WorldWideScience

Sample records for providing technical support

  1. ERLN Technical Support for Labs

    Science.gov (United States)

    The Environmental Response Laboratory Network provides policies and guidance on lab and data requirements, Standardized Analytical Methods, and technical support for water and radiological sampling and analysis

  2. Engineering Technical Support Center (ETSC)

    Science.gov (United States)

    ETSC is EPA’s technical support and resource centers responsible for providing specialized scientific and engineering support to decision-makers in the Agency’s ten regional offices, states, communities, and local businesses.

  3. Technical Support Essentials Advice to Succeed in Technical Support

    CERN Document Server

    Sanchez, Andrew

    2010-01-01

    Technical Support Essentials is a book about the many facets of technical support. It attempts to provide a wide array of topics to serve as points of improvement, discussion, or simply topics that you might want to learn. The topics range from good work habits to the way technical supportgroups establish their own style of work. This book applies theories, models, and concepts synthesized from existing research in other fields-such as management, economics, leadership, and psychology-and connects them to technical support. The goal is to build on the work of others and allow their success to

  4. Technical Support for Contaminated Sites | Science Inventory ...

    Science.gov (United States)

    In 1987, the U.S. Environmental Protection Agency’s (EPA) Office of Research and Development (ORD), Office of Land and Emergency Management, and EPA Regional waste management offices established the Technical Support Project. The creation of the Technical Support Project enabled ORD to provide effective technical assistance by ensuring ORD scientists and engineers were accessible to the Agency’s Office and Regional decision makers, including Remedial Project Managers, On-Scene Coordinators, and corrective action staff. Five ORD Technical Support Centers (TSCs) were created to facilitate this technical assistance. Three of the five TSCs are supported by the Sustainable and Healthy Communities Research Program, and are summarized in the poster being presented:• Engineering Technical Support Center (ETSC) in Cincinnati, Ohio• Ground Water Technical Support Center (GWTSC) in Ada, Oklahoma• Site Characterization and Monitoring Technical Support Center (SCMTSC) in Atlanta, GeorgiaOver the past 29 years, the Technical Support Centers have provided numerous influential products to its internal Agency clients and to those at the State level (through the EPA Regions). These products include, but are not limited to the following: Annual TSC reports from the three Centers, a hard-rock mining conference every other year, PRO-UCL software development for site characterization statistics, groundwater modeling using state-of-the-art modeling software, numerical mo

  5. 75 FR 48273 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-08-10

    ... provisions by expanding the definition Technical Service Provider Assistance, which contained an error in the omission of ``Indian Tribe'' in the definition of Technical Service Provider. DATES: Effective Date: This amendment is effective on August 10, 2010. FOR FURTHER INFORMATION CONTACT: Angel Figueroa, Team Leader...

  6. 75 FR 6839 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-02-12

    ... Conservation Service 7 CFR Part 652 RIN 0578-AA48 Technical Service Provider Assistance AGENCY: Natural... Final rule amends the Natural Resources Conservation Service (NRCS) regulations for technical service provider (TSP) provisions under the Food Security Act of 1985. The Food, Conservation, and Energy Act of...

  7. Technical Support Documents Used to Develop the Chesapeake Bay TMDL

    Science.gov (United States)

    The Chesapeake Bay TMDL development was supported by several technical documents for water quality standards and allocation methodologies specific to the Chesapeake Bay. This page provides the technical support documents.

  8. Engineering Technical Support Center Annual Report Fiscal ...

    Science.gov (United States)

    The United States Environmental Protection Agency (EPA or Agency) Office of Research and Development (ORD) created the Engineering Technical Support Center (ETSC) in 1987, one of several technical support centers created as part of the Technical Support Project (TSP). ETSC provides engineering expertise to Agency program and regional offices and remediation teams working at contaminated sites across the country. The ETSC is operated within ORD’s Land Remediation and Pollution Control Division (LRPCD) of the National Risk Management Research Laboratory (NRMRL) in Cincinnati, Ohio. The ETSC’s mission is to provide site-specific scientific and engineering technical support to Remedial Project Managers, On-Scene Coordinators, and other remediation personnel at contaminated sites. This allows local, regional, or national authorities to work more quickly, efficiently, and cost effectively, while also increasing the technical experience of the remediation team. Since its inception, the ETSC has supported countless projects across all EPA Regions in almost all states and territories. This report highlights significant projects the ETSC supported in fiscal year 2015 (FY15). These projects addressed an array of environmental scenarios, such as remote mining contamination, expansive landfill waste, cumulative impacts from multiple contamination sources, and persistent threats from abandoned industrial sites. Constructing and testing new and innovative treatment technol

  9. Engineering Technical Support Center Annual Report Fiscal Year 2015

    Science.gov (United States)

    The United States Environmental Protection Agency (EPA or Agency) Office of Research and Development (ORD) created the Engineering Technical Support Center (ETSC) in 1987, one of several technical support centers created as part of the Technical Support Project (TSP). ETSC provid...

  10. Technical Support and Transfer of Geothrmal Technical Knowledge and Information

    Energy Technology Data Exchange (ETDEWEB)

    John W. Lund; Toni" Boyd

    2007-11-14

    The Geo-Heat Center (GHC) staff provided responses to 1442 technical support requests during the contract period (April 1, 2006 to September 30, 2007), which were six quarters under this contract. Our website, consisting of 1900 files, also contributes to our technical assistance activity. Downloaded files were 1,889,323 (3,448 per day) from our website, the total number of users was 1,365,258 (2,491 per day), and the total number of hits were 6,008,500 (10,064 per day). The GHC staff attended 60 workshops, short course and professional meeting and made 29 technical presentations. The staff also prepared and mailed out 2,000 copies of each of five issues of the GHC Quaterly Bulletin which contained 26 articles. We also mailed out approximately 5,000 papers and publications to interested individuals and organizations.

  11. The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

    Science.gov (United States)

    Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

    Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

  12. Wind Turbine Providing Grid Support

    DEFF Research Database (Denmark)

    2011-01-01

    A variable speed wind turbine is arranged to provide additional electrical power to counteract non-periodic disturbances in an electrical grid. A controller monitors events indicating a need to increase the electrical output power from the wind turbine to the electrical grid. The controller...

  13. Support Net for Frontline Providers

    Science.gov (United States)

    2016-03-01

    With a multidisciplinary team that included an external evaluator (Dr. Robert Durham), and an extended research team (Drs. Alan Peterson and Bret...21.7%) indicated being single. The sample of providers included 13 clinical psychologists (21.7%), 17 counselors or psychotherapists (28.3%), three...a sample of service members from Iraq and Afghanistan. Military Medicine, 172, 359–363. Figley, C. R. (2002). Compassion fatigue: Psychotherapists

  14. Draft federal GHG accounting and reporting : technical support document

    Science.gov (United States)

    2010-07-01

    This is a technical support document (TSD) that accompanies the Federal Greenhouse Gas Accounting and Reporting Guidance (or Guidance). This document provides detailed information on the inventory reporting process and accepted calculation methodolog...

  15. Technical Support for the development of DCS

    Energy Technology Data Exchange (ETDEWEB)

    Oh, In Seok; Lee, Cheol Kwon; Kim, Dong Hoon; Kim, Jung Taek; Hwang, In Koo; Park, Jae Chang; Lee, Dong Young; Park, Won Man

    2008-05-15

    The objective of this project is to provide a technical support to Woori Tech Co. in its design and manufacture process of the DCS as a part of KNICS development program to promote the technology self-reliance for non-safety equipment for NPPs(Nuclear Power Plants). We support Woori Tech Co. to develop a DCS which satisfies the requirements for Shinkori 3 and 4 NPPs in the aspects of reliability, applicability and technical competitiveness. As the results of this project the following items were developed and/or implemented; {center_dot} Design basis and requirements for a DCS system {center_dot} Design requirements for control communication networks {center_dot} Architecture of control networks {center_dot} Design requirements of EWS(Engineering Workstation) {center_dot} Plan of software verification and validation {center_dot} Operation display design {center_dot} Soft control functions {center_dot} Application development tools of DCS {center_dot} Analysis and V/V activities on DCS control network protocols {center_dot} Software verification and validation and documentation guidelines {center_dot} User manual documents.

  16. Impact of Technical Support on Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Natasa Gajic

    2015-10-01

    Full Text Available Technical support through co-creation of value in automotive paint processes and activities is essential to the success of paint manufacturing companies. This study aimed to explore the impact of technical support on customer satisfaction through value-in-use in the automotive paint market. A quantitative questionnaire survey involving a convenience sample of 169 respondents was used for data collection. The questionnaire design bore on the SERVPERF instrument with embedded value-in-use attributes. The data were analyzed by using SPSS 21 statistical methods exploratory factor analysis (EFA and multiple regression analysis (MRA. The findings of this study revealed that the key value-in-use attributes were relationship quality (trust, knowledge required for providing help in getting maximum product benefits, sharing of knowledge, and a range of product and service offerings that satisfy customer needs. Trust had the greatest impact on customer satisfaction. The results also revealed that service quality dimension assurance exerted the greatest positive impact on customer satisfaction.

  17. The Technical Baccalaureate: Providing Excellence in Vocational Education?

    Science.gov (United States)

    Acquah, Daniel K.; Malpass, Debra

    2017-01-01

    Proposals for a technical baccalaureate have received cross-party support in England. The technical baccalaureate is intended to deliver the necessary training to enable young people to fill the UK's skills gap in intermediate-level occupations in STEM and other sectors. This paper explores how to design and implement a high-quality technical…

  18. USACE AIS Transmit Technical Support Summary Report

    Science.gov (United States)

    2014-09-01

    transmitter antenna height at several locations. USACE AIS Transmit Technical Support Summary Report vi UNCLAS//Public | CG-926 RDC | I. Gonin et al...Agreement MPI Multi-Protocol Interface NMEA National Marine Electronics Association NOAA National Oceanic and Atmospheric Administration NWS National...include National Oceanic and Atmospheric Administration ( NOAA ), National Weather Service (NWS), United States Geological Survey (USGS), Ohio River

  19. Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) Quality Assurance Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fix, N. J.

    2008-02-20

    The scope of the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) is to provide technical and integration support to Fluor Hanford, Inc., including operable unit investigations at 300-FF-5 and other groundwater operable units, strategic integration, technical integration and assessments, remediation decision support, and science and technology. This Quality Assurance Management Plan provides the quality assurance requirements and processes that will be followed by the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project).

  20. Supportive personnel training program based at a technical college.

    Science.gov (United States)

    Smith, T P; Adams, R C; Brewer, C D

    1982-03-01

    A supportive personnel training program based at a technical college is described. During the nine-month curriculum, the students spend time in the classroom and in a laboratory on the college campus. Part of the program is taught by the college faculty, providing the students with courses on basic chemistry, anatomy and physiology, medical vocabulary, typing, and math fundamentals. The other part of the curriculum is taught by pharmacists, including courses on hospital pharmacy, pharmacology, and pharmacy mathematics. The students' first experiences with unit-dose and i.v.-admixture programs are in an artificial laboratory under controlled conditions. Later in the program, the students rotate through each of the participating hospitals for thorough on-the-job training. By combining the resources of a local technical college and the area hospitals, a uniform program of training supportive personnel has been implemented that produces enough technical support for all the participating hospital pharmacies.

  1. Deployment and Automated Technical Order Support

    Science.gov (United States)

    1989-02-01

    Bureaucracy ....................................... 8 2 Technical Order Distribution Office Organization ................................... 9 3 Volume...20 Shop or per TODS TOs Workstation Figure 2. Technical Order Distribution Office Organization . 9 The Nature of Technical Orders Several factors have

  2. Wikis supporting PLM and Technical Documentation

    CERN Document Server

    Høimyr, Nils-Joar; CERN. Geneva. IT Department

    2007-01-01

    Over the last years, Wikis have arisen as powerful tools for collaborative documentation on the Internet. The Encyclopaedia Wikipedia has become a reference, and the power of community editing in a Wiki allows for capture of knowledge from contributors all over the world. Use of a Wiki for Technical Documentation, along with hyper-links to other data sources such as a Product Lifecycle Management (PLM) system, provides a very effective collaboration tool as information can be easily feed into the system throughout the project life-cycle. In particular for software- and hardware projects with rapidly evolving documentation, the Wiki approach has proved to be successful. Certain Wiki implementations, such as TWiki, are project-oriented and include functionality such as automatic page revisioning. This paper addresses the use of TWiki to document hardware and software projects at CERN, from the requirements and brain-storming phase to end-product documentation. 2 examples are covered: large scale engineering for...

  3. 78 FR 70586 - Technical Support Document: Technical Update of the Social Cost of Carbon for Regulatory Impact...

    Science.gov (United States)

    2013-11-26

    .... This Technical Support Document explains the derivation of the SCC estimates using three peer reviewed..., which means OMB will not know your identity or contact information unless you provide it in the body of... interim values that agencies used in a number of rules, an interagency group of technical experts...

  4. PROVIDING R-TREE SUPPORT FOR MONGODB

    Directory of Open Access Journals (Sweden)

    L. Xiang

    2016-06-01

    Full Text Available Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB’s features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  5. Providing R-Tree Support for Mongodb

    Science.gov (United States)

    Xiang, Longgang; Shao, Xiaotian; Wang, Dehao

    2016-06-01

    Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB's features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  6. Technical Support Document for Version 3.6.1 of the COMcheck Software

    Energy Technology Data Exchange (ETDEWEB)

    Bartlett, Rosemarie; Connell, Linda M.; Gowri, Krishnan; Halverson, Mark A.; Lucas, Robert G.; Richman, Eric E.; Schultz, Robert W.; Winiarski, David W.

    2009-09-29

    This technical support document (TSD) is designed to explain the technical basis for the COMcheck software as originally developed based on the ANSI/ASHRAE/IES Standard 90.1-1989 (Standard 90.1-1989). Documentation for other national model codes and standards and specific state energy codes supported in COMcheck has been added to this report as appendices. These appendices are intended to provide technical documentation for features specific to the supported codes and for any changes made for state-specific codes that differ from the standard features that support compliance with the national model codes and standards.

  7. AHMCT Intelligent Roadway Information System (IRIS) technical support and testing

    Science.gov (United States)

    2011-12-31

    This report documents the research project AHMCT IRIS Technical Support and Testing, : performed under contract 65A0275, Task ID 1777. It presents an overview of the Intelligent : Roadway Information System (IRIS), and its design and function. ...

  8. Technical support for universal health coverage pilots in Karnataka ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The project team will provide technical assistance to these early adopter states to assist with UHC intervention activities. The project ... They provided technical assistance to help officials design and develop their universal health coverage action plans based on an extensive baseline assessment and top health priorities.

  9. Air Systems Provide Life Support to Miners

    Science.gov (United States)

    2014-01-01

    Through a Space Act Agreement with Johnson Space Center, Paragon Space Development Corporation, of Tucson, Arizona, developed the Commercial Crew Transport-Air Revitalization System, designed to provide clean air for crewmembers on short-duration space flights. The technology is now being used to help save miners' lives in the event of an underground disaster.

  10. The CHPRC Groundwater and Technical Integration Support (Master Project) Quality Assurance Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fix, N. J.

    2009-04-03

    The scope of the CH2M Hill Plateau Remediation Company, LLC (CHPRC) Groundwater and Technical Integration Support (Master Project) is for Pacific Northwest National Laboratory staff to provide technical and integration support to CHPRC. This work includes conducting investigations at the 300-FF-5 Operable Unit and other groundwater operable units, and providing strategic integration, technical integration and assessments, remediation decision support, and science and technology. The projects under this Master Project will be defined and included within the Master Project throughout the fiscal year, and will be incorporated into the Master Project Plan. This Quality Assurance Management Plan provides the quality assurance requirements and processes that will be followed by the CHPRC Groundwater and Technical Integration Support (Master Project) and all releases associated with the CHPRC Soil and Groundwater Remediation Project. The plan is designed to be used exclusively by project staff.

  11. (Technical and engineering support for the Office of Industrial Programs)

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    As of April 19, 1991, technical, operational and analytic support and assistance to the offices and divisions of the Office of Renewable Energy, under contract DE-AC01-86CE30844 was completed. The overall work effort, initiated February 20, 1986, was characterized by timely, comprehensive, high quality, professional responsiveness to a broad range of renewable energy program operational support requirements. These are no instances of failure to respond, nor unacceptable response, during the five-year period. The technology program areas covered are Solar Buildings Technology, Wind Energy Technology, Photovoltaic Energy Technology, Geothermal Energy Technology, Biofuels and Municipal Waste Technology, Solar Thermal Technology, Hydropower Energy Technology, Ocean Energy Technology, and Electric Energy Systems and Energy Storage. The analytical and managerial support provided to the office and staff of the Deputy Assistant Secretary for Renewable Energy enabled a comprehensive evaluation of program and policy alternatives, and the selection and execution of appropriate courses of action from amongst those alternatives. Largely through these means the Office has been able to maintain continuity and a meaningful program thrust through the vacillations of policies and budgets that it has experienced over that it has experienced over the past five years. Appended are summaries of support activities within each of the individual technology program areas, as well as a complete listing of all project deliverables and due-dates for each submittal under the contract.

  12. City Reach Code Technical Support Document

    Energy Technology Data Exchange (ETDEWEB)

    Athalye, Rahul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chen, Yan [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhang, Jian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Frankel, Mark [New Buildings Inst., Portland, OR (United States); Lyles, Mark [New Buildings Inst., Portland, OR (United States)

    2017-10-31

    This report describes and analyzes a set of energy efficiency measures that will save 20% energy over ASHRAE Standard 90.1-2013. The measures will be used to formulate a Reach Code for cities aiming to go beyond national model energy codes. A coalition of U.S. cities together with other stakeholders wanted to facilitate the development of voluntary guidelines and standards that can be implemented in stages at the city level to improve building energy efficiency. The coalition's efforts are being supported by the U.S. Department of Energy via Pacific Northwest National Laboratory (PNNL) and in collaboration with the New Buildings Institute.

  13. 48 CFR 9.505-1 - Providing systems engineering and technical direction.

    Science.gov (United States)

    2010-10-01

    ... engineering and technical direction. 9.505-1 Section 9.505-1 Federal Acquisition Regulations System FEDERAL... of Interest 9.505-1 Providing systems engineering and technical direction. (a) A contractor that provides systems engineering and technical direction for a system but does not have overall contractual...

  14. Integrated Project Control and Technical Support

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Yeon; Joo, Po Kook; Kim, Gye Ryung (and others)

    2003-06-15

    First, Since PEFP puts it's aim on technology innovation through collaboration and technological fusion among the subprojects from the various fields, It has been tried to make the subprojects consist with the goal of the whole project through building and running the integrated project control system. Also, adopting CPM(Critical Process Management), intensive process management framework has been founded. Secondly, for the every procedure, including purchase, building, installation and a trial running, license, quality control, etc., could be efficiently executed, every related task has been carried out. And, the tasks involved in international cooperative relationship and host site selection are carried out as well, so that PEFP could be firmly supported. Finally, TRM(Technology Road Map) is made up not only for the purpose of managing efficiency and effectiveness on the investment, but also for the purpose of life cycle management from developing stage to commercializing stage.

  15. Logistic management materials-technical support railway enterprises

    OpenAIRE

    Dykan, V.; Borozenetc, T.

    2014-01-01

    The essence of logistics management. Determine the feasibility of applying the principles of logistics management in organizing the logistics of railway transport. Discussed measures to develop suppliers in the implementation of logistics management logistics. Identified the need to develop and implement regulatory and methodical system to improve materials-technical support through the introduction of modern logistics principles. Applied systemic campaign to organize the materials-technical ...

  16. Game-based dynamic simulations supporting technical education and training

    OpenAIRE

    Tore Bjølseth; Ole K. Solbjørg; Bjarne A. Foss; Tor Ivar Eikaas

    2006-01-01

    Educational games may improve learning by taking advantage of the new knowledge and skills of today’s students obtained from extensive use of interactive games. This paper describes how interactive dynamic simulators of advanced technical systems and phenomena can be shaped and adapted as games and competitions supporting technical education and training. Some selected examples at different educational levels are shown, from vocational training to university level courses. The potential ...

  17. Large Hospital 50% Energy Savings: Technical Support Document

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, E.; Studer, D.; Parker, A.; Pless, S.; Torcellini, P.

    2010-09-01

    This Technical Support Document documents the technical analysis and design guidance for large hospitals to achieve whole-building energy savings of at least 50% over ANSI/ASHRAE/IESNA Standard 90.1-2004 and represents a step toward determining how to provide design guidance for aggressive energy savings targets. This report documents the modeling methods used to demonstrate that the design recommendations meet or exceed the 50% goal. EnergyPlus was used to model the predicted energy performance of the baseline and low-energy buildings to verify that 50% energy savings are achievable. Percent energy savings are based on a nominal minimally code-compliant building and whole-building, net site energy use intensity. The report defines architectural-program characteristics for typical large hospitals, thereby defining a prototype model; creates baseline energy models for each climate zone that are elaborations of the prototype models and are minimally compliant with Standard 90.1-2004; creates a list of energy design measures that can be applied to the prototype model to create low-energy models; uses industry feedback to strengthen inputs for baseline energy models and energy design measures; and simulates low-energy models for each climate zone to show that when the energy design measures are applied to the prototype model, 50% energy savings (or more) are achieved.

  18. General Merchandise 50% Energy Savings Technical Support Document

    Energy Technology Data Exchange (ETDEWEB)

    Hale, E.; Leach, M.; Hirsch, A.; Torcellini, P.

    2009-09-01

    This report documents technical analysis for medium-box general merchandise stores aimed at providing design guidance that achieves whole-building energy savings of at least 50% over ASHRAE Standard 90.1-2004.

  19. Integrated Project Control and Technical Support

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Yeon; Kim, Jun Yeon; Joo, Po Kook and others

    2005-08-15

    First, Since PEFP puts it's aim on technology innovation through collaboration and technological fusion among the sub-projects from the various fields. It has been tried to make the sub-projects consist with the goal of the whole project through building and running the integrated project control system. Also, adopting CPM(Critical Process Management), intensive process management framework has been founded. Secondly, for the every procedure, including purchase, building, installation and a trial running, license, quality control, etc., could be efficiently executed, every related task has been carried out. And, the tasks involved in international cooperative relationship and host site selection are carried out as well, so that PEFP could be firmly supported. Finally, Strategic management procedures including TRM(Technology Road Map), economic evaluation on PEFP, preliminary evaluation on company-involved R and D and TRESIS(Technology, Resources, Economic Evaluation System) are made up not only for the purpose of managing efficiency and effectiveness on the investment, but also for the purpose of life cycle management from developing stage to commercializing stage.

  20. Impact of the WHO Technical Support Towards Malaria Elimination ...

    African Journals Online (AJOL)

    The importance of this technical support is evidenced in the malaria elimination strategy within an environment of changing epidemiological malaria profile, insecticide and drug resistance. INTRODUCTION. In Zambia, malaria is the leading cause for hospital. 1 consultations. It is a life-threatening disease caused by the.

  1. Impact of the WHO Technical Support Towards Malaria Elimination ...

    African Journals Online (AJOL)

    ABSTRACT. Background: Zambia's National Malaria Strategic Plan. (NMSP) 2011-2016 aims to eliminate malaria by the year. 2020. The WHO Country Office is supporting Zambia in its goal to attain this national target earlier than the global goal contained in Global Technical Strategy (GTS) 2016-. 2030. WHO's focus is to ...

  2. Impact of the WHO Technical Support Towards Malaria Elimination ...

    African Journals Online (AJOL)

    Background: Zambia's National Malaria Strategic Plan (NMSP) 2011-2016 aims to eliminate malaria by the year 2020. The WHO Country Office is supporting Zambia in its goal to attain this national target earlier than the global goal contained in Global Technical Strategy (GTS) 2016- 2030. WHO's focus is to accelerate ...

  3. Technical Support Services to the Office of Major Project Management. Final report. [DOE demonstration plants

    Energy Technology Data Exchange (ETDEWEB)

    This document represents the final report on Contract No. DE-AC01-76ET13053, Technical Support Services to the Office of Major Project Management. The report provides brief technical summaries of contract activities. The purpose was for Radian Corporation to provide the Energy Research and Development Administration (ERDA) with environmental technical support for the development of fossil fuel demonstration plants. Since that time, Radian has provided environmental technical support services to ERDA, and now to DOE, in a variety of areas supporting the fossil fuel demonstration programs. Also Radian provided DOE with quick reviews of environmental documents, technology transfer requests, and/or quick studies to provide timely technical input to a DOE decision-making process. Because some task orders were expressly designed to provide quick-response, as-needed assistance, they did not generate any major reports. Task orders are listed and brief descriptions of work done are given; seventeen report titles in response to these task orders are listed.

  4. 20 CFR 404.1662 - What support we will provide.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What support we will provide. 404.1662 Section 404.1662 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... support we will provide. Performance support may include, but is not limited to, any or all of the...

  5. 20 CFR 416.1062 - What support we will provide.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What support we will provide. 416.1062 Section 416.1062 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... What support we will provide. Performance support may include, but is not limited to, any or all of the...

  6. Technical Support Document: 50% Energy Savings for Small Office Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Brian A.; Wang, Weimin; Huang, Yunzhi; Lane, Michael D.; Liu, Bing

    2010-04-30

    The Technical Support Document (TSD) for 50% energy savings in small office buildings documents the analysis and results for a recommended package of energy efficiency measures (EEMs) referred to as the advanced EEMs. These are changes to a building design that will reduce energy usage. The package of advanced EEMs achieves a minimum of 50% energy savings and a construction area weighted average energy savings of 56.6% over the ANSI/ASHRAE/IESNA Standard 90.1-2004 for 16 cities which represent the full range of climate zones in the United States. The 50% goal is for site energy usage reduction. The weighted average is based on data on the building area of construction in the various climate locations. Cost-effectiveness of the EEMs is determined showing an average simple payback of 6.7 years for all 16 climate locations. An alternative set of results is provided which includes a variable air volume HVAC system that achieves at least 50% energy savings in 7 of the 16 climate zones with a construction area weighted average savings of 48.5%. Other packages of EEMs may also achieve 50% energy savings; this report does not consider all alternatives but rather presents at least one way to reach the goal. Design teams using this TSD should follow an integrated design approach and utilize additional analysis to evaluate the specific conditions of a project.

  7. 75 FR 5779 - Notice Providing Agenda for Technical Conference on RTO/ISO Responsiveness

    Science.gov (United States)

    2010-02-04

    ... Energy Regulatory Commission Notice Providing Agenda for Technical Conference on RTO/ISO Responsiveness.... ER09-1050-000, ER09- 1192-000. ISO New England, Inc. and New England Docket No. ER09-1051-000. Power... , (202) 502-8048. Kimberly D. Bose, Secretary. Agenda--Technical Conference on RTO/ISO Responsiveness...

  8. Effects and effectiveness of dynamic arm supports: a technical review.

    Science.gov (United States)

    van der Heide, Loek A; Gelderblom, Gert Jan; de Witte, Luc P

    2015-01-01

    Numerous dynamic arm supports have been developed in recent decades to increase independence in the performance of activities of daily living. Much effort and money have been spent on their development and prescription, yet insight into their effects and effectiveness is lacking. This article is a systematic review of evaluations of dynamic arm supports. The 8 technical evaluations, 12 usability evaluations, and 27 outcome studies together make 47 evaluations. Technical evaluations were often used as input for new developments and directed at balancing quality, forces and torques, and range of motion of prototypes. Usability studies were mostly single-measure designs that had varying results as to whether devices were usable for potential users. An increased ability to perform activities of daily living and user satisfaction were reported in outcome studies. However, the use of dynamic arm supports in the home situation was reported to be low. Gaining insight into why devices are not used when their developers believe them to be effective seems crucial for every new dynamic arm support developed. The methodological quality of the outcome studies was often low, so it is important that this is improved in the future.

  9. Outsourcing customer support : The role of provider customer focus

    NARCIS (Netherlands)

    Wuyts, S.H.K.; Rindfleisch, A.; Citrin, A.

    An increasing number of firms are outsourcing customer support to external service providers. This creates a triadic setting in which an outsourcing provider serves end customers on behalf of its clients. While outsourcing presents an opportunity to serve customers, service providers differ in their

  10. Providing producer mobility support in NDN through proactive data replication

    OpenAIRE

    Lehmann, Matheus; Barcellos, Marinho; Mauthe, Andreas Ulrich

    2016-01-01

    Email Print Request Permissions Named Data Networking (NDN) is a novel architecture expected to overcome limitations of the current Internet. User mobility is one of the most relevant limitations to be addressed. NDN supports consumer mobility by design but fails to offer the same level of support for producer mobility. Existing approaches to extend NDN are host-centric, which conflicts with NDN principles, and provide limited support for producer mobility. This paper proposes a content-centr...

  11. Parent-to-Parent support providers: How recruits are identified.

    Science.gov (United States)

    Dodds, Robin L; Singer, George H S

    2017-10-24

    To examine selection criteria for Parent-to-Parent support parents trained to provide support to other parents of children with disabilities. Ten leaders of Parent-to-Parent programmes participated in telephone interviews to explore attributes associated with parents selected to be trained as support parents. Qualitative analysis reveals parents deemed "ready" to become support parents, build relationships, exhibit positivity, build capacities, have good communication skills and a future orientation and feel the need to give back. An additional set of attributes we have named, "red flags" are associated with parents not suitable to provide support are also presented. Parent-to-Parent support parents are informally identified by a set of characteristics that can be operationalized for screening purposes. Findings provide support for the positive influence of the peer support relationship and identify the need for a measure of parent "readiness" to assist in the recruitment of quality support parents for the Parent-to-Parent organization. © 2017 John Wiley & Sons Ltd.

  12. Providing information communication technology-based support to ...

    African Journals Online (AJOL)

    Student support is a major factor in distance education. This study was concerned with the use of ICT as a medium for providing student support at the University of Zambia. It was necessary to study the factors that would affect the application of ICT, in order to inform policy makers and managers of distance education which ...

  13. Design of Technical Support System for Retail Company Based on Cloud

    Directory of Open Access Journals (Sweden)

    Shao Ping

    2017-01-01

    Full Text Available With the retail side of the market in China, the sale of electricity companies as a new source of power retail, they participate in the electricity market business. National and local governments subsequently introduced the corresponding policies and rules, the technical support system becomes one of the necessary conditions for the access of the retail company. Retail electricity companies have started the system construction, but has not yet formed a standardized, complete architecture. This paper analyzes the business and data interaction requirements of retail electricity companies, and then designs the functional architecture based on basic application, advanced application and value-added application, and the technical architecture based on “cloud”. On this basis, the paper discusses the selection of private cloud, public cloud and mixed cloud model, and the rationalization suggestion of system construction. Which can provide reference for the construction of the technical support system of the domestic retail enterprises.

  14. FY07 Summary of System Interface and Support Systems R&D and Technical Issues Map

    Energy Technology Data Exchange (ETDEWEB)

    Steven R. Sherman

    2007-09-01

    This document provides a summary of research and development activities in the System Interface and Support Systems area of the DOE Nuclear Hydrogen Initiative in FY 2007. Project cost and performance data obtained from the PICS system, at least up through July 2007, are presented and analyzed. Brief summaries of accomplishments and references are provided. A mapping of System Interface and Support Systems technical issues versus the work performed is updated and presented. Lastly, near-term research plans are described, and recommendatioins are provided for additional research.

  15. RESEARCH OF PROBLEMS OF DESIGN OF COMPLEX TECHNICAL PROVIDING AND THE GENERALIZED MODEL OF THEIR DECISION

    Directory of Open Access Journals (Sweden)

    A. V. Skrypnikov

    2015-01-01

    Full Text Available Summary. In this work the general ideas of a method of V. I. Skurikhin taking into account the specified features develop and questions of the analysis and synthesis of a complex of technical means, with finishing them to the level suitable for use in engineering practice of design of information management systems are in more detail considered. In work the general system approach to the solution of questions of a choice of technical means of the information management system is created, the general technique of the sys tem analysis and synthesis of a complex of the technical means and its subsystems providing achievement of extreme value of criterion of efficiency of functioning of a technical complex of the information management system is developed. The main attention is paid to the applied party of system researches of complex technical providing, in particular, to definition of criteria of quality of functioning of a technical complex, development of methods of the analysis of information base of the information management system and definition of requirements to technical means, and also methods of structural synthesis of the main subsystems of complex technical providing. Thus, the purpose is research on the basis of system approach of complex technical providing the information management system and development of a number of methods of the analysis and the synthesis of complex technical providing suitable for use in engineering practice of design of systems. The well-known paradox of development of management information consists of that parameters of the system, and consequently, and requirements to the complex hardware, can not be strictly reasonable to development of algorithms and programs, and vice versa. The possible method of overcoming of these difficulties is prognostication of structure and parameters of complex hardware for certain management informations on the early stages of development, with subsequent clarification and

  16. Optimization of a Virtual Power Plant to Provide Frequency Support.

    Energy Technology Data Exchange (ETDEWEB)

    Neely, Jason C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Johnson, Jay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gonzalez, Sigifredo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lave, Matthew Samuel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Delhotal, Jarod James [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-12-01

    Increasing the penetration of distributed renewable sources, including photovoltaic (PV) sources, poses technical challenges for grid management. The grid has been optimized over decades to rely upon large centralized power plants with well-established feedback controls, but now non-dispatchable, renewable sources are displacing these controllable generators. This one-year study was funded by the Department of Energy (DOE) SunShot program and is intended to better utilize those variable resources by providing electric utilities with the tools to implement frequency regulation and primary frequency reserves using aggregated renewable resources, known as a virtual power plant. The goal is to eventually enable the integration of 100s of Gigawatts into US power systems.

  17. Providing Mainstream Parser Generators with Modular Language Definition Support

    OpenAIRE

    Karol, Sven; Zschaler, Steffen

    2012-01-01

    The composition and reuse of existing textual languages is a frequently re-occurring problem. One possibility of composing textual languages lies on the level of parser specifications which are mainly based on context-free grammars and regular expressions. Unfortunately most mainstream parser generators provide proprietary specification languages and usually do not provide strong abstractions for reuse. New forms of parser generators do support modular language development, but they can often...

  18. Lactation Consultants' Perceived Barriers to Providing Professional Breastfeeding Support.

    Science.gov (United States)

    Anstey, Erica H; Coulter, Martha; Jevitt, Cecilia M; Perrin, Kay M; Dabrow, Sharon; Klasko-Foster, Lynne B; Daley, Ellen M

    2018-02-01

    Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems. This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti. A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems. Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.

  19. Providing Automatic Support for Heuristic Rules of Methods

    NARCIS (Netherlands)

    Tekinerdogan, B.; Aksit, Mehmet; Demeyer, Serge; Bosch, H.G.P.; Bosch, Jan

    In method-based software development, software engineers create artifacts based on the heuristic rules of the adopted method. Most CASE tools, however, do not actively assist software engineers in applying the heuristic rules. To provide an active support, the rules must be formalized, implemented

  20. Depressive Symptoms and Unmitigated Communion in Support Providers

    NARCIS (Netherlands)

    Jin, Lihua; Van Yperen, Nico W.; Sanderman, Robbert; Hagedoorn, Mariet

    In this research, we argue and demonstrate that the association between enacted (un)supportive behaviour and depressive symptoms is a function of the providers' levels of unmitigated communion (UC). UC is characterized by overinvolvement in others' problems, self-neglect and externalized

  1. METHOD OF JUSTIFICATION OF METHODS OF APPLICATION OF COMPLEXES OF TECHNICAL MEANS OF INFORMATION SUPPORT OF CONFLICT INTERACTION OF ORGANIZATIONAL AND TECHNICAL SYSTEMS

    Directory of Open Access Journals (Sweden)

    L. E. Mistrov

    2015-01-01

    Full Text Available The method of justification of methods of application of complexes of technical means of information support of conflict interaction of organizational and technical systems on the basis of the solution of an optimizing problem of distribution of a discrete resource of technical means of measurement, extraction, distortion and destruction of information is offered. The method is based on methods of branches and borders, consecutive distribution of units of a resource, standard planning and the maximum element. The proposed method provides an implementation of the optimal methods for coordinated implementation of the set of individual information security and complex group of information security within the complex of technical means for operations of single and groups of elements of objects of technical means and justification of the basic requirements to the management system that implements these methods in the dynamics of the conflict.

  2. TECHNICAL SUPPORT AS A BASIS OF HIGH AVAILABILITY LEVEL AND IT SYSTEM SERVICE QUALITY

    Directory of Open Access Journals (Sweden)

    Dejan Vidojevic

    2007-06-01

    Full Text Available This work presents the development and implementation methodology of technical support in IT1system operation. Methodology is developed and applied in realistic system (Information system of the Tax administration - DIS 2003, which is technically very complex and highly distributed. The results of IT system availability assessment and identification of the critical components are input parameters in the process of establishing of the technical support. The importance of technical support for achieving optimal IT system availability and IT service quality is assessed according to its operation during one year. The history of technical support system operation is a basis for further continuous improvement.

  3. Technical Support Document for Version 3.9.1 of the COMcheck Software

    Energy Technology Data Exchange (ETDEWEB)

    Bartlett, Rosemarie; Connell, Linda M.; Gowri, Krishnan; Halverson, Mark A.; Lucas, Robert G.; Richman, Eric E.; Schultz, Robert W.; Winiarski, David W.

    2012-09-01

    COMcheck provides an optional way to demonstrate compliance with commercial and high-rise residential building energy codes. Commercial buildings include all use groups except single family and multifamily not over three stories in height. COMcheck was originally based on ANSI/ASHRAE/IES Standard 90.1-1989 (Standard 90.1-1989) requirements and is intended for use with various codes based on Standard 90.1, including the Codification of ASHRAE/IES Standard 90.1-1989 (90.1-1989 Code) (ASHRAE 1989a, 1993b) and ASHRAE/IESNA Standard 90.1-1999 (Standard 90.1-1999). This includes jurisdictions that have adopted the 90.1-1989 Code, Standard 90.1-1989, Standard 90.1-1999, or their own code based on one of these. We view Standard 90.1-1989 and the 90.1-1989 Code as having equivalent technical content and have used both as source documents in developing COMcheck. This technical support document (TSD) is designed to explain the technical basis for the COMcheck software as originally developed based on the ANSI/ASHRAE/IES Standard 90.1-1989 (Standard 90.1-1989). Documentation for other national model codes and standards and specific state energy codes supported in COMcheck has been added to this report as appendices. These appendices are intended to provide technical documentation for features specific to the supported codes and for any changes made for state-specific codes that differ from the standard features that support compliance with the national model codes and standards. Beginning with COMcheck version 3.8.0, support for 90.1-1989, 90.1-1999, and the 1998 IECC and version 3.9.0 support for 2000 and 2001 IECC are no longer included, but those sections remain in this document for reference purposes.

  4. Technical Support Document: 50% Energy Savings Design Technology Packages for Medium Office Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Brian A.; Wang, Weimin; Lane, Michael D.; Rosenberg, Michael I.; Liu, Bing

    2009-09-01

    This Technical Support Document (TSD) describes the process and methodology for development of the Advanced Energy Design Guide for Medium Offices (AEDG-MO or the Guide), a design guidance document which intends to provide recommendations for achieving 50% energy savings in medium office buildings that just meet the requirements of ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings.

  5. Technical Support Document: 50% Energy Savings Design Technology Packages for Highway Lodging Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Wei; Gowri, Krishnan; Lane, Michael D.; Thornton, Brian A.; Rosenberg, Michael I.; Liu, Bing

    2009-09-28

    This Technical Support Document (TSD) describes the process, methodology and assumptions for development of the 50% Energy Savings Design Technology Packages for Highway Lodging Buildings, a design guidance document intended to provide recommendations for achieving 50% energy savings in highway lodging properties over the energy-efficiency levels contained in ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings.

  6. 16 CFR 1401.5 - Providing performance and technical data to purchasers by labeling.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Providing performance and technical data to purchasers by labeling. 1401.5 Section 1401.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... identification and warning statement may appear on a firmly affixed tag, tape, card, or sticker or similar...

  7. Organising, Providing and Evaluating Technical Training for Early Career Researchers: A Case Study

    Science.gov (United States)

    van Besouw, Rachel M.; Rogers, Katrine S.; Powles, Christopher J.; Papadopoulos, Timos; Ku, Emery M.

    2013-01-01

    This paper considers the importance of providing technical training opportunities for Early Career Researchers (ECRs) worldwide through the case study of a MATLAB training programme, which was proposed, organised, managed and evaluated by a team of five ECRs at the University of Southampton. The effectiveness of the programme in terms of the…

  8. Industry Perceptions of Industry-Based Training Provided by Technical Colleges.

    Science.gov (United States)

    Dahlgren, Judith; Stone, James R., III

    1990-01-01

    Focus groups and interviews with representatives of 36 businesses explored business and industry perceptions regarding industry-based training (IBT) provided by technical colleges. The study found that several types of programs were being used; the more successful models were personalized or standardized generic occupational training. (JOW)

  9. 16 CFR 1407.3 - Providing performance and technical data to purchasers by labeling.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Providing performance and technical data to purchasers by labeling. 1407.3 Section 1407.3 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... the portable generator that cannot be removed without the use of tools, and (B) On a location that is...

  10. The Men's Shed: providing biopsychosocial and spiritual support.

    Science.gov (United States)

    Moylan, Matthew M; Carey, Lindsay B; Blackburn, Ric; Hayes, Rick; Robinson, Priscilla

    2015-02-01

    Community Men's Sheds (CMS) have been a unique approach within Australia for addressing and promoting men's health and well-being issues by providing biopsychosocial support. Given the decline of traditional religious influence, and the contemporary understanding of 'spirituality', it can be argued that CMS may also develop and demonstrate characteristics of a communal spirituality. This research aimed to explore the individual and community contribution of CMS in terms of men's health and well-being and subsequently whether CMS programmes satisfied the contemporary and consensus understanding of spirituality. A qualitative case study was undertaken combining both participant observation over a 6-month period and semi-structured in-depth interviews with 21 men of varying ages and occupations attending a Melbourne suburban CMS (Victoria, Australia). Thematic analysis indicated that the CMS provided a number of health and well-being benefits at individual, family, community and public health levels. These included increased self-esteem and empowerment, respite from families, a sense of belonging in the community and the opportunity to exchange ideas relating to personal, family, communal and public health issues. It is concluded that CMS, through the provision of an appropriate spatial context and organizational activities, encourage intra-personal and inter-personal reflection and interaction that subsequently results in men meaningfully, purposefully and significantly connecting with the moment, to self, to others and to their environment-and thus, CMS not only provides biopsychosocial support but can also deliver spiritual support.

  11. Providers' Response to Clinical Decision Support for QT Prolonging Drugs.

    Science.gov (United States)

    Sharma, Sunita; Martijn Bos, J; Tarrell, Robert F; Simon, Gyorgy J; Morlan, Bruce W; Ackerman, Michael J; Caraballo, Pedro J

    2017-09-02

    Commonly used drugs in hospital setting can cause QT prolongation and trigger life-threatening arrhythmias. We evaluate changes in prescribing behavior after the implementation of a clinical decision support system to prevent the use of QT prolonging medications in the hospital setting. We conducted a quasi-experimental study, before and after the implementation of a clinical decision support system integrated in the electronic medical record (QT-alert system). This system detects patients at risk of significant QT prolongation (QTc>500ms) and alerts providers ordering QT prolonging drugs. We reviewed the electronic health record to assess the provider's responses which were classified as "action taken" (QT drug avoided, QT drug changed, other QT drug(s) avoided, ECG monitoring, electrolytes monitoring, QT issue acknowledged, other actions) or "no action taken". Approximately, 15.5% (95/612) of the alerts were followed by a provider's action in the pre-intervention phase compared with 21% (228/1085) in the post-intervention phase (p=0.006). The most common type of actions taken during pre-intervention phase compared to post-intervention phase were ECG monitoring (8% vs. 13%, p=0.002) and QT issue acknowledgment (2.1% vs. 4.1%, p=0.03). Notably, there was no significant difference for other actions including QT drug avoided (p=0.8), QT drug changed (p=0.06) and other QT drug(s) avoided (p=0.3). Our study demonstrated that the QT alert system prompted a higher proportion of providers to take action on patients at risk of complications. However, the overall impact was modest underscoring the need for educating providers and optimizing clinical decision support to further reduce drug-induced QT prolongation.

  12. Women Support Providers Are More Susceptible than Men to Emotional Contagion Following Brief Supportive Interactions

    Science.gov (United States)

    Magen, Eran; Konasewich, Paul A.

    2011-01-01

    People in distress often turn to friends for emotional support. Ironically, although receiving emotional support contributes to emotional and physical health, providing emotional support may be distressing as a result of emotional contagion. Women have been found to be more susceptible than men to emotional contagion in certain contexts, but no…

  13. Technical Support Document for Version 3.9.0 of the COMcheck Software

    Energy Technology Data Exchange (ETDEWEB)

    Bartlett, Rosemarie; Connell, Linda M.; Gowri, Krishnan; Halverson, Mark A.; Lucas, R. G.; Richman, Eric E.; Schultz, Ralph W.; Winiarski, David W.

    2011-09-01

    COMcheck provides an optional way to demonstrate compliance with commercial and high-rise residential building energy codes. Commercial buildings include all use groups except single family and multifamily not over three stories in height. COMcheck was originally based on ANSI/ASHRAE/IES Standard 90.1-1989 (Standard 90.1-1989) requirements and is intended for use with various codes based on Standard 90.1, including the Codification of ASHRAE/IES Standard 90.1-1989 (90.1-1989 Code) (ASHRAE 1989a, 1993b) and ASHRAE/IESNA Standard 90.1-1999 (Standard 90.1-1999). This includes jurisdictions that have adopted the 90.1-1989 Code, Standard 90.1-1989, Standard 90.1-1999, or their own code based on one of these. We view Standard 90.1-1989 and the 90.1-1989 Code as having equivalent technical content and have used both as source documents in developing COMcheck. This technical support document (TSD) is designed to explain the technical basis for the COMcheck software as originally developed based on the ANSI/ASHRAE/IES Standard 90.1-1989 (Standard 90.1-1989). Documentation for other national model codes and standards and specific state energy codes supported in COMcheck has been added to this report as appendices. These appendices are intended to provide technical documentation for features specific to the supported codes and for any changes made for state-specific codes that differ from the standard features that support compliance with the national model codes and standards. Beginning with COMcheck version 3.8.0, support for 90.1-1989, 90.1-1999, and the 1998 IECC are no longer included, but those sections remain in this document for reference purposes.

  14. Technical Reference Suite Addressing Challenges of Providing Assurance for Fault Management Architectural Design

    Science.gov (United States)

    Fitz, Rhonda; Whitman, Gerek

    2016-01-01

    Research into complexities of software systems Fault Management (FM) and how architectural design decisions affect safety, preservation of assets, and maintenance of desired system functionality has coalesced into a technical reference (TR) suite that advances the provision of safety and mission assurance. The NASA Independent Verification and Validation (IV&V) Program, with Software Assurance Research Program support, extracted FM architectures across the IV&V portfolio to evaluate robustness, assess visibility for validation and test, and define software assurance methods applied to the architectures and designs. This investigation spanned IV&V projects with seven different primary developers, a wide range of sizes and complexities, and encompassed Deep Space Robotic, Human Spaceflight, and Earth Orbiter mission FM architectures. The initiative continues with an expansion of the TR suite to include Launch Vehicles, adding the benefit of investigating differences intrinsic to model-based FM architectures and insight into complexities of FM within an Agile software development environment, in order to improve awareness of how nontraditional processes affect FM architectural design and system health management. The identification of particular FM architectures, visibility, and associated IV&V techniques provides a TR suite that enables greater assurance that critical software systems will adequately protect against faults and respond to adverse conditions. Additionally, the role FM has with regard to strengthened security requirements, with potential to advance overall asset protection of flight software systems, is being addressed with the development of an adverse conditions database encompassing flight software vulnerabilities. Capitalizing on the established framework, this TR suite provides assurance capability for a variety of FM architectures and varied development approaches. Research results are being disseminated across NASA, other agencies, and the

  15. Meeting Basic Needs: Social Supports and Services Provided by Hospice.

    Science.gov (United States)

    Boucher, Nathan A; Kuchibhatla, Maragatha; Johnson, Kimberly S

    2017-06-01

    Describe social goods and services for which hospices assist patients and families and the resources hospices use to do so. Basic social supports and services not routinely covered by insurers may be needed by terminally ill patients and their families. Little is known about hospices' provision of such social supports and services. A 2014-2015 cross-sectional survey of hospices nationwide. Participating hospices had been in operation for at least 3 years and were located in any of the 50 states or District of Columbia. Hospices were surveyed about availability and sources of internal funds and referral to obtain basic social supports for patients. Descriptive statistics, bivariate analysis, and categorization were used to describe hospice practices. Measures included frequency and nature of goods and services provision in the prior year; and extent to which hospices used internal funds or community referral for goods and services. Over 80% (n = 203) reported internal funds covered services not reimbursed by insurers; 78% used funds in last year. Hospices used internal funds for food (81.7%), shelter (57.8%), utility bills (73.5%), and funeral costs (50%). Hospices referred patients/families to community organizations to obtain a similar range of services, including transportation, clothing, linens/towels, furniture/appliances, home repairs, and caregiver support. Hospices are using internal resources and accessing community resources to provide patients with basic social needs not routinely covered by insurance.

  16. Health information support provided by professional associations in Canada.

    Science.gov (United States)

    Chatterley, Trish; Storie, Dale; Chambers, Thane; Buckingham, Jeanette; Shiri, Ali; Dorgan, Marlene

    2012-09-01

    Healthcare practitioners in Alberta and across Canada have varying levels of access to information resources depending on their institutional and professional affiliations, yet access to current health information is critical for all. To determine what information resources and services are provided by Albertan and Canadian professional health associations to their members. Representatives of professional colleges and associations were interviewed regarding information resources and services offered to members and perceptions of their members' information needs. National-level associations are more likely to provide resources than provincial ones. There is a clear distinction between colleges and associations in terms of information offered: colleges provide regulatory information, while associations are responsible for provision of clinical information resources. Only half of the associations interviewed provide members with access to licensed databases, with cost being a major barrier. There is considerable variation in the number of electronic resources and the levels of information support provided by professional health associations in Alberta and Canada. Access and usage vary among the health professions. National licensing of resources or creation of a portal linking to freely available alternatives are potential options for increasing access and awareness. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  17. Technical Support Document for Version 3.4.0 of the COMcheck Software

    Energy Technology Data Exchange (ETDEWEB)

    Bartlett, Rosemarie; Connell, Linda M.; Gowri, Krishnan; Halverson, Mark A.; Lucas, Robert G.; Richman, Eric E.; Schultz, Robert W.; Winiarski, David W.

    2007-09-14

    COMcheck provides an optional way to demonstrate compliance with commercial and high-rise residential building energy codes. Commercial buildings include all use groups except single family and multifamily not over three stories in height. COMcheck was originally based on ANSI/ASHRAE/IES Standard 90.1-1989 (Standard 90.1-1989) requirements and is intended for use with various codes based on Standard 90.1, including the Codification of ASHRAE/IES Standard 90.1-1989 (90.1-1989 Code) (ASHRAE 1989a, 1993b) and ASHRAE/IESNA Standard 90.1-1999 (Standard 90.1-1999). This includes jurisdictions that have adopted the 90.1-1989 Code, Standard 90.1-1989, Standard 90.1-1999, or their own code based on one of these. We view Standard 90.1-1989 and the 90.1-1989 Code as having equivalent technical content and have used both as source documents in developing COMcheck. This technical support document (TSD) is designed to explain the technical basis for the COMcheck software as originally developed based on the ANSI/ASHRAE/IES Standard 90.1-1989 (Standard 90.1-1989). Documentation for other national model codes and standards and specific state energy codes supported in COMcheck has been added to this report as appendices. These appendices are intended to provide technical documentation for features specific to the supported codes and for any changes made for state-specific codes that differ from the standard features that support compliance with the national model codes and standards.

