upon involvement in end-of-life care decisions. The purpose of this paper is to explore nursing home patients' and next-of-kin's experiences with- and perspectives on end-of-life care conversations, information and shared decision-making. The study has a qualitative and explorative design, based on a combination of individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 33 relatives. The data was analysed applying a "bricolage" approach". Participation was based on informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Few patients and relatives had participated in conversations about end-of-life care. Most relatives wanted such conversations, while the patients' opinions varied. With some exceptions, patients and relatives wanted to be informed about the patient's health condition. The majority wanted to be involved in the decision-making process, but leave the final decisions to the health professionals. Among the patients, the opinion varied; some patients wanted to leave the decisions more or less completely to the nursing home staff. Conversations about end-of-life care issues are emotionally challenging, and very few patients had discussed these questions with their family. The relatives' opinions of the patient's preferences were mainly based on assumptions; they had seldom talked about this explicitly. Both patients and relatives wanted the staff to raise these questions. Nursing home staff should initiate conversations about preferences for end-of-life care, assisting patients and relatives in talking about these issues, while at the same time being sensitive to the diversity in

  4. Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis.

    Oczkowski, Simon J; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-01-01

    Patients with serious illness, and their families, state that better communication and decision-making with healthcare providers is a high priority to improve the quality of end-of-life care. Numerous communication tools to assist patients, family members, and clinicians in end-of-life decision-making have been published, but their effectiveness remains unclear. To determine, amongst adults in ambulatory care settings, the effect of structured communication tools for end-of-life decision-making on completion of advance care planning. We searched for relevant randomized controlled trials (RCTs) or non-randomized intervention studies in MEDLINE, EMBASE, CINAHL, ERIC, and the Cochrane Database of Randomized Controlled Trials from database inception until July 2014. Two reviewers independently screened articles for eligibility, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each of the primary and secondary outcomes. Sixty-seven studies, including 46 RCTs, were found. The majority evaluated communication tools in older patients (age >50) with no specific medical condition, but many specifically evaluated populations with cancer, lung, heart, neurologic, or renal disease. Most studies compared the use of communication tools against usual care, but several compared the tools to less-intensive advance care planning tools. The use of structured communication tools increased: the frequency of advance care planning discussions/discussions about advance directives (RR 2.31, 95% CI 1.25-4.26, p = 0.007, low quality evidence) and the completion of advance directives (ADs) (RR 1.92, 95% CI 1.43-2.59, pcare desired and care received by patients (RR 1.17, 95% CI 1.05-1.30, p = 0.004, low quality evidence, 2 RCTs). The use of structured communication tools may increase the frequency of discussions about and completion of advance directives, and concordance between

  5. Review/decide and inquiry/decide. Two approaches to decision making. Report from a team syntegrity meeting. Project RISCOM

    Andersson, Kjell

    1998-01-01

    The meeting addressed the question how it is possible to make decision processes and risk assessment for deep repository development more transparent. The two dominant decision approaches used in Sweden and the UK, review/decide(r/d) and inquiry/decide(i/d), were discussed. The main conclusions from group discussions were: It was acknowledged that the concept of transparency includes three equally important aspects: factual issues, value issues, and stake holder's authenticity. There is a need in both countries to bring in the best aspects of both the r/d and the i/d approaches. Both approaches seem to offer possibilities and suffer limitations with respect to the segregation of facts, uncertainties and value judgements, and some sort of combination of the two may present a valuable development. However, neither the i/d nor the r/d approach seems to provide a good framework for clarification of the value issue. Experts have dominated the decision process in both countries. There is a need for a more genuine consultation process. The Swedish EIA is evolving in this direction. The regulator should take part in the process, also at an early stage. It is important that the integrity of the regulator is maintained. Rules and responsibilities of implementers, regulators, planning authorities and other decision-makers should be established early in the process. The public should know that they have access to a process that clarifies value judgements, facts, uncertainties and questions. It is necessary for the public to know what the technical issues are, and to have the means to evaluate the authenticity of the experts. It is important that political decisions are not taken without due consideration of scientific and technical arguments. There are factors beside safety assessments which are completely legitimate to consider. An approach with intense interaction between politicians, experts and the public is needed

  6. Review/decide and inquiry/decide. Two approaches to decision making. Report from a team syntegrity meeting. Project RISCOM

    Andersson, Kjell [ed.] [Karinta-Konsult, Taeby (Sweden)

    1998-01-01

    The meeting addressed the question how it is possible to make decision processes and risk assessment for deep repository development more transparent. The two dominant decision approaches used in Sweden and the UK, review/decide(r/d) and inquiry/decide(i/d), were discussed. The main conclusions from group discussions were: It was acknowledged that the concept of transparency includes three equally important aspects: factual issues, value issues, and stake holder`s authenticity. There is a need in both countries to bring in the best aspects of both the r/d and the i/d approaches. Both approaches seem to offer possibilities and suffer limitations with respect to the segregation of facts, uncertainties and value judgements, and some sort of combination of the two may present a valuable development. However, neither the i/d nor the r/d approach seems to provide a good framework for clarification of the value issue. Experts have dominated the decision process in both countries. There is a need for a more genuine consultation process. The Swedish EIA is evolving in this direction. The regulator should take part in the process, also at an early stage. It is important that the integrity of the regulator is maintained. Rules and responsibilities of implementers, regulators, planning authorities and other decision-makers should be established early in the process. The public should know that they have access to a process that clarifies value judgements, facts, uncertainties and questions. It is necessary for the public to know what the technical issues are, and to have the means to evaluate the authenticity of the experts. It is important that political decisions are not taken without due consideration of scientific and technical arguments. There are factors beside safety assessments which are completely legitimate to consider. An approach with intense interaction between politicians, experts and the public is needed.

  7. Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

    Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-04-09

    For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU. We searched multiple databases including MEDLINE, Embase, CINAHL, ERIC, and Cochrane from database inception until July 2014. Two reviewers independently screened articles, assessed eligibility, verified data extraction, and assessed risk of bias using the tool described by the Cochrane Collaboration and the Newcastle Ottawa Scale. Pooled estimates of effect (relative risk, standardized mean difference, or mean difference), were calculated where sufficient data existed. GRADE was used to evaluate the overall quality of evidence for each outcome. We screened 5785 abstracts and reviewed the full text of 424 articles, finding 168 eligible articles, including 19 studies in the ICU setting. The use of communication tools increased documentation of goals-of-care discussions (RR 3.47, 95% CI 1.55, 7.75, p = 0.020, very low-quality evidence), but did not have an effect on code status documentation (RR 1.03, 95% CI 0.96, 1.10, p = 0.540, low-quality evidence) or decisions to withdraw or withhold life-sustaining treatments (RR 0.98, 95% CI 0.89, 1.08, p = 0.70, low-quality evidence). The use of such tools was associated with a decrease in multiple measures of health care resource utilization, including duration of mechanical ventilation (MD -1.9 days, 95% CI -3.26, -0.54, p = 0.006, very low-quality evidence), length of ICU stay (MD -1.11 days, 95% CI -2.18, -0.03, p = 0.04, very low-quality evidence), and health care costs (SMD -0.32, 95

  8. End to End Travel

    US Agency for International Development — E2 Solutions is a web based end-to-end travel management tool that includes paperless travel authorization and voucher document submissions, document approval...

  9. End-of-life decision making in respiratory failure. The therapeutic choices in chronic respiratory failure in a 7-item questionnaire

    Dagmar Elfriede Rinnenburger

    2012-01-01

    Full Text Available INTRODUCTION: The transition from paternalistic medicine to a healthcare culture centred on the patient's decision making autonomy presents problems of communication and understanding. Chronic respiratory failure challenges patients, their families and caregivers with important choices, such as invasive and non-invasive mechanical ventilation and tracheostomy, which, especially in the case of neuromuscular diseases, can significantly postpone the end of life. MATERIAL AND METHODS: A 7-item questionnaire was administered to 100 patients with advanced COPD, neuromuscular diseases and pulmonary fibrosis, all of them on oxygen therapy and receiving day-hospital treatment for respiratory failure. The objective was to find out whether or not patients, if faced with a deterioration of their health condition, would want to take part in the decision making process and, if so, how and with whom. RESULTS. Results showed that: 90% of patients wanted to be interviewed, 10% preferred not to be interviewed, 82% wanted to be regularly updated on their clinical situation, 75% wanted to be intubated, if necessary, and 56% would also agree to have a tracheostomy. These choices have been confirmed one year later, with 93% of respondents accepting the questionnaire and considering it useful. CONCLUSIONS: It is possible to conclude that a simple questionnaire can be a useful tool contributing to therapeutic decision making in respiratory failure.

  10. Physician Approaches to Conflict with Families Surrounding End-of-Life Decision-making in the Intensive Care Unit. A Qualitative Study.

    Mehter, Hashim M; McCannon, Jessica B; Clark, Jack A; Wiener, Renda Soylemez

    2018-02-01

    Families of critically ill patients are often asked to make difficult decisions to pursue, withhold, or withdraw aggressive care or resuscitative measures, exercising "substituted judgment" from the imagined standpoint of the patient. Conflict may arise between intensive care unit (ICU) physicians and family members regarding the optimal course of care. To characterize how ICU physicians approach and manage conflict with surrogates regarding end-of-life decision-making. Semistructured interviews were conducted with 18 critical care physicians from four academically affiliated hospitals. Interview transcripts were analyzed using methods of grounded theory. Physicians described strategies for engaging families to resolve conflict about end-of-life decision-making and tending to families' emotional health. Physicians commonly began by gauging family receptiveness to recommendations from the healthcare team. When faced with resistance to recommendations for less aggressive care, approaches ranged from deference to family wishes to various persuasive strategies designed to change families' minds, and some of those strategies may be counterproductive or harmful. The likelihood of deferring to family in the event of conflict was associated with the perceived sincerity of the family's "substituted judgment" and the ability to control patient pain and suffering. Physicians reported concern for the family's emotional needs and made efforts to alleviate the burden on families by assuming decision-making responsibility and expressing nonabandonment and commitment to the patient. Physicians were attentive to repairing damage to their relationship with the family in the aftermath of conflict. Finally, physicians described their own emotional responses to conflict, ranging from frustration and anxiety to satisfaction with successful resolution of conflict. Critical care physicians described a complex and multilayered approach to physician-family conflict. The reported strategies

  11. Hydration and nutrition at the end of life: a systematic review of emotional impact, perceptions, and decision-making among patients, family, and health care staff.

    Del Río, M I; Shand, B; Bonati, P; Palma, A; Maldonado, A; Taboada, P; Nervi, F

    2012-09-01

    Decrease in oral intake, weight loss, and muscular weakness in the last phases of a terminal illness, particularly in the context of the cachexia-anorexia syndrome, can be an important source of anxiety for the triad of patient, family, and health staff. The present literature review examines the emotional impact of reduced oral intake as well as perceptions and attitudes toward assisted nutrition and hydration for terminally ill patients(1) at the end of life, among patients, family, and health care staff. We have identified the ways in which emotional and cultural factors influence decision-making about assisted nutrition and hydration. Lack of information and misperceptions of medically assisted nutrition and hydration can play a predominant role in the decision to begin or suspend nutritional or hydration support. Our literature review reveals that these social, emotional, and clinical misperception elements should be considered in the decision-making processes to help the triad develop functional forms of care at this final stage of life. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

  12. A Legal and Ethical Analysis of the Effects of Triggering Conditions on Surrogate Decision-Making in End-of-Life Care in the US.

    Clint Parker, J; Goldberg, Daniel S

    2016-03-01

    The central claim of this paper is that American states' use of so-called "triggering conditions" to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the triggering conditions, and yet both the appropriate surrogates and the care team agree that withdrawal of life-sustaining treatment is in the best interest of the patient. The paper surveys applicable law across the 50 states and weighs the arguments for and against the inclusion of such triggering conditions in relevant legal regimes. The paper concludes by assessing the various legal and policy options states have for regulating surrogate decision-making authority in light of the moral considerations (including epistemic difficulties), and notes the possibility for conflict within ethics teams arising from the potential tension between prudence, risk-aversion, and moral obligation.

  13. Decision making about medical interventions in the end-of-life care of people with intellectual disabilities: a national survey of the considerations and beliefs of GPs, ID physicians and care staff.

    Bekkema, N.; Veer, A.J.E. de; Wagemans, A.M.A.; Hertogh, C.M.P.M.; Francke, A.L.

    2014-01-01

    Objective: This paper explores the personal beliefs and specific considerations of professionals regarding decisions about potentially burdensome medical interventions in the end-of-life care for people with intellectual disabilities (ID). Methods: A survey questionnaire covering decision making

  14. Decision making about medical interventions in the end-of-life care of people with intellectual disabilities: A national survey of the considerations and beliefs of GPs, ID physicians and care staff

    Bekkema, N.; de Veer, A.J.E.; Wagemans, A.M.A.; Hertogh, C.M.P.M.; Francke, A.L.

    2014-01-01

    Objective: This paper explores the personal beliefs and specific considerations of professionals regarding decisions about potentially burdensome medical interventions in the end-of-life care for people with intellectual disabilities (ID). Methods: A survey questionnaire covering decision making

  15. The Impact of Faith Beliefs on Perceptions of End-of-Life Care and Decision Making among African American Church Members.

    Johnson, Jerry; Hayden, Tara; True, Jennifer; Simkin, Daren; Colbert, Louis; Thompson, Beverly; Stewart, Denise; Martin, Latoya

    2016-02-01

    African Americans underuse palliative care and hospice services because of a combination of factors including faith beliefs. As the spiritual family for many African Americans, the church presents an opportunity to improve communication about palliative care and hospice and end-of-life (EOL) decision making. We conducted a focus group study to understand the cultural and spiritual perspectives that influence decisions about palliative care and hospice among African American church members who visit and support persons with life-limiting illnesses. Our specific aims were to elicit their perceptions, beliefs, and attitudes about: (1) the relation between faith beliefs and EOL care; (2) emotional and family influences on EOL decision making; (3) palliative care and hospice resources; and (4) opportunities to improve communication among lay persons and health professionals and within families. Seven focus groups using purposeful sampling. We partnered with two African American churches. Of 51 persons, 27 were deacons or deaconesses, 17 were members of health or bereavement ministries, and 7 were other members of the congregations. We found that faith beliefs of African Americans can support discussions about palliative care and hospice. Participants perceived that many of their congregants harbor beliefs, perceptions, and feelings about death and dying that were often not communicated to family members or to health providers. Among African Americans, faith beliefs, emotional issues, family dynamics, and insufficient knowledge of palliative care and hospice are intertwined and influence decision making about palliative care and hospice. Our findings confirm the influence of faith beliefs of African Americans on decisions about palliative care and hospice and demonstrate the opportunity to improve communication about palliative care and hospice and EOL through collaborations with the African American church.

  16. The Trial of Ascertaining Individual Preferences for Loved Ones' Role in End-of-Life Decisions (TAILORED) Study: A Randomized Controlled Trial to Improve Surrogate Decision Making.

    Sulmasy, Daniel P; Hughes, Mark T; Yenokyan, Gayane; Kub, Joan; Terry, Peter B; Astrow, Alan B; Johnson, Julie A; Ho, Grace; Nolan, Marie T

    2017-10-01

    Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role. To test the effectiveness of an intervention to help surrogate decision makers. One hundred sixty-six patients (41% with amyotrophic lateral sclerosis and 59% with gastrointestinal cancers) and their surrogates at two university medical centers were randomized to an intensive nurse-directed discussion of the end-of-life decision control preferences of the patient (TAILORED) or a discussion of nutrition (CONTROL); 163 completed baseline interviews and underwent the intervention. Twelve patients died during follow-up and 137 dyads completed the study. Post-intervention, using all available data, TAILORED patients and surrogates became more likely to endorse mutual surrogate decision making, that is, a balance of their own wishes and what the surrogate thinks best (adjusted odds compared with baseline for patients = 1.78, P = 0.04; adjusted odds for surrogates = 2.05, P = 0.03). CONTROL patients became 40% less likely to endorse mutual surrogate decision making (P = 0.08), and CONTROL surrogates did not change significantly from baseline (adjusted odds = 1.44, P = 0.28). Stress levels decreased for TAILORED surrogates (impact of events scale = 23.1 ± 14.6 baseline, 20.8 ± 15.3 f/u, P = 0.046), but not for CONTROL (P = 0.85), and post-intervention stress was lower for TAILORED than CONTROL (P = 0.04). Surrogates' confidence was uniformly high at baseline and did not change. Caregiver burden (Zarit) increased from 12.5 ± 6.5 to 14.7 ± 8.1 for TAILORED (P decision making was higher at follow-up for TAILORED than for CONTROL (71% vs. 52%, P = 0.03). TAILORED patients and surrogates who

  17. "It's hard to ask": examining the factors influencing decision-making among end-stage renal disease patients considering approaching family and friends for a kidney.

    Jones, Merryn A; Cornwall, Jon

    2018-05-04

    People needing kidney transplants in New Zealand can receive organs from deceased donors or from a living kidney donor. This project explored issues surrounding donor recruitment, examining the lived experience of end-stage renal disease (ESRD) patients in order to facilitate improved donor recruitment for ESRD patients. A qualitative study comprising interviews of ESRD patients in Hawke's Bay, focusing on the factors surrounding approaching family and friends for a kidney. Purposeful sampling and thematic analysis of data was utilised. Fifteen participants were interviewed (Five female; mean age 49.8yrs). Most stated it was hard to ask for a kidney; almost half had never approached anyone. For many, approaching potential donors was a barrier. Many Māori had limited recruitment opportunities due to comorbidities within extended whanau, making the decision of who to approach difficult. Other barriers included concern for donor health, poor health literacy and poor self-efficacy. Recipients desired more support to facilitate approaching donors, with cultural differences observed between Māori and non-Māori in recruitment expectations. Tailored support could be enabled with development of a screening tool to assess willingness and motivation to accept donation, cultural needs, self-efficacy, communication skills and health literacy. Psychosocial support could help address barriers such as reciprocity concerns.

  18. Online public reactions to fMRI communication with patients with disorders of consciousness: Quality of life, end-of-life decision making, and concerns with misdiagnosis.

    Chandler, Jennifer A; Sun, Jeffrey A; Racine, Eric

    2017-01-01

    Recently, the news media have reported on the discovery of covert awareness and the establishment of limited communication using a functional magnetic resonance imaging (fMRI) neuroimaging technique with several brain-injured patients thought to have been in a vegetative state. This discovery has raised many ethical, legal, and social questions related to quality of life, end-of-life decision making, diagnostic and prognostic accuracy in disorders of consciousness, resource allocation, and other issues. This project inquires into the public responses to these discoveries. We conducted a thematic analysis of online comments (n = 779) posted in response to 15 news articles and blog posts regarding the case of a Canadian patient diagnosed for 12 years as in a vegetative state, but who was reported in 2012 as having been able to communicate via fMRI. The online comments were coded using an iteratively refined codebook structured around 14 main themes. Among the most frequent public reactions revealed in the online comments were discussions of the quality of life of patients with disorders of consciousness, whether life-sustaining treatment should be withdrawn (and whether the fMRI communication technique should be used to ask patients about this), and misgivings about the accuracy of diagnosis in disorders of consciousness and brain death. These public perspectives are relevant to the obligations of clinicians, lawyers, and public policymakers to patients, families, and the public. Future work should consider how best to alleviate families' concerns as this type of research shakes their faith in diagnostic accuracy, to clarify the legal rules relating to advance directives in this context, and to address the manner in which public messaging might help to alleviate any indirect impact on confidence in the organ donation system.

  19. Early home-based group education to support informed decision-making among patients with end-stage renal disease: a multi-centre randomized controlled trial.

    Massey, Emma K; Gregoor, Peter J H Smak; Nette, Robert W; van den Dorpel, Marinus A; van Kooij, Anthony; Zietse, Robert; Zuidema, Willij C; Timman, Reinier; Busschbach, Jan J; Weimar, Willem

    2016-05-01

    The aim was to test the effectiveness of early home-based group education on knowledge and communication about renal replacement therapy (RRT). We conducted a randomized controlled trial using a cross-over design among 80 end-stage renal disease (ESRD) patients. Between T0 and T1 (weeks 1-4) Group 1 received the intervention and Group 2 received standard care. Between T1 and T2 (weeks 5-8) Group 1 received standard care and Group 2 received the intervention. The intervention was a group education session on RRT options held in the patient's home given by social workers. Patients invited members from their social network to attend. Self-report questionnaires were used at T0, T1 and T2 to measure patients' knowledge and communication, and concepts from the Theory of Planned Behaviour such as attitude. Comparable questionnaires were completed pre-post intervention by 229 attendees. Primary RRT was registered up to 2 years post-intervention. Multilevel linear modelling was used to analyse patient data and paired t-tests for attendee data. Statistically significant increases in the primary targets knowledge and communication were found among patients and attendees after receiving the intervention. The intervention also had a significant effect in increasing positive attitude toward living donation and haemodialysis. Of the 80 participants, 49 underwent RRT during follow-up. Of these, 34 underwent a living donor kidney transplant, of which 22 were pre-emptive. Early home-based group education supports informed decision-making regarding primary RRT for ESRD patients and their social networks and may remove barriers to pre-emptive transplantation. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  20. Key role of social work in effective communication and conflict resolution process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and shared medical decision making at the end of life.

    Bomba, Patricia A; Morrissey, Mary Beth; Leven, David C

    2011-01-01

    In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care.

  1. Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

    Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

    2018-01-01

    Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

  2. Social disinvestment and vulnerable groups in Europe in the aftermath of the financial crisis : The case of households that have difficulties with making ends meet in the Netherlands

    Haffner, M.E.A.; Elsinga, M.G.; Marien, A.A.A.

    2017-01-01

    After the Netherlands in 2009 landed in the first of three recessions, the government, which took office in 2012, announced that spending cuts had become inevitable. Government deficits and government debts were increasing and the country no longer complied with the requirements for a stable

  3. Making Ends Meet: Flow Synthesis as the Answer to Reproducible High-Performance Conjugated Polymers on the Scale that Roll-to-Roll Processing Demands

    Helgesen, Martin; Carlé, Jon Eggert; Benatto, Gisele Alves dos Reis

    2015-01-01

    reaction times down to 10 min afforded PBDTTTz-4 with high molecular weight and a constant quality. The flow method enables full control of the molecular weight via tuning of the flow speed, catalyst loading, and temperature and avoids variation in materials’ quality associated with conventional batch......Continuous flow methods are employed for the controlled polymerization of the roll-to-roll (R2R) compatible polymer PBDTTTz-4 including optimization and upscaling experiments. The polymerization rate and materials’ quality can be increased significantly with the continuous fl ow method where...

  4. Using simulation to isolate physician variation in intensive care unit admission decision making for critically ill elders with end-stage cancer: a pilot feasibility study.

    Barnato, Amber E; Hsu, Heather E; Bryce, Cindy L; Lave, Judith R; Emlet, Lillian L; Angus, Derek C; Arnold, Robert M

    2008-12-01

    To determine the feasibility of high-fidelity simulation for studying variation in intensive care unit admission decision making for critically ill elders with end-stage cancer. Mixed qualitative and quantitative analysis of physician subjects participating in a simulation scenario using hospital set, actors, medical chart, and vital signs tracings. The simulation depicted a 78-yr-old man with metastatic gastric cancer, life-threatening hypoxia most likely attributable to cancer progression, and stable preferences to avoid intensive care unit admission and intubation. Two independent raters assessed the simulations and subjects completed a postsimulation web-based survey and debriefing interview. Peter M. Winter Institute for Simulation Education and Research at the University of Pittsburgh. Twenty-seven hospital-based attending physicians, including 6 emergency physicians, 13 hospitalists, and 8 intensivists. Outcomes included qualitative report of clinical verisimilitude during the debriefing interview, survey-reported diagnosis and prognosis, and observed treatment decisions. Independent variables included physician demographics, risk attitude, and reactions to uncertainty. All (100%) reported that the case and simulation were highly realistic, and their diagnostic and prognostic assessments were consistent with our intent. Eight physicians (29.6%) admitted the patient to the intensive care unit. Among the eight physicians who admitted the patient to the intensive care unit, three (37%) initiated palliation, two (25%) documented the patient's code status (do not intubate/do not resuscitate), and one intubated the patient. Among the 19 physicians who did not admit the patient to the intensive care unit, 13 (68%) initiated palliation and 5 (42%) documented code status. Intensivists and emergency physicians (p = 0.048) were more likely to admit the patient to the intensive care unit. Years since medical school graduation were inversely associated with the

  5. End of Life Issues

    Planning for the end of life can be difficult. But by deciding what end-of-life care best suits your needs when you are healthy, you can ... right choices when the time comes. End-of-life planning usually includes making choices about the following: ...

  6. Preferences for care towards the end of life when decision-making capacity may be impaired: A large scale cross-sectional survey of public attitudes in Great Britain and the United States.

    Gemma Clarke

    Full Text Available There is continuing public debate about treatment preferences at the end of life, and the acceptability and legal status of treatments that sustain or end life. However, most surveys use binary yes/no measures, and little is known about preferences in neurological disease when decision-making capacity is lost, as most studies focus on cancer. This study investigates changes in public preferences for care towards the end of life, with a focus on measures to sustain or end life.Large-scale international public opinion surveys using a six-stage patient vignette, respondents chose a level of intervention for each stage as health and decision-making capacity deteriorated. Cross-sectional representative samples of the general public in Great Britain and the USA (N = 2016. Primary outcome measure: changes in respondents' preferences for care, measured on a four-point scale designed before data collection. The scale ranged from: maintaining life at all costs; to intervention with agreement; to no intervention; to measures for ending life.There were no significant differences between GB and USA. Preference for measures to sustain life at all costs peaked at short-term memory loss (30.2%, n = 610. Respondents selecting 'measures to help me die peacefully' increased from 3.9% to 37.0% as the condition deteriorated, with the largest increase occurring when decision-making capacity was lost (10.3% to 23.0%. Predictors of choosing 'measures to help me die peacefully' at any stage were: previous personal experience (OR = 1.34, p<0.010, and older age (OR = 1.09 per decade, p<0.010. Negative predictors: living with children (OR = 0.72, p<0.010 and being of "black" race/ethnicity (OR = 0.45, p<0.001.Public opinion was uniform between GB and USA, but markedly heterogeneous. Despite contemporaneous capacitous consent providing an essential legal safeguard in most jurisdictions, there was a high prevalence of preference for "measures to end my life peacefully" when

  7. Ethical issues in communication of diagnosis and end-of-life decision-making process in some of the Romanian Roma communities.

    Roman, Gabriel; Enache, Angela; Pârvu, Andrada; Gramma, Rodica; Moisa, Ştefana Maria; Dumitraş, Silvia; Ioan, Beatrice

    2013-08-01

    Medical communication in Western-oriented countries is dominated by concepts of shared decision-making and patient autonomy. In interactions with Roma patients, these behavioral patterns rarely seem to be achieved because the culture and ethnicity have often been shown as barriers in establishing an effective and satisfying doctor-patient relationship. The study aims to explore the Roma's beliefs and experiences related to autonomy and decision-making process in the case of a disease with poor prognosis. Forty-eight Roma people from two Romanian counties participated in semi-structured interviews, conducted by a research team from the University of Medicine and Pharmacy of Iasi. Participants were recruited among the chronically ill patients and caregivers. The Roma community opposes informing the terminal patients about their condition, the "silence conspiracy" being widely practiced. The family fully undertakes the right of decision making, thus minimizing the patient's autonomy. We identified ethical dilemmas concerning autonomy, lack of patients' real decision-making power, and paternalistic attitudes exerted firstly by the family and, on demand, by the physician. Instead, the Roma patient benefits from a very active support network, being accompanied at the hospital by numerous relatives. The patient's right to make autonomous decisions promoted in the Western countries and stipulated by the Romanian law has diminished value in the Roma community. For the Roma, the understanding of dignity is not simply individual and personal, but it is closely related to their cultural particularities. Ignoring their cultural values could create conflicts between healthcare providers and community.

  8. Is patient autonomy a critical determinant of quality of life in Korea? End-of-life decision making from the perspective of the patient.

    Mo, Ha Na; Shin, Dong Wook; Woo, Jae Ha; Choi, Jin Young; Kang, Jina; Baik, Young Ji; Huh, Yu Rae; Won, Joo Hee; Park, Myung Hee; Cho, Sang Hee

    2012-04-01

    We aimed to investigate the current practice of the involvement in decision making from the perspectives of terminal cancer patients, and to explore its possible associations with quality of life and quality of death in Korea. A multi-center, cross-sectional survey was performed on 93 terminal cancer patients. The questionnaire solicited their opinions regarding participation in treatment decision making, as well as quality of life (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for Palliative Care) and quality of death (Good Death Inventory-Patient Version). A total of 78.5% of the patients had awareness of their terminal status, while 21.5% did not; 42.4% stated that they knew their condition and shared the decision-making responsibility with the medical staff and their family, while 21.7% made decisions on their own, and 35.9% left the decision-making responsibility to others. Patients who were aware of their illness and who actively participated in the decision making did not score higher than others on outcome measures of quality of life and quality of death. Moreover, the former even showed lower scores in some domains, including the 'physical and psychological comfort' (4.99 versus 5.61, p = 0.03), 'environmental comfort' (5.51 versus 6.04, p = 0.08), and 'emotional functioning' (55.70 versus 71.01, p = 0.06). in Korea, patient autonomy is not a universally accepted value from the perspectives of terminal cancer patients, nor is patient involvement in decision making always conducive to high quality of life or quality of death. The level of information and the pace at which it is provided should be tailored to each individual's ability, preference, need, and culture.

  9. The reluctance to burden others as a value in end-of-life decision making: a source of inaccuracy in substituted judgment.

    Winter, Laraine; Parks, Susan M

    2012-03-01

    Most patients are decisionally incapacitated at the end of life, leaving final treatment decisions to proxies, whose substituted judgment is often inaccurate. We investigated the reluctance to burden others (RBO), a commonly cited patient value, as a possible source of proxy inaccuracy. In a sample of 202 elders and their proxies, elders responded to three burden-related questions and the Life-prolonging Treatment Preferences Questionnaire. Proxies used substituted judgment to respond to the same questions. Although RBO predicted treatment preferences for both elders and proxies, elders rated RBO significantly more important than did proxies. In addition, larger elder-proxy differences in RBO were associated with more inaccurate substituted judgment.

  10. Evolution and ecology meet molecular genetics: adaptive phenotypic plasticity in two isolated Negev desert populations of Acacia raddiana at either end of a rainfall gradient

    Ward, David; Shrestha, Madan K.; Golan-Goldhirsh, Avi

    2012-01-01

    Background and Aims The ecological, evolutionary and genetic bases of population differentiation in a variable environment are often related to the selection pressures that plants experience. We compared differences in several growth- and defence-related traits in two isolated populations of Acacia raddiana trees from sites at either end of an extreme environmental gradient in the Negev desert. Methods We used random amplified polymorphic DNA (RAPD) to determine the molecular differences between populations. We grew plants under two levels of water, three levels of nutrients and three levels of herbivory to test for phenotypic plasticity and adaptive phenotypic plasticity. Key Results The RAPD analyses showed that these populations are highly genetically differentiated. Phenotypic plasticity in various morphological traits in A. raddiana was related to patterns of population genetic differentiation between the two study sites. Although we did not test for maternal effects in these long-lived trees, significant genotype × environment (G × E) interactions in some of these traits indicated that such plasticity may be adaptive. Conclusions The main selection pressure in this desert environment, perhaps unsurprisingly, is water. Increased water availability resulted in greater growth in the southern population, which normally receives far less rain than the northern population. Even under the conditions that we defined as low water and/or nutrients, the performance of the seedlings from the southern population was significantly better, perhaps reflecting selection for these traits. Consistent with previous studies of this genus, there was no evidence of trade-offs between physical and chemical defences and plant growth parameters in this study. Rather, there appeared to be positive correlations between plant size and defence parameters. The great variation in several traits in both populations may result in a diverse potential for responding to selection pressures in

  11. High-End Scientific Computing

    EPA uses high-end scientific computing, geospatial services and remote sensing/imagery analysis to support EPA's mission. The Center for Environmental Computing (CEC) assists the Agency's program offices and regions to meet staff needs in these areas.

  12. Planning and conducting meetings effectively, part I: planning a meeting.

    Harolds, Jay

    2011-12-01

    Meetings are held by leaders for many purposes, including conveying information, raising morale, asking for opinions, brain storming, making people part of the problem-solving process, building trust, getting to a consensus, and making decisions. However, many meetings waste time, some undermine the leader's power, and some decrease morale. Part I of this series of articles gives some tips on basic planning for decision-making meetings. Part II of this series of articles analyzes selected components of decision-making meetings. Part III of this series will be on how the chairperson keeps decision-making meetings on track to make them efficient and productive.

  13. The End

    Hasse Jørgensen, Stina

    2016-01-01

    Operaen THE END af den japanske komponist og DJ, Keiichiro Shibuya, skubber radikalt til publikums forventninger om, hvad en opera kan og skal være. THE END byder på 3D animation, surround sound, elektronisk glitch og syntetiske stemmer i en kompromisløs virtuel forestilling med det japanske...

  14. Making "ethical safe space" in the translation of contested knowledge: the role of community debate in defining end-of-life decision ethics.

    Kaufert, Joseph; Schwartz, Karen; Wiebe, Rhonda; Derksen, Jim; Lutfiyya, Zana M; Richert, Dean

    2013-04-01

    The objectives of this article are, first, to document a unique process of research knowledge translation (KT), which the authors describe as the creation of "ethical safe space," and, second, to document the narratives of forum participants and describe their interaction in a dialogue about vulnerability, the authority of physicians, and the perspective of people with disabilities on the policy. Narrative data from qualitative interviews with individual key informants and focus groups were used to identify speakers with specific expertise on policy, disability perspectives, and bioethical issues, who were invited to participate in the Forum on Ethical Safe Space. The planning workgroup adopted a model for enabling representative participation in the public forum designed to reduce the impact of physical, sensory, financial, language, and professional status barriers. Using the transcripts and keynote speakers' printed texts, primary themes and patterns of interaction were identified reflecting the alternative perspectives. Through the development of a workshop on ethical, legal, and disability-related implications of professional policy guidelines developed by the College of Physicians and Surgeons of Manitoba, we provided a qualitative analysis of the discourse involving experts and disability community members supporting alternative positions on the impact of the policy statement, and discuss ethical, legal, and disability rights issues identified in the public debate. Contested policy and ethical frameworks for making decisions about withdrawing and withholding life supporting treatment may influence both the perspectives of palliative care providers and patients referred to palliative care facilities. An innovative model for KT using a public forum that enabled stakeholders with conflicting perspectives to engage with ethical and professional policy issues asserting the physician's authority in contested decisions involving withdrawing or withholding life

  15. Steel making

    Chakrabarti, A K

    2014-01-01

    "Steel Making" is designed to give students a strong grounding in the theory and state-of-the-art practice of production of steels. This book is primarily focused to meet the needs of undergraduate metallurgical students and candidates for associate membership examinations of professional bodies (AMIIM, AMIE). Besides, for all engineering professionals working in steel plants who need to understand the basic principles of steel making, the text provides a sound introduction to the subject.Beginning with a brief introduction to the historical perspective and current status of steel making together with the reasons for obsolescence of Bessemer converter and open hearth processes, the book moves on to: elaborate the physiochemical principles involved in steel making; explain the operational principles and practices of the modern processes of primary steel making (LD converter, Q-BOP process, and electric furnace process); provide a summary of the developments in secondary refining of steels; discuss principles a...

  16. You never get a second chance to make a first impression : meet your users’ expectations regarding web object placement in online shops

    Bargas-Avila, J. A.; Roth, S. P.; Tuch, A. N.; Opwis, K.

    2011-01-01

    Knowledge about users’ expectations and mental models is a key aspect of interface development. By meeting users’ expectations, errors may be prevented and interaction quality enhanced. In the case of online shops, this means that it is crucial to know where users expect to find the most common Web ob- jects such as the search field, shopping cart, or navigation. In this chapter, we show how users’ mental models of an online shop can be analyzed and validated empirically. The resulting model ...

  17. Learning to Facilitate (Online) Meetings

    Reimann, Peter; Bull, Susan; Vatrapu, Ravi

    2013-01-01

    We describe an approach to teaching collaboration skills directly by building on competences for meeting facilitation. (Online) meetings provide a rich arena to practice collaboration since they can serve multiple purposes: learning, problem solving, decision making, idea generation and advancement...

  18. Treatment decision-making for advanced non-small cell lung cancer and differences among European countries: 1st AIOT-ETOP meeting.

    Gridelli, Cesare; Stahel, Rolf; Besse, Benjamin; Ciardiello, Fortunato; Felip, Enriqueta; Gasparini, Stefano; Graziano, Paolo; Rossi, Antonio; de Marinis, Filippo

    2011-12-01

    The Italian Association of Thoracic Oncology (AIOT) and the European Thoracic Oncology Platform (ETOP) realized the first conjunct educational meeting, open to European oncologists involved in the treatment of thoracic malignancies, entitled "Advanced non-small cell lung cancer: new perspectives in first-line setting". The educational meeting included 8 interactive talks, held by European key opinion leaders, and 5 related clinical cases in which the attendees, divided in working tables based on their country origin, were involved for interactive discussion. The aim of this course was to elucidate the differences or similarities among the European countries in the first-line treatment of patients affected by advanced non-small cell lung cancer (NSCLC). Twenty-two attendees of the following countries participated: Austria, France, Italy, Spain, Swiss, and UK. As expected, some discrepancies between the groups were identified concerning the approach to the diagnostic phase, the choice of first-line regimen, the duration of treatment and the use of maintenance therapy. These discrepancies were mainly due to familiarity with specific therapies and lack of access to certain therapies due to local regulatory issues. The European Medicine Agency grants marketing of drugs in all Europe, regulatory agency of each country can register the drug, but can also deny public reimbursement thus restricting the options of the oncologist. The European Oncology Associations should join to their effort to achieve a uniform access to the cancer therapy for all patients in Europe. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Meeting excellence: 33 tools to lead meetings that get results

    Parker, Glenn; Hoffman, Robert

    2006-01-01

    ... Chapter 17 - TELECONFERENCE TIPS Chapter 18 - ACHIEVING CLEAR COMMUNICATION IN A MULTICULTURAL MEETING Chapter 19 - HOW TO MAKE A DECISION Chapter 20 - PRESENTING AT A TEAM MEETINGChapter 21 - ...

  20. The effectiveness of sharp end and rounded end bristle toothbrush

    Paulus Januar; Anastasia Susetyo; Ratih Widyastuti

    2010-01-01

    Background: Numerous designs of manual toothbrush are available in the market with the claims of superiority in plaque removal. It often makes the public confuse which is the best design. The sharp end bristle toothbrush is a modification that commercially available in the market. Purpose: The objective of the study was to compare the effectiveness in plaque removal of the sharp end bristle toothbrush and the rounded end bristle toothbrush. Methods: This clinical trial was a double blind cros...

  1. Joint federal research and development process to meet state and local needs. Part 1. Science and technology and political decision making

    Wise, H F; Smith, L K; Einsweiler, R C; Jensen, D E

    1980-10-01

    This part of the handbook addresses the basic how to do it - how states and local governments can identify complex and cross-cutting issues and develop and manage scientific and technical resources in seeking policy solutions to such issues. The following subjects are discussed: background statement of the issue; the research/decision-making process; defining problems and identifying research components; research and decision-making strategies; how to identify existing knowledge or ongoing research in the area of policy concern; and managing multi-disciplinary research. The fourteen agencies involved in this effort include: US Departments of Energy, Agriculture, Transportation, Housing and Urban Development, Environmental Protection Agency, and National Science Foundation. (PSB)

  2. Application of multi-criteria decision-making model for choice of the optimal solution for meeting heat demand in the centralized supply system in Belgrade

    Grujić, Miodrag; Ivezić, Dejan; Živković, Marija

    2014-01-01

    The expected growth of living standard, number of inhabitants and development of technology, industry and agriculture will cause a significant increase of energy consumption in cities. Three scenarios of energy sector development until 2030 and corresponding energy consumption for the city of Belgrade are analyzed in this paper. These scenarios consider different level of economic development, investments in energy sector, substitution of fossil fuels, introduction of renewable energy sources and implementation of energy efficiency measures. The proposed model for selection of optimal district heating system compares different options for fulfilling expected new heat demand through eight criteria for each scenario. Proposed options are combination of different energy sources and technologies for their use. The criteria weights are set according to Serbian economy and energy position. The criteria include financial aspects, environmental impact and availability of energy. Multi-criteria method ELECTRE (ELimination Et Choix Traduisant la REalite) is used as a tool for obtaining the optimal option. It is concluded that combination of CHP (combined heat and power) plant and centralized use of geothermal energy is optimal choice in the optimistic scenario. In the pessimistic and business as usual scenario the optimal option is combination of new gas boilers and centralized use of geothermal energy. - Highlights: • Three scenarios for meeting new heat demand are developed and assessed. • Constructing CHP (combined heat and power) is desirable in case of significant electricity price growth. • In all scenarios the chosen option includes using geothermal energy for heating

  3. Dos procesos de fin de vida: Cuando la intervención de los profesionales marca la diferencia Two end-of-life processes: When professional intervention makes all the difference

    J. Schmidt

    2008-12-01

    Full Text Available Introducción. Desde el punto de vista de la medicina curativa actual la muerte es una consecuencia indeseable, que no debe contemplarse como una posibilidad. El desarrollo de la medicina paliativa está cambiando estas mentalidades, aunque persisten aún muchos problemas organizativos. Metodología. En este artículo presentamos dos procesos de fin de vida: en una unidad de cuidados paliativos y en unidades hospitalarias convencionales. Los datos se recogieron a través de familiares trascurrido un mes desde su fallecimiento. Los datos se analizaron cualitativamente mediante análisis narrativo. Resultados. El conocimiento u omisión del diagnóstico y del pronóstico marca la diferencia entre los dos procesos y el posterior duelo de la familia. Discusión. El conocimiento de la cercanía de la propia muerte permite al paciente y a la familia elaborar estrategias de duelo anticipado y contribuye a afianzar la sensación de “auto-control”. El desconocimiento de dicho diagnóstico se traduce en un esfuerzo infructuoso por la alternativa curativa. Los cuidados paliativos han demostrado que cuando las necesidades físicas y emocionales de los procesos de fin de vida son tenidas en cuenta disminuye la frustración en el paciente y la familia.Introduction. From the point of view of modern curative medicine, death is an undesirable consequence which should not be considered as a possibility. Although the development of palliative medicine is changing those attitudes, many organisational problems still persist. Methodology. In this article we present two end-of-life processes: one in a palliative care unit and one in conventional hospital units. Data were collected from family members a month after the patients' deaths. Data were qualitatively analysed using narrative analysis. Results. The knowledge or omission of diagnostic and prognostic makes all the difference in both processes and in the subsequent families' grief. Discussion. Being aware of

  4. Nuclear fuel cycle, nuclear fuel makes the rounds: choosing a closed fuel cycle, nuclear fuel cycle processes, front-end of the fuel cycle: from crude ore to enriched uranium, back-end of the fuel cycle: the second life of nuclear fuel, and tomorrow: multiple recycling while generating increasingly less waste

    Philippon, Patrick

    2016-01-01

    France has opted for a policy of processing and recycling spent fuel. This option has already been deployed commercially since the 1990's, but will reach its full potential with the fourth generation. The CEA developed the processes in use today, and is pursuing research to improve, extend, and adapt these technologies to tomorrow's challenges. France has opted for a 'closed cycle' to recycle the reusable materials in spent fuel (uranium and plutonium) and optimise ultimate waste management. France has opted for a 'closed' nuclear fuel cycle. Spent fuel is processed to recover the reusable materials: uranium and plutonium. The remaining components (fission products and minor actinides) are the ultimate waste. This info-graphic shows the main steps in the fuel cycle currently implemented commercially in France. From the mine to the reactor, a vast industrial system ensures the conversion of uranium contained in the ore to obtain uranium oxide (UOX) fuel pellets. Selective extraction, purification, enrichment - key scientific and technical challenges for the teams in the Nuclear Energy Division (DEN). The back-end stages of the fuel cycle for recycling the reusable materials in spent fuel and conditioning the final waste-forms have reached maturity. CEA teams are pursuing their research in support of industry to optimise these processes. Multi-recycle plutonium, make even better use of uranium resources and, over the longer term, explore the possibility of transmuting the most highly radioactive waste: these are the challenges facing future nuclear systems. (authors)

  5. 21 CFR 312.47 - Meetings.

    2010-04-01

    ... resources permit. The general principle underlying the conduct of such meetings is that there should be free...) “End-of-Phase 2” meetings and meetings held before submission of a marketing application. At specific... meetings held near completion of Phase 3 and before submission of a marketing application (“pre-NDA...

  6. Believer-Skeptic Meets Actor-Critic: Rethinking the Role of Basal Ganglia Pathways during Decision-Making and Reinforcement Learning

    Dunovan, Kyle; Verstynen, Timothy

    2016-01-01

    The flexibility of behavioral control is a testament to the brain's capacity for dynamically resolving uncertainty during goal-directed actions. This ability to select actions and learn from immediate feedback is driven by the dynamics of basal ganglia (BG) pathways. A growing body of empirical evidence conflicts with the traditional view that these pathways act as independent levers for facilitating (i.e., direct pathway) or suppressing (i.e., indirect pathway) motor output, suggesting instead that they engage in a dynamic competition during action decisions that computationally captures action uncertainty. Here we discuss the utility of encoding action uncertainty as a dynamic competition between opposing control pathways and provide evidence that this simple mechanism may have powerful implications for bridging neurocomputational theories of decision making and reinforcement learning. PMID:27047328

  7. End-Users, Front Ends and Librarians.

    Bourne, Donna E.

    1989-01-01

    The increase in end-user searching, the advantages and limitations of front ends, and the role of the librarian in end-user searching are discussed. It is argued that librarians need to recognize that front ends can be of benefit to themselves and patrons, and to assume the role of advisors and educators for end-users. (37 references) (CLB)

  8. Meeting the home-care needs of disabled older persons living in the community: does integrated services delivery make a difference?

    Raîche Michel

    2011-10-01

    Full Text Available Abstract Background The PRISMA Model is an innovative coordination-type integrated-service-delivery (ISD network designed to manage and better match resources to the complex and evolving needs of elders. The goal of this study was to examine the impact of this ISD network on unmet needs among disabled older persons living in the community. Methods Using data from the PRISMA study, we compared unmet needs of elders living in the community in areas with or without an ISD network. Disabilities and unmet needs were assessed with the Functional Autonomy Measurement System (SMAF. We used growth-curve analysis to examine changes in unmet needs over time and the variables associated with initial status and change. Sociodemographic characteristics, level of disability, self-perceived health status, cognitive functioning, level of empowerment, and the hours of care received were investigated as covariates. Lastly, we report the prevalence of needs and unmet needs for 29 activities in both areas at the end of the study. Results On average, participants were 83 years old; 62% were women. They had a moderate level of disability and mild cognitive problems. On average, they received 2.07 hours/day (SD = 1.08 of disability-related care, mostly provided by family. The findings from growth-curve analysis suggest that elders living in the area where ISD was implemented and those with higher levels of disability experience better fulfillment of their needs over time. Besides the area, being a woman, living alone, having a higher level of disability, more cognitive impairments, and a lower level of empowerment were linked to initial unmet needs (r2 = 0.25; p Conclusions In spite of more than 30 years of home-care services in the province of Quebec, disabled older adults living in the community still have unmet needs. ISD networks such as the PRISMA Model, however, appear to offer an effective response to the long-term-care needs of the elderly.

  9. Meeting Venus

    Sterken, Christiaan; Aspaas, Per Pippin

    2013-06-01

    On 2-3 June 2012, the University of Tromsoe hosted a conference about the cultural and scientific history of the transits of Venus. The conference took place in Tromsoe for two very specific reasons. First and foremost, the last transit of Venus of this century lent itself to be observed on the disc of the Midnight Sun in this part of Europe during the night of 5 to 6 June 2012. Second, several Venus transit expeditions in this region were central in the global enterprise of measuring the scale of the solar system in the eighteenth century. The site of the conference was the Nordnorsk Vitensenter (Science Centre of Northern Norway), which is located at the campus of the University of Tromsoe. After the conference, participants were invited to either stay in Tromsoe until the midnight of 5-6 June, or take part in a Venus transit voyage in Finnmark, during which the historical sites Vardoe, Hammerfest, and the North Cape were to be visited. The post-conference program culminated with the participants observing the transit of Venus in or near Tromsoe, Vardoe and even from a plane near Alta. These Proceedings contain a selection of the lectures delivered on 2-3 June 2012, and also a narrative description of the transit viewing from Tromsoe, Vardoe and Alta. The title of the book, Meeting Venus, refers the title of a play by the Hungarian film director, screenwriter and opera director Istvan Szabo (1938-). The autobiographical movie Meeting Venus (1991) directed by him is based on his experience directing Tannhauser at the Paris Opera in 1984. The movie brings the story of an imaginary international opera company that encounters a never ending series of difficulties and pitfalls that symbolise the challenges of any multicultural and international endeavour. As is evident from the many papers presented in this book, Meeting Venus not only contains the epic tales of the transits of the seventeenth, eighteenth and nineteenth centuries, it also covers the conference

  10. Life's end: Ethnographic perspectives.

    Goodwin-Hawkins, Bryonny; Dawson, Andrew

    2018-01-01

    In this introduction to the special issue, Life's End: Ethnographic Perspectives, we review the field of anthropological studies of death and dying. We make the argument that, largely because of its sub-disciplining into the larger field of the anthropology of religion, ritual and symbolism, the focus of anthropological research on death has been predominantly on post- rather than pre-death events, on death's beginnings rather than life's ends. Additionally, we argue that an anthropological aversion to the study of dying may also lie in the intimacy of the discipline's principal method, ethnography. Contrastingly, we argue that this very methodological intimacy can be a source of insight, and we offer this as a rationale for the special issue as a whole, which comprises eight ethnographic studies of dying and social relations at life's end from across Africa, Australia, Europe, and North America. Each of these studies is then summarized, and a rationale for their presentation around the themes of "structures of dying," "care for the dying," "hope in dying," and "ending life" is presented.

  11. Fifteenth LAMPF users group meeting

    Cochran, D.R.F.

    1982-03-01

    The Fifteenth LAMPF Users Group Meeting was held November 2-3, 1981 at the Clinton P. Anderson Meson Physical Facility. The program of papers scheduled to be presented was amended to include a Report from Washington by Clarence R. Richardson, US Department of Energy. The general meeting ended with a round-table working group discussion concerning the Planning for a Kaon Factory. Individual items from the meeting were prepared separately for the data base

  12. THE MAKING OF DECISION MAKING

    Leonardo Yuji Tamura

    2016-04-01

    Full Text Available Quantum Electronics was a Brazilian startup in the 1990's that was acquired by an American equity fund in 2012. They are currently the largest manufacturer of vehicle tracking and infotainment systems. The company was founded by three college friends, who are currently executives at the company: Camilo Santos, Pedro Barbosa and Luana Correa. Edward Hutter was sent by the equity fund to take over the company’s finances, but is having trouble making organizational decisions with his colleagues. As a consultant, I was called to help them improve their decision making process and project prioritization. I adapted and deployed our firm's methodology, but, in the end, its adequacy is shown to be very much in question. The author of this case study intends to explore how actual organizational decisions rely on different decision models and their assumptions, .as well as demonstrate that a decision model is neither absolutely good nor bad as its quality is context dependent.

  13. Meeting Disorders.

    Yager, Joel; Katzman, Jeffrey W

    2017-12-01

    Although meetings are central to organizational work, considerable time devoted to meetings in Academic Health Centers appears to be unproductively spent. The primary purposes of this article are to delineate and describe Meeting Disorders, pathological processes resulting in these inefficient and ineffective scenarios, and Meeting Fatigue Disorder (MFD), a clinical syndrome. The paper also offers preliminary approaches to remedies. The authors integrate observations made during tens of thousands of hours in administrative meetings in academic medical settings with information in the literature regarding the nature, causes and potential interventions for dysfunctional groups and meetings. Meeting Disorders, resulting from distinct pathologies of leadership and organization, constitute prevalent subgroups of the bureaucrapathologies, pathological conditions caused by dysfunctional bureaucratic processes that generate excesses of wasted time, effort, and other resources. These disorders also generate frustration and demoralization among participants, contributing to professional burnout. Meeting Fatigue Disorder (MFD) is a subjective condition that develops in individuals who overdose on these experiences and may reflect one manifestation of burnout. Meeting disorders and Meeting Fatigue Disorder occur commonly in bureaucratic life. Resources and potential remedies are available to help ameliorate their more deleterious effects.

  14. STAFF MEETING

    2003-01-01

    I should like to invite all members of the CERN Personnel to a meeting on Wednesday 25th June 2003 at 11.00 hrs - Auditorium, bldg. 500 to give a report on the outcome of the June Meetings of Council and its Committees. Closed-circuit transmission of the meeting will be available in the AB Auditorium (Prévessin), the AB Auditorium (Meyrin - bldg. 6), the IT Auditorium (bldg. 31) and the AT Auditorium (bldg. 30). Luciano Maiani Director General

  15. 75 FR 40850 - Notice of Public Meeting

    2010-07-14

    ... meeting may end early if all business is completed. If the meeting date and location are changed due to... Membership 10. Old Business a. Denali Subsistence Management Plan b. Subsistence Uses of Horns, Antlers... Subsistence Resource Commission (SRC) program. SUMMARY: The Denali National Park SRC plans to meet to develop...