  18. Rapid Deterioration of Basic Life Support Skills in Dentists With Basic Life Support Healthcare Provider.

    Science.gov (United States)

    Nogami, Kentaro; Taniguchi, Shogo; Ichiyama, Tomoko

    2016-01-01

    The aim of this study was to investigate the correlation between basic life support skills in dentists who had completed the American Heart Association's Basic Life Support (BLS) Healthcare Provider qualification and time since course completion. Thirty-six dentists who had completed the 2005 BLS Healthcare Provider course participated in the study. We asked participants to perform 2 cycles of cardiopulmonary resuscitation on a mannequin and evaluated basic life support skills. Dentists who had previously completed the BLS Healthcare Provider course displayed both prolonged reaction times, and the quality of their basic life support skills deteriorated rapidly. There were no correlations between basic life support skills and time since course completion. Our results suggest that basic life support skills deteriorate rapidly for dentists who have completed the BLS Healthcare Provider. Newer guidelines stressing chest compressions over ventilation may help improve performance over time, allowing better cardiopulmonary resuscitation in dental office emergencies. Moreover, it may be effective to provide a more specialized version of the life support course to train the dentists, stressing issues that may be more likely to occur in the dental office.

  19. Examining the Support Peer Supporters Provide Using Structural Equation Modeling: Nondirective and Directive Support in Diabetes Management.

    Science.gov (United States)

    Kowitt, Sarah D; Ayala, Guadalupe X; Cherrington, Andrea L; Horton, Lucy A; Safford, Monika M; Soto, Sandra; Tang, Tricia S; Fisher, Edwin B

    2017-12-01

    Little research has examined the characteristics of peer support. Pertinent to such examination may be characteristics such as the distinction between nondirective support (accepting recipients' feelings and cooperative with their plans) and directive (prescribing "correct" choices and feelings). In a peer support program for individuals with diabetes, this study examined (a) whether the distinction between nondirective and directive support was reflected in participants' ratings of support provided by peer supporters and (b) how nondirective and directive support were related to depressive symptoms, diabetes distress, and Hemoglobin A1c (HbA1c). Three hundred fourteen participants with type 2 diabetes provided data on depressive symptoms, diabetes distress, and HbA1c before and after a diabetes management intervention delivered by peer supporters. At post-intervention, participants reported how the support provided by peer supporters was nondirective or directive. Confirmatory factor analysis (CFA), correlation analyses, and structural equation modeling examined the relationships among reports of nondirective and directive support, depressive symptoms, diabetes distress, and measured HbA1c. CFA confirmed the factor structure distinguishing between nondirective and directive support in participants' reports of support delivered by peer supporters. Controlling for demographic factors, baseline clinical values, and site, structural equation models indicated that at post-intervention, participants' reports of nondirective support were significantly associated with lower, while reports of directive support were significantly associated with greater depressive symptoms, altogether (with control variables) accounting for 51% of the variance in depressive symptoms. Peer supporters' nondirective support was associated with lower, but directive support was associated with greater depressive symptoms.

  20. Chemistry, manufacturing and control (CMC) and clinical trial technical support for influenza vaccine manufacturers.

    Science.gov (United States)

    Wahid, Rahnuma; Holt, Renee; Hjorth, Richard; Berlanda Scorza, Francesco

    2016-10-26

    With the support of the Biomedical Advanced Research and Development Authority (BARDA) of the US Department of Health and Human Services, PATH has contributed to the World Health Organization's (WHO's) Global Action Plan for Influenza Vaccines (GAP) by providing technical and clinical assistance to several developing country vaccine manufacturers (DCVMs). GAP builds regionally based independent and sustainable influenza vaccine production capacity to mitigate the overall global shortage of influenza vaccines. The program also ensures adequate influenza vaccine manufacturing capacity in the event of an influenza pandemic. Since 2009, PATH has worked closely with two DCVMs in Vietnam: the Institute of Vaccines and Medical Biologicals (IVAC) and VABIOTECH. Beginning in 2013, PATH also began working with Torlak Institute in Serbia; Instituto Butantan in Brazil; Serum Institute of India Private Ltd. in India; and Changchun BCHT Biotechnology Co. (BCHT) in China. The DCVMs supported under the GAP program all had existing influenza vaccine manufacturing capability and required technical support from PATH to improve vaccine yield, process efficiency, and product formulation. PATH has provided customized technical support for the manufacturing process to each DCVM based on their respective requirements. Additionally, PATH, working with BARDA and WHO, supported several DCVMs in the clinical development of influenza vaccine candidates progressing toward national licensure or WHO prequalification. As a result of the activities outlined in this review, several companies were able to make excellent progress in developing state-of-the-art manufacturing processes and completing early phase clinical trials. Licensure trials are currently ongoing or planned for several DCVMs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Technical and economic analysis of Soft Starter Providing in LV Electrical Installation

    Directory of Open Access Journals (Sweden)

    Virgil Maier

    2014-09-01

    Full Text Available The main aim of this paper is to identify the consequences magnitude of providing electronic starters, also called Soft Starters, in AC electrical motors with largest powers and the economical appreciation of this measure. Through this, it aims not only to identify the technical and economic arguments for applying more decided the provision of electronic starters, but also the limits of its application, given the great diversity of receivers rated power. Thus, it is appreciated that there is no question of applying Soft Starters for the whole power range of asynchronous motors.In context of the proposed analysis, a summary of electronic starters issues is made which may be a guide of their choice and application, facilitating the specialists access in the technical manuals of the companies producing Soft Starters.

  2. 77 FR 46763 - Documents to Support Submission of an Electronic Common Technical Document; Availability

    Science.gov (United States)

    2012-08-06

    ... HUMAN SERVICES Food and Drug Administration Documents to Support Submission of an Electronic Common Technical Document; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The... documents that support making regulatory submissions in electronic format using the electronic Common...

  3. 78 FR 10181 - Documents To Support Submission of an Electronic Common Technical Document; Availability

    Science.gov (United States)

    2013-02-13

    ... HUMAN SERVICES Food and Drug Administration Documents To Support Submission of an Electronic Common Technical Document; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The... versions of documents that support making regulatory submissions in ] electronic format using the...

  4. 76 FR 66311 - Draft Documents To Support Submission of an Electronic Common Technical Document; Availability

    Science.gov (United States)

    2011-10-26

    ... HUMAN SERVICES Food and Drug Administration Draft Documents To Support Submission of an Electronic Common Technical Document; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice... the following draft versions of documents that support making regulatory submissions in electronic...

  5. Air Quality Modeling Technical Support Document for the 2015 Ozone NAAQS Preliminary Interstate Transport Assessment

    Science.gov (United States)

    In this technical support document (TSD) EPA describes the air quality modeling performed to support the 2015 ozone National Ambient Air Quality Standards (NAAQS) preliminary interstate transport assessment Notice of Data Availability (NODA).

  6. 75 FR 11936 - Hewlett Packard; Technical Support Call Center; Boise, ID; Notice of Termination of Investigation

    Science.gov (United States)

    2010-03-12

    ... Employment and Training Administration Hewlett Packard; Technical Support Call Center; Boise, ID; Notice of... was initiated in response to a petition filed on November 16, 2009 on behalf of workers Hewlett Packard, Technical Support Call Center, Boise, Idaho. The petitioner has requested that the petition be...

  7. Loads Providing Ancillary Services: Review of InternationalExperience-- Technical Appendix: Market Descriptions

    Energy Technology Data Exchange (ETDEWEB)

    Grayson Heffner, Charles Goldman, Kintner-Meyer, M; Kirby, Brendan

    2007-05-01

    In this study, we examine the arrangements for andexperiences of end-use loads providing ancillary services (AS) in fiveelectricity markets: Australia, the United Kingdom (UK), the Nordicmarket, and the ERCOT and PJM markets in the United States. Our objectivein undertaking this review of international experience was to identifyspecific approaches or market designs that have enabled customer loads toeffectively deliver various ancillary services (AS) products. We hopethat this report will contribute to the ongoing discussion in the U.S.and elsewhere regarding what institutional and technical developments areneeded to ensure that customer loads can meaningfully participate in allwholesale electricity markets.

  8. Providing over-the-horizon awareness to driver support systems

    NARCIS (Netherlands)

    van Eenennaam, Martijn; Heijenk, Geert

    2008-01-01

    Vehicle-to-vehicle communications is a promising technique for driver support systems to increase traffic safety and efficiency. A proposed system is the Congestion Assistant [1], which aims at supporting drivers when approaching and driving in a traffic jam. Studies have shown great potential for

  9. Non-technical skills of anaesthesia providers in Rwanda: an ethnography.

    Science.gov (United States)

    Livingston, Patricia; Zolpys, Lauren; Mukwesi, Christian; Twagirumugabe, Theogene; Whynot, Sara; MacLeod, Anna

    2014-01-01

    Patient safety depends on excellent practice of anaesthetists' non-technical skills (ANTS). The ANTS framework has been validated in developed countries but there is no literature on the practice of ANTS in low-income countries. This study examines ANTS in this unexplored context. This qualitative ethnographic study used observations of Rwandan anaesthesia providers and in-depth interviews with both North American and Rwandan anaesthesia providers to understand practice of ANTS in Rwanda. Communication is central to the practice of ANTS. Cultural factors in Rwanda, such as lack of assertiveness and discomfort taking leadership, and the strains of working in a resource-limited environment hinder the unfettered and focused communication needed for excellent anaesthesia practice. Despite the challenges, anaesthesia providers are able to coordinate activities when good communication is actively encouraged. Future teaching interventions should address leadership and communication skills through encouraging both role definition and speaking up for patient safety.

  10. Systems engineering and technical assistance in support of digital gallium arsenide insertion projects

    Science.gov (United States)

    Butler, Daniel H.

    1992-04-01

    Booz-Allen provided a high level of support, including systems engineering analyses and technical assistance for systems insertion efforts using digital Gallium Arsenide (GaAs). Once insertion candidates were chosen, Booz-Allen supported the insertion efforts by acting as a liaison between the government and GaAs contractors, attending and arranging contractor reviews, providing meeting facilities, and producing presentation materials. A major accomplishment under this contract was the development of a methodology for appraising the likelihood of a successful technology insertion. This methodology is described in detail. Systems analyses and other work performed according to the terms of the statement of work is described as well. The conclusion discusses accomplishments under this project and of the DARPA digital GaAs insertion program generally.

  11. Providing Co-Curricular Support: A Multi-Case Study of Engineering Student Support Centers

    Science.gov (United States)

    Lee, Walter C., Jr.

    2015-01-01

    In response to the student retention and diversity issues that have been persistent in undergraduate engineering education, many colleges have developed Engineering Student Support Centers (ESSCs) such as Minority Engineering Programs (MEPs) and Women in Engineering Programs (WEPs). ESSCs provide underrepresented students with co-curricular…

  12. Review of Technical Studies in the United States in Support of Burnup Credit Regulatory Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, John C [ORNL; Parks, Cecil V [ORNL; Mueller, Don [ORNL; Gauld, Ian C [ORNL

    2010-01-01

    Taking credit for the reduction in reactivity associated with fuel depletion can enable more cost-effective, higher-density storage, transport, disposal, and reprocessing of spent nuclear fuel (SNF) while maintaining sufficient subcritical margin to establish an adequate safety basis. Consequently, there continues to be considerable interest in the United States (U.S.), as well as internationally, in the increased use of burnup credit in SNF operations, particularly related to storage, transport, and disposal of commercial SNF. This interest has motivated numerous technical studies related to the application of burnup credit, both domestically and internationally, as well as the design of SNF storage, transport and disposal systems that rely on burnup credit for maintaining subcriticality. Responding to industry requests and needs, the U.S. Nuclear Regulatory Commission (NRC) initiated a burnup credit research program in 1999, with support from the Oak Ridge National Laboratory (ORNL), to develop regulatory guidance and the supporting technical bases for allowing and expanding the use of burnup credit in pressurized-water reactor SNF storage and transport applications. Although this NRC research program has not been continuous since its inception, considerable progress has been achieved in many key areas in terms of increased understanding of relevant phenomena and issues, availability of relevant information and data, and subsequently updated regulatory guidance for expanded use of burnup credit. This paper reviews technical studies performed by ORNL for the U.S. NRC burnup credit research program. Examples of topics include reactivity effects associated with reactor operating characteristics, fuel assembly characteristics, burnable absorbers, control rods, spatial burnup distributions, cooling time, and assembly misloading; methods and data for validation of isotopic composition predictions; methods and data for validation of criticality calculations; and

  13. Providing 'auxiliary' academic writing support to postgraduate students

    African Journals Online (AJOL)

    cultural approach to academic writing support which was part of the inception of a broader orientation programme in a newly established Centre for Postgraduate Studies at a research intensive South African university. The role of writing ...

  14. THE SUPPORTING OF EXPLOITATION AND MAINTENANCE MANAGEMENT WITHIN NETWORKED TECHNICAL SYSTEMS

    OpenAIRE

    Dąbrowski, Marcin

    2015-01-01

    Network technical systems are complex systems, which include distribution networks with devices and engineering objects supporting their work. These kind of systems are used for media distribution, such as: drinking water, fuel, gas, heat, etc. One of specific features of this system is large territorial dispersion of technical objects within the system. The exploitation specificity of networked technical systems requires a special approach for implementing maintenance and repair work, taking...

  15. The role of organisational support in teleworker wellbeing: a socio-technical systems approach.

    Science.gov (United States)

    Bentley, T A; Teo, S T T; McLeod, L; Tan, F; Bosua, R; Gloet, M

    2016-01-01

    The prevalence of telework and other forms of mobile working enabled by digital technology is increasing markedly. Following a socio-technical systems approach, this study aims to examine the role of organisational social support and specific support for teleworkers in influencing teleworker wellbeing, the mediating role of social isolation, potentially resulting from a person-environment mismatch in these relationships, and possible differences in these relationships between low-intensity and hybrid teleworkers. Teleworkers' (n = 804) perceptions of support and telework outcomes (psychological strain, job satisfaction, and social isolation) were collected using an on-line survey of teleworking employees distributed within 28 New Zealand organisations where knowledge work was undertaken. Organisational social support and teleworker support was associated with increased job satisfaction and reduced psychological strain. Social isolation mediated the relationship between organisational social support and the two outcome variables, and some differences were observed in the structural relationships for hybrid and low-intensity teleworker sub-samples. These findings suggest that providing the necessary organisational and teleworker support is important for enhancing the teleworker-environment fit and thereby ensuring desirable telework outcomes. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  16. Providing monitoring and evaluation support for CCAA projects

    International Development Research Centre (IDRC) Digital Library (Canada)

    CCAA

    In February 2010, when CCAA's program leader visited a Malawi-based project team focusing on agricultural innovations, researchers explained how helpful they had found the program's training and mentoring in outcome mapping (OM). This support, organized in 2007 and 2008 by CCAA, helped them and their partners ...

  17. Potential for low fracture toughness and lamellar tearing on PWR steam generator and reactor coolant pump supports. Resolution of generic technical activity A-12

    Energy Technology Data Exchange (ETDEWEB)

    Snaider, R.P.; Hodge, J.M.; Levin, H.A.; Zudans, J.J.

    1979-10-01

    This report summarizes work performed by the Nuclear Regulatory Commission staff and its contractor, Sandia Laboratories, in the resolution of Generic Technical Activity A-12, ''Potential for Low Fracture Toughness and Lamellar Tearing in PWR Steam Generator and Reactor Coolant Pump Supports.'' The report describes the technical issues, the technical studies performed by Sandia describes the technical issues, the technical studies performed by Sandia Laboratories, the NRC staff's technical positions based on these studies, and the staff's plan for implementing its technical positions. It also provides recommendations for further work. The complete technical input from Sandia Laboratories is appended to the report.

  18. The experiences of nurses in providing psychosocial support to ...

    African Journals Online (AJOL)

    The study was conducted in the surgical ICUs of two private hospitals and one public hospital in the Durban metropolitan area. Findings. Four main themes emerged from the data: cultural awareness, communication challenges, providing assistance, and lack of training. Conclusion. These findings provide implications for ...

  19. Distance Education Programs: The Technical Support to Be Successful.

    Science.gov (United States)

    McNew, Ryan E; Gordon, Jeffry S; Weiner, Elizabeth E; Trangenstein, Patricia

    2016-01-01

    Academic success requires support on a variety of levels as well as access to contemporary tools and services. Supporting students enrolled in a successful higher education distance learning program, requires a strong, properly trained IT support staff in addition to a stable IT environment. Our distance education program began with a regional market but has grown significantly over the past few years. This is primarily due to the success of our distance education tools and support which have contributed to achieving a ranking of eleventh of best graduate schools in nursing according to the U.S. News and World Report. The entire student population is "Bring Your Own Devices" (BYOD). Critical to this support is the initial configuration and loading of needed software during the first week of orientation. All of this success requires a robust team of members prepared in a range of skill sets from networking to instructional design.

  20. THE SUPPORTING OF EXPLOITATION AND MAINTENANCE MANAGEMENT WITHIN NETWORKED TECHNICAL SYSTEMS

    Directory of Open Access Journals (Sweden)

    Marcin DĄBROWSKI

    2015-04-01

    Full Text Available Network technical systems are complex systems, which include distribution networks with devices and engineering objects supporting their work. These kind of systems are used for media distribution, such as: drinking water, fuel, gas, heat, etc. One of specific features of this system is large territorial dispersion of technical objects within the system. The exploitation specificity of networked technical systems requires a special approach for implementing maintenance and repair work, taking into account the large territorial dispersion of their components and limited access to technical infra-structure. The features pointed above show the difference between networked technical system and the typical industri-al technical objects (e.g. available in manufacturing plants. This difference also requires the use of specific IT tools for maintenance management. This article discusses examples of selected tools in this class.

  1. Instrumentation and Controls Division, Technical Support Department Management Plan, FY 1993--FY 1996

    Energy Technology Data Exchange (ETDEWEB)

    Adkisson, B.P.; Kunselman, C.W.; Effler, R.P.; Miller, D.R.; Millet, A.J.; Stansberry, C.T.

    1993-08-01

    This report describes the organization, key functions, and major activities of the Technical Support Department The Department is the programmatic support element of the Instrumentation and Controls Division. The Department`s primary focus is the support of existing equipment and systems at Oak Ridge National Laboratory that are generally characterized as instrumentation and controls. The support takes the form of repair, calibration, fabrication, field engineering, preventive maintenance, software support, and record keeping.

  2. Engineering Technical Support Center Annual Report Fiscal Year 2016

    Science.gov (United States)

    This report highlights significant projects that the ETSC supported in fiscal year 2016. These projects have addressed an array of environmental scenarios, including, but not limited to remote mining contamination, expansive landfill waste, cumulative impacts from multiple contam...

  3. Private Training Providers: Their Characteristics and Training Activities. Support Document

    Science.gov (United States)

    Harris, Roger; Simons, Michele; McCarthy, Carmel

    2006-01-01

    This document was produced by the authors based on their research for the report, "Private Training Providers: Their Characteristics and Training Activities," [ED495181] and is an added resource for further information. That study examined the nature of the training activity of private registered training organisations (RTOs) offered to…

  4. 75 FR 41522 - Hewlett Packard, Technical Support Call Center, Including On-Site Leased Workers From Manpower...

    Science.gov (United States)

    2010-07-16

    ... Employment and Training Administration Hewlett Packard, Technical Support Call Center, Including On-Site... workers of Hewlett Packard, Technical Support Call Center, including on-site leased workers from Manpower..., Idaho location of Hewlett Packard, Technical Support Call Center. The Department has determined that...

  5. Using Model-Based System Engineering to Provide Artifacts for NASA Project Life-Cycle and Technical Reviews Presentation

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    This is the presentation for the AIAA Space conference in September 2017. It highlights key information from Using Model-Based Systems Engineering to Provide Artifacts for NASA Project Life-cycle and Technical Reviews paper.

  6. Providing of Spatial Wetland Information for Supporting National Development

    Directory of Open Access Journals (Sweden)

    Aris Poniman

    2016-05-01

    Full Text Available The wetland has a strategic role in national development. The potential uses of the wetland are varied such as for agriculture, fisheries, industries, and forestry. The intensive use of the wetland for agricultural development in Sumatera, Kalimantan, Sulawesi, and Papua through transmigration projects has been run since in 1973. Unfortunately, not all the projects were well developed, causing the social, economic, and physical environmental problems. These problems resulted in the negative impact for the life of the transmigration people. For that reason, the community empowerment for the unlucky transmigration people by handling the physical and non physical aspects is very important. This paper will describe the importance of providing spatial data and information biophysical wetland as an initial step in empowering people who live in the wetland resource.

  7. Providing Total Quality Fundamentals: 1995 Workshops for the NASA Lewis Research Center's Technical Services Directorate

    Science.gov (United States)

    Antczak, Paul; Jacinto,Gilda; Simek, Jimmy

    1997-01-01

    The National Aeronautics and Space Administration's (NASA) agency-wide movement to cultivate a quality workplace is the basis for Lewis Research Center to implement Total Quality Fundamentals (TQF) initiatives. The Lewis Technical Services Directorate (TSD) introduced the Total Quality Fundamentals (TQF) workshops to its work force as an opportunity to introduce the concepts and principles of TQF. These workshops also provided the participants with the opportunity to dialogue with fellow TSD employees and managers. This report describes, through the perspective of the Lewis TSD TQF Coaches, how the TQF work- shop process was accomplished in TSD. It describes the structure for addressing the need, implementation process, input the TSD Coaches provided, common themes and concerns raised, conclusions, and recommendations. The Coaches concluded that these types of workshops could be the key to open the communication channels that are necessary to help everyone at Lewis understand where they fit in the organization. TQF workshops can strengthen the participant's connection with the Mission, Vision of the Center, and Vision of the Agency. Reconunendations are given based on these conclusions that can help the TSD Quality Board develop attainable measures towards a quality workplace.

  8. Technical and mapping support for marine spatial planning: Final report

    OpenAIRE

    Menza , Charles; Battista, Tim; Dorfman, Dan

    2013-01-01

    Washington depends on a healthy coastal and marine ecosystem to maintain a thriving economy and vibrant communities. These ecosystems support critical habitats for wildlife and a growing number of often competing ocean activities, such as fishing, transportation, aquaculture, recreation, and energy production. Planners, policy makers and resource managers are being challenged to sustainably balance ocean uses, and environmental conservation in a finite space and with limited information. This...

  9. 78 FR 52776 - Documents to Support Submission of an Electronic Common Technical Document; Availability

    Science.gov (United States)

    2013-08-26

    ... HUMAN SERVICES Food and Drug Administration Documents to Support Submission of an Electronic Common Technical Document; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The... final versions of the following four documents that support making regulatory submissions in electronic...

  10. Technical Support Document: Development of the Advanced Energy Design Guide for Large Hospitals - 50% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, E.; Leach, M.; Pless, S.

    2013-06-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Large Hospitals: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-LH) ASHRAE et al. (2011b). The AEDG-LH is intended to provide recommendations for achieving 50% whole-building energy savings in large hospitals over levels achieved by following Standard 90.1-2004. The AEDG-LH was created for a 'standard' mid- to large-size hospital, typically at least 100,000 ft2, but the strategies apply to all sizes and classifications of new construction hospital buildings. Its primary focus is new construction, but recommendations may be applicable to facilities undergoing total renovation, and in part to many other hospital renovation, addition, remodeling, and modernization projects (including changes to one or more systems in existing buildings).

  11. Technical Support Document: The Development of the Advanced Energy Design Guide for Highway Lodging Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Wei; Jarnagin, Ronald E.; Gowri, Krishnan; McBride, M.; Liu, Bing

    2008-09-30

    This Technical Support Document (TSD) describes the process and methodology for development of the Advanced Energy Design Guide for Highway Lodgings (AEDG-HL or the Guide), a design guidance document intended to provide recommendations for achieving 30% energy savings in highway lodging properties over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The AEDG-HL is the fifth in a series of guides being developed by a partnership of organizations, including the American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IESNA), the United States Green Buildings Council (USGBC), and the U.S. Department of Energy (DOE).

  12. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 23. Environmental effluent analyses

    Energy Technology Data Exchange (ETDEWEB)

    1978-04-01

    This volume, Y/OWI/TM-36/23, ''Environmental Effluent Analysis,'' is one of a 23-volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-36, which supplements the ''Contribution to Drat Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-44. The series provides a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling, no recycling of spent fuel and uranium-only recycling. This volume discusses the releases to the environment of radioactive and non-radioactive materials that arise during facility construction and waste handling operations, as well as releases that could occur in the event of an operational accident. The results of the analyses are presented along with a detailed description of the analytical methodologies employed.

  13. TECHNICAL NOTE: Observations on the use of a viscoelastic joint to provide noise reduced sonar domes

    Science.gov (United States)

    House, J. R.

    1997-10-01

    This paper concerns the noise and vibration advantages of an energy absorbing composite joint and its relevance to noise reduced glass reinforced polyester (GRP) sonar domes. Once installed on an operational boat, hydrodynamic flow and supporting structural induced vibrations cause the dome to vibrate, thus radiating noise and interfering with sonar sensor response. The results of a vibration transmissibility study on a GRP - steel interface are discussed as the first step in designing a composite viscoelastic joint that can act as a vibration sink to absorb flow generated and structure borne noise within GRP sonar domes. Preliminary investigations concerning the absorption of compressional waves by use of a tapered viscoelastic interlayer are discussed. It is shown that a tapered viscoelastic interlayer placed between a GRP beam and steel supporting substrate can produce a significant absorption of vibrational energy, reducing water borne radiated noise and providing a significantly quieter noise platform than conventional sonar jointing technology.

  14. 13 CFR 120.714 - How are grants made to non-lending technical assistance providers (NTAP)?

    Science.gov (United States)

    2010-01-01

    ... entity that is not an Intermediary may apply to SBA for a grant to provide marketing, management and... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false How are grants made to non-lending technical assistance providers (NTAP)? 120.714 Section 120.714 Business Credit and Assistance SMALL BUSINESS...

  15. A new hat for librarians: providing REDCap support to establish the library as a central data hub.

    Science.gov (United States)

    Read, Kevin; LaPolla, Fred Willie Zametkin

    2018-01-01

    REDCap, an electronic data capture tool, supports good research data management, but many researchers lack familiarity with the tool. While a REDCap administrator provided technical support and a clinical data management support unit provided study design support, a service gap existed. Librarians with REDCap expertise sought to increase and improve usage through outreach, workshops, and consultations. In collaboration with a REDCap administrator and the director of the clinical data management support unit, the role of the library was established in providing REDCap training and consultations. REDCap trainings were offered to the medical center during the library's quarterly data series, which served as a springboard for offering tailored REDCap support to researchers and research groups. Providing REDCap support has proved to be an effective way to associate the library with data-related activities in an academic medical center and identify new opportunities for offering data services in the library. By offering REDCap services, the library established strong partnerships with the Information Technology Department, Clinical Data Support Department, and Compliance Office by filling in training gaps, while simultaneously referring users back to these departments when additional expertise was required. These new partnerships continue to grow and serve to position the library as a central data hub in the institution.

  16. A mixed methods analysis of support for self-management behaviors: Perspectives of people with epilepsy and their support providers

    OpenAIRE

    Walker, Elizabeth Reisinger; Engelhard, George; Barmon, Christina; McGee, Robin E.; Sterk, Claire E.; DiIorio, Colleen; Thompson, Nancy

    2014-01-01

    Social support is associated with improved self-management for people with chronic conditions, such as epilepsy; however, little is known about the perceived ease or difficulty of receiving and providing support for epilepsy self-management. We examined patterns of epilepsy self-management support from the perspectives of both people with epilepsy and their support persons. Fifty-three people with epilepsy and 48 support persons completed a survey on epilepsy self-management support. Of these...

  17. Technical analysis support for Transportation Energy Conservation Division of DOE. Tenth progress report for May 1979

    Energy Technology Data Exchange (ETDEWEB)

    1979-06-10

    The work to be performed by the Aerospace Corporation for the DOE/TEC is confined to the following basic task areas: (1) technical support of ongoing research and development programs in energy efficient transportation systems; (2) analysis for the future commercialization of transportation technologies; (3) new concept evaluation program support; (4) technical evaluation of new concepts, inventions, and ideas; (5) assessment of technological and other factors on the implementation and utilization of transportation in the United States; and (6) program planning analysis and documentation. The status of achieved progress through the period ending May 31, 1979 is presented; and the expenditure status is summarized. (WHK)

  18. 47 CFR 54.625 - Support for services beyond the maximum supported distance for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Support for services beyond the maximum supported distance for rural health care providers. 54.625 Section 54.625 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.625...

  19. Supportive accountability: a model for providing human support to enhance adherence to eHealth interventions.

    Science.gov (United States)

    Mohr, David C; Cuijpers, Pim; Lehman, Kenneth

    2011-03-10

    The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.

  20. The Relationship between Return on Profitability and Costs of Outsourcing Information Technology Technical Support

    Science.gov (United States)

    Odion, Segun

    2011-01-01

    The purpose of this quantitative correlational research study was to examine the relationship between costs of operation and total return on profitability of outsourcing information technology technical support in a two-year period of outsourcing operations. United States of America list of Fortune 1000 companies' chief information officers…

  1. Subsurface Contaminants Focus Area (SCFA) Lead Laboratory Providing Technical Assistance to the DOE Weapons Complex in Subsurface Contamination

    Energy Technology Data Exchange (ETDEWEB)

    Wright, J. A. Jr.; Corey, J. C.

    2002-02-27

    The Subsurface Contaminants Focus Area (SCFA), a DOE-HQ EM-50 organization, is hosted and managed at the Savannah River Site in Aiken, South Carolina. SCFA is an integrated program chartered to find technology and scientific solutions to address DOE subsurface environmental restoration problems throughout the DOE Weapons Complex. Since its inception in 1989, the SCFA program has resulted in a total of 269 deployments of 83 innovative technologies. Until recently, the primary thrust of the program has been to develop, demonstrate, and deploy those remediation technology alternatives that are solutions to technology needs identified by the DOE Sites. Over the last several years, the DOE Sites began to express a need not only for innovative technologies, but also for technical assistance. In response to this need, DOE-HQ EM-50, in collaboration with and in support of a Strategic Lab Council recommendation directed each of its Focus Areas to implement a Lead Laboratory Concept to enhance their technical capabilities. Because each Focus Area is unique as defined by the contrast in either the type of contaminants involved or the environments in which they are found, the Focus Areas were given latitude in how they set up and implemented the Lead Lab Concept. The configuration of choice for the SCFA was a Lead-Partner Lab arrangement. Savannah River Technology Center (SRTC) teamed with the SCFA as the Focus Area's Lead Laboratory. SRTC then partnered with the DOE National Laboratories to create a virtual consulting function within DOE. The National Laboratories were established to help solve the Nation's most difficult problems, drawing from a resource pool of the most talented and gifted scientists and engineers. Following that logic, SRTC, through the Lead-Partner Lab arrangement, has that same resource base to draw from to provide assistance to any SCFA DOE customer throughout the Complex. This paper briefly describes how this particular arrangement is

  2. 34 CFR 86.302 - What are the procedures used by the Secretary for providing information or technical assistance?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What are the procedures used by the Secretary for providing information or technical assistance? 86.302 Section 86.302 Education Office of the Secretary, Department of Education DRUG AND ALCOHOL ABUSE PREVENTION Responses and Sanctions Issued or Imposed by the...

  3. Health organizations providing and seeking social support: a Twitter-based content analysis.

    Science.gov (United States)

    Rui, Jian Raymond; Chen, Yixin; Damiano, Amanda

    2013-09-01

    Providing and seeking social support are important aspects of social exchange. New communication technologies, especially social network sites (SNSs), facilitate the process of support exchange. An increasing number of health organizations are using SNSs. However, how they provide and seek social support via SNSs has yet to garner academic attention. This study examined the types of social support provided and sought by health organizations on Twitter. A content analysis was conducted on 1,500 tweets sent by a random sample of 58 health organizations within 2 months. Findings indicate that providing informational and emotional support, as well as seeking instrumental support, were the main types of social support exchanged by health organizations through Twitter. This study provides a typology for studying social support exchanges by health organizations, and recommends strategies for health organizations regarding the effective use of Twitter.

  4. A mixed methods analysis of support for self-management behaviors: perspectives of people with epilepsy and their support providers.

    Science.gov (United States)

    Walker, Elizabeth Reisinger; Engelhard, George; Barmon, Christina; McGee, Robin E; Sterk, Claire E; Diiorio, Colleen; Thompson, Nancy J

    2014-02-01

    Social support is associated with improved self-management for people with chronic conditions, such as epilepsy; however, little is known about the perceived ease or difficulty of receiving and providing support for epilepsy self-management. We examined patterns of epilepsy self-management support from the perspectives of both people with epilepsy and their support persons. Fifty-three people with epilepsy and 48 support persons completed a survey on epilepsy self-management support. Of these individuals, 22 people with epilepsy and 16 support persons completed an in-depth interview. Rasch measurement models were used to evaluate the degree of difficulty of receiving or providing support often for nine self-management tasks. We analyzed model-data fit, person and item location along the support latent variable and differential person and item functioning. Qualitative methods were used to provide context and insight into the quantitative results. The results demonstrated good model-data fit. Help with seizures was the easiest type of support to receive or provide more often, followed by rides to a doctor's appointments and help avoiding seizure triggers. The most difficult types of support to receive or provide more often were reminders, particularly for taking and refilling medications. While most participants' responses fit the model, responses of several individuals misfit the model. Person misfit generally occurred because the scale items did not adequately capture some individuals' behaviors. These results could be useful in designing interventions that use support as a means of improving self-management. Additionally, the results provide information to improve or expand current measures of support for epilepsy self-management to better assess the experiences of people with epilepsy and their support persons. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Can branding by health care provider organizations drive the delivery of higher technical and service quality?

    Science.gov (United States)

    Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric

    2009-01-01

    Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

  6. Rationales for Support That African American Grandmothers Provide to Their Children Who Are Parenting Adolescents

    Science.gov (United States)

    Sumo, Jen'nea; Dancy, Barbara; Julion, Wrenetha; Wilbur, JoEllen

    2015-01-01

    African American grandmothers are known to be a major source of support for their children who are parenting adolescents, but little is known about why they provide support. The purpose of this study was to describe the kinds of support provided by African American maternal and paternal grandmothers to their parenting adolescents and the reasons…

  7. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Limitations on supported services for rural health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported...

  8. Air Quality Modeling Technical Support Document for the 2008 Ozone NAAQS Cross-State Air Pollution Rule Proposal

    Science.gov (United States)

    In this technical support document (TSD) we describe the air quality modeling performed to support the proposed Cross-State Air Pollution Rule for the 2008 ozone National Ambient Air Quality Standards (NAAQS)

  9. Support provider's appraisal detection bias and the efficacy of received support in medical students preparing for an exam.

    Science.gov (United States)

    Knoll, Nina; Schulz, Ute; Schwarzer, Ralf; Rosemeier, Hans Peter

    2006-09-01

    Matching social support to the recipient's needs requires diagnostic sensitivity on the part of the provider. In particular, support needs to be responsive to the recipient's stress-related appraisals to be maximally effective. To assess the impact of bias in interpersonal stress assessment, medical students in 43 dyads reported on their own and each other's stress appraisals, social support, affect and performance during a 5-day preparation period culminating in a multiple choice examination. Less biased perceptions of loss appraisals by support providers within dyads were followed by support transactions associated with lower negative affect and better exam performance among recipients. More biased perceptions of threat appraisals were followed by increases in the recipients' negative affect. Results therefore suggest that support is more effective when the provider understands the recipient's concerns.

  10. The effects of customers' mobile experience and technical support on the intention to use mobile banking.

    Science.gov (United States)

    Chung, Namho; Kwon, Soon Jae

    2009-10-01

    While mobile banking has become an integral part of banking activities, it has also caused systems-related stress and consequent distrust among mobile banking users. This study looks into the phenomenon of technology adoption for mobile banking users and identifies potential factors that nurture positive intentions toward mobile banking usage. It examines the effects of a customer's mobile experience and technical support on mobile banking acceptance and explains how some variables affect this intention. After a literature review, the method of empirical analysis using a structured questionnaire is developed. Hierarchical Moderated Regression Analyses (HMRA) is used to examine the model. We find that mobile experience and technical support tend to strengthen the relationship between technological characteristics and a customer's intention to use the mobile technology.

  11. Human System Simulation in Support of Human Performance Technical Basis at NPPs

    Energy Technology Data Exchange (ETDEWEB)

    David Gertman; Katya Le Blanc; alan mecham; william phoenix; Magdy Tawfik; Jeffrey Joe

    2010-06-01

    This paper focuses on strategies and progress toward establishing the Idaho National Laboratory’s (INL’s) Human Systems Simulator Laboratory at the Center for Advanced Energy Studies (CAES), a consortium of Idaho State Universities. The INL is one of the National Laboratories of the US Department of Energy. One of the first planned applications for the Human Systems Simulator Laboratory is implementation of a dynamic nuclear power plant simulation (NPP) where studies of operator workload, situation awareness, performance and preference will be carried out in simulated control rooms including nuclear power plant control rooms. Simulation offers a means by which to review operational concepts, improve design practices and provide a technical basis for licensing decisions. In preparation for the next generation power plant and current government and industry efforts in support of light water reactor sustainability, human operators will be attached to a suite of physiological measurement instruments and, in combination with traditional Human Factors Measurement techniques, carry out control room tasks in simulated advanced digital and hybrid analog/digital control rooms. The current focus of the Human Systems Simulator Laboratory is building core competence in quantitative and qualitative measurements of situation awareness and workload. Of particular interest is whether introduction of digital systems including automated procedures has the potential to reduce workload and enhance safety while improving situation awareness or whether workload is merely shifted and situation awareness is modified in yet to be determined ways. Data analysis is carried out by engineers and scientists and includes measures of the physical and neurological correlates of human performance. The current approach supports a user-centered design philosophy (see ISO 13407 “Human Centered Design Process for Interactive Systems, 1999) wherein the context for task performance along with the

  12. Material Not Categorized As Waste (MNCAW) data report. Radioactive Waste Technical Support Program

    Energy Technology Data Exchange (ETDEWEB)

    Casey, C.; Heath, B.A.

    1992-11-01

    The Department of Energy (DOE), Headquarters, requested all DOE sites storing valuable materials to complete a questionnaire about each material that, if discarded, could be liable to regulation. The Radioactive Waste Technical Support Program entered completed questionnaires into a database and analyzed them for quantities and type of materials stored. This report discusses the data that TSP gathered. The report also discusses problems revealed by the questionnaires and future uses of the data. Appendices contain selected data about material reported.

  13. Some administrative features for maintaining the material and technical base of medical centers providing transplant care to Russian citizens

    Directory of Open Access Journals (Sweden)

    I. I. Antoshina

    2017-01-01

    Full Text Available In this article, the authors defined the procedure for maintaining the material and technical base of medical centers providing high-tech assistance (especially, transplant care to Russian citizens. The current regulatory and methodological base determining the procedure for repairs of fixed assets is evaluated, the main issues of capital repair planning in budgetary medical centers providing high-tech medical care are considered. The innovations introduced at the present time into the legislation determining the procedure for capital repairs are defined; the applicable concepts and scope of regulation are disclosed; the procedure for the implementation of major repairs in accordance with the current regulations is considered; the key issues that make it difficult to start capital repairs of the premises in budgetary medical centers providing high-tech medical care to Russian citizens are identified. Administrative and financial discipline while ensuring the working conditions of the material and technical base has been strengthened. Considerable attention should be paid to the medium-term planning of works, preparation of technical documentation, and procurement of funds for preparatory works. Whereas it is necessary to coordinate such decisions with the Ministry of Healthcare of Russia and other governmental institutions in Russia the timing of the implementation of such projects has significantly increased.

  14. Critical Analysis of the Quality, Readability, and Technical Aspects of Online Information Provided for Neck-Lifts.

    Science.gov (United States)

    Rayess, Hani; Zuliani, Giancarlo F; Gupta, Amar; Svider, Peter F; Folbe, Adam J; Eloy, Jean Anderson; Carron, Michael A

    2017-03-01

    The number of patients using the internet to obtain health information is growing. This material is unregulated and heterogeneous and can influence patient decisions. To compare the quality, readability, and technical aspects of online information about neck-lifts provided by private practice websites vs academic medical centers and reference sources. In this cross-sectional analysis conducted between November 2015 and January 2016, a Google search of the term neck-lift was performed, and the first 45 websites were evaluated. The websites were categorized as private practice vs other. Private websites (PWs) included sites created by private practice physicians. Other websites (OWs) were created by academic medical centers or reference sources. Quality, readability, and technical aspects of online websites related to neck-lifts. Quality was assessed using the DISCERN criteria and the Health on the Net principles (HONcode). Readability was assessed using 7 validated and widely used criteria. Consensus US reading grade level readability was provided by a website (readabilityformulas.com). Twelve technical aspects were evaluated based on criteria specified by medical website creators. Forty-five websites (8 OWs [18%] and 37 PWs [82%]) were analyzed. There was a significant difference in quality between OWs and PWs based on the DISCERN criteria and HONcode principles. The DISCERN overall mean (SD) scores were 2.3 (0.5) for OWs and 1.3 (0.3) for PWs (P analysis, the mean (SD) was 8.6 (1.8) (range, 5-11) for OW, and the mean (SD) was 5.8 (1.7) (range, 2-9) for PW. The mean (SD) readability consensus reading grade level scores were 11.7 (1.9) for OWs and 10.6 (1.9) for PWs. Of a total possible score of 12, the mean (SD) technical scores were 6.3 (1.8) (range, 4-9) for OWs and 6.4 (1.5) (range, 3-9) for PWs. Compared with PWs, OWs had a significantly higher quality score based on both the DISCERN criteria and HONcode principles. The mean readability for OWs and PWs was

  15. Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: Utility, technical performance and service provider perspective

    Directory of Open Access Journals (Sweden)

    Breen Patricia

    2010-09-01

    Full Text Available Abstract Background Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions. Methods A teleneurophysiology service providing routine EEG investigation was established. Service use, technical performance and satisfaction of clinical neurophysiology personnel were assessed qualitatively and quantitatively. These were contrasted with a previously reported analysis of the need for teleneurophysiology, and examination of expectation and satisfaction with clinical neurophysiology services in Ireland. A preliminary cost-benefit analysis was also conducted. Results Over the course of 40 clinical sessions during 20 weeks, 142 EEG investigations were recorded and stored on a file server at a satellite centre which was 130 miles away from the host clinical neurophysiology department. Using a virtual private network, the EEGs were accessed by a consultant neurophysiologist at the host centre for interpretation. The model resulted in a 5-fold increase in access to EEG services as well as reducing average waiting times for investigation by a half. Technically the model worked well, although a temporary loss of virtual private network connectivity highlighted the need for clarity in terms of responsibility for troubleshooting and repair of equipment problems. Referral quality, communication between host and satellite centres, quality of EEG recordings, and ease of EEG review and reporting indicated that appropriate organisational processes were adopted by the service. Compared to traditional CN service delivery, the teleneurophysiology model resulted in a comparable unit cost per EEG. Conclusion Observations suggest that when traditional organisational boundaries are crossed challenges associated with the

  16. Technical Support Document: Development of the Advanced Energy Design Guide for K-12 Schools--30% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Pless, S.; Torcellini, P.; Long, N.

    2007-09-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for K-12 School Buildings (K-12 AEDG), a design guidance document intended to provide recommendations for achieving 30% energy savings in K-12 Schools over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The 30% energy savings target is the first step toward achieving net-zero energy schools; schools that, on an annual basis, draw from outside sources less or equal energy than they generate on site from renewable energy sources.

  17. Parents and Peers as Providers of Support in Adolescents' Social Network: A Developmental Perspective

    Science.gov (United States)

    del Valle, Jorge F.; Bravo, Amaia; Lopez, Monica

    2010-01-01

    The authors carried out an assessment of social support networks with a sample of 884 Spanish adolescents aged 12 to 17. The main goal was to analyze the development of the figures of parents and peers as providers of social support in the two basic dimensions of emotional and instrumental support. In peers, they distinguished between the contexts…

  18. Beliefs about the empirical support of drug abuse treatment interventions: a survey of outpatient treatment providers.

    Science.gov (United States)

    Benishek, Lois A; Kirby, Kimberly C; Dugosh, Karen Leggett; Padovano, Alicia

    2010-03-01

    This study assessed substance abuse treatment providers' beliefs about empirically supported treatments (ESTs) to determine if providing information about empirical support for interventions would change beliefs. Treatment providers (N=136) completed an interview regarding five interventions with varied empirical support: contingency management (CM), motivational interviewing (MI), relapse prevention (RP), 12-step approaches (TSA), and verbal confrontation (VC). Participants then read primers describing empirical support for each intervention prior to completing a repeat interview. Overall, providers reported positive beliefs about ESTs. Baseline beliefs about empirical support for each intervention were inflated relative to that of expert raters except for CM. After reading the primers, beliefs about efficacy changed in the direction of the experts for all interventions except MI, but continued to be inflated except for CM. Willingness to utilize interventions increased for RP, MI, and CM and decreased for TSA and VC, but remained higher than warranted by empirical support. Copyright 2009. Published by Elsevier Ireland Ltd.

  19. Using Variables in School Mathematics: Do School Mathematics Curricula Provide Support for Teachers?

    Science.gov (United States)

    Dogbey, James

    2016-01-01

    This study employed content analysis to examine 3 popular middle-grades mathematics curricula in the USA on the support they provide for teachers to implement concepts associated with variables in school mathematics. The results indicate that each of the 3 curricula provides some type of support for teachers, but in a varied amount and quality.…

  20. (Too) Anxious to help? Social support provider anxiety and cardiovascular function.

    Science.gov (United States)

    Kent de Grey, Robert G; Uchino, Bert N; Smith, Timothy W; Baucom, Brian R W

    2018-01-01

    Provider factors, such as anxiety, may be important in understanding effects of received social support (SS), which are less consistently positive than those of perceived SS. Due to the dyadic nature of support, anxiety on the part of the provider was predicted to influence the effectiveness of received SS. This laboratory study examined effects of SS provider anxiety within unacquainted dyads on cardiovascular reactivity during acute stress. 148 participants were assigned to support roles, and each dyad was randomized to low or high provider anxiety. Results include that SS provider anxiety resulted in greater blood pressure reactivity and less recovery toward baseline diastolic blood pressure within the dyad. Overall, it appears provider anxiety contributes to less effective SS for recipients and that health costs may accompany providing and receiving support under nonoptimal conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. The effect of environmental factors on technical and scale efficiency of primary health care providers in Greece

    Directory of Open Access Journals (Sweden)

    Aletras Vassilis H

    2007-11-01

    Full Text Available Abstract Background The purpose of this study was to compare technical and scale efficiency of primary care centers from the two largest Greek providers, the National Health System (NHS and the Social Security Foundation (IKA and to determine if, and how, efficiency is affected by various exogenous factors such as catchment population and location. Methods The sample comprised of 194 units (103 NHS and 91 IKA. Efficiency was measured with Data Envelopment Analysis (DEA using three inputs, -medical staff, nursing/paramedical staff, administrative/other staff- and two outputs, which were the aggregated numbers of scheduled/emergency patient visits and imaging/laboratory diagnostic tests. Facilities were categorized as small, medium and large (30,000 respectively to reflect catchment population and as urban/semi-urban or remote/island to reflect location. In a second stage analysis, technical and scale efficiency scores were regressed against facility type (NHS or IKA, size and location using multivariate Tobit regression. Results Regarding technical efficiency, IKA performed better than the NHS (84.9% vs. 70.1%, Mann-Whitney P P P = 0.103. As for scale efficiency, IKA again outperformed the NHS (89.7% vs. 85.9%, Mann-Whitney P = 0.080, but results were reversed in respect to facility size and location. Specifically, larger units performed better (96.3% vs. 90.9% vs. 75.9%, Kruskal-Wallis P P Conclusion Variations appeared to exist in the productive performance of the NHS and IKA as the two main primary care providers in Greece. These variations reflect differences in primary care organization, economical incentives, financial constraints, sociodemographic and local peculiarities. In all technical efficiency comparisons, IKA facilities appeared to outperform NHS ones irrespective of facility size or location. In respect to scale efficiency, the results were to some extent inconclusive and observed differences were mostly insignificant, although

  2. 78 FR 27963 - Reliability Technical Conference; Notice of Technical Conference

    Science.gov (United States)

    2013-05-13

    ... Energy Regulatory Commission Reliability Technical Conference; Notice of Technical Conference Take notice that the Federal Energy Regulatory Commission will hold a Technical Conference on Tuesday, July 9, 2013... to the webcast. The Capitol Connection provides technical support for webcasts and offers the option...

  3. Integration of Photovoltaics in Buildings—Support Policies Addressing Technical and Formal Aspects

    Directory of Open Access Journals (Sweden)

    Thorsten Schuetze

    2013-06-01

    Full Text Available The integration of photovoltaic (PV generators in the envelope of a building by means of building-integrated photovoltaics (BIPV offers an immense potential, both in market development and the production of renewable electric energy that is close to the point of electricity consumption. In Germany, for example, by integrating photovoltaics in buildings up to 50% of the electricity demand can be covered. The political support of BIPV would contribute to the development and installation of BIPV components and therefore also promote the development of new business areas for industries dealing with components used in building envelopes and photovoltaic generators. BIPV can be separated into three different integration types: “technical”, “formal” and “technical & formal”. Political instruments for the support of PV-installations, particularly BIPV are discussed in this paper using Germany and France as examples. Due to successful financial support policies, PV became the most powerful electricity production technology in Germany. In France, the unique financial support of BIPV is resulting in an exemplary development and growth of certified BIPV components available on the market and, from a technical, aesthetic architectural and legal certainty point of view, facilitating the easy and widespread integration of photovoltaic generators in buildings.

  4. Providing support to nursing students in the clinical environment: a nursing standard requirement.

    Science.gov (United States)

    Anderson, Carina; Moxham, Lorna; Broadbent, Marc

    2016-10-01

    This discussion paper poses the question 'What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?'. Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners. Contributing factors that enable and deter Registered Nurses from fulfilling this expectation to support nursing students in their clinical learning include; workloads, preparedness for the teaching role, confidence in teaching and awareness of the competency requirement to support students. Factors exist which can enable or deter Registered Nurses from carrying out the licence requirement to provide clinical education and support to nursing students.

  5. Organizational Structures and Processes to Support and Sustain Effective Technical Assistance in a State-Wide Multi-Tiered System of Support Initiative

    Science.gov (United States)

    Morrison, Julie Q.; Russell, Christine; Dyer, Stephanie; Metcalf, Terri; Rahschulte, Rebecca L.

    2014-01-01

    Despite the national proliferation of technical assistance as a driver for school reform and as a model for embedded and sustained professional development, very little is known about the organizational structures and processes needed to support technical assistance. The purpose of this paper is to describe a structured needs assessment process…

  6. Collaborative learning: A next step in the training of peer support providers.

    Science.gov (United States)

    Cronise, Rita

    2016-09-01

    This column explores how peer support provider training is enhanced through collaborative learning. Collaborative learning is an approach that draws upon the "real life" experiences of individual learners and encompasses opportunities to explore varying perspectives and collectively construct solutions that enrich the practice of all participants. This description draws upon published articles and examples of collaborative learning in training and communities of practice of peer support providers. Similar to person-centered practices that enhance the recovery experience of individuals receiving services, collaborative learning enhances the experience of peer support providers as they explore relevant "real world" issues, offer unique contributions, and work together toward improving practice. Three examples of collaborative learning approaches are provided that have resulted in successful collaborative learning opportunities for peer support providers. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 8. Repository preconceptual design studies: salt

    Energy Technology Data Exchange (ETDEWEB)

    1978-04-01

    This volume, Volume 8 ''Repository Preconceptual Design Studies: Salt,'' is one of a 23-volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-36, which supplements the ''Contribution to Draft Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-44. The series provides a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling, no recycling of spent fuel and uranium-only recycling. This document describes a preconceptual design for a nuclear waste storage facility in salt. The facility design consists of several chambers excavated deep within a geologic formation together with access shafts and supportive surface structures. The facility design provides for: receiving and unloading waste containers; lowering them down shafts to the mine level; transporting them to the proper storage area, and emplacing them in mined storage rooms. Drawings of the facility design are contained in TM-36/9, ''Drawings for Repository Preconceptual Design Studies: Salt.''

  8. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 10. Repository preconceptual design studies: granite

    Energy Technology Data Exchange (ETDEWEB)

    1978-04-01

    This volume, Volume 10 ''Repository Preconceptual Design Studies: Granite,'' is one of a 23-volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-36, which supplements the ''Contribution to Draft Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-44. The series provides a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling, no recycling of spent fuel and uranium-only recycling. This document describes a preconceptual design for a nuclear waste storage facility in granite. The facility design consists of several chambers excavated deep within a geologic formation together with access shafts and supportive surface structures. The facility design provides for: receiving and unloading waste containers; lowering them down shafts to the mine level; transporting them to the proper storage area, and emplacing them in mined storage rooms. Drawings of the facility design are contained in TM-36/11, ''Drawings for Repository Preconceptual Design Studies: Granite.''