  16. 78 FR 76660 - Arts Advisory Panel Meeting

    2013-12-18

    ... otherwise noted) as follows (all meetings are Eastern time and ending times are approximate): Folk... p.m. in room 716. Music (review of nominations): This meeting will be closed. Dates: January 14... Columbus Circle, 12th Floor, New York, NY 10019. Music (application review): This meeting will be virtual...

  17. 77 FR 43064 - Meeting; Technology Advisory Committee

    2012-07-23

    ... customer fund segregation laws, and making false statements in financial statements filed with the... COMMODITY FUTURES TRADING COMMISSION Meeting; Technology Advisory Committee AGENCY: Commodity Futures Trading Commission (CFTC). ACTION: Notice of emergency meeting of technology advisory committee...

  18. Logic Meeting

    Tugué, Tosiyuki; Slaman, Theodore

    1989-01-01

    These proceedings include the papers presented at the logic meeting held at the Research Institute for Mathematical Sciences, Kyoto University, in the summer of 1987. The meeting mainly covered the current research in various areas of mathematical logic and its applications in Japan. Several lectures were also presented by logicians from other countries, who visited Japan in the summer of 1987.

  19. Fuel cell end plate structure

    Guthrie, Robin J.; Katz, Murray; Schroll, Craig R.

    1991-04-23

    The end plates (16) of a fuel cell stack (12) are formed of a thin membrane. Pressure plates (20) exert compressive load through insulation layers (22, 26) to the membrane. Electrical contact between the end plates (16) and electrodes (50, 58) is maintained without deleterious making and breaking of electrical contacts during thermal transients. The thin end plate (16) under compressive load will not distort with a temperature difference across its thickness. Pressure plate (20) experiences a low thermal transient because it is insulated from the cell. The impact on the end plate of any slight deflection created in the pressure plate by temperature difference is minimized by the resilient pressure pad, in the form of insulation, therebetween.

  20. Review of Meeting Objectives

    Braams, B.J.; Chung, H.-K.

    2011-01-01

    This is the 21st meeting of the International Atomic and Molecular Data Centres Network. The traditional DCN meeting objectives are: to exchange information about activities in the Centres and review progress; to coordinate work in the Centres; to assess priorities in data evaluation and data production; to make plans for specific evaluations; and to evaluate and revise procedures for collection and exchange of bibliographical and numerical data. All of these are objectives for the present meeting too. In addition to the presentations from DCN and prospective DCN members we have two participants from outside the field of fusion data: Dr N. Mason will tell us about coordination of the Virtual Atomic and Molecular Data Centre and Dr S. Simakov will describe the manner in which nuclear structure and cross-section database development is coordinated by our colleagues in the Nuclear Data Section. In the discussions on Thursday and Friday there are two topics that need special attention this year: the future of our bibliographical data compilation and ways in which we can strengthen data evaluation activities, all with emphasis on collision processes and plasma-material interaction. The first 3 Data Centre Network meetings were held in 1977, 1980 and 1982 and the reports of those meetings make interesting reading and can still provide inspiration for the present meeting. I show some excerpts in the presentation. In 1977 the emphasis was on the coordination of the bibliographical database, AMBDAS, and a collision data index, CIAMDA, as the initial activities of the Network and of the newly formed IAEA A+M Data Unit. In 1980 the central topic of discussion at the meeting shifted to the numerical database and to data evaluation. The Network recommended that numerical data be reviewed by a selected group of scientists and that no unevaluated numerical A+M collision data should be distributed by the IAEA. The report of the meeting in 1982 shows that the bibliographical

  1. The meeting goer's lament.

    Meyer, H

    1980-10-22

    Executives spend about 69% of their time in meeting with at least two other people, according to a recent study out of McGill University. In spite of this, participants do not consider this to be time used wisely and, according to the respondents, the problem seems to be growing worse. Despite the claims of some executives that government regulations or increased corporate complexity underlies the problem, society at large is viewed as the source of the change. Meyer asserts that all institutions have become less authoritarian and the trend away from command has left persuasion and consensus as the basis for corporate level decision-making. Although executives seem to agree that most time is wasted because participants fail to be succinct, the author argues that leaders could improve meetings by choosing the right participants, guiding them briskly through the agenda, and closing the meeting before it degenerates into a shouting match. The article suggests that chief executives are concluding that meeting skills can be learned. Most of the FORTUNE 500 companies have hired outside experts to teach these skills and some companies are building inhouse units for the same purpose. Since meetings have become an integral part of the business day, Meyer concluded that the goal of the executive should be to use the meeting time well.

  2. August Meeting

    chifaou.amzat

    2011-10-19

    Oct 19, 2011 ... rural hometowns, where they unite with their rural-based colleagues for ... extent have they empowered the women-folk in the public sphere? ...... It would be safe, therefore, for one to conceptualise the 'August Meeting'.

  3. Public meetings

    Staff Association

    2014-01-01

    You were hundreds of persons to participate in our information meetings of October 3 and 6 2014, and we thank you for your participation! The full presentation is available here. A summary of the topics is available here (in french).

  4. Public meetings

    Staff Association

    2017-01-01

    Do you have questions about the elections to the Staff Council, 2017 MERIT exercise, EVE and School, LD to IC exercise, CHIS, the Pension Fund… Come get informed and ask your questions at our public meetings. These public meetings are also an opportunity to get the more information on current issues. Benefit from this occasion to get the latest news and to discuss with the representatives of the statutory body that is the Staff Association!

  5. An alternate end design for SSC dipoles

    Peters, C.; Caspi, S.; Taylor, C.

    1989-02-01

    Experience in the SSC dipole program has shown that fabrication of cylindrical coil ends is difficult. Cable stiffness requires large forces to maintain the proper position of the conductors in the end during winding. After winding, the coil ends remain distorted nd significant motion of the need conductors is required to force the coil end into the molding cavity. Local mechanical stresses are high during this process and extra pieces of insulation are required to prevent turn-to-turn shorts from developing during the winding and molding steps. Prior to assembly the coil end is compressed in a mold cavity and injected with a filler material to correct surface irregularities and fill voids in the end. LBL has developed an alternate design which permits the conductors to be wound over the end using minimal force and technician coerosion. The conductors are placed on a conical surface where the largest diameter over the outer layer conductors is 10 cm. No coil end spaces or insulation pieces between turns are required. The conductor geometry was analytically optimized to meet SSC multipole requirements for the ends. The first 1-m dipole utilizing this end geometry has been constructed and successfully tested. Design and construction data are presented. Also model test results, including training and multipole measurements of the end are given. 1 ref., 12 figs., 3 tabs

  6. Meeting Mid-Year Meeting

    23 Newsletter of the Indian Academy of ScienCE. 57th Annual. Meeting ... Srinivas, Institute for Social and Economic. Change ... "Quantum mechanics and statistical mechanics of anyons" .... Special Issue on Geomagnetic Methods and.

  7. Editorial: Nanoscience makes catalysis greener

    Polshettiwar, Vivek; Basset, Jean-Marie; Astruc, Didier

    2012-01-01

    Green chemistry by nanocatalysis: Catalysis is a strategic field of science because it involves new ways of meeting energy and sustainability challenges. The concept of green chemistry, which makes the science of catalysis even more creative, has

  8. CFCC working group meeting: Proceedings

    NONE

    1995-12-31

    The theme of the meeting was ``A Path to Commercialization`` and discussion was devoted to addressing the nearest-term products and the time frame for implementation. The objectives of the meeting were to identify the barriers to commercialization, methods to overcome these barriers, and the actions required to achieve success. The meeting was planned to bring together government agencies and industry customers and, suppliers to discuss and conclude where the CFCC Program is today, where it is going, and how they plan to get there. It was also planned to join component developers with end users who can describe systems needs and projected schedules for introducing CFCC components in industrial applications.

  9. Fuel rod end plug

    McGeary, R.K.; Bucher, G.D.

    1989-01-01

    This patent describes an end plug for welded disposition within the end of a tube. It comprises a circumferentially extending, axially oriented land surface, having a radial extent defined by means of a first predetermined dimension, for disposition within the end of the tube; a circumferentially extending, axially oriented land surface, having a radial extent defined by means of a second predetermined dimension which is greater than the first predetermined dimension, for disposition outside of the end of the tube. The second land surface being disposed upstream of the first land surface; an annularly extending, radially oriented shoulder portion, defined at the downstream end of the second land surface and having a radially inward depth which is greater than the difference defined between the first and second radial dimensions of the first and second land surfaces, for engaging the end of the tube in a butt contact fashion; and annular groove means defined between the upstream end of the first land surface and the shoulder portion of the end plug, for eliminating porosity defects normally developed within a weldment defined between the tube end and the end plug when the end plug is welded within the tube end, and including a conical surface which extends radially outwardly from the innermost radial depth extent of the shoulder portion to the upstream end of the first land surface

  10. Public meeting

    HR Department

    2010-01-01

    Dear Colleagues, I am pleased to invite you to a public meeting which will be held on Thursday 11 November 2010 at 2:30 p.m., in the Main Auditorium (welcome coffee from 2 p.m.) In this meeting Sigurd Lettow, Director for Administration and General Infrastructure will present the Management’s proposals towards restoring full funding of the Pension Fund. The meeting will follow discussions which took place with the Staff Association, at the Standing Concertation Committee (CCP) of 1 November 2010 and will be held with the Members States, at the Tripartite Employment Conditions Forum (TREF) of 4 November 2010. You will be able to attend this presentation in the Main Auditorium or via the webcast. The Management will also be available to reply to your questions on this subject. Best regards, Anne-Sylvie Catherin

  11. ACCU Meeting

    PH Department

    2010-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 December 2010 at 9:15 a.m. in room 60-6-002 Chairperson's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department The CERN Ombuds The new account management system Crèche progress + Restaurants Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairperson in writing or by e-mail to Michael.Hauschild@cern.ch   Michael Hauschild (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): ...

  12. ACCU Meeting

    PH Department

    2011-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 March 2011 At 9:15 a.m. in room 60-6-002   Chairperson's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department Update on Safety at CERN The new account management system Users’ Office news Any Other Business Agenda for the next meeting   Anyone wishing to raise any points under item 10 is invited to send them to the Chairperson in writing or by e-mail to Michael.Hauschild@cern.ch Michael Hauschild (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) Belgium ...

  13. ACCU MEETING

    PH Department

    2010-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 September 2010 at 9:15 a.m. in Room 60-6-002 Chairperson’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS Department An update on Safety at CERN The CERN Summer Student program Bringing Library services to users Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairperson in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): ...

  14. ACCU Meeting

    PH Department

    2010-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 June 2010 At 9:15 a.m. in room 60-6-002 Chairperson’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department CERN Global Network An update on Safety at CERN Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairperson in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) ...

  15. Staff meeting

    2006-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Thursday 18 January 2007 at 3:00 p.m. Main Auditorium (bldg.. 500) to convey my best wishes for the new year, to review CERN's activities during 2006 and to present the perspectives for this special year of the LHC start-up. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg.. 31) and the AT Auditorium (bldg.. 30). Simultaneous translation into English will be available in the main Auditorium. Robert AYMAR

  16. Scientific meetings

    1973-01-01

    One of the main aims of the IAEA is to foster the exchange of scientific and technical information and one of the main ways of doing this is to convene international scientific meetings. They range from large international conferences bringing together several hundred scientists, smaller symposia attended by an average of 150 to 250 participants and seminars designed to instruct rather than inform, to smaller panels and study groups of 10 to 30 experts brought together to advise on a particular programme or to develop a set of regulations. The topics of these meetings cover every part of the Agency's activities and form a backbone of many of its programmes. (author)

  17. STAFF MEETING

    Robert Aymar

    2005-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Thursday 12 January 2006 at 4:00 p.m. - Main Auditorium (bldg. 500) to convey my best wishes for the new year, to review CERN's activities during 2005 and to present the perspectives for this coming year. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg. 31) and the AT Auditorium (bldg. 30). A simultaneous translation into English will be available in the main Auditorium. Best wishes for the festive season Robert AYMAR

  18. STAFF MEETING

    2004-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Tuesday 13 January 2004 at 4:00 p.m. - Main Auditorium (bldg. 500) to convey my best wishes for the new year and to present a perspective of CERN's future activities. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg. 31) and the AT Auditorium (bldg. 30). A simultaneous translation into English will be available in the main Auditorium. Robert AYMAR

  19. Public meetings

    Staff Association

    2014-01-01

      Public meetings : Come and talk about your future employment conditions !   The Staff Association will come and present the results of our survey on the 2015 five-yearly review. Following the survey, the topics discussed, will be contract policy, recognition of merit (MARS), working time arrangements and family policy. After each meeting and around a cup of coffee or tea you will be able to continue the discussions. Do not hesitate to join us, the five-yearly review, it is with YOU!

  20. Crisis meeting

    Staff Association

    2014-01-01

      To all CERN staff: your rights are at risk ! We invite you to come to a crisis meeting on Wednesday 2nd April at 10:30 a.m., Auditorium, Main Building, Meyrin site. Your presence is crucial, we are ALL concerned !

  1. Crisis meeting

    Staff Association

    2015-01-01

    To all CERN staff: your rights are at risk! We invite you to come to a crisis meeting on Thursday 7th May 2015 at 9 a.m., Auditorium, Main Building, Meyrin site. Your presence is crucial, we are ALL concerned!

  2. ACCU MEETING

    Chris Onions

    2002-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 4 December 2002 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Fellows, Associates and Summer Student Programmes Particle Data Book distribution Revoking Computer accounts Equipment insurance on site Reports from ACCU representatives on other committees Users' Office news Any Other Business Dates for meetings in 2003 Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch   ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (74837...

  3. ACCU MEETING

    Chris Onions (Secretary)

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 December 2001 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 2. Adoption of the agenda 3. Minutes of the previous meeting 4. Matters arising 5. News from the CERN Management 6. Housing 7. Restaurant Surveillance Committee 8. Users' Office news 9. Election of ACCU chairman 10. Any Other Business 11. Dates for meetings in 2002 12. Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria  W. Adam  (71661) Belgium  G. Wilquet  (74664) Bulgaria  R. Tzenov  (77958) Czech Republic  P. Závada&am...

  4. ACCU MEETING

    Chris Onions (Secretary)

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 December 2001 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 2. Adoption of the agenda 3. Minutes of the previous meeting 4. Matters arising 5. News from the CERN Management 6. Housing 7. Restaurant Surveillance Committee 8. Users' Office news 9. Election of ACCU chairman 10. Any Other Business 11. Dates for meetings in 2002 12. Agenda for the next meetingAnyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland A. Kiiskinen (79387) Fr...

  5. ACCU MEETING

    2000-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 December 2000 At 10 a.m. in the 6th floor Conference Room, Main Building Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising Equal Opportunities at CERN The Summer Student programme CERN Programme for Physics High School Teachers Users' Office News Any Other Business Dates for Meetings in 2001 Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets) :   Austria G. Neuhofer (74094) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958)...

  6. ACCU MEETING

    Chris Onions (Secretary)

    2000-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 December 2000 At 10 a.m. in the 6th floor Conference Room, Main Building Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising Equal Opportunities at CERN The Summer Student programme CERN Programme for Physics High School Teachers Users' Office News Any Other Business Dates for Meetings in 2001 Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets) : Austria G. Neuhofer (74094) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Re...

  7. ACCU Meeting

    PH Department

    2011-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 15 June 2011 At 9:15 a.m. in room 60-6-002 Chairperson’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department Update on Safety at CERN Reports from ACCU representatives on other Committees a. Scientific Information Policy Board (SIPB) b. IT Service Review Meeting (ITSRM) c. GS User Commission Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairperson in writing or by e-mail to Michael.Hauschild@cern.ch Michael Hauschild (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in bra...

  8. Open-ended education

    Nørgård, Rikke Toft; Paaskesen, Rikke Berggreen

    2016-01-01

    THE ARTICLE DESCRIBES OPEN-ENDED EDUCATION FOR 21ST CENTURY LEARNING AS THE COMING TOGETHER OF OPEN-ENDED TECHNOLOGY, OPEN-ENDED PROJECTS, AND OPEN-ENDED INSTITUTIONS IN WAYS THAT FOSTER AND PROMOTE FUTURE EDUCATION FOR CITIZENSHIP IN SOCIETY. THROUGH THE CASE OF THE CODING PIRATES FUTURE ISLAND......, THE ARTICLE DEMONSTRATES HOW OPEN-ENDED EDUCATION CAN BE PRACTICED TO FOSTER AND PROMOTE TECHNOLOGICAL IMAGINATION, ENTERPRISING, AND PARTICIPATION. THIS PRACTICE IS THEN DEVELOPED INTO A THEORETICAL MODEL FOR THE CONCEPT OF OPEN-ENDED EDUCATION AS A WAY OF AND FRAMEWORK FOR PRACTICING FUTURE EDUCATION FOR 21......ST CENTURY LEARNING WITH NEW TECHNOLOGIES. THE ARTICLE PRESENTS AN ANSWER TO THE CALL FOR 21ST CENTURY LEARNING AS THOROUGHLY COLLABORATIVE, COMMUNICATIVE, CREATIVE, AND CRITICALLY REFLECTIVE THROUGH THE CASE AND THE CONCEPT OF OPEN-ENDED EDUCATION. IT OUTLINES THE IMPLICATIONS OF THIS CALL...

  9. Analytical solutions to SSC coil end design

    Bossert, R.C.; Brandt, J.S.; Carson, J.A.; Fulton, H.J.; Lee, G.C.; Cook, J.M.

    1989-03-01

    As part of the SCC magnet effort, Fermilab will build and test a series of one meter model SSC magnets. The coils in these magnets will be constructed with several different end configurations. These end designs must satisfy both mechanical and magnetic criteria. Only the mechanical problem will be addressed. Solutions will attempt to minimize stresses and provide internal support for the cable. Different end designs will be compared in an attempt to determine which is most appropriate for the SSC dipole. The mathematics required to create each end configuration will be described. The computer aided design, programming and machine technology needed to make the parts will be reviewed. 2 refs., 10 figs

  10. Public meetings

    Staff Association

    2012-01-01

    MARS PENSIONS CONTRACT POLICY GENERAL INFORMATION   PUBLIC MEETINGS COME AND BE INFORMED! Public meetings Monday 15 Oct. 2 pm Amphi IT, 31-3-004 Meyrin Wednesday 17 Oct. 10 am Amphi BE, 864-1-D02 Prévessin Thursday 18 Oct. 10 am Salle du Conseil/ Council Chamber 503-1-001 Meyrin Thursday 18 Oct. 2 pm Filtration Plant, 222-R-001(in English) Meyrin   Overview of the topics to be discussed Recognition of Merit – MARS Outcome of last exercise 2007 to 2012 : lessons learned Pension Fund Capital preservation policy : what is it ? Contract policy LC2IC statistics SA proposal General information CVI 2013 Voluntary programmes (PRP, SLS)  

  11. Staff meeting

    2007-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Wednesday 16 January 2008 at 3:00 p.m. Main Auditorium (bldg 500) to convey my best wishes for the new year, to review CERN’s activities during 2007 and to present the perspectives for 2008, the year of the LHC start-up. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (Bldg. 31) and the AT Auditorium (Bldg. 30). Simultaneous translation into English will be available in the main Auditorium. Best wishes for the festive season! Robert AYMAR

  12. Meeting information

    The 1986 Ocean Sciences Meeting of the American Geophysical Union and the American Society of Limnology and Oceanography (ASLO) will be held January 13-17, 1986, in New Orleans, La., at the Fairmont Hotel. Co-sponsoring societies are the Acoustical Society of America (ASA), the American Meteorological Society (AMS), the Marine Technology Society (MTS), and the Institute of Electrical and Electronics Engineers, Oceanic Engineering Society (OES).

  13. ACCU Meeting

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 March 2004 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 6. The PH Department 2. Adoption of the agenda 7. Reports from ACCU representatives on other committees 3. Minutes of the previous meeting 8. Users' Office news 4. News from the CERN Management 9. Any Other Business 5. Matters arising 10. Agenda for the next meeting Anyone wishing to raise any points under item 9 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Norway H. Helstrup (73601) Belgium G. Wilquet (74664) Poland Z. Hajduk (75917) Bulgaria R. Tsenov (79573) Portugal P. Bordalo (74704) Czech Republic P. Závada ...

  14. ACCU MEETING

    Chris Onions

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 March 2004 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting News from the CERN Management Matters arising The PH Department Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 9 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark P. Hansen (75941) Finland E. Tuominen (71534) France F. Bauer (71247) L. Serin...

  15. ACCU MEETING

    Chris Onions/EP (Secretary)

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 June 2001 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising EP Space management Cars Housing EDH from the User's point of view VRVS Users' Office News Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland A. Kiiskinen (79387) France M. Déj...

  16. ACCU Meeting

    Chris Onions

    2006-01-01

    DRAFT Agenda of the meeting to be held on Wednesday 8 March 2006 At 9:15 a.m. in Room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Proposal for a centralised access control service Report from PH Space Management Policy Board Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under Item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives on ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) ...

  17. ACCU MEETING

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 December 2007 at 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks7.\tEmergency Services at CERN 2.\tAdoption of the agenda\t8.\tThe Meyrin Tram project 3.\tMinutes of the previous meeting9.\tReports from ACCU representatives on other committees 4.\tMatters arising10.\tUsers’ Office news 5.\tNews from the CERN Management11.\tElection of ACCU Chair 6. LHC 2008 start-up events 6.\tLogistics and transport at CERN 12.\tAny Other Business 13.\tAgenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Aust...

  18. ACCU MEETING

    PH Department

    2008-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 11 June 2008 At 9:15 a.m. in Room 60-6-002 1.\tChairman’s remarks 2.\tAdoption of the agenda 3.\tMinutes of the previous meeting 4.\tMatters arising 5.\tNews from the CERN Management 6.\tAn update on safety at CERN 7.\tChildcare initiative 8.\tReports from ACCU representatives on other committees 9.\tUsers’ Office news 10.\tAny Other Business 11.\tAgenda for the next meeting Anyone wishing to raise any points under Item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium C. Vander Velde (71539) Bulgaria Czech Republic P. Závada (75...

  19. ACCU meeting

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 December 2007 At 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks 2.\tAdoption of the agenda 3.\tMinutes of the previous meeting 4.\tMatters arising 5.\tNews from the CERN Management 6.\tLHC 2008 start-up events 7.\tEmergency Services at CERN 8.\tThe Meyrin Tram project 9.\tReports from ACCU representatives on other committees 10.\tUsers’ Office news 11.\tElection of ACCU Chair 12.\tAny Other Business 13.\tAgenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilq...

  20. ACCU MEETING

    Chris Onions

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 June 2004 at 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Update on CERN's 50th anniversary celebrations Report from the EPOG (European Particle Physics Outreach Group) Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark P. Hansen (75941...

  1. ACCU Meeting

    Chris Onions

    2005-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 7 September 2005 At 9:15 a.m. in room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Logistics at CERN Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finland K. Lassila-Perini (79354) France F. Bauer S. Laplace...

  2. ACCU Meeting

    Chris Onions

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 September 2004 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management The Visits Service Lifetime of Computer Accounts Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tsenov (79573) Czech Republic P. Závada (75877) Denmark P. Hansen (75941) Finland K. Lassila-Perini (79354) France F. Bauer (7...

  3. ACCU MEETING

    2006-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 September 2006 at 9:15 a.m. in room 60-6-002 1.     Chairman's remarks 2.     Adoption of the agenda 3.     Minutes of the previous meeting 4.     Matters arising 5.     News from the CERN Management 6.     Report on Fellows and Associates programme 7.     Overview of safety at CERN 8.     Reports from ACCU representatives on other committees 9.     Users' Office news 10.  Any Other Business 11.  Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets):Austria W. Adam  (71661) Belgium G. Wilquet (74664) Bulgaria ...

  4. ACCU Meeting

    Chris Onions

    2005-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 7 December 2005 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Closure of computer accounts upon CERN contract expiry Reports from ACCU representatives on other committees Users' Office news Election of ACCU Chair Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets). Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) ...

  5. ACCU Meeting

    Chris Onions

    2005-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 June 2005 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Logistics at CERN Open Access Publishing Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tsenov (79573) Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finland K. Lassila-Perini ...

  6. ACCU Meeting

    Chris Onions

    2006-01-01

    DRAFT Agendafor the meeting to be held on Wednesday 8 March 2006At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Proposal for a centralised access control service Report from PH Space Management Policy Board Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Fin...

  7. ACCU Meeting

    Chris Onions

    2005-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 March 2005 At 9:15 a.m. in room 160-1-009 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Purchasing procedures at CERN Reports from ACCU representatives on other committees Users' Office news CERN Clubs Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tsenov (79573) Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finland K. Las...

  8. ACCU MEETING

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 12 September 2007 at 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks7.\tCar sharing pilot project 2.\tAdoption of the agenda\t8.\tReports from ACCU representatives on other committees 3.\tMinutes of the previous meeting9.\tUsers’ Office newss 4.\tMatters arising10.\tAny Other Business 5.\tNews from the CERN Management11.\tAgenda for the next meeting 6.\tLogistics and transport at CERN Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria\tW. Adam (71661)NorwayG. Løvhøiden (73176)Belgium\tG. Wilquet (74664)PolandM. Witek (78967)...

  9. ACCU MEETING

    PH Department

    2008-01-01

    DRAFT Agenda for the meeting to be heldon Wednesday 5 March 2008 At 9:15 a.m. in room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management An update on Safety at CERN The CERN Ombudsperson proposal Childcare initiative Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) BelgiumnC. Vander Velde (71539) Bulgaria Czech Republic P. Závada (75877) Denm...

  10. ACCU MEETING

    2006-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 December 2006 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Safety at CERN Car sharing pilot project CERN Public Web Sites and Intranet Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria   Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finl...

  11. ACCU Meeting

    Chris Onions

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 December 2004 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting The effects of the reorganization of CERN's structure, one year on Matters arising News from the CERN Management Computer Security The new CERN Dosimeter Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tsenov (79573) Czech Republic P. Závada (75877) Denmark P. Hansen (7594...

  12. ACCU MEETING

    2006-01-01

    DRAFT Agenda of the meeting to be held on Wednesday 6 September 2006 at 9:15 a.m. in Room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on Fellows and Associates Programme Overview of safety at CERN Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under Item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finland K....

  13. ACCU meeting

    PH Department

    2008-01-01

    DRAFT Agenda for the meeting to be heldon Wednesday 5 March 2008 At 9:15 a.m. in room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management An update on Safety at CERN The CERN Ombudsperson proposal Childcare initiative Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) BelgiumnC. Vander Velde (71539) Bulgaria Czech Republic P. Závada (75877) Denm...

  14. ACCU MEETING

    PH Department

    2008-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 September 2008 At 9:15 a.m. in Room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management An update on Safety at CERN Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 9 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria, W. Adam (71661) Belgium, C. Vander Velde (71539) Bulgaria Czech Republic, P. Závada (75877) Denmark, J.B. Hansen (...