  9. Effects of Demographic Characteristics, Educational Background, and Supporting Factors on ICT Readiness of Technical and Vocational Teachers in Malaysia

    Science.gov (United States)

    Alazzam, Abu-Obaideh; Bakar, Ab Rahim; Hamzah, Ramlah; Asimiran, S.

    2012-01-01

    The aim of this study was to examine ICT readiness and the effects of demographic characteristics, educational background, and support factors on the ICT readiness of technical and vocational teachers in Malaysia. The questionnaire was administered to 329 technical and vocational teachers who are teaching engineering subjects in Malaysian…

  10. 78 FR 22554 - Document to Support Submission of an Electronic Common Technical Document-Specifications for File...

    Science.gov (United States)

    2013-04-16

    ... HUMAN SERVICES Food and Drug Administration Document to Support Submission of an Electronic Common Technical Document--Specifications for File Format Types Using Electronic Common Technical Document Specifications; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...

  11. ANL Technical Support Program for DOE Environmental Restoration and Waste Management. Annual report, October 1990--September 1991

    Energy Technology Data Exchange (ETDEWEB)

    Bates, J.K.; Bradley, C.R.; Buck, E.C.; Cunnane, J.C.; Dietz, N.L.; Ebert, W.L.; Emery, J.W.; Feng, X.; Gerding, T.J.; Gong, M.; Hoh, J.C.; Mazer, J.J.; Wronkiewicz, D.J. [Argonne National Lab., IL (United States); Bourcier, W.L.; Morgan, L.E.; Nielsen, J.K.; Steward, S.A. [Lawrence Livermore National Lab., CA (United States); Ewing, R.C.; Wang, L.M. [New Mexico Univ., Albuquerque, NM (United States); Han, W.T.; Tomozawa, M. [Rensselaer Polytechnic Inst., Troy, MI (United States)

    1992-03-01

    This report provides an overview of progress during FY 1991 for the Technical Support Program that is part of the ANL Technology Support Activity for DOE, Environmental Restoration and Waste Management (EM). The purpose is to evaluate, before hot start-up of the Defenses Waste Processing Facility (DWPF) and the West Valley Demonstration Project (WVDP), factors that are likely to affect glass reaction in an unsaturated environment typical of what may be expected for the candidate Yucca Mountain repository site. Specific goals for the testing program include the following: (1) to review and evaluate available information on parameters that will be important in establishing the long-term performance of glass in a repository environment; (2) to perform testing to further quantify the effects of important variables where there are deficiencies in the available data; and (3) to initiate long-term testing that will bound glass performance under a range of conditions applicable to repository disposal.

  12. Modification of the BioMedicus centrifugal pump to provide continuous irrigation for neuroendoscopy: technical note.

    Science.gov (United States)

    Koueik, Joyce; Rocque, Brandon G; Henry, Jordan; Bragg, Taryn; Paul, Jennifer; Iskandar, Bermans J

    2018-02-01

    Continuous irrigation is an important adjunct for successful intraventricular endoscopy, particularly for complex cases. It allows better visualization by washing out blood and debris, improves navigation by expanding the ventricles, and assists with tissue dissection. A method of irrigation delivery using a centrifugal pump designed originally for cardiac surgery is presented. The BioMedicus centrifugal pump has the desirable ability to deliver a continuous laminar flow of fluid that excludes air from the system. A series of modifications to the pump tubing was performed to adapt it to neuroendoscopy. Equipment testing determined flow and pressure responses at various settings and simulated clinical conditions. The pump was then studied clinically in 11 endoscopy cases and eventually used in 310 surgical cases. Modifications of the pump tubing allowed for integration with different endoscopy systems. Constant flow rates were achieved with and without surgical instruments through the working ports. Optimal flow rates ranged between 30 and 100 ml/min depending on endoscope size. Intraoperative use was well tolerated with no permanent morbidity and showed consistent flow rates, minimal air accumulation, and seamless irrigation bag replacement during prolonged surgery. Although the pump is equipped with an internal safety mechanism to protect against pressure buildup when outflow obstructions occur, equipment testing revealed that flow cessation is not instantaneous enough to protect against sudden intracranial pressure elevation. A commonly available cardiac pump system was modified to provide continuous irrigation for intraventricular endoscopy. The system alleviates the problems of inconsistent flow rates, air in the irrigation lines, and delays in changing irrigation bags, thereby optimizing patient safety and surgical efficiency. Safe use of the pump requires good ventricular outflow and, clearly, sound surgical judgment.

  13. Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers

    NARCIS (Netherlands)

    Fransen, Mirjam P.; Beune, Erik J. A. J.; Baim-Lance, Abigail M.; Bruessing, Raynold C.; Essink-Bot, Marie-Louise

    2015-01-01

    The aim of the present study was to explore perceptions and strategies of health care providers regarding diabetes self-management support for patients with low health literacy (LHL), and to compare their self-management support with the needs of patients with LHL and type 2 diabetes. This study

  14. Maintaining Long-Distance Friendships: Communication Practices for Seeking and Providing Social Support across Geographic Divides

    Science.gov (United States)

    Lobburi, Patipan

    2012-01-01

    People seek and provide support through their personal social network, especially when they must cope with stress, deal with an emergency, or need help. Coping with a new culture or new environment is a stressful situation that sojourner students must face. Support through friendship plays an important role in facing such new situations. Focusing…

  15. Children's Support Services: Providing a System of Care for Urban Preschoolers with Significant Behavioral Challenges

    Science.gov (United States)

    Tewhey, Karen

    2006-01-01

    In this article, the author features the Children's Support Services (CSS) project in Lowell, Massachusetts, which is an interagency, multidisciplinary program that provides young children and their families a range of child development, mental health, and family support services. The CSS project, which was begun in September 2000, addresses the…

  16. What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer.

    Science.gov (United States)

    Ussher, Jane; Kirsten, Laura; Butow, Phyllis; Sandoval, Mirjana

    2006-05-01

    This qualitative study examined the questions of what cancer support groups provide that other supportive relationships do not, and what the self perceived consequences are of support group attendance. Nine representative Australian cancer peer support groups, consisting of a total of 93 interviewees, 75 women, and 18 men, with a mean age of 62, took part in participant observation and focus group interviews, with the data analysed using positioning theory. Support groups were positioned by participants as providing a unique sense of community, unconditional acceptance, and information about cancer and its treatment, in contrast to the isolation, rejection, and lack of knowledge about cancer frequently experienced outside the group. Groups were also positioned as occasionally emotionally challenging, in contrast to the experience of normalising support from family and friends. Increased empowerment and agency were positioned as the most significant consequences of group support, consisting of increased confidence and a sense of control in relation to self, living with cancer, and interactions with others, in particular the medical profession. The support group was also positioned as facilitating positive relationships with family and friends because of relieving their burden of care, by providing a safe space for the expression of emotion. No difference was found between professionally led and peer led support groups, suggesting that it is not the professional background of the leader which is of importance, but whether the group provides a supportive environment, mutuality, and a sense of belonging, and whether it meets the perceived needs of those attending. It is suggested that future research should examine the construction and experience of social support in those who drop out of, or who do not attend, cancer support groups, in order to provide further insight into the contrast between social support within groups and support in other contexts.

  17. Support Needs for Canadian Health Providers Responding to Disaster: New Insights from a Grounded Theory Approach.

    Science.gov (United States)

    Fahim, Christine; O'Sullivan, Tracey L; Lane, Dan

    2015-07-01

    An earlier descriptive study exploring the various supports available to Canadian health and social service providers who deployed to the 2010 earthquake disaster in Haiti, indicated that when systems are compromised, professionals are at physical, emotional and mental risk during overseas deployment. While these risks are generally well-identified, there is little literature that explores the effectiveness of the supports in place to mitigate this risk. This study provides evidence to inform policy development regarding future disaster relief, and the effectiveness of supports available to responders assisting with international disaster response. This study follows Strauss and Corbin's 1990 structured approach to grounded theory to develop a framework for effective disaster support systems. N=21 interviews with Canadian health and social service providers, who deployed to Haiti in response to the 2010 earthquake, were conducted and analyzed. Resulting data were transcribed, coded and analysed for emergent themes. Three themes were identified in the data and were used to develop the evolving theory. The interview data indicate that the experiences of responders are determined based on an interaction between the individual's 'lens' or personal expectations, as well as the supports that an organization is able to provide. Therefore, organizations should consider the following factors: experience, expectations, and supports, to tailor a successful support initiative that caters to the needs of the volunteer workforce.

  18. FY 2016 Grant Announcement: FY 2016 Technical Analysis and Programmatic Evaluation Support to the Chesapeake Bay Program Partnership

    Science.gov (United States)

    The U.S. Environmental Protection Agency’s Chesapeake Bay Program Office is announcing a Request for Proposals for applicants to provide the Chesapeake Bay Program partners with a proposal(s) for providing technical analysis and programmatic evaluation

  19. Using Model-Based Systems Engineering to Provide Artifacts for NASA Project Life-cycle and Technical Reviews

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    This paper is for the AIAA Space Conference. The ability of systems engineers to use model-based systems engineering (MBSE) to generate self-consistent, up-to-date systems engineering products for project life-cycle and technical reviews is an important aspect for the continued and accelerated acceptance of MBSE. Currently, many review products are generated using labor-intensive, error-prone approaches based on documents, spreadsheets, and chart sets; a promised benefit of MBSE is that users will experience reductions in inconsistencies and errors. This work examines features of SysML that can be used to generate systems engineering products. Model elements, relationships, tables, and diagrams are identified for a large number of the typical systems engineering artifacts. A SysML system model can contain and generate most systems engineering products to a significant extent and this paper provides a guide on how to use MBSE to generate products for project life-cycle and technical reviews. The use of MBSE can reduce the schedule impact usually experienced for review preparation, as in many cases the review products can be auto-generated directly from the system model. These approaches are useful to systems engineers, project managers, review board members, and other key project stakeholders.

  20. Using Model-Based Systems Engineering To Provide Artifacts for NASA Project Life-Cycle and Technical Reviews

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    The ability of systems engineers to use model-based systems engineering (MBSE) to generate self-consistent, up-to-date systems engineering products for project life-cycle and technical reviews is an important aspect for the continued and accelerated acceptance of MBSE. Currently, many review products are generated using labor-intensive, error-prone approaches based on documents, spreadsheets, and chart sets; a promised benefit of MBSE is that users will experience reductions in inconsistencies and errors. This work examines features of SysML that can be used to generate systems engineering products. Model elements, relationships, tables, and diagrams are identified for a large number of the typical systems engineering artifacts. A SysML system model can contain and generate most systems engineering products to a significant extent and this paper provides a guide on how to use MBSE to generate products for project life-cycle and technical reviews. The use of MBSE can reduce the schedule impact usually experienced for review preparation, as in many cases the review products can be auto-generated directly from the system model. These approaches are useful to systems engineers, project managers, review board members, and other key project stakeholders.

  1. An Investigation of Student Participation in Synchronous Online Tutorials and the Impact of a Technical Support Resource

    Directory of Open Access Journals (Sweden)

    Edel Gavan

    2015-06-01

    Full Text Available As schools, universities, retail stores and corporations flock to Online and eLearning, there are many compelling arguments to support their decision. Synchronous virtual classroom tools are used to support Online and eLearning interaction to mirror face-to-face learning. Martin (2012 identified that synchronous tools are a relatively new solution to supporting interaction in the virtual classroom. Ward et al. (2010 distinguished a strong, convincing body of literature which shows that synchronous online classrooms, enhanced by two-way audio, allow for real-time oral presentation, discourse, and checks for understanding among tutor and learners. Hrastinski (2008 determined the aural component of the synchronous virtual classroom as offering real time contact between teachers and students, mirroring faceto- face contact. Much of the research to date focuses on synchronous online resources and their link with participation while there is little or no research on the use of a resource to assist with technical issues inhibiting learners from participating. The aim of the study was to address this gap through means of an exploratory case study. The research included investigating, creating and assessing the usefulness of a resource to assist with technological issues impacting learners’ ability to participate. The learners were students undertaking a post graduate qualification at Hibernia College. Data was collected through observations and surveys from 46 sstudents and tutors. This research concluded that audio is particularly important for both knowledge construction and learning but also in creating a social atmosphere. While the technical support resource provided a useful aid to learners in this study, further study will need to be conducted over a prolonged period to investigate the full extent of its usefulness. External factors do effect participation and poses a case for extending Moore’s Theory of Transactional Distance to include

  2. Support provided by municipalities for families: Experience of families with children with special needs in Latvia

    Directory of Open Access Journals (Sweden)

    Millere J.

    2012-10-01

    Full Text Available For families that are not capable to obtain necessary supplies to meet their needs, State’s social policy guidelines determine support for improving the quality of life for these families. However, it is concluded, that neither the state nor municipality’ provided support for families with children with special needs, does not meet the needs of families, because state social policy is not focused on the assessment of the family needs, as well as often families do not receive the support due to lack of necessary information and disinterest by social service workers, which in turn reflects the problems in social policy delivery mechanisms. The most necessary support that families need is concerned with lodging and financial security, lack of assistants/care at home, as well as – emotional support.

  3. In-vivo job development training among peer providers of homeless veterans supported employment programs.

    Science.gov (United States)

    Gao, Ni; Dolce, Joni; Rio, John; Heitzmann, Carma; Loving, Samantha

    2016-06-01

    This column describes a goal-oriented, time-limited in vivo coaching/training approach for skills building among peer veterans vocational rehabilitation specialists of the Homeless Veteran Supported Employment Program (HVSEP). Planning, implementing, and evaluating the training approach for peer providers was intended, ultimately, to support veterans in their goal of returning to community competitive employment. The description draws from the training experience that aimed to improve the ability of peer providers to increase both rates of employment and wages of the homeless veterans using their services. Training peers using an in vivo training approach provided a unique opportunity for the veterans to improve their job development skills with a focus to support employment outcomes for the service users. Peers who received training also expressed that learning skills through an in vivo training approach was more engaging than typical classroom trainings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Technical Support Document: Strategies for 50% Energy Savings in Large Office Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Leach, M.; Lobato, C.; Hirsch, A.; Pless, S.; Torcellini, P.

    2010-09-01

    This Technical Support Document (TSD) documents technical analysis that informs design guidance for designing and constructing large office buildings that achieve 50% net site energy savings over baseline buildings defined by minimal compliance with respect to ANSI/ASHRAE/IESNA Standard 90.1-2004. This report also represents a step toward developing a methodology for using energy modeling in the design process to achieve aggressive energy savings targets. This report documents the modeling and analysis methods used to identify design recommendations for six climate zones that capture the range of U.S. climate variability; demonstrates how energy savings change between ASHRAE Standard 90.1-2007 and Standard 90.1-2004 to determine baseline energy use; uses a four-story 'low-rise' prototype to analyze the effect of building aspect ratio on energy use intensity; explores comparisons between baseline and low-energy building energy use for alternate energy metrics (net source energy, energy emissions, and energy cost); and examines the extent to which glass curtain construction limits achieve energy savings by using a 12-story 'high-rise' prototype.

  5. Providing solutions to energy and environmental problems. Quarterly technical progress report, July 1, 1997--September 30, 1997

    Energy Technology Data Exchange (ETDEWEB)

    1997-10-01

    The Jointly Sponsored Research Program emphasizes technology commercialization and continues to be highly successful and supported strongly and enthusiastically by WRI`s industrial clientele. All of the available Department of Energy (USDOE) funding for each of the first seven years has been committed to projects. This report provides a description of projects and expenditures on fossil projects and environmental monitoring.

  6. Technical support for the EPA cleanup rule on radioactively contaminated sites

    Energy Technology Data Exchange (ETDEWEB)

    Hull, H.B.; Newman, A.; Wolbarst, A.B. [Environmental Protection Agency, Washington, DC (United States)] [and others

    1995-12-31

    The U.S. Environmental Protection Agency (EPA) is developing a radiation site cleanup regulation for the protection of the public from radionuclide contamination at sites that are to be cleaned up and released for public use. The regulation will apply to sites under the control of Federal agencies, and to sites licensed by the Nuclear Regulatory Commission (NRC) or NRC Agreement States. The agency is therefore conducting a comprehensive technical analysis aimed at developing information that will be used to support the rule. This presentation describes the regulation and the approach developed to determine how radiological health impacts and volumes of soil requiring remediation vary as functions of the possible cleanup dose or risk level.

  7. Macintosh support is provided at the level of the Service Desk

    CERN Multimedia

    2011-01-01

    Since September 2010 the Apple laptops & desktops with Mac OS are recognized and supported at CERN by the IT department. Therefore, the “Macintosh support” procedure now follows the same ITIL*) schema as for all IT services, i.e.: All CERN users must address any request for support on Macintosh PCs to the Service Desk. The Service Desk will move on questions or problems they cannot solve to “IT 2nd level” support people, provided by the “computing support” contract managed by IT department. Mac OS being officially supported by the IT department, a 3rd level support is provided by CERN IT staff; they may give specialized expert assistance, within the scope described at the ITUM-2 presentation, for all incidents or requests which can be neither resolved nor fulfilled by the Service Desk (1st level) and the 2nd level support people. Therefore, users who have problems related to Mac OS should simply fill-in the appropriate form from th...

  8. Technical Support Document: Development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings - 50% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, E.; Leach, M.; Pless, S.

    2013-06-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-MBBR) ASHRAE et al. (2011b). The AEDG-MBBR is intended to provide recommendations for achieving 50% whole-building energy savings in retail stores over levels achieved by following ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings (Standard 90.1-2004) (ASHRAE 2004b). The AEDG-MBBR was developed in collaboration with the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IES), the U.S. Green Building Council (USGBC), and the U.S. Department of Energy.

  9. Technical Support Document: Development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings - 50% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Leach, Matt [National Renewable Energy Lab. (NREL), Golden, CO (United States); Pless, Shanti [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-06-05

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-MBBR) ASHRAE et al. (2011b). The AEDG-MBBR is intended to provide recommendations for achieving 50% whole-building energy savings in retail stores over levels achieved by following ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings (Standard 90.1-2004) (ASHRAE 2004b). The AEDG-MBBR was developed in collaboration with the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IES), the U.S. Green Building Council (USGBC), and the U.S. Department of Energy.

  10. Patients’ and nurses’ views on providing psychological support within cardiac rehabilitation programmes: a qualitative study

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-01-01

    Objective To explore patients’ and nurses’ views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. Design In-depth interviews analysed thematically. Participants 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Setting Cardiac services based in the South West of England and the East Midlands, UK. Results Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients’ accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual’s mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Conclusions Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. Trial registration number ISCTRN34701576. PMID:28864707

  11. Hospice providers' key approaches to support informal caregivers in managing medications for patients in private residences.

    Science.gov (United States)

    Lau, Denys T; Joyce, Brian; Clayman, Marla L; Dy, Sydney; Ehrlich-Jones, Linda; Emanuel, Linda; Hauser, Joshua; Paice, Judith; Shega, Joseph W

    2012-06-01

    Managing and administering medications to relieve pain and symptoms are common, important responsibilities for informal caregivers of patients receiving end-of-life care at home. However, little is known about how hospice providers prepare and support caregivers with medication-related tasks. This qualitative study explores the key approaches that hospice providers use to facilitate medication management for caregivers. Semistructured, open-ended interviews were conducted with 22 providers (14 nurses, four physicians, and four social workers) from four hospice organizations around an urban setting in the midwestern U.S. Based on the interviews, the following five key approaches emerged, constituting how the hospice team collectively helped caregivers manage medications: 1) establishing trust; 2) providing information; 3) promoting self-confidence; 4) offering relief (e.g., provided in-home medication assistance, mobilized supportive resources, and simplified prescriptions); and 5) assessing understanding and performance. Each hospice discipline used multiple approaches. Nurses emphasized tailoring information to individual caregivers and patients, providing in-home assistance to help relieve caregivers, and assessing caregivers' understanding and performance of medication management during home visits. Physicians simplified medication prescriptions to alleviate burden and reassured caregivers using their perceived medical authority. Social workers facilitated medication management by providing emotional support to promote self-confidence and mobilizing resources in caregivers' support networks and the community at large. Hospice nurses, physicians, and social workers identified distinct, yet overlapping, approaches in aiding caregivers with medication management. These findings emphasize the importance of interdisciplinary teamwork among hospice providers. Future research should investigate how common, standardized, effective, and efficient these approaches are in

  12. Providing a Full Circle of Support to Teachers in an Inclusive Elementary School

    Science.gov (United States)

    Waldron, Nancy L.; Redd, Lacy

    2011-01-01

    Providing a full circle of support to teachers in an inclusive elementary school, the Newberry Elementary School (NES) principal and staff have worked for 5 years to ensure the inclusion of students with disabilities in general education classrooms. The authors would like to share their perceptions of how this full circle (the multiple systems) of…

  13. The Implementation of a Behavioural Support Programme: Teachers' Perceptions of the Programme and Themselves as Providers

    Science.gov (United States)

    Ingemarson, Maria; Bodin, Maria; Rubenson, Birgitta; Guldbrandsson, Karin

    2016-01-01

    Purpose: The purpose of this paper is to investigate how teachers received and perceived the school programme Prevention in School (PS), a positive behavioural support programme; how did the teachers perceive the programme characteristics and themselves as providers; and how did this affect programme implementation? Design/methodology/approach:…

  14. Addressing Needs of Military Families during Deployment: Military Service Providers' Perceptions of Integrating Support Services

    Science.gov (United States)

    Hayden, Seth Christian Walter

    2011-01-01

    Service providers are increasingly recognizing the need to develop effective methods for delivering supporting services to military families during deployment. Research suggests that military families experience increased levels of stress during the cycle of deployment. Bronfenbrenner (1979) conceptualized the family operating within the context…

  15. Factors Predicting Oncology Care Providers' Behavioral Intention to Adopt Clinical Decision Support Systems

    Science.gov (United States)

    Wolfenden, Andrew

    2012-01-01

    The purpose of this quantitative correlation study was to examine the predictors of user behavioral intention on the decision of oncology care providers to adopt or reject the clinical decision support system. The Unified Theory of Acceptance and Use of Technology (UTAUT) formed the foundation of the research model and survey instrument. The…

  16. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 21. Ground water movement and nuclide transport

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-04-01

    This volume, TM-36/21 Ground Water Movement and Nuclide Transport, is one of a 23-volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations, Y/OWI/TM-36'' which supplements a ''Contribution to Draft Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations, Y/OWI/TM-44.'' The series provides a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling of spent fuel and uranium-only recycling. The studies presented in this volume consider the effect of the construction of the repository and the consequent heat generation on the ground water movement. Additionally, the source concentrations and leach rates of selected radionuclides were studied in relation to the estimated ground water inflow rates. Studies were also performed to evaluate the long term migration of radionuclides as affected by the ground water flow. In all these studies, three geologic environments are considered; granite, shale and basalt.

  17. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 7. Baseline rock properties-basalt

    Energy Technology Data Exchange (ETDEWEB)

    1978-04-01

    This volume, Y/OWI/TM-36/7 Baseline Rock Properties--Basalt, is one of a 23-volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations, Y/OWI/TM-36'' which supplements a ''Contribution to Draft Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations, Y/OWI/TM-44.'' The series provides a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling, no recycling of spent fuel and uranium-only recycling. This report contains an evaluation of the results of a literature survey to define the rock mass properties of a generic basalt, which could be considered as a geological medium for storing radioactive waste. The general formation and structure of basaltic rocks is described. This is followed by specific descriptions and rock property data for the Dresser Basalt, the Amchitka Island Basalt, the Nevada Test Site Basalt and the Columbia River Group Basalt. Engineering judgment has been used to derive the rock mass properties of a typical basalt from the relevant intact rock property data and the geological information pertaining to structural defects, such as joints and faults.

  18. RADIO-TECHNICAL FLIGHT SUPPORT MILITARY AND CIVIL AVIATION – THE STRATEGIC PROBLEM OF RUSSIA ARCTIC ZONE

    Directory of Open Access Journals (Sweden)

    N. I. Didenko

    2017-01-01

    Full Text Available It should be noted that a number of countries consider that the Arctic is the property of all mankind and therefore the legal regime of the usage of this region territory is necessary to be reconsidered. The intensification of the armed forces activities on the northern borders is caused by aggravated international disagreements on the issues of territorial influence in this region, by the need to ensure the safety of increasing freight traffic through the Northern Sea Route and also by an increase in production capacities of domestic extractive enterprises on the shelf. The article deals with the challenge of the accelerated development in the Arctic region of Russia. It is noted that the major role in the solution of this problem belongs to an air-transport complex which is almost the only means to provide the operational availability to objects in the region. For the effective usage of the air-transport complex the approach based on the concept of radio-technical flight support, founded on the technologies of global navigation satellite systems and automatic dependent observation is offered. The existence of readymade technical solutions for these technologies implementation allows to accelerate the solvation of social and economic development problems of the Arctic region in general, alongside with the problems of national security of Russia.

  19. Family carers providing support to a person dying in the home setting: A narrative literature review.

    Science.gov (United States)

    Morris, Sara M; King, Claire; Turner, Mary; Payne, Sheila

    2015-06-01

    This study is based on people dying at home relying on the care of unpaid family carers. There is growing recognition of the central role that family carers play and the burdens that they bear, but knowledge gaps remain around how to best support them. The aim of this study is to review the literature relating to the perspectives of family carers providing support to a person dying at home. A narrative literature review was chosen to provide an overview and synthesis of findings. The following search terms were used: caregiver, carer, 'terminal care', 'supportive care', 'end of life care', 'palliative care', 'domiciliary care' AND home AND death OR dying. During April-May 2013, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Pubmed, Cochrane Reviews and Citation Indexes were searched. Inclusion criteria were as follows: English language, empirical studies and literature reviews, adult carers, perspectives of family carers, articles focusing on family carers providing end-of-life care in the home and those published between 2000 and 2013. A total of 28 studies were included. The overarching themes were family carers' views on the impact of the home as a setting for end-of-life care, support that made a home death possible, family carer's views on deficits and gaps in support and transformations to the social and emotional space of the home. Many studies focus on the support needs of people caring for a dying family member at home, but few studies have considered how the home space is affected. Given the increasing tendency for home deaths, greater understanding of the interplay of factors affecting family carers may help improve community services. © The Author(s) 2015.

  20. What support do nurses need to provide palliative care for people with dementia?

    Science.gov (United States)

    Champion, Elizabeth

    2017-08-31

    The aim of this project was to identify the support required by registered nurses and unregistered healthcare support workers to provide palliative care for people with dementia in an acute hospital in England. A quantitative approach was taken and participants were asked to fill in a questionnaire. Data were collated and analysed to identify support needs and any emerging themes. Respondents were confident in identifying the different stages of dementia. There was less confidence in identifying a patient with dementia for palliative care referral compared with a patient without dementia. Further needs were identified by respondents in supporting the family/carer of the person with dementia and being aware of available support to facilitate palliative care for people with dementia and support for end of life care (EoLC) planning. The findings suggest that further work is required in relation to dementia and EoLC. Practical and educational collaboration with EoLC/palliative care practitioners and dementia leads would be beneficial.

  1. Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective.

    LENUS (Irish Health Repository)

    Breen, Patricia

    2010-01-01

    Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions.

  2. Decision support system of e-book provider selection for library using Simple Additive Weighting

    Science.gov (United States)

    Ciptayani, P. I.; Dewi, K. C.

    2018-01-01

    Each library has its own criteria and differences in the importance of each criterion in choosing an e-book provider for them. The large number of providers and the different importance levels of each criterion make the problem of determining the e-book provider to be complex and take a considerable time in decision making. The aim of this study was to implement Decision support system (DSS) to assist the library in selecting the best e-book provider based on their preferences. The way of DSS works is by comparing the importance of each criterion and the condition of each alternative decision. SAW is one of DSS method that is quite simple, fast and widely used. This study used 9 criteria and 18 provider to demonstrate how SAW work in this study. With the DSS, then the decision-making time can be shortened and the calculation results can be more accurate than manual calculations.

  3. Characteristics of Adults Seeking Health Care Provider Support Facilitated by Mobile Technology: Secondary Data Analysis.

    Science.gov (United States)

    Bosak, Kelly; Park, Shin Hye

    2017-12-21

    Mobile health technology is rapidly evolving with the potential to transform health care. Self-management of health facilitated by mobile technology can maximize long-term health trajectories of adults. Little is known about the characteristics of adults seeking Web-based support from health care providers facilitated by mobile technology. This study aimed to examine the following: (1) the characteristics of adults who seek human support from health care providers for health concerns using mobile technology rather than from family members and friends or others with similar health conditions and (2) the use of mobile health technology among adults with chronic health conditions. Findings of this study were interpreted in the context of the Efficiency Model of Support. We first described characteristics of adults seeking Web-based support from health care providers. Using chi-square tests for categorical variables and t test for the continuous variable of age, we compared adults seeking Web-based and conventional support by demographics. The primary aim was analyzed using multivariate logistic regression to examine whether chronic health conditions and demographic factors (eg, sex, income, employment status, race, ethnicity, education, and age) were associated with seeking Web-based support from health care providers. The sample included adults (N=1453), the majority of whom were female 57.60% (837/1453), white 75.02% (1090/1453), and non-Hispanic 89.13% (1295/1453). The age of the participants ranged from 18 to 92 years (mean 48.6, standard deviation [SD] 16.8). The majority 76.05% (1105/1453) of participants reported college or higher level of education. A disparity was found in access to health care providers via mobile technology based on socioeconomic status. Adults with annual income of US $30,000 to US $100,000 were 1.72 times more likely to use Web-based methods to contact a health care provider, and adults with an annual income above US $100,000 were 2.41 to

  4. Technical Support Document: The Development of the Advanced Energy Design Guide for Small Retail Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Bing; Jarnagin, Ronald E.; Winiarski, David W.; Jiang, Wei; McBride, Merle F.; Crall, C.

    2006-09-30

    The Advanced Energy Design Guide for Small Retail Buildings (AEDG-SR) was developed by a partnership of organizations, including the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IESNA), the United States Green Buildings Council (USGBC), and the Department of Energy (DOE). The guide is intended to offer recommendations to achieve 30% energy savings and thus to encourage steady progress towards net-zero energy buildings. The baseline level energy use was set at buildings built at the turn of the millennium, which are assumed to be based on ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings (refer to as the ?Standard? in this report). ASHRAE and its partners are engaged in the development of a series of guides for small commercial buildings, with the AEDG-SR being the second in the series. Previously the partnership developed the Advanced Energy Design Guide for Small Office Buildings: Achieving 30% Energy Savings Over ANSI/ASHRAE/IESNA Standard 90.1-1999, which was published in late 2004. The technical support document prepared by PNNL details how the energy analysis performed in support of the Guide and documents development of recommendation criteria.

  5. Rural health professionals' perspectives on providing grief and loss support in cancer care.

    Science.gov (United States)

    Breen, L J; O'Connor, M

    2013-11-01

    Research demonstrates considerable inequalities in service delivery and health outcomes for people with cancer living outside large metropolitan cities. Semi-structured interviews with 11 professionals providing grief and loss support for people with cancer and their families in rural, regional, and remote areas Western Australia revealed the challenges they faced in delivering such support. The data are presented in four themes - Inequity of regional versus metropolitan services, Strain of the 'Jack of all trades' role, Constraints to accessing professional development, and Challenges in delivering post-bereavement services. These challenges are likely to be of growing concern given that populations are declining in rural areas as Australia becomes increasingly urban. The findings have implications in enhancing the loss and grief support services available in rural, regional, and remote Western Australia, including those grieving the death of a loved one through cancer. © 2013 John Wiley & Sons Ltd.

  6. Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study.

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Richards, David A; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-09-01

    To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. In-depth interviews analysed thematically. 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Cardiac services based in the South West of England and the East Midlands, UK. Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. ISCTRN34701576. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. An Intelligent Virtual Human System For Providing Healthcare Information And Support

    Science.gov (United States)

    2011-01-01

    CyberPsychology and Behavior 8, 3 (2005), 187-211. [2] T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508 [4] G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8...3 (2005), 220- 230. [5] F.D. Rose, B.M. Brooks & A.A. Rizzo, Virtual Reality in Brain Damage Rehabilitation: Review, CyberPsychology and Behavior

  8. The "specter" of cancer: exploring secondary trauma for health professionals providing cancer support and counseling.

    Science.gov (United States)

    Breen, Lauren J; O'Connor, Moira; Hewitt, Lauren Y; Lobb, Elizabeth A

    2014-02-01

    Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in "high-death" contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) ways of working with patients with cancer and their families, (c) the unique qualities of cancer-related loss and grief experiences, and (d) the emotional demands of the work and associated self-care. The provision of psychological services in the context of cancer is colored by the specter of cancer, an unseen yet real phenomenon that contributes to secondary trauma and burnout. The participants' reported secondary trauma has serious repercussions for their well-being and may compromise the care they provide. The findings have implications for the retention and well-being of personnel who provide psychosocial care in cancer and the quality and delivery of services for people with cancer and their families. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  9. Task Order 22 – Engineering and Technical Support, Deep Borehole Field Test. AREVA Summary Review Report

    Energy Technology Data Exchange (ETDEWEB)

    Denton, Mark A. [AREVA Federal Services, Charlotte, NC (United States)

    2016-01-19

    Under Task Order 22 of the industry Advisory and Assistance Services (A&AS) Contract to the Department of Energy (DOE) DE-NE0000291, AREVA has been tasked with providing assistance with engineering, analysis, cost estimating, and design support of a system for disposal of radioactive wastes in deep boreholes (without the use of radioactive waste). As part of this task order, AREVA was requested, through a letter of technical direction, to evaluate Sandia National Laboratory’s (SNL’s) waste package borehole emplacement system concept recommendation using input from DOE and SNL. This summary review report (SRR) documents this evaluation, with its focus on the primary input document titled: “Deep Borehole Field Test Specifications/M2FT-15SN0817091” Rev. 1 [1], hereafter referred to as the “M2 report.” The M2 report focuses on the conceptual design development for the Deep Borehole Field Test (DBFT), mainly the test waste packages (WPs) and the system for demonstrating emplacement and retrieval of those packages in the Field Test Borehole (FTB). This SRR follows the same outline as the M2 report, which allows for easy correlation between AREVA’s review comments, discussion, potential proposed alternatives, and path forward with information established in the M2 report. AREVA’s assessment focused on three primary elements of the M2 report: the conceptual design of the WPs proposed for deep borehole disposal (DBD), the mode of emplacement of the WP into DBD, and the conceptual design of the DBFT. AREVA concurs with the M2 report’s selection of the wireline emplacement mode specifically over the drill-string emplacement mode and generically over alternative emplacement modes. Table 5-1 of this SRR compares the pros and cons of each emplacement mode considered viable for DBD. The primary positive characteristics of the wireline emplacement mode include: (1) considered a mature technology; (2) operations are relatively simple; (3) probability of a

  10. CO2 removal from biogas with supported amine sorbents : First technical evaluation based on experimental data

    NARCIS (Netherlands)

    Sutanto, Stevia; Dijkstra, J. W.; Pieterse, J. A.Z.; Boon, J; Hauwert, P.; Brilman, D. W.F.

    2017-01-01

    Biogas from fermentation of manure and organic residues produces a gas stream that can be fed into the natural gas grid, provided impurities (CO2, H2S and H2O) are removed according to specifications prior to grid injection. Compared to conventional technologies, supported amine sorbents (SAS) seem

  11. Guidance document for revision of DOE Order 5820.2A, Radioactive Waste Technical Support Program. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Kudera, D.E.; McMurtrey, C.D.; Meagher, B.G.

    1993-04-01

    This document provides guidance for the revision of DOE Order 5820.2A, ``Radioactive Waste Management.`` Technical Working Groups have been established and are responsible for writing the revised order. The Technical Working Groups will use this document as a reference for polices and procedures that have been established for the revision process. The overall intent of this guidance is to outline how the order will be revised and how the revision process will be managed. In addition, this document outlines technical issues considered for inclusion by a Department of Energy Steering Committee.

  12. Data development technical support document for the aircraft crash risk analysis methodology (ACRAM) standard

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, C.Y.; Glaser, R.E.; Mensing, R.W.; Lin, T.; Haley, T.A.; Barto, A.B.; Stutzke, M.A.

    1996-08-01

    The Aircraft Crash Risk Analysis Methodology (ACRAM) Panel has been formed by the US Department of Energy Office of Defense Programs (DOE/DP) for the purpose of developing a standard methodology for determining the risk from aircraft crashes onto DOE ground facilities. In order to accomplish this goal, the ACRAM panel has been divided into four teams, the data development team, the model evaluation team, the structural analysis team, and the consequence team. Each team, consisting of at least one member of the ACRAM plus additional DOE and DOE contractor personnel, specializes in the development of the methodology assigned to that team. This report documents the work performed by the data development team and provides the technical basis for the data used by the ACRAM Standard for determining the aircraft crash frequency. This report should be used to provide the generic data needed to calculate the aircraft crash frequency into the facility under consideration as part of the process for determining the aircraft crash risk to ground facilities as given by the DOE Standard Aircraft Crash Risk Assessment Methodology (ACRAM). Some broad guidance is presented on how to obtain the needed site-specific and facility specific data but this data is not provided by this document.

  13. Caregiver and health care provider preferences of nutritional support in a hematopoietic stem cell transplant unit.

    Science.gov (United States)

    Williams-Hooker, Ruth; Adams, Marissa; Havrilla, David A; Leung, Wing; Roach, Robin R; Mosby, Terezie T

    2015-08-01

    Many pediatric oncology patients undergoing hematopoietic stem cell transplantation (HSCT) require nutritional support (NS) because of their inability to consume adequate caloric intake enough calories orally. Although NS can be provided either enteraly (EN) or parenteraly (PN), EN is the preferred method of NS as long as if the gastrointestinal tract is functioning. In this qualitative study, we determined the type of NS preferences and the reservations of caregivers of pediatric HSCT patients undergoing hematopoietic stem cell transplantation (HSCT) as well as those of health care (HC) providers working on the HSCT unit. A survey was developed and completed anonymously by HC providers and caregivers. The hypothesis was that HC providers and caregivers would prefer PN because it is convenient to use in patients who already have a central line in place. Most caregivers preferred PN to EN, while most HC providers preferred EN to PN. The barrier between EN initiation and caregivers' approval was the caregivers' perception that EN was invasive and painful, most common obstacle for initiation of EN among caregivers was that it hurts/is invasive, while the barrier with HC providers was vomiting and/abdominal pain associated with EN. If caregivers were better educated about NS and the advantages/disadvantages of the different forms of NS, their preferences may change. There have been policy changes at St. Jude have been implemented since this study, and an outpatient dietitian now provides education to caregivers about NS during the pre-evaluation for HSCT. © 2015 Wiley Periodicals, Inc.

  14. Management support services to the Office of Utility Technologies. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-16

    The Office of Utility Technologies works cooperatively with industry and the utility sector to realize the market potential for energy efficiency and renewable energy technologies. Under this contract, BNF has provided management support services for OUT R&D activities for the following Program offices: (1) Office of Energy Management; (2) Office of Solar Energy Conversion; (3) Office of Renewable Energy Conversion; and (4) Deputy Assistant Secretary. During the period between 4/17/91 and 9/17/93, BNF furnished the necessary personnel, equipment, materials, facilities and travel required to provide management support services for each of the above Program Offices. From 9/18/93 to 12/17/93, BNF has been involved in closeout activities, including final product deliverables. Research efforts that have been supported in these Program Offices are: (1) for Energy Management -- Advanced Utility Concepts Division; Utility Systems Division; Integrated Planning; (2) for Solar Energy Conversion -- Photovoltaics Division; Solar Thermal and Biomass Power Division; (3) for Renewable Energy Conversion -- Geothermal Division; Wind, Hydroelectric and Ocean Systems Division; (4) for the Deputy Assistant Secretary -- support as required by the Supporting Staff. This final report contains summaries of the work accomplished for each of the Program Offices listed above.

  15. Dose Modeling Evaluations and Technical Support Document for the Authorized Limits Request for the C-746-U Landfill at the Paducah Gaseous Diffusion Plant, Paducah, Kentucky

    Energy Technology Data Exchange (ETDEWEB)

    Boerner, A. J. [IEAVP, ORISE, Oak Ridge, TN (United States); Maldonado, D. G. [IEAVP, ORISE, Oak Ridge, TN (United States; Hansen, Tom [Ameriphysics, LLC (United States)

    2012-06-01

    This report contains the technical basis in support of the DOE?s derivation of Authorized Limits (ALs) for the DOE Paducah C-746-U Landfill. A complete description of the methodology, including an assessment of the input parameters, model inputs, and results is provided in this report. This report also provides initial recommendations on applying the derived soil guidelines. The ORISE-derived soil guidelines are specifically applicable to the Landfill at the end of its operational life. A suggested 'upper bound' multiple of the derived soil guidelines for individual shipments is provided.

  16. Asset Management Planning – providing the evidence to support robust and risk-based investment decisions

    Directory of Open Access Journals (Sweden)

    Mitchell Chrissy

    2016-01-01

    Full Text Available Over the last decade the UK’s joint Flood and Coastal Erosion Risk Management Research and Development programme has been developing methods to support a move to a risk-based approach to flood defence asset management. Looking to ensure investment is less ‘find and fix’ and made to those assets where the biggest risk reduction can be made for the money available. In addition, providing the capability to articulate the benefits of investing in these assets quantitatively and transparently. This paper describes how the Asset Performance Tools (APT project [1] is delivering practical methods, prototype tools and supporting guidance which, together with related initiatives such as the Environment Agency’s Creating Asset Management Capacity (CAMC strategic programme [2] and the ‘State of the Nation’ (SoN [3] supportive datasets, will enable a risk-based, ‘predict and protect’ approach to asset management. A key advance is the ability to bring in local knowledge to make national generic datasets locally relevant. The paper also highlights existing outputs that can already be used to support a more proactive approach to asset management. It will summarise the ongoing work which will further develop and fine tune performance assessment and investment decision processes within an integrated conceptual framework aligned with ISO55000, deliverable via CAMC and whose concepts can be used by all risk management authorities.

  17. Training veterans to provide peer support in a weight-management program: MOVE!

    Science.gov (United States)

    Allicock, Marlyn; Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C; Weiner, Bryan J; Kinsinger, Linda

    2013-11-07

    The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. We developed an MI peer ounselor training program for volunteer veterans, the "Buddies" program, to provide one-on-one telephone support for veterans enrolled in MOVE!. Buddies were recruited at 5 VHA sites and trained to provide peer support for the 6-month MOVE! intervention. We used a DVD to teach MI skills and followed with 2 to 3 booster sessions. We observed training, conducted pre- and posttraining surveys, and debriefed focus groups to assess training feasibility. Fifty-six Buddies were trained. Results indicate positive receipt of the program (89% reported learning about peer counseling and 87% reported learning communication skills). Buddies showed a small improvement in MI self-efficacy on posttraining surveys. We also identified key challenges to learning MI and training implementation. MI training is feasible to implement and acceptable to volunteer Buddies. Trainers must assess how effectively volunteers learn MI skills in order to enhance its effective use in health promotion.

  18. The Oncology Family App: Providing Information and Support for Families Caring for Their Child With Cancer.

    Science.gov (United States)

    Slater, Penelope J; Fielden, Philippa E; Bradford, Natalie K

    2017-11-01

    The Oncology Family App supports families across the vast state of Queensland, Australia, with easy access to vital information, including management plans for a deteriorating child, patient specific information and other resources. This article describes the development and evaluation of this mobile app. The app was developed and tested in collaboration with parents, caregivers, and clinicians and released in November 2015. This first version featured "Statewide Hospital Contacts," including phone numbers, links to Google maps, and 24-hour emergency contacts with click to call functionality; "When to Call" describing symptoms to look out for in a deteriorating child; "Blood Results Table"; and "Information" listing recommended websites, health care team contacts, appointments, and notes. The app was evaluated through interviews with parents, caregivers and patients and download metrics. Six months after the app release, 68% of the 38 parents and caregivers surveyed had downloaded the app. The most used modules were "Blood Results Table," "When to Call," and "Statewide Hospital Contacts," but families reported using all features available. Families were enthusiastic about the support the app provided and gave useful feedback to direct future development. Using mobile health technology to support families is a novel, but rapidly growing concept. Family and caregiver feedback showed that the Oncology Family App was an efficient and convenient way to provide much needed information. A new version of the app is under development and evaluation of outcomes will be ongoing.

  19. A world-wide databridge supported by a commercial cloud provider

    Science.gov (United States)

    Tat Cheung, Kwong; Field, Laurence; Furano, Fabrizio

    2017-10-01

    Volunteer computing has the potential to provide significant additional computing capacity for the LHC experiments. One of the challenges with exploiting volunteer computing is to support a global community of volunteers that provides heterogeneous resources. However, high energy physics applications require more data input and output than the CPU intensive applications that are typically used by other volunteer computing projects. While the so-called databridge has already been successfully proposed as a method to span the untrusted and trusted domains of volunteer computing and Grid computing respective, globally transferring data between potentially poor-performing residential networks and CERN could be unreliable, leading to wasted resources usage. The expectation is that by placing a storage endpoint that is part of a wider, flexible geographical databridge deployment closer to the volunteers, the transfer success rate and the overall performance can be improved. This contribution investigates the provision of a globally distributed databridge implemented upon a commercial cloud provider.

  20. Retaining the next generation of nurses: the Wisconsin nurse residency program provides a continuum of support.

    Science.gov (United States)

    Bratt, Marilyn Meyer

    2009-09-01

    Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits. Copyright 2009, SLACK Incorporated.

  1. Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

    Science.gov (United States)

    Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

    2017-05-01

    Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal

  2. Advanced Life Support Providers Have Poor Knowledge of When to Administer Resuscitation Drugs

    DEFF Research Database (Denmark)

    Johnsen, Josephine; Glerup Lauridsen, Kasper; Løfgren, Bo

    2017-01-01

    Background: Advanced life support (ALS) including resuscitation drugs improves return of spontaneous circulation after cardiac arrest. Resuscitation drugs are recommended to be administered at predefined time-points depending on whether the cardiac rhythm is shockable or non-shockable. Timing...... to administer drugs during shockable rhythm only. Similar, only one third knew when to administer drugs during non-shockable rhythm only. Knowledge on when to administer drugs in case of rhythm transition was poor (Figure 1).Conclusion: Advanced life support providers have poor knowledge of when to administer...... resuscitation drugs. Future studies should address methods to improve learning and skill retention of resuscitation drug administration.Author Disclosures: J. Johnsen: None. K.G. Lauridsen: None. B. Løfgren: None....

  3. Primary Health Care Providers' Perspectives: Facilitating Older Patients' Access to Community Support Services.

    Science.gov (United States)

    Ploeg, Jenny; Denton, Margaret; Hutchison, Brian; McAiney, Carrie; Moore, Ainsley; Brazil, Kevin; Tindale, Joseph; Wu, Amina; Lam, Annie

    2016-12-01

    The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs. Participants collaborated extensively with interprofessional colleagues within and outside their organizations to find relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to find that they relied on out-of-date resources and inefficient search strategies to find CSSs. Our findings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs.

  4. Primary care provider preferences for working with a collaborative support team

    Directory of Open Access Journals (Sweden)

    Flores Jennifer A

    2007-05-01

    Full Text Available Abstract Background Clinical interventions based on collaborative models require effective communication between primary care providers (PCPs and collaborative support teams. Despite growing interest in collaborative care, we have identified no published studies describing how PCPs prefer to communicate and interact with collaborative support teams. This manuscript examines the communication and interaction preferences of PCPs participating in an ongoing randomized clinical trial of a collaborative intervention for chronic pain and depression. Methods The trial is being conducted in five primary care clinics of a Veterans Affairs Medical Center. Twenty-one PCPs randomized to the study intervention completed a survey regarding preferences for interacting with the collaborative support team. Results A majority of PCPs identified email (95% and telephone calls (68% as preferred modes for communicating with members of the support team. In contrast, only 29% identified in-person communications as preferred. Most PCPs preferred that the care manager and physician pain specialist assess patients (76% and make initial treatment changes (71% without first conferring with the PCP. One-half wanted to be designated cosigners of all support team notes in the electronic medical record, one-half wanted to receive brief and focused information rather than in-depth information about their patients, and one-half wanted their practice nurses automatically included in communications. Panel size was strongly associated (p Conclusion The substantial variation in PCP communication preferences suggests the need for knowledge of these preferences when designing and implementing collaborative interventions. Additional research is needed to understand relationships between clinician and practice characteristics and interaction preferences.

  5. Technical support for open-cycle MHD program. Progress report, April-June 1978

    Energy Technology Data Exchange (ETDEWEB)

    Bomkamp, D H [ed.

    1979-07-01

    The support program for open-cycle MHD at Argonne National Laboratory is developing the analytical tools needed to investigate the performance of the major components in the combined cycle MHD/steam power system. The analytical effort is centered on the primary components of the system that are unique to MHD and also on the integration of these analytical representations into a model of the entire power producing system. The project activities currently include modeling of the combustor, MHD channel, slag separator and the high temperature air heater. In addition, these models are combined into a complete system model which is presently capable of carrying out optimizations of the entire system on either thermodynamic efficiency or cost of electrical power. Also, in support of other aspects of the open-cycle program, test plans are developed and facility and program reviews are provided upon request to support the needs and requirements of the DOE/MHD Division.

  6. Technical Support Task Report for the Modernization of Defense Logistics Standard Systems. Volume 3: Logistics Gateway Node Technical Specifications

    Science.gov (United States)

    1991-05-01

    addition to GOSIP, the CLGN also shall support Transmission Control Protocol/ Internet Protocol (TCP/IP) and its data transfer via file transfer protocol (FTP... Internet protocol IPC interprocess communications ISO International Standards Organization Kbps kilobits per second LAN local area network LGN logistics...OI.i PCU * ; L ’U’ *A A 9 S z - CosA -v vwA L L- L C~ L L- L. L. U.U u~W u u u ULS AU UU U U *~ a -’ - - -A - - - -0-0- -A- - WNU, W W n ftU 0 V OW

  7. Dental School Administrators' Attitudes Towards Providing Support Services for LGBT-Identified Students.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Morris, Dustin R

    2015-08-01

    A lack of curriculum time devoted to teaching dental students about the needs of lesbian, gay, bisexual, and transgendered (LGBT) health care patient needs and biases against LGBT students and faculty have been reported. Understanding dental school administrators' attitudes about LGBT students' needs might provide further insight into these long-standing issues. The aims of this study were to develop a survey to assess dental administrators' attitudes regarding the support services they believe LGBT-identified students need, to identify dental schools' current diversity inclusion policies, and to determine what types of support dental schools currently provide to LGBT students. A survey developed with the aid of a focus group, cognitive interviewing, and pilot testing was sent to 136 assistant and associate deans and deans of the 65 U.S. and Canadian dental schools. A total of 54 responses from 43 (66%) schools were received from 13 deans, 29 associate deans, and 11 assistant deans (one participant did not report a position), for a 40% response rate. The findings suggest there is a considerable lack of knowledge or acknowledgment of LGBT dental students' needs. Future studies are needed to show the importance of creating awareness about meeting the needs of all dental student groups, perhaps through awareness campaigns initiated by LGBT students.