  15. ACCU MEETING

    Chris Onions

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 13 June 2007 at 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Dosimetry at CERN Status of collaborative tools at CERN Reports from ACCU representatives on other committees Users' Office newss Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finland K. Lassila-Perini (7935...

  16. ACCU Meeting

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 7 March 2007 at 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Car-sharing pilot project Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 9 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finland K. Lassila-Perini (79354) France F. Kunne S. ...

  17. ACCU MEETING

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 13 June 2007 at 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks 6.\tDosimetry at CERN 2.\tAdoption of the agenda 7.\tStatus of collaborative tools at CERN 3.\tMinutes of the previous meeting 8.\tReports from ACCU representatives on other committees 4.\tMatters arising 9.\tUsers’ Office newss 5.\tNews from the CERN Management 10.\tAny Other Business 11.\tAgenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Norway G. Løvhøiden (73176) Belgium G. Wilquet (74664) Poland M. Witek (78967) Bulgaria Portugal...

  18. ACCU Meeting

    Chris Onions

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 September 2004 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management The Visits Service Lifetime of Computer Accounts Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tsenov (79573) Czech Republic P. Závada (75877) Denmark P. Hansen (75941) Finland K. Lassila-Perini (79354) France F. Bauer (...

  19. ACCU Meeting

    2006-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 December 2006 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Safety at CERN Car sharing pilot project CERN Public Web Sites and Intranet Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria   Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finl...

  20. ACCU Meeting

    PH Department

    2008-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 11 June 2008 At 9:15 a.m. in room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management An update on Safety at CERN Childcare initiative Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria - W. Adam (71661) Belgium - C. Vander Velde (71539) Bulgaria Czech Republic - P. Závada (75877) Denmark - J.B. Hansen...

  1. ACCU Meeting

    Chris Onions

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 December 2004 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting The effects of the reorganization of CERN's structure, one year on Matters arising News from the CERN Management Computer Security The new CERN Dosimeter Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tsenov (79573) Czech Republic P. Závada (75877) Denmark P. Hansen (75941) Finl...

  2. ACCU Meeting

    Chris Onions

    2004-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 June 2004 at 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Update on CERN's 50th anniversary celebrations Report from the EPOG (European Particle Physics Outreach Group) Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tsenov (79573) Czech Republic P. Závada (75877) Denmark P. Hansen (75941) Finlan...

  3. ACCU MEETING

    PH Department

    2008-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 3 December 2008 at 9:15 a.m. in Room 60-6-002 1.\tChairman’s remarks 2.\tAdoption of the agenda 3.\tMinutes of the previous meeting 4.\tMatters arising 5.\tNews from the CERN Management 6.\tReport from the new Director-General 7.\tReport on the Fellows and Associates programme 8.\tAn update on Safety at CERN 9.\tReports from ACCU representatives on other committees 10.\tUsers’ Office news 11.\tAny Other Business 12.\tAgenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium C. ...

  4. ACCU MEETING

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 12 September 2007 at 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks6.\tLogistics and transport at CERN2.\tAdoption of the agenda\t7.\tCar sharing pilot project3.\tMinutes of the previous meeting8.\tReports from ACCU representatives on other committees4.\tMatters arising9.\tUsers’ Office newss5.\tNews from the CERN Management10.\tAny Other Business11.\tAgenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria\tW. Adam (71661)NorwayG. Løvhøiden (73176)Belgium\tG. Wilquet (74664)PolandM. Witek (78967)Bulgaria\tPortugalP...

  5. ACCU Meeting

    2007-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 7 March 2007 at 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Car-sharing pilot project Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 9 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) Denmark J.B. Hansen (75941) Finland K. Lassila-Perini (79354) France F. Kunne S. La...

  6. ACCU MEETING

    Chris Onions (Secretary)

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 June 2001 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising Logistics and Self-service stores EP Space management follow-up How to improve IT User Support? Users' Office News Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Roger.Jones@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland A. Kiis...

  7. ACCU MEETING

    Chris Onions (Secretary)

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 12 September 2001 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising Logistics and Self-service stores EP Space management follow-up How to improve IT User Support? Users' Office News Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Roger.Jones@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland A. Kiiskin...

  8. ACCU MEETING

    Chris Onions

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 7 March 2001 At 9:15 a.m. in the 6th floor Conference Room, Main Building Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising Video-conferencing/recording Fellows programme Operational Circular No. 6 EP Space management Update on Computing Issues Users' Office News Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary)  ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic...

  9. ACCU Meeting

    2003-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 September 2003 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 7. Equal Opportunities Commission 2. Adoption of the agenda 8. Registration plans for portables 3. Minutes of the previous meeting 9. Reports from ACCU representatives on other committees 4. Matters arising 10. Users' Office news 5. News from the CERN Management 11. Any Other Business 6. The Press Office 12. Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Norway H. Helstrup (73601) Belgium G. Wilquet (74664) Poland Z. Hajduk (75917) Bulgar...

  10. ACCU MEETING

    2003-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 March 2003 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 7. Equipment insurance on site 2. Adoption of the agenda,8. ACCU reporting mechanisms in the different countries 3. Minutes of the previous meeting9. Reports from ACCU representatives on other committees 4. Matters arising10. Users' Office news 5. News from the CERN Management11. Any Other Business 6. CHIS news and follow-up of survey12. Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661)NorwayH. Helstrup (73601) Belgium G. Wilquet (74664) Poland Z. Hajduk (7591...

  11. ACCU MEETING

    Chris Onions

    2002-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 11 September 2002 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Health Insurance Questionnaire Host States Relations Service Update on EP Space management Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland E. Tuominen (71534) France F. Bauer (71247) L. Serin (...

  12. ACCU MEETING

    2003-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 December 2003 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 8. Report from IT division on Computing matters 2. Adoption of the agenda 9. Young Particle Physicists Association 3. Minutes of the previous meeting 10. Reports from ACCU representatives on other committees 4. Matters arising 11. Users' Office news 5. News from the CERN Management 12. Election of the ACCU Chair 6. Report from the new Director-General 13. Any Other Business 7. CERN's 50th anniversary 14. Agenda for the next meeting Anyone wishing to raise any points under item 13 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Ada...

  13. ACCU MEETING

    2003-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 March 2003 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 7. Equipment insurance on site 2. Adoption of the agenda 8. ACCU reporting mechanisms in the different countries 3. Minutes of the previous meeting 9. Reports from ACCU representatives on other committees 4. Matters arising 10. Users' Office news 5. News from the CERN Management 11. Any Other Business 6. Health Insurance news and follow-up of survey 12. Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Norway H. Helstrup (73601) Belgium G. Wil...

  14. ACCU MEETING

    2003-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 11 June 2003 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 7. Reports from ACCU representatives 2. Adoption of the agenda on other committees 3. Minutes of the previous meeting 8. Users' Office news 4. Matters arising 9. Any Other Business 5. News from the CERN Management 10. Agenda for the next meeting 6. Property Protection at CERN Anyone wishing to raise any points under item 9 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Norway H. Helstrup (73601) Belgium G. Wilquet (74664) Poland Z. Hajduk (75917) Bulgaria R. Tsenov (74837) Portugal P. Bordalo (74704) Czech Republic ...

  15. ACCU Meeting

    2003-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 September 2003 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 8. Registration plans for portables 2. Adoption of the agenda 9. Reports from ACCU representatives 3. Minutes of the previous meeting on other committees 4. Matters arising 10. Users' Office news 5. News from the CERN Management 11. Any Other Business 6. The Press Office 12. Agenda for the next meeting 7. Equal Opportunities Commission Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): AustriaW. Adam (71661) Norway H. Helstrup (73601) Belgium G. Wilquet (74664) Poland Z. Hajduk (75917) Bulgari...

  16. ACCU MEETING

    2003-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 December 2003 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 8. Report from IT division on Computing matters 2. Adoption of the agenda 9. Young Particle Physicists Association 3. Minutes of the previous meeting 10. Reports from ACCU representatives on other committees 4. Matters arising 11. Users' Office news 5. News from the CERN Management 12. Election of the ACCU Chair 6. Report from the new Director-General 13. Any Other Business 7. CERN's 50th anniversary 14. Agenda for the next meeting Anyone wishing to raise any points under item 13 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (716...

  17. ACCU MEETING

    Chris Onions

    2002-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 March 2002 At 9:15 a.m. in the Council Chamber Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Follow-up on Space Management Users' Desktop needs PIE procedures Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland E. Tuominen (71534) France F. Bauer L. Serin (712...

  18. ACCU MEETING

    Chris Onions

    2002-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 12 June 2002 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management PIE procedures CERN Cars EP Electronics Advisory Board Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch   ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland E. Tuominen (71534) France F. Bauer (71247) L. Serin (71143) Germany H. Kroha...

  19. ACCU MEETING

    2000-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 13 September 2000 At 10 a.m. in the 6th floor Conference Room, Main Building 1. Chairman's remarks 2. Adoption of the agenda 3. News from the CERN Management 4. Minutes of the previous meeting 5. Matters arising 6. Report from the Scientific Information Policy Board 7. Report from ETT Division: The Press Office 8. Update on Computing Issues 9. Users' Office News 10. Any Other Business 11. Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Bryan Pattison (Secretary). ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets) : Austria G. Neuhofer (74094) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Z vada (75...

  20. ACCU MEETING

    Bryan Pattison

    2000-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 13 September 2000 At 10 a.m. in the 6th floor Conference Room, Main Building1. Chairman's remarks2. Adoption of the agenda3. News from the CERN Management4. Minutes of the previous meeting5. Matters arising6. Report from the Scientific Information Policy Board7. Report from ETT Division: The Press Office8. Update on Computing Issues9. Users' Office News10. Any Other Business11. Agenda for the next meetingAnyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail toBryan Pattison(Secretary).ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets) :Austria G. Neuhofer (74094)Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958)Czech Republic P. Závada (75877)Den...

  1. ACCU MEETING

    Chris Onions

    2002-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 12 June 2002 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management PIE procedures CERN Cars EP Electronics Advisory Board Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch   ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland E. Tuominen (71534) France F. Bauer (71247) L. Serin (71143) Germany H. Kroha ...

  2. ACCU MEETING

    PH Department

    2009-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 11 March 2009 At 9:15 a.m. in room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management The CERN Press Office An update on Safety at CERN The Burotel project Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel () Belgium C. Vander Velde (71539) Bulgaria Czech Republic P. Závada (75877) Denmark...

  3. ACCU MEETING

    PH Department

    2010-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 March 2010 At 9:15 a.m. in room 60-6-002 Chairperson’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department An update on Safety at CERN Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives on ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) Belgium C. Vander Velde (Chairperson) (71539) Bulgaria Czech Republic S. Nemecek (71144) ...

  4. ACCU MEETING

    PH Department

    2011-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 7 September 2011 at 9:15 a.m. in room 60-6-002   Chairperson's remarks Adoption of the agenda      Minutes of the previous meeting Matters arising       News from the CERN Management Report on services from GS department Report on new CHIS rules Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 9 is invited to send them to the Chairperson in writing or by e-mail to Michael.Hauschild@cern.ch Michael Hauschild (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria M. Jeitler (76307) Belgium C. Vander Velde (Chairperson)...

  5. ACCU MEETING

    PH Department

    2009-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 September 2009 At 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks 2.\tAdoption of the agenda 3.\tMinutes of the previous meeting 4.\tMatters arising 5.\tNews from the CERN Management 6.\tCode of conduct 7.\tEqual Opportunities at CERN 8.\tAn update on safety at CERN 9.\tThe CERN shuttle service 10.\tReports from ACCU representatives on other committees 11.\tUsers’ Office news 12.\tOther business 13.\tAgenda of the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives on ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) Belgium C. Vander Velde (71539) Bulgaria Czech Re...

  6. ACCU MEETING

    PH Department

    2009-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 10 June 2009At 9:15 a.m. in room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management CERN Social Services User services in GS Department An update on Safety at CERN Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria - G. Walzel (76592) Belgium - C. Vander Velde (71539) Bulgaria Czech Republic - P. Závada (7587...

  7. ACCU Meeting

    Chris Onions

    DRAFT Agenda for the meeting to be held on Wednesday 9 December 2009 At 9:15 a.m. in Room 60-6-002 Chairman’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Restaurant No. 1 extension An update on Safety at CERN Reports from ACCU representatives on other committees Users’ Office news Election of the ACCU Chair Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) Belgium C. Vander Velde (71539) Bulgaria Czech Republic P. Záv...

  8. ACCU MEETING

    PH Department

    2009-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 September 2009 At 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks 2.\tAdoption of the agenda 3.\tMinutes of the previous meeting 4.\tMatters arising 5.\tNews from the CERN Management 6.\tCode of Conduct 7.\tEqual Opportunities at CERN 8.\tAn update on Safety at CERN 9.\tThe CERN shuttle service 10.\tReports from ACCU representatives on other committees 11.\tUsers’ Office news 12.\tAny Other Business 13.\tAgenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) Belgium C. Vander Velde (71539) Bulgaria Cze...

  9. ACCU MEETING

    PH Department

    2009-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 11 March 2009 At 9:15 a.m. in room 60-6-002 1.\tChairman’s remarks 2.\tAdoption of the agenda 3.\tMinutes of the previous meeting 4.\tMatters arising 5.\tNews from the CERN Management 6.\tThe CERN Press Office 7.\tAn update on Safety at CERN 8.\tThe Burotel project 9.\tReports from ACCU representatives on other committees 10.\tUsers’ Office news 11.\tAny Other Business 12.\tAgenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to mailto:Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel () Belgium C. Vander Velde (71539) Bulgaria C...

  10. ACCU Meeting

    Chris Onions

    2006-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 14 June 2006 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Car sharing pilot project The CERN Document Server : the portal to Open Access Videoconferencing and collaborative tools at CERN Reports from ACCU representatives on other committees Users' Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (7...

  11. ACCU Meeting

    Chris Onions

    2006-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 14 June 2006 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Car sharing pilot project The CERN Document Server : the portal to Open Access Videoconferencing and collaborative tools at CERN Reports from ACCU representatives on other committees Users'Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria Czech Republic P. Závada (75877) ...

  12. Decision Making

    Pier Luigi Baldi

    2006-06-01

    Full Text Available This article points out some conditions which significantly exert an influence upon decision and compares decision making and problem solving as interconnected processes. Some strategies of decision making are also examined.

  13. Staff meeting

    2007-01-01

    Dear Colleagues, 2007 is a very special year for CERN. I would like to review the status of our activities with you, and I invite you to a presentation on Wednesday 27 June 2007 at 3:00 p.m. Main Auditorium (bldg. 500) Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg. 31) and the AT Auditorium (bldg. 30). Simultaneous translation into English will be available in the Main Auditorium. Robert AYMAR

  14. Public meetings

    Staff Association

    2014-01-01

      MARS 2015 FIVE YEARLY REVIEW CONTRACT POLICY PENSION FUND GENERAL INFORMATION   COME AND BE INFORMED! PUBLIC MEETINGS Friday 3rd October at 10 am Amphi BE, 864-1-D02 Prévessin Friday 3rd October at 2 pm Salle du Conseil / Council Chamber, 503-1-001 (in English) Meyrin Monday 6th October at 10 am Kjell Johnsen Auditorium, 30-7-018 Meyrin Monday 6th October at 2 pm Salle du Conseil / Council Chamber, 503-1-001 Meyrin  

  15. End the nuclear threat

    Douglas, Michael

    2005-01-01

    In 1945 the United Nations was founded with one major goal in mind, and I quote, 'to save succeeding generations from the scourge of war.' The founders noted that twice in the 20th Century major wars had brought 'untold sorrow to mankind.' Since its founding, 191 nations have joined the UN. We have no other place where all nations can work together for peace, a place where we can use verbal conflict rather than armed conflict to solve problems. And often, the UN, with US support, has provided armed force to help ensure the peace. The entire planet now faces global challenges including ensuring bio-diversity and ending the destruction of thousands of species; reversing the depletion of fishing stocks; controlling ocean dumping; preventing ozone depletion; halting global warming; controlling and eliminating terrorism and weapons of mass destruction; fighting pandemic diseases; ending the tragedy of crushing poverty and lack of clean drinking water; and addressing crises arising from failed States. No nation or even a small group of nations can succeed in addressing these issues alone. The United Nations is based on political insights that have led to successful governance principles and enhanced the wealth of nations. These values include market freedoms, religious liberty, an independent judiciary, government transparency and accountability, democracy, and a high level of respect for civil liberties and human rights. They have evolved into nearly universal goals and norms. The countries that have adhered to these principles are the most secure and healthy. The United Nations is guided by such countries, and simultaneously provides the only viable forum for the expression of the aspirations of the poor and the weak. The establishment of international norms of conduct is where idealism informs realism. We are called to nothing less than moral leadership. When moral leadership is coupled with power, it galvanizes the world. Moral leadership requires living up to one

  16. Hospice decision making: diagnosis makes a difference.

    Waldrop, Deborah P; Meeker, Mary Ann

    2012-10-01

    This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36 hospice patients and 55 caregivers after 2 weeks of hospice care. The study was guided by Janis and Mann's conflict theory model (CTM) of decision making. Qualitative data analysis involved a directed content analysis using concepts from the CTM. A model of hospice enrollment decision making is presented. Concepts from the CTM (appraisal, surveying and weighing the alternatives, deliberations, adherence) were used as an organizing framework to illustrate the dynamics. Distinct differences were found by diagnosis (cancer vs. other chronic illness, e.g., heart and lung diseases) during the pre-encounter phase or before the hospice referral but no differences emerged during the post-encounter phase. Differences in decision making by diagnosis suggest the need for research about effective means for tailored communication in end-of-life decision making by type of illness. Recognition that decision making about hospice admission varies is important for clinicians who aim to provide person-centered and family-focused care.

  17. ACCU MEETING

    PH Department

    2008-01-01

    DRAFT Agenda for the meetingto be held on Wednesday 3 December 2008 at 9:15 a.m.in Room 60-6-002 1.\tChairman’s remarks 2.\tAdoption of the agenda 3.\tMinutes of the previous meeting 4.\tMatters arising 5.\tNews from the CERN Management 6.\tReport from the new Director-General 7.\tReport on the Fellows and Associates programme 8.\tAn update on Safety at CERN 9.\tReports from ACCU representatives on other committees 10.\tUsers’ Office news 11.\tAny Other Business 12.\tAgenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium C. Va...

  18. End of Life Care

    ... Related Topics Choosing Wisely Join our e-newsletter! Aging & Health A to Z End of Life Care ... be used. Ice chips, popsicles, moist swabs, or artificial saliva can help prevent the mouth from becoming ...

  19. CENTRIFUGE END CAP

    Beams, J.W.; Snoddy, L.B.

    1960-08-01

    An end cap for ultra-gas centrifuges is designed to impart or remove angular momentum to or from the gas and to bring the entering gas to the temperature of the gas inside the centrifuge. The end cap is provided with slots or fins for adjusting the temperature and the angular momentum of the entering gas to the temperature and momentum of the gas in the centrifuge and is constructed to introduce both the inner and the peripheral stream into the centrifuge.

  20. Model : making

    Bottle, Neil

    2013-01-01

    The Model : making exhibition was curated by Brian Kennedy in collaboration with Allies & Morrison in September 2013. For the London Design Festival, the Model : making exhibition looked at the increased use of new technologies by both craft-makers and architectural model makers. In both practices traditional ways of making by hand are increasingly being combined with the latest technologies of digital imaging, laser cutting, CNC machining and 3D printing. This exhibition focussed on ...

  1. Public meetings

    Staff Association

    2013-01-01

    MARS SURVEY 5YR 2015 GENERAL INFORMATION ELECTIONS 2013   COME AND BE INFORMED! Public meetings Tuesday 1st Oct. 10 am Amphi IT, 31-3-004 Meyrin Tuesday 1st Oct. 2 pm Council Chamber, 503-1-001 Meyrin Friday 4 Oct. 10 am Amphi BE, 864-1-D02 Prévessin Monday 7 Oct. 2 pm Council Chamber, 503-1-001 (in English) Meyrin Tuesday 8 Oct. 10 am Amphi Kjell Johnsen, 30-7-018 Meyrin   Overview of the topics to be discussed Recognition of Merit – MARS Outcome of last exercise 2007 to 2013: lessons learned Survey: five-yearly review, give us your opinion General information CVI 2014 Voluntary programmes (PRP, SLS) Elections 2013 Renewal of the Staff Council 2014 - 2015  

  2. The upgraded CDF front end electronics for calorimetry

    Drake, G.; Frei, D.; Hahn, S.R.; Nelson, C.A.; Segler, S.L.; Stuermer, W.

    1991-11-01

    The front end electronics used in the calorimetry of the CDF detector has been upgraded to meet system requirements for higher expected luminosity. A fast digitizer utilizing a 2 {mu}Sec, 16 bit ADC has been designed and built. Improvements to the front end trigger circuitry have been implemented, including the production of 900 new front end modules. Operational experience with the previous system is presented, with discussion of the problems and performance goals.

  3. The upgraded CDF front end electronics for calorimetry

    Drake, G.; Frei, D.; Hahn, S.R.; Nelson, C.A.; Segler, S.L.; Stuermer, W.

    1991-11-01

    The front end electronics used in the calorimetry of the CDF detector has been upgraded to meet system requirements for higher expected luminosity. A fast digitizer utilizing a 2 μSec, 16 bit ADC has been designed and built. Improvements to the front end trigger circuitry have been implemented, including the production of 900 new front end modules. Operational experience with the previous system is presented, with discussion of the problems and performance goals

  4. Meetings and Meeting Modeling in Smart Environments

    Nijholt, Antinus; op den Akker, Hendrikus J.A.; Heylen, Dirk K.J.

    In this paper we survey our research on smart meeting rooms and its relevance for augmented reality meeting support and virtual reality generation of meetings in real time or off-line. The research reported here forms part of the European 5th and 6th framework programme projects multi-modal meeting

  5. Meetings and meeting modeling in smart surroundings

    op den Akker, Hendrikus J.A.; Heylen, Dirk K.J.; Nijholt, Antinus; Nishida, T.

    2004-01-01

    In this paper we survey our research on smart meeting rooms and its relevance for augmented reality meeting support and virtual reality generation of meetings in real-time or off-line. Intelligent real-time and off-line generation requires understanding of what is going on during a meeting. The

  6. 76 FR 23568 - Civil Nuclear Trade Advisory Committee Public Meeting

    2011-04-27

    ... registrants requesting to make statements is greater than can be reasonably accommodated during the meeting... meeting. Man K. Cho, Acting Director, Office of Energy and Environmental Industries. [FR Doc. 2011-10149...

  7. 77 FR 12008 - Civil Nuclear Trade Advisory Committee Public Meeting

    2012-02-28

    ... make statements is greater than can be reasonably accommodated during the meeting, ITA may conduct a... within 90 days of the meeting. Man K. Cho, Team Leader for Energy, Office of Energy and Environmental...

  8. 78 FR 3041 - Notice of Sunshine Act Meetings

    2013-01-15

    ..., 2013--Tentative Thursday, January 31, 2013 9:00 a.m. Briefing on Public Participation in NRC Regulatory Decision-Making (Public Meeting) (Contact: Lance Rakovan, 301-415-2589). This meeting will be webcast live...

  9. Integrated assessment and environmental policy making. In pursuit of usefulness

    Parson, E.A.

    1995-01-01

    Current integrated assessment projects primarily seek end to end integration through formal models at a national to global scale, and show three significant representational weaknesses: determinants of decadal-scale emissions trends; valuing impacts and adaptive response; and the formation and effects of policies. Meeting the needs of policy audiences may require other forms of integration; may require integration by formal modeling or by other means; and may require representing decisions of other actors through political and negotiating processes. While rational global environmental policy making requires integrated assessment, current practice admits no single vision of how to do it, so understanding will be best advanced by a diverse collection of projects pursuing distinct methods and approaches. Further practice may yield some consensus on best practice, possibly including generic assessment skills generalizable across issues. (Author)

  10. Personal values underlying ethnic food choice: Means-end evidence for Japanese food

    Yeong S. Tey

    2018-03-01

    Full Text Available Background: Ethnic cuisines are increasingly popular in global food markets. This study identifies the personal values underlying Malaysian consumers' decision making with respect to Japanese food. Methods: A total of 134 Malaysian consumers were interviewed and analyzed using means-end chain methodology. Results: Our findings indicate that Japanese food is chosen for the values that the attribute “tasty” can help achieve, not for that attribute per se. Conclusion: Identified values primarily related to longevity, meaningful life-style and sense of accomplishment. The identification of these connections is an important step in understanding why a particular ethnic food is favored by foreign consumers. Our findings could be helpful to restaurateurs in meeting marketing strategies with consumer values and policymakers when designing health campaigns. Keywords: Attributes, Japanese food, Means-end chain, Personal values, Product attributes, Cognition

  11. End of an era?

    Abrahamson, Peter

    2016-01-01

    At the end of 2015, China put an end to the one-child policy (OCP), thereby terminating the largest family planning program in human history. For nearly four decades it had shaped relations between generations and between men and women to an extent never before seen. Today, China struggles with t...... because of the strong preference for boys, which has led to so-called “bare branches:” Chinese men who are not able to find a spouse or have to rely on “mail-order brides.” The paper concludes that the OCP has come to an end, but the unintended consequences prevail.......At the end of 2015, China put an end to the one-child policy (OCP), thereby terminating the largest family planning program in human history. For nearly four decades it had shaped relations between generations and between men and women to an extent never before seen. Today, China struggles...... cultural values and legal prescriptions foresee reciprocal care responsibilities between generations. This has led to an enormous care deficit, which triggers conflicts between both genders and generations. A second major unintended consequence has been a skewed gender ratio of only 18 women per 20 men...

  12. A List of Astronomical Meetings Available via Mosaic

    Bryson, E.; Crabtree, D.

    We have been making a list of astronomical and related meetings available electronically for a number of years. Recently, several meeting organizers have made information about their meetings available via anonymous ftp or even NCSA Mosaic. We have produced a new version of our electronic meeting list available via NCSA Mosaic which provides links to the information being provided electronically. Depending upon the amount of information being provided for an individual meeting, it may be possible for a user browsing the list of meetings to click on the meeting of interest, fill out a registration form, download maps, browse abstracts, etc. We hope the availability of this service will encourage other meeting organizers to make information about their meetings available electronically and to take advantage of new technology such as NCSA Mosaic. URL: http:// cadcwww.dao.nrc.calmeetings/meetings.html

  13. Public meeting

    Staff Association

    2015-01-01

    Last Monday at 9 a.m. the Council Chamber was full, with several people standing, for the public meeting of the Staff Association. Simultaneously, many of our colleagues followed the presentations in the Amphitheatre in Prévessin. We would like to thank all of you for the interest you have shown and for your feedback. In the introduction we explained how the Staff Association represents the staff in its discussions with Management and Member States, and how the staff itself defined, by its participation in the 2013 staff survey, the priority assigned to various points related to the employment conditions. The position of the Staff Association regarding the new contract policy, to be implemented as of 31 March 2015 after approval by Council, was stated. Then, in the framework of the 2015 five-yearly review, the general approach that we would like to see for the new career structure, was explained. Concerning diversity, based on what we know about the situation in other international organiza...