  8. Evaluation of Basic Life Support Training Program Provided for Nurses in A University Hospital

    Directory of Open Access Journals (Sweden)

    Banu Terzi

    2017-06-01

    Full Text Available Aims: This study was conducted to assess the efficiency of the basic life support (BLS training program provided for nurses in a university hospital. To evaluate the efficiency of the BLS training program provided for nurses in a university hospital. Methods: In this a quasi-experimental study, a total of 404 nurses who received BLS training were enrolled. The study was performed in two stages. In stage one, the participant nurses were given a pre-test that consisted of 25 questions, four points each, before the training on the first day of the 2-day BLS training. The post-test was conducted in addition to practical exams on manikins to determine nurses’ practice skills on BLS. Results: There was a statistically significant difference between the nurses with previous BLS training and the difference between their pre- and post-test results (p<0.05, and high statistically significant difference was found between the nurses with previous advanced life support (ALS training and the difference between their pre- and post-test results (p<0.001. Conclusion: Nurses should receive BLS training in hospitals and the training should be repeated on a regular basis. The BLS training that the nurses received in this study was effective and increased their knowledge level on BLS

  9. Effects of Providing Peer Support on Diabetes Management in People With Type 2 Diabetes.

    Science.gov (United States)

    Yin, Junmei; Wong, Rebecca; Au, Shimen; Chung, Harriet; Lau, Maggie; Lin, Laihar; Tsang, Chiuchi; Lau, Kampiu; Ozaki, Risa; So, Wingyee; Ko, Gary; Luk, Andrea; Yeung, Roseanne; Chan, Juliana C N

    2015-08-01

    We examined the effects of participating in a "train-the-trainer" program and being a peer supporter on metabolic and cognitive/psychological/behavioral parameters in Chinese patients with type 2 diabetes. In response to our invitation, 79 patients with fair glycemic control (HbA1c peer supporters. Of the 59 who completed the program successfully, 33 agreed to be peer supporters ("agreed trainees") and were each assigned to support 10 patients for 1 year, with a voluntary extension period of 3 additional years, while 26 trainees declined to be supporters ("refused trainees"). A group of 60 patients with fair glycemic control who did not attend the training program and were under usual care were selected as a comparison group. The primary outcome was the change in average HbA1c levels for the 3 groups from baseline to 6 months. At 6 months, HbA1c was unchanged in the trainees (at baseline, 7.1 ± 0.3%; at 6 months, 7.1 ± 1.1%) but increased in the comparison group (at baseline, 7.1 ± 0.5%; at 6 months, 7.3 ± 1.1%. P = .02 for between-group comparison). Self-reported self-care activities including diet adherence and foot care improved in the trainees but not the comparison group. After 4 years, HbA1c remained stable among the agreed trainees (at baseline, 7.0 ± 0.2%; at 4 years: 7.2 ± 0.6%), compared with increases in the refused trainees (at baseline, 7.1 ± 0.4%; at 4 years, 7.8 ± 0.8%) and comparison group (at baseline, 7.1 ± 0.5%; at 4 years, 8.1 ± 0.6%. P = .001 for between-group comparison). Patients with diabetes who engaged in providing ongoing peer support to other patients with diabetes improved their self-care while maintaining glycemic control over 4 years. © 2015 Annals of Family Medicine, Inc.

  10. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    Directory of Open Access Journals (Sweden)

    Chaya Greenberger

    2016-07-01

    Full Text Available Background There is a consensus among the halachic authorities that life-saving actions override Sabbath prohibitions. They are painstaking in securing that the sanctity of the Sabbath is maintained but that not a single life be lost. Objective This manuscript examines if and when a relative’s presence at the bedside of a seriously ill individual is potentially life-saving against the backdrop of the scientific literature. It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one’s relative in hospital for the provision of emotional support. Methods Discourse of the halachic issues in the context of the scientific literature. Results Stress, mental or physical, has been determined as a potentially life-threatening condition in many disease entities. The literature attests to both the patient’s and the professionals’ perception of the curative potential of the presence of loved ones by advocating for the patient and relieving stress in the hospital experience. Emotional support from a loved one is perceived by some patients as vital to survival. There is halachic consensus that a patient’s perception of the emotional need for a relative’s presence is sufficient to permit overriding rabbinic prohibitions. Torah prohibitions, which may be overridden for medical needs, may be overridden for emotional support, providing a health professional or family member attests to the fulfilment of this specific need as diminishing the danger to the patient’s life. In certain cases, the latter contingency is unnecessary. Conclusions Emotional support has an impact on the patient’s health status; the degree to which its impact is strong enough to save life is still being studied. As more data from scientific studies emerge, they may be relevant to sharpening the halachic rulings with respect to the issue at hand.

  11. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    Science.gov (United States)

    Greenberger, Chaya; Mor, Pnina

    2016-07-28

    There is a consensus among the halachic authorities that life-saving actions override Sabbath prohibitions. They are painstaking in securing that the sanctity of the Sabbath is maintained but that not a single life be lost. This manuscript examines if and when a relative's presence at the bedside of a seriously ill individual is potentially life-saving against the backdrop of the scientific literature. It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one's relative in hospital for the provision of emotional support. Discourse of the halachic issues in the context of the scientific literature. Stress, mental or physical, has been determined as a potentially life-threatening condition in many disease entities. The literature attests to both the patient's and the professionals' perception of the curative potential of the presence of loved ones by advocating for the patient and relieving stress in the hospital experience. Emotional support from a loved one is perceived by some patients as vital to survival. There is halachic consensus that a patient's perception of the emotional need for a relative's presence is sufficient to permit overriding rabbinic prohibitions. Torah prohibitions, which may be overridden for medical needs, may be overridden for emotional support, providing a health professional or family member attests to the fulfilment of this specific need as diminishing the danger to the patient's life. In certain cases, the latter contingency is unnecessary. Emotional support has an impact on the patient's health status; the degree to which its impact is strong enough to save life is still being studied. As more data from scientific studies emerge, they may be relevant to sharpening the halachic rulings with respect to the issue at hand.

  12. Lipid-anchored Synaptobrevin Provides Little or No Support for Exocytosis or Liposome Fusion.

    Science.gov (United States)

    Chang, Che-Wei; Chiang, Chung-Wei; Gaffaney, Jon D; Chapman, Edwin R; Jackson, Meyer B

    2016-02-05

    SNARE proteins catalyze many forms of biological membrane fusion, including Ca(2+)-triggered exocytosis. Although fusion mediated by SNAREs generally involves proteins anchored to each fusing membrane by a transmembrane domain (TMD), the role of TMDs remains unclear, and previous studies diverge on whether SNAREs can drive fusion without a TMD. This issue is important because it relates to the question of the structure and composition of the initial fusion pore, as well as the question of whether SNAREs mediate fusion solely by creating close proximity between two membranes versus a more active role in transmitting force to the membrane to deform and reorganize lipid bilayer structure. To test the role of membrane attachment, we generated four variants of the synaptic v-SNARE synaptobrevin-2 (syb2) anchored to the membrane by lipid instead of protein. These constructs were tested for functional efficacy in three different systems as follows: Ca(2+)-triggered dense core vesicle exocytosis, spontaneous synaptic vesicle exocytosis, and Ca(2+)-synaptotagmin-enhanced SNARE-mediated liposome fusion. Lipid-anchoring motifs harboring one or two lipid acylation sites completely failed to support fusion in any of these assays. Only the lipid-anchoring motif from cysteine string protein-α, which harbors many lipid acylation sites, provided support for fusion but at levels well below that achieved with wild type syb2. Thus, lipid-anchored syb2 provides little or no support for exocytosis, and anchoring syb2 to a membrane by a TMD greatly improves its function. The low activity seen with syb2-cysteine string protein-α may reflect a slower alternative mode of SNARE-mediated membrane fusion. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  13. Technical Basis for the Removal of Unremediated Nitrate Salt Sampling (UNS) to Support LANL Treatment Studies

    Energy Technology Data Exchange (ETDEWEB)

    Funk, David John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-05-05

    The sampling of unremediated nitrate salts (UNS) was originally proposed by the U.S. Department of Energy (DOE) and Los Alamos National Security, LLC (LANS) (collectively, the Permittees) as a means to ensure adequate understanding and characterization of the problematic waste stream created when the Permittees remediated these nitrate salts-bearing waste with an organic absorbent. The proposal to sample the UNS was driven by a lack of understanding with respect to the radioactive contamination release that occurred within the underground repository at the Waste Isolation Pilot Plant (WIPP) in February 14, 2014, as well as recommendations made by a Peer Review Team. As discussed, the Permittees believe that current knowledge and understanding of the waste has sufficiently matured such that this additional sampling is not required. Perhaps more importantly, the risk of both chemical and radiological exposure to the workers sampling the UNS drum material is unwarranted. This memo provides the technical justification and rationale for excluding the UNS sampling from the treatment studies.

  14. Chronic kidney disease and support provided by home care services: a systematic review.

    Science.gov (United States)

    Aydede, Sema K; Komenda, Paul; Djurdjev, Ognjenka; Levin, Adeera

    2014-07-18

    Chronic diseases, such as chronic kidney disease (CKD), are growing in incidence and prevalence, in part due to an aging population. Support provided through home care services may be useful in attaining a more efficient and higher quality care for CKD patients. A systematic review was performed to identify studies examining home care interventions among adult CKD patients incorporating all outcomes. Studies examining home care services as an alternative to acute, post-acute or hospice care and those for long-term maintenance in patients' homes were included. Studies with only a home training intervention and those without an applied research component were excluded. Seventeen studies (10 cohort, 4 non-comparative, 2 cross-sectional, 1 randomized) examined the support provided by home care services in 15,058 CKD patients. Fourteen studies included peritoneal dialysis (PD), two incorporated hemodialysis (HD) and one included both PD and HD patients in their treatment groups. Sixteen studies focused on the dialysis phase of care in their study samples and one study included information from both the dialysis and pre-dialysis phases of care. Study settings included nine single hospital/dialysis centers and three regional/metropolitan areas and five were at the national level. Studies primarily focused on nurse assisted home care patients and mostly examined PD related clinical outcomes. In PD studies with comparators, peritonitis risks and technique survival rates were similar across home care assisted patients and comparators. The risk of mortality, however, was higher for home care assisted PD patients. While most studies adjusted for age and comorbidities, information about multidimensional prognostic indices that take into account physical, psychological, cognitive, functional and social factors among CKD patients was not easily available. Most studies focused on nurse assisted home care patients on dialysis. The majority were single site studies incorporating

  15. Provider perceptions on HIV risk and prevention services within permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Henwood, Benjamin; Harris, Taylor; Winetrobe, Hailey; Rhoades, Harmony

    2017-10-01

    Permanent supportive housing (PSH) is an evidence-based solution to homelessness for persons experiencing chronic or long-term homelessness and one or more physical or behavioral health problems. Health services through PSH typically focus on physical and behavioral health. With the exception of programs specifically designed for persons living with HIV/AIDS, little attention has focused on services through PSH to prevent transmission of HIV or other sexually transmitted infections (STIs), yet sexual risk behavior continues after homeless persons move into PSH. The purpose of this study was to investigate how PSH providers approach HIV prevention and the challenges they perceive surrounding HIV prevention in PSH. Results serve as a critical first step toward addressing the acceptability and feasibility of providing HIV/STI prevention services to PSH residents. As part of a longitudinal mixed methods study examining HIV risk and prevention behavior among homeless unaccompanied adults moving into PSH in Los Angeles, we conducted eleven focus groups with a total of 60 frontline staff across 10 PSH agencies. Thirty-three percent of focus group participants were African American, 32% were Hispanic, and 55% were women. Results suggest that provider awareness and knowledge of PrEP is very limited, and provision of formal HIV prevention programing for residents is perceived as challenging. Informal, ad hoc conversations with residents about sexual risk and HIV prevention do occur when providers have rapport with clients and perceive risk. There are significant gaps in HIV prevention services through PSH but also opportunities to enhance providers' efforts to promote the health of residents through prevention.

  16. The relationship between women's experiences of mistreatment at facilities during childbirth, types of support received and person providing the support in Lucknow, India.

    Science.gov (United States)

    Diamond-Smith, Nadia; Sudhinaraset, May; Melo, Jason; Murthy, Nirmala

    2016-09-01

    a growing body of literature has highlighted the prevalence of mistreatment that women experience around the globe during childbirth, including verbal and physical abuse, neglect, lack of support, and disrespect. Much of this has been qualitative. Research around the world suggests that support during childbirth can improve health outcomes and behaviours, and improve experiences. Support can be instrumental, informational, or emotional, and can be provided by a variety of people including family (husbands, mothers) or health providers of various professional levels. This study explores women's reported experiences of mistreatment during childbirth quantitatively, and how these varied by specific types of support available and provided by specific individuals. participants were women age 16-30 who had delivered infants in a health facility in the previous five years and were living in slums of Lucknow India. Data were collected on their experiences of mistreatment, the types of support they received, and who provided that support. women who reported lack of support were more likely to report mistreatment. Lack of support in regards to discussions with providers and provider information were most strongly associated with a higher mistreatment score. Women who received any type of support from their husband or a health worker were significantly more likely to report lower mistreatment scores. Receiving informational support from a mother/mother-in-law or emotional support from a health worker was also associated with lower mistreatment scores. However, receiving emotional support from a friend/neighbour/other family member was associated with a higher mistreatment score. women rely on different people to provide different types of support during childbirth in this setting. Some of these individuals provide specific types of support that ultimately improve a woman's overall experience of her childbirth. Interventions aiming to reduce mistreatment to women during

  17. Providing Data Management Support to NASA Airborne Field Studies through Streamlined Usability Design

    Science.gov (United States)

    Beach, A. L., III; Northup, E. A.; Early, A. B.; Chen, G.

    2016-12-01

    Airborne field studies are an effective way to gain a detailed understanding of atmospheric processes for scientific research on climate change and air quality relevant issues. One major function of airborne project data management is to maintain seamless data access within the science team. This allows individual instrument principal investigators (PIs) to process and validate their own data, which requires analysis of data sets from other PIs (or instruments). The project's web platform streamlines data ingest, distribution processes, and data format validation. In May 2016, the NASA Langley Research Center (LaRC) Atmospheric Science Data Center (ASDC) developed a new data management capability to help support the Korea U.S.-Air Quality (KORUS-AQ) science team. This effort is aimed at providing direct NASA Distributed Active Archive Center (DAAC) support to an airborne field study. Working closely with the science team, the ASDC developed a scalable architecture that allows investigators to easily upload and distribute their data and documentation within a secure collaborative environment. The user interface leverages modern design elements to intuitively guide the PI through each step of the data management process. In addition, the new framework creates an abstraction layer between how the data files are stored and how the data itself is organized(i.e. grouping files by PI). This approach makes it easy for PIs to simply transfer their data to one directory, while the system itself can automatically group/sort data as needed. Moreover, the platform is "server agnostic" to a certain degree, making deployment and customization more straightforward as hardware needs change. This flexible design will improve development efficiency and can be leveraged for future field campaigns. This presentation will examine the KORUS-AQ data portal as a scalable solution that applies consistent and intuitive usability design practices to support ingest and management of airborne

  18. Could implantable cardioverter defibrillators provide a human model supporting the learned helplessness theory of depression?

    Science.gov (United States)

    Goodman, M; Hess, B

    1999-01-01

    Affective symptoms were examined retrospectively in 25 patients following placement of implantable cardioverter defibrillators (ICD) which can produce intermittent shocks without warning in response to cardiac ventricular arrhythmias. The number of ICD random, uncontrollable discharge shocks and pre-ICD history of psychological distress (i.e., depression and/or anxiety) were documented in all patients using a demographics questionnaire and a standardized behavioral/psychological symptoms questionnaire (i.e., Symptom Checklist-90 Revised). ICD patients were dichotomized into two groups: those without a history of psychological distress prior to ICD (n = 18) and those with a history of psychological distress prior to ICD (n = 7). In ICD patients without a prior history, results indicated that quantity of ICD discharge shocks was significantly predictive of current reported depression (r = 0.45, p = 0.03) and current reported anxiety (r = 0.51, p = 0.02). Conversely, in patients with a reported history of psychological distress, there was no significant relationship found between quantity of discharge shocks and current reported depression or anxiety. This study may provide evidence in support of a human model of learned helplessness in that it supports the notion that exposure to an unavoidable and inescapable aversive stimulus was found to be related to patients' reported depression. Further studies may wish to prospectively consider a larger sample as well as a more comprehensive assessment of premorbid psychological symptoms.

  19. A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers.

    Science.gov (United States)

    Yang, Chih-Wei; Yen, Zui-Shen; McGowan, Jane E; Chen, Huiju Carrie; Chiang, Wen-Chu; Mancini, Mary E; Soar, Jasmeet; Lai, Mei-Shu; Ma, Matthew Huei-Ming

    2012-09-01

    Advanced life support (ALS) guidelines are widely adopted for healthcare provider training with recommendations for retraining every two years or longer. This systematic review studies the retention of adult ALS knowledge and skills following completion of an ALS course in healthcare providers. We retrieved original articles using Medline, CINAHL, Cochrane Library, and PubMed, and reviewed reference citations to identify additional studies. We extracted data from included articles using a structured approach and organized outcomes by evaluation method, and knowledge and skills retention. Among 336 articles retrieved, 11 papers were included. Most studies used multiple-choice questionnaires to evaluate knowledge retention and cardiac arrest simulation or other skills tests to evaluate skills retention. All studies reported variable rates of knowledge or skills deterioration over time, from 6 weeks to 2 years after training. Two studies noted retention of knowledge at 18 months and up to 2 years, and one reported skills retention at 3 months. Clinical experience, either prior to or after the courses, has a positive impact on retention of knowledge and skills. There is a lack of large well-designed studies examining the retention of adult ALS knowledge and skills in healthcare providers. The available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training and that skills decay faster than knowledge. Additional studies are needed to help provide evidence-based recommendations for assessment of current knowledge and skills and need for refresher training to maximize maintenance of ALS competency. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Technical basis for radiological release of Grand Junction Office Building 2. Volume 2, dose assessment supporting data

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    The second volume of the Grand Junction Office Action Program Technical Basis for Radiological Release of Grand Junction Office Building 2 report includes the data quality objectives (DQO), sampling plan, collected data, and analysis used to model future radiation doses to members of the public occupying Building 2 on the U.S. Department of Energy (DOE) Grand Junction Office (GJO) site. This volume was assembled by extracting relevant components of the Grand Junction Projects Office Remedial Action Project Building 2 Public Dose Evaluation (DOE 1996) and inserting recent additional data that was gathered and dose pathway modeling that was performed. The intent of this document is to provide all derived guidance decisions, assumptions, measured data, testing results, and pathway modeling software input and output data that supports the discussion and determinations presented in Volume 1 of this report. For constructive employment of this document, the reader is encouraged to closely follow Volume 1 for proper association with the segment of information being examined.

  1. Provider order entry with integrated decision support: from academia to industry.

    Science.gov (United States)

    Giuse, D A

    2003-01-01

    To describe the evolution of a provider order entry system with integrated decision support, from a research prototype to full implementation at one academic center, and finally to a commercial product. Describe the institutional environment and planning process in which the system originated. Highlight the historical evolution of the provider entry system, and analyze its system architecture and functionality. Describe the requirements for successful design and deployment both within a single health care organization and as part of a commercial product line. Over a period of eight years the system evolved from a research prototype to a fully integrated order entry system in routine use on most inpatient units of a large academic medical center. Around 12,000 orders are entered every day into the computer system; 70% of those are entered directly by the responsible physician. The system embeds best-of-care practice guidelines, and is used to reduce resource utilization by limiting unnecessary testing and suggesting more effective or less costly therapeutic replacements. The system was recently acquired by a large HIS software vendor and is being rapidly implemented at numerous customer sites. Large-scale development or deployment of complex health information systems requires considerable organizational agreement and resources, as well as close attention to iterative system design that explicitly includes constant feedback from the user community. The transformation of such a system from a single-site success to a widely deployed product requires convergence of resources and needs.

  2. Critical experiments supporting close proximity water storage of power reactor fuel. Technical progress report

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, M.N.; Hoovler, G.S.; Eng, R.L.; Welfare, F.G.

    1979-07-01

    Close-packed storage of LWR fuel assemblies is needed in order to expand the capacity of existing underwater storage pools. This increased capacity is required to accommodate the large volume of spent fuel produced by prolonged onsite storage. To provide benchmark criticality data in support of this effort, 20 critical assemblies were constructed that simulated a variety of close-packed LWR fuel storage configurations. Criticality calculations using the Monte Carlo KENO-IV code were performed to provide an analytical basis for comparison with the experimental data. Each critical configuration is documented in sufficient detail to permit the use of these data in validating calculational methods according to ANSI Standard N16.9-1975.

  3. Primary Care Providers' Use of a Child Psychiatry Telephone Support Program.

    Science.gov (United States)

    Van Cleave, Jeanne; Holifield, Chloe; Perrin, James M

    2017-11-29

    The Massachusetts Child Psychiatry Access Project (MCPAP) provides telephone support from mental health specialists to primary care providers (PCPs). Understanding PCPs' use may inform implementation of similar programs. We sought to examine PCPs' decision-making process to use or not use MCPAP when encountering mental health problems. We analyzed data regarding calls from PCPs to MCPAP from October 1, 2010, to July 31, 2011, and interviewed 14 PCPs with frequent use (≥7 calls) and infrequent use (≤4 calls). PCPs were asked about recent patients with mental health problems, and they were asked to describe reasons for calling or not calling MCPAP. Frequent callers were asked what sustained use; infrequent callers were asked about alternative management strategies. Comparisons were made between these groups in qualitative analysis. PCPs (n = 993) made 6526 calls (mean = 6.6; median = 3). Factors influencing calling included: MCPAP's guidance is timely and tailored to individual scope of practice; MCPAP's ability to arrange therapy referrals exceeds PCPs' ability; providing a plan at point of care relieves anxious families; and MCPAP's assistance helps accommodate families' preference to keep mental health in primary care. Some infrequent callers had gained skills through MCPAP before 2010 and now called only for complex cases. Other reasons for infrequent calling: PCPs have other consultation sources, have fear of being asked to manage more than they are comfortable, or have misperceptions of MCPAP's offerings. MCPAP enhanced PCPs' ability to deliver mental health care consistent with families' preferences. PCPs applied knowledge gained from calls to subsequent patients. Promoting MCPAP components through outreach and tailoring guidance to PCPs' scope of practice may entice greater use. Copyright © 2018. Published by Elsevier Inc.

  4. Attrition of advanced trauma life support (ATLS) skills among ATLS instructors and providers in Mexico.

    Science.gov (United States)

    Azcona, Luis Am; Gutierrez, Guillermo E O; Fernandez, Cesar J P; Natera, Octavio M; Ruiz-Speare, Octavio; Ali, Jameel

    2002-09-01

    Mexico has had the Advanced Trauma Life Support (ATLS) program since 1986. We assessed the attrition of ATLS skills among ATLS providers and instructors in this country. Three groups (S, 16 students [new medical graduates enrolled for an ATLS course]; P, 33 providers; and I, 26 instructors [who had completed courses previously]) were evaluated. Group S read the manual before pretesting. Groups P and I were subdivided based on the length of time since the course had been completed: P1, less than 2 years (n = 22); P2, more than 2 years (n = 11); I1, less than 2 years (n = 16); and I2, more than 2 years (n = 10). Multiple-choice and psychomotor testing using ATLS scoring criteria were used. Affect was assessed post-ATLS for motivational factors, interactivity, and attitude toward trauma care. Multiple-choice test scores (means +/- SD) out of a maximum of 40 were as follows: S, 24.3 +/- 2.6; P1, 24.0 +/- 5.7; P2, 21.3 +/- 8.0; I1, 23.2 +/- 8.2; and I2, 24.0 +/- 7.2. Group S all passed the post-ATLS multiple-choice test (with correct answer percentages of 60.3% +/- 6.6% pre-ATLS versus 88.8% +/- 5.6% post-ATLS). An ATLS passing score of 80% correct answers was achieved in 2 of 33 for group P and 8 of 26 for group I (p ATLS group than in the P and I groups (p ATLS attitude to trauma care. Reading the manual alone yields similar cognitive but inferior psychomotor performance compared with subjects who completed the course previously. The majority of previous providers and instructors did not obtain a passing score (80%) in the multiple-choice test, but all the new providers passed the post-ATLS multiple-choice test, suggesting major attrition of cognitive skills but maintenance of psychomotor skills. Instructors had superior cognitive performance versus providers with worsening performance over time, but clinical skills performance was maintained at an equally high level by all groups. A very positive attitude toward ATLS prevailed among all participants.

  5. The Effect of Interactivity and Technical Support in the use Intention of an E-learning System

    Directory of Open Access Journals (Sweden)

    Angilberto Sabino de Freitas

    2017-05-01

    Full Text Available The objective of this research is to identify the variables that influence the use of e-learning by students in an undergraduate distance course of a Higher Education Institution (HEI. It was identified that Davis’ (1989 Technology Acceptance Model (TAM with the introduction of interactivity and technical support as external variables would be the most appropriate to assess the intention of the student to follow using e-learning. A questionnaire was sent over the internet and resulted in a sample of 260 students. The data were analyzed by Structural Equation Modeling (SEM and the results confirmed the validity of all the hypotheses confirming the importance of interactivity and technical support for the students to continue to use e-learning.

  6. Interleukin 1 genetic tests provide no support for reduction of preventive dental care.

    Science.gov (United States)

    Diehl, Scott R; Kuo, Fengshen; Hart, Thomas C

    2015-03-01

    It has been proposed that the PST and PerioPredict genetic tests that are based on polymorphisms in interleukin 1 (IL-1) genes identify a subset of patients who experience fewer tooth extractions if provided with 2 annual preventive visits. Economic analyses indicate rationing preventive care to only "high-risk" genotypes, smokers, patients with diabetes, or combinations of these risk factors would reduce the cost of dental care by $4.8 billion annually in the United States. Data presented in the study that claimed clinical utility for the PST and PerioPredict tests were obtained for reanalysis using logistic regression to assess whether the PST genetic test, smoking, diabetes, or number of preventive visits were risk factors for tooth extraction during a span of 16 years. Consistency of risk classification by the PST (version 1) and PerioPredict (version 2) genetic tests was evaluated in different ethnic groups from the 1000 Genomes database. Multivariate analyses revealed association of tooth extraction with diabetes (P preventive visits (P = .004), but no support for the PST genetic test (P = .96) nor indication that the benefit of 2 preventive visits was affected by this genetic test (P = .58). Classification of risk was highly inconsistent between the PST (version 1) and PerioPredict (version 2) genetic tests. Two annual preventive visits were supported as beneficial for all patients, and there was no evidence that the IL-1 PST genetic test has any effect on tooth extraction risk or influences the benefits of 2 annual preventive visits. Neither IL-1 PST nor PerioPredict genetic tests are useful for rationing preventive dental care. Further research is needed to identify genetic biomarkers with robust clinical validity and clinical utility to effectively personalize the practice of dentistry. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  7. EDP Sciences and A&A: partnering to providing services to support the scientific community

    Science.gov (United States)

    Henri, Agnes

    2015-08-01

    Scholarly publishing is no longer about simply producing and packaging articles and sending out to subscribers. To be successful, as well as being global and digital, Publishers and their journals need to be fully engaged with their stakeholders (authors, readers, funders, libraries etc), and constantly developing new products and services to support their needs in the ever-changing environment that we work in.Astronomy & Astrophysics (A&A) is a high quality, major international Journal that belongs to the astronomical communities of a consortium of European and South American countries supported by ESO who sponsor the journal. EDP Sciences is a non-profit publisher belonging to several learned societies and is appointed by ESO to publish the journal.Over the last decade, as well as publishing the results of worldwide astronomical and astrophysical research, A&A and EDP Sciences have worked in partnership to develop a wide range of services for the authors and readers of A&A:- A specialist language editing service: to provide a clear and excellent level of English ensuring full understanding of the high-quality science.- A flexible and progressive Open Access Policy including Gold and Green options and strong links with arXiv.- Enriched articles: authors are able to enhance their articles using a wide range of rich media such as 3D models, videos and animations.Multiple publishing formats: allowing readers to browse articles on multiple devices including eReaders and Kindles.- “Scientific Writing for Young Astronomers”: In 2008 EDP Sciences and A&A set up the Scientific Writing for Young Astronomers (SWYA) School with the objective to teach early PhD Students how write correct and efficient scientific papers for different mediums (journals, proceedings, thesis manuscripts, etc.).

  8. Principals Supporting Teachers in Providing Language Instruction to English Learners in Elementary School

    Science.gov (United States)

    Munguia, Celia

    2017-01-01

    The purpose of the study was to examine the systems of support that principals establish at their school sites to support teachers with the academic achievement of the English learner population. Two schools from a single district were selected. Specific strategies, structures, and processes that support teachers and principals of English learners…

  9. Testing of tunnel support : dynamic load testing of rockbolt elements to provide data for safer support design.

    CSIR Research Space (South Africa)

    Ortlepp, WD

    1998-06-01

    Full Text Available forward has been accomplished in that it is now possible to use the same rational procedure for the design of tunnel support as is classically employed for the design of structures or machine components in more rigorous and precise engineering disciplines...

  10. Computer-Supported Feedback Message Tailoring for Healthcare Providers in Malawi: Proof-of-Concept

    Science.gov (United States)

    Landis-Lewis, Zach; Douglas, Gerald P; Hochheiser, Harry; Kam, Matthew; Gadabu, Oliver; Bwanali, Mwatha; Jacobson, Rebecca S

    2015-01-01

    Although performance feedback has the potential to help clinicians improve the quality and safety of care, healthcare organizations generally lack knowledge about how this guidance is best provided. In low-resource settings, tools for theory-informed feedback tailoring may enhance limited clinical supervision resources. Our objectives were to establish proof-of-concept for computer-supported feedback message tailoring in Malawi, Africa. We conducted this research in five stages: clinical performance measurement, modeling the influence of feedback on antiretroviral therapy (ART) performance, creating a rule-based message tailoring process, generating tailored messages for recipients, and finally analysis of performance and message tailoring data. We retrospectively generated tailored messages for 7,448 monthly performance reports from 11 ART clinics. We found that tailored feedback could be routinely generated for four guideline-based performance indicators, with 35% of reports having messages prioritized to optimize the effect of feedback. This research establishes proof-of-concept for a novel approach to improving the use of clinical performance feedback in low-resource settings and suggests possible directions for prospective evaluations comparing alternative designs of feedback messages. PMID:26958217

  11. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

    Directory of Open Access Journals (Sweden)

    Michael Schuckers

    2017-01-01

    Full Text Available The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks” can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics department, or part of a learning commons, or a stand-alone center. There are hundreds of these centers in the U.S. The new handbook, which is the outgrowth of a 2013 NSF-sponsored, national workshop attended by 23 QMaSC directors from all quarters of the U.S., is available open access on the USF Scholar Commons and in hard copy from Amazon.com. This editorial by the handbook’s editors provides background and overview of the 20 detailed chapters on center leadership and management; community interactions; staffing, hiring and training; center assessment; and starting a center; and then a collection of ten case studies from research universities, four-year state colleges, liberal arts colleges, and a community college. The editorial ends by pointing out the need and potential benefits of a professional organization for QMaSC directors.

  12. UK University and College Technical Support for "Second Life" Developers and Users

    Science.gov (United States)

    Kirriemuir, John

    2010-01-01

    Background: Numerous surveys, articles, ephemera and online information sources indicate that "Second Life" has been the predominant virtual world, for educational purposes, in UK universities for the latter half of the 2000s. However, the infrastructure required to operate "Second Life" presents a number of technical concerns…

  13. Service-Oriented Architecture (SOA) as a Technical Framework for Web-Based Support Systems (WSS)

    Science.gov (United States)

    Singh, Vishav Vir

    Software-oriented architecture (SOA) is a very powerful Internet-based framework which can be targeted towards Web-based Support Systems (WSS). SOA equips these systems to supplement their intelligence, decision-making, and processing potential with the universality and ubiquity of the Internet. It makes the WSS 'agile', implying that these support systems can adapt their intelligence very quickly due to the swift access of data available in the form of a 'service' through SOA. No matter how distributed and specialized a data source is, and regardless of whether it is domain-independent or domain-dependent, these systems can just 'plug' into any technology they want by acting as consumers of a 'service'. This truly amplifies the performance and system response of WSS. This chapter follows this vision of defining the architectural technique of SOA and how its nuances interplay with the concept of WSS. A complete case study outlining the marriage of SOA and WSS has been provided to further illustrate the merits of such a combined system.

  14. The Effect of Providing Life Support on Nurses' Decision Making Regarding Life Support for Themselves and Family Members in Japan.

    Science.gov (United States)

    Shaku, Fumio; Tsutsumi, Madoka

    2016-12-01

    Decision making in terminal illness has recently received increased attention. In Japan, patients and their families typically make decisions without understanding either the severity of illness or the efficacy of life-supporting treatments at the end of life. Japanese culture traditionally directs the family to make decisions for the patient. This descriptive study examined the influence of the experiences of 391 Japanese nurses caring for dying patients and family members and how that experience changed their decision making for themselves and their family members. The results were mixed but generally supported the idea that the more experience nurses have in caring for the dying, the less likely they would choose to institute lifesupport measures for themselves and family members. The results have implications for discussions on end-of-life care. © The Author(s) 2016.

  15. Monolayer-crystal streptavidin support films provide an internal standard of cryo-EM image quality

    Energy Technology Data Exchange (ETDEWEB)

    Han, Bong-Gyoon [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Watson, Zoe [Univ. of California, Berkeley, CA (United States); Cate, Jamie H. D. [Univ. of California, Berkeley, CA (United States); Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Glaeser, Robert M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-03-01

    Analysis of images of biotinylated Escherichia coli 70S ribosome particles, bound to streptavidin affinity grids, demonstrates that the image-quality of particles can be predicted by the image-quality of the monolayer crystalline support film. Also, the quality of the Thon rings is a good predictor of the image-quality of particles, but only when images of the streptavidin crystals extend to relatively high resolution. When the estimated resolution of streptavidin was 5 Å or worse, for example, the ribosomal density map obtained from 22,697 particles went to only 9.5 Å, while the resolution of the map reached 4.0 Å for the same number of particles, when the estimated resolution of streptavidin crystal was 4 Å or better. It thus is easy to tell which images in a data set ought to be retained for further work, based on the highest resolution seen for Bragg peaks in the computed Fourier transforms of the streptavidin component. The refined density map obtained from 57,826 particles obtained in this way extended to 3.6 Å, a marked improvement over the value of 3.9 Å obtained previously from a subset of 52,433 particles obtained from the same initial data set of 101,213 particles after 3-D classification. These results are consistent with the hypothesis that interaction with the air-water interface can damage particles when the sample becomes too thin. Finally, streptavidin monolayer crystals appear to provide a good indication of when that is the case.

  16. Migrants and Mobile Technology Use: Gaps in the Support Provided by Current Tools

    Science.gov (United States)

    Epp, Carrie Demmans

    2017-01-01

    Our current understanding of how migrants use mobile tools to support their communication and language learning is inadequate. This study, therefore, explores the learner-initiated use of technologies to support their comprehension, production, and acquisition of English following migration to Canada. Information about migrant use of technologies…

  17. Providing Students with Interdisciplinary Support to Improve Their Organic Chemistry Posters

    Science.gov (United States)

    Widanski, Bozena; Thompson, Jo Ann; Foran-Mulcahy, Katie; Abafo, Amy

    2016-01-01

    A two-semester-long interdisciplinary support effort to improve student posters in organic chemistry lab is described. In the first semester, students' literature search report is supported by a workshop conducted by an Instruction Librarian. During the subsequent semester, a second workshop is presented by the Instruction Librarian, an English…

  18. The performance implications of outsourcing customer support to service providers in emerging versus established economies

    NARCIS (Netherlands)

    Raassens, N.; Wuyts, S.H.K.; Geyskens, I.

    Recent discussions in the business press query the contribution of customer-support outsourcing to firm performance. Despite the controversy surrounding its performance implications, customer-support outsourcing is still on the rise, especially to emerging markets. Against this backdrop, we study

  19. Grower networks support adoption of innovations in pollination management: The roles of social learning, technical learning, and personal experience.

    Science.gov (United States)

    Garbach, Kelly; Morgan, Geoffrey P

    2017-12-15

    Management decisions underpinning availability of ecosystem services and the organisms that provide them in agroecosystems, such as pollinators and pollination services, have emerged as a foremost consideration for both conservation and crop production goals. There is growing evidence that innovative management practices can support diverse pollinators and increase crop pollination. However, there is also considerable debate regarding factors that support adoption of these innovative practices. This study investigated pollination management practices and related knowledge systems in a major crop producing region of southwest Michigan in the United States, where 367 growers were surveyed to evaluate adoption of three innovative practices that are at various stages of adoption. The goals of this quantitative, social survey were to investigate grower experience with concerns and benefits associated with each practice, as well as the influence of grower networks, which are comprised of contacts that reflect potential pathways for social and technical learning. The results demonstrated that 17% of growers adopted combinations of bees (e.g. honey bees, Apis mellifera, with other species), representing an innovation in use by early adopters; 49% of growers adopted flowering cover crops, an innovation in use by the early majority 55% of growers retained permanent habitat for pollinators, an innovation in use by the late majority. Not all growers adopted innovative practices. We found that growers' personal experience with potential benefits and concerns related to the management practices had significant positive and negative relationships, respectively, with adoption of all three innovations. The influence of these communication links likely has different levels of importance, depending on the stage of the adoption that a practice is experiencing in the agricultural community. Social learning was positively associated with adopting the use of combinations of bees

  20. Can CH-53K 3D Technical Data Support the Provisioning Process

    Science.gov (United States)

    2017-05-01

    section of government stakeholders, or high- level government decision makers—are reviewed in compliance with LMI’s ISO- certified quality management...using 3D models documented in CATIA computer-aided design (CAD) software .1 PMA-261’s planned approach for delivering 3D technical data as CATIA models...to use 3D models in proprietary CAD software formats will preclude NAVSUP and DLA LIS from conducting their provisioning and cataloging processes

  1. A Digital Framework to Support Providers and Patients in Diabetes Related Behavior Modification.

    Science.gov (United States)

    Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

    2017-01-01

    We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients. We present the qualitative analysis of D-WISE usability by both physicians and patients.

  2. Nuss procedure: Technical modifications to ease bending of the support bar and lateral stabilizer placement

    Directory of Open Access Journals (Sweden)

    Osman Zeki Karakus

    2016-01-01

    Conclusion: Preoperative bending of the support bar according to anthropometric measurements and fixation of the lateral stabilizers to the support bar in inverted position facilitates bar shaping and lateral stabilizer placement.

  3. PTC test bed upgrades to provide ACSES testing support capabilities at transportation technology center.

    Science.gov (United States)

    2015-06-01

    FRA Task Order 314 upgraded the Positive Train Control (PTC) Test Bed at the Transportation Technology Center to support : testing of PTC systems, components, and related equipment associated with the Advanced Civil Speed Enforcement System : (ACSES)...

  4. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    National Research Council Canada - National Science Library

    Greenberger, Chaya; Mor, Pnina

    2016-01-01

    .... It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one's relative in hospital for the provision of emotional support...

  5. Support options provided and required for modeling with DynaLearn - A case study

    NARCIS (Netherlands)

    Or-Bach, R.; Bredeweg, B.

    2013-01-01

    Science educators strongly advocate the importance of scientific modeling within science education. Although widely advocated for students, modeling is a complex task involving integration of topics, "languages" and abstraction levels. Thus support for the modeling task and for developing modeling

  6. Spontaneously Breathing Extracorporeal Membrane Oxygenation Support Provides the Optimal Bridge to Lung Transplantation.

    Science.gov (United States)

    Schechter, Matthew Adam; Ganapathi, Asvin M; Englum, Brian R; Speicher, Paul J; Daneshmand, Mani A; Davis, R Duane; Hartwig, Matthew G

    2016-12-01

    Extracorporeal membrane oxygenation (ECMO) is being increasingly used as a bridge to lung transplantation. Small, single-institution series have described increased success using ECMO in spontaneously breathing patients compared with patients on ECMO with mechanical ventilation, but this strategy has not been evaluated on a large scale. Using the United Network for Organ Sharing database, all adult patients undergoing isolated lung transplantation from May 2005 through September 2013 were identified. Patients were categorized by their type of pretransplant support: no support, ECMO only, invasive mechanical ventilation (iMV) only, and ECMO + iMV. Kaplan-Meier survival analysis with log-rank testing was performed to compare survival based on type of preoperative support. A Cox regression model was used to determine whether type of preoperative support was independently associated with survival, using previously established predictors of survival as covariates. Approximately 12,403 primary adult pulmonary transplantations were included in this analysis. Sixty-five patients (0.52%) were on ECMO only, 612 (4.93%) required only iMV, 119 (0.96%) were on ECMO + iMV, and the remaining 11,607 (94.6%) required no invasive support before transplantation. One-year survival was decreased in all patients requiring support, regardless of type. However, mid-term survival was similar between patients on ECMO alone and those not on support but significantly worse with patients requiring iMV only or ECMO + iMV. In multivariable analysis, ECMO + iMV and iMV alone were independently associated with decreased survival compared with nonsupport patients, whereas ECMO alone was not significant. In patients with worsening pulmonary disease awaiting lung transplantation, those supported via ECMO with spontaneous breathing demonstrated improved survival compared with other bridging strategies.

  7. Human Factors and Technical Considerations for a Computerized Operator Support System Prototype

    Energy Technology Data Exchange (ETDEWEB)

    Ulrich, Thomas Anthony [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lew, Roger Thomas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Medema, Heather Dawne [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald Laurids [Idaho National Lab. (INL), Idaho Falls, ID (United States); Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    A prototype computerized operator support system (COSS) has been developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based on four underlying elements consisting of a digital alarm system, computer-based procedures, PI&D system representations, and a recommender module for mitigation actions. At this point, the prototype simulates an interface to a sensor validation module and a fault diagnosis module. These two modules will be fully integrated in the next version of the prototype. The initial version of the prototype is now operational at the Idaho National Laboratory using the U.S. Department of Energy’s Light Water Reactor Sustainability (LWRS) Human Systems Simulation Laboratory (HSSL). The HSSL is a full-scope, full-scale glass top simulator capable of simulating existing and future nuclear power plant main control rooms. The COSS is interfaced to the Generic Pressurized Water Reactor (gPWR) simulator with industry-typical control board layouts. The glass top panels display realistic images of the control boards that can be operated by touch gestures. A section of the simulated control board was dedicated to the COSS human-system interface (HSI), which resulted in a seamless integration of the COSS into the normal control room environment. A COSS demonstration scenario has been developed for the prototype involving the Chemical & Volume Control System (CVCS) of the PWR simulator. It involves a primary coolant leak outside of containment that would require tripping the reactor if not mitigated in a very short timeframe. The COSS prototype presents a series of operator screens that provide the needed information and soft controls to successfully mitigate the event.

  8. Language facilitates event memory in early childhood: Child comprehension, adult-provided linguistic support and delayed recall at 16 months.

    Science.gov (United States)

    Lukowski, Angela F; Phung, Janice N; Milojevich, Helen M

    2015-01-01

    Adult-provided supportive language facilitates memory for the past in preverbal and verbal children. Work conducted with 18-month-olds indicates that children benefit from supportive adult language when tested after a 4-week delay but not when tested immediately after sequence demonstration; moreover, findings reveal that supportive language provided only at test may be more facilitative of recall after a delay relative to supportive language provided only at encoding. In the present study, we examined whether child language comprehension abilities moderated the extent to which preverbal children benefitted from supportive language provided at encoding and test. The findings indicated that child language comprehension and supportive language provided at encoding were unassociated with performance at baseline or immediate imitation; however, the moderating effect of child language comprehension on adult-provided supportive language at encoding and test was observed after a 1-week delay. Correlations revealed continuous associations between general comprehension scores and recall performance after the 1-week delay on sequences presented in the most supportive condition at encoding. Taken together, the presented findings reveal that the complex interplay between language and cognition is established in early childhood, with foundational relations emerging before children are capable of verbally reporting on the past.

  9. Final Technical Report: Supporting Wind Turbine Research and Testing - Gearbox Durability Study

    Energy Technology Data Exchange (ETDEWEB)

    Matthew Malkin

    2012-04-30

    The combination of premature failure of wind turbine gearboxes and the downtime caused by those failures leads to an increase in the cost of electricity produced by the wind. There is a need for guidance to asset managers regarding how to maximize the longevity of their gearboxes in order to help keep the cost of wind energy as low as possible. A low cost of energy supports the US Department of Energy's goal of achieving 20% of the electricity in the United States produced by wind by the year 2030. DNV KEMA has leveraged our unique position in the industry as an independent third party engineering organization to study the problem of gearbox health management and develop guidance to project operators. This report describes the study. The study was conducted in four tasks. In Task 1, data that may be related to gearbox health and are normally available to wind project operators were collected for analysis. Task 2 took a more in-depth look at a small number of gearboxes to gain insight in to relevant failure modes. Task 3 brought together the previous tasks by evaluating the available data in an effort to identify data that could provide early indications of impending gearbox failure. Last, the observations from the work were collected to develop recommendations regarding gearbox health management.

  10. Factors that influence evidence-based program sustainment for family support providers in child protection services in disadvantaged communities.

    Science.gov (United States)

    Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Forster, Michell

    2017-08-01

    This paper evaluates program, workplace and process factors associated with implementation and sustainment of an evidence-based parenting support program (EBP) in disadvantaged communities. Correlation analyses and binary logistic regressions were used to assess the associations between key implementation support factors and program implementation (at 18 months) and sustainment (at 36 months) post training with (N=35) Australian Aboriginal and Torres Strait Islander family support providers using the Triple P - Positive Parenting Program in Indigenous child protection agencies. This study demonstrated that for implementation at 18 months, there was a trend for implementing providers to report higher levels of partnership support, perceived program benefit, workplace support and workplace cohesion. However, the only significant relationship was with partnership support (r=.31 pprogram implementation. For sustained implementation at 36 months, no relationship was found between sustainment and program characteristics, workplace characteristics, supervision and peer support or sustainability planning. Supportive coaching was the only significant correlate (r=0.46, pp=0.009] in the program sustainment model. Overall, these findings suggest the need for further exploration of program and workplace variables and provide evidence to consider incorporating partnership support and supportive coaching in real world implementation models to improve the likelihood of EBP implementation and sustainment in Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. The emotional impact of errors or adverse events on healthcare providers in the NICU: The protective role of coworker support.

    Science.gov (United States)

    Winning, Adrien M; Merandi, Jenna M; Lewe, Dorcas; Stepney, Lois M C; Liao, Nancy N; Fortney, Christine A; Gerhardt, Cynthia A

    2017-07-26

    To examine the impact of errors or adverse events on emotional distress and professional quality of life in healthcare providers in the neonatal intensive care unit, and the moderating role of coworker support. Errors or adverse events can result in negative outcomes for healthcare providers. However, the role of coworker support in improving emotional and professional outcomes has not been examined. A cross-sectional online survey from a quality improvement initiative to train peer supporters in a neonatal intensive care unit. During 2015, 463 healthcare providers in a neonatal intensive care unit completed a survey assessing their experiences with an error or adverse event, anxiety, depression, professional quality of life and coworker support. Compared with those who did not experience an error or adverse event (58%), healthcare providers who observed (23%) or were involved (19%) in an incident reported higher levels of anxiety and secondary traumatic stress. Those who were involved in an event reported higher levels of depression and burnout. Differences between the three groups (no event, observation and involvement) for compassion satisfaction were non-significant. Perceived coworker support moderated the association between experiencing an event and both anxiety and depression. Specifically, experiencing an event was associated with higher levels of anxiety and depression when coworkers were perceived as low in supportiveness, but not when they were viewed as highly supportive. Findings suggest that errors or adverse events can have a harmful impact on healthcare providers and that coworker support may reduce emotional distress. © 2017 John Wiley & Sons Ltd.

  12. Does Vicarious Instigation Provide Support for Observational Learning Theories? A Critical Review.

    Science.gov (United States)

    Green, Gina; Osborne, J. Grayson

    1985-01-01

    Examines the theories of Aronfreed, Bandura, Berger, and Hygge. Also reviews experimental evidence published since 1962 which supports theories of observational learning of emotional behavior. While the theories posit that different conditions are necessary to vicarious instigation, most research does not test the theories in any direct way.…

  13. Potential For Plug-In Electric Vehicles To Provide Grid Support Services

    Energy Technology Data Exchange (ETDEWEB)

    Dias, F. G.; Luo, Y.; Mohanpurkar, M.; Hovsapian, R.; Scoffield, D.

    2017-04-01

    Since the modern-day introduction of plug-in electric vehicles (PEVs), scientists have proposed leveraging PEV battery packs as distributed energy resources for the electric grid. PEV charging can be controlled not only to provide energy for transportation but also to provide grid services and to facilitate the integration of renewable energy generation. With renewable generation increasing at an unprecedented rate, most of which is non-dispatchable and intermittent, the concept of using PEVs as controllable loads is appealing to electric utilities. This additional functionality could also provide value to PEV owners and drive PEV adoption. It has been widely proposed that PEVs can provide valuable grid services, such as load shifting to provide voltage regulation. The objective this work is to address the degree to which PEVs can provide grid services and mutually benefit the electric utilities, PEV owners, and auto manufacturers.

  14. Final Report. SFAA No. DEFC02-98CH10961. Technical assistance for joint implementation and other supporting mechanisms and measures for greenhouse gas emissions mitigation

    Energy Technology Data Exchange (ETDEWEB)

    Knight, Denise

    2001-10-15

    IIEC, a division of CERF, has developed an extensive base of experience implementing activities that support climate action by developing USIJI projects in transitional countries within Asia, Latin America, Central and Eastern Europe, and southern Africa. IIEC has been able to provide a range of technical and policy assistance to governments and industry in support of sustainable energy use. IIEC continues to work in key countries with local partners to develop and implement energy efficiency policies and standards, develop site-specific projects, and assist governing bodies to establish national priorities and evaluation criteria for approving GHG-mitigation projects. As part of this project, IIEC focused on promoting a series of activities in Thailand and South Africa in order to identify GHG mitigation projects and work within the national approval process of those countries. The sections of this report outline the activities conducted in each country in order to achieve that goal.

  15. Kennedy Space Center (KSC) Pad B Catenary Capability Analysis and Technical Exchange Meeting (TEM) Support

    Science.gov (United States)

    Wilson, Timmy R.; Kichak, Robert; Rakov, Vladimir; Kithil, Richard, Jr.; Sargent, Noel B.

    2009-01-01

    The existing lightning protection system at Pad 39B for the Space Shuttle is an outgrowth of a system that was put in place for the Apollo Program. Dr. Frank Fisher of Lightning Technologies was a key participant in the design and implementation of that system. He conveyed to the NESC team that the catenary wire provision was put in place quickly (as assurance against possible vehicle damage causing critical launch delays) rather than being implemented as a comprehensive system designed to provide a high degree of guaranteed protection. Also, the technology of lightning protection has evolved over time with considerable work being conducted by groups such as the electric utilities companies, aircraft manufacturers, universities, and others. Several accepted present-day methods for analysis of lightning protection were used by Drs. Medelius and Mata to study the expected lightning environment for the Pad 39B facility and to analyze the degree of protection against direct lightning attachment to the Space Shuttle. The specific physical configuration directly affects the vulnerability, so cases that were considered included the RSS next to and rolled back from the Space Shuttle, and the GOx Vent Arm both extended and withdrawn from the ET. Elements of the lightning protection system at Pad 39B are shown in Figure 6.0-1 and consist of an 80 foot insulating mast on top of the Fixed Support Structure (FSS), a catenary wire system that runs from the mast in a North/South direction to grounds 1000 feet away on each side of the mast, the RSS which can either be next to or away from the Space Shuttle, and a GOx vent that can either be extended or retracted from the top of the ET.

  16. Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

    Energy Technology Data Exchange (ETDEWEB)

    Feldman, D.L.; Dobson, J.E.

    1990-08-01

    This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures, and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.

  17. 16 CFR 1406.4 - Requirements to provide performance and technical notice to prospective purchasers and purchasers.

    Science.gov (United States)

    2010-01-01

    ... recommends the use of this 2 label format in order to provide more consumer awareness of the operation and... any identification of the manufacturer, brand, model, and similar designations. At the manufacturer's...

  18. Providing Staff Training and Programming to Support People with Disabilities: An Academic Library Case Study

    Science.gov (United States)

    Brannen, Michelle H.; Milewski, Steven; Mack, Thura

    2017-01-01

    This case study explores services academic libraries provide to students with disabilities and the impact these can have on the success and experience of these students. The study focuses on staff training and outreach programming. The authors examine the academic library literature surrounding these topics, provide examples of programming…

  19. Child Care Providers' Strategies for Supporting Healthy Eating: A Qualitative Approach

    Science.gov (United States)

    Lynch, Meghan; Batal, Malek

    2012-01-01

    Recent research has revealed child care settings and providers to be important influences on children's developing behaviors. Yet most research on children's nutritional development has focused on home settings and parents. Thus, through semistructured interviews with child care providers, this study aimed to develop a better understanding of the…

  20. Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers

    NARCIS (Netherlands)

    Barker, Gerry J.; Epstein, Joel B.; Williams, Karen B.; Gorsky, Meir; Raber-Durlacher, Judith E.