  14. Fruitful meeting

    Mike Lamont

    2010-01-01

    The annual meeting for the LHC Performance Workshop was held in Chamonix from 25 to 29 January 2010 in the Centre de Congrès Le Majestic. The Workshop focused on how to reach the maximum operating energy.   The LHC Performance Workshop took place between 25 and 29 January 2010 in a rather chilly Chamonix. Following the successful start of beam commissioning last year, there remain a number of important questions about the near future of the machine. Topics discussed included the maximum operational energy that will be possible in 2010 and the steps need to go above the planned 2010 start-up energy of 3.5 TeV. Of particular importance were the required splice and magnet consolidation measures that would be demanded by an increase above this energy.  The energy in the magnets and beams will always represent a considerable threat, and the possible impact of an incident and the potential measures required to speed up a recovery were put on the table. Safety is critical and there were...

  15. Mere end marionetdukker

    Lehmann-Jacobsen, Emilie Tinne

    2016-01-01

    Pressefrihed er en mangelvare i flere sydøstasiatiske lande, og journalisterne beskrives sjældent som andet end viljeløse marionetdukker for de siddende magthavere. Det er dog langt fra den fulde fortælling. Men myten lever videre til frustration for de fagligt stolte journalister og med konsekve......Pressefrihed er en mangelvare i flere sydøstasiatiske lande, og journalisterne beskrives sjældent som andet end viljeløse marionetdukker for de siddende magthavere. Det er dog langt fra den fulde fortælling. Men myten lever videre til frustration for de fagligt stolte journalister og med...

  16. The end of truth?

    C. W. du Toit

    1997-01-01

    As we are approaching the end of the century, many ideas, systems, and certainties, previously taken for granted, seem to be questioned, altered and rejected. One of these is the notion of truth, which pervades the very fibre of Western thinking. Rejecting the relevant critique as simply a postmodem fad, this article proceeds to give attention to the questions regarding the end of religious, scientific, and metaphysical truth. Truth and power are dealt with, as well as the narrative nature of...

  17. 78 FR 4476 - Sunshine Act; Meeting Notice

    2013-01-22

    ...: Commissioners' Conference Room, 11555 Rockville Pike, Rockville, Maryland. STATUS: Public and Closed. Week of... live at the Web address--www.nrc.gov. 9:00 a.m. Briefing on Public Participation in NRC Regulatory Decision- Making (Public Meeting) (Contact: Lance Rakovan, 301-415-2589). This meeting will be webcast live...

  18. Charting the social order of meetings

    Ravn, Ib

    , with its cumbersome rules safeguarding formal-democratic decision-making, (3) the collective–egalitarian style of community-type meetings where anyone can speak anytime about anything, and (4) the facilitative style, in which a facilitator guides the meeting conversation with a firm hand such that all...

  19. End-of-life decisions in the intensive care unit

    Jensen, Hanne Irene

    2012-01-01

    be interdisciplinary, but the literature shows that this is not always the case. Research on end-of-life issues in Danish ICUs is limited. Aim The aims of this thesis were to • Examine Danish practices regarding end-of-life decisions in the ICU. • Examine the opinions of nurses and physicians who work in Danish ICUs...... and decision-making. Hypotheses • Nurses, intensivists, and primary physicians have different experiences of interdisciplinary collaboration regarding end-of-life decision-making in the ICU. • Specific interventions targeting end-of-life decision-making in the ICU, such as interdisciplinary audits......Background When making end-of-life decisions in intensive care units, the different staff groups have different roles in the decision-making process and may not always assess the situation identically. Practice recommendations for withholding or withdrawing therapy state that decisions should...

  20. Make Sense?

    Gyrd-Jones, Richard; Törmälä, Minna

    Purpose: An important part of how we sense a brand is how we make sense of a brand. Sense-making is naturally strongly connected to how we cognize about the brand. But sense-making is concerned with multiple forms of knowledge that arise from our interpretation of the brand-related stimuli......: Declarative, episodic, procedural and sensory. Knowledge is given meaning through mental association (Keller, 1993) and / or symbolic interaction (Blumer, 1969). These meanings are centrally related to individuals’ sense of identity or “identity needs” (Wallpach & Woodside, 2009). The way individuals make...... sense of brands is related to who people think they are in their context and this shapes what they enact and how they interpret the brand (Currie & Brown, 2003; Weick, Sutcliffe, & Obstfeld, 2005; Weick, 1993). Our subject of interest in this paper is how stakeholders interpret and ascribe meaning...

  1. 77 FR 5798 - Sunshine Act Meeting

    2012-02-06

    ... to the public (limited space available) and parts will be closed to the public. In order to increase the accessibility to Board meetings, persons requiring assistance should make arrangements in advance...

  2. Open-Ended Evolution

    Taylor, Tim; Bedau, Mark A.; Channon, Alastair

    2016-01-01

    This report describes the First Workshop on Open-Ended Evolution: Recent Progress and Future Milestones (OEE1), held during the ECAL 2015 conference at the University of York, U.K., in July 2015. We briefly summarise the content of the talks and discussions and the workshop, and provide links...

  3. The Ends of Revolution

    Haugbølle, Sune; Bandak, Andreas

    2017-01-01

    from the days of Tahrir Square in early 2011, when people with elated spirits poured into the streets to demand a better political future. If the large-scale social mobilization back then provided the best refutation of Francis Fukuyama’s the end of history thesis then the failure to translate...

  4. When Strategy Ends

    Vestenskov, David; Jørgensen, Lars Wille

    2014-01-01

    This chapter deals with the end of strategy, that is, conflict termination and how strategic achievements are measured and evaluated. It claims that the modern intervention of choice by NATO and its allies are transformation wars and challenges the concept of victory in such wars. Through a compa...

  5. End Ordovician extinctions

    Harper, David A. T.; Hammarlund, Emma; Rasmussen, Christian M. Ø.

    2014-01-01

    -global anoxia associated with a marked transgression during the Late Hirnantian. Most recently, however, new drivers for the extinctions have been proposed, including widespread euxinia together with habitat destruction caused by plate tectonic movements, suggesting that the end Ordovician mass extinctions were...

  6. Virksomhedscensur farligere end selvcensur

    Brink, Dennis Meyhoff

    2010-01-01

    Når TV-stationer som SBS og auktionshuse som lauritz.com ikke tør vise provokerende materiale, så er der ikke tale om selvcensur, men om virksomhedscensur. Og det er langt farligere end selvcensur....

  7. [The 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences].

    Shiokawa, Mitsuru; Kawamura, Kazumi

    2018-01-01

     The 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences was held at Act City Hamamatsu, Japan, with a total of 2634 participants in attendance. The theme of the meeting was realized through a number of new concepts, such as a debate symposium, information sessions, nurses' workshops, and so on. The results obtained from the participation questionnaire (n=438), which were aggregated up to 1 month following the end of this year's meeting, revealed that 89% of the participants at considered it to have been appealing. In particular, 63% of the participants favored the adoption of a debate symposium whereby it was possible to ask and respond to questions in real time. In the free comments section of the questionnaire, the participants expressed how they felt the debate symposium made it easy to give their opinions, and that this element might be further developed in the future. They also stated that they found the introduction of the Clica system effective in terms of making the annual meeting an active learning place. One issue that was highlighted concerned the observation that the hall used to host the symposium was designed as a concert venue, which meant it was highly shielded from the outside environment, in addition to access to the internet being blocked. I hope that many of the projects from this Annual Meeting will serve to guide the future style of the Society's Annual Meetings.

  8. Profitable tail-end production

    Pinchbeck, R.H.

    1997-12-31

    This presentation discusses the origins of the present challenge faced in making mature oil fields profitable in the North Sea. It briefly examines the origins of these challenges, which are rooted in the industrial psychology of the North Sea. It develops a methodological formula for the successful re-engineering of inefficiently-run assets, focusing in particular on the personnel management aspects. It identifies some key areas to seek sustainable cost reductions and recognises the importance of renewing the context for investment in tail-end fields. Finally, it speculates about the way in which the learnings developed in the experiences of the last few years will influence the future of the North Sea. 2 refs.

  9. End of the Road?

    Fisker, Christian

    to meet their needs. Utilizing a case study with a mixed methods approach, examining two different cities, Aarhus, Denmark and Mississauga, Ontario, Canada, this research project investigates what happens to the mobility and networks of seniors when their automobility is lessened or disappears completely...... the use of mobility action chains, among the participants in the two settings under consideration, one can see the social, design and operational scripts that contribute to the creation, or reconfiguration of these chains, in order to retain connections between the self and needs. Overall, the research...

  10. Communication as care at end of life: an emerging issue from an exploratory action research study of renal end-of-life care for ethnic minorities in the UK.

    Wilkinson, Emma; Randhawa, Gurch; Brown, Edwina A; Da Silva Gane, Maria; Stoves, John; Warwick, Graham; Akhtar, Tahira; Magee, Regina; Sharman, Sue; Farrington, Ken

    2014-09-01

    South Asian people have a higher risk of developing kidney disease, are disproportionately represented in the patient population requiring renal replacement therapy and wait longer to receive a kidney transplant, compared with white Europeans. As a result, there is a demand for end-of-life care, which meets the needs of this group of patients. Providing end-of-life care to patients from different cultures is a challenge for renal services as there can be barriers to communication in the form of language, delegated decision-making within families and reluctance to discuss death. To explore end-of-life care for South Asians with kidney disease, 16 interviews with patients and 14 focus groups with care providers were conducted at four research sites in the UK with large South Asian populations. Using an action research design the data were analysed thematically and fed back to inform the research in a cyclical manner. If patients are not fully aware of their condition or of what end-of-life care is, it is less likely that they will be able to be involved in decision-making about their care and this is compounded where there are communication barriers. Variations in care provider awareness and experience of providing end-of-life care to South Asian patients, in turn, contributes to lack of patient awareness of end-of-life care. Communication as care at the end of life should be explored further. Researching the South Asian patient experience of end of life highlights many relevant and generalisable issues. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  11. PENGEMBANGAN 24 DESTINASI WISATA BAHARI KABUPATEN ENDE

    Josef Alfonsius Gadi Djou

    2013-04-01

    Full Text Available There are 24 marine tourism destinations in Ende District that have not been managed well enough. To improve tourism development, some management strategies should be taken by stakeholders. First, the government should make some policies that give opportunities and easy access to stakeholders. Scond, the government should make a development planning for the potential destinations. Third, they should make plans that would give information about the most potential destination. Fourth, the government and marine communities should prepare human resource in management. At last, the government should promote those marine tourism destinations continuosly.

  12. Decision making.

    Chambers, David W

    2011-01-01

    A decision is a commitment of resources under conditions of risk in expectation of the best future outcome. The smart decision is always the strategy with the best overall expected value-the best combination of facts and values. Some of the special circumstances involved in decision making are discussed, including decisions where there are multiple goals, those where more than one person is involved in making the decision, using trigger points, framing decisions correctly, commitments to lost causes, and expert decision makers. A complex example of deciding about removal of asymptomatic third molars, with and without an EBD search, is discussed.

  13. Making Connections

    Pien, Cheng Lu; Dongsheng, Zhao

    2011-01-01

    Effective teaching includes enabling learners to make connections within mathematics. It is easy to accord with this statement, but how often is it a reality in the mathematics classroom? This article describes an approach in "connecting equivalent" fractions and whole number operations. The authors illustrate how a teacher can combine a common…

  14. Nuclear power's effects on electric rate making

    Smith, D.S.; Lancaster, A.A.

    1978-01-01

    Government and the electric utility industry are re-evaluating nuclear power's contribution to the total U.S. energy supplies. This article addresses how the recently increased nuclear plant construction and operation costs are translated into the prices that consumers pay for electricity. The electric rates that consumers pay must reflect the costs of producing electricity, as well as the costs of transmission, distribution, metering, and billing. The use of nuclear power for electric production is anticipated to grow rapidly so as to meet a larger portion of our country's electricity needs through the end of the century; so nuclear power costs are expected to be an even larger portion of the total electricity price. There are certain rate-making issues that are actively being discussed in public forums and before state and Federal regulatory bodies. These issues are not unique to nuclear power, but take on added significance when nuclear power is used by utilities to produce electricity because of the technology required and because of the type, timing, and magnitude of the costs involved. These are: (1) inclusion of construction work in progress in the rate base; (2) fuel adjustment clauses and treatment of nuclear fuel cycle costs; (3) treatment of certain taxes under the rate-making method called normalization or deferral accounting (sometimes referred to as ''phantom taxes''); and (4) rate treatment for particular nuclear expense items reflecting costs of delays, plant cancellations, and operational slowdowns

  15. Report of fission study meeting

    1986-03-01

    This book is the report of fission Study Meeting held from September 19 to 21, 1985 in the Research Center for Nuclear Physics, Osaka University. The objective of this study meeting was to stimulate the research on nuclear physics in Japan, which began to show new development accompanying the advance of the research on heavy ion nuclear reaction, and to make this a new starting point. More than 50 participants from physical, chemical and engineering fields, who have interest in the theory and experiment related to nuclear fission, gathered, and the meeting was a success beyond expectation. The contents covered a wide range including nuclear smashing reaction as well as nuclear fission in a narrow sense. In this book, the gists of 28 papers are collected. (Kako, I.)

  16. Identity negotiations in meetings

    Asmuß, Birte; Oshima, Sae

    of the company, and all members know (and display) that he holds some information that the rest don’t have access to. Our analysis shows that the participants evoke various identities of the manager, sometimes orienting to the structure of the organization, and other times orienting to wider social categories......Meetings are places, where identity negotiation is a central activity and where members’ local practices recurrently inform and are informed by larger categories (Antaki and Widdicombe 1998). Correspondingly, the approach to understanding organization (macro) by way of identity work (micro) has...... company, and in the data recorded over 10 days, the employees frequently complain about the many changes that have taken place. Our focus lies in a unique occasion where one of the managers makes an unusual appearance at the lunchroom. In this situation, he is the only one that is on the business side...

  17. 78 FR 59337 - Black Hills National Forest Advisory Board; Meeting

    2013-09-26

    ... Advisory Board (Board) will meet in Rapid City, South Dakota. The Board is established consistent with the... include time for people to make oral statements of three minutes or less. Individuals wishing to make an...

  18. 22 CFR 507.8 - Recording keeping of closed meetings.

    2010-04-01

    ... of a meeting, closed to the public. (b) The Board, after review by the Chairman, shall make promptly... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Recording keeping of closed meetings. 507.8 Section 507.8 Foreign Relations BROADCASTING BOARD OF GOVERNORS RULES FOR IMPLEMENTING OPEN MEETINGS UNDER...

  19. 77 FR 9214 - National Security Education Board Members Meeting

    2012-02-16

    ... DEPARTMENT OF DEFENSE Office of the Secretary National Security Education Board Members Meeting... meeting of the National Security Education Board. The purpose of the meeting is to review and make... p.m. ADDRESSES: Defense Language and National Security Education Office, 1101 Wilson Boulevard...

  20. REASONING IN THE FUZZY FRONT END OF INNOVATION:

    Haase, Louise Møller; Laursen, Linda Nhu

    2018-01-01

    in the fuzzy front end is the reasoning process: innovation teams are faced with open-ended, ill-defined problems, where they need to make decisions about an unknown future but have only incomplete, ambiguous and contradicting insights available. We study the reasoning of experts, how they frame to make sense...... of all the insights and create a basis for decision-making in relation to a new project. Based on case studies of five innovative products from various industries, we propose a Product DNA model for understanding the reasoning in the fuzzy front end of innovation. The Product DNA Model explains how...... experts reason and what direct their reasoning....

  1. 50 CFR 600.135 - Meeting procedures.

    2010-10-01

    ... accessible to persons with disabilities, and that the public can make timely requests for language interpreters or other auxiliary aids at public meetings. (b) Drafts of emergency public notices must be... with disabilities, and that the public can make timely requests for language interpreters or other...

  2. The End of Militarism

    Afsah, Ebrahim

    2008-01-01

    in obscure ideas of racial and national supremacy; to engage in propagandising these ideas to society at large; and to interfere with civilian policy making. The emergence of exemplary civil-military relations in a pluralistic democracy was the result of a long political process of normative evaluation......, this study cautions against over-ambitious predictive claims and the ability to impose social and institutional engineering in a post-conflict setting....

  3. An Economic Case for End System Multicast

    Analoui, Morteza; Rezvani, Mohammad Hossein

    This paper presents a non-strategic model for the end-system multicast networks based on the concept of replica exchange economy. We believe that microeconomics is a good candidate to investigate the problem of selfishness of the end-users (peers) in order to maximize the aggregate throughput. In this solution concept, the decisions that a peer might make, does not affect the actions of the other peers at all. The proposed mechanism tunes the price of the service in such a way that general equilibrium holds.

  4. Remedial action programs annual meeting: Meeting notes

    1987-01-01

    The US Department of Energy Grand Junction Projects Office was pleased to host the 1987 Remedial Action programs Annual Meeting and herein presents notes from that meeting as prepared (on relatively short notice) by participants. These notes are a summary of the information derived from the workshops, case studies, and ad hoc committee reports rather than formal proceedings. The order of the materials in this report follows the actual sequence of presentations during the annual meeting

  5. Making Yugoslavs

    Nielsen, Christian Axboe

    . By the time Aleksandar was killed by an assassin’s bullet five years later, he not only had failed to create a unified Yugoslav nation but his dictatorship had also contributed to an increase in interethnic tensions.   In Making Yugoslavs, Christian Axboe Nielsen uses extensive archival research to explain...... the failure of the dictatorship’s program of forced nationalization. Focusing on how ordinary Yugoslavs responded to Aleksandar’s nationalization project, the book illuminates an often-ignored era of Yugoslav history whose lessons remain relevant not just for the study of Balkan history but for many...

  6. Lower end fitting debris collector and end cap spacer grid

    Bryan, W.J.

    1990-01-01

    This patent describes a nuclear reactor having fuel assemblies including an upper end fitting and spaced nuclear fuel rod spacer grids for supporting and spacing a plurality of elongated nuclear fuel rods. Each includes a hollow active portion of nuclear fuel filled cladding intermediate the rod ends and tapering end cap of solid material with a circumferential groove on the rod end which first encounters reactor coolant flow, a lower end filtering debris collector and end cap spacer grid for capturing and retaining deleterious debris carried by reactor coolant before it enters the active region of a fuel assembly and creates fuel rod cladding damage

  7. Brachistochrones with loose ends

    Mertens, Stephan; Mingramm, Sebastian [Institut fuer Theoretische Physik, Otto-von-Guericke Universitaet, PF 4120, 39016 Magdeburg (Germany)

    2008-11-15

    The classical problem of the brachistochrone asks for the curve down which a body sliding from rest and accelerated by gravity will slip (without friction) from one point to another in least time. In undergraduate courses on classical mechanics, the solution of this problem is the primary example of the power of variational calculus. Here, we address the generalized brachistochrone problem that asks for the fastest sliding curve between a point and a given curve or between two given curves. The generalized problem can be solved by considering variations with varying end points. We will contrast the formal solution with a much simpler solution based on symmetry and kinematic reasoning. Our exposition should encourage teachers to include variational problems with free boundary conditions in their courses and students to try simple, intuitive solutions first.

  8. Sealing a conduit end

    Mentz, R.M.

    1993-01-01

    An apparatus for sealing or blocking conduits, such as the primary nozzles of a nuclear steam generator is described. It includes an annular bracket sealingly attached to the open end of the nozzle, the bracket having a plurality of threaded holes therein. Mounted atop the bracket is a generally circular nozzle dam for covering the opening. Interposed between the nozzle dam and the bracket is an extrusion-resistant seal member having a plurality of apertures therethrough for receiving each bolt. The seal member is configured to resist extrusion by having laminated layers of differing hardnesses, so that the seal member will not laterally extrude away from each bolt in a manner that enlarges the aperture surrounding each bolt as the nozzle dam is bolted to the bracket. (author)

  9. The unscalable frequency of meetings

    CERN. Geneva

    2015-01-01

    The November 2014 document "Summary of IT Programme of Work and Outlook for 2015" mentions: '...the input generated by the IT staff survey (...) suggested to make increased use of more modern communication methods (e.g. social.cern.ch)...'. Experience has shown the futility of investing all hopes for making an effective change into a single method, even the most contemporary or versatile. This talk will suggest small, achievable steps for staying connected and informed, yet limiting all kinds of meetings-for-their-own-sake.

  10. A method for studying decision-making by guideline development groups.

    Gardner, Benjamin; Davidson, Rosemary; McAteer, John; Michie, Susan

    2009-08-05

    Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG. This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.

  11. A method for studying decision-making by guideline development groups

    Michie Susan

    2009-08-01

    Full Text Available Abstract Background Multidisciplinary guideline development groups (GDGs have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. Methods A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Results Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE acute physical health GDG. Conclusion This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making

  12. Traditional expectations versus US realities: first- and second-generation Asian Indian perspectives on end-of-life care.

    Sharma, Rashmi K; Khosla, Nidhi; Tulsky, James A; Carrese, Joseph A

    2012-03-01

    Although end-of-life care preferences vary across racial/ethnic groups, little is known about how cultural values affect end-of-life care preferences among South Asian immigrants and their offspring in the US. To examine the perspectives of first- and second-generation South Asians living in the US regarding end-of-life care. Focus group study. Discussions explored participant preferences and experiences with family members facing the end of life. Twelve first-generation and 11 second-generation self-identified Asian Indians living in the mid-Atlantic region. Content analysis of focus group transcripts. First-generation participants ranged in age from 41 to 76 years and were evenly split by gender. Second-generation participants ranged in age from 23 to 36 years and included seven women and four men. All participants were highly educated, and two thirds were either studying or working in a health care field. All but two subjects were Hindu. Several themes emerged that highlighted cultural differences and challenges for this population in the context of end-of-life care: attitudes toward death and suffering; family duty; and preferences for information disclosure and decision making. Participants described cultural challenges due to the evolution of traditional roles, lack of explicit discussion between patients and family members about preferences and care expectations, and a tension between wanting to meet traditional expectations and the challenges in doing so given US social realities. Traditional cultural values, such as duty to family, greatly influenced end-of-life care preferences and retained importance across generations. Clinicians caring for Asian Indian patients at the end of life may be better able to assess care preferences after exploring the complex interplay between traditional expectations and specific social realities for each patient. Particular attention should be given to attitudes toward death and suffering, family duty, and preferences for

  13. End-to-end System Performance Simulation: A Data-Centric Approach

    Guillaume, Arnaud; Laffitte de Petit, Jean-Luc; Auberger, Xavier

    2013-08-01

    In the early times of space industry, the feasibility of Earth observation missions was directly driven by what could be achieved by the satellite. It was clear to everyone that the ground segment would be able to deal with the small amount of data sent by the payload. Over the years, the amounts of data processed by the spacecrafts have been increasing drastically, leading to put more and more constraints on the ground segment performances - and in particular on timeliness. Nowadays, many space systems require high data throughputs and short response times, with information coming from multiple sources and involving complex algorithms. It has become necessary to perform thorough end-to-end analyses of the full system in order to optimise its cost and efficiency, but even sometimes to assess the feasibility of the mission. This paper presents a novel framework developed by Astrium Satellites in order to meet these needs of timeliness evaluation and optimisation. This framework, named ETOS (for “End-to-end Timeliness Optimisation of Space systems”), provides a modelling process with associated tools, models and GUIs. These are integrated thanks to a common data model and suitable adapters, with the aim of building suitable space systems simulators of the full end-to-end chain. A big challenge of such environment is to integrate heterogeneous tools (each one being well-adapted to part of the chain) into a relevant timeliness simulation.

  14. Report of nuclear powered ship meeting

    Anon.

    1983-01-01

    The research and development of nuclear powered ships in Japan have been advanced centering around the Japan Nuclear Ship Development Agency established in 1963. It is regretful that the development of ''Mutsu'' is largely behind the schedule due to the radiation leak in 1974, and the expected objective has not yet been attained even today. The government decided to advance the research on the improvement of marine nuclear reactors in 1980, and this new research function was given to the Agency by changing its organization. However, recently various arguments have arisen concerning the way of the research and development of nuclear ships in Japan centering around ''Mutsu'', such as the necessity of developing nuclear ships, the enormous expenditure for the development, the aging of ''Mutsu'' more than 10 years after the construction, the introduction of nuclear ship technology from foreign countries and so on. By the end of fiscal 1984, the Agency is expected to merge with other organization related to atomic energy, therefore, it is necessary to decide the way of research and development. This meeting organized by the Atomic Energy Commission makes this report to show the way of thinking about the above arguments. (Kako, I.)

  15. End-to-side and end-to-end anastomoses give similar results in cervical oesophagogastrostomy.

    Pierie, J P; De Graaf, P W; Poen, H; Van Der Tweel, I; Obertop, H

    1995-12-01

    To find out if there were any differences in healing between end-to-end and end-to-side anastomoses for oesophagogastrostomy. Open study with historical controls. University hospital, The Netherlands. 28 patients with end-to-end and 90 patients with end-to-side anastomoses after transhiatal oesophagectomy and partial gastrectomy for cancer of the oesophagus or oesophagogastric junction, with gastric tube reconstruction and cervical anastomosis. Leak and stricture rates, and the number of dilatations needed to relieve dysphagia. There were no significant differences in leak rates (end-to-end 4/28, 14%, and end-to-side 13/90, 14%) or anastomotic strictures (end-to-end 9/28, 32%, and end-to-side 26/90, 29%). The median number of dilatations needed to relieve dysphagia was 7 (1-33) after end-to-end and 9 (1-113) after end-to-side oesophagogastrostomy. There were no differences between the two methods of suture of cervical oesophagogastrostomy when leakage, stricture, and number of dilatations were used as criteria of good healing.

  16. End-of-life decisions: Christian perspectives.

    Stempsey, William E

    1997-12-01

    While legal rights to make medical treatment decisions at the end of one's life have been recognized by the courts, particular religious traditions put axiological and metaphysical meat on the bare bones of legal rights. Mere legal rights do not capture the full reality, meaning and importance of death. End-of-life decisions reflect not only the meaning we find in dying, but also the meaning we have found in living. The Christian religions bring particular understandings of the vision of life as a gift from God, human responsibility for stewardship of that life, the wholeness of the person, and the importance of the dying process in preparing spiritually for life beyond earthly life, to bear on end-of-life decisions.

  17. Meeting the Educational Challenges of Income Inequality

    Duncan, Greg J.; Murnane, Richard J.

    2014-01-01

    Can the nation's schools meet today's challenge of providing all students with the skills they will need to thrive in the rapidly changing economy and society of the 21st century? The authors point out in this article that a large percentage of children, overwhelmingly from low-income families, end their formal schooling without the…

  18. Advanced nuclear plants: Meeting the economic challenge

    Redding, J.R.; MacGregor, P.R.