    2005-01-01

    The Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral/dental management of cancer patients among supportive health care providers. The main purpose was

  1. The Relationship between Environmental Turbulence, Management Support, Organizational Collaboration, Information Technology Solution Realization, and Process Performance, in Healthcare Provider Organizations

    Science.gov (United States)

    Muglia, Victor O.

    2010-01-01

    The Problem: The purpose of this study was to investigate relationships between environmental turbulence, management support, organizational collaboration, information technology solution realization, and process performance in healthcare provider organizations. Method: A descriptive/correlational study of Hospital medical services process…

  2. Reframing cooperation: Challenges in overcoming tensions between professional services and volunteer organizations providing parenting support in immigrant communities

    NARCIS (Netherlands)

    Ponzoni, E.

    2015-01-01

    Volunteer organizations can potentially partner with mainstream professional services to provide better parenting support to immigrant parents. This qualitative study of cooperation between professional agencies and volunteer organizations known as migrant volunteer and community organizations

  3. A Reference Architecture for Providing Tools as a Service to Support Global Software Development

    DEFF Research Database (Denmark)

    Chauhan, Aufeef

    2014-01-01

    -based solutions. The restricted ability of the organizations to have desired alignment of tools with software engineering and development processes results in administrative and managerial overhead that incur increased development cost and poor product quality. Moreover, stakeholders involved in the projects have......Global Software Development (GSD) teams encounter challenges that are associated with distribution of software development activities across multiple geographic regions. The limited support for performing collaborative development and engineering activities and lack of sufficient support...... specific constraints regarding availability and deployments of the tools. The artifacts and data produced or consumed by the tools need to be governed according to the constraints and corresponding quality of service (QoS) parameters. In this paper, we present the research agenda to leverage cloud...

  4. Training Veterans to Provide Peer Support in a Weight-Management Program: MOVE!

    OpenAIRE

    Allicock, Marlyn; Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C; Weiner, Bryan J.; Kinsinger, Linda

    2013-01-01

    Introduction The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. Methods We developed an MI peer cou...

  5. Providing effective support to “deep democracy”:  how can it realistically be done?

    Directory of Open Access Journals (Sweden)

    Jean Bossuyt

    2014-02-01

    Full Text Available Martin Dahinden’s article on “Democracy Promotion at the local level: Experiences, Perspectives and Policy of Swiss International Cooperation” comes at the right time. Democracy promotion is not a new topic on the agenda of the international (European community. Since the democratisation wave of the early 1990s that swept across the developing world, a wide range of donor-supported programmes, mobilising substantial funds, have sought to build institutions and nurture democratic values in hu...

  6. Use of reinforced soil foundation (RSF) to support shallow foundation : technical summary report, November 2008.

    Science.gov (United States)

    2008-11-01

    The presence of a weak soil supporting structural foundations results in low load bearing capacity and : excessive settlements, which can cause structural damage, reduction in durability, and/or deterioration in : performance level. Conventional trea...

  7. Providing support for problem-based learning in dentistry: the Manchester experience.

    Science.gov (United States)

    Hoad-Reddick, Gillian; Theaker, Elizabeth

    2003-02-01

    The introduction of problem-based learning (PBL) into any programme demands a period of adjustment on the part of faculty. Similarly, students new to PBL take time to adapt to what is, for the majority of them, an unfamiliar mode of learning. At Manchester, closed loop PBL is used throughout the first and second years of the dental programme; the method is interdisciplinary; there are no subject boundaries. Dental students work in groups of between 10 and 15, facilitated by a tutor from the Department of Biological Sciences, to research topics and share information in a mutually supportive environment. Each week a different problem forms the focus for learning. In this paper, we seek to describe the measures introduced in response to student feedback collected via routine meetings with the senior tutor, after meetings with their academic or personal tutors and through discussion at the staff students' committee, which we at Manchester have taken to facilitate the process of adaptation to PBL. Changes have been made in the areas of recruitment, pre-admission interviewing, induction (development of an induction booklet and communication skills module) and tutorial support (overhaul of personal tutor system and introduction of peer-assisted study (PAS) and personal and academic development programmes (PADPs)). Feedback on these changes, gathered via the routes described above, has been positive and continues to be central to our processes of development in these areas. Although the various ways in which PBL has been implemented worldwide may place limits on the transferability of our methods, this paper serves to illustrate some of the means available to support students in the transition to self-directed learning. The latter is not only an essential component of PBL but also something we should be seeking to foster in all students, no matter what philosophy and method of course delivery are utilized.

  8. A programmable rules engine to provide clinical decision support using HTML forms.

    Science.gov (United States)

    Heusinkveld, J; Geissbuhler, A; Sheshelidze, D; Miller, R

    1999-01-01

    The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser.

  9. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

    OpenAIRE

    Michael Schuckers; Mary B. O'Neill; Grace Coulombe

    2017-01-01

    The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks”) can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics departm...

  10. Workshop for Early Career Geoscience Faculty: Providing resources and support for new faculty to succeed

    Science.gov (United States)

    Hill, T. M.; Beane, R. J.; Macdonald, H.; Manduca, C. A.; Tewksbury, B. J.; Allen-King, R. M.; Yuretich, R.; Richardson, R. M.; Ormand, C. J.

    2015-12-01

    A vital strategy to educate future geoscientists is to support faculty at the beginning of their careers, thus catalyzing a career-long impact on the early-career faculty and on their future students. New faculty members are at a pivotal stage in their careers as they step from being research-focused graduate students and post-doctoral scholars, under the guidance of advisors, towards launching independent careers as professors. New faculty commonly, and not unexpectedly, feel overwhelmed as they face challenges to establish themselves in a new environment, prepare new courses, begin new research, and develop a network of support. The workshop for Early Career Geoscience Faculty: Teaching, Research, and Managing Your Career has been offered annually in the U.S. since 1999. The workshop is currently offered through the National Association of Geoscience Teachers On the Cutting Edge professional development program with support from the NSF, AGU and GSA. This five-day workshop, with associated web resources, offers guidance for incorporating evidence-based teaching practices, developing a research program, and managing professional responsibilities in balance with personal lives. The workshop design includes plenary and concurrent sessions, individual consultations, and personalized feedback from workshop participants and leaders. Since 1999, more than 850 U.S. faculty have attended the Early Career Geoscience Faculty workshop. Participants span a wide range of geoscience disciplines, and are in faculty positions at two-year colleges, four-year colleges, comprehensive universities and research universities. The percentages of women (~50%) and underrepresented participants (~8%) are higher than in the general geoscience faculty population. Multiple participants each year are starting positions after receiving all or part of their education outside the U.S. Collectively, participants report that they are better prepared to move forward with their careers as a result of

  11. ANL Technical Support Program for DOE Environmental Restoration and Waste Management; Annual report, October 1992--September 1993

    Energy Technology Data Exchange (ETDEWEB)

    Bates, J.K.; Bourcier, W.L.; Bradley, C.R. [and others

    1994-06-01

    This report is an overview of the progress during FY 1993 for the Technical Support Program that is part of the ANL Technology Support Activity for DOE Environmental Restoration and Waste Management (EM). The purpose is to evaluate, before hot start-up of the Defense Waste Processing Facility (DWPF) and the West Valley Demonstration Project (WVDP), factors that are anticipated to affect glass reaction in an unsaturated environment typical of what may be expected for the candidate Yucca Mountain repository site. Specific goals for the testing program include the following: reviewing and evaluating available data on parameters that will be important in establishing the long-term performance of glass in a repository environment; performing tests to further quantify the effects of important variables where there are deficiencies in the available data; and initiating long-term tests to determine glass performance under a range of conditions applicable to repository disposal.

  12. The Anterior Thalamus Provides A Subcortical Circuit Supporting Memory And Spatial Navigation

    Directory of Open Access Journals (Sweden)

    Shane M O‘Mara

    2013-08-01

    Full Text Available The anterior thalamic nuclei, a central component of Papez’ circuit, are generally assumed to be key constituents of the neural circuits responsible for certain categories of learning and memory. Supporting evidence for this contention is that damage to either of two brain regions, the medial temporal lobe and the medial diencephalon, is most consistently associated with anterograde amnesia. Within these respective regions, the hippocampal formation and the anterior thalamic nuclei (anteromedial, anteroventral, anterodorsal are the particular structures of interest. The extensive direct and indirect hippocampal-anterior thalamic interconnections and the presence of theta-modulated cells in both sites further support the hypothesis that these structures constitute a neuronal network crucial for memory and cognition. The major tool in understanding how the brain processes information is the analysis of neuronal output at each hierarchical level along the pathway of signal propagation coupled with neuroanatomical studies. Here, we discuss the electrophysiological properties of cells in the anterior thalamic nuclei with an emphasis on their role in spatial navigation. In addition, we describe neuroanatomical and functional relationships between the anterior thalamic nuclei and hippocampal formation.

  13. Fostering a supportive moral climate for health care providers: Toward cultural safety and equity

    Directory of Open Access Journals (Sweden)

    Adel F. Almutairi

    Full Text Available In Western forms of health care delivery around the globe, research tells us that nurses experience excessive workloads as they face increasingly complex needs in the populations they serve, professional conflicts, and alienation from leadership in health care bureaucracies. These problems are practical and ethical as well as cultural. Cultural conflicts can arise when health care providers and the populations they serve come from diverse economic, ethnic, and cultural backgrounds. The purpose in this paper is to draw from Almutairi’s research with health care teams in Saudi Arabia to show the complexity of culturally and morally laden interactions between health care providers and patients and their families. Then, I will argue for interventions that promote social justice and cultural safety for nurses, other health care providers, and the individuals, families, and communities they serve. This will include addressing international implications for nursing practice, leadership, policy and research. Keywords: Moral climate, Social justice, Equity, Cultural diversity

  14. Predictors of Quality and Commitment in Family Child Care: Provider Education, Personal Resources, and Support.

    Science.gov (United States)

    Weaver, Ruth Harding

    2002-01-01

    Examined the personal characteristics and resources in 65 licensed family child care providers' lives that influence developmentally enhancing caregiving and professional commitment. Unique predictors to higher quality of care were higher levels of formal education and training, college coursework in early childhood education, higher psychological…

  15. Beyond the Clinic: Providing Services, Supports, and Connections to Help Children and Their Families Thrive

    Science.gov (United States)

    Nolan, Kevin J., Jr.

    2013-01-01

    As one of the premier pediatric hospitals in the United States, Boston Children's Hospital serves a wide range of children and provides top quality medical care, including a program for deaf and hard of hearing children that extends services beyond the medical scope. Within this program is a unique and particularly critical position--that of…

  16. Providing Social Enterprises with Better Access to Public Procurement : The Development of Supportive Legal Frameworks

    NARCIS (Netherlands)

    Argyrou, A.

    2017-01-01

    This article discusses the issue of social enterprises gaining access to public procurement processes and contracts at the EU and national level. It primarily examines the opportunities for social enterprises to access public procurement contracts provided for in the Public Procurement Directive

  17. Views on Logistics, Candid Voices, Providing Responsive Logistics Support: Applying LEAN Thinking to Logistics

    Science.gov (United States)

    1999-10-01

    repair, production, transportation, etc.) must provide customers with what they need when they need it. It must also minimize the cost to the customer . What...repair, produce or purchase things based on forecasted demands. However, in order to minimize the cost to the customer , the logistics system must repair

  18. Providing a Supportive Alternative Education Environment for At-Risk Students

    Science.gov (United States)

    McGee, John J.; Lin, Fan-Yu

    2017-01-01

    Many factors cause student disengagement from school that subsequently result in high dropout rates. Alternative education (AE) programs provide a different pathway for at-risk youths who do not meet the goals, standards, and requirements of traditional educational settings. However, educational agencies have vastly different interpretations…

  19. Parenting During Residency: Providing Support for Dr Mom and Dr Dad.

    Science.gov (United States)

    Morris, Laura; Cronk, Nikole J; Washington, Karla T

    2016-02-01

    Parenting during family medicine residency is increasingly common. Relatively little is known about how the competing demands of work and family life affect residents. We conducted an exploratory qualitative study of parenting family medicine residents at one program in the Midwest utilizing focus groups to understand residents' perceptions of the positive and negative characteristics of their roles as physicians and parents. We used consensus coding to identify themes in the data and then developed a model to illustrate the relationships among the identified themes. Competing demands on their time require parenting family medicine residents to often make difficult choices, which result in both positive and negative outcomes for residents, their families, and their residency experience. Parenting family medicine residents experience numerous conflicts in their concurrent roles of learner, physician, and parent. Parenting-friendly residency training programs would likely offer valuable support for these individuals during this stressful life period.

  20. Using e-Coaching to Support an Early Intervention Provider's Implementation of a Functional Assessment-Based Intervention

    Science.gov (United States)

    Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.

    2016-01-01

    This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…

  1. Students seeking technical internships as part of an exchange program

    OpenAIRE

    Nystrom, Lynn A.

    2004-01-01

    Virginia Tech students are seeking the support of research centers, academic departments, and area businesses to provide opportunities for technical internships through the International Association for the Exchange of Students for Technical Experience (IAESTE).

  2. Use of an Online Community to Provide Support to Caregivers of People With Dementia

    OpenAIRE

    Pagán-Ortiz, Marta E.; Dharma E. Cortés; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue

    2014-01-01

    One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, since linguistically and culturally appropriate information is often not available. In response to these needs, we developed a website for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and ...

  3. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers

    Directory of Open Access Journals (Sweden)

    Nicholas David

    2010-06-01

    Full Text Available Abstract Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1 post-operative AIS patients or surgical candidates (10-18 years (n = 11, (2 their parents (n = 6 and (3 health care providers (n = 11. This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1 create the website with the target audience in mind; (2 clearly state the purpose of the website and organize website content

  4. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers.

    Science.gov (United States)

    Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G

    2010-06-29

    Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1) post-operative AIS patients or surgical candidates (10-18 years) (n = 11), (2) their parents (n = 6) and (3) health care providers (n = 11). This paper reports on the findings from focus groups with health care providers. Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1) create the website with the target audience in mind; (2) clearly state the purpose of the website and organize website content to support the user; (3) offer a

  5. Satellite provided customer premise services: A forecast of potential domestic demand through the year 2000. Volume 2: Technical report

    Science.gov (United States)

    Kratochvil, D.; Bowyer, J.; Bhushan, C.; Steinnagel, K.; Al-Kinani, G.

    1983-01-01

    The potential United States domestic telecommunications demand for satellite provided customer premises voice, data and video services through the year 2000 were forecast, so that this information on service demand would be available to aid in NASA program planning. To accomplish this overall purpose the following objectives were achieved: development of a forecast of the total domestic telecommunications demand, identification of that portion of the telecommunications demand suitable for transmission by satellite systems, identification of that portion of the satellite market addressable by Computer premises services systems, identification of that portion of the satellite market addressabble by Ka-band CPS system, and postulation of a Ka-band CPS network on a nationwide and local level. The approach employed included the use of a variety of forecasting models, a market distribution model and a network optimization model. Forecasts were developed for; 1980, 1990, and 2000; voice, data and video services; terrestrial and satellite delivery modes; and C, Ku and Ka-bands.

  6. Using High-Technology Simulators to Prepare Anesthesia Providers Before Implementation of a New Electronic Health Record Module: A Technical Report.

    Science.gov (United States)

    Weintraub, Ari Y; Deutsch, Ellen S; Hales, Roberta L; Buchanan, Newton A; Rock, Whitney L; Rehman, Mohamed A

    2017-06-01

    Learning to use a new electronic anesthesia information management system can be challenging. Documenting anesthetic events, medication administration, and airway management in an unfamiliar system while simultaneously caring for a patient with the vigilance required for safe anesthesia can be distracting and risky. This technical report describes a vendor-agnostic approach to training using a high-technology manikin in a simulated clinical scenario. Training was feasible and valued by participants but required a combination of electronic and manual components. Further exploration may reveal simulated patient care training that provides the greatest benefit to participants as well as feedback to inform electronic health record improvements.

  7. Active Control of Thermostatic Loads for Economic and Technical Support to Distribution Grids

    DEFF Research Database (Denmark)

    Bhattarai, Bishnu Prasad; Mendaza, Iker Diaz de Cerio; Bak-Jensen, Birgitte

    2016-01-01

    Active control of electric water heaters (EWHs) is presented in this paper as a means of exploiting demand flexibility for supporting low-voltage (LV) distribution grids. A single-node model of an EWH is implemented in DIgSILENT PowerFactory using a thermal energy balancing equation and three dec...

  8. Map maker’s guide: a decision support system for interpolation, aggregation, and disaggregation : technical documentation

    NARCIS (Netherlands)

    Walvoort, D.J.J.; Knotters, M.; Hoogland, T.; Wijnen, van H.; Dijk, van T.A.; Schöll, van L.; Groenenberg, J.E.

    2013-01-01

    This report documents a decision support system (DSS) that has been developed to assist environmental researchers in selecting interpolation, aggregation, and disaggregation methods. The DSS has been implemented as a web-application. This facilitates updating and makes the DSS generally accessible.

  9. Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis.

    Science.gov (United States)

    Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I

    2017-10-13

    Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.

  10. FINDER, A system providing complex decision support for commercial transport replanning operations

    Science.gov (United States)

    Bittermann, Vincent; Deker, Guy; Sassus, Pierre; Mielnik, Jean-Christophe; Jud, Jean-Marie

    1994-03-01

    Decision-aid systems, likely to appear in future aircraft generations, could play a central role in the cockpit thanks to the broad spectrum of functionalities and decision support facilities they will offer to the crew. As part of such systems, the exploratory FINDER mock-up is a knowledge based system (KBS) designed to help crew members continually optimize their flight plan by suggesting solutions considering exhaustive information related to flight context, either on pilot request or upon external information occurrence. The successful evaluation by Air France pilots of that first mock-up dedicated to diversion procedure on pilot request has led to the current development of an enhanced system with nominal enroute operations and real-time capabilities. Nominal enroute operations concern the optimization with respect to an evolutive constraining of favoring environment (due to weather, traffic or regulated areas, and ETOPS constraints). This study paves the way for a future flight assistant system concept which is already under investigation and may take place in SEXTANT Avionique's future development steps.

  11. Providing Palliative Care in a Swedish Support Home for People Who Are Homeless.

    Science.gov (United States)

    Håkanson, Cecilia; Sandberg, Jonas; Ekstedt, Mirjam; Kenne Sarenmalm, Elisabeth; Christiansen, Mats; Öhlén, Joakim

    2016-07-01

    Despite high frequencies of multiple, life-limiting conditions relating to palliative care needs, people who are homeless are one of the most underserved and rarely encountered groups in palliative care settings. Instead, they often die in care places where palliative competence is not available. In this qualitative single-case study, we explored the conditions and practices of palliative care from the perspective of staff at a Swedish support home for homeless people. Interpretive description guided the research process, and data were generated from repeated reflective conversations with staff in groups, individually, and in pairs. The findings disclose a person-centered approach to palliative care, grounded in the understanding of the person's health/illness and health literacy, and how this is related to and determinant on life as a homeless individual. Four patterns shape this approach: building trustful and family-like relationships, re-dignifying the person, re-considering communication about illness and dying, and re-defining flexible and pragmatic care solutions. © The Author(s) 2015.

  12. Providing Evidence-Based, Intelligent Support for Flood Resilient Planning and Policy: The PEARL Knowledge Base

    Directory of Open Access Journals (Sweden)

    George Karavokiros

    2016-09-01

    Full Text Available While flood risk is evolving as one of the most imminent natural hazards and the shift from a reactive decision environment to a proactive one sets the basis of the latest thinking in flood management, the need to equip decision makers with necessary tools to think about and intelligently select options and strategies for flood management is becoming ever more pressing. Within this context, the Preparing for Extreme and Rare Events in Coastal Regions (PEARL intelligent knowledge-base (PEARL KB of resilience strategies is presented here as an environment that allows end-users to navigate from their observed problem to a selection of possible options and interventions worth considering within an intuitive visual web interface assisting advanced interactivity. Incorporation of real case studies within the PEARL KB enables the extraction of (evidence-based lessons from all over the word, while the KB’s collection of methods and tools directly supports the optimal selection of suitable interventions. The Knowledge-Base also gives access to the PEARL KB Flood Resilience Index (FRI tool, which is an online tool for resilience assessment at a city level available to authorities and citizens. We argue that the PEARL KB equips authorities with tangible and operational tools that can improve strategic and operational flood risk management by assessing and eventually increasing resilience, while building towards the strengthening of risk governance. The online tools that the PEARL KB gives access to were demonstrated and tested in the city of Rethymno, Greece.

  13. Energy Flexibility from Large Prosumers to Support Distribution System Operation—A Technical and Legal Case Study on the Amsterdam ArenA Stadium

    Directory of Open Access Journals (Sweden)

    Dirk Kuiken

    2018-01-01

    Full Text Available To deal with the rising integration of stochastic renewables and energy intensive distributed energy resources (DER to the electricity network, alternatives to expensive network reinforcements are increasingly needed. An alternative solution often under consideration is integrating flexibility from the consumer side to system management. However, such a solution needs to be contemplated from different angles before it can be implemented in practice. To this end, this article considers a case study of the Amsterdam ArenA stadium and its surrounding network where flexibility is expected to be available to support the network in the future. The article studies the technical aspects of using this flexibility to determine to what extent, despite the different, orthogonal goals, the available flexibility can be used by various stakeholders in scenarios with a large load from electric vehicle charging points. Furthermore, a legal study is performed to determine the feasibility of the technical solutions proposed by analysing current European Union (EU and Dutch law and focusing on the current agreements existing between the parties involved. The article shows that flexibility in the network provided by Amsterdam ArenA is able to significantly increase the number of charging points the network can accommodate. Nonetheless, while several uses of flexibility are feasible under current law, the use of flexibility provided by electric vehicles specifically faces several legal challenges in current arrangements.

  14. Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Bazzano AN

    2016-11-01

    Full Text Available Alessandra N Bazzano,1 Lisa Littrell,1 Amelia Brandt,1 Shelley Thibeau,2 Kamala Thriemer,3 Katherine P Theall1 1Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 2Ochsner Health System, New Orleans, LA, USA; 3MLT EpiConsult, Jingili, NT, Australia Background: Exclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited. Lactation consultants, obstetricians, and other health providers are an important point of contact for breastfeeding women experiencing challenges with lactation. This study explored providers’ perceptions, experiences, and practices in relation to galactagogue recommendation. Method: A cross-sectional survey was conducted among a convenience sample of English-speaking health providers in the US who counsel breastfeeding women and their infants. Results: More than 70% of respondents reported to recommend galactagogues. The most frequently recommended galactagogue was fenugreek with respondents indicating that they recommend it either ‘always’ (8.5% or ‘most of the time’ (14.9% and ‘sometimes’ (46.8%. More than 80% of the respondents indicated that galactagogues were useful for their clients and only one-third reported side effects. Reasons for refraining from recommending galactagogues were insufficient evidence of its efficacy and safety. Respondents reported a wide variety of sources of information used for their own education about galactagogues. Discussion: Despite little evidence regarding safety and efficacy, some galactagogues are widely recommended and often perceived to be useful. However, concerns about their efficacy and safety

  15. Use of an online community to provide support to caregivers of people with dementia.

    Science.gov (United States)

    Pagán-Ortiz, Marta E; Cortés, Dharma E; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue

    2014-01-01

    One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, because linguistically and culturally appropriate information is often not available. In response to these needs, we developed a web site for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in 3 countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.

  16. TECHNICAL COMPARISON OF CANDIDATE ION EXCHANGE MEDIA FOR SMALL COLUMN ION EXCHANGE (SCIX) APPLICATIONS IN SUPPORT OF SUPPLEMENTAL LAW PRETREATMENT

    Energy Technology Data Exchange (ETDEWEB)

    RAMSEY AA; THORSON MR

    2010-12-28

    At-tank supplemental pretreatment including both filtration and small column ion exchange is currently under evaluation to facilitate salt waste retrieval and processing in the Hanford tank farms. Spherical resorcinol formaldehyde (sRF) resin is the baseline ion exchange resin for use in the Waste Treatment and Immobilization Plant (WTP). This document provides background and technical rationale to assist in determining whether spherical resorcinol formaldehyde (sRF) is also the appropriate ion exchange resin for supplemental LAW pretreatment processes and compares sRF with crystalline silicotitanate (CST) as potential supplemental pretreatment ion exchange media.

  17. Scientific support, soil information and education provided by the Austrian Soil Science Society

    Science.gov (United States)

    Huber, Sigbert; Baumgarten, Andreas; Birli, Barbara; Englisch, Michael; Tulipan, Monika; Zechmeister-Boltenstern, Sophie

    2015-04-01

    The Austrian Soil Science Society (ASSS), founded in 1954, is a non-profit organisation aiming at furthering all branches of soil science in Austria. The ASSS provides information on the current state of soil research in Austria and abroad. It organizes annual conferences for scientists from soil and related sciences to exchange their recent studies and offers a journal for scientific publications. Annually, ASSS awards the Kubiena Research Prize for excellent scientific studies provided by young scientists. In order to conserve and improve soil science in the field, excursions are organized, also in cooperation with other scientific organisations. Due to well-established contacts with soil scientists and soil science societies in many countries, the ASSS is able to provide its members with information about the most recent developments in the field of soil science. This contributes to a broadening of the current scientific knowledge on soils. The ASSS also co-operates in the organisation of excursions and meetings with neighbouring countries. Several members of the ASSS teach soil science at various Austrian universities. More detail on said conferences, excursions, publications and awards will be given in the presentation. Beside its own scientific journal, published once or twice a year, and special editions such as guidebooks for soil classification, the ASSS runs a website providing information on the Society, its activities, meetings, publications, awards and projects. Together with the Environment Agency Austria the ASSS runs a soil platform on the internet. It is accessible for the public and thus informs society about soil issues. This platform offers a calendar with national and international soil events, contacts of soil related organisations and networks, information on national projects and publications. The society has access to products, information material and information on educational courses. Last but not least information on specific soil

  18. Preventing HIV by providing support for orphan girls to stay in school: does religion matter?

    Science.gov (United States)

    Hallfors, Denise D; Cho, Hyunsan; Iritani, Bonita J; Mapfumo, John; Mpofu, Elias; Luseno, Winnie K; January, James

    2013-01-01

    The paper examines the influence of religion on attitudes, behaviors, and HIV infection among rural adolescent women in Zimbabwe. We analyzed data from a 2007 to 2010 randomized controlled trial in rural eastern Zimbabwe testing whether school support can prevent HIV risk behaviors and related attitudes among rural adolescent orphan girls; supplementary data from the 2006 Zimbabwe Demographic and Health Survey (ZDHS) were also analyzed. The present study design is largely cross-sectional, using the most recent available survey data from the clinical trial to examine the association between religious affiliation and religiosity on school dropout, marriage, and related attitudes, controlling for intervention condition, age and orphan type. The ZDHS data examined the effect of religious denomination on marriage and HIV status among young rural women, controlling for age. Apostolic Church affiliation greatly increased the likelihood of early marriage compared to reference Methodist Church affiliation (odds ratio = 4.5). Greater religiosity independently reduced the likelihood of school dropout, increased gender equity attitudes and disagreement with early sex, and marginally reduced early marriage. Young rural Apostolic women in the ZDHS were nearly four times as likely to marry as teenagers compared to Protestants, and marriage doubled the likelihood of HIV infection. Findings contradict an earlier seminal study that Apostolics are relatively protected from HIV compared to other Christian denominations. Young Apostolic women are at increased risk of HIV infection through early marriage. The Apostolic Church is a large and growing denomination in sub-Saharan Africa and many Apostolic sects discourage medical testing and treatment in favor of faith healing. Since this can increase the risk of undiagnosed HIV infection for young married women and their infants in high prevalence areas, further study is urgently needed to confirm this emerging public health problem

  19. Technical work plan for Surface Impoundments Operable Unit engineering support studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    This document provides a comprehensive work plan which, when utilized as a data collection guide for field activities, will provide the necessary information required to complete a report on geotechnical properties of the sediments contained in the Surface Impoundments Operable Unit at Oak Ridge National Laboratory in Oak Ridge, Tennessee. Detailed guidance is provided for the following activities: collection of samples from the impoundments; compressive strength testing of the raw sediments; compressive strength testing of the structurally modified (lime and cement additives) sediments; testing for sediment physical properties and settling rates; testing for sediment dewatering characteristics; testing for radiation activity during the field work; testing for polymer additions that may enhance settling. The work plan additionally provides guidance and examples for the preparation of documents necessary to establish readiness for safe and satisfactory performance of the field activities. An outline for the format requested for a report of these data is also provided.

  20. Technical support for open-cycle MHD program. Progress report, July-September 1979

    Energy Technology Data Exchange (ETDEWEB)

    Berry, G.F. (ed.)

    1981-06-01

    The support program for open-cycle MHD at the Argonne National Laboratory consists of developing the analytical tools needed for investigation of the performance of the major components in the combined-cycle MHD/steam power system. The analytical effort is centered on the primary components of the system that are unique to MHD and, also, in the integration of these analytical models into a mode for the entire power-producing system. The present project activities include modeling of the secondary combustor, generator, seed deposition, and formation and decomposition of NO. Costing models were developed and used to assess the effect of parameter changes on cost of electricity. Parametric studies were performed to evaluate the performance of the U-25B generator and to support the design of the US U-25B generator. Refinements and improvements to the MHD systems code and executive program are described.

  1. Cost-Effectiveness Analysis of the 2009 and 2012 IECC Residential Provisions – Technical Support Document

    Energy Technology Data Exchange (ETDEWEB)

    Mendon, Vrushali V.; Lucas, Robert G.; Goel, Supriya

    2012-12-04

    This analysis was conducted by Pacific Northwest National Laboratory (PNNL) in support of the U.S. Department of Energy’s (DOE) Building Energy Codes Program (BECP). DOE supports the development and adoption of efficient residential and commercial building energy codes. These codes set the minimum requirements for energy efficient building design and construction and ensure energy savings on a national level. This analysis focuses on one and two family dwellings, townhomes, and low-rise multifamily residential buildings. For these buildings, the basis of the energy codes is the International Energy Conservation Code (IECC). This report does not address commercial and high-rise residential buildings, which reference ANSI/ASHRAE/IES Standard 90.1.

  2. Deficiencies in postgraduate training for healthcare professionals who provide diabetes education and support

    DEFF Research Database (Denmark)

    Byrne, J. L.; Davies, Melanie J; Willaing, I.

    2017-01-01

    : The present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management......Aims: To consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Methods: A total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17...... in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31–60% of healthcare professionals across the different...

  3. Life support systems analysis and technical trades for a lunar outpost

    Science.gov (United States)

    Ferrall, J. F.; Ganapathi, G. B.; Rohatgi, N. K.; Seshan, P. K.

    1994-01-01

    The NASA/JPL life support systems analysis (LISSA) software tool was used to perform life support system analysis and technology trades for a Lunar Outpost. The life support system was modeled using a chemical process simulation program on a steady-state, one-person, daily basis. Inputs to the LiSSA model include metabolic balance load data, hygiene load data, technology selection, process operational assumptions and mission parameter assumptions. A baseline set of technologies has been used against which comparisons have been made by running twenty-two cases with technology substitutions. System, subsystem, and technology weights and powers are compared for a crew of 4 and missions of 90 and 600 days. By assigning a weight value to power, equivalent system weights are compared. Several less-developed technologies show potential advantages over the baseline. Solid waste treatment technologies show weight and power disadvantages but one could have benefits associated with the reduction of hazardous wastes and very long missions. Technology development towards reducing the weight of resupplies and lighter materials of construction was recommended. It was also recommended that as technologies are funded for development, contractors should be required to generate and report data useful for quantitative technology comparisons.

  4. Ketosteroid isomerase provides further support for the idea that enzymes work by electrostatic preorganization.

    Science.gov (United States)

    Kamerlin, Shina C L; Sharma, Pankaz K; Chu, Zhen T; Warshel, Arieh

    2010-03-02

    One of the best systems for exploring the origin of enzyme catalysis has been the reaction of ketosteroid isomerase (KSI). Studies of the binding of phenolates to KSI have been taken as proof that the electrostatic preorganization effect only makes a minor contribution to the binding of the real, multiring, transition state (TS). However, our simulation study has determined that the difference between the phenolates and the TS arises from the fact that the nonpolar state of the phenolate can rotate freely relative to the oxyanion hole and thus loses the preorganization contribution. A recent study explored the reactivity of both small and multiring systems and concluded that their similar reactivity contradicts our preorganization idea. Herein, we establish that the available experiments in fact provide what is perhaps the best proof and clarification of the preorganization idea and its crucial role in enzyme catalysis. First, we analyze the binding energy and the pK(a) of equilenin and identify direct experimental evidence for our prediction about the differential electrostatic stabilization of the large TS and the small phenolates. Subsequently, we show that the similar reactivity of the small and large systems is also due to an electrostatic preorganization effect but that this effect only appears in the intermediate state because the TS is not free to rotate. This establishes the electrostatic origin of enzyme catalysis. We also clarify the crucial importance of having a well-defined physical concept when examining catalytic effects and the need for quantitative tools for analyzing such effects.

  5. Kelp transcriptomes provide robust support for interfamilial relationships and revision of the little known Arthrothamnaceae (Laminariales).

    Science.gov (United States)

    Jackson, Chris; Salomaki, Eric D; Lane, Christopher E; Saunders, Gary W

    2017-02-01

    If ever there were "charismatic megaflora" of the sea, the Laminariales (kelp) would undoubtedly meet that designation. From the Northeast Pacific kelp forests to the less diverse, but nonetheless dense, kelp beds ranging from the Arctic to the cold temperate waters of the Southern Hemisphere, kelp provide habitat structure and food for a variety of productive marine systems. Consequently, kelp are well represented in the literature, however, understanding their evolution has proven challenging. We used a 152-gene phylogenomics approach to better resolve the phylogeny of the "derived" kelp families (viz., Agaraceae, Alariaceae, Laminariaceae, and Lessoniaceae). The formerly unresolved Egregia menziesii firmly joined a significantly expanded Arthrothamnaceae including Arthrothamnus, Cymathaere, Ecklonia, Macrocystis, Nereocystis, Pelagophycus, Postelsia, Pseudolessonia, Saccharina, and Streptophyllopsis, which rendered both the Laminariaceae and Lessoniaceae monogeneric. A published eight-gene alignment, the most marker-rich prior to this study, was expanded and analyzed to facilitate inclusion of Aureophycus. Although the topology was unchanged at the family level between the transcriptome data set relative to eight-gene analyses, the superior resolving power of the former was clearly established. © 2016 Phycological Society of America.

  6. An enabling system for echocardiography providing adaptive support through behavioral analysis.

    Science.gov (United States)

    Trochim, S; Weidenbach, M; Pieper, S; Wick, C; Berlage, T

    2001-01-01

    Echocardiography requires the integrated application of a broad spectrum of cognitive and practical skills, e.g. diagnostic knowledge (symbolic), image interpretation (visual perception) and handling of the ultrasound probe (sensorimotor). This complex expertise is acquired through extensive practical training guided by a skilled cardiologist that is often incompatible with clinical reality. Especially for beginners, the most critical point during an echocardiographic examination is the steering of the ultrasound probe to navigate between different cardiological standard planes (sensorimotor skill) without loosing orientation. These transitions or "standard trajectories" can roughly be described by specific movement patterns. We propose an enabling system based on an Augmented Reality simulator for two-dimensional echocardiography imitating this apprenticeship [1]-[3]. During a simulated ultrasound examination the system monitors the activities of the trainee and analyzes the motion pattern of the ultrasound probe. The simulator reacts by mapping the motion patterns onto cognitive orientation demands and providing adaptive feedback in the form of context sensitive help (animations). It partly takes the role of the critical teacher.

  7. Technical Support Document: Development of the Advanced Energy Design Guide for Grocery Stores--50% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Hale, E. T.; Macumber, D. L.; Long, N. L.; Griffith, B. T.; Benne, K. S.; Pless, S. D.; Torcellini, P. A.

    2008-09-01

    This report provides recommendations that architects, designers, contractors, developers, owners, and lessees of grocery store buildings can use to achieve whole-building energy savings of at least 50% over ASHRAE Standard 90.1-2004.

  8. Continuing professional development: researching non-technical competencies can support cognitive reappraisal and reduced stress in clinicians.

    Science.gov (United States)

    Kinnison, Tierney; May, Stephen

    2017-09-09

    Generic professional capabilities (non-technical competencies) are increasingly valued for their links to patient outcomes and clinician well-being. This study explores the emotional change, and practice-related outcomes, of participants of a veterinary professional key skills (PKS) continuing professional development (CPD) module. Reflective summaries produced by participants were analysed. A change in emotion, from 'negative' to 'positive', was the focus of analysis. Sections regarding these emotions were thematically analysed. Analysis was performed on 46 summaries. Three themes were identified: 'the PKS module' (centred on reluctance becoming surprise and stimulation), 'developing non-technical competencies' (unease to confidence) and 'stress and coping through a reflective focus' (anxiety to harmony). The changing emotions were connected to positive cognitive reappraisal and often behaviour changes, benefitting self, practice, clients and patients. The PKS module teaches participants to reflect; a new and challenging concept. The consequences of this enabled participants to understand the importance of professional topics, to be appreciative as well as critical, and to enjoy their job. Importantly, the module stimulated coping responses. Better understanding of roles led to participants having more reasonable expectations of themselves, more appreciation of their work and reduced stress. This research supports more attention to professional skills CPD for health professions. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Catchment structure that supports organic matter providing a natural control on rising river nutrient concentrations

    Science.gov (United States)

    Stutter, Marc; Ibiyemi, Adekunle; Wang, Chen

    2017-04-01

    The connectivity of sources of pollution in catchments has been well studied and brings concepts such as pollution hotspots and critical source areas. However, consideration of the placement of other structures combating rising pollution impacts has been less considered. One such area that is receiving developing focus is the layout of riparian management and buffer strips. However, there are wider aspects of connectivity and landscape structure that can bring benefits to delivery and in-stream processing of pollution. These include wetlands, forests and the distribution of soils of differing connectivity of organic matter varying in bioavailability. Organic matter is a great modulator of catchment processes from controlling the potential of land use (e.g. constraints of soil organic matter and wetness on agricultural use), to the amount and form of nutrients leached from soils, to controls of dissolved organic matter on in-stream biology that responds to nutrient concentrations. As the fundamental control of ecosystem energy available for many heterotrophic processes it mediates uptake, recycling and speciation of N, P at many stages of the catchment from soils to waters; as such DOM can be considered as a nature-based solution exerting a background level of control on inorganic nutrients. This poster explores the role of different structural aspects of catchments that provide beneficial organic matter inputs to rivers. At the fine scale the lability of riparian soil and leaf litter DOC are considered. At a riparian management scale the local changes in buffer strip soil C and DOC relative to field soils are considered. At the largest scale spatial data are explored for riparian structure, forests, wetlands and soils differing in delivery and forms of C across major Scottish rivers and used as co-variates to explain differences in in-stream processing of nutrients.

  10. Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

    Science.gov (United States)

    Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

    2017-11-21

    Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in

  11. Strengthening government management capacity to scale up HIV prevention programs through the use of Technical Support Units: lessons from Karnataka state, India

    Science.gov (United States)

    Sgaier, Sema K; Anthony, John; Bhattacharjee, Parinita; Baer, James; Malve, Vidyacharan; Bhalla, Aparajita; Hugar, Vijaykumar S

    2014-01-01

    ABSTRACT Scaling up HIV prevention programming among key populations (female sex workers and men who have sex with men) has been a central strategy of the Government of India. However, state governments have lacked the technical and managerial capacity to oversee and scale up interventions or to absorb donor-funded programs. In response, the national government contracted Technical Support Units (TSUs), teams with expertise from the private and nongovernmental sectors, to collaborate with and assist state governments. In 2008, a TSU was established in Karnataka, one of 6 Indian states with the highest HIV prevalence in the country and where monitoring showed that its prevention programs were reaching only 5% of key populations. The TSU provided support to the state in 5 key areas: assisting in strategic planning, rolling out a comprehensive monitoring and evaluation system, providing supportive supervision to intervention units, facilitating training, and assisting with information, education, and communication activities. This collaborative management model helped to increase capacity of the state, enabling it to take over funding and oversight of HIV prevention programs previously funded through donors. With the combined efforts of the TSU and the state government, the number of intervention units statewide increased from 40 to 126 between 2009 and 2013. Monthly contacts with female sex workers increased from 5% in 2008 to 88% in 2012, and with men who have sex with men, from 36% in 2009 to 81% in 2012. There were also increases in the proportion of both populations who visited HIV testing and counseling centers (from 3% to 47% among female sex workers and from 6% to 33% among men who have sex with men) and sexually transmitted infection clinics (from 4% to 75% among female sex workers and from 7% to 67% among men who have sex with men). Changes in sexual behaviors among key populations were also documented. For example, between 2008 and 2010, the proportion of

  12. Does minimally invasive transsacral fixation provide anterior column support in adult scoliosis?

    Science.gov (United States)

    Anand, Neel; Baron, Eli M; Khandehroo, Babak

    2014-06-01

    Spinal fusion to the sacrum, especially in the setting of deformity and long constructs, is associated with high complication and pseudarthrosis rates. Transsacral discectomy, fusion, and fixation is a minimally invasive spine surgery technique that provides very rigid fixation. To date, this has been minimally studied in the setting of spinal deformity correction. We determined (1) the fusion rate of long-segment arthrodeses, (2) heath-related quality-of-life (HRQOL) outcomes (VAS pain score, Oswestry Disability Index [ODI], SF-36), and (3) the common complications and their frequency in adult patients with scoliosis undergoing transsacral fixation without supplemental pelvic fixation. Between April 2007 and May 2011, 92 patients had fusion of three or more segments extending to the sacrum for spinal deformity. Transsacral L5-S1 fusion without supplemental pelvic fixation was performed in 56 patients. Of these, 46 with complete data points and a minimum of 2 years of followup (mean, 48 months; range, 24-72 months; 18% of patients lost to followup) were included in this study. Nineteen of the 46 (41%) had fusions extending above the thoracolumbar junction, with one patient having fusion into the proximal thoracic spine (T3-S1). General indications for the use of transsacral fixation were situations where the fusion needed to be extended to the sacrum, such as spondylolisthesis, prior laminectomy, stenosis, oblique take-off, and disc degeneration at L5-S1. Contraindications included anatomic variations in the sacrum, vascular anomalies, prior intrapelvic surgery, and rectal fistulas or abscesses. Fusion rates were assessed by full-length radiographs and CT scanning. HRQOL data, including VAS pain score, ODI, and SF-36 scores, were assessed at all pre- and postoperative visits. Intraoperative and postoperative complications were noted. Forty-one of 46 patients (89%) developed a solid fusion at L5-S1. There were significant improvements in all HRQOL parameters. Eight

  13. GPHS-RTGs in support of the Cassini RTG Program. Semi annual technical progress report, September 26, 1994--April 2, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-20

    The technical progress achieved during the period 26 September 1994 through 2 April 1995 on Contract DE-AC03-91SF18852 Radioisotope Thermoelectric Generators and Ancillary Activities is described herein. Monthly technical activity for the period 27 February 1995 through 2 April 1995 is included in this progress report. The report addresses tasks, including: spacecraft integration and liaison; engineering support; safety; qualified unicouple production; ETG Fabrication, assembly, and test; ground support equipment; RTG shipping and launch support; designs, reviews, and mission applications; project management, quality assurance, reliability, contract changes, CAGO acquisition (operating funds), and CAGO maintenance and repair; and CAGO acquisition (capital funds).

  14. Technical support for geopressured-geothermal well activities in Louisiana: Annual report for the period 1 November 1984 to 31 December 1986

    Energy Technology Data Exchange (ETDEWEB)

    Groat, C.G.

    1987-09-01

    This report describes environmental monitoring activities carried out by Louisiana State University (LSU) under US Department of Energy Contract FC07-85NV10425 for the period 1 November 1984 through 31 December 1986. Other aspects of the LSU technical support program completed under prior contracts were covered in final form in reports preceding this one. During the contract period, the Louisiana Geological Survey, aided by subcontractors, monitored microseismic activity, land-surface subsidence, and surface and ground-water quality at three designed geopressured-geothermal test well sites in Louisiana and Texas. Don Stevenson supervised microseismic monitoring activities, and Drukell Trahan coordinated water quality and land-surface subsidence studies. This is a progress report in the sense that it discusses program components, provides raw data, and presents preliminary interpretations. The environmental monitoring program continues and will be the subject of subsequent annual reports.

  15. Solar technical assistance provided to Forest City military communities in Hawaii for incorporation of 20-30 MW of solar energy generation to power family housing for US Navy personnel.

    Energy Technology Data Exchange (ETDEWEB)

    Dominick, Jeff (National Renewable Energy Laboratory, Golden, CO); Merrigan, Tim (National Renewable Energy Laboratory, Golden, CO); Boudra, Will (Forest City Military Communities, Honolulu, HI); Miller, Ryan (CH2M Hill, Englewood, CO); Cisneros, Gabriela (New Mexico State University, Las Cruces, NM); Rosenthal, Andrew L. (New Mexico State University, Las Cruces, NM); Kuszmaul, Scott S.; Gupta, Vipin P.

    2010-06-01

    In May 2007, Forest City Military Communities won a US Department of Energy Solar America Showcase Award. As part of this award, executives and staff from Forest City Military Communities worked side-by-side with a DOE technical assistance team to overcome technical obstacles encountered by this large-scale real estate developer and manager. This paper describes the solar technical assistance that was provided and the key solar experiences acquired by Forest City Military Communities over an 18 month period.

  16. Technical-Induced Hemolysis in Patients with Respiratory Failure Supported with Veno-Venous ECMO - Prevalence and Risk Factors.

    Directory of Open Access Journals (Sweden)

    Karla Lehle

    Full Text Available The aim of the study was to explore the prevalence and risk factors for technical-induced hemolysis in adults supported with veno-venous extracorporeal membrane oxygenation (vvECMO and to analyze the effect of hemolytic episodes on outcome. This was a retrospective, single-center study that included 318 adult patients (Regensburg ECMO Registry, 2009-2014 with acute respiratory failure treated with different modern miniaturized ECMO systems. Free plasma hemoglobin (fHb was used as indicator for hemolysis. Throughout a cumulative support duration of 4,142 days on ECMO only 1.7% of the fHb levels were above a critical value of 500 mg/l. A grave rise in fHb indicated pumphead thrombosis (n = 8, while acute oxygenator thrombosis (n = 15 did not affect fHb. Replacement of the pumphead normalized fHb within two days. Neither pump or cannula type nor duration on the first system was associated with hemolysis. Multiple trauma, need for kidney replacement therapy, increased daily red blood cell transfusion requirements, and high blood flow (3.0-4.5 L/min through small-sized cannulas significantly resulted in augmented blood cell trauma. Survivors were characterized by lower peak levels of fHb [90 (60, 142 mg/l] in comparison to non-survivors [148 (91, 256 mg/l, p≤0.001]. In conclusion, marked hemolysis is not common in vvECMO with modern devices. Clinically obvious hemolysis often is caused by pumphead thrombosis. High flow velocity through small cannulas may also cause technical-induced hemolysis. In patients who developed lung failure due to trauma, fHb was elevated independantly of ECMO. In our cohort, the occurance of hemolysis was associated with increased mortality.

  17. U.S. forest products module : a technical document supporting the Forest Service 2010 RPA Assessment

    Science.gov (United States)

    Peter J. Ince; Andrew D. Kramp; Kenneth E. Skog; Henry N. Spelter; David N. Wear

    2011-01-01

    The U.S. Forest Products Module (USFPM) is a partial market equilibrium model of the U.S. forest sector that operates within the Global Forest Products Model (GFPM) to provide long-range timber market projections in relation to global economic scenarios. USFPM was designed specifically for the 2010 RPA forest assessment, but it is being used also in other applications...

  18. Drawings in computer-supported collaborative learning - Empirical and technical results

    NARCIS (Netherlands)

    Bollen, Lars; Gijlers, Aaltje H.; van Joolingen, Wouter

    2015-01-01

    Self-constructed external representations are thought to be beneficial in teaching and learning, especially when embedded in peer interactions, and can positively affect the course and type of reasoning, for example by providing grounding for explanations and self-explanations, by helping to

  19. Computer-supported collaborative drawing in primary school education – Technical realization and empirical findings

    NARCIS (Netherlands)

    Bollen, Lars; Gijlers, Aaltje H.; van Joolingen, Wouter; Herskovic, H.; Hoppe, H.U.; Jansen, M.; Ziegler, J.

    2012-01-01

    Self-constructed external representation, especially when embedded in peer inter-actions, are supposed to be beneficial in learning and teaching and can positively affect the course and type of reasoning for various reasons, e.g. by providing a ground for explanations and self-explanations, by

  20. Future scenarios: a technical document supporting the Forest Service 2010 RPA Assessment

    Science.gov (United States)

    . USDA Forest Service.

    2012-01-01

    The Forest and Rangeland Renewable Resources Planning Act of 1974 (RPA) mandates a periodic assessment of the conditions and trends of the Nation's renewable resources on forests and rangelands. The RPA Assessment includes projections of resource conditions and trends 50 years into the future. The 2010 RPA Assessment used a set of future scenarios to provide a...

  1. Zirconia-Based Screw-Retained Prostheses Supported by Implants: A Retrospective Study on Technical Complications and Failures.

    Science.gov (United States)

    Worni, Andreas; Kolgeci, Lumni; Rentsch-Kollar, Andrea; Katsoulis, Joannis; Mericske-Stern, Regina

    2015-12-01

    Little information is yet available on zirconia-based prostheses supported by implants. To evaluate technical problems and failures of implant-supported zirconia-based prostheses with exclusive screw-retention. Consecutive patients received screw-retained zirconia-based prostheses supported by implants and were followed over a time period of 5 years. The implant placement and prosthetic rehabilitation were performed in one clinical setting, and all patients participated in the maintenance program. The treatment comprised single crowns (SCs) and fixed dental prostheses (FDPs) of three to 12 units. Screw-retention of the CAD/CAM-fabricated SCs and FDPs was performed with direct connection at the implant level. The primary outcome was the complete failure of zirconia-based prostheses; outcome measures were fracture of the framework or extensive chipping resulting in the need for refabrication. A life table analysis was performed, the cumulative survival rate (CSR) calculated, and a Kaplan-Meier curve drawn. Two hundred and ninety-four implants supported 156 zirconia-based prostheses in 95 patients (52 men, 43 women, average age 59.1 ± 11.7 years). Sixty-five SCs and 91 FDPs were identified, comprising a total of 441 units. Fractures of the zirconia framework and extensive chipping resulted in refabrication of nine prostheses. Nearly all the prostheses (94.2%) remained in situ during the observation period. The 5-year CSR was 90.5%, and 41 prostheses (14 SCs, 27 FDPs) comprising 113 units survived for an observation time of more than 5 years. Six SCs exhibited screw loosening, and polishing of minor chipping was required for five prostheses. This study shows that zirconia-based implant-supported fixed prostheses exhibit satisfactory treatment outcomes and that screw-retention directly at the implant level is feasible. © 2014 Wiley Periodicals, Inc.

  2. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Science.gov (United States)

    Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851

  3. Parents' experiences of family functioning, health and social support provided by nurses--a pilot study in paediatric intensive care.

    Science.gov (United States)

    Hakio, Nora; Rantanen, Anja; Åstedt-Kurki, Päivi; Suominen, Tarja

    2015-02-01

    The objective of this study was to describe parents' experiences of family functioning, health and social support provided by nursing personnel, while their child was in intensive care, and to determine how social support was associated with family functioning and family health. Cross-sectional study. The data were collected by a self-administered questionnaire from 31 parents of critically ill children from 2010 to 2011. The data were analysed statistically. The parents considered their family functioning, health and social support provided by the nursing personnel to be good. The sub-area of family functioning that rated the lowest was strengths of family, whereas the lowest rated sub-area of family health was ill-being. Child's previous hospital treatments were associated with family health. Parents, whose child had already been in hospital care, reported more well-being and less ill-being than parents with children hospitalised for the first time. Parents' education was associated with family functioning, family health and social support given by the nurses. Weak positive correlation was also found between social support given by nurses and family health experienced by parents. There is a need to discuss how nursing care can further support parental resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider.

    Science.gov (United States)

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-04-10

    There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  5. A pilot study examining the impact of care provider support program on resiliency, coping, and compassion fatigue in military health care providers.

    Science.gov (United States)

    Weidlich, Christopher P; Ugarriza, Doris N

    2015-03-01

    The Care Provider Support Program (CPSP) was created as a way to improve the resiliency of military health care providers. The purpose of this pilot study was to update what is currently known about the resiliency, coping, and compassion fatigue of military and civilian registered nurses, licensed practical nurses (LPNs), and medics who treat wounded Soldiers and whether these factors can be improved over a sustained period of time. A prospective cohort pilot study was implemented to investigate the long-term effects of CPSP training on military and civilian nurses, LPNs, and medics (n = 93) at an Army Medical Center utilizing the Connor-Davidson Resilience Scale, the Ways of Coping Questionnaire, and Professional Quality of Life Questionnaire. Twenty-eight participants returned follow-up questionnaires. CPSP was significant in reducing burnout as measured by the Professional Quality of Life questionnaire, leading to decreased compassion fatigue. CPSP training did not affect resiliency scores on the Connor-Davidson resilience scale or coping scores as measured by the Ways of Coping Questionnaire. on the basis of the results of this study, CPSP training was effective in reducing burnout, which often leads to decreased compassion fatigue in a group of military and civilian registered nurses, LPNs, and medics. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  6. Innovations in basic life support education for healthcare providers: improving competence in cardiopulmonary resuscitation through self-directed learning.

    Science.gov (United States)

    Cason, Carolyn L; Kardong-Edgren, Suzan; Cazzell, Mary; Behan, Deborah; Mancini, Mary Elizabeth

    2009-01-01

    Providing cardiopulmonary resuscitation is an essential competency for nurses. Nurse educators involved in staff development and continuing education spend numerous hours offering basic life support courses and conducting performance improvement activities such as mock codes. This study provides evidence that cardiopulmonary resuscitation performance skills using self-directed learning methods are as good as or, on a number of parameters, better than those achieved with a more resource- and time-intensive traditional approach.

  7. Technical Steps to Support Nuclear Arsenal Downsizing: A Report by the APS Panel on Public Affairs

    Science.gov (United States)

    2010-02-01

    human resource development. For the past several years, the U.S. Department of State (DOS) has run a successful program to improve bioethics and...control for extended periods of time) also poses tech- nical challenges. Research and experimentation have been actively ongo- ing for a wide variety of...addition, these centers will provide a venue for university experimentation and partnerships so that key technological advances, innovative academic

  8. Perceptions of Supported Employment Providers: What Students with Developmental Disabilities, Families, and Educators Need to Know for Transition Planning

    Science.gov (United States)

    Moon, Sherril; Simonsen, Monica L.; Neubert, Debra A.

    2011-01-01

    The purpose of this exploratory study was to survey community rehabilitation providers (CRPs) to determine their perceptions of the skills, experiences, and information that transitioning youth with developmental disabilities (DD) and their families need to access supported employment (SE) services. Supervisors of SE from 12 CRPs across one state…

  9. Support given to lecturers when providing mobile centric services in teaching and learning: a policy analysis perspective

    CSIR Research Space (South Africa)

    Chipangura, B

    2015-05-01

    Full Text Available The objective of this study is to examine the status of Higher Education Institutions (HEIs) policies in supporting lecturers when providing mobile centric services to students. The research was undertaken as a single case study within the Open...

  10. Emotional Literacy Support Assistants' Views on Supervision Provided by Educational Psychologists: What EPs Can Learn from Group Supervision

    Science.gov (United States)

    Osborne, Cara; Burton, Sheila

    2014-01-01

    The Educational Psychology Service in this study has responsibility for providing group supervision to Emotional Literacy Support Assistants (ELSAs) working in schools. To date, little research has examined this type of inter-professional supervision arrangement. The current study used a questionnaire to examine ELSAs' views on the supervision…

  11. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  12. Unattended network operations technology assessment study. Technical support for defining advanced satellite systems concepts

    Science.gov (United States)

    Price, Kent M.; Holdridge, Mark; Odubiyi, Jide; Jaworski, Allan; Morgan, Herbert K.

    1991-01-01

    The results are summarized of an unattended network operations technology assessment study for the Space Exploration Initiative (SEI). The scope of the work included: (1) identified possible enhancements due to the proposed Mars communications network; (2) identified network operations on Mars; (3) performed a technology assessment of possible supporting technologies based on current and future approaches to network operations; and (4) developed a plan for the testing and development of these technologies. The most important results obtained are as follows: (1) addition of a third Mars Relay Satellite (MRS) and MRS cross link capabilities will enhance the network's fault tolerance capabilities through improved connectivity; (2) network functions can be divided into the six basic ISO network functional groups; (3) distributed artificial intelligence technologies will augment more traditional network management technologies to form the technological infrastructure of a virtually unattended network; and (4) a great effort is required to bring the current network technology levels for manned space communications up to the level needed for an automated fault tolerance Mars communications network.

  13. Technical support to the Solvent Refined Coal (SRC) demonstration projects: assessment of current research and development

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, M.S.; Rodgers, B.R.; Brown, C.H.; Carlson, P.K.; Gambill, W.R.; Gilliam, T.M.; Holmes, J.M.; Krishnan, R.P.; Parsly, L.F.

    1980-12-01

    A program to demonstrate Solvent Refined Coal (SRC) technology has been initiated by the US Department of Energy (DOE) in partnership with two industrial groups. Project management responsibility has been assigned to the Oak Ridge Operations Office (ORO) of DOE. ORO requested that the Oak Ridge National Laboratory assess current research and development (R and D) activities and develop recommendations for those activities that might contribute to successful completion of the SRC demonstration plant projects. The objectives of this final report are to discuss in detail the problem areas in SRC; to discuss the current and planned R and D investigations relevant to the problems identified; and to suggest appropriate R and D activities in support of designs for the SRC demonstration plants. Four types of R and D activities are suggested: continuation of present and planned activities; coordination of activities and results, present and proposed; extension/redirection of activities not involving major equipment purchase or modifications; and new activities. Important examples of the first type of activity include continuation of fired heater, slurry rheology, and slurry mixing studies at Ft. Lewis. Among the second type of activity, coordination of data acquisition and interpretation is recommended in the areas of heat transfer, vapor/liquid equilibria, and physical properties. Principal examples of recommendations for extension/redirection include screening studies at laboratory scale on the use of carbonaceous precoat (e.g., anthracite) infiltration, and 15- to 30-day continuous tests of the Texaco gasifier at the Texaco Montebello facility (using SRC residues).

  14. Mothers' and health visitors' perceptions of the support provided to mothers who have experienced domestic violence: A systematic review.

    Science.gov (United States)

    Eynon, Julia; Carrier, Judith; Rees, Sally; Cartwright, Annie

    2012-01-01

    Domestic violence has been described as a public health epidemic, with victims of domestic violence encountered in all health care settings. Within the United Kingdom the role of the health visitor (specialist community public health nurse) is to promote health in the whole community; every family with a child under five years has a named health visitor. Preparation for the health visitor role is unique to the United Kingdom. Health visitors are particularly well placed to identify and support mothers who are experiencing domestic violence. The objective of this review was to synthesise the best available evidence relating to support provided by UK health visitors for mothers who have experienced domestic violence, from both the mothers and the health visitors' perspectives. The participants of interest were mothers who have experienced domestic violence and health visitors who offer support to those mothers.The self reported experiences of health visitor support provided to mothers who have experienced domestic violence, from the perspective of both the mothers and the health visitors providing the support.This review considered studies that focus on qualitative data including, but not limited to, designs such as ethnography, phenomenology, grounded theory, action research and feminist research. Studies published up to April 2011 were included in the review. The search was restricted to English language studies. The databases searched were: Medline, CINAHL, PsycINFO, PsycARTICLES, EMBASE, British Nursing Index and Archive, ASSIA and TRIP. Studies were assessed for methodological quality using the standardised critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardised data extraction tools from the Joanna Briggs Institute. Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories, which were aggregated into synthesised findings. Four

  15. Technical support for digital systems technology development. Task order 1: ISP contention analysis and control

    Science.gov (United States)

    Stehle, Roy H.; Ogier, Richard G.

    1993-01-01

    Alternatives for realizing a packet-based network switch for use on a frequency division multiple access/time division multiplexed (FDMA/TDM) geostationary communication satellite were investigated. Each of the eight downlink beams supports eight directed dwells. The design needed to accommodate multicast packets with very low probability of loss due to contention. Three switch architectures were designed and analyzed. An output-queued, shared bus system yielded a functionally simple system, utilizing a first-in, first-out (FIFO) memory per downlink dwell, but at the expense of a large total memory requirement. A shared memory architecture offered the most efficiency in memory requirements, requiring about half the memory of the shared bus design. The processing requirement for the shared-memory system adds system complexity that may offset the benefits of the smaller memory. An alternative design using a shared memory buffer per downlink beam decreases circuit complexity through a distributed design, and requires at most 1000 packets of memory more than the completely shared memory design. Modifications to the basic packet switch designs were proposed to accommodate circuit-switched traffic, which must be served on a periodic basis with minimal delay. Methods for dynamically controlling the downlink dwell lengths were developed and analyzed. These methods adapt quickly to changing traffic demands, and do not add significant complexity or cost to the satellite and ground station designs. Methods for reducing the memory requirement by not requiring the satellite to store full packets were also proposed and analyzed. In addition, optimal packet and dwell lengths were computed as functions of memory size for the three switch architectures.

  16. PNNL Technical Support to The Implementation of EMTA and EMTA-NLA Models in Autodesk® Moldflow® Packages

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Ba Nghiep; Wang, Jin

    2012-12-01

    Under the Predictive Engineering effort, PNNL developed linear and nonlinear property prediction models for long-fiber thermoplastics (LFTs). These models were implemented in PNNL’s EMTA and EMTA-NLA codes. While EMTA is a standalone software for the computation of the composites thermoelastic properties, EMTA-NLA presents a series of nonlinear models implemented in ABAQUS® via user subroutines for structural analyses. In all these models, it is assumed that the fibers are linear elastic while the matrix material can exhibit a linear or typical nonlinear behavior depending on the loading prescribed to the composite. The key idea is to model the constitutive behavior of the matrix material and then to use an Eshelby-Mori-Tanaka approach (EMTA) combined with numerical techniques for fiber length and orientation distributions to determine the behavior of the as-formed composite. The basic property prediction models of EMTA and EMTA-NLA have been subject for implementation in the Autodesk® Moldflow® software packages. These models are the elastic stiffness model accounting for fiber length and orientation distributions, the fiber/matrix interface debonding model, and the elastic-plastic models. The PNNL elastic-plastic models for LFTs describes the composite nonlinear stress-strain response up to failure by an elastic-plastic formulation associated with either a micromechanical criterion to predict failure or a continuum damage mechanics formulation coupling damage to plasticity. All the models account for fiber length and orientation distributions as well as fiber/matrix debonding that can occur at any stage of loading. In an effort to transfer the technologies developed under the Predictive Engineering project to the American automotive and plastics industries, PNNL has obtained the approval of the DOE Office of Vehicle Technologies to provide Autodesk, Inc. with the technical support for the implementation of the basic property prediction models of EMTA and

  17. Technical Information to Support Double Shell Tank (DST) Emergency Annulus Pumping [SEC 1 and 2

    Energy Technology Data Exchange (ETDEWEB)

    REBERGER, D.W.

    2000-09-14

    This document provides the design calculations for the DST Annulus Emergency Pumping Project. This document also contains essential information relative to DST annulus emergency pumping that may not be found in other documents. This information consists of the following: Index drawing for annulus pumping; References to the Acceptance Test Report, DST Emergency Pumping Guide, Time Deployment study, etc.; Statements of work; and Reference CEIS and RMIS numbers. A Vendor Information document, VI-50121, is not included in this document, but a copy can be obtained by contacting Document Control Services. This document contains various information regarding the Hydrostar pumps, such as the air motor, cylinder size, pump installation and operation manual. It also contains information regarding the Flygt BS2060 submersible pump, such as parts list, pump handling, preventative maintenance, overhaul and repair. In addition, this document also has information on 3-way PM ball valves, electrical skid components and the alternate Gurman-Rupp stainless steel submersible pump.

  18. Providing Informal Care in Terminal Illness: An Analysis of Preferences for Support Using a Discrete Choice Experiment.

    Science.gov (United States)

    Hall, Jane; Kenny, Patricia; Hossain, Ishrat; Street, Deborah J; Knox, Stephanie A

    2014-08-01

    The trend for terminally ill patients to receive much of their end-of-life care at home necessitates the design of services to facilitate this. Care at home also requires that informal care be provided by family members and friends. This study investigated informal carers' preferences for support services to aid the development of end-of-life health care services. This cross-sectional study used 2 discrete choice experiments to ascertain the preferences of carers supporting patients with different levels of care need, determined by the assistance needed with personal care and labeled High Care (HC) and Low Care (LC). The sample included 168 informal carers of people receiving palliative care at home from 2 palliative care services in Sydney, Australia. Data were collected in face-to-face interviews; carers chose between 2 hypothetical plans of support services and their current services. Data were analyzed with generalized multinomial logit models that were used to calculate the impact of each attribute on the probability of a carer choosing a service plan. Preferred support included nursing services; the probability of choosing a plan increased significantly if it included nurse home visits and phone advice (P situation. The most valued services are those that support carers in their caregiving role; however, supportive care preferences vary with the different circumstances of patients and carers. © The Author(s) 2013.

  19. THE UNIFICATION OF THE CODE LISTS PROVIDED WITHIN THE DATA MODEL ORIGINATING FROM THE INSPIRE TECHNICAL GUIDELINES AND THE ONES PROVIDED FOR GESUT DATABASES IN THE CONTEXT OF POTENTIAL EXPLOITATION IN THE MINING INDUSTRY

    Directory of Open Access Journals (Sweden)

    Andrzej ZYGMUNIAK

    2016-07-01

    Full Text Available This study is aimed at exposing differences between two data models in case of code lists values provided there. The first of them is an obligatory one for managing Geodesic Register of Utility Networks databases in Poland [9] and the second is the model originating from the Technical Guidelines issued to the INSPIRE Directive. Since the second one mentioned is the basis for managing spatial databases among European parties, correlating these two data models has an effect in easing the way of harmonizing and, in consequence, exchanging spatial data. Therefore, the study presents the possibilities of increasing compatibility between the values of the code lists concerning attributes for objects provid-ed in both models. In practice, it could lead to an increase of the competitiveness of entities managing or processing such databases and to greater involvement in scientific or research projects when it comes to the mining industry. More-over, since utility networks located on mining areas are under particular protection, the ability of making them more fitted to their own needs will make it possible for mining plants to exchange spatial data in a more efficient way.

  20. Independent technical support for the frozen soil barrier installation and operation at the Fukushima Daiichi Nuclear Power Station (F1 Site)

    Energy Technology Data Exchange (ETDEWEB)

    Looney, Brian B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Jackson, Dennis G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-02-23

    TEPCO is implementing a number of water countermeasures to limit the releases and impacts of contaminated water to the surrounding environment. The diverse countermeasures work together in an integrated manner to provide different types, and several levels, of protection. In general, the strategy represents a comprehensive example of a “defense in depth” concept that is used for nuclear facilities around the world. One of the key countermeasures is a frozen soil barrier encircling the damaged reactor facilities. The frozen barrier is intended to limit the flow of water into the area and provide TEPCO the ability to reduce the amount of contaminated water that requires treatment and storage. The National Laboratory team supports the selection of artificial ground freezing and the incorporation of the frozen soil barrier in the contaminated water countermeasures -- the technical characteristics of a frozen barrier are relatively well suited to the Fukushima-specific conditions and the need for inflow reduction. Further, our independent review generally supports the TEPCO/Kajima design, installation strategy and operation plan.

  1. Social support in the practices of informal providers: The case of patent and proprietary medicine vendors in Nigeria.

    Science.gov (United States)

    Sieverding, Maia; Liu, Jenny; Beyeler, Naomi

    2015-10-01

    The social and institutional environments in which informal healthcare providers operate shape their health and business practices, particularly in contexts where regulatory enforcement is weak. In this study, we adopt a social capital perspective to understanding the social networks on which proprietary and patent medicine vendors (PPMVs) in Nigeria rely for support in the operation of their shops. Data are drawn from 70 in-depth interviews with PPMVs in three states, including interviews with local leaders of the PPMV professional association. We find that PPMVs primarily relied on more senior colleagues and formal healthcare professionals for informational support, including information about new medicines and advice on how to treat specific cases of illness. For instrumental support, including finance, start-up assistance, and intervention with regulatory agencies, PPMVs relied on extended family, the PPMVs with whom they apprenticed, and the leaders of their professional association. PPMVs' networks also provided continual reinforcement of what constitutes good PPMV practice through admonishments to follow scope of practice limitations. These informal reminders, as well as monitoring activities conducted by the professional association, served to reinforce PPMVs' concern with avoiding negative customer health outcomes, which were perceived to be detrimental to their business reputations. That PPMVs' networks both encouraged practices to reduce the likelihood of poor health outcomes, and provided advice regarding customers' health conditions, highlights the potential impact of informal providers' access to different forms of social capital on their delivery of health services, as well as their success as microenterprises. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ericson, Jenny; Eriksson, Mats; Hellström-Westas, Lena; Hagberg, Lars; Hoddinott, Pat; Flacking, Renée

    2013-05-10

    Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. proportion of mothers exclusively breastfeeding at eight weeks after discharge. proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be

  3. Improving support for parents of children with hearing loss: provider training on use of targeted communication strategies.

    Science.gov (United States)

    Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael

    2015-02-01

    When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management

  4. OSH technical reference manual

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    In an evaluation of the Department of Energy (DOE) Occupational Safety and Health programs for government-owned contractor-operated (GOCO) activities, the Department of Labor`s Occupational Safety and Health Administration (OSHA) recommended a technical information exchange program. The intent was to share written safety and health programs, plans, training manuals, and materials within the entire DOE community. The OSH Technical Reference (OTR) helps support the secretary`s response to the OSHA finding by providing a one-stop resource and referral for technical information that relates to safe operations and practice. It also serves as a technical information exchange tool to reference DOE-wide materials pertinent to specific safety topics and, with some modification, as a training aid. The OTR bridges the gap between general safety documents and very specific requirements documents. It is tailored to the DOE community and incorporates DOE field experience.

  5. Registered nurse and health care chaplains experiences of providing the family support person role during family witnessed resuscitation.

    Science.gov (United States)

    James, Jayne; Cottle, Elita; Hodge, Reverend Debbie

    2011-02-01

    To provide an in-depth exploration regarding the Registered Nurse (RN) and Healthcare Chaplains' (HCC) perspective of the role of the family support person (FSP) during family witnessed resuscitation (FWR). A phenomenological approach utilising in-depth interviews were undertaken outside of the work setting. A purposive sample of 4 RN's and 3 HCC were recruited from four sites within the United Kingdom. All interviews were tape recorded, transcribed verbatim and analysed utilising Husserl's framework. Seven key themes emerged which included assessment, managing choice, navigating the setting, on-going commentary, coming to terms with death, conflicts and support. This study has provided an insight regarding the intense clinical engagement associated with the role of the FSP and highlighted the importance of this role for family member's optimal care and support. It is vital that adequate professional development is instigated and that support mechanisms are in place for those health care professionals (HCP) undertaking this role in order to help family members through this difficult experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Providing support to surrogate decision-makers for people living with dementia: Healthcare professional, organisational and community responsibilities.

    Science.gov (United States)

    Shanley, Christopher; Fetherstonhaugh, Deirdre; McAuliffe, Linda; Bauer, Michael; Beattie, Elizabeth

    2017-09-01

    The prevalence of dementia will continue to increase with the ageing of the population. Many people living with dementia will reach a stage where surrogate decision-makers-mostly family carers-will need to make a range of decisions on their behalf. The aim of this study was to learn from surrogate decision-makers how they can be most effectively supported in this role. The study employed a qualitative design using semi-structured face-to-face or telephone interviews with a purposive sample of 34 surrogate decision-makers of people living with dementia. Transcripts of participant interviews were reviewed using a thematic approach to analysis. Four main themes were identified from this analysis: needing greater community awareness of dementia and its impact; intervening early in cognitive decline; relying on health professionals for ongoing support; and seeking and using support from wherever is relevant for each person. Based on this analysis and a review of the literature, we propose a wholistic set of recommendations for the support of surrogate decision-makers. Healthcare professionals need to help family carers understand the likely trajectory of dementia, including the significance of surrogate decision-making. They can support the person living with dementia and their surrogates to undertake advance care planning and they can act as empathic guides during this process. Health and community care organisations need to provide a "key worker" model wherever possible so that the person living with dementia and their surrogate decision-maker do not have to seek support from multiple staff members or organisations. Carer support programmes can routinely include information and resources about surrogate decision-making. Community and government organisations can help people prepare for the possibility of becoming surrogate decision-makers by promoting a greater public awareness and understanding of both dementia and advance care planning. © 2017 John Wiley & Sons Ltd.

  7. Adapting the Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course for emergency care education in Rwanda

    Directory of Open Access Journals (Sweden)

    William E. Cayley Jr

    2011-02-01

    Full Text Available The Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course uses a case-based curriculum to teach emergency resuscitation principles to experienced health care professionals. This article describes the adaptation of the ACLS-EP curriculum to be used in a family medicine training programme in Rwanda, including lessons learned and recommendations for future use of this material for emergency care education in the African setting.

  8. Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support.

    Science.gov (United States)

    Fazel, Maryam T; Fazel, Mohammad; Bedrossian, Nora L; Picazo, Fernando; Sobel, Julia D; Fazel, Mahdieh; Te, Charisse; Pendergrass, Merri L

    2017-01-01

    The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients. A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses. A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (ptraining modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.

  9. What do healthcare providers know about nutrition support? A survey of the knowledge, attitudes, and practice of pharmacists and doctors toward nutrition support in Malaysia.

    Science.gov (United States)

    Karim, Sarah A; Ibrahim, Baharudin; Tangiisuran, Balamurugan; Davies, J Graham

    2015-05-01

    Malnutrition is one of the health problems that can be prevented by appropriate nutrition care provided by healthcare providers. However, this practice is still lacking possibly because of the providers' inadequate knowledge. The aim of this study was to evaluate the self-reported knowledge, attitudes, and practices of pharmacists and doctors toward nutrition support in a tertiary care hospital setting. A validated questionnaire was distributed to all the doctors and pharmacists working in a tertiary hospital in Penang, Malaysia. Seven individuals including academics, general surgeons, and pharmacists performed the face and content validity. The questionnaire was piloted using 24 healthcare providers at a different hospital. Of 400 surveyed, 158 doctors and 72 pharmacists from various grades completed the questionnaire. More doctors (31.6%) than pharmacists (15.3%) reported adequate knowledge to perform patients' nutrition screening. However, in the knowledge assessment, pharmacists had a higher mean score (6.07 ± 1.77) than the doctors did (4.59 ± 1.87; P doctors have ambivalent attitudes toward nutrition support. Only 31.3% stated that they perform nutrition screening on admission, and half of them performed nutrition assessment during hospitalization. Inappropriate nutrition care might be due to the lack of guidelines and insufficient knowledge among doctors and pharmacists. Special nutrition training and education for both pharmacists and doctors should be established. © 2014 American Society for Parenteral and Enteral Nutrition.

  10. Provider Opinions and Experiences Regarding Development of a Social Support Assessment to Inform Hospital Discharge: The Going Home Toolkit.

    Science.gov (United States)

    Wallace, Andrea; Papke, Todd; Davisson, Erica; Spooner, Kara; Gassman, Laura

    Despite over three decades of research linking social support and optimal health outcomes, social support is not systematically assessed or addressed during clinical care. This study sought input from health care providers to inform the design of an intervention intended to facilitate assessment of social support in a way that could aid in anticipatory planning during the process of hospital discharge. Using a purposive sampling strategy, data were collected from providers in two acute care settings serving rural patients, one academic and one community based. Opinions about what an assessment of social support would seek to accomplish, what is currently done and by whom, and the preferred format for delivery were elicited during a series of individual and group interviews. During phase two, feasibility was assessed with three inpatient nurses over 3 clinical days. Field notes were analyzed throughout the project using rapid data analysis techniques. Health care providers endorsed the creation of an assessment and stated that target users would include all members of the discharge team (e.g., clinical nurses, case managers, discharge coordinators, hospitalists, and specialty care). They identified the need for a patient-family resource (vs. a traditional provider-facing assessment). Participants stated that, although both the information collected and the interview process would meet a need to increase patient engagement in inpatient settings, competing clinical demands would require a tool that was easily completed by patients and family and seen as directly informing clinical activities. To this end, although focusing on the eventual development of an electronic tool seemed valuable, a hard-copy resource was considered more feasible for patient use at the present time. The preliminary test of the resulting hard-copy "Going Home Toolkit" demonstrated potential feasibility and usefulness during clinical practice. There is need for not only assessing patients

  11. Provision of utility support services to the US Department of Energy San Francisco Operations Office. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    The main purpose of this project was to provide to DOE/SAN continuing, follow-up support to realize savings from a number of alternate supply arrangements that had already been and/or were expected to be identified under the original project. This expected continuation of these efforts is demonstrated by certain of the tasks that are spelled out in the Statement of Work. For example: Evaluate and propose alternative options and methods for improving efficiency, reducing cost, and making effective use of the energy supplies and facilities under various conditions of use; Provide engineering and economic analysis and recommendations for utility-related facilities and service issues, such as high voltage discounts, ownership of facilities, etc.; Assist in developing strategy and documentation in support of negotiating utility contracts and modifications thereto. In addition, the follow-on contract provided for monitoring and intervening in rate cases that had particular relevance to the DOE/SAN laboratories.

  12. A train the trainer program for healthcare professionals tasked with providing psychosocial support to breast cancer survivors.

    Science.gov (United States)

    Park, Eunyoung; Yoon, Junghee; Choi, Eun-Kyung; Kim, Im Ryung; Kang, Danbee; Lee, Se-Kyung; Lee, Jeong Eon; Nam, Seok Jin; Ahn, Jin Seok; Visser, Adriaan; Cho, Juhee

    2018-01-06

    The objective of this study is to develop, implement, and evaluate a training program for healthcare providers to improve ability to provide psychosocial support to breast cancer survivors in Korea. Based on a needs assessment survey and in-depth interviews with breast cancer survivors, a multidisciplinary team developed two-day intensive training program as well as education materials and counseling notes. Participants' overall satisfaction was evaluated after the training. The training program included a total of 16 lectures held over the course of seven sessions. Forty-one nurses and 3 social workers participated in the training program. Mean age was 37.5(± 6.4) years, and on average, they had 11.1 (± 5.6) years of experience. Participants' overall satisfaction was good as following: program contents (4.04), trainee guidebook (3.82), location and environment (4.10), and program organization (4.19). Among the participants, 31 (70.4%) received certification after submitting real consultation cases after the training. Two day intensive training can provide a comprehensive and coordinated education to healthcare professionals for implementing survivorship care with an emphasis on psychosocial support. Furthermore, the program should resume as a periodic continuing education course for healthcare providers. Similar education for graduate students in oncology nursing would be beneficial.

  13. Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

    Science.gov (United States)

    Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

    2016-01-01

    Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

  14. Feasible way of Human Solid and Liquid Wastes' Inclusion Into Intersystem Mass Exchange of Biological-Technical Life Support Systems

    Science.gov (United States)

    Ushakova, Sofya; Tikhomirov, Alexander A.; Tikhomirova, Natalia; Kudenko, Yurii; Griboskaya, Illiada; Gros, Jean-Bernard; Lasseur, Christophe

    The basic objective arising at use of mineralized human solid and liquid wastes serving as the source of mineral elements for plants cultivation in biological-technical life support systems appears to be NaCl presence in them. The given work is aimed at feasibility study of mineralized human metabolites' utilization for nutrient solutions' preparation for their further employment at a long-term cultivation of uneven-aged wheat and Salicornia europaea L. cenosis in a conveyer regime. Human solid and liquid wastes were mineralized by the "wet incineration" method developed by Yu. Kudenko. On their base the solutions were prepared which were used for cultivation of 5-aged wheat conveyer with the time step-interval of 14 days. Wheat was cultivated by hydroponics method on expanded clay aggregate. For partial demineralization of nutrient solution every two weeks after regular wheat harvesting 12 L of solution was withdrawn from the wheat irrigation tank and used for Salicornia europaea cultivation by the water culture method in a conveyer regime. The Salicornia europaea conveyer was represented by 2 ages with the time step-interval of 14 days. Resulting from repeating withdrawal of the solution used for wheat cultivation, sodium concentration in the wheat irrigation solution did not exceed 400 mg/l, and mineral elements contained in the taken solution were used for Salicornia europaea cultivation. The experiment lasted 7 months. Total wheat biomass productivity averaged 30.1 g*m-2*day-1 at harvest index equal to 36.8The work was carried out under support of SB RAS grant 132 and INTAS 05-1000008-8010

  15. A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA.

    Science.gov (United States)

    Schulte, Marya; Liang, Di; Wu, Fei; Lan, Yu-Ching; Tsay, Wening; Du, Jiang; Zhao, Min; Li, Xu; Hser, Yih-Ing

    2016-09-01

    Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health's potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions.

  16. Changing current practice in urological cancer care: Providing better information, advice and related support on work engagement.

    Science.gov (United States)

    MacLennan, S J; Murdoch, S E; Cox, T

    2017-09-01

    There is a growing body of evidence on the importance of work following a diagnosis of cancer and the need to provide better information, advice and related support to patients on work engagement. The aim of this study was to better understand the nature of those needs and to identify better ways to meet these for those with a urological cancer. The focus was on the issues that were common to three key stakeholder groups. Semi-structured interviews were conducted with stakeholders in North East Scotland: 12 individuals with kidney, bladder or prostate cancer, 10 healthcare providers and 10 managers from large organisations. Five key themes emerged from the Framework Analysis: perceived importance of work engagement; decision-making: treatment, work and cancer; roles and responsibilities; education and training; information, advice and support resources. The data confirmed that work engagement is important to those with urological cancer. It also made clear that the current provision of information and advice could be improved. Any such interventions should involve all three key stakeholder groups with greater clarity on their respective roles and responsibilities. Finally, any new system would be best integrated with existing care provision and supported by adequate education and training of those involved. © 2017 John Wiley & Sons Ltd.

  17. Comprehensive Technical Support for High-Quality Anthracite Production: A Case Study in the Xinqiao Coal Mine, Yongxia Mining Area, China

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    2015-12-01

    Full Text Available The effective production of high-quality anthracite has attracted increasing global attention. Based on the coal occurrence in Yongxia Mining Area and mining conditions of a coalface in Xinqiao Coal Mine, we proposed a systematic study on the technical support for the production of high-quality anthracite. Six key steps were explored, including coal falling at the coalface, transport, underground bunker storage, main shaft hoisting, coal preparation on the ground, and railway wagon loading. The study resulted in optimized running parameters for the shearers, and the rotating patterns of the shearer drums was altered (one-way cutting was employed. Mining height and roof supporting intensity were reduced. Besides, loose presplitting millisecond blasting and mechanized mining were applied to upgrade the coal quantity and the lump coal production rate. Additionally, the coalface end transloading, coalface crush, transport systems, underground storage, and main shaft skip unloading processes were improved, and fragmentation-prevention techniques were used in the washing and railway wagon loading processes. As a result, the lump coal production rate was maintained at a high level and fragmentation was significantly reduced. Because of using the parameters and techniques determined in this research, high-quality coal production and increased profits were achieved. The research results could provide theoretical guidance and methodology for other anthracite production bases.

  18. Population and harvest trends of big game and small game species: a technical document supporting the USDA Forest Service Interim Update of the 2000 RPA Assessment

    Science.gov (United States)

    Curtis H. Flather; Michael S. Knowles; Stephen J. Brady

    2009-01-01

    This technical document supports the Forest Service's requirement to assess the status of renewable natural resources as mandated by the Forest and Rangeland Renewable Resources Planning Act of 1974 (RPA). It updates past reports on national and regional trends in population and harvest estimates for species classified as big game and small game. The trends...

  19. Geographic patterns of at-risk species: A technical document supporting the USDA Forest Service Interim Update of the 2000 RPA Assessment

    Science.gov (United States)

    Curtis H. Flather; Michael S. Knowles; Jason McNees

    2008-01-01

    This technical document supports the Forest Service's requirement to assess the status of renewable natural resources as mandated by the Forest and Rangeland Renewable Resources Planning Act of 1974. It updates past reports on the trends and geographic patterns of species formally listed as threatened or endangered under the Endangered Species Act of 1973. We...

  20. Report of the Joint Industry - DoD Task Force on Computer Aided Logistic Support (CALS). Volume 5. Report of Technical Issues Subgroup.

    Science.gov (United States)

    1985-06-01

    technical support systems are generally hierarchical in nature, are transaction driven, and many operate in a batch environment. Data resides in a...scheme or sequential (presumably, automated) processes of acquisition and a single proceso is slow (say, manual) - then the entire acquisition will be

  1. Imagining Technicities

    DEFF Research Database (Denmark)

    Liboriussen, Bjarke; Plesner, Ursula

    2011-01-01

    to the elements of taste and skill. In the final analysis those references were synthesized as five imagined technicities: the architect, the engineer, the client, the Chinese, and the Virtual World native. Because technicities are often assumed and rarely discussed as actants who influence practice, their role......, this article focuses on innovative uses of virtual worlds in architecture. We interviewed architects, industrial designers and other practitioners. Conceptually supported by an understanding of technicity found in Cultural Studies, the interviews were then coded with a focus on interviewees’ references...

  2. Translating sustainability from strategy to operations: how can decision support mod-els help logistics service providers to attain strategic as well as operational goals?

    NARCIS (Netherlands)

    Reinder Pieters; Stef Weijers; Hans-Heinrich Glöckner

    2010-01-01

    Decision Support Models could help Logistic Service Providers as a means to make transportation more sustainable. When researching this hypothesis, we discovered that Logistic Service Providers were reluctant to use Decision Support Models when making transportation more sustainable.

  3. Technical support document: Energy conservation standards for consumer products: Dishwashers, clothes washers, and clothes dryers including: Environmental impacts; regulatory impact analysis

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-01

    The Energy Policy and Conservation Act as amended (P.L. 94-163), establishes energy conservation standards for 12 of the 13 types of consumer products specifically covered by the Act. The legislation requires the Department of Energy (DOE) to consider new or amended standards for these and other types of products at specified times. This Technical Support Document presents the methodology, data and results from the analysis of the energy and economic impacts of standards on dishwashers, clothes washers, and clothes dryers. The economic impact analysis is performed in five major areas: An Engineering Analysis, which establishes technical feasibility and product attributes including costs of design options to improve appliance efficiency. A Consumer Analysis at two levels: national aggregate impacts, and impacts on individuals. The national aggregate impacts include forecasts of appliance sales, efficiencies, energy use, and consumer expenditures. The individual impacts are analyzed by Life-Cycle Cost (LCC), Payback Periods, and Cost of Conserved Energy (CCE), which evaluate the savings in operating expenses relative to increases in purchase price; A Manufacturer Analysis, which provides an estimate of manufacturers' response to the proposed standards. Their response is quantified by changes in several measures of financial performance for a firm. An Industry Impact Analysis shows financial and competitive impacts on the appliance industry. A Utility Analysis that measures the impacts of the altered energy-consumption patterns on electric utilities. A Environmental Effects analysis, which estimates changes in emissions of carbon dioxide, sulfur oxides, and nitrogen oxides, due to reduced energy consumption in the home and at the power plant. A Regulatory Impact Analysis collects the results of all the analyses into the net benefits and costs from a national perspective. 47 figs., 171 tabs. (JF)

  4. Promoting Military Cultural Awareness in an Off-post Community of Behavioral Health and Social Support Service Providers

    Directory of Open Access Journals (Sweden)

    Christi Duette Luby

    2012-03-01

    Full Text Available Due to U.S. military Base Realignment and Closure (BRAC efforts and ongoing Overseas Contingency Operations, the number of military servicemembers and veterans seeking civilian-based services has increased. As the military presence grows in previously underrepresented areas, the need for culturally competent providers will also increase both on and off military installations. The purpose of this article is to promote military cultural awareness, while suggesting ways to enhance existing community behavioral health and social support services. It builds on a review of the extant literature and findings from a community assessment to introduce civilian providers to some specific issues affecting servicemembers and their families. A framework describes ways to increase military cultural competence and build community capacity to enhance civilian-based services. In addition, two appendices list some common military terminology and multiple training resources available through military organizations and websites.

  5. Effects of computer-aided clinical decision support systems in improving antibiotic prescribing by primary care providers: a systematic review.

    Science.gov (United States)

    Holstiege, Jakob; Mathes, Tim; Pieper, Dawid

    2015-01-01

    To assess the effectiveness of computer-aided clinical decision support systems (CDSS) in improving antibiotic prescribing in primary care. A literature search utilizing Medline (via PubMed) and Embase (via Embase) was conducted up to November 2013. Randomized controlled trials (RCTs) and cluster randomized trials (CRTs) that evaluated the effects of CDSS aiming at improving antibiotic prescribing practice in an ambulatory primary care setting were included for review. Two investigators independently extracted data about study design and quality, participant characteristics, interventions, and outcomes. Seven studies (4 CRTs, 3 RCTs) met our inclusion criteria. All studies were performed in the USA. Proportions of eligible patient visits that triggered CDSS use varied substantially between intervention arms of studies (range 2.8-62.8%). Five out of seven trials showed marginal to moderate statistically significant effects of CDSS in improving antibiotic prescribing behavior. CDSS that automatically provided decision support were more likely to improve prescribing practice in contrast to systems that had to be actively initiated by healthcare providers. CDSS show promising effectiveness in improving antibiotic prescribing behavior in primary care. Magnitude of effects compared to no intervention, appeared to be similar to other moderately effective single interventions directed at primary care providers. Additional research is warranted to determine CDSS characteristics crucial to triggering high adoption by providers as a perquisite of clinically relevant improvement of antibiotic prescribing. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.

  6. A Promotion Program of Academic-Industrial Collaboration with Active and Joint Participation by Technical College Students Utilizing the Support Program for Contemporary Educational Needs

    Science.gov (United States)

    Furusaki, Tsuyoshi; Ueda, Shigeta; Kojima, Yoichiro; Ikeda, Shin-Ichi; Abe, Tsukasa; Yoshizawa, Kousuke; Tada, Mitsuhiro

    Since 2005, Tomakomai National College of Technology has been conducting “A Promotion Program of Academic-Industrial Collaboration with Active and Joint Participation by Technical College Students” , in which the students actively challenged to resolve technical problems of local companies through internships and graduation researches. This project was adopted as part of the Support Program for Contemporary Educational Needs by the Ministry of Education, Culture, Sports, Science and Technology. It has been revealed that the program is practical and effective engineering education for the students, i.e. “Future Engineers” . In addition, it leads to the revitalization of local companies which carried out collaborative researches with the participating students.

  7. Support and services provided by public health regional surveillance teams to Local Health Departments in North Carolina.

    Science.gov (United States)

    Horney, Jennifer A; Markiewicz, Milissa; Meyer, Anne Marie; Macdonald, Pia D M

    2011-01-01

    Since 2001, many states have created regional structures in an effort to better coordinate/public health preparedness and response efforts, consolidate services, and supplement local government capacity. While several studies have identified specific benefits to regionalization, including enhanced networking, coordination, and communication, little research has examined the effect of regionalization on specific preparedness and response activities. To better understand the impact of regionalizing public health workforce assets in North Carolina, a survey aimed at documenting specific support and services that Public Health Regional Surveillance Teams(PHRSTs) provide to local health departments (LHDs) was developed and administered by the North Carolina Preparedness and Emergency Response Research Center, located at the North Carolina Institute for Public Health. Of80 potential types of assistance, 26 (33%) were received by 75% or more LHDs, including 9 related to communication and 7 related to exercises. There was significant variation by PHRST region in both the quantity and quality of support and services reported by LHDs. This variation could not be explained by county- or LHD-level variables. PHRST assistance to LHDs is largely focused on communication and liaison activities, regional exercises, and planning. On the basis of these findings, regionalization may provide North Carolina with benefits consistent with those found in other studies such as improved networking and coordination. However, further research is needed to identify whether regional variation is the result of varying capacity or priorities of the PHRSTs or LHDs and to determine how much variation is acceptable.

  8. Community, intervention and provider support influences on implementation: reflections from a South African illustration of safety, peace and health promotion

    Science.gov (United States)

    2014-01-01

    Background The development, implementation and evaluation of community interventions are important for reducing child violence and injuries in low- to middle-income contexts, with successful implementation critical to effective intervention outcomes. The assessment of implementation processes is required to identify the factors that influence effective implementation. This article draws on a child safety, peace and health initiative to examine key factors that enabled or hindered its implementation, in a context characterised by limited resources. Methods A case study approach was employed. The research team was made up of six researchers and intervention coordinators, who led the development and implementation of the Ukuphepha Child Study in South Africa, and who are also the authors of this article. The study used author observations, reflections and discussions of the factors perceived to influence the implementation of the intervention. The authors engaged in an in-depth and iterative dialogic process aimed at abstracting the experiences of the intervention, with a recursive cycle of reflection and dialogue. Data were analysed utilising inductive content analysis, and categorised using classification frameworks for understanding implementation. Results The study highlights key factors that enabled or hindered implementation. These included the community context and concomitant community engagement processes; intervention compatibility and adaptability issues; community service provider perceptions of intervention relevance and expectations; and the intervention support system, characterised by training and mentorship support. Conclusions This evaluation illustrated the complexity of intervention implementation. The study approach sought to support intervention fidelity by fostering and maintaining community endorsement and support, a prerequisite for the unfolding implementation of the intervention. PMID:25081088

  9. A Pilot Study to Examine the Feasibility and Potential Effectiveness of Using Smartphones to Provide Recovery Support for Adolescents.

    Science.gov (United States)

    Dennis, Michael L; Scott, Christy K; Funk, Rodney R; Nicholson, Lisa

    2015-01-01

    Smartphone applications can potentially provide recovery monitoring and support in real-time, real-life contexts. Study aims included determining feasibility of (a) adolescents completing ecological momentary assessments (EMAs) and utilizing phone-based ecological momentary interventions (EMIs); and (b) using EMA and EMI data to predict substance use in the subsequent week. Twenty-nine adolescents were recruited at discharge from residential treatment, regardless of their discharge status or length of stay. During the 6-week pilot, youth were prompted to complete an EMA at 6 random times per day and were provided access to a suite of recovery support EMI. Youth completed 87% of the 5580 EMAs. Based on use in the next 7 days, EMA observations were classified into 3 risk groups: "Current Use" in the past 30 minutes (3% of observations), "Unrecognized Risk" (42%), or "Recognized Risk" (55%). All youth had observations in 2 or more risk groups and 38% in all 3. Youth accessed an EMI on average 162 times each week. Participants were 31% female, 48% African American, 21% Caucasian, 7% Hispanic, and 24% Mixed/Other; average age was 16.6 years. During the 90 days prior to entering treatment, youth reported using alcohol (38%), marijuana (41%), and other drugs (7%). When compared with the "Recognized Risk" group's use in the following week (31%), both the "Unrecognized Risk" (50%, odds ratio [OR]=2.08) and "Current Use" (96%, OR=50.30) groups reported significantly higher rates of use in the next week. When an EMI was accessed 2 or more times within the hour following an EMA, the rate of using during the next week was significantly lower than when EMIs were not accessed (32% vs. 43%, OR=0.62). Results demonstrate the feasibility of using smartphones for recovery monitoring and support with adolescents, with potential to reduce use.

  10. Demonstration of shield-type longwall supports at York Canyon Mine of Kaiser Steel Corporation. Final technical report A

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, R.G.; King, R.

    1980-04-01

    This report represents work on a program that was originated by the USBM of the Department of the Interior and was transferred to the Department of Energy on October 1, 1977. A demonstration with the Government funded Hemscheidt 320 HSL caliper type shield supports was conducted at three longwall panels of Kaiser Steel Corporation's York Canyon Mine. The purpose of this longwall demonstration was to provide the US coal industry with information on all aspects of shield longwall mining in high seams. The demonstration provided a working model for the coal industry and during the project, 350 people from the industry, schools, and government agencies visited the demonstration. They were provided with a first hand knowledge of a working shield longwall. The demonstration showed that the control of large coal lumps may be a problem in the mining of coal seam thicker than 8 feet. Mining with shield type supports provided good working conditions and a safe working environment. The shield requires very little maintenance and has a high mechanical availability.

  11. Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

    Science.gov (United States)

    Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel

    2012-01-01

    Background It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. Results The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59). Conclusions This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between

  12. Technical documentation in support of the project-specific analysis for construction and operation of the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Lazaro, M.A.; Vinikour, W. [Argonne National Lab., IL (United States). Environmental Assessment Div.; Allison, T. [Argonne National Lab., IL (United States). Decision and Information Sciences Div.] [and others

    1996-09-01

    This document provides information that supports or supplements the data and impact analyses presented in the National Ignition Facility (NIF) Project-Specific Analysis (PSA). The purposes of NIF are to achieve fusion ignition in the laboratory for the first time with inertial confinement fusion (ICF) technology and to conduct high- energy-density experiments ins support of national security and civilian application. NIF is an important element in the DOE`s science-based SSM Program, a key mission of which is to ensure the reliability of the nation`s enduring stockpile of nuclear weapons. NIF would also advance the knowledge of basic and applied high-energy- density science and bring the nation a large step closer to developing fusion energy for civilian use. The NIF PSA includes evaluations of the potential environmental impacts of constructing and operating the facility at one of five candidate site and for two design options.

  13. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    Science.gov (United States)

    Burgos, Jose L.; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C.; Segovia, Luis A.; Strathdee, Steffanie A.; Olivares-Nevarez, Jose A.; Ojeda, Victoria D.

    2015-01-01

    Background The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. Activities and outcomes This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP), a new quarterly undergraduate internship program based at a US–Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. Discussion The HFiT-UIP might serve as a model for other educational partnerships across the US–Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students’ desires to learn about Latino, border, and global health within resource-limited settings. PMID:26088189

  14. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    Directory of Open Access Journals (Sweden)

    Jose L. Burgos

    2015-06-01

    Full Text Available Background: The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons. By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. Activities and outcomes: This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP, a new quarterly undergraduate internship program based at a US–Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. Discussion: The HFiT-UIP might serve as a model for other educational partnerships across the US–Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students’ desires to learn about Latino, border, and global health within resource-limited settings.

  15. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States-Mexico border region.

    Science.gov (United States)

    Burgos, Jose L; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C; Segovia, Luis A; Strathdee, Steffanie A; Olivares-Nevarez, Jose A; Ojeda, Victoria D

    2015-01-01

    The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP), a new quarterly undergraduate internship program based at a US-Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. The HFiT-UIP might serve as a model for other educational partnerships across the US-Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students' desires to learn about Latino, border, and global health within resource-limited settings.

  16. Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

    Science.gov (United States)

    Paxton, Avery B; Pickering, Emily A; Adler, Alyssa M; Taylor, J Christopher; Peterson, Charles H

    2017-01-01

    Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH), special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of reefs on the seafloor

  17. Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

    Directory of Open Access Journals (Sweden)

    Avery B Paxton

    Full Text Available Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH, special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of

  18. Opinions of Artistically Talented Eminent Adults on Supports Provided by the State for Gifted Children in the Arts

    Directory of Open Access Journals (Sweden)

    Faruk Levent

    2017-12-01

    Full Text Available The purpose of the study was to examine opinions of artists in music about state supports for students talented in music. Participants had state sup-ports in music when they were young. A phenomenological study was undertaken to interview the participants. They were interviewed face to face. Data was coded and content-analyzed and categorized by themes. The findings showed that all of the participants expressed that policies related to the education of gifted children in the field of arts in Turkey did not work anymore, losing functionality and effects and special services to be provided for artistically gifted students depended upon individuals who were in charge, showing that the policies were no longer useful. In addition, the participants stated that policies and practices have changed constantly as a result of changes in perceptions of educational politics and decision makers. Therefore, it is reasonable to claim that the greatest challenge in the education of students highly talented in the arts is the lack of a consistent and sustainable national policy

  19. Communication architecture for AAL. Supporting patient care by health care providers in AAL-enhanced living quarters.

    Science.gov (United States)

    Nitzsche, T; Thiele, S; Häber, A; Winter, A

    2014-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". Concepts of Ambient Assisted Living (AAL) support a long-term health monitoring and further medical and other services for multi-morbid patients with chronic diseases. In Germany many AAL and telemedical applications exist. Synergy effects by common agreements for essential application components and standards are not achieved. It is necessary to define a communication architecture which is based on common definitions of communication scenarios, application components and communication standards. The development of a communication architecture requires different steps. To gain a reference model for the problem area different AAL and telemedicine projects were compared and relevant data elements were generalized. The derived reference model defines standardized communication links. As a result the authors present an approach towards a reference architecture for AAL-communication. The focus of the architecture lays on the communication layer. The necessary application components are identified and a communication based on standards and their extensions is highlighted. The exchange of patient individual events supported by an event classification model, raw and aggregated data from the personal home area over a telemedicine center to health care providers is possible.

  20. [Six years of Advanced Trauma Life Support (ATLS) in Germany: the 100th provider course in Hamburg].

    Science.gov (United States)

    Münzberg, M; Mahlke, L; Bouillon, B; Paffrath, T; Matthes, G; Wölfl, C G

    2010-07-01

    With over 1 million certified physicians in more than 50 countries worldwide, the Advanced Trauma Life Support (ATLS) concept is one of the most successful international education programs. The concept is simple, priority-orientated (ABCDE scheme) and assesses the situation of the trauma patient on the basis of vital signs to treat the life-threatening injuries immediately. With over 100 ATLS provider courses and 10 instruction courses accomplished in less than 6 years, no other land in the world has successfully established this concept in such a short time as Germany. Meanwhile nearly 1,600 colleagues have been trained and certified. Evaluation of the first 100 ATLS courses in Germany supports this concept. The total evaluation of all courses is 1.36 (1.06-1.8, n=100). The individual parts of the course were marked as followed: presentations 1.6 (1.0-2.81, n=100), practical skills stations 1.46 (1.0-2.4, n=100) and surgical skills stations 1.38 (1.0-2.38, n=100). In 2009 a total of 47 ATLS courses were accomplished which will clearly increase in 2010. Other ATLS formats, such as ATCN (Advanced Trauma Care for Nurses) and refresher courses are planned for the beginning of 2010.

  1. Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study.

    Science.gov (United States)

    Vandrevala, T; Samsi, K; Rose, C; Adenrele, C; Barnes, C; Manthorpe, J

    2017-02-01

    The aim of the current exploratory study was to investigate the impact on care home staff when working with people with dementia at the end of life and to explore how they cope with this aspect of their work. With UK policy encouraging death in the place of residence, rather than hospital, more people with dementia are dying in care homes. A qualitative approach was employed; 20 care home staff working in five English care homes were interviewed. Thematic Analysis was used to analyse the data. Care home staff found the external demands on them and difficulties associated with interacting with people with dementia sometimes challenging, stressful and anxiety-provoking, particularly as residents approached end of life. Emotional aspects of caring for dying residents were sometimes heightened by close attachments with residents and their families. Staff were able to recognise these unmet needs and identified a need for further training and emotional support to manage these stressors. This study revealed rich and complex understandings of the practice dimensions of caring for people with dementia at the end of life and the impact these have on staff. There is a need to develop effective psychosocial interventions that focus on emotional support for care home staff. There will be challenges in providing this in employment settings that are generally low paid, low status, have high turnover and are reliant on temporary or migrant staff, where training is not rewarded, mandatory or culturally valued. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Providing Logistics Support to CDC-Deployed Staff for the Ebola Response in Liberia, Guinea, and Sierra Leone.

    Science.gov (United States)

    Dopson, Stephanie A; Rodriguez, Rockie; Rouse, Edward N

    2015-11-01

    The first Ebola cases in West Africa were reported by the Guinea Ministry of Health on March 23, 2014, and by June it became the largest recorded Ebola outbreak. Centers for Disease Control and Prevention field teams were deployed to West Africa, including in-country logistics staff who were critical for ensuring the movement of staff, equipment, and supplies to locations where public health knowledge and experience were applied to meet mission-related requirements. The logistics role was critical to creating the support for epidemiologists, medical doctors, laboratory staff, and health communicators involved in health promotion activities to successfully respond to the epidemic, both in the capital cities and in remote villages. Logistics personnel worked to procure equipment, such as portable video projectors, and have health promotion materials printed. Logistics staff also coordinated delivery of communication and health promotion materials to the embassy and provided assistance with distribution to various partners. © 2015 Society for Public Health Education.