    1993-01-01

    This article examines the economic challenges to nuclear power meeting the forecasted power demand of the end of the century. The topics of the article include the economic challenge, safety, competition from other energy sources, a US case study, environmental costs, capital costs, reducing operation and maintenance costs, and non-technical features

  19. NEWS: AAPT Summer Meeting

    Mellema, Steve

    2000-11-01

    .andrew.cmu.edu/projects/visual. David Sokoloff (University of Oregon) and Priscilla Laws (Dickinson College) led a discussion session on the Interactive Lecture Demonstrations that they have been developing to promote active learning in the classroom. Loren Winters of the North Carolina School of Science and Mathematics showed some very fine work done with digital video cameras, both in producing motion videos for frame-by-frame analysis and in producing still images of high-speed phenomena. Finally, Patrick Tam of Humboldt State University in California talked about the Multimedia Resource for Learning and Online Teaching (MERLOT), a project to organize and review the proliferation of internet-based teaching materials that are rapidly becoming available. Their purpose is to make it easier for teachers like us to sift through the plethora of new innovations, to locate those that are potentially useful in our teaching, and finally to implement them effectively. You can check out the project on the web at www.merlot.org. As is evident from the number of sessions of contributed papers and the tandem conference, the quality and quantity of physics education research into new curricula and teaching methods continue to increase. A number of interesting areas were discussed including interactive lecture techniques, studio-classroom approaches combining lectures and labs, assessment techniques, and identifying and correcting student misconceptions. In addition to the plenary talks on current research topics in physics mentioned above, there were sessions on Space Physics and Hot Topics in Physics. There were sessions on professional and career concerns including Preparing Future Physics Faculty, New Faculty Experiences and Concerns, Balancing Career and Family, How Physics Topics Support the Job Market and Recruiting and Retaining Women in Physics. Whether one was a high school teacher or a university professor, this was an enjoyable and educational meeting. We all look forward to the Winter 2001 meeting from

  20. Politics at its end

    Proske, R.

    1992-01-01

    The author sees politics describing towards its end under the impact of the development science, technology and the economy have undergone. One of the signposts on this road of change has been the discovery of nuclear fission, leading to a revolution in the field of science, and developments such as the atomic bomb and, later on, the peaceful uses of nuclear energy, with technological development contributing the safe and economically operating reactors for power generation. In the eyes of the author, politics has little to contribute to solving the biggest problems of the future, which are the population explosion, and the global climate change caused by man-made emissions of trace gases. In order to tackle the climate problem, there is urgent need for a drastic outback in the consumption of fossil fuels, although renewable energy sources have not yet become reality to count on, the hydrogen economy still being just a hope, - so that nuclear power may be gaining second wind. (HP) [de

  1. Orbital maneuvering end effectors

    Myers, W. Neill (Inventor); Forbes, John C. (Inventor); Barnes, Wayne L. (Inventor)

    1986-01-01

    This invention relates to an end effector device for grasping and maneuvering objects such as berthing handles of a space telescope. The device includes a V-shaped capture window defined as inclined surfaces in parallel face plates which converge toward a retainer recess in which the handle is retained. A pivotal finger (30) meshes with a pair of pivoted fingers which rotate in counterrotation. The fingers rotate to pull a handle within the capture window into recess where latches lock handle in the recess. To align the capture window, plates may be cocked plus or minus five degrees on base. Drive means is included in the form of a motor coupled with a harmonic drive speed reducer, which provides for slow movement of the fingers at a high torque so that large articles may be handled. Novelty of the invention is believed to reside in the combined intermeshing finger structure, drive means and the harmonic drive speed reducer, which features provide the required maneuverability and strength.

  2. Youth in Dead End

    Duygu TANRIKULU

    2011-01-01

    Full Text Available The primary factor to ensure economic and social development and also to build a healthy society is the education system which plays a significant role in human capital formation and shapes the social structure and its outputs. In this context, there are some risks threatening the youth that is trying to position itself on the education-employment line and some critical areas in need of national policy intervention as well. Hence, by analyzing indicators on education and labor force, this study aims to reveal the amount of youth under risk and to identify these critical areas, while targeting to highlight the urgent need for policy development focusing on youth in dead end. Within the study, it is emphasized that the education system causes youth to face with the problems of access and quality, and that there is a significant amount of youth not in education and employment, while underlining the necessity of bringing especially this inactive youth in economy in addition to equipping with required qualifications for their active participation in social life. Thus, in order to hinder human capital loss additionally, there is policy need in two directions, as focusing on the education system to prevent new hopeless generations on the one hand, and on the inclusion of the disadvantaged youth on the other.

  3. Nuclear regulatory decision making

    2005-01-01

    The fundamental objective of all nuclear safety regulatory bodies is to ensure that nuclear utilities operate their plants at all times in an acceptably safe manner. In meeting this objective, the regulatory body should strive to ensure that its regulatory decisions are technically sound, consistent from case to case, and timely. In addition, the regulator must be aware that its decisions and the circumstances surrounding those decisions can affect how its stakeholders, such as government policy makers, the industry it regulates, and the public, view it as an effective and credible regulator. In order to maintain the confidence of those stakeholders, the regulator should make sure that its decisions are transparent, have a clear basis in law and regulations, and are seen by impartial observers to be fair to all parties. Based on the work of a Nuclear Energy Agency (NEA) expert group, this report discusses some of the basic principles and criteria that a regulatory body should consider in making decisions and describes the elements of an integrated framework for regulatory decision making. (author)

  4. Storage system software solutions for high-end user needs

    Hogan, Carole B.

    1992-01-01

    Today's high-end storage user is one that requires rapid access to a reliable terabyte-capacity storage system running in a distributed environment. This paper discusses conventional storage system software and concludes that this software, designed for other purposes, cannot meet high-end storage requirements. The paper also reviews the philosophy and design of evolving storage system software. It concludes that this new software, designed with high-end requirements in mind, provides the potential for solving not only the storage needs of today but those of the foreseeable future as well.

  5. Optimization of CNC end milling process parameters using PCA ...

    Optimization of CNC end milling process parameters using PCA-based Taguchi method. ... International Journal of Engineering, Science and Technology ... To meet the basic assumption of Taguchi method; in the present work, individual response correlations have been eliminated first by means of Principal Component ...

  6. Proportional counter end effects eliminator

    Meekins, J.F.

    1976-01-01

    An improved gas-filled proportional counter which includes a resistor network connected between the anode and cathode at the ends of the counter in order to eliminate ''end effects'' is described. 3 Claims, 2 Drawing Figures

  7. [End of life and vulnerability, a public health issue].

    Boucomont, Aude

    2016-02-01

    End of life and precarity, two words which were linked by the French national observatory for end of life care in its work carried out in 2014. The study provided an overview of current support practices in different areas, highlighting certain lessons to be learned and making recommendations to the different partners involved. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Making Sustainable Decisions Using the KONVERGENCE Framework

    Piet, Steven James; Gibson, Patrick Lavern; Joe, Jeffrey Clark; Kerr, Thomas A; Nitschke, Robert Leon; Dakins, Maxine Ellen

    2003-02-01

    Hundreds of contaminated facilities and sites must be cleaned up. “Cleanup” includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done - some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches, including: • New ways (mental model) to analyze and visualize the problem, • Awareness of the option to shift strategy or reframe from a single decision to an adaptable network of decisions, and • Improved tactical processes that account for several challenges. These include the following: • Stakeholder values are a more fundamental basis for decision making and keeping than “meeting regulations.” • Late-entry players and future generations will question decisions. • People may resist making “irreversible” decisions. • People need “compelling reasons” to take action in the face of uncertainties. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period—from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept “as is” or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: • Knowledge: what is known about the problem and possible solutions? • Values: what is important to those affected by the decision? • Resources: what is available to implement

  9. What Makes Women Experience Desire?

    Laan, Ellen; Both, Stephanie

    2008-01-01

    What makes women experience sexual desire? According to Kaplan, normal sexual response starts with desire, progresses through excitement or arousal, and ends with orgasm (Kaplan, 1974). This model implies that sexual desire is something you either have or don't have, and, if you don't have it, there

  10. Notification of upcoming AGU Council meeting

    Williams, Billy

    2012-10-01

    The AGU Council will meet on Sunday, 2 December 2012, at the InterContinental Hotel in San Francisco, Calif. The meeting, which is open to all AGU members, will include discussions of AGU's new Grand Challenge Project (a project that will be introduced to members at the 2012 Fall Meeting), the proposed AGU scientific ethics policy, publishing strategies, future plans for honors and recognition, and leadership transition as new members join the Council. This year the Council experimented with a new approach to conducting business. By holding virtual meetings throughout the year, Council members have been able to act in a more timely manner and provide input on important membership and science issues on the Board of Directors' agenda. The Council Leadership Team—an elected subset of the Council—also experimented with a new approach, meeting every month to keep moving projects forward. This approach has increased communication and improved effectiveness in Council decision making.

  11. Realizing directional cloning using sticky ends produced by 3ʹ-5ʹ ...

    The Klenow fragment (KF) has been used to make the blunt end as a tool enzyme. Its 5′-3′ polymerase activity can extend the 5′ overhanging sticky end to the blunt end, and 3′-5′ exonuclease activity can cleave the 3′ overhanging sticky end to the blunt end. The blunt end is useful for cloning. Here, we for the first ...

  12. 75 FR 29538 - SFIREG Full Committee; Notice of Public Meeting

    2010-05-26

    ... (SFIREG) Full Committee will hold a 2-day meeting, beginning on June 21, 2010 and ending June 22, 2010. This notice announces the location and times for the meeting and sets forth the tentative agenda topics. DATES: The meeting will be held on Monday, June 21, 2010 from 8:30 a.m. to 5 p.m. and 8:30 a.m to 12...

  13. Building dialogue POMDPs from expert dialogues an end-to-end approach

    Chinaei, Hamidreza

    2016-01-01

    This book discusses the Partially Observable Markov Decision Process (POMDP) framework applied in dialogue systems. It presents POMDP as a formal framework to represent uncertainty explicitly while supporting automated policy solving. The authors propose and implement an end-to-end learning approach for dialogue POMDP model components. Starting from scratch, they present the state, the transition model, the observation model and then finally the reward model from unannotated and noisy dialogues. These altogether form a significant set of contributions that can potentially inspire substantial further work. This concise manuscript is written in a simple language, full of illustrative examples, figures, and tables. Provides insights on building dialogue systems to be applied in real domain Illustrates learning dialogue POMDP model components from unannotated dialogues in a concise format Introduces an end-to-end approach that makes use of unannotated and noisy dialogue for learning each component of dialogue POM...

  14. Back end of the fuel cycle

    Wolfe, B.; Lambert, R.W.

    1975-01-01

    At present, that portion of the nuclear fuel cycle involving reprocessing, waste management, and mixed-oxide fuel fabrication is in an unsettled state. Government regulatory requirements with respect to all aspects of the back end of the fuel cycle are still being formulated, and there is little positive experience on the operation of commercial reprocessing or mixed-oxide fabrication plants. In view of this unsettled situation, it will be difficult to meet the reprocessing and mixed-oxide fabrication needs of the next decade in the pattern previously anticipated. The costs in the back end of the fuel cycle are much higher than had been anticipated several years ago, a situation similar to that of almost all large endeavors in this country. On the other hand, the added costs are small relative to total power costs and do not affect the economic advantage of nuclear power as compared to other power sources. A rough economic analysis indicates that the question for the back end of the fuel cycle has changed from one of optimizing profitability to one of determining the most economic disposition of spent fuel. Long-term spent fuel storage is a practical and economically acceptable way to provide time for determining a sound course of action for the back end of the fuel cycle. Indeed, if one could count on a breeder economy before the end of the century, one possible course of action is to store light-water fuel until the plutonium can be used in breeders. However, for philosophical as well as practical reasons, it is important that the uncertainties in the course of action should be resolved as quickly as possible. Long-term storage should not be an excuse to delay resolution of the basic questions. (U.S.)

  15. How to make your development process user centred

    CERN. Geneva

    2017-01-01

    I’ve been designing and managing the development processes of websites and applications for companies since the 90s. In those years I’ve seen a lot of projects fail. The biggest issue: development teams prefer to spend the majority of their time in their cave behind their screens and clients stay in their ivory tower. This means that software is developed based on assumptions and personal taste. I’ve been to way to many meetings where arguments were leverages with ‘I don’t like this’ or ‘I think the user doesn’t want this’. During this presentation I will show the steps that should be taken to avoid all these issues and make a product that does bring the business objectives and the user’s desires together and is optimised for the real end user thus creates a usable product.

  16. Standardizing an End-to-end Accounting Service

    Greenberg, Edward; Kazz, Greg

    2006-01-01

    Currently there are no space system standards available for space agencies to accomplish end-to-end accounting. Such a standard does not exist for spacecraft operations nor for tracing the relationship between the mission planning activities, the command sequences designed to perform those activities, the commands formulated to initiate those activities and the mission data and specifically the mission data products created by those activities. In order for space agencies to cross-support one another for data accountability/data tracing and for inter agency spacecraft to interoperate with each other, an international CCSDS standard for end-to-end data accountability/tracing needs to be developed. We will first describe the end-to-end accounting service model and functionality that supports the service. This model will describe how science plans that are ultimately transformed into commands can be associated with the telemetry products generated as a result of their execution. Moreover, the interaction between end-to-end accounting and service management will be explored. Finally, we will show how the standard end-to-end accounting service can be applied to a real life flight project i.e., the Mars Reconnaissance Orbiter project.

  17. 76 FR 54536 - Meeting

    2011-09-01

    ... UNITED STATES INSTITUTE OF PEACE Meeting AGENCY: United States Institute of Peace. Date/Time... Peace Act, Public Law 98-525. Agenda: September 22, 2011 Board Meeting; Approval of Minutes of the One Hundred Fortieth Meeting (June 23-24, 2011) of the Board of Directors; Chairman's Report; President's...

  18. 75 FR 58350 - Meeting

    2010-09-24

    ... UNITED STATES ARCTIC RESEARCH COMMISSION Meeting Notice is hereby given that the U.S. Arctic Research Commission will hold its 94th meeting in Fairbanks, AK, on October 6-8, 2010. The business session... approval of the agenda. (2) Approval of the minutes from the 93rd meeting. (3) Commissioners and staff...

  19. Evaluating meeting support tools

    Post, W.M.; Huis in 't Veld, M. M.A.; Boogaard, S.A.A. van den

    2007-01-01

    Many attempts are underway for developing meeting support tools, but less attention is paid to the evaluation of meetingware. This article describes the development and testing of an instrument for evaluating meeting tools. First, we specified the object of evaluation -meetings- by means of a set of

  20. Evaluating meeting support tools

    Post, W.M.; Huis in't Veld, M.A.A.; Boogaard, S.A.A. van den

    2008-01-01

    Many attempts are underway for developing meeting support tools, but less attention is paid to the evaluation of meetingware. This article describes the development and testing of an instrument for evaluating meeting tools. First, we specified the object of evaluation - meetings - by means of a set

  1. Commuting for meetings

    Fosgerau, Mogens; Engelson, Leonid; Franklin, Joel P.

    2014-01-01

    Urban congestion causes travel times to exhibit considerable variability, which leads to coordination problems when people have to meet. We analyze a game for the timing of a meeting between two players who must each complete a trip of random duration to reach the meeting, which does not begin...

  2. Participation in decision making

    EG Valoyi

    2000-06-01

    Full Text Available The aim of the present study was to determine the extent to which employees would like to participate in decision making concerning various organisational issues, especially those concerning: the work itself, working conditions, human resources issues, and corporate policy and planning. The sample consisted of 146 participants, including managers, middle managers, and junior officials from a South African development corporation. A questionnaire to measure employees' desire to participate in decision making was specially constructed for this investigation. It has found that employees with higher academic qualifications were more desirous to participate in decision-making at all levels than employees with lower academic qualifications. This was also true for employees in higher job grades than in lower job grades. Men were more desirous to participate in decision making than women. The implications of the findings are discussed. Opsomming Die doel van die huidige studie was om vas te stel in watter mate werknemers sal wil deelneem aan die besluit- nameproses van organisasies, veral rakende die volgende sake: die werk self, werksomstandighede, menslike hulpbronaangeleenthede en korporatiewe beleid en beplanning. Die steekproef het uit 146 deelnemers, insluitende bestuurders, middelvlakbestuurders en junior amptenare van'n Suid Afrikaanse ontwikkelingskorporasie, bestaan. nVraelys wat die begeerte van werknemers meet om aan die besluitnameproses deel te neem, is spesiaal vir die doel van hierdie ondersoek, ontwerp. Dit is bevind dat werknemers met hoer akademiese kwalifikasies meer begerig is om aan die besluitnameproses op alle vlakke deel te neem as werknemers met laer akademiese kwalifikasies. Dit was ook waar vir werknemers in hoervlakposte vergeleke met werknemers in laervlakposte. Mans was ook meer begerig om aan die besluitnameproses deel te neem as vroue. Die implikasies van die studie word bespreek.

  3. Editorial: Nanoscience makes catalysis greener

    Polshettiwar, Vivek

    2012-01-09

    Green chemistry by nanocatalysis: Catalysis is a strategic field of science because it involves new ways of meeting energy and sustainability challenges. The concept of green chemistry, which makes the science of catalysis even more creative, has become an integral part of sustainability. This special issue is at the interface of green chemistry and nanocatalysis, and features excellent background articles as well as the latest research results. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Completion of the Design of the Top End Optical Assembly for ATST

    Canzian, Blaise; Barentine, J.

    2013-01-01

    L-3 Integrated Optical Systems (IOS) Division has been selected by the National Solar Observatory (NSO) to make the Top End Optical Assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope (ATST) to operate at Haleakala, Maui. ATST will perform to a very high optical performance level in a difficult operational environment. The TEOA (including a 0.65-meter silicon carbide secondary mirror and support, mirror thermal management system, mirror positioning and fast tip-tilt system, field stop with thermally managed heat dump, Lyot stop, safety interlock and control system, and support frame) operates in the “hot spot” at the prime focus of the ATST, presenting unusual challenges. L-3 IOS has passed Critical Design Review of the TEOA. In this paper, we describe L-3 IOS success meeting technical challenges, including our solutions for optic fabrication, opto-mechanical positioning, rejected and stray light control, wavefront tip-tilt compensation, and thermal management and control.

  5. Challenges in Special Steel Making

    Balachandran, G.

    2018-02-01

    Special bar quality [SBQ] is a long steel product where an assured quality is delivered by the steel mill to its customer. The bars have enhanced tolerance to higher stress application and it is demanded for specialised component making. The SBQ bars are sought for component making processing units such as closed die hot forging, hot extrusion, cold forging, machining, heat treatment, welding operations. The final component quality of the secondary processing units depends on the quality maintained at the steel maker end along with quality maintained at the fabricator end. Thus, quality control is ensured at every unit process stages. The various market segments catered to by SBQ steel segment is ever growing and is reviewed. Steel mills need adequate infrastructure and technological capability to make these higher quality steels. Some of the critical stages of processing SBQ and the critical quality maintenance parameters at the steel mill in the manufacture has been brought out.

  6. Making working in retailing interesting

    Esbjerg, Lars; Buck, Nuka; Grunert, Klaus G.

    2010-01-01

    This paper is about how five retail chains in the Danish grocery industry attempt to make low-wage, low-status store-level retail jobs as checkout operators and sales assistants interesting from the perspective of both retailers and employees. Following analysis of the social and institutional...... and make store-level retail jobs interesting to them. Although retailers mainly focus their attention on career seekers, we find that working in retailing is interesting for all employee types because the retailers are currently able to meet their respective motivations and aspirations. Nevertheless, we...

  7. Standardized End Point Definitions for Coronary Intervention Trials: The Academic Research Consortium-2 Consensus Document.

    Garcia-Garcia, Hector M; McFadden, Eugène P; Farb, Andrew; Mehran, Roxana; Stone, Gregg W; Spertus, John; Onuma, Yoshinobu; Morel, Marie-Angèle; van Es, Gerrit-Anne; Zuckerman, Bram; Fearon, William F; Taggart, David; Kappetein, Arie-Pieter; Krucoff, Mitchell W; Vranckx, Pascal; Windecker, Stephan; Cutlip, Donald; Serruys, Patrick W

    2018-06-14

    The Academic Research Consortium (ARC)-2 initiative revisited the clinical and angiographic end point definitions in coronary device trials, proposed in 2007, to make them more suitable for use in clinical trials that include increasingly complex lesion and patient populations and incorporate novel devices such as bioresorbable vascular scaffolds. In addition, recommendations for the incorporation of patient-related outcomes in clinical trials are proposed. Academic Research Consortium-2 is a collaborative effort between academic research organizations in the United States and Europe, device manufacturers, and European, US, and Asian regulatory bodies. Several in-person meetings were held to discuss the changes that have occurred in the device landscape and in clinical trials and regulatory pathways in the last decade. The consensus-based end point definitions in this document are endorsed by the stakeholders of this document and strongly advocated for clinical trial purposes. This Academic Research Consortium-2 document provides further standardization of end point definitions for coronary device trials, incorporating advances in technology and knowledge. Their use will aid interpretation of trial outcomes and comparison among studies, thus facilitating the evaluation of the safety and effectiveness of these devices.

  8. OISI dynamic end-to-end modeling tool

    Kersten, Michael; Weidler, Alexander; Wilhelm, Rainer; Johann, Ulrich A.; Szerdahelyi, Laszlo

    2000-07-01

    The OISI Dynamic end-to-end modeling tool is tailored to end-to-end modeling and dynamic simulation of Earth- and space-based actively controlled optical instruments such as e.g. optical stellar interferometers. `End-to-end modeling' is meant to denote the feature that the overall model comprises besides optical sub-models also structural, sensor, actuator, controller and disturbance sub-models influencing the optical transmission, so that the system- level instrument performance due to disturbances and active optics can be simulated. This tool has been developed to support performance analysis and prediction as well as control loop design and fine-tuning for OISI, Germany's preparatory program for optical/infrared spaceborne interferometry initiated in 1994 by Dornier Satellitensysteme GmbH in Friedrichshafen.

  9. Decision-making in abnormal radiological situations

    Pretre, S.

    1998-01-01

    General problems associated with social impacts of radiology and decision making is discussed, as the main topics of the meeting. The problem of population is discussed living in areas contaminates with radioactive substances resulting from a major accident or from pest practices. This situation needs decision making process for initiating actions like relocation, resettlement or large-scale decontamination. The roles of various participants in this decision making process and in the communication with the public are considered. (R.P.)

  10. Making the Most of Your Board Meetings: 10 Lessons

    Campbell, Gary

    2010-01-01

    Malcolm Gladwell, in his book "Outliers," describes how studies of expertise consistently show that 10,000 hours of practice in a discipline is required for true mastery. This is problematic for those who become independent school trustees--bringing with them a passion for their school and for education in general, but not much else. Many…

  11. Making sense of science: Meeting the public's information needs

    Abalkina, I.

    2005-01-01

    The study aimed at better understanding of specific information needs as well as of how the public perceives the issue of radioactive contamination. Main conclusions of the study:1. Information is lacking 2. Great concern for health effects of radiation 3. Poverty is a worry. Study results are very much consistent with the ideas of 2002 UN Report: Human Consequences of the Chernobyl Accident: A Strategy for Recovery

  12. Data Mining Meets HCI: Making Sense of Large Graphs

    2012-07-01

    demo video of GRAPHITE can be downloaded at http://youtu.be/nZYHazugVNA. Chapter adapted from work appeared at ICDM 2008 [30] 89 6.1 Introduction...which contain either ‘sex’, ‘adult’, or ‘ porno ’ have low goodness prior(0.05). Among 11.8 million web pages containing sexually explicit keywords, we...Essa, G. Turk, and A. Bobick. Graphcut textures: Image and video synthesis using graph cuts. ACM Transactions on Graph- ics, 22(3):277–286, 2003. [89] R

  13. 12 CFR 516.170 - When will OTS conduct a meeting on an application?

    2010-01-01

    ... application, or otherwise determines that a meeting will benefit the decision-making process. OTS may limit... inform the applicant and all commenters requesting a meeting of its decision to grant or deny a meeting request, or of its decision to conduct a meeting on its own initiative. (c) If OTS decides to conduct a...

  14. Last Research Board Meeting for Leon Van Hove

    CERN PhotoLab

    1980-01-01

    Leon Van Hove chaired the meeting for the last time, the end of the year being also the end of his term as Research Director General. The place was as usual the 6th floor conference room at the Main Building. The photo shows Sergio Fubini, Claude Bovet, Erwin Gabathuler, Volker Soergel, Leslie Camilleri, Jurg May, Mike Crowley-Milling

  15. Decision making in neonatologia.

    Paterlini, G; Tagliabue, P

    2010-06-01

    The field of neonatology presents a fascinating context in which hugely important decisions have to be made on the basis of physicians' assessments of the long term consequences of various possible choices. In many cases such assessments cannot be derived from a consensual professional opinion; the situation is characterized by a high level of uncertainty. A sample of neonatologists in different countries received a questionnaire including vignette cases for which no clear consensus exists regarding the (probabilistic) prognosis. They were asked to (I) assess the probability of various outcomes (death, severe impairment) and (II) choose a treatment to be offered to the parents. Information on the physicians' professional and socio-demographic characteristics and their ethical "values" was also collected. The goal of this international survey is to understand the prognosis and to analyze decision making by professionals in the context of life and death in medicine. The availability of an identical technology in different social and institutional contexts should help identifying the convergences and differences under consideration. Seventy percent of those invited responded to the questionnaire (International 60-80%). Italian neonatologists seem to be quite pessimistic about the prognosis of infants at high risk of death or long term disabilities, they show a pro-life attitude, but in a certain proportion are willing to change their minds if requested by parents. Furthermore personal opinions predominate in the decision-making process and the contribution of team meeting and/or ethic consultation seem not significantly modify the decisions.

  16. Adaptive RF front-ends for hand-held applications

    van Bezooijen, Andre; van Roermund, Arthur

    2010-01-01

    The RF front-end - antenna combination is a vital part of a mobile phone because its performance is very relevant to the link quality between hand-set and cellular network base-stations. The RF front-end performance suffers from changes in operating environment, like hand-effects, that are often unpredictable. ""Adaptive RF Front-Ends for Hand-Held Applications"" presents an analysis on the impact of fluctuating environmental parameters. In order to overcome undesired behavior two different adaptive control methods are treated that make RF frond-ends more resilient: adaptive impedance control,

  17. Nuclear fuel element end fitting

    Jabsen, F.S.