  3. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 14. Repository preconceptual design studies: basalt

    Energy Technology Data Exchange (ETDEWEB)

    1978-04-01

    This document describes a preconceptual design for a nuclear waste storage facility in basalt. The facility design consists of several chambers excavated deep within a geologic formation together with access shafts and supportive surface structures. The facility design provides for: receiving and unloading waste containers; lowering them down shafts to the mine level; transporting them to the proper storage area and emplacing them in mined storage rooms. Drawings of the facility design are contained in TM-36/15, ''Drawings for Repository Preconceptual Design Studies: Basalt.''

  4. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 12. Repository preconceptual design studies: shale

    Energy Technology Data Exchange (ETDEWEB)

    1978-04-01

    This document describes a preconceptual design for a nuclear waste storage facility in shale. The facility design consists of several chambers excavated deep within a geologic formation together with access shafts and supportive surface structures. The facility design provides for: receiving and unloading waste containers; lowering them down shafts to the mine level; transporting them to the proper storage area, and emplacing them in mined storage rooms. Drawings of the facility design are contained in TM-36/13, ''Drawings for Repository Preconceptual Design Studies: Shale.''

  5. Control of nitrogen oxides: assessment of needs and options, technical support document. Volume 6. Applying NO/sub x/ air quality models. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hayes, S.R.; Liu, C.; Holman, H.Y.; Souten, D.R.; Hillyer, M.J.; Killus, J.P.

    1981-09-01

    This is the final volume of a six-volume Technical Support Document which is designed to provide utilities with information needed to contend with several pending NO/sub x/-related regulatory changes. This volume examines the use and choice of air quality models to assess the impacts of power plant emissions of NO/sub x/. Simple Gaussian models and more refined reactive plume models are considered. The choice is seen to depend upon the specific circumstances and the regulatory issue being addressed as well as upon the resources required by the alternative models. Since general dicta for model choice are not possible, a case study approach is used to explain the choice through analogy. For each case study, four steps are outlined. Background material for basic reader orientation are presented, thus illustrating the types of information that must be assembled. The situation is visualized in air quality modeling terms. The selection of a suitable model or set of models is demonstrated with the use of a series of decision trees. Guidance is offered the reader in identifying data needs and assessing data availability. By examining the representative case studies, the reader should gain insight into the planning and conduct of the NO/sub x/ modeling process.

  6. Methodological approach and tools for systems thinking in health systems research: technical assistants' support of health administration reform in the Democratic Republic of Congo as an application.

    Science.gov (United States)

    Ribesse, Nathalie; Bossyns, Paul; Marchal, Bruno; Karemere, Hermes; Burman, Christopher J; Macq, Jean

    2017-03-01

    In the field of development cooperation, interest in systems thinking and complex systems theories as a methodological approach is increasingly recognised. And so it is in health systems research, which informs health development aid interventions. However, practical applications remain scarce to date. The objective of this article is to contribute to the body of knowledge by presenting the tools inspired by systems thinking and complexity theories and methodological lessons learned from their application. These tools were used in a case study. Detailed results of this study are in process for publication in additional articles. Applying a complexity 'lens', the subject of the case study is the role of long-term international technical assistance in supporting health administration reform at the provincial level in the Democratic Republic of Congo. The Methods section presents the guiding principles of systems thinking and complex systems, their relevance and implication for the subject under study, and the existing tools associated with those theories which inspired us in the design of the data collection and analysis process. The tools and their application processes are presented in the results section, and followed in the discussion section by the critical analysis of their innovative potential and emergent challenges. The overall methodology provides a coherent whole, each tool bringing a different and complementary perspective on the system.

  7. Independent technical review, handbook

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    Purpose Provide an independent engineering review of the major projects being funded by the Department of Energy, Office of Environmental Restoration and Waste Management. The independent engineering review will address questions of whether the engineering practice is sufficiently developed to a point where a major project can be executed without significant technical problems. The independent review will focus on questions related to: (1) Adequacy of development of the technical base of understanding; (2) Status of development and availability of technology among the various alternatives; (3) Status and availability of the industrial infrastructure to support project design, equipment fabrication, facility construction, and process and program/project operation; (4) Adequacy of the design effort to provide a sound foundation to support execution of project; (5) Ability of the organization to fully integrate the system, and direct, manage, and control the execution of a complex major project.

  8. Technical support and preparations for the response to radiological emergencies; Soporte tecnico y preparativos para la respuesta a emergencias radiologicas

    Energy Technology Data Exchange (ETDEWEB)

    Cardenas H, J.; Ramos V, E.O.; Fernandez G, I.M.; Capote F, E.; Zerquera J, T.; Garcia L, O.; Lopez B, G.; Molina P, D.; Lamdrid B, A.I.; Benitez N, J.C.; Salgado M, M. [CPHR, Calle 20 No. 4113, e/41 y 47 Playa, CP 11300, La Habana (Cuba); Lopez F, Y.; Jerez V, P. [CNSN, Calle 28 e/5ta y 7ta, Playa, La Habana (Cuba)]. e-mail: cardenas@cphr.edu.cu

    2006-07-01

    The work picks up the efforts directed to elevate the technical capacity of the answer in front of the radiological emergencies. Expressing them by means of the actions carried out as for teaching, research and development and intervention before accidental radiological events. The same one reflects the leading role of the participant institutions in those marks of the answer system to radiological emergencies that for its technical level it satisfies the national and international demands in the matter. In execution of the mentioned goals research projects guided to endow to the national system of methodologies and procedures for the administration of radiological emergencies have been executed that favor the improvement of its technical and organizational capacities. As well as the postulates of the National Plan of Measures for Case of Catastrophes in the corresponding to radiological accidents. (Author)

  9. The Electronic Delivery of Automated Technical Information for Logistics Support of Navy Weapon Systems: Potential, System Description and Status

    Science.gov (United States)

    1989-02-01

    Charles S. Sawyer. Test and Evaluation of The Navy Technical Information Presentation System (NTIPS), AN/SPA-25D Test Results. DTRC-88-035, September 1988...L. LeBeau; Anne S. Mavor; Theodore J. Post; and Charles S. Sawyer. Test and Evaluation of The Navy Technical Information Presentpl ier System (NTIPS...Karpovich 1 EER Systems 1 NPFC-100 H. Bukowski LCDR F. Harmer 2 EG&G 1 NOSC WASC L. Snodgrass R. Smillie WASCI R. Beckham 1 NOS Indianhead 4 Essex Corp. G

  10. Organizacija rada u jedinicama tehničke službe u borbenim dejstvima / Organization of technical service support units in combat operations

    Directory of Open Access Journals (Sweden)

    Marko Andrejić

    2005-05-01

    Full Text Available U radu se obrađuje organizacija rada u jedinicama tehničke službe u združenim taktičkim jedinicama, osloncem na sistematizovana iskustva, postojeću normativu i dostupna teorijska saznanja. Jedinice tehničke službe posmatraju se kao složeni organizacioni sistem, sa različitih aspekata. Analitičko-sintetičkim pristupom razmatraju se raspored jedinica tehničke službe, principi organizacije rada, organizacije radnog mesta i individualnog rada, prostorna integracija elemenata stanica i sekcija, izbor rejona razmeštaja jedinica tehničke službe, razvijanje i uređenje stanica i organizacija rada u stanicama za snabdevanje i održavanje. / In this paper it has been presented organization of technical service support in joined tactical military unit, based on systemized recent experiences, existing normative rules and available theoretical knowledge. Technical service support units are considered as complex organization system from different standpoint. Using analytical - synthetical methodology it has been examined technical service support units deployment, work organization principles, individual workplace organization, spatial integration of service stations and sections, choice of units deployment regions and, work organization in station for supply and maintenance.

  11. Dose Modeling Evaluations and Technical Support Document For the Authorized Limits Request for the DOE-Owned Property Outside the Limited Area, Paducah Gaseous Diffusion Plant Paducah, Kentucky

    Energy Technology Data Exchange (ETDEWEB)

    Boerner, A. J. [Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States). Independent Environmental Assessment and Verification Program; Maldonado, D. G. [Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States). Independent Environmental Assessment and Verification Program; Hansen, Tom [Ameriphysics, LLC (United States)

    2012-09-01

    guidelines as inputs into the code was also performed to determine the maximum (peak) dose for all receptors. This report contains the technical basis in support of the DOE?s derivation of ALs for the 'Property.' A complete description of the methodology, including an assessment of the input parameters, model inputs, and results is provided in this report. This report also provides initial recommendations on applying the derived soil guidelines.

  12. Protein Based Molecular Markers Provide Reliable Means to Understand Prokaryotic Phylogeny and Support Darwinian Mode of Evolution

    Directory of Open Access Journals (Sweden)

    Vaibhav eBhandari

    2012-07-01

    Full Text Available The analyses of genome sequences have led to the proposal that lateral gene transfers (LGTs among prokaryotes are so widespread that they disguise the interrelationships among these organisms. This has led to questioning whether the Darwinian model of evolution is applicable to the prokaryotic organisms. In this review, we discuss the usefulness of taxon-specific molecular markers such as conserved signature indels (CSIs and conserved signature proteins (CSPs for understanding the evolutionary relationships among prokaryotes and to assess the influence of LGTs on prokaryotic evolution. The analyses of genomic sequences have identified large numbers of CSIs and CSPs that are unique properties of different groups of prokaryotes ranging from phylum to genus levels. The species distribution patterns of these molecular signatures strongly support a tree-like vertical inheritance of the genes containing these molecular signatures that is consistent with phylogenetic trees. Recent detailed studies in this regard on Thermotogae and Archaea, which are reviewed here, have identified large numbers of CSIs and CSPs that are specific for the species from these two taxa and a number of their major clades. The genetic changes responsible for these CSIs (and CSPs initially likely occurred in the common ancestors of these taxa and then vertically transferred to various descendants. Although some CSIs and CSPs in unrelated groups of prokaryotes were identified, their small numbers and random occurrence has no apparent influence on the consistent tree-like branching pattern emerging from other markers. These results provide evidence that although LGT is an important evolutionary force, it does not mask the tree-like branching pattern of prokaryotes or understanding of their evolutionary relationships. The identified CSIs and CSPs also provide novel and highly specific means for identification of different groups of microbes and for taxonomical and biochemical

  13. Dying at home: a qualitative study of family carers' views of support provided by GPs community staff.

    Science.gov (United States)

    Seamark, David; Blake, Susan; Brearley, Sarah G; Milligan, Christine; Thomas, Carol; Turner, Mary; Wang, Xu; Payne, Sheila

    2014-12-01

    Dying at home is the preference of many patients with life-limiting illness. This is often not achieved and a key factor is the availability of willing and able family carers. To elicit family carers' views about the community support that made death at home possible. Qualitative study in East Devon, North Lancashire, and Cumbria. Participants were bereaved family carers who had provided care at the end of life for patients dying at home. Semi-structured interviews were conducted 6-24 months after the death. Fifty-nine bereaved family carers were interviewed (54% response rate; 69% female). Two-thirds of the patients died from cancer with median time of home care being 5 months and for non-cancer patients the median time for home care was 30 months. An overarching theme was of continuity of care that divided into personal, organisational, and informational continuity. Large numbers and changes in care staff diluted personal continuity and failure of the GPs to visit was viewed negatively. Family carers had low expectations of informational continuity, finding information often did not transfer between secondary and primary care and other care agencies. Organisational continuity when present provided comfort and reassurance, and a sense of control. The requirement for continuity in delivering complex end-of-life care has long been acknowledged. Family carers in this study suggested that minimising the number of carers involved in care, increasing or ensuring personal continuity, and maximising the informational and organisational aspects of care could lead to a more positive experience. © British Journal of General Practice 2014.

  14. Extracellular matrix inspired surface functionalization with heparin, fibronectin and VEGF provides an anticoagulant and endothelialization supporting microenvironment

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xue [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Liu, Tao [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology, Huai’an (China); Chen, Yuan [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Zhang, Kun [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); School of Life Science, Zhengzhou University, Zhengzhou (China); Maitz, Manfred F. [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials, Hohe Str. 06, 01069 Dresden (Germany); Pan, Changjiang [Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology, Huai’an (China); Chen, Junying, E-mail: chenjy@263.net [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Huang, Nan [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China)

    2014-11-30

    Highlights: • Surface modification with fibronectin, heparin and VEGF could selectively anticoagulant and promote endothelialization. • The bioactivity of biomolecules was more efficiently maintained via specific intermolecular interaction. • Poly-l-lysine interlayer was more feasible and the degradation product had no harm to human body. - Abstract: The biocompatibility of currently used coronary artery stent is still far from perfect, which closely related to insufficient endothelialization and thrombus formation. In this study, heparin, fibronectin and VEGF were immobilized on Ti surface to construct a multifunctional microenvironment with favorable properties to inhibit thrombosis formation and promote endothelialization simultaneously. The microenvironment on Ti surface was characterized in detail and demonstrated that the Hep/Fn/VEGF biofunctional coating was constructed successfully on Ti surface. The influence of surface properties such as chemical composition, roughness, hydrophilicity, and binding density of biomolecules on the performances of hemocompatibility and cytocompatibility was evaluated and discussed. Modified surface significantly enhanced the AT III binding density and prolonged the clotting time. In vitro platelet adhesion and activation assays further proved that the modified surface presented favorable anti-coagulant property. In addition, the proliferation of endothelial progenitor cells (EPCs) and endothelial cells (ECs) on the Hep/Fn/VEGF biofunctional coating was significantly promoted. In conclusion, the Hep/Fn/VEGF biofunctional coating was successfully constructed with desirable anticoagulant and endothelialization supporting properties. This work may provide a promising approach for biofunctional surface modification of coronary artery stent to acquire a desired multifunctional microenvironment.

  15. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Science.gov (United States)

    Eshrati, Babak; Asl, Rahim Taghizadeh; Dell, Colleen Anne; Afshar, Parviz; Millson, Peggy Margaret E; Kamali, Mohammad; Weekes, John

    2008-01-01

    Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM) and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices. PMID:18541032

  16. Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.

    Science.gov (United States)

    Ranji, Sumant R; Rennke, Stephanie; Wachter, Robert M

    2014-09-01

    Adverse drug events (ADEs) are a major cause of morbidity in hospitalised and ambulatory patients. Computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) are being widely implemented with the goal of preventing ADEs, but the effectiveness of these systems remains unclear. We searched the specialised database Agency for Healthcare Research and Quality (AHRQ) Patient Safety Net to identify reviews of the effect of CPOE combined with CDSS on ADE rates in inpatient and outpatient settings. We included systematic and narrative reviews published since 2008 and controlled clinical trials published since 2012. We included five systematic reviews, one narrative review and two controlled trials. The existing literature consists mostly of studies of homegrown systems conducted in the inpatient setting. CPOE+CDSS was consistently reported to reduce prescribing errors, but does not appear to prevent clinical ADEs in either the inpatient or outpatient setting. Implementation of CPOE+CDSS profoundly changes staff workflow, and often leads to unintended consequences and new safety issues (such as alert fatigue) which limit the system's safety effects. CPOE+CDSS does not appear to reliably prevent clinical ADEs. Despite more widespread implementation over the past decade, it remains a work in progress. 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.

  17. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Directory of Open Access Journals (Sweden)

    Millson Peggy

    2008-06-01

    Full Text Available Abstract Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices.

  18. Evidence-based practice implementation: The impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

    Directory of Open Access Journals (Sweden)

    Sommerfeld David H

    2009-12-01

    Full Text Available Abstract Background The goal of this study is to extend research on evidence-based practice (EBP implementation by examining the impact of organizational type (public versus private and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170. Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in

  19. Zoe's Story: Exploring the Complexity of "Help-Providing" and "Help-Receiving" Relationships on the "Front-Line" of Family Support

    Science.gov (United States)

    Leese, Maggie

    2013-01-01

    The subject of engaging mothers in appropriate family support continues to be debated and this paper explores the complex factors that influenced one mother's willingness to accept support. In addition, it captures how her family support worker built and sustained a "help-providing" and "help-receiving" relationship despite the…

  20. Predator diversity and abundance provide little support for the enemies hypothesis in forests of high tree diversity.

    Directory of Open Access Journals (Sweden)

    Andreas Schuldt

    Full Text Available Predatory arthropods can exert strong top-down control on ecosystem functions. However, despite extensive theory and experimental manipulations of predator diversity, our knowledge about relationships between plant and predator diversity--and thus information on the relevance of experimental findings--for species-rich, natural ecosystems is limited. We studied activity abundance and species richness of epigeic spiders in a highly diverse forest ecosystem in subtropical China across 27 forest stands which formed a gradient in tree diversity of 25-69 species per plot. The enemies hypothesis predicts higher predator abundance and diversity, and concomitantly more effective top-down control of food webs, with increasing plant diversity. However, in our study, activity abundance and observed species richness of spiders decreased with increasing tree species richness. There was only a weak, non-significant relationship with tree richness when spider richness was rarefied, i.e. corrected for different total abundances of spiders. Only foraging guild richness (i.e. the diversity of hunting modes of spiders was positively related to tree species richness. Plant species richness in the herb layer had no significant effects on spiders. Our results thus provide little support for the enemies hypothesis--derived from studies in less diverse ecosystems--of a positive relationship between predator and plant diversity. Our findings for an important group of generalist predators question whether stronger top-down control of food webs can be expected in the more plant diverse stands of our forest ecosystem. Biotic interactions could play important roles in mediating the observed relationships between spider and plant diversity, but further testing is required for a more detailed mechanistic understanding. Our findings have implications for evaluating the way in which theoretical predictions and experimental findings of functional predator effects apply to species

  1. Predator Diversity and Abundance Provide Little Support for the Enemies Hypothesis in Forests of High Tree Diversity

    Science.gov (United States)

    Schuldt, Andreas; Both, Sabine; Bruelheide, Helge; Härdtle, Werner; Schmid, Bernhard; Zhou, Hongzhang; Assmann, Thorsten

    2011-01-01

    Predatory arthropods can exert strong top-down control on ecosystem functions. However, despite extensive theory and experimental manipulations of predator diversity, our knowledge about relationships between plant and predator diversity—and thus information on the relevance of experimental findings—for species-rich, natural ecosystems is limited. We studied activity abundance and species richness of epigeic spiders in a highly diverse forest ecosystem in subtropical China across 27 forest stands which formed a gradient in tree diversity of 25–69 species per plot. The enemies hypothesis predicts higher predator abundance and diversity, and concomitantly more effective top-down control of food webs, with increasing plant diversity. However, in our study, activity abundance and observed species richness of spiders decreased with increasing tree species richness. There was only a weak, non-significant relationship with tree richness when spider richness was rarefied, i.e. corrected for different total abundances of spiders. Only foraging guild richness (i.e. the diversity of hunting modes) of spiders was positively related to tree species richness. Plant species richness in the herb layer had no significant effects on spiders. Our results thus provide little support for the enemies hypothesis—derived from studies in less diverse ecosystems—of a positive relationship between predator and plant diversity. Our findings for an important group of generalist predators question whether stronger top-down control of food webs can be expected in the more plant diverse stands of our forest ecosystem. Biotic interactions could play important roles in mediating the observed relationships between spider and plant diversity, but further testing is required for a more detailed mechanistic understanding. Our findings have implications for evaluating the way in which theoretical predictions and experimental findings of functional predator effects apply to species-rich forest

  2. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.

    2001-07-15

    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  3. Mathematical Models for the Education Sector, Supporting Material to the Survey. (Les Modeles Mathematiques du Secteur Enseignement. Annexes.) Technical Report.

    Science.gov (United States)

    Organisation for Economic Cooperation and Development, Paris (France).

    This document contains supporting material for the survey on current practice in the construction and use of mathematical models for education. Two kinds of supporting material are included: (1) the responses to the questionnaire, and (2) supporting documents and other materials concerning the mathematical model-building effort in education.…

  4. The hybrid assisted limb (HAL) for Care Support, a motion assisting robot providing exoskeletal lumbar support, can potentially reduce lumbar load in repetitive snow-shoveling movements.

    Science.gov (United States)

    Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Endo, Hirooki; Murakami, Hideki; Doita, Minoru; Kumagai, Hiroshi; Nagashima, Katsuya; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

    2017-12-15

    An excessive lumbar load with snow-shoveling is a serious problem in snowfall areas. Various exoskeletal robots have been developed to reduce lumbar load in lifting work. However, few studies have reported the attempt of snow-shoveling work using exoskeletal robots. The purpose of the present study was to test the hypothesis that the HAL for Care Support robot would reduce lumbar load in repetitive snow-shoveling movements. Nine healthy male volunteers performed repetitive snow-shoveling movements outdoors in a snowfall area for as long as possible until they were fatigued. The snow-shoveling trial was performed under two conditions: with and without HAL for Care Support. Outcome measures were defined as the lumbar load assessed by the VAS of lumbar fatigue after the snow-shoveling trial and the snow-shoveling performance, including the number of scoops, and snow shoveling time and distance. The mean of VAS of lumbar fatigue, the number of scoops, and snow-shoveling time and distance without HAL for Care Support were 75.4 mm, 50.3, 145 s, and 9.6 m, while with HAL for Care Support were 39.8 mm, 144, 366 s, and 35.4 m. The reduction of lumbar fatigue and improvement of snow-shoveling performance using HAL for Care Support were statistically significant. There was no adverse event during snow-shoveling with HAL for Care Support. In conclusion, the HAL for Care Support can reduce lumbar load in repetitive snow-shoveling movements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust

    National Research Council Canada - National Science Library

    Jones, Ray B; O'Connor, Anita; Brelsford, Jade; Parsons, Neil; Skirton, Heather

    2012-01-01

    .... Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients...

  6. Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support.

    Science.gov (United States)

    Denno, Donna M; Hoopes, Andrea J; Chandra-Mouli, Venkatraman

    2015-01-01

    Access to youth friendly health services is vital for ensuring sexual and reproductive health (SRH) and well-being of adolescents. This study is a descriptive review of the effectiveness of initiatives to improve adolescent access to and utilization of sexual and reproductive health services (SRHS) in low- and middle-income countries. We examined four SRHS intervention types: (1) facility based, (2) out-of-facility based, (3) interventions to reach marginalized or vulnerable populations, (4) interventions to generate demand and/or community acceptance. Outcomes assessed across the four questions included uptake of SRHS or sexual and reproductive health commodities and sexual and reproductive health biologic outcomes. There is limited evidence to support the effectiveness of initiatives that simply provide adolescent friendliness training for health workers. Data are most ample (10 initiatives demonstrating weak but positive effects and one randomized controlled trial demonstrating strong positive results on some outcome measures) for approaches that use a combination of health worker training, adolescent-friendly facility improvements, and broad information dissemination via the community, schools, and mass media. We found a paucity of evidence on out-of-facility-based strategies, except for those delivered through mixed-use youth centers that demonstrated that SRHS in these centers are neither well used nor effective at improving SRH outcomes. There was an absence of studies or evaluations examining outcomes among vulnerable or marginalized adolescents. Findings from 17 of 21 initiatives assessing demand-generation activities demonstrated at least some association with adolescent SRHS use. Of 15 studies on parental and other community gatekeepers' approval of SRHS for adolescents, which assessed SRHS/commodity uptake and/or biologic outcomes, 11 showed positive results. Packages of interventions that train health workers, improve facility adolescent friendliness

  7. You can't always give what you want: the challenge of providing social support to low self-esteem individuals.

    Science.gov (United States)

    Marigold, Denise C; Cavallo, Justin V; Holmes, John G; Wood, Joanne V

    2014-07-01

    It can be challenging for support providers to facilitate effective social support interactions even when they have the best intentions. In the current article, we examine some reasons for this difficulty, with a focus on support recipients' self-esteem as a crucial variable. We predicted that recipients' receptiveness to support would be influenced by both support strategy and recipient self-esteem and that receptiveness in turn would impact providers' perceived caregiving efficacy and relationship quality. Study 1 (hypothetical scenarios), Study 2 (confederate interaction), and Study 3 (reports of recently received support) showed that individuals with low self-esteem (LSEs) are less receptive than are individuals with high self-esteem (HSEs) to support that positively reframes their experience but are equally receptive to support that validates their negative feelings. In Study 4, providers demonstrated some knowledge that positive reframing would be less helpful to LSEs than to HSEs but indicated equal intention to give such support. Study 5 showed that, in a real interaction, friends were indeed equally likely to offer positive reframing to both LSEs and HSEs but were less likely to offer validation to LSEs. LSEs were less accepting of such support, and in turn providers felt worse about the interaction, about themselves, and about their friendship more broadly. Study 6 confirmed that recipients' receptivity to support directly influenced providers' experience of a support interaction as well as their self- and relationship evaluations. The findings illustrate how well-meaning support attempts that do not match recipients' particular preferences may be detrimental to both members of the dyad.

  8. Mobilization and Defense Management Technical Reports Series. Contemporary Issues Affecting the Ability of Commercial Air Cargo Carriers to Support the Civil Air Reserve Fleet.

    Science.gov (United States)

    1983-05-01

    antitrust authority over airline operations and mergers , control over subsidies, consumer affairs matters, and safety and technical matters will be...has varied from fourteen to eighteen over the period examined with changes primarily the result of bankruptcies and mergers . Table 111-2 provides a...acir of these additions entails an acquisitio )n cost 1 1 add-s -operating weiqiht to the aircraft Wien in passer? e ri’. weight increases fuel

  9. ESSENTIAL FEATURES OF METHODOLOGICAL SUPPORT FOR THE FORMATION OF COMPETENCE IN GERMAN IN STUDENTS OF TECHNICAL SPECIALTIES

    Directory of Open Access Journals (Sweden)

    Наталія Ленюк

    2016-03-01

    Full Text Available The article deals with the results of experimental learning of the students of technical higher educational institutions in the process of autonomous learning, using a study and methodical textbook. The research presents theoretical substantiation to the advantages of such textbook in making autonomous out of class German studies by the students of techical specialties in German language more effective. The article identifies the directions, which modern scientific investigations of foreign language competence as methodical problem in the process of autonomous learning are conducted in.

  10. GPHS-RTGs in support of the Cassini Mission. Semiannual technical progress report, 27 September 1993--27 March 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-24

    This report is organized by the program task structure as follows: (1) spacecraft integration and liaison; (2) engineering support; (3) safety; (4) qualified unicouple fabrication; (5) ETG fabrication, assembly, and test; (6) ground support equipment (GSE); (7) RTG shipping and launch support; (8) designs, reviews, and mission applications; (9) project management, quality assurance and reliability, contract changes, non-capital CAGO acquisition, and CAGO maintenance; and (H) contractor acquired government owned property (CAGO) acquisition.

  11. External support to local institutions: providing political leverage to weaker groups, or sustaining traditional relations of power?

    DEFF Research Database (Denmark)

    Nygaard, Ivan

    2008-01-01

    economic resources. The study thus enhances our understanding of mechanisms for access to local donor-supported institutions. Il existe tout un pan de la littérature qui montre que les institutions appuyées par les bailleurs de fonds en Afrique Subsaharienne (ASS) sont accaparées par les élites locales...

  12. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial

    OpenAIRE

    Ericson, Jenny; Eriksson, Mats; Hellström-Westas, Lena; Hagberg, Lars; Hoddinott, Pat; Flacking, Renée

    2013-01-01

    Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mo...

  13. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    OpenAIRE

    Jose L. Burgos; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C.; Luis A. Segovia; Strathdee, Steffanie A.; Olivares-Nevarez, Jose A.; Ojeda, Victoria D.

    2015-01-01

    Background: The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity.Activities and outcomes: This article describes the Health Frontiers in Tijuana Undergraduate Internship Program...

  14. Rhetoric or reality? What nurse practitioners do to provide self-management support in outpatient clinics: an ethnographic study.

    Science.gov (United States)

    Ter Maten-Speksnijder, Ada J; Dwarswaard, Jolanda; Meurs, Pauline L; van Staa, AnneLoes

    2016-11-01

    To describe how nurse practitioners enact their role in outpatient consultations, and how this compares to their perception of their responsibility for patients with chronic conditions. Nurse practitioners working with patients with chronic conditions seek to support them in self-managing their diseases. An ethnographic study. Episodic participant observations (in total 48 hours) were carried out combined with formal interviews. The study population consisted of a purposive sample of nurse practitioners working in five outpatient clinics related to chronic care in one university medical centre in the Netherlands. Two different types of clinics were selected, namely (1) for patients with episodic flare-ups and (2) for patients with diseases requiring life-saving procedures. The nurse practitioners perceived the monitoring of patients' treatment as their main professional responsibility. Four monitoring strategies could be distinguished: 'assessing health conditions', 'connecting with patients', 'prioritising treatment in daily living' and 'educating patients'. While nurse practitioners considered building a relationship with their patients of utmost importance, their consultations were mostly based on a conventional medical model of medical history taking. Little attention was paid to the social, psychological and behavioural dimensions of illness. Nurse practitioners in this study seemed quite successful in their extension into medical territory, but moving patients' illness perceptions to the background was not conducive to self-management support. By their medical subspecialty expertise, nurse practitioners have a major role in the longitudinal process of the management of chronic diseases' treatment. Supporting patients to reduce the impact of the disease and its complications requires nurse practitioners to develop new coaching strategies designed to meet patients' individual needs. © 2016 John Wiley & Sons Ltd.

  15. Neuroanatomic overlap between intelligence and cognitive factors: morphometry methods provide support for the key role of the frontal lobes.

    Science.gov (United States)

    Colom, Roberto; Burgaleta, Miguel; Román, Francisco J; Karama, Sherif; Alvarez-Linera, Juan; Abad, Francisco J; Martínez, Kenia; Quiroga, Ma Ángeles; Haier, Richard J

    2013-05-15

    Evidence from neuroimaging studies suggests that intelligence differences may be supported by a parieto-frontal network. Research shows that this network is also relevant for cognitive functions such as working memory and attention. However, previous studies have not explicitly analyzed the commonality of brain areas between a broad array of intelligence factors and cognitive functions tested in the same sample. Here fluid, crystallized, and spatial intelligence, along with working memory, executive updating, attention, and processing speed were each measured by three diverse tests or tasks. These twenty-one measures were completed by a group of one hundred and four healthy young adults. Three cortical measures (cortical gray matter volume, cortical surface area, and cortical thickness) were regressed against psychological latent scores obtained from a confirmatory factor analysis for removing test and task specific variance. For cortical gray matter volume and cortical surface area, the main overlapping clusters were observed in the middle frontal gyrus and involved fluid intelligence and working memory. Crystallized intelligence showed an overlapping cluster with fluid intelligence and working memory in the middle frontal gyrus. The inferior frontal gyrus showed overlap for crystallized intelligence, spatial intelligence, attention, and processing speed. The fusiform gyrus in temporal cortex showed overlap for spatial intelligence and attention. Parietal and occipital areas did not show any overlap across intelligence and cognitive factors. Taken together, these findings underscore that structural features of gray matter in the frontal lobes support those aspects of intelligence related to basic cognitive processes. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Which level of evidence does the US National Toxicology Program provide? Statistical considerations using the Technical Report 578 on Ginkgo biloba as an example.

    Science.gov (United States)

    Gaus, Wilhelm

    2014-09-02

    The US National Toxicology Program (NTP) is assessed by a statistician. In the NTP-program groups of rodents are fed for a certain period of time with different doses of the substance that is being investigated. Then the animals are sacrificed and all organs are examined pathologically. Such an investigation facilitates many statistical tests. Technical Report TR 578 on Ginkgo biloba is used as an example. More than 4800 statistical tests are possible with the investigations performed. Due to a thought experiment we expect >240 false significant tests. In actuality, 209 significant pathological findings were reported. The readers of Toxicology Letters should carefully distinguish between confirmative and explorative statistics. A confirmative interpretation of a significant test rejects the null-hypothesis and delivers "statistical proof". It is only allowed if (i) a precise hypothesis was established independently from the data used for the test and (ii) the computed p-values are adjusted for multiple testing if more than one test was performed. Otherwise an explorative interpretation generates a hypothesis. We conclude that NTP-reports - including TR 578 on Ginkgo biloba - deliver explorative statistics, i.e. they generate hypotheses, but do not prove them. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  17. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball and W. Zeuner

    2011-01-01

    In this report we will review the main achievements of the Technical Stop and the progress of several centrally-managed projects to support CMS operation and maintenance and prepare the way for upgrades. Overview of the extended Technical Stop  The principal objectives of the extended Technical Stop affecting the detector itself were the installation of the TOTEM T1 telescopes on both ends, the readjustment of the alignment link-disk in YE-2, the replacement of the light-guide sleeves for all PMs of both HFs, and some repairs on TOTEM T2 and CASTOR. The most significant tasks were, however, concentrated on the supporting infrastructure. A detailed line-by-line leak search was performed in the C6F14 cooling system of the Tracker, followed by the installation of variable-frequency drives on the pump motors of the SS1 and SS2 tracker cooling plants to reduce pressure transients during start-up. In the electrical system, larger harmonic filters were installed in ...

  18. Challenges to Providing a Successful Central Configuration Service to Support CERN’s New Controls Diagnostics and Monitoring System

    CERN Document Server

    Makonnen, Z; Zaharieva, Z

    2014-01-01

    The Controls Diagnostic and Monitoring service (DIAMON) provides monitoring and diagnostics tools to the operators in the CERN Control Centre. A recent reengineering presented the opportunity to restructure its data management and to integrate it with the central Controls Configuration Service (CCS). The CCS provides the Configuration Management for the Controls System for all accelerators at CERN. The new facility had to cater for the configuration management of all agents monitored by DIAMON, (>3000 computers of different types), provide deployment information, relations between metrics, and historical information. In addition, it had to be integrated into the operational CCS, while ensuring stability and data coherency. An important design decision was to largely reuse the existing infrastructure in the CCS and adapt the DIAMON data management to it e.g. by using the device/property model through a Virtual Devices framework to model the DIAMON agents. This article will show how these challenging requiremen...

  19. The Application of the DMC Strategy and Experience to Provide Additional Support to a European Global Monitoring System Programme

    Science.gov (United States)

    Cutter, M. A.; Giwa, S. C.; Graham, K. L.; Hodgson, D. J.; Mackin, S.; Sweeting, M. N.; Vanotti, M.; Regan, A.

    2008-08-01

    Surrey Satellite Technology Ltd has reviewed the ability of small satellites to provide additional capability to the presently defined Global Monitoring for Environment and Security (GMES) space segment, allowing the broadest set of user requirements to be met. User- focused services have been compared with the instruments defined for the currently proposed Sentinels. SSTL has developed the Disaster Monitoring Constellation (DMC) of small satellites at a very low cost, which provide land-focused data products in the visible wavebands with daily access capability. The study undertaken by SSTL for the European Space Agency analysed the DMC operational concept in a GMES context, reviewing a range of possible services with different payload configurations on small satellite platforms. One concept was selected and an appropriate payload definition derived. The chosen mission concept was based on the provision of near time operational oceanography information using a constellation of small satellites. The aim is to provide sea surface height, significant wave height and wind speed.

  20. THE INFLUENCE OF IMPLEMENTING THE STRATEGIC POLICY IN CREATING BUSINESS CLIMATE, BUSINESS ENVIRONMENT AND PROVIDING SUPPORT FACILITIES TOWARDS BUSINESS EMPOWERMENT ON SMALL MEDIUM CRAFT ENTERPRISES IN AMBON INDONESIA

    Directory of Open Access Journals (Sweden)

    Josef Papilaya

    2015-04-01

    Full Text Available This study aims at analyzing and explaining whether there was the influence of implementing the strategic policy in creating business climate, business environment and providing support facilities towards empowerment on small and medium enterprises as well as whether there is synchronously influence of implementing the strategic policy in creating business climate, business environment and providing support facilities for business empowerment on small and medium scale enterprises through a survey in the city of Ambon. The results show, that there is a positive and significant effect of implementing the strategic policy in creating business climate to empower small and medium enterprises. There is a positive and significant effect on the business environment toward the empowerment of small and medium enterprises, there is a positive and significant effect of providing support facilities toward the empowerment of small and medium enterprises, and there is a positive and significant simultaneously effect in business climate, business environment and support facilities for business towards the empowerment of small business in Ambon city. Empowerment programs are conducted to maintain a conducive business climate, including: 1. the innovation promotion, 2. enhancing human resources through training development; 3. providing financial support, 4. giving support to the marketing strategy, 5. opening the business partnership. While the supporting facilities granted to small and medium enterprises including: 1. giving the fishing boat for the Fishermen, 2. providing the workshop (machine shop service facilities to small crafts business Enterprises, 3. establish vendors for small enterprises, 4. provide the area for street vendors, 5. provide tents for merchants culinary who work at night. Providing the assistance to encourage the business climate and create conducive business environment.

  1. Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust

    Directory of Open Access Journals (Sweden)

    Jones Ray B

    2012-03-01

    Full Text Available Abstract Background Better use of e-health services by patients could improve outcomes and reduce costs but there are concerns about inequalities of access. Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients more. This pilot study explored the feasibility and cost of recruiting patients for an e-health intervention in one primary care trust. Methods The sample comprised 46 practices with total patient population of 250,000. We approached all practices using various methods, seeking collaboration to recruit patients via methods agreed with each practice. A detailed research diary was kept of time spent recruiting practices and patients. Researcher time was used to estimate costs. Patients who consented to participate were offered email support for their use of the Internet for health. Results Eighteen practices agreed to take part; we recruited 27 patients, most (23/27 from five practices. Practices agreed to recruit patients for an e-health intervention via waiting room leaflets (16, posters (16, practice nurses (15, doctors giving patients leaflets (5, a study website link (7, inclusion in planned mailshots (2, and a special mailshot to patients selected from practice computers (1. After low recruitment response we also recruited directly in five practices through research assistants giving leaflets to patients in waiting rooms. Ten practices recruited no patients. Those practices that were more difficult to recruit were less likely to recruit patients. Leaving leaflets for practice staff to distribute and placing posters in the practice were not effective in recruiting patients. Leaflets handed out by practice nurses and website links were more successful. The practice with lowest costs per patient recruited (£70 used a special mailshot to selected patients. Conclusion Recruitment via

  2. [Dietary training for school food service providers in support of the Acuerdo Nacional para la Salud Alimentaria].

    Science.gov (United States)

    Muñoz-Dávila, Carolina; Rangel-Peniche, Diana Beatriz

    2015-01-01

    To address the problem of overweight and obesity in Mexico, in 2010 the Acuerdo Nacional para la Salud Alimentaria was published. At school level, food service providers were considered essential to comply with certain commitments. The goal of this intervention was to train school food service providers in school eating establishments (SEE) as to the criteria in the general guidelines for the sale and distribution of food in schools of basic education. 13 SEE in San Luis Potosi participated. Based on an initial diagnosis, a class-workshop of 5 sessions was designed. Knowledge regarding food was evaluated at the beginning and end of the sessions. The percentage of adherence regarding general hygiene and food preparation and distribution was obtained at the beginning, one month, and two months post-intervention. School food service providers had little knowledge on the objectives of the Acuerdo in food groups and combination, as well as reading labels; there were significant changes in the last two after intervention. The initial percentage of overall hygiene compliance was 60 %, with an increase of almost 20 % post-training. The preparation and distribution of food did not show significant changes. School food service providers acquired knowledge about the guidelines that a SEE comply with, without putting them into practice, given the economic impact that it implies.

  3. Supporting Early Childhood Educators' Use of Embedded Communication Strategies by Providing Feedback via Bug-in-Ear Technology

    Science.gov (United States)

    Riggie, Jennifer

    2013-01-01

    The purpose of this study was to examine the relationship between coaching provided with bug-in-ear technology, the frequency of the early childhood educators' use of targeted communication strategies and children's expressive communication. Four multiple-baseline single-case design experiments were completed to evaluate these relationships.…

  4. Which Cognitive Processes Support Learning during Small-Group Discussion? The Role of Providing Explanations and Listening to Others

    Science.gov (United States)

    van Blankenstein, Floris M.; Dolmans, Diana H. J. M.; van der Vleuten, Cees P. M.; Schmidt, Henk G.

    2011-01-01

    Seventy students participated in an experiment to measure the effects of either providing explanations or listening during small group discussions on recall of related subject-matter studied after the discussion. They watched a video of a small group discussing a problem. In the first experimental condition, the video was stopped at various points…

  5. Enhancing Context Analysis with Intelligence in Providing e-Health Services: Less Infrastructure Dependency in Supporting Cardio-Vascular Patients

    NARCIS (Netherlands)

    Verbraeck, A.; Widya, I.A.; Shishkov, Boris; Cordeiro, J.; Ranchordas, A.

    2009-01-01

    In Europe, we observe an increasing number of people with health problems, who could theoretically receive care outside of a hospital when their condition could be properly monitored. Not being able to provide this monitoring leads to an increasing pressure on an already overcrowded hospital system

  6. The PTSD Practitioner Registry: An Innovative Tracking, Dissemination, and Support Tool for Providers in Military and Nonmilitary settings

    Science.gov (United States)

    2017-10-01

    engineering, and the academic world on areas such as:  improving public knowledge, attitudes, skills, and abilities;  changing behavior, practices...previously reported in writing , provide the following additional information or state, “Nothing to Report,” if applicable: Changes in approach...Describe partner organizations – academic institutions, other nonprofits, industrial or commercial firms, state or local governments, schools or

  7. A Context-Aware Ubiquitous Learning Approach for Providing Instant Learning Support in Personal Computer Assembly Activities

    Science.gov (United States)

    Hsu, Ching-Kun; Hwang, Gwo-Jen

    2014-01-01

    Personal computer assembly courses have been recognized as being essential in helping students understand computer structure as well as the functionality of each computer component. In this study, a context-aware ubiquitous learning approach is proposed for providing instant assistance to individual students in the learning activity of a…

  8. Peer mentoring supports the learning needs of nurses providing palliative care in a rural acute care setting.

    Science.gov (United States)

    Rabbetts, Lyn

    2017-06-02

    A specific set of assessment scales can underpin the management of distressing symptoms of patients requiring palliative care. A research assistant supported nurses working in a rural hospital setting during the introduction of these scales. A secondary analysis was conducted to further explore the qualitative data of a previously reported mixed-method study. In particular, the experiences of nurses working alongside a research assistant in the facilitation of using a new assessment form. Purposeful sampling was employed: participating nurses were invited to attend one of three focus group meetings. Data analysis revealed three main themes: a contact person, coach/mentor and extra help initiatives. Three to four subthemes corresponded with each main theme. Findings suggest nurses benefit from having someone to assist in learning about new documentation. Nurses respond positively to mentorship and practical guidance when integrating a new assessment form into routine evidence-based practice.

  9. Improving Depression Care for Adults With Serious Mental Illness in Underresourced Areas: Community Coalitions Versus Technical Support.

    Science.gov (United States)

    Castillo, Enrico G; Shaner, Roderick; Tang, Lingqi; Chung, Bowen; Jones, Felica; Whittington, Yolanda; Miranda, Jeanne; Wells, Kenneth B

    2018-02-01

    Community Partners in Care (CPIC) was a group-randomized study of two approaches to implementing expanded collaborative depression care: Community Engagement and Planning (CEP), a coalition approach, and Resources for Services (RS), a technical assistance approach. Collaborative care networks in both arms involved health care and other agencies in five service sectors. This study examined six- and 12-month outcomes for CPIC participants with serious mental illness. This secondary analysis focused on low-income CPIC participants from racial-ethnic minority groups with serious mental illness in underresourced Los Angeles communities (N=504). Serious mental illness was defined as self-reported severe depression (≥20 on the Patient Health Questionnaire-8) at baseline or a lifetime history of bipolar disorder or psychosis. Logistic and Poisson regression with multiple imputation and response weights, controlling for covariates, was used to model intervention effects. Among CPIC participants, 50% had serious mental illness. Among those with serious mental illness, CEP relative to RS reduced the likelihood of poor mental health-related quality of life (OR=.62, 95% CI=.41-.95) but not depression (primary outcomes); reduced the likelihood of having homelessness risk factors and behavioral health hospitalizations; increased the likelihood of mental wellness; reduced specialty mental health medication and counseling visits; and increased faith-based depression visits (each pmental health-related quality of life and some social outcomes for adults with serious mental illness, although no evidence was found for long-term effects in this subsample.

  10. The Impact of Learning Style on Healthcare Providers' Preference for Voice Advisory Manikins versus Live Instructors in Basic Life Support Training

    Science.gov (United States)

    DiGiovanni, Lisa Marie

    2013-01-01

    The American Heart Association's HeartCode[TM] Healthcare Provider (HCP) Basic Life Support (BLS) e-learning program with voice-advisory manikins was implemented in an acute care hospital as the only teaching method offered for BLS certification. On course evaluations, healthcare provider staff commented that the VAM technology for skills practice…

  11. Criteria for the selection of a technical platform for WWW-based course support within a faculty.

    NARCIS (Netherlands)

    Collis, Betty

    1999-01-01

    Based on experience with the use of telematics applications for course support in a faculty of educational technology, a team responsible for the implementation of more-flexible education within the Faculty of Educational Science and Technology at the University of Twente derived a set of

  12. Support of enhanced oil recovery to independent producers in Texas. Quarterly technical progress report, July 1, 1995--September 30, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Fotouh, K.H.

    1995-09-30

    The main objective of this project is to support independent oil producers in Texas and to improve the productivity of marginal wells utilizing enhanced oil recovery techniques. The main task carried out this quarter was the generation of an electronic data base.

  13. Mental Health Support Provided Throughout the Bariatric Surgery Clinical Pathway in French Specialized Care Centers for Obesity.

    Science.gov (United States)

    Lamore, Kristopher; Kaci, Sandra S; Czernichow, Sébastien; Bretault, Marion; Bouillot, Jean-Luc; Naudé, Anne-Jeanne; Gribe-Ouaknine, Sandra; Carette, Claire; Flahault, Cécile

    2017-03-01

    Pre-operative psychological assessment is recommended by international guidelines for bariatric surgery candidates. Thereby, service teams caring for bariatric patients should include at least one mental health provider (e.g., a psychologist or psychiatrist). The objective of this study was to evaluate the psychology and psychiatry resources and practices in the 37 specialized obesity centers (CSOs) created by the French Ministry of Health. CSO coordinators were contacted by e-mail to collect general information on the centers (e.g., number of bariatric operations). Secondly, psychologists and psychiatrists of each center completed an anonymous questionnaire assessing their professional practices and their organization of care pathways. The vast majority of CSO coordinators (81%, n = 26/32) answered our survey. These results show significant differences and shortages in terms of the psychology/psychiatry resources available. Most of the psychologists (n = 26/31) and psychiatrists (n = 10/10) stated that they systematically meet new patients only before surgery (56%) or both before and after the operation (30%); however, some psychologists and psychiatrists (14%) do not systematically meet all the patients (before and/or after surgery). Nevertheless, all the professionals provide psychology assessments, and about 75% of them offer a psychological follow-up, indicating a similarity regarding the practices of psychologists and psychiatrists. Our results highlight the place of psychological/psychiatric evaluations in French CSOs and emphasize the absence of mental health providers in several of these services. Post-operative psychological follow-up is not usually provided. It would be appropriate to create clear recommendations for post-operative psychological or psychiatric long-term follow-up.

  14. Development of a National Consensus for Tactical Emergency Medical Support (TEMS) Training Programs--Operators and Medical Providers.

    Science.gov (United States)

    Schwartz, Richard; Lerner, Brooke; Llwewllyn, Craig; Pennardt, Andre; Wedmore, Ian; Callaway, David; Wightman, John; Casillas, Raymond; Eastman, Alex; Gerold, Kevin; Giebner, Stephen; Davidson, Robert; Kamin, Richard; Piazza, Gina; Bollard, Glenn; Carmona, Phillip; Sonstrom, Ben; Seifarth, William; Nicely, Barbara; Croushorn, John; Carmona, Richard

    2014-01-01

    Tactical teams are at high risk of sustaining injuries. Caring for these casualties in the field involves unique requirements beyond what is provided by traditional civilian emergency medical services (EMS) systems. Despite this need, the training objectives and competencies are not uniformly agreed to or taught. An expert panel was convened that included members from the Departments of Defense, Homeland Security, Justice, and Health and Human Services, as well as federal, state, and local law-enforcement officers who were recruited through requests to stakeholder agencies and open invitations to individuals involved in Tactical Emergency Medical Services (TEMS) or its oversight. Two face-to-face meetings took place. Using a modified Delphi technique, previously published TEMS competencies were reviewed and updated. The original 17 competency domains were modified and the most significant changes were the addition of Tactical Emergency Casualty Care (TECC), Tactical Familiarization, Legal Aspects of TEMS, and Mass Casualty Triage to the competency domains. Additionally, enabling and terminal learning objectives were developed for each competency domain. This project has developed a minimum set of medical competencies and learning objectives for both tactical medical providers and operators. This work should serve as a platform for ensuring minimum knowledge among providers, which will serve enhance team interoperability and improve the health and safety of tactical teams and the public. 2014.

  15. The benefit of meeting a stranger: experiences with emotional support provided by nurses among Danish-born and migrant cancer patients.

    Science.gov (United States)

    Kristiansen, M; Tjørnhøj-Thomsen, T; Krasnik, A

    2010-07-01

    Research among cancer patients has shown that emotional support in informal relationships may be difficult to access because of a fear or lack of knowledge about cancer. Consequently, formal relationships with healthcare professionals may be important sources of support. This study explores needs for and experiences with emotional support provided by nurses as well as prerequisites for the provision of support among Danish-born and migrant cancer patients. We conducted narrative interviews with 18 adult Danish-born and migrant cancer patients. Patients were recruited from a variety of places in a purposive strategic sampling process. Analysis was inspired by phenomenological methods and Simmel's theoretical concept of "the stranger". Both Danish-born and migrant patients perceived the support delivered by healthcare professionals as available, empathic and valuable. Prerequisites for providing emotional support were 1) setting aside time for the patient to feel safe and able to verbalise emotional concerns, 2) continuity in relationships with healthcare professionals, and 3) nurses' ability to understand the patient's emotional reactions without creating additional distress. Being positioned as a stranger to the patient gives nurses a unique position from which to provide emotional support during cancer treatment. Thus, formal relationships with healthcare professionals are of great importance for many cancer patients.

  16. [Quality of life and mental health of patients with severe heart failure with or without technical support for the left cardiac ventricle - a cross-sectional study].

    Science.gov (United States)

    Dahrmann, Birte; Sindermann, Jürgen; Geldmacher, Thomas; Heuft, Gereon

    2017-12-01

    Quality of life and mental health of patients with severe heart failure with or without technical support for the left cardiac ventricle - a cross-sectional study Objectives: Chronic heart failure is associated with reduced quality of life (QoL) and poor prognosis. Support via a left ventricular assist device (LVAD) is an alternative to optimised medical management for patients with advanced heart failure. This study evaluated health-related QoL with both therapy options. In this consecutive cross-sectional study, patients with LVAD support (n = 50) and patients with optimised medical management (n = 50) were interviewed comprehensively about various domains of QoL, emotional stress, perceived self-efficacy, social support, life satisfaction, and communication. LVAD patients had a better overall QoL (KCCQ, clinical summary: MW: 67.4 vs. 52.9). Patients with medical management reported increased emotional stress stemming from depressed mood (HADS-D, MW: 7.1 vs.MW: 6.0). Depressed mood proved to be the most significant negative predictor for health-related QoL as well as for emotional well-being. Although they had a worse clinical situation preoperatively, LVAD patients had a significantly better QoL in both physical dimensions and functional competencies as well as significantly less psychological stress through depressed mood and anxiety.

  17. Gene expression suggests conserved aspects of Hox gene regulation in arthropods and provides additional support for monophyletic Myriapoda.

    Science.gov (United States)

    Janssen, Ralf; Budd, Graham E

    2010-07-05

    Antisense transcripts of Ultrabithorax (aUbx) in the millipede Glomeris and the centipede Lithobius are expressed in patterns complementary to that of the Ubx sense transcripts. A similar complementary expression pattern has been described for non-coding RNAs (ncRNAs) of the bithoraxoid (bxd) locus in Drosophila, in which the transcription of bxd ncRNAs represses Ubx via transcriptional interference. We discuss our findings in the context of possibly conserved mechanisms of Ubx regulation in myriapods and the fly.Bicistronic transcription of Ubx and Antennapedia (Antp) has been reported previously for a myriapod and a number of crustaceans. In this paper, we show that Ubx/Antp bicistronic transcripts also occur in Glomeris and an onychophoran, suggesting further conserved mechanisms of Hox gene regulation in arthropods.Myriapod monophyly is supported by the expression of aUbx in all investigated myriapods, whereas in other arthropod classes, including the Onychophora, aUbx is not expressed. Of the two splice variants of Ubx/Antp only one could be isolated from myriapods, representing a possible further synapomorphy of the Myriapoda.

  18. Gene expression suggests conserved aspects of Hox gene regulation in arthropods and provides additional support for monophyletic Myriapoda

    Directory of Open Access Journals (Sweden)

    Janssen Ralf

    2010-07-01

    Full Text Available Abstract Antisense transcripts of Ultrabithorax (aUbx in the millipede Glomeris and the centipede Lithobius are expressed in patterns complementary to that of the Ubx sense transcripts. A similar complementary expression pattern has been described for non-coding RNAs (ncRNAs of the bithoraxoid (bxd locus in Drosophila, in which the transcription of bxd ncRNAs represses Ubx via transcriptional interference. We discuss our findings in the context of possibly conserved mechanisms of Ubx regulation in myriapods and the fly. Bicistronic transcription of Ubx and Antennapedia (Antp has been reported previously for a myriapod and a number of crustaceans. In this paper, we show that Ubx/Antp bicistronic transcripts also occur in Glomeris and an onychophoran, suggesting further conserved mechanisms of Hox gene regulation in arthropods. Myriapod monophyly is supported by the expression of aUbx in all investigated myriapods, whereas in other arthropod classes, including the Onychophora, aUbx is not expressed. Of the two splice variants of Ubx/Antp only one could be isolated from myriapods, representing a possible further synapomorphy of the Myriapoda.

  19. Providing support at time of death from cancer: results of a 5-year post-bereavement group study.

    Science.gov (United States)

    Clark, Paul G; Brethwaite, Drucilla S; Gnesdiloff, Sabine

    2011-01-01

    Despite advances in the quality and availability of hospice and palliative care for people with end stage cancers, research addressing the psychosocial needs of family members and concerned others during the dying process has been limited primarily to caregivers. In addition, many of these studies focused on the recently bereaved. In this study, the authors sought to broaden that perspective by examining the psychosocial needs of secondary survivors, a term that applies to caregivers, family members, and others who felt a caring bond with a dying person. A qualitative exploration of needs expressed by secondary survivors following the conclusion of a structured 8-week psychoeducational grief group experience revealed that secondary cancer survivors experience a sense of isolation and powerlessness that is often unrecognized by physicians, nurses, oncology social workers, or other health care professionals. Furthermore, these secondary survivors needed support that extends well beyond activities that are traditionally associated with the physical and emotional care of the dying. Social work intervention strategies directed toward helping secondary survivors assert personal needs, develop greater proximity with the health care team, and prepare for the processes associated with end-of-life may be helpful later during bereavement.

  20. Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines

    Directory of Open Access Journals (Sweden)

    Jones Christopher M

    2012-08-01

    Full Text Available Abstract Introduction Effective delivery of cardiopulmonary resuscitation (CPR and prompt defibrillation following sudden cardiac arrest (SCA is vital. Updated guidelines for adult basic life support (BLS were published in 2010 by the European Resuscitation Council (ERC in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p  Conclusions The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

  1. Spatial patterns of land cover in the United States: a technical document supporting the Forest Service 2010 RPA Assessment

    Science.gov (United States)

    Kurt H. Riitters

    2011-01-01

    Land cover patterns inventoried from a national land cover map provide information about the landscape context and fragmentation of the Nation’s forests, grasslands, and shrublands. This inventory is required to quantify, map, and evaluate the capacities of landscapes to provide ecological goods and services sustainably. This report documents the procedures to...

  2. DC microgrids with energy storage systems and demand response for providing support to frequency regulation of electrical power systems

    DEFF Research Database (Denmark)

    Basic, Hrvoje; Dragicevic, Tomislav; Pandzic, Hrvoje

    2017-01-01

    Frequency regulation of electric power systems efficiency depends on response time and on power reserves for frequency regulation. As integration of non-dispatchable renewable generation in the power system results with increased need for power reserves from fast responding power units, the idea...... of using aggregated DC microgrids in frequency regulation is presented. Model proposed in this work is based on using battery energy storage, combined with demand response for achieving efficient usage of battery energy storage. It is shown that large number of DC microgrids can provide sufficient....

  3. ARRA FEMP Technical Assistance -- Federal Aviation Administration Project 209 -- Control Tower and Support Building, Palm Springs, CA

    Energy Technology Data Exchange (ETDEWEB)

    Arends, J.; Sandusky, William F.

    2010-03-31

    This report represents findings of a design review team that evaluated construction documents (at the 100% level) and operating specifications for a new control tower and support building that will be built in Palm Springs, California by the Federal Aviation Administration (FAA). The focus of the review was to identify measures that could be incorporated into the final design and operating specifications that would result in additional energy savings for the FAA that would not have otherwise occurred.

  4. Nasotracheal tube wire support: a safety device in maxillofacial surgery technical note after five years of experience

    OpenAIRE

    Fernando Melhem Elias; Fábio Ricardo Loureiro Sato; Flávio Wellington da Silva Ferraz

    2014-01-01

    A well fixed endotracheal tube is essential for safety during general anesthesia. In maxillofacial surgeries, securely fixing a nasotracheal tube in place has always been problematic. The aim of this article is to describe a simple but effective technique to fasten the nasotracheal tube using a wire support that allows a full range of head movement without interference in the surgical field. During the last 5 years, this device was successfully used in almost two hundred patients with very fe...

  5. Nasotracheal tube wire support: a safety device in maxillofacial surgery technical note after five years of experience

    Science.gov (United States)

    Sato, Fábio Ricardo Loureiro; Ferraz, Flávio Wellington da Silva

    2014-01-01

    A well fixed endotracheal tube is essential for safety during general anesthesia. In maxillofacial surgeries, securely fixing a nasotracheal tube in place has always been problematic. The aim of this article is to describe a simple but effective technique to fasten the nasotracheal tube using a wire support that allows a full range of head movement without interference in the surgical field. During the last 5 years, this device was successfully used in almost two hundred patients with very few complications. PMID:28652994

  6. Emerging Business Models in Education Provisioning: A Case Study on Providing Learning Support as Education-as-a-Service

    Directory of Open Access Journals (Sweden)

    Loina Prifti

    2017-09-01

    Full Text Available This study aims to give a deeper understanding on emerging business models in the context of education. Industry 4.0/the Industrial Internet in general and especially recent advances in cloud computing enable a new kind of service offering in the education sector and lead to new business models for education: Education-as-a-Service (EaaS. Within EaaS, learning, and teaching contents are delivered as services. By combining a literature review with a qualitative case study, this paper makes a three-fold contribution to the field of business models in education: First, we provide a theoretical definition for a common understanding of EaaS. Second, we present the state-of-the-art research on this new paradigm. Third, in the case study we describe a “best practices” business model of an existing EaaS provider. These insights build a theoretical foundation for further research in this area. The paper concludes with a research agenda for further research in this emerging field.

  7. The need for social support provided by the non-profit cancer societies throughout different phases in the cancer trajectory and its integration into public healthcare.

    Science.gov (United States)

    Yli-Uotila, Tiina; Kaunonen, Marja; Pylkkänen, Liisa; Suominen, Tarja

    2016-04-01

    To describe the phases of the cancer trajectory when social support, in the form of electronic counselling services, as provided by the non-profit cancer societies, is needed, as well as how these services are integrated into the cancer care in public healthcare. In this descriptive qualitative study a purposive sample of patients with cancer (n = 12) were interviewed. The data were content analysed inductively. Social support was needed when emotional well-being was weakened, when the body broke, when the care pathway induced unawareness, and when empowerment needed strengthening. There was no need for social support when well-being was considered in balance. The electronic counselling services were integrated into cancer care by supporting the patient with cancer emotionally, developing the informational expertise of the patient with cancer, expanding the opportunities for support, and supporting public healthcare. Integration required improvements to the actions of the patients and various actors involved in the healthcare system. There was no integration due to the health status of the patient and the sufficiency of the primary support sources. The received social support was not integrated into the actual cancer treatment process of the patient with cancer in the public healthcare system. The phases of support needed in the cancer trajectory as defined by the patient differ from the traditional biomedical phases of treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Discrepancies Between the Supports Needed for Discharge of Patients With Terminal Cancer to Family Caregivers and What Supports Were Actually Provided in Japan: Assessment of Palliative Care Unit Nurses.

    Science.gov (United States)

    Oosono, Yasufumi; Yokoyama, Kazuhito; Itoh, Hiroaki; Enomoto, Miyuki; Ishiwata, Miki

    2017-01-01

    Even if patients with terminal cancer hope to spend the rest of their lives at home, they are often unable to leave the hospital early due to their family caregivers' anxiety. This study aimed to investigate in Japan the discrepancies between the supports needed by and actually provided by palliative care unit nurses (PCUNs) to the family caregivers for discharge of patients with terminal cancer. In this cross-sectional study, self-administered questionnaires including 6-point Likert-type scales assessing the reasons for difficulties in transition to home-based care were distributed to 1227 PCUNs. Using paired t tests, the differences between the scores on perceived importance and actual supports to family caregivers were examined. The supports actually provided were classified by factor analysis. The relationships between the PCUNs' characteristics and mean scores on the supports in each category were examined using multiple regression analysis. A total of 1023 (83.4%) completed questionnaires were returned. Scores on the actually provided supports for discharge to family caregivers were consistently and significantly lower than the corresponding scores on perceived importance for all 57 items ( P care, receiving necessary training, cooperating with palliative care staff, and cooperating with local service providers were significantly associated with higher levels of actual supply of supports to family caregivers. Our findings suggest that PCUNs need to be encouraged to provide further support to family caregivers for the discharge of patients with terminal cancer.

  9. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online.

    Science.gov (United States)

    van Veen, Merel Rebecca; Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

    2015-09-08

    Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors' questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. The website provides access to evidence- and eminence-based information on nutrition and cancer. As can be

  10. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions.

    Science.gov (United States)

    Baker, Michael G; Zhang, Jane; Blakely, Tony; Crane, Julian; Saville-Smith, Kay; Howden-Chapman, Philippa

    2016-02-16

    Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW) Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5% of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. It was possible to match the majority (96%) of applicant and tenant household members with their National Health Index (NHI) number allowing linkage to anonymised coded data on their hospitalisations and mortality. By December 2011, the study population consisted of 11,196 applicants and 196,612 tenants. Half were less than 21 years of age. About two-thirds identified as Māori or Pacific ethnicity. Household incomes were low. Of tenant households, 44% containing one or more smokers compared with 33% for New Zealand as a whole. Exposure to household crowding, as measured by a deficit of one or more bedrooms, was common for applicants (52%) and tenants (38%) compared with New Zealanders as whole (10%). This project has shown that an administrative housing database can be used to form a large cohort population and successfully link cohort members to their health records in a way that meets confidentiality and ethical requirements. This study also confirms that social housing tenants are a highly deprived population with relatively low incomes and high levels of exposure to household crowding and environmental

  11. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online

    Science.gov (United States)

    Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

    2015-01-01

    Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence

  12. A critical review of the use of technology to provide psychosocial support for children and young people with long-term conditions.

    Science.gov (United States)

    Aldiss, Susie; Baggott, Christina; Gibson, Faith; Mobbs, Sarah; Taylor, Rachel M

    2015-01-01

    Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes.

    Science.gov (United States)

    Mohn, J; Graue, M; Assmus, J; Zoffmann, V; B Thordarson, H; Peyrot, M; Rokne, B

    2015-11-01

    To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. This cross-sectional study comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43.2% reported elevated (≥40) Problem Areas in Diabetes scores. A significant negative association was found between autonomy support and Problem Areas in Diabetes score (B = -3.61, P = 0.001), indicating that lower autonomy support was associated with greater diabetes distress. When perceived competence was controlled, it mediated the association of autonomy support with diabetes distress, reducing it to non-significance. There was a significant negative association between perceived competence and Problem Areas in Diabetes score (B = -8.89, P autonomy support and diabetes distress; autonomy support was associated with increased perceived competence, which, in turn, was associated with reduced distress. Healthcare providers' communication styles enhancing perceived competence through autonomy support may contribute to effective treatment for people with Type 1 diabetes and suboptimum glycaemic control. © 2015 The Authors. Diabetic Medicine Published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  14. Project quality assurance plan for research and development services provided by Oak Ridge National Laboratory in support of the Hanford Grout Disposal Program

    Energy Technology Data Exchange (ETDEWEB)

    Spence, R.D.; Gilliam, T.M.

    1991-11-01

    This Project Quality Assurance Plan (PQAP) is being published to provide the sponsor with referenceable documentation for work conducted in support of the Hanford WHC Grout Disposal Program. This plan, which meets NQA-1 requirements, is being applied to work performed at Oak Ridge National Laboratory (ORNL) during FY 1991 in support of this program. It should also be noted that with minor revisions, this plan should be applicable to other projects involving research and development that must comply with NQA-1 requirements.

  15. Nasotracheal tube wire support: a safety device in maxillofacial surgery technical note after five years of experience

    Directory of Open Access Journals (Sweden)

    Fernando Melhem Elias

    2014-03-01

    Full Text Available A well fixed endotracheal tube is essential for safety during general anesthesia. In maxillofacial surgeries, securely fixing a nasotracheal tube in place has always been problematic. The aim of this article is to describe a simple but effective technique to fasten the nasotracheal tube using a wire support that allows a full range of head movement without interference in the surgical field. During the last 5 years, this device was successfully used in almost two hundred patients with very few complications.

  16. A model to identify mathematics topics in MXit lingo to provide tutors quick access to supporting documentation

    Directory of Open Access Journals (Sweden)

    Laurie Butgereit

    2011-11-01

    Full Text Available Dr MathTM is a mobile, online tutoring system where learners can use MXitTM on their mobile phones to receive help with their mathematics homework from volunteer tutors. These conversations between learners and Dr Math are held in MXit lingo. MXit lingo is a heavily abbreviated, English-like language that is evolving between users of mobile phones that communicate using MXit. The Dr Math project has been running since January 2007 and uses volunteer tutors who are mostly university students who readily understand and use MXit lingo. However, due to the large number of simultaneous conversations that the tutors are often involved in and the diversity of topics discussed, it would often be beneficial to provide assistance regarding the mathematics topic to the tutors. This article explains how the μ model identifies the mathematics topic in the conversation. The model identifies appropriate mathematics topics in just over 75% of conversations in a corpus of conversations identified to be about mathematics topics in the school curriculum.

  17. Becoming successful entrepreneurs. Bangladesh. ADB supports pioneering family-based approach to provide micro-credit and skills training.

    Science.gov (United States)

    Molitor, C

    1996-01-01

    The Thana Resource Development and Employment Project (TRDEP), built upon the successful experience of the Grameen Bank and other nongovernmental organizations, is a comprehensive poverty alleviation scheme implemented by the government of Bangladesh and targeted to the poorest segment of Bangladeshi society. The project provides soft loans to landless poor for income-generating activities involving non-crop livelihoods and trades. The loans are granted at an 18% interest rate including a 2% charge which goes into a risk fund. The poorest of poor are eligible to receive loans as long as each borrowing unit is a self-help group comprised of five members of one family and each member of the group assumes the responsibility of paying each other member's loan. Each member of a borrowing group may receive loans in the amount of Taka 3000-5000 (US$75-125). The loans are then repayable in 50 equal installments over the course of 1 year. One member's default disqualifies all other group members from receiving future credit until the default is cleared. TRDEP borrowers have started small, successful entrepreneurial activities with their loans as capital.

  18. A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy.

    Science.gov (United States)

    Trambert, Renee; Kowalski, Mildred Ortu; Wu, Betty; Mehta, Nimisha; Friedman, Paul

    2017-10-01

    Aromatherapy has been used to reduce anxiety in a variety of settings, but usefulness associated with breast biopsies has not been documented. This study was conducted in women undergoing image-guided breast biopsy. We explored the use of two different aromatherapy scents, compared to placebo, aimed at reducing anxiety with the intent of generating new knowledge. This was a randomized, placebo-controlled study of two different types of external aromatherapy tabs (lavender-sandalwood and orange-peppermint) compared with a matched placebo-control delivery system. Anxiety was self-reported before and after undergoing a breast biopsy using the Spielberger State Anxiety Inventory Scale. Eighty-seven women participated in this study. There was a statistically significant reduction in self-reported anxiety with the use of the lavender-sandalwood aromatherapy tab compared with the placebo group (p = .032). Aromatherapy tabs reduced anxiety during image-guided breast biopsy. The completion of the biopsy provided some relief from anxiety in all groups. The use of aromatherapy tabs offers an evidence-based nursing intervention to improve adaptation and reduce anxiety for women undergoing breast biopsy. Lavender-sandalwood aromatherapy reduced anxiety and promoted adaptation more than orange-peppermint aromatherapy or placebo. © 2017 Sigma Theta Tau International.

  19. The Brazilian psychiatric reform: historical and technical-supportive aspects of experiences carried out in the cities of São Paulo, Santos and Campinas

    Directory of Open Access Journals (Sweden)

    Cristina Amélia Luzio

    2007-01-01

    Full Text Available The Brazilian psychiatric reform: historical and technical-supportive aspects of experiences carried out in the cities of São Paulo (capital, Santos and Campinas, in order to understand their material, social and political impacts, the progress in the process of breaking away from the psychiatric ward model, and the establishment of creative and productive groups, required to build up the psychosocial treatment in regard to mental health, as well as to evaluate the contribution that the SUS (Brazilian Public Health System had on the psychiatric reform in the mentioned cities. The research, which is the basis of this paper, is part of a thesis regarding mental health care, whereby the innovative projects implemented in those cities served as framework and basis for comparison to analyze mental health policy in small and medium-sized cities and towns in the state of São Paulo.

  20. Tree cover and aridity projections to 2060: a technical document supporting the Forest Service 2010 RPA assessment

    Science.gov (United States)

    Eric J. Greenfield; David J. Nowak

    2013-01-01

    Future projections of tree cover and climate change are useful to natural resource managers as they illustrate potential changes to our natural resources and the ecosystem services they provide. This report a) details three projections of tree cover change across the conterminous United States based on predicted land-use changes from 2000 to 2060; b) evaluates nine...

  1. Prosthetic Management of an Extensive Maxillary Alveolar Resorption with an Implant-supported Restoration: a Technical Report

    Directory of Open Access Journals (Sweden)

    Fariborz Saadat

    2013-01-01

    Full Text Available Despite the recent developments in peri-implant surgical regenerative procedures, re-establishing the hard and soft tissue contour is still a challenge in cases with severe ridge deficiency. It becomes more difficult when incorrectly placed implants cause screw connections to come out onto the labial surfaces of the teeth. A two-part maxillary implant supported fixed restoration was constructed. The first part was consisted of a screw retained sub-structure that replaced gingival portions of the deficient maxilla and the second part was a cement retained super-structure that reconstructed the anatomical crowns of the lost teeth. In this way awkwardly placed implants did not interfere with the desired esthetic result. Another great advantage was that the alterations or repairs on cemented crowns can easily be carried out without compromising the entire construction.

  2. GPHS RTGs in Support of the Cassini RTG Program. Final Technical Report, January 11, 1991 - April 30, 1998

    Science.gov (United States)

    1998-08-01

    As noted in the historical summary, this program encountered a number of changes in direction, schedule, and scope over the period 11 January 1991 to 31 December 1998. The report provides a comprehensive summary of all the varied aspects of the program over its seven and a quarter years, and highlights those aspects that provide information beneficial to future radioisotope programs. In addition to summarizing the scope of the Cassini GPHS RTG Program provided as background, the introduction includes a discussion of the scope of the final report and offers reference sources for information on those topics not covered. Much of the design heritage of the GPHS RTG comes from the Multi Hundred Watt (MHW) RTGs used on the Lincoln Experimental Satellites (LES) 8/9 and Voyager spacecraft. The design utilized for the Cassini program was developed, in large part, under the GPHS RTG program which produced the Galileo and Ulysses RTGs. Reports from those programs included detailed documentation of the design, development, and testing of converter components and full converters that were identical to, or similar to, components used in the Cassini program.

  3. GPHS-RTGs in support of the Cassini RTG Program. Final technical report, January 11, 1991--April 30, 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

    As noted in the historical summary, this program encountered a number of changes in direction, schedule, and scope over the period 11 January 1991 to 31 December 1998. The report provides a comprehensive summary of all the varied aspects of the program over its seven and a quarter years, and highlights those aspects that provide information beneficial to future radioisotope programs. In addition to summarizing the scope of the Cassini GPHS-RTG Program provided as background, the introduction includes a discussion of the scope of the final report and offers reference sources for information on those topics not covered. Much of the design heritage of the GPHS-RTG comes from the Multi-Hundred Watt (MHW) RTGs used on the Lincoln Experimental Satellites (LES) 8/9 and Voyager spacecraft. The design utilized for the Cassini program was developed, in large part, under the GPHS-RTG program which produced the Galileo and Ulysses RTGs. Reports from those programs included detailed documentation of the design, development, and testing of converter components and full converters that were identical to, or similar to, components used in the Cassini program. Where such information is available in previous reports, it is not repeated here.

  4. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes

    DEFF Research Database (Denmark)

    Mohn, J; Graue, M; Assmus, J

    2015-01-01

    AIM: To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. METHODS: This cross-sectional study...... comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess...... the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. RESULTS: Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43...

  5. Review of inputs provided to Jason Associates Corporation in support of RWEV-REP-001, the Analysis of Postclosure Groundwater Impacts report.

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Charles R.; Weck, Philippe F.; Vaughn, Palmer; Arnold, Bill Walter

    2014-04-01

    Report RWEV-REP-001, Analysis of Postclosure Groundwater Impacts for a Geologic Repository for the Disposal of Spent Nuclear Fuel and High Level Radioactive Waste at Yucca Mountain, Nye County, Nevada was issued by the DOE in 2009 and is currently being updated. Sandia National Laboratories (SNL) provided support for the original document, performing calculations and extracting data from the Yucca Mountain Performance Assessment Model that were used as inputs to the contaminant transport and dose calculations by Jason Associates Corporation, the primary developers of the DOE report. The inputs from SNL were documented in LSA-AR-037, Inputs to Jason Associates Corporation in Support of the Postclosure Repository Supplemental Environmental Impact Statement. To support the updating of the original Groundwater Impacts document, SNL has reviewed the inputs provided in LSA-AR-037 to verify that they are current and appropriate for use. The results of that assessment are documented here.

  6. Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists

    NARCIS (Netherlands)

    Timmers, L.; Boons, C.C.; Verbrugghe, M.; Bemt, B.J.F van den; Hecke, A. Van; Hugtenburg, J.G.

    2017-01-01

    BACKGROUND: Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the

  7. Nuclear forensic field exercise no.1: work performed in support of CRTI project 04-0030TD. Technical memorandum

    Energy Technology Data Exchange (ETDEWEB)

    Larsson, C. [Defence R and D Canada - Ottawa, Ottawa, Ontario (Canada); Hinton, A. [Canadian Nuclear Safety Commission, Ottawa, Ontario (Canada)

    2006-11-15

    DRDC Ottawa is leading a project designed in part to develop protocols for forensic investigators working in a radiologically contaminated environment. As such, a radiological field exercise was held to review current forensic investigator methods and identify problem areas with respect to the collection of evidence from a contaminated crime scene. The Canadian Nuclear Safety Commission (CNSC), DRDC Ottawa, Royal Canadian Mounted Police (RCMP) and the Ottawa Police Service (OPS) CBRN Forensic Investigation Specialists participated in the exercise. This document provides a description of the scenario and the responder actions during the exercise, and gives lessons learned and recommendations that will feed directly into the forensic investigator protocols. (author)

  8. Technical presentation

    CERN Multimedia

    GS Department

    2010-01-01

    10 March 2010 DYNEOS 10:00 – 12:00 - Main Building, Room B, 61-1-009 Dyneos AG is active in the fields of photonics, laser and high-precision positioning. Our highly qualified engineer team has more than 30 years of experience in electro-optical solutions sales. The engineers are supported by a technical and administrative team. We are focused on the Swiss market and represent six suppliers (Coherent, PI Physik Instrumente, SIOS, Nanonics Imaging, APE, Ekspla) in order to give a qualified sales and service support to our customers. Our products are dedicated to the research field as well as to industry. In addition to standard catalog products, we offer custom designs to fulfill the specific needs of OEM customers or specific applications.

  9. TECHNICAL BASIS FOR VENTILATION REQUIREMENTS IN TANK FARMS OPERATING SPECIFICATIONS DOCUMENTS

    Energy Technology Data Exchange (ETDEWEB)

    BERGLIN, E J

    2003-06-23

    This report provides the technical basis for high efficiency particulate air filter (HEPA) for Hanford tank farm ventilation systems (sometimes known as heating, ventilation and air conditioning [HVAC]) to support limits defined in Process Engineering Operating Specification Documents (OSDs). This technical basis included a review of older technical basis and provides clarifications, as necessary, to technical basis limit revisions or justification. This document provides an updated technical basis for tank farm ventilation systems related to Operation Specification Documents (OSDs) for double-shell tanks (DSTs), single-shell tanks (SSTs), double-contained receiver tanks (DCRTs), catch tanks, and various other miscellaneous facilities.

  10. [Technical improvement of cohort constitution in administrative health databases: Providing a tool for integration and standardization of data applicable in the French National Health Insurance Database (SNIIRAM)].

    Science.gov (United States)

    Ferdynus, C; Huiart, L

    2016-09-01

    Administrative health databases such as the French National Heath Insurance Database - SNIIRAM - are a major tool to answer numerous public health research questions. However the use of such data requires complex and time-consuming data management. Our objective was to develop and make available a tool to optimize cohort constitution within administrative health databases. We developed a process to extract, transform and load (ETL) data from various heterogeneous sources in a standardized data warehouse. This data warehouse is architected as a star schema corresponding to an i2b2 star schema model. We then evaluated the performance of this ETL using data from a pharmacoepidemiology research project conducted in the SNIIRAM database. The ETL we developed comprises a set of functionalities for creating SAS scripts. Data can be integrated into a standardized data warehouse. As part of the performance assessment of this ETL, we achieved integration of a dataset from the SNIIRAM comprising more than 900 million lines in less than three hours using a desktop computer. This enables patient selection from the standardized data warehouse within seconds of the request. The ETL described in this paper provides a tool which is effective and compatible with all administrative health databases, without requiring complex database servers. This tool should simplify cohort constitution in health databases; the standardization of warehouse data facilitates collaborative work between research teams. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Technical Support Document: Development of the Advanced Energy Design Guide for Medium Box Retail -- 50% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Hale, E. T.; Macumber, D. L.; Long, N. L.; Griffith, B. T.; Benne, K. S.; Pless, S. D.; Torcellini, P. A.

    2008-09-01

    This report provides recommendations that architects, designers, contractors, developers, owners, and lessees of medium box retail buildings can use to achieve whole-building energy savings of at least 50% over ASHRAE Standard 90.1-2004. The recommendations are given by climate zone and address building envelope, fenestration, lighting systems, HVAC systems, building automation and controls, outside air treatment, service water heating, plug loads, and photovoltaic systems. The report presents several paths to 50% savings, which correspond to different levels of integrated design. These are recommendations only, and are not part of a code or standard. The recommendations are not exhaustive, but we do try to emphasize the benefits of integrated building design, that is, a design approach that analyzes a building as a whole system, rather than as a disconnected collection of individually engineered subsystems.

  12. Technical Note: Using a high finesse optical resonator to provide a long light path for differential optical absorption spectroscopy: CE-DOAS

    Directory of Open Access Journals (Sweden)

    J. Meinen

    2010-04-01

    Full Text Available Cavity enhanced methods in absorption spectroscopy have seen a considerable increase in popularity during the past decade. Especially Cavity Enhanced Absorption Spectroscopy (CEAS established itself in atmospheric trace gas detection by providing tens of kilometers of effective light path length using a cavity as short as 1 m. In this paper we report on the construction and testing of a compact and power efficient light emitting diode based broadband Cavity Enhanced Differential Optical Absorption Spectrometer (CE-DOAS for in situ observation of atmospheric NO3. This device combines the small size of the cavity with the advantages of the DOAS approach in terms of sensitivity, specificity and insensivity to intensity fluctuations of the light source. In particular, no selective removal of the analyte (here NO3 is necessary for calibration of the instrument if appropriate corrections are applied to the CEAS theory. Therefore the CE-DOAS technique can – in principle – measure any gas detectable by DOAS. We will discuss the advantages of using a light emitting diode (LED as light source particularly the precautions which have to be considered for the use of LEDs with a broad wavelength range. The instrument was tested in the lab by detecting NO3 formed by mixing of NO2 and O3 in air. It was then compared to other trace gas detection techniques in an intercomparison campaign in the atmosphere simulation chamber SAPHIR at Forschungszentrum Jülich at NO3 concentrations as low as 6.3 ppt.

  13. The nature of parent support provided by parent mentors for families with deaf/hard-of-hearing children: voices from the start.

    Science.gov (United States)

    Narr, Rachel Friedman; Kemmery, Megan

    2015-01-01

    This study used a qualitative design to explore parent mentors' summaries of conversations with more than 1,000 individual families of deaf and hard-of-hearing (DHH) children receiving parent-to-parent support as part of an existing family support project. Approximately 35% of the families were Spanish speaking. Five parent mentors who have DHH children provided varied support primarily via the telephone to families with DHH children, frequently birth to age 3. The nature and types of support provided were examined and resulted in an in-depth analysis of the summary notes prepared by the parent mentors. The notes were coded using a mixed-methods software application. Three topics were the most prevalent within the conversations between parent mentors and family members: hearing-related topics, early intervention, and multiple disabilities. Several differences emerged between English-speaking and Spanish-speaking families receiving support. Implications and the significance of this study are discussed. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. [Digital electroencephalography in brain death diagnostics : Technical requirements and results of a survey on the compatibility with medical guidelines of digital EEG systems from providers in Germany].

    Science.gov (United States)

    Walter, U; Noachtar, S; Hinrichs, H

    2018-02-01

    The guidelines of the German Medical Association and the German Society for Clinical Neurophysiology and Functional Imaging (DGKN) require a high procedural and technical standard for electroencephalography (EEG) as an ancillary method for diagnosing the irreversible cessation of brain function (brain death). Nowadays, digital EEG systems are increasingly being applied in hospitals. So far it is unclear to what extent the digital EEG systems currently marketed in Germany meet the guidelines for diagnosing brain death. In the present article, the technical und safety-related requirements for digital EEG systems and the EEG documentation for diagnosing brain death are described in detail. On behalf of the DGKN, the authors sent out a questionnaire to all identified distributors of digital EEG systems in Germany with respect to the following technical demands: repeated recording of the calibration signals during an ongoing EEG recording, repeated recording of all electrode impedances during an ongoing EEG recording, assessability of intrasystem noise and galvanic isolation of measurement earthing from earthing conductor (floating input). For 15 of the identified 20 different digital EEG systems the specifications were provided by the distributors (among them all distributors based in Germany). All of these EEG systems are provided with a galvanic isolation (floating input). The internal noise can be tested with all systems; however, some systems do not allow repeated recording of the calibration signals and/or the electrode impedances during an ongoing EEG recording. The majority but not all of the currently available digital EEG systems offered for clinical use are eligible for use in brain death diagnostics as per German guidelines.

  15. Association Between Perceived Health Care Provider Support and Satisfaction with Insulin Pumps in Children with Type 1 Diabetes Mellitus: Opportunities for Pharmacists

    Directory of Open Access Journals (Sweden)

    Laura Brooke Jowers

    2015-01-01

    Full Text Available Purpose: The purpose of this pilot study was to describe parents’ perceived healthcare provider support for integrating technology, satisfaction with insulin pump use in their child with T1DM, and the relationship between parents’ perceived healthcare provider support and satisfaction with insulin pump use. Methods: A cross-sectional, correlational design was used to collect data for the present study. The study was conducted through an Internet survey among Mid-South parents who have a child with T1DM, 18 years old or younger using an insulin pump and/or continuous glucose monitoring (CGM. Frequencies, descriptive statistics, and correlation coefficients were calculated. Results: Most of the parents surveyed used an endocrinologist/pediatric endocrinologist as their primary diabetes healthcare provider and considered three to four healthcare professionals as part of the diabetes healthcare team who helped them utilize insulin pumps and advanced technologies. Parents (23.4% indicated a pharmacist was part of the healthcare team who helped them utilize technology. Parents appeared to perceive support for using insulin pumps; however, there is room for improvement. The more perceived support for integrating technology, the more satisfied the parents were with using insulin pumps (r=0.431, p=0.005. Conclusions: Results from this study suggest that parents and children need continued education, support and training to integrate insulin pumps into diabetes self-management. As more patients attempt to adopt insulin pumps and other advanced technologies, it will be important for pharmacists to support the adoption and integration of these technologies and be knowledgeable and helpful if asked about technology-related challenges.   Type: Student Project

  16. Technical basis, supporting information, and strategy for development and implementation of DOE policy for natural phenomena hazards

    Energy Technology Data Exchange (ETDEWEB)

    Murray, R.C.

    1991-09-01

    Policy for addressing natural phenomenon comprises a hierarchy of interrelated documents. The top level of policy is contained in the code of Federal Regulations which establishes the framework and intent to ensure overall safety of DOE facilities when subjected to the effects of natural phenomena. The natural phenomena to be considered include earthquakes and tsunami, winds, hurricanes and tornadoes, floods, volcano effects and seiches. Natural phenomena criteria have been established for design of new facilities; evaluation of existing facilities; additions, modifications, and upgrades to existing facilities; and evaluation criteria for new or existing sites. Steps needed to implement these four general criteria are described. The intent of these criteria is to identify WHAT needs to be done to ensure adequate protection from natural phenomena. The commentary provides discussion of WHY this is needed for DOE facilities within the complex. Implementing procedures identifying HOW to carry out these criteria are next identified. Finally, short and long term tasks needed to identify the implementing procedure are tabulated. There is an overall need for consistency throughout the DOE complex related to natural phenomena including consistent terminology, policy, and implementation. 1 fig, 6 tabs.

  17. Dying patients' need for emotional support and personalized care from physicians: perspectives of patients with terminal illness, families, and health care providers.

    Science.gov (United States)

    Wenrich, Marjorie D; Curtis, J Randall; Ambrozy, Donna A; Carline, Jan D; Shannon, Sarah E; Ramsey, Paul G

    2003-03-01

    This study addressed the emotional and personal needs of dying patients and the ways physicians help or hinder these needs. Twenty focus groups were held with 137 individuals, including patients with chronic and terminal illnesses, family members, health care workers, and physicians. Content analyses were performed based on grounded theory. Emotional support and personalization were 2 of the 12 domains identified as important in end-of-life care. Components of emotional support were compassion, responsiveness to emotional needs, maintaining hope and a positive attitude, and providing comfort through touch. Components of personalization were treating the whole person and not just the disease, making the patient feel unique and special, and considering the patient's social situation. Although the levels of emotional support and personalization varied, there was a minimal level, defined by compassion and treating the whole person and not just the disease, that physicians should strive to meet in caring for all dying patients. Participants also identified intermediate and advanced levels of physician behavior that provide emotional and personal support.

  18. Why patient summaries in electronic health records do not provide the cognitive support necessary for nurses' handoffs on medical and surgical units: insights from interviews and observations.

    Science.gov (United States)

    Staggers, Nancy; Clark, Lauren; Blaz, Jacquelyn W; Kapsandoy, Seraphine

    2011-09-01

    Patient care handoffs are cognitively intense activities, especially on medical and surgical units where nurses synthesize information across an average of four to five patients every shift. The objective of this study was to examine handoffs and nurses' use of computerized patient summary reports in an electronic health record after computerized provider order entry (CPOE) was installed. We observed and audio taped 93 patient handoffs on 25 occasions on 5 acute care units in 2 different facilities sharing a vendor's electronic health record. We found that the computerized patient summary report and the electronic health record were minimally used during the handoff and that the existing patient summary reports did not provide adequate cognitive support for nurses. The patient summary reports were incomplete, rigid and did not offer "at a glance" information, or help nurses encode information. We make recommendations about a redesign of patient summary reports and technology to support the cognitive needs of nurses during handoffs at the change of shift.

  19. Key components of a service model providing early childhood support for women attending opioid treatment clinics: an Australian state health service review.

    Science.gov (United States)

    Harvey, Susan R; Schmied, Virginia; Nicholls, Daniel; Dahlen, Hannah

    2012-09-01

    To report the findings of a service review--specifically the strategy to provide early childhood services 'on site' at opioid treatment clinics to address access difficulties. Child and family health nurses are skilled in the assessment and support of families during early childhood. However, women with a history of substance abuse are often cautious when engaging with universal and other health services, with the result that the infant may miss recommended developmental screening and early referral to improve health outcomes. In 2006, an internal review was undertaken of the integration of early childhood and parenting services at opioid treatment clinics in a large Area Health Service of New South Wales, Australia. A qualitative study design, using semi-structured interview questions was used. Data were collected via six focus groups (4-15 participants in each group) and individual interview of child and family health nurses, nurse unit managers and clinical staff (n=58). Three key components of a model for providing early childhood support in collaboration with opioid treatment services were identified. First, the importance of building a trusting relationship between the woman and the child and family health nurses, second, maintaining continuity of care and a multidisciplinary/multiagency approach, and finally the importance of staff education, support and professional development. The provision of early childhood and parenting services on site, as part of a multidisciplinary 'one stop shop' approach to service delivery was a clear recommendation of the review. Reduction of access difficulties to specialised early childhood support is of benefit to clients, community health services attempting to provide a service to this difficult to reach population and to drug and alcohol services seeking to provide a high level of holistic care for clients. © 2012 Blackwell Publishing Ltd.

  20. Social pedagogy as a model to provide support for siblings of children with intellectual disabilities: A report of the views of the children and young people using a sibling support group.

    Science.gov (United States)

    Carter, Sid; Cook, James; Sutton-Boulton, Gary; Ward, Vicki; Clarke, Steve

    2016-03-01

    The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report of a service evaluation survey. The value of providing support to those young siblings is however clear. An established method of support is within a group of peers who also have a sibling with an intellectual disability, though no specific method for running this type of group has yet been fully explored. This article reports the views of 39 children taking part in such a group, analysing their perspective through a proposed model for the operation of sibling groups: social pedagogy. It was found that the closer the group's activities were to social pedagogy, the more supported the children and young people felt. © The Author(s) 2015.

  1. Symbiotic bacteria are responsible for diet-induced mating preference in Drosophila melanogaster, providing support for the hologenome concept of evolution.

    Science.gov (United States)

    Sharon, Gil; Segal, Daniel; Zilber-Rosenberg, Ilana; Rosenberg, Eugene

    2011-01-01

    Diet-induced mating preference in Drosophila melanogaster results from amplification of the commensal bacterium Lactobacillus plantarum, providing a new role for gut microbiota and support for the hologenome concept of evolution. When the flies were treated with antibiotics prior to changing their diet, mating preference did not occur. These data also indicate that other potentially beneficial bacteria could be irreversibly lost by antibiotic treatment and that their replacement could provide a health benefit. We suggest that D. melanogaster can be a useful model organism to study the activities of gut microbiota and their interaction with the immune system.

  2. A Reflection on the Work of an Educational Psychologist in Providing Supervision for a Team of Community Based Support Workers, Supporting Families with Vulnerable Adolescents at Risk of Exclusion from School

    Science.gov (United States)

    Maxwell, Tim

    2013-01-01

    The evolving role of the educational psychologist (EP) is discussed with an emphasis on the supervision provided for a team of support workers for vulnerable adolescents, working within a Local Service Team. This development is considered in the context of the Every Child Matters (DfES, 2004) agenda and the Farrell, Woods, Lewis, Rooney, Squire…

  3. A Guide to Locating Technical Reports in U.S. Government Publications Collections. Metrodocs Monograph One. First Edition.

    Science.gov (United States)

    Hardick, Mary

    This guide is designed to provide aid and support to library staff in finding government scientific and technical reports. Following an introduction to bibliographic sources for the technical report literature, the guide outlines a general search strategy for the retrieval of technical reports and presents an overview of the following five major…

  4. TECHNICAL COORDINATION

    CERN Multimedia

    Austin Ball

    Summary of progress since last CMS week. Ten years of construction work have been completed. CMS is closed, in very close to the ideal low luminosity configuration, and performed well in the first tests with LHC beam. Behind this encouraging news is the story of a summer of intense commitment by many teams (from the collaboration and 3 CERN departments) working together, against the clock and despite many minor setbacks, to ensure that the experiment was ready to play a leading role in the excitement of September 10. Following beampipe bakeout and refill with pure neon, a magnificent effort by the ECAL group and the pt 5 technical crew made it possible to install and commission all 4 ECAL endcap Dees before the end of August. In the shadow of this activity, the barrel and forward pixel trackers and part of the beam monitoring were installed within the vac tank. The pt 5 technical teams then succeeded in safely removing the 20t installation tables and their support blocks from beneath the already installed ...

  5. Supporting students' scientific explanations: A case study investigating the synergy focusing on a teacher's practices when providing instruction and using mobile devices

    Science.gov (United States)

    Delen, Ibrahim

    Engage students in constructing scientific practices is a critical component of science instruction. Therefore a number of researchers have developed software programs to help students and teachers in this hard task. The Zydeco group, designed a mobile application called Zydeco, which enables students to collect data inside and outside the classroom, and then use the data to create scientific explanations by using claim-evidence-reasoning framework. Previous technologies designed to support scientific explanations focused on how these programs improve students' scientific explanations, but these programs ignored how scientific explanation technologies can support teacher practices. Thus, to increase our knowledge how different scaffolds can work together, this study aimed to portray the synergy between a teacher's instructional practices (part 1) and using supports within a mobile devices (part 2) to support students in constructing explanations. Synergy can be thought of as generic and content-specific scaffolds working together to enable students to accomplish challenging tasks, such as creating explanations that they would not normally be able to do without the scaffolds working together. Providing instruction (part 1) focused on understanding how the teacher scaffolds students' initial understanding of the claim-evidence-reasoning (CER) framework. The second component of examining synergy (part 2: using mobile devices) investigated how this teacher used mobile devices to provide feedback when students created explanations. The synergy between providing instruction and using mobile devices was investigated by analyzing a middle school teacher's practices in two different units (plants and water quality). Next, this study focused on describing how the level of synergy influenced the quality of students' scientific explanations. Finally, I investigated the role of focused teaching intervention sessions to inform teacher in relation to students' performance. In

  6. Technical and Management Information System (TMIS)

    Science.gov (United States)

    Rau, Timothy R.

    1987-01-01

    The TMIS goals developed to support the Space Station Program (SSP) mission requirements are outlined. The TMIS will provide common capabilities to all SSP centers and facilitate the flow of technical and management information throughout the program as well as SSP decision-making processes. A summary is presented of the various TMIS phases.

  7. Interventions to improve the self-management support health professionals provide for people with progressive neurological conditions: protocol for a realist synthesis.

    Science.gov (United States)

    Davies, Freya; Wood, Fiona; Bullock, Alison; Wallace, Carolyn; Edwards, Adrian

    2017-03-20

    Supporting self-management among people with long-term conditions is recognised as an important component of healthcare. Progressive neurological conditions (PNCs), for example, Parkinson's disease and multiple sclerosis are associated with problems such as fatigue and cognitive impairment which may make self-management more challenging. Health professionals may need to develop specific skills in order to provide effective self-management support for these patients. The review aims to develop explanatory theories about how health professional-targeted interventions to improve self-management support provision for people with PNCs operate in different circumstances. A realist synthesis of the evidence is proposed. There are 2 priority questions for the review to address. These relate to the role of a shared concept of self-management support within the healthcare team, and the need to tailor the support provided to the requirements of people with PNCs. Key stakeholders will be involved throughout the process. The initial search strategy uses terms relating to (1) self-management, (2) health professionals and (3) PNCs. Searching, data extraction and synthesis will occur in parallel. Studies will be prioritised for inclusion based on anticipated contribution to generating explanatory theories. Key informant interviews are planned to direct supplementary searches and help further refine the theories developed. Results will be expressed in the form of context-mechanism-outcome configurations. Publication guidelines on realist synthesis will be followed. The results will be published in a peer-reviewed journal and made available to organisations involved in the provision of health professional training. 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/.

  8. New tools for an old trade: a socio-technical appraisal of how electronic decision support is used by primary care practitioners.

    Science.gov (United States)

    Peiris, David; Usherwood, Tim; Weeramanthri, Tarun; Cass, Alan; Patel, Anushka

    2011-11-01

    This article explores Australian general practitioners' (GPs) views on a novel electronic decision support (EDS) tool being developed for cardiovascular disease management. We use Timmermans and Berg's technology-in-practice approach to examine how technologies influence and are influenced by the social networks in which they are placed. In all, 21 general practitioners who piloted the tool were interviewed. The tool occupied an ill-defined middle ground in a dialectical relationship between GPs' routine care and factors promoting best practice. Drawing on Lipsky's concept of 'street-level bureaucrats', the tool's ability to process workloads expeditiously was of greatest appeal to GPs. This feature of the tool gave it the potential to alter the structure, process and content of healthcare encounters. The credibility of EDS tools appears to be mediated by fluid notions of best practice, based on an expert scrutiny of the evidence, synthesis via authoritative guidelines and dissemination through trusted and often informal networks. Balanced against this is the importance of 'soft' forms of knowledge such as intuition and timing in everyday decision-making. This resonates with Aristotle's theory of phronesis (practical wisdom) and may render EDS tools inconsequential if they merely process biomedical data. While EDS tools show promise in improving health practitioner performance, the socio-technical dimensions of their implementation warrant careful consideration. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  9. FY2017 Final Report: Power of the People: A technical ethical and experimental examination of the use of crowdsourcing to support international nuclear safeguards verification.

    Energy Technology Data Exchange (ETDEWEB)

    Gastelum, Zoe Nellie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Sentz, Kari [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Swanson, Meili Claire [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rinaudo, Cristina [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-10-01

    Recent advances in information technology have led to an expansion of crowdsourcing activities that utilize the “power of the people” harnessed via online games, communities of interest, and other platforms to collect, analyze, verify, and provide technological solutions for challenges from a multitude of domains. To related this surge in popularity, the research team developed a taxonomy of crowdsourcing activities as they relate to international nuclear safeguards, evaluated the potential legal and ethical issues surrounding the use of crowdsourcing to support safeguards, and proposed experimental designs to test the capabilities and prospect for the use of crowdsourcing to support nuclear safeguards verification.

  10. Using Patient-Generated Health Data From Mobile Technologies for Diabetes Self-Management Support: Provider Perspectives From an Academic Medical Center.

    Science.gov (United States)

    Nundy, Shantanu; Lu, Chen-Yuan E; Hogan, Patrick; Mishra, Anjuli; Peek, Monica E

    2014-01-01

    Mobile health and patient-generated health data are promising health IT tools for delivering self-management support in diabetes, but little is known about provider perspectives on how best to integrate these programs into routine care. We explored provider perceptions of a patient-generated health data report from a text-message-based diabetes self-management program. The report was designed to relay clinically relevant data obtained from participants' responses to self-assessment questions delivered over text message. Likert-type scale response surveys and in-depth interviews were conducted with primary care physicians and endocrinologists who pilot tested the patient-generated health data report in an actual clinical encounter. Interview guides were designed to assess providers' perceptions of the feasibility and utility of patient-generated health data in routine clinical practice. Interviews were audiotaped, transcribed, and analyzed using the constant comparative method. Twelve providers successfully piloted the summary report in clinic. Although only a minority of providers felt the report changed the care they provided (3 of 12 or 25%), most were willing to use the summary report in a future clinical encounter (9 of 12 or 75%). Perceived benefits of patient-generated health data included agenda setting, assessment of self-care, and identification of patient barriers. Major themes discussed included patient selection, reliability of patient-generated health information, and integration into clinical workflow. Providers perceived multiple benefits of patient-generated health data in overcoming common barriers to self-management support in clinical practice and found the summary report feasible and usable in a clinical context. © 2014 Diabetes Technology Society.

  11. Assessing clinical support and inter-professional interactions among front-line primary care providers in remote communities in northern Canada: a pilot study

    Directory of Open Access Journals (Sweden)

    Stephanie K. Young

    2016-09-01

    Full Text Available Background: Primary care in remote communities in northern Canada is delivered primarily by nurses who receive clinical support from physicians in regional centres and the patient transportation system. To improve continuity, quality and access to care in remote northern communities, it is important to understand the perspectives of front-line providers and the complex challenges they face. Objective: To design and implement a survey of primary care providers to identify issues relating to inter-professional communication, clinical support and patient evacuation. Methods: In collaboration with the territorial government and regional health authority partners, we developed a 21-item self-administered questionnaire survey, which could be completed online. The survey was sent to 218 physicians and nurses who were employed in the Northwest Territories (NWT at the time of the survey and were involved in sending patients out of the community and/or receiving patients. The survey also contained an open-ended question at the end seeking comments regarding primary health care. Results: The overall low response rate of 39% among nurses and 19% among physicians threatens the validity of the quantitative results. The majority of providers were satisfied with their ability to communicate with other providers in a timely manner, their freedom to make clinical decisions and their overall experience practicing in the NWT. The patient transfer system appears to work from both the sender and receiver perspectives. However, a common theme reported by nurses was that physicians providing clinical advice, especially short-term locums, were not familiar with the local situation, whilst physicians at the receiving end remarked that the clinical information provided to them often lacked clarity. Conclusions: Important lessons were learnt from the pilot study, especially in better engagement of providers in planning and dissemination. The questionnaire design and the

  12. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Science.gov (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

    2015-01-01

    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (peducation. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  13. The Tulip GT® airway versus the facemask and Guedel airway: a randomised, controlled, cross-over study by Basic Life Support-trained airway providers in anaesthetised patients.

    Science.gov (United States)

    Shaikh, A; Robinson, P N; Hasan, M

    2016-03-01

    We performed a randomised, controlled, cross-over study of lung ventilation by Basic Life Support-trained providers using either the Tulip GT® airway or a facemask with a Guedel airway in 60 anaesthetised patients. Successful ventilation was achieved if the provider produced an end-tidal CO2 > 3.5 kPa and a tidal volume > 250 ml in two of the first three breaths, within 60 sec and within two attempts. Fifty-seven (95%) providers achieved successful ventilation using the Tulip GT compared with 35 (58%) using the facemask (p Tulip GT and facemask, the mean (SD) end-tidal CO2 was 5.0 (0.7) kPa vs 2.5 (1.5) kPa, tidal volume was 494 (175) ml vs 286 (186) ml and peak inspiratory pressure was 18.3 (3.4) cmH2 O vs 13.6 (7) cmH2 O respectively (all p Tulip GT airway. These results are similar to a previous manikin study using the same protocol, suggesting a close correlation between human and manikin studies for this airway device. We conclude that the Tulip GT should be considered as an adjunct to airway management both within and outside hospitals when ventilation is being undertaken by Basic Life Support-trained airway providers. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  14. HIV Care Providers' Attitudes regarding Mobile Phone Applications and Web-Based Dashboards to support Patient Self-Management and Care Coordination: Results from a Qualitative Feasibility Study.

    Science.gov (United States)

    Swendeman, Dallas; Farmer, Shu; Mindry, Deborah; Lee, Sung-Jae; Medich, Melissa

    2016-10-01

    In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination. Newly diagnosed and patients with co-morbidities were highest priorities for mobile application support. Facilitators included universal mobile phone ownership and use of smartphones or text messaging. Patient-level barriers included concerns about low motivation and financial instability for consistent use by some patients. Organizational barriers, cited primarily by physicians, included concerns about privacy protections, easy dashboard access, non-integrated electronic records, and competing burdens in limited appointment times. Psychosocial services providers were most supportive of the proposed mobile tools.

  15. Qualitative study to explore the health and well-being impacts on adults providing informal support to female domestic violence survivors.

    Science.gov (United States)

    Gregory, Alison; Feder, Gene; Taket, Ann; Williamson, Emma

    2017-03-24

    Domestic violence (DV) is hazardous to survivors' health, from injuries sustained and from resultant chronic physical and mental health problems. Support from friends and relatives is significant in the lives of DV survivors; research shows associations between positive support and the health, well-being and safety of survivors. Little is known about how people close to survivors are impacted. The aim of this study was exploratory, with the following research question: what are the health and well-being impacts on adults who provide informal support to female DV survivors? A qualitative study using semistructured interviews conducted face to face, by telephone or using Skype. A thematic analysis of the narratives was carried out. Community-based, across the UK. People were eligible