    1980-01-01

    An invention is described whereby end fittings are formed from lattices of mutually perpendicular plates. At the plate intersections, sockets are secured to the end fittings in a manner that permits the longitudinal axes of each of the sockets to align with the respective lines of intersection of the plates. The sockets all protrude above one of the surfaces of the end fitting. Further, a detent is formed in the proturding sides of each of the sockets. Annular grooves are formed in each of the ends of the fuel rods that are to be mounted between the end fittings. The socket detents protrude into the respective annular grooves, thus engaging the grooves and retaining the fuel rods and end fittings in one integral structure. (auth)

  18. Evaluation of End Mill Coatings

    L. J. Lazarus; R. L. Hester,

    2005-08-01

    Milling tests were run on families of High Speed Steel (HSS) end mills to determine their lives while machining 304 Stainless Steel. The end mills tested were made from M7, M42 and T15-CPM High Speed Steels. The end mills were also evaluated with no coatings as well as with Titanium Nitride (TiN) and Titanium Carbo-Nitride (TiCN) coatings to determine which combination of HSS and coating provided the highest increase in end mill life while increasing the cost of the tool the least. We found end mill made from M42 gave us the largest increase in tool life with the least increase in cost. The results of this study will be used by Cutting Tool Engineering in determining which end mill descriptions will be dropped from our tool catalog.

  19. Composite material and method of making

    Fryxell, Glen E.; Samuels, William D.; Simmons, Kevin L.

    2004-04-20

    The composite material and methods of making the present invention rely upon a fully dense monolayer of molecules attached to an oxygenated surface at one end, and an organic terminal group at the other end, which is in turn bonded to a polymer. Thus, the composite material is a second material chemically bonded to a polymer with fully dense monolayer there between.

  20. 39 CFR 6.1 - Regular meetings, annual meeting.

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Regular meetings, annual meeting. 6.1 Section 6.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE MEETINGS (ARTICLE VI) § 6.1 Regular meetings, annual meeting. The Board shall meet regularly on a schedule...

  1. End-to-End Security for Personal Telehealth

    Koster, R.P.; Asim, M.; Petkovic, M.

    2011-01-01

    Personal telehealth is in rapid development with innovative emerging applications like disease management. With personal telehealth people participate in their own care supported by an open distributed system with health services. This poses new end-to-end security and privacy challenges. In this

  2. MEETING REPORT: OMG Technical Committee Meeting in Orlando, FL, sees significant enhancement to CORBA

    1998-06-01

    The Object Management Group (OMG) Platform Technology Committee (PTC) ratified its support for a new asynchronous messaging service for CORBA at OMG's recent Technical Committee Meeting in Orlando, FL. The meeting, held from 8 - 12 June, saw the PTC send the Messaging Service out for a final vote among the OMG membership. The Messaging Service, which will integrate Message Oriented Middleware (MOM) with CORBA, will give CORBA a true asynchronous messaging capability - something of great interest to users and developers. Formal adoption of the specification will most likely occur by the end of the year. The Messaging Service The Messaging Service, when adopted, will be the world's first standard for Message Oriented Middleware and will give CORBA a true asynchronous messaging capability. Asynchronous messaging allows developers to build simpler, richer client environments. With asynchronous messaging there is less need for multi-threaded clients because the Asynchronous Method Invocation is non-blocking, meaning the client thread can continue work while the application waits for a reply. David Curtis, Director of Platform Technology for OMG, said: `This messaging service is one of the more valuable additions to CORBA. It enhances CORBA's existing asynchronous messaging capabilities which is a feature of many popular message oriented middleware products. This service will allow better integration between ORBs and MOM products. This enhanced messaging capability will only make CORBA more valuable for builders of distributed object systems.' The Messaging Service is one of sixteen technologies currently being worked on by the PTC. Additionally, seventeen Revision Task Forces (RTFs) are working on keeping OMG specifications up to date. The purpose of these Revision Task Forces is to take input from the implementors of OMG specifications and clarify or make necessary changes based on the implementor's input. The RTFs also ensure that the specifications remain up to date

  3. Proceedings of the 2007 LWR Fuel Performance Meeting / TopFuel 2007 'Zero by 2010'

    2007-01-01

    ANS, ENS, AESJ and KNS are jointly organizing the 2007 International LWR Fuel Performance Meeting following the successful ENS TopFuel meeting held during 22-26 October, 2006 in Salamaca, Spain. Merging three premier nuclear fuel design and performance meetings: the ANS LWR Fuel Performance Meeting, the ENS TopFuel and Asian Water Reactor Fuel Performance Meeting (WRFPM) created this international meeting. The meeting will be held annually on a tri-annual rotational basis in USA, Asia, and Europe. The technical scope of the meeting includes all aspects of nuclear fuel from fuel rod to core design as well as performance experience in commercial and test reactors. The meeting excludes front end and back end fuel issues, however, it covers all front and/or back issues that impact fuel designs and performance

  4. UO3 deactivation end point criteria

    Stefanski, L.D.

    1994-01-01

    The UO 3 Deactivation End Point Criteria are necessary to facilitate the transfer of the UO 3 Facility from the Office of Facility Transition and Management (EM-60) to the office of Environmental Restoration (EM-40). The criteria were derived from a logical process for determining end points for the systems and spaces at the UO 3 , Facility based on the objectives, tasks, and expected future uses pertinent to that system or space. Furthermore, the established criteria meets the intent and supports the draft guidance for acceptance criteria prepared by EM-40, open-quotes U.S. Department of Energy office of Environmental Restoration (EM-40) Decontamination and Decommissioning Guidance Document (Draft).close quotes For the UO 3 Facility, the overall objective of deactivation is to achieve a safe, stable and environmentally sound condition, suitable for an extended period, as quickly and economically as possible. Once deactivated, the facility is kept in its stable condition by means of a methodical surveillance and maintenance (S ampersand M) program, pending ultimate decontamination and decommissioning (D ampersand D). Deactivation work involves a range of tasks, such as removal of hazardous material, elimination or shielding of radiation fields, partial decontamination to permit access for inspection, installation of monitors and alarms, etc. it is important that the end point of each of these tasks be established clearly and in advance, for the following reasons: (1) End points must be such that the central element of the deactivation objective - to achieve stability - is unquestionably achieved. (2) Much of the deactivation work involves worker exposure to radiation or dangerous materials. This can be minimized by avoiding unnecessary work. (3) Each task is, in effect, competing for resources with other deactivation tasks and other facilities. By assuring that each task is appropriately bounded, DOE's overall resources can be used most fully and effectively

  5. Summary of the 1982 small tokamak users meeting

    Sprott, J.C.

    1982-11-01

    On November 1, 1982, the sixth in a series of approximately annual meetings of the users of small tokamaks was held in conjunction with the APS Division of Plasma Physics meeting at New Orleans. The meeting lasted three hours, with 34 people attending. The interest was on strengthening the ties between the small tokamaks and the large tokamaks. Accordingly, the latest meeting was dedicated to this theme, and in contrast to previous meetings, a few representatives from the large tokamaks were invited to attend and make presentations. Summaries of the various talks are included

  6. What makes microfinance happen?

    Manuel Antonio Jiménez Castillo

    2015-12-01

    Full Text Available In this paper we have attempted to shed light on what makes development happen from those determinants that enable microfinance work as an effective tool to eradicate poverty. The effectiveness of such instrument in the generation of wealth to the poorest class demand overcoming the minimalist approach that condemns its practices to a mere provision of microfinancial services. This hypothesis will be analytically and empirically proven assuming human development as a cause and not only as an outcome of the microfinance success. To such end, two regression lines were designed where variables such as education, health and food security proved to be explanatory determinant to explain income behaviour for those beneficiaries of the microfinance programs.

  7. QoS Modeling for End-to-End Performance Evaluation over Networks with Wireless Access

    Gómez Gerardo

    2010-01-01

    Full Text Available This paper presents an end-to-end Quality of Service (QoS model for assessing the performance of data services over networks with wireless access. The proposed model deals with performance degradation across protocol layers using a bottom-up strategy, starting with the physical layer and moving on up to the application layer. This approach makes it possible to analytically assess performance at different layers, thereby facilitating a possible end-to-end optimization process. As a representative case, a scenario where a set of mobile terminals connected to a streaming server through an IP access node has been studied. UDP, TCP, and the new TCP-Friendly Rate Control (TFRC protocols were analyzed at the transport layer. The radio interface consisted of a variable-rate multiuser and multichannel subsystem, including retransmissions and adaptive modulation and coding. The proposed analytical QoS model was validated on a real-time emulator of an end-to-end network with wireless access and proved to be very useful for the purposes of service performance estimation and optimization.

  8. Analytical Framework for End-to-End Delay Based on Unidirectional Highway Scenario

    Aslinda Hassan

    2015-01-01

    Full Text Available In a sparse vehicular ad hoc network, a vehicle normally employs a carry and forward approach, where it holds the message it wants to transmit until the vehicle meets other vehicles or roadside units. A number of analyses in the literature have been done to investigate the time delay when packets are being carried by vehicles on both unidirectional and bidirectional highways. However, these analyses are focusing on the delay between either two disconnected vehicles or two disconnected vehicle clusters. Furthermore, majority of the analyses only concentrate on the expected value of the end-to-end delay when the carry and forward approach is used. Using regression analysis, we establish the distribution model for the time delay between two disconnected vehicle clusters as an exponential distribution. Consequently, a distribution is newly derived to represent the number of clusters on a highway using a vehicular traffic model. From there, we are able to formulate end-to-end delay model which extends the time delay model for two disconnected vehicle clusters to multiple disconnected clusters on a unidirectional highway. The analytical results obtained from the analytical model are then validated through simulation results.

  9. Managing Controversies in the Fuzzy Front End

    Christiansen, John K.; Gasparin, Marta

    2016-01-01

    . The analysis investigates the microprocesses around the controversies that emerge during the fuzzy front end of four products. Five different types of controversies are identified: profit, production, design, brand and customers/market. Each controversy represents a threat, but also an opportunity to search...... for new solutions in the unpredictable non-linear processes. The study uses an ethnographic approach using qualitative data from interviews, company documents, external communication and marketing material, minutes of meetings, informal conversations and observations. The analysis of four FFE processes...... demonstrates how the fuzzy front requires managers to deal with controversies that emerge from many different places and involve both human and non-human actors. Closing the controversies requires managers to take account of the situation, identify the problem that needs to be addressed, and initiate a search...

  10. ATLAS end-cap detector

    Maximilien Brice

    2003-01-01

    Three scientists from the Institute of Nuclear Phyiscs at Novossibirsk with one of the end-caps of the ATLAS detector. The end-caps will be used to detect particles produced in the proton-proton collisions at the heart of the ATLAS experiment that are travelling close to the axis of the two beams.

  11. Clostridium XIV Meeting

    Lynd, Lee

    2016-08-28

    The 14th biannual Clostridium meeting was held at Dartmouth College from August 28 through 31, 2016. As noted in the meeting program (http://clostridiumxiv.com/wp-content/uploads/2016/09/Clostridium_XIV_program.pdf). the meeting featured 119 registered attendees, 33 oral presentations, 5 of which were given by younger presenters, 40 posters, and 2 keynote presentations, with strong participation by female and international scientists.

  12. 1990 Fall Meeting Report

    Chapman, David S.

    The AGU 1990 Fall Meeting, held in San Francisco December 3-7, continued the steady growth trend for the western meeting set over the last decade. About 5200 members registered for the meeting and 3836 papers were given. The scientific kickoff to the meeting was provided by a Union session on initial results of the current Magellan mission to Venus. The mission was also the focus of a public lecture and short film on highlights of the mission and an extensive Union poster session.

  13. Meetings in Organizations

    Ravn, Ib

    as having to serve organizational stakeholders (such as customers and users), and work must be subjectively meaningful to the modern, well-educated employee. Do meetings answer to these challenges? A survey of 300 knowledge workers in five highly successful, knowledge-intensive corporations in Denmark...... showed that although employees were satisfied with their managers; traditional meeting-management skills, the customer was largely invisible in organizational meetings, and the hearts and minds of the employees were not engaged to any significant degree in meetings. It is concluded that despite massive...

  14. 77 FR 42484 - Civil Nuclear Trade Advisory Committee (CINTAC) Public Meeting

    2012-07-19

    .... If the number of registrants requesting to make statements is greater than can be reasonably.... Copies of CINTAC meeting minutes will be available within 90 days of the meeting. Man K. Cho, Team Leader...

  15. Uncharted terrain: preference construction at the end of life.

    White, Mary T

    2014-01-01

    Respect for patients' self-determination has long been considered central to efforts to improve end-of-life care, yet efforts to promote advance directives or engage patients in end-of-life discussions are often unsuccessful. In this article, I contend that this is because the shared decision-making approach typically used in healthcare assumes patients' capacity to make rational choices, which is not always possible in end-of-life decisions. Drawing on decision theory, behavioral psychology, and related studies of end-of-life care, I present a growing body of evidence that suggests the novelty, complexity, and uncertainty of end-of-life circumstances make rational and stable preferences difficult to establish. I argue that an effective decision-making approach for the terminally ill must recognize and respond to the unique characteristics of end-of-life choices, including their nonrational dimensions. I conclude with a description of an initiative that appears to do so, resulting in increased patients' satisfaction. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.

  16. MFTF-α+T end plug magnet design

    Srivastava, V.C.; O'Toole, J.A.

    1983-01-01

    The conceptual design of the end-plug magnets for MFTF-α+T is described. MFTF-α+ T is a near-term upgrade of MFTF-B, which features new end plugs to improve performance. The Fusion Engineering Design Center has performed the engineering design of MFTF-α+T under the overall direction of Lawrence Livermore National Laboratory. Each end plug consists of two Yin-Yang pairs, each with approx.2.5:1 mirror ratio and approx.5-T peak field on axis; two transition coils; and a recircularizing solenoid. This paper describes the end-plug magnet system functional requirements and presents a conceptual design that meets them. The peak field at the windings of the end-plug coils is approx.6-T. These coils are designed using the NbTi MFTF-B conductor and cooled by a 4.2K liquid helium bath. All the end-plug magnets are designed to operate in the cryostable mode with adequate quench protection for safety. Shielding requirements are stated and a summary of heat loads is provided. Field and force calculations are discussed. The field on axis is shown to meet the functional requirements. Force resultants are reported in terms of winding running loads and resultant coil forces are also given. The magnet structural support is described. A trade study to determine the optimum end-cell coil internal nuclear shield thickness and the resulting coil size based on minimizing the end-cell life cycle cost is summarized

  17. Museum professionals meet at CERN

    2005-01-01

    As part of the World Year of Physics, CERN organised a day of meetings attended by professionals from French and Swiss science museums. The poster for the Einstein exhibition that will open in Bern on 16 June 2005. Around thirty professionals from science museums, as well as representatives of France's Office de Coopération et d'Information Muséographiques (OCIM) and the Suisse Romande Réseau Science et Cité, congregated at CERN on 10th February with the purpose, among other things, of exchanging ideas and information on proposed exhibitions for the World Year of Physics. "We thought that it would be a good idea to start the World Year of Physics with a meeting at CERN that could provide inspiration for future exhibitions", explains Emma Sanders, Head of the Visits Service and Microcosm. Many scientific museums are trying to improve the way they cover contemporary science, and CERN is an ideal place to observe science in the making. Other goals of the meeting were to strengthen links between French and...

  18. Meeting Ecologists Requirements with Adaptive Data Acquisition

    Chang, Marcus; Bonnet, Philippe

    their potential if they meet the scientists requirements. In an ideal world, an ecologist expresses requirements in terms of a target dataset, which the sensor network then actually collects and stores. In fact, failures occur and interesting events happen making uniform, systematic ecosys- tem sampling neither...

  19. 78 FR 23960 - Annual Public Meeting

    2013-04-23

    ... annual open public meeting. The Foundation will provide an overview of its history, project updates, as... p.m. Time allotted for each registrant will be 3 minutes. The contact person will notify interested... individuals interested in making formal comments should notify the contact person and submit a brief statement...

  20. 76 FR 35410 - Science Advisory Board; Meeting

    2011-06-17

    ... statements. In general, each individual or group making a verbal presentation will be limited to a total time... Advisory Board (SAB) was established by a Decision Memorandum dated September 25, 1997, and is the only... management. Time and Date: The meeting will be held Wednesday, July 20, 2011, from 9:30 a.m. to 5:30 p.m. and...

  1. 77 FR 38273 - Science Advisory Board; Meeting

    2012-06-27

    ... will be limited to a total time of five (5) minutes. Individuals or groups planning to make a verbal... Advisory Board (SAB) was established by a Decision Memorandum dated September 25, 1997, and is the only... management. Time and Date: The meeting will be held Monday, July 16, 2012 from 9 a.m. to 5:30 p.m. and...

  2. 78 FR 60851 - Science Advisory Board Meeting

    2013-10-02

    ... written statements. In general, each individual or group making a verbal presentation will be limited to a... Advisory Board (SAB) was established by a Decision Memorandum dated September 25, 1997, and is the only... resource management. Time and Date: The meeting will be held Tuesday, November 19, 2013 from 10:00 a.m. to...

  3. Utilizing Domain Knowledge in End-to-End Audio Processing

    Tax, Tycho; Antich, Jose Luis Diez; Purwins, Hendrik

    2017-01-01

    to learn the commonly-used log-scaled mel-spectrogram transformation. Secondly, we demonstrate that upon initializing the first layers of an end-to-end CNN classifier with the learned transformation, convergence and performance on the ESC-50 environmental sound classification dataset are similar to a CNN......-based model trained on the highly pre-processed log-scaled mel-spectrogram features....

  4. SPD very front end electronics

    Luengo, S.; Gascon, D.; Comerma, A.; Garrido, L.; Riera, J.; Tortella, S.; Vilasis, X.

    2006-01-01

    The Scintillator Pad Detector (SPD) is part of the LHCb calorimetry system [D. Breton, The front-end electronics for LHCb calorimeters, Tenth International Conference on Calorimetry in Particle Physics, CALOR, Pasadena, 2002] that provides high-energy hadron, electron and photon candidates for the first level trigger. The SPD is designed to distinguish electrons from photons. It consists of a plastic scintillator layer, divided into about 6000 cells of different size to obtain better granularity near the beam [S. Amato, et al., LHCb technical design report, CERN/LHCC/2000-0036, 2000]. Charged particles will produce, and photons will not, ionization in the scintillator. This ionization generates a light pulse that is collected by a WaveLength Shifting (WLS) fiber that is coiled inside the scintillator cell. The light is transmitted through a clear fiber to the readout system that is placed at the periphery of the detector. Due to space constraints, and in order to reduce costs, these 6000 cells are divided in groups using a MAPMT [Z. Ajaltouni, et al., Nucl. Instr. and Meth. A 504 (2003) 9] of 64 channels that provides information to the VFE readout electronics. The SPD signal has rather large statistical fluctuations because of the low number (20-30) of photoelectrons per MIP. Therefore the signal is integrated over the whole bunch crossing length of 25 ns in order to have the maximum value. Since in average about 85% of the SPD signal is within 25 ns, 15% of a sample is subtracted from the following one using an operational amplifier. The SPD VFE readout system that will be presented consists of the following components. A specific ASIC [D. Gascon, et al., Discriminator ASIC for the VFE SPD of the LHCb Calorimeter, LHCB Technical Note, LHCB 2004-xx] integrates the signal, makes the signal-tail subtraction, and compares the level obtained to a programmable threshold (to distinguish electrons from photons). A FPGA programmes the ASIC threshold and the value for

  5. EDITORIAL: Nano Meets Spectroscopy Nano Meets Spectroscopy

    Birch, David J. S.

    2012-08-01

    The multidisciplinary two-day Nano Meets Spectroscopy (NMS) event was held at the National Physical Laboratory (NPL), Teddington, UK, in September 2011. The event was planned from the outset to be at the interface of several areas—in particular, spectroscopy and nanoscience, and to bring together topics and people with different approaches to achieving common goals in biomolecular science. Hence the meeting cut across traditional boundaries and brought together researchers using diverse techniques, particularly fluorescence and Raman spectroscopy. Despite engaging common problems, these techniques are frequently seen as mutually exclusive with the two communities rarely interacting at conferences. The meeting was widely seen to have lived up to its billing in good measure. It attracted the maximum capacity of ~120 participants, including 22 distinguished speakers (9 from outside the UK), over 50 posters and a vibrant corporate exhibition comprising 10 leading instrument companies and IOP Publishing. The organizers were Professor David Birch (Chair), Dr Karen Faulds and Professor Duncan Graham of the University of Strathclyde, Professor Cait MacPhee of the University of Edinburgh and Dr Alex Knight of NPL. The event was sponsored by the European Science Foundation, the Institute of Physics, the Royal Society of Chemistry, NPL and the Scottish Universities Physics Alliance. The full programme and abstracts are available at http://sensor.phys.strath.ac.uk/nms/program.php. The programme was quite ambitious in terms of the breadth and depth of scope. The interdisciplinary and synergistic concept of 'X meets Y' played well, cross-fertilization between different fields often being a source of inspiration and progress. Fluorescence and Raman spectroscopy provided the core, but the meeting had little repetition and also attracted contributions on more specialist techniques such as CARS, super-resolution, single molecule and chiral methods. In terms of application the

  6. Signal processing and electronics for nuclear spectrometry. Proceedings of a technical meeting

    2009-12-01

    The IAEA has responded to Member States needs by implementing programmatic activities that provide interested Member States, particularly those in developing countries, with support to increase, and in some cases establish national and regional capabilities for the proper operation, calibration, maintenance and utilization of instruments in nuclear spectrometry applications. Technological advances in instrumentation, as well as the consequent high rate of obsolescence, make it important for nuclear instrumentation laboratories in Member States to keep their knowledge and skills up to date. This publication reviews the current status, developments and trends in electronics and digital methods for nuclear spectrometry, providing useful information for interested Member States to keep pace with new and evolving technologies. All nuclear spectrometry systems contain electronic circuits and devices, commonly referred to as front-end electronics, which accept and process the electrical signals produced by radiation detectors. This front-end electronics are composed of a chain of signal processing subsystems that filter, amplify, shape, and digitise these electrical signals to finally produce digitally encoded information about the type and nature of the radiation that stimulated the radiation detector. The design objective of front-end electronics is to obtain maximum information about the radiation and with the highest possible accuracy. Historically, the front-end electronics has consisted of all analog components. The performance delivered has increased continually over time through the development and implementation of new and improved analog electronics and electronic designs. The development of digital electronics, programmable logic, and digital signal processing techniques has now enabled most of the analog front-end electronics to be replaced by digital electronics, opening up new opportunities and delivering new benefits not previously achievable. Digital

  7. Wear of micro end mills

    Bissacco, Giuliano; Hansen, Hans Nørgaard; De Chiffre, Leonardo

    2005-01-01

    This paper addresses the important issue of wear on micro end mills considering relevant metrological tools for its characterization and quantification. Investigation of wear on micro end mills is particularly difficult and no data are available in the literature. Small worn volumes cause large...... part. For this investigation 200 microns end mills are considered. Visual inspection of the micro tools requires high magnification and depth of focus. 3D reconstruction based on scanning electron microscope (SEM) images and stereo-pair technique is foreseen as a possible method for quantification...

  8. Calorimetry end-point predictions

    Fox, M.A.

    1981-01-01

    This paper describes a portion of the work presently in progress at Rocky Flats in the field of calorimetry. In particular, calorimetry end-point predictions are outlined. The problems associated with end-point predictions and the progress made in overcoming these obstacles are discussed. The two major problems, noise and an accurate description of the heat function, are dealt with to obtain the most accurate results. Data are taken from an actual calorimeter and are processed by means of three different noise reduction techniques. The processed data are then utilized by one to four algorithms, depending on the accuracy desired to determined the end-point

  9. Taking minutes of meetings

    Gutmann, Joanna

    2016-01-01

    aking Minutes of Meetings guides you through the entire process behind minute taking: arranging the meeting; writing the agenda; creating the optimum environment; structuring the meeting and writing notes up accurately. The minute-taker is one of the most important and powerful people in a meeting and you can use this opportunity to develop your knowledge, broaden your horizons and build credibility within the organization. Taking Minutes of Meetings is an easy to read 'dip-in, dip-out' guide which shows you how to confidently arrange meetings and produce minutes. It provides hands-on advice about the sections of a meeting as well as tips on how to create an agenda, personal preparation, best practice advice on taking notes and how to improve your accuracy. Brand new chapters of this 4th edition include guidance on using technology to maximize effectiveness and practical help with taking minutes for a variety of different types of meetings. The creating success series of books... With over one million copi...

  10. CMS MANAGEMENT MEETINGS

    2010-01-01

    The Agendas and Minutes of the Management Board meetings are accessible to CMS members at: http://indico.cern.ch/categoryDisplay.py?categId=223 The Agendas and Minutes of the Collaboration Board meetings are accessible to CMS members at: http://indico.cern.ch/categoryDisplay.py?categId=174

  11. CMS MANAGEMENT MEETINGS

    The Agendas and Minutes of the Management Board meetings are accessible to CMS members at: http://indico.cern.ch/categoryDisplay.py?categId=223  The Agendas and Minutes of the Collaboration Board meetings are accessible to CMS members at: http://indico.cern.ch/categoryDisplay.py?categId=174 

  12. Measurements and analysis of end-to-end Internet dynamics

    Paxson, Vern [Univ. of California, Berkeley, CA (United States). Computer Science Division

    1997-04-01

    Accurately characterizing end-to-end Internet dynamics - the performance that a user actually obtains from the lengthy series of network links that comprise a path through the Internet - is exceptionally difficult, due to the network`s immense heterogeneity. At the heart of this work is a `measurement framework` in which a number of sites around the Internet host a specialized measurement service. By coordinating `probes` between pairs of these sites one can measure end-to-end behavior along O(N2) paths for a framework consisting of N sites. Consequently, one obtains a superlinear scaling that allows measuring a rich cross-section of Internet behavior without requiring huge numbers of observation points. 37 sites participated in this study, allowing the author to measure more than 1,000 distinct Internet paths. The first part of this work looks at the behavior of end-to-end routing: the series of routers over which a connection`s packets travel. Based on 40,000 measurements made using this framework, the author analyzes: routing `pathologies` such as loops, outages, and flutter; the stability of routes over time; and the symmetry of routing along the two directions of an end-to-end path. The author finds that pathologies increased significantly over the course of 1995 and that Internet paths are heavily dominated by a single route. The second part of this work studies end-to-end Internet packet dynamics. The author analyzes 20,000 TCP transfers of 100 Kbyte each to investigate the performance of both the TCP endpoints and the Internet paths. The measurements used for this part of the study are much richer than those for the first part, but require a great degree of attention to issues of calibration, which are addressed by applying self-consistency checks to the measurements whenever possible. The author finds that packet filters are capable of a wide range of measurement errors, some of which, if undetected, can significantly taint subsequent analysis.

  13. Increasing operations profitability using an end-to-end, wireless internet, gas monitoring system

    McDougall, M. [Northrock Resources Ltd., AB (Canada); Benterud, K. [zed.i solutions, inc., Calgary, AB (Canada)

    2004-10-01

    Implementation by Northrock Resources Ltd., a wholly-owned subsidiary of Unocal Corporation, of a fully integrated end-to-end gas measurement and production analysis system, is discussed. The system, dubbed Smart-Alek(TM), utilizes public wireless communications and a web browser only delivery system to provide seamless well visibility to a desk-top computer. Smart-Alek(TM) is an example of a new type of end-to-end electronic gas flow measurement system, known as FINE(TM), which is an acronym for Field Intelligence Network and End-User Interface. The system delivers easy-to-use, complete, reliable and cost effective production information, far more effective than is possible to obtain with conventional SCADA technology. By installing the system, Northrock was able to increase gas volumes with more accurate electronic flow measurement in place of mechanical charts, with very low technical maintenance, and at a reduced operating cost. It is emphasized that deploying the technology alone will produce only partial benefits; to realize full benefits it is also essential to change grass roots operating practices, aiming at timely decision-making at the field level. 5 refs., 5 figs.

  14. End of Life: Suicide Grief

    Healthy Lifestyle End of life A loved one's suicide can be emotionally devastating. Use healthy coping strategies — ... Clinic Staff When a loved one dies by suicide, overwhelming emotions can leave you reeling. Your grief ...

  15. End-stage kidney disease

    ... stage; Kidney failure - end stage; ESRD; ESKD Images Kidney anatomy References Fogarty DG, Taal MW. A stepped care approach to the management of chronic kidney disease. In: Skorecki K, Chertow GM, Marsden PA, ...

  16. 76 FR 8352 - Meeting of a Federal Advisory Committee

    2011-02-14

    ... committee meeting of the DoD Medicare-Eligible Retiree Health Care Board of Actuaries will take place: DATES... 22203. FOR FURTHER INFORMATION CONTACT: Margot Kaplan at the DoD Office of the Actuary, 4040 N. Fairfax... desiring to attend the DoD Medicare-Eligible Retiree Health Care Board of Actuaries meeting or make an oral...

  17. 76 FR 8350 - Notice of Federal Advisory Committee Meeting

    2011-02-14

    ... federal advisory committee meeting of the DoD Board of Actuaries will take place: DATES: July 14-15, 2011... Office of the Actuary, 4040 N. Fairfax Drive, Suite 308, Arlington, VA 22203. SUPPLEMENTARY INFORMATION... Board of Actuaries meeting or make an oral presentation or submit a written statement for consideration...

  18. Meeting to discuss laser cavity design for photon linear collider ...

    linear collider – Daresbury, UK, 10 January 2006. ALEXANDER JOHN FINCH ... On 10 January 2006, a meeting to discuss laser cavity design for the photon linear collider was held at the Daresbury .... important to continue making contact with people in fields outside the accelerator community. Few experts at this meeting ...

  19. Nuclear instrumentation cable end seal

    Cannon, C.P.; Brown, D.P.

    1979-01-01

    An improved coaxial end seal for hermetically sealed nuclear instrumentation cable exhibiting an improved breakdown pulse noise characteristic under high voltage, high temperature conditions is described. A tubular insulator body has metallized interior and exterior surface portions which are braze sealed to a center conductor and an outer conductive sheath. The end surface of the insulator body which is directed toward the coaxial cable to which it is sealed has a recessed surface portion within which the braze seal material terminates

  20. 77 FR 26758 - Sunshine Act Meeting; Farm Credit Administration Board

    2012-05-07

    ... to the public (limited space available) and parts will be closed to the public. In order to increase the accessibility to Board meetings, persons requiring assistance should make arrangements in [[Page...

  1. 77 FR 47068 - Farm Credit Administration Board; Sunshine Act Meeting

    2012-08-07

    ... to the public (limited space available) and parts will be closed to the public. In order to increase the accessibility to Board meetings, persons requiring assistance should make arrangements in advance...

  2. Constructions of accountability in child protection workers decision-making processes

    Schrøder, Ida Marie

    2014-01-01

    collected from three Danish local governments and consists of 24 qualitative interviews with child protection workers, leaders and economic consultants, 12 observations of team meetings and a quantitative survey of 150 cases. The study ends summer 2014 and the results of the research will be utilized...... construction of accountability as relational effects of these new forms of accounting practice. The paper draws on the preliminary results from a 2 ½ year mixed method study of how budgeting and accounting practice influences the processes of decision-making in child protection work. The data has been...... systems – such as setting standards or deciding on the delegation of decision-making authority. Using Actor-network theory as a methodological and analytical approach, it furthermore becomes clear how the types of accountability are enacted as effects, not only by the technologies offered to support...

  3. Functions and requirements for the INEL light duty utility arm gripper end effector

    Pace, D.P.; Barnes, G.E.

    1995-02-01

    This gripper end effector system functions and requirements document defines the system functions that the end effector must perform as well as the requirements the design must meet. Safety, quality assurance, operations, environmental conditions, and regulatory requirements have been considered. The main purpose of this document is to provide a basis for the end effector engineering, design, and fabrication activities. The document shall be the living reference document to initiate the development activities and will be updated as system technologies are finalized

  4. Functions and requirements for the INEL light duty utility arm sampler end effector

    Pace, D.P.; Barnes, G.E.

    1995-02-01

    This sampler end effector system functions and requirements document defines the system functions that the end effector must perform as well as the requirements the design must meet. Safety, quality assurance, operations, environmental conditions, and regulatory requirements have been considered. The main purpose of this document is to provide a basis for the end effector engineering, design, and fabrication activities. The document shall be the living reference document to initiate the development activities and will be updated as system technologies are finalized

  5. Public meetings in the departments

    Staff Association

    2012-01-01

    During our recent information meetings, we discussed four topics: the new Saved Leave Scheme (LTSLS); the new developments concerning pensions; the MARS Advancement and Promotion scheme and its 2012 budget; the recently updated Administrative and Operation Circulars. These meetings were attended by a large number of staff members and were a great opportunity for the Staff Association to engage in direct dialogue with the staff in the various departments. The vast majority of questions or comments were on the LTSLS and on the possibility to save leave, which is to be taken at the end of a career.  A few comments were also made on MARS, a system many considered to be not very motivating and that takes up a lot of resources for minimal positive results. Thanks and encouragement After the presentation on Pensions, on behalf of the Staff Association we thanked Dorothée Duret, who for personal reasons had to resign from the Pension Fund Governing Board (PFGB) and from the Staff Council...

  6. Toward a Psychology of Surrogate Decision Making.

    Tunney, Richard J; Ziegler, Fenja V

    2015-11-01

    In everyday life, many of the decisions that we make are made on behalf of other people. A growing body of research suggests that we often, but not always, make different decisions on behalf of other people than the other person would choose. This is problematic in the practical case of legally designated surrogate decision makers, who may not meet the substituted judgment standard. Here, we review evidence from studies of surrogate decision making and examine the extent to which surrogate decision making accurately predicts the recipient's wishes, or if it is an incomplete or distorted application of the surrogate's own decision-making processes. We find no existing domain-general model of surrogate decision making. We propose a framework by which surrogate decision making can be assessed and a novel domain-general theory as a unifying explanatory concept for surrogate decisions. © The Author(s) 2015.

  7. Correcting coils in end magnets of accelerators

    L. R. P. Kassab

    1998-05-01

    Full Text Available We present an empirical investigation of the correcting coils behavior used to homogenize the field distribution of the race-track microtron accelerator end magnets. These end magnets belong to the second stage of the 30.0 MeV cw electron accelerator under construction at IFUSP, the race-track microtron booster, in which the beam energy is raised from 1.97 to 5.1 MeV. The correcting coils are attached to the pole faces and are based on the inhomogeneities of the magnetic field measured. The performance of these coils, when operating the end magnets with currents that differ by ±10% from the one used in the mappings that originated the coils copper leads, is presented. For one of the magnets, adjusting conveniently the current of the correcting coils makes it possible to homogenize field distributions of different intensities, once their shapes are practically identical to those that originated the coils. For the other one, the shapes are changed and the coils are less efficient. This is related to intrinsic factors that determine the inhomogeneities. However, we obtained uniformity of 0.001% in both cases.

  8. System of end-to-end symmetric database encryption

    Galushka, V. V.; Aydinyan, A. R.; Tsvetkova, O. L.; Fathi, V. A.; Fathi, D. V.

    2018-05-01

    The article is devoted to the actual problem of protecting databases from information leakage, which is performed while bypassing access control mechanisms. To solve this problem, it is proposed to use end-to-end data encryption, implemented at the end nodes of an interaction of the information system components using one of the symmetric cryptographic algorithms. For this purpose, a key management method designed for use in a multi-user system based on the distributed key representation model, part of which is stored in the database, and the other part is obtained by converting the user's password, has been developed and described. In this case, the key is calculated immediately before the cryptographic transformations and is not stored in the memory after the completion of these transformations. Algorithms for registering and authorizing a user, as well as changing his password, have been described, and the methods for calculating parts of a key when performing these operations have been provided.

  9. George Williams in Thailand: An Ethical Decision-Making Exercise

    James, Constance R.; Smith, J. Goosby

    2007-01-01

    This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…

  10. End-to-End Operations in the ELT Era

    Hainaut, O. R.; Bierwirth, T.; Brillant, S.; Mieske, S.; Patat, F.; Rejkuba, M.; Romaniello, M.; Sterzik, M.

    2018-03-01

    The Data Flow System is the infrastructure on which Very Large Telescope (VLT) observations are performed at the Observatory, before and after the observations themselves take place. Since its original conception in the late 1990s, it has evolved to accommodate new observing modes and new instruments on La Silla and Paranal. Several updates and upgrades are needed to overcome its obsolescence and to integrate requirements from the new instruments from the community and, of course, from ESO's Extremely Large Telescope (ELT), which will be integrated into Paranal's operations. We describe the end-to-end operations and the resulting roadmap guiding their further development.

  11. End-to-end plasma bubble PIC simulations on GPUs

    Germaschewski, Kai; Fox, William; Matteucci, Jackson; Bhattacharjee, Amitava

    2017-10-01

    Accelerator technologies play a crucial role in eventually achieving exascale computing capabilities. The current and upcoming leadership machines at ORNL (Titan and Summit) employ Nvidia GPUs, which provide vast computational power but also need specifically adapted computational kernels to fully exploit them. In this work, we will show end-to-end particle-in-cell simulations of the formation, evolution and coalescence of laser-generated plasma bubbles. This work showcases the GPU capabilities of the PSC particle-in-cell code, which has been adapted for this problem to support particle injection, a heating operator and a collision operator on GPUs.

  12. Shear strength of end slabs of prestressed concrete reactor vessels

    Cheung, K.C.; Gotschall, H.L.; Liu, T.C.

    1975-01-01

    Prestressed concrete reactor vessels (PCRV's) have been adopted for primary containments in most large high-temperature gas-cooled reactor installations. The most common configuration for PCRVs is a right-vertical cylinder with thick end slabs. In order to assess the integrity of a PCRV it is necessary to predict the ultimate strength of the end slabs. The complexity of the basic mechanism of shear failure in the PCRV end slabs has thus far prohibited the development of a completely analytical solution. However, many experimental investigations of PCRV end slabs have been conducted over the past decade. This information makes it possible to establish empirical formulae for the ultimate strength of PCRV end slabs. The basis and development of an empirical shear-flexure interaction expression is presented. (Auth.)

  13. Ethical challenges in nursing homes--staff's opinions and experiences with systematic ethics meetings with participation of residents' relatives.

    Bollig, Georg; Schmidt, Gerda; Rosland, Jan Henrik; Heller, Andreas

    2015-12-01

    Many ethical problems exist in nursing homes. These include, for example, decision-making in end-of-life care, use of restraints and a lack of resources. The aim of the present study was to investigate nursing home staffs' opinions and experiences with ethical challenges and to find out which types of ethical challenges and dilemmas occur and are being discussed in nursing homes. The study used a two-tiered approach, using a questionnaire on ethical challenges and systematic ethics work, given to all employees of a Norwegian nursing home including nonmedical personnel, and a registration of systematic ethics discussions from an Austrian model of good clinical practice. Ninety-one per cent of the nursing home staff described ethical problems as a burden. Ninety per cent experienced ethical problems in their daily work. The top three ethical challenges reported by the nursing home staff were as follows: lack of resources (79%), end-of-life issues (39%) and coercion (33%). To improve systematic ethics work, most employees suggested ethics education (86%) and time for ethics discussion (82%). Of 33 documented ethics meetings from Austria during a 1-year period, 29 were prospective resident ethics meetings where decisions for a resident had to be made. Agreement about a solution was reached in all 29 cases, and this consensus was put into practice in all cases. Residents did not participate in the meetings, while relatives participated in a majority of case discussions. In many cases, the main topic was end-of-life care and life-prolonging treatment. Lack of resources, end-of-life issues and coercion were ethical challenges most often reported by nursing home staff. The staff would appreciate systematic ethics work to aid decision-making. Resident ethics meetings can help to reach consensus in decision-making for nursing home patients. In the future, residents' participation should be encouraged whenever possible. © 2015 The Authors. Scandinavian Journal of Caring

  14. FAMS DECOMMISSIONING END-STATE ALTERNATIVE EVALUATION

    Grimm, B; Stephen Chostner, S; Brenda Green, B

    2006-01-01

    Nuclear Material Management (NMM) completed a comprehensive study at the request of the Department of Energy Savannah River Operations Office (DOE-SR) in 2004 (Reference 11.1). The study evaluated the feasibility of removal and/or mitigation of the Pu-238 source term in the F-Area Material Storage (FAMS) facility during on-going material storage operations. The study recommended different options to remove and/or mitigate the Pu-238 source term depending on its location within the facility. During April 2005, the Department of Energy (DOE) sent a letter of direction (LOD) to Washington Savannah River Company (WSRC) directing WSRC to implement a new program direction that would enable an accelerated shutdown and decommissioning of FAMS (Reference 11.2). Further direction in the LOD stated that effective December 1, 2006 the facility will be transitioned to begin deactivation and decommissioning (D and D) activities. To implement the LOD, Site D and D (SDD) and DOE agreed the planning end-state would be demolition of the FAMS structure to the building slab. SDD developed the D and D strategy, preliminary cost and schedule, and issued the deactivation project plan in December 2005 (Reference 11.3). Due to concerns and questions regarding the FAMS planning end-state and in support of the project's Critical Decision 1, an alternative study was performed to evaluate the various decommissioning end-states and the methods by which those end-states are achieved. This report documents the results of the alternative evaluation which was performed in a structured decision-making process as outlined in the E7 Manual, Procedure 2.15, ''Alternative Studies'' (Reference 11.4)

  15. Meetings on Particle Physics - Abstracts and Slides

    Hirsch, M.; Machado, P.; Bertuzzo, E.; Villanova del Moral, A.; Wingerter, A.; Lellouch, L.; Garron, N.; Portelli, A.; Vulvert, G.; Zerwas, D.; Djouadi, A.; Drieu la Rochelle, G.; Fairbairn, M.; Le Boulc'h, Q.; Dumont, B.; Da Silva, J.; Brax, P.; Weiland, C.; Gelis, F.; Mehtar-Tani, Y.; Epelbaum, T.; Meunier, E.; Dudas, E.; Jezo, T.; Urbano, A.; Smith, C.; Machet, B.; Nezri, E.; Salam, G.; Kosnik, N.; Greynat, D.; Petrov, K.

    2014-01-01

    RPP (Meetings on Particle Physics) annual meetings are aimed at gathering the theoretical particle physicists' community, providing the participants with the opportunity not only to present their research topics, but also to make contact with the latest developments in adjacent fields. RPP-2012 will have a few review talks on topics such as flavors, Higgs bosons, astro-particle physics and cosmology, heavy ions, physics beyond the standard model, and quantum chromodynamics. This document gathers the slides of the presentations, a few presentations are accompanied by an abstract.

  16. Making a difference through veterinary public health.

    2016-06-11

    More than 100 people gathered in Birmingham on April 23 for the third joint conference of the Veterinary Public Health Association and the Association of Government Vets. With the theme of 'VPH hands on - making a difference together', the meeting considered the role vets play in society through their work on public health and sustainability. Kathryn Clark reports. British Veterinary Association.

  17. Scientific meeting abstracts

    1999-01-01

    The document is a collection of the scientific meeting abstracts in the fields of nuclear physics, medical sciences, chemistry, agriculture, environment, engineering, different aspects of energy and presents research done in 1999 in these fields

  18. ASIST 2002 annual meeting

    Peek, R

    2003-01-01

    Review of discussions and presentations at the American Society for Information Science and Technology 2002 annual meeting. Topics covered included new models of scholarly publishing and the development of the semantic web (1 page).

  19. Science meeting. Abstracts

    2000-01-01

    the document is a collection of the science meeting abstracts in the fields of nuclear physics, medical sciences, chemistry, agriculture, environment, engineering, material sciences different aspects of energy and presents research done in 2000 in these fields

  20. Experts' meeting: Maintenance '83

    1983-01-01

    The brochure presents, in full wording, 20 papers read at the experts' meeting ''Maintenance '83'' in Wiesbaden. Most of the papers discuss reliability data (acquisition, evaluation, processing) of nearly all fields of industry. (RW) [de

  1. Meeting Associates - 1 990

    Mid-Year Meeting. In order to provide an opportunity to more ... quantitative treatment of high quality chemical data on minerals ..... be an important centre for training and research in paediatrics. ..... and military officers in the service of the East.

  2. Diamond Jubilee Meeting

    1994-10-01

    Oct 1, 1994 ... Science, Bangalore, the Diamond Jubilee Annual. Meeting will be held in ... "The fascination of statistics" .... on post Hartree-Fock methods, highly correlated systems ..... Gold Medal of the National Institute of Social. Sciences ...

  3. 51st Annual Meeting

    1966, (a brief account of the meeting is given in this issue), and which .... was placed on neutrinos which are produced copiously during the ..... new vaccine against hepatitis and his work on filariasis, malaria, intestinal parasites, rheumatoid ...

  4. Cyberinfrastructure for End-to-End Environmental Explorations

    Merwade, V.; Kumar, S.; Song, C.; Zhao, L.; Govindaraju, R.; Niyogi, D.

    2007-12-01

    The design and implementation of a cyberinfrastructure for End-to-End Environmental Exploration (C4E4) is presented. The C4E4 framework addresses the need for an integrated data/computation platform for studying broad environmental impacts by combining heterogeneous data resources with state-of-the-art modeling and visualization tools. With Purdue being a TeraGrid Resource Provider, C4E4 builds on top of the Purdue TeraGrid data management system and Grid resources, and integrates them through a service-oriented workflow system. It allows researchers to construct environmental workflows for data discovery, access, transformation, modeling, and visualization. Using the C4E4 framework, we have implemented an end-to-end SWAT simulation and analysis workflow that connects our TeraGrid data and computation resources. It enables researchers to conduct comprehensive studies on the impact of land management practices in the St. Joseph watershed using data from various sources in hydrologic, atmospheric, agricultural, and other related disciplines.

  5. The End of ‘the end of impunity’?

    Holtermann, Jakob von Holderstein

    2010-01-01

    With its express intention ‘to put an end to impunity’, the International Criminal Court (ICC) faces a substantial challenge in the shape of conditional amnesties granted in future national truth commissions (TCs)—a challenge that invokes fundamental considerations of criminal justice ethics...

  6. Network analysis on skype end-to-end video quality

    Exarchakos, Georgios; Druda, Luca; Menkovski, Vlado; Liotta, Antonio

    2015-01-01

    Purpose – This paper aims to argue on the efficiency of Quality of Service (QoS)-based adaptive streamingwith regards to perceived quality Quality of Experience (QoE). Although QoS parameters are extensivelyused even by high-end adaptive streaming algorithms, achieved QoE fails to justify their use

  7. Making motherhood work

    Rachel Thomson

    2011-07-01

    Full Text Available Motherhood can be a critical moment in the making of gendered biographies, and in the negotiation of a gendered division of labour within a household. This paper draws on the 'Making of Modern Motherhoods' study, which combined interviews with a diverse group of expectant first time mothers and family case studies in order to build an intergenerational and longitudinal perspective on contemporary mothering situations within the UK. In this paper, the category 'work' is used as a lens through which to encounter new motherhood. After contextualising working motherhood in relation to a sociological literature the paper draws on interviews undertaken with women towards the end of their pregnancy with their first child to reveal something of the emergent collision of working and maternal identities, women's experiences of being pregnant at work including the anticipation and managing of maternity leave. The second part presents a case study, which animates the personal drama involved in reconciling working and maternal commitments, tracing how a woman's feelings about work change over time in negotiation with partner, family and the market. As Sue Sharpe observed in her 1984 book on working mothers, 'full-time mothering has never been accessible to all women in the same way at the same time' (1984: 22. Social class, locality and migration shape a range of cultures of mothering within which work features very differently. Divisions exist between women who share a generational location as well as between women of different generations. This complexity is revealed through a juxtaposition of the voices of mothers and grandmothers, which show how work may both, divide and unite women in the project of motherhood.

  8. A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder.

    Fisher, Alana; Manicavasagar, Vijaya; Sharpe, Louise; Laidsaar-Powell, Rebekah; Juraskova, Ilona

    2018-02-01

    Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. To explore patient and family perspectives of treatment decision-making in BPII. Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed. Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms. This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users. This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.

  9. End-of-life decisions for people with intellectual disabilities, an interview study with patient representatives

    Wagemans, A.M.; Schrojenstein Lantman-de Valk, H.M. van; Proot, I.M.; Metsemakers, J.; Tuffrey-Wijne, I.; Curfs, L.M.G.

    2013-01-01

    Background: Not much is known about the process of end-of-life decision-making for people with intellectual disabilities. Aim: To clarify the process of end-of-life decision-making for people with intellectual disabilities from the perspective of patient representatives. Design: A qualitative study

  10. Meeting report: nuclear receptors

    Tuckermann, Jan; Bourguet, William; Mandrup, Susanne

    2010-01-01

    The biannual European Molecular Biology Organization (EMBO) conference on nuclear receptors was organized by Beatrice Desvergne and Laszlo Nagy and took place in Cavtat near Dubrovnik on the Adriatic coast of Croatia September 25-29, 2009. The meeting brought together researchers from all over...... the world covering a wide spectrum from fundamental mechanistic studies to metabolism, clinical studies, and drug development. In this report, we summarize the recent and exciting findings presented by the speakers at the meeting....

  11. myrmeet | meetings | Resources | public

    error. The page your are looking for can not be found! Please check the link or use the navigation bar at the top. YouTube; Twitter; Facebook; Blog. Academy News. IAS Logo. 29th Mid-year meeting. Posted on 19 January 2018. The 29th Mid-year meeting of the Academy will be held from 29–30 June 2018 in Infosys, Mysuru ...

  12. Designing end-user interfaces

    Heaton, N

    1988-01-01

    Designing End-User Interfaces: State of the Art Report focuses on the field of human/computer interaction (HCI) that reviews the design of end-user interfaces.This compilation is divided into two parts. Part I examines specific aspects of the problem in HCI that range from basic definitions of the problem, evaluation of how to look at the problem domain, and fundamental work aimed at introducing human factors into all aspects of the design cycle. Part II consists of six main topics-definition of the problem, psychological and social factors, principles of interface design, computer intelligenc

  13. Nuclear fuel element end fitting

    Jabsen, F.S.

    1979-01-01

    A typical embodiment of the invention has an array of sockets that are welded to the intersections of the plates that form the upper and lower end fittings of a nuclear reactor fuel element. The sockets, which are generally cylindrical in shape, are oriented in directions that enable the longitudinal axes of the sockets to align with the longitudinal axes of the fuel rods that are received in the respective sockets. Detents impressed in the surfaces of the sockets engage mating grooves that are formed in the ends of the fuel rods to provide for the structural integrity of the fuel element

  14. ‘From the Prophet to Postmodernism? New World Orders and the End of Islamic Art’, in Elizabeth Mansfield, ed., Making Art History: A Changing Discipline and its Institutions, London and New York: Routledge, 2007. Reproduced by permission of the author and publishers.

    Finbarr Barry Flood

    2012-06-01

    Full Text Available This article addresses the peculiar fact that in most art historical surveys the narrative of Islamic art history ends around 1800 CE. It considers the roots of this idiosyncrasy and its implications for attempts to coopt or instrumentalize the objects of Islamic art in the decade after 2001 in discourses of liberalism and tolerance in which an originary Islam was contrasted with modern more 'fundamentalist' understandings of religious belief and practice. It explores contradictions inherent in related attempts to locate models for Muslim religious subjectivity in medieval artefacts secularized as art objects.

  15. IAEA International Database on Irradiated Nuclear Graphite Properties. Summary report of consultants' meeting. 12. meeting of the Technical Steering Committee

    Chung, H.K.; Wickham, A.J.

    2010-02-01

    The 12th Meeting of the Technical Steering Committee for the International Database on Irradiated Nuclear Graphite Properties was held on 12-13 November 2009 at the IAEA Headquarters, Vienna, Austria. All discussions, recommendations and actions of this Consultants' Meeting are recorded in this report. The purposes of the meeting were to review the matters and actions identified in the previous meeting, undertake a review of the current status of the database, and make recommendations for action over the next year. This report contains the status of the identified actions as well as a summary of the recommendations on enhancements to the database. (author)

  16. 76 FR 13182 - Science Advisory Board Staff Office; Notification of a Public Meeting of the Science Advisory...

    2011-03-10

    ... a Public Meeting of the Science Advisory Board Committee on Science Integration for Decision Making... Agency (EPA or Agency) Science Advisory Board (SAB) Staff Office announces a public meeting of the SAB Committee on Science Integration for Decision Making. DATES: The meeting dates are March 29, 2011 from 9 a.m...

  17. Means and ends of control

    Lind, Morten

    2004-01-01

    assumptions. Means-end analysis also lacks a proper definition of the control concept. It is proposed that control is defined as a binary relation that assign functional roles to subsystems. This control concept leads to distinct but entangled process and control hierarchies. It is argued that the problems...

  18. Open-Ended Electric Motor

    Gould, Mauri

    1975-01-01

    Presents complete instructions for assembling an electric motor which does not require large amounts of power to operate and which is inexpensive as well as reliable. Several open-ended experiments with the motor are included as well as information for obtaining a kit of parts and instructions. (BR)

  19. Align the Front End First.

    Perry, Jim

    1995-01-01

    Discussion of management styles and front-end analysis focuses on a review of Douglas McGregor's theories. Topics include Theories X, Y, and Z; leadership skills; motivational needs of employees; intrinsic and extrinsic rewards; and faulty implementation of instructional systems design processes. (LRW)

  20. End of Life: An Overview

    Toner, Mary Ann; Shadden, Barbara B.

    2012-01-01

    Speech-language pathologists (SLPs) provide services to patients confronting the end of life (EOL) in a variety of settings. Instead of targeting improvement of health or sustaining life, EOL services focus primarily on quality of life. Although SLPs may not consider themselves core members of the health care team providing EOL services, the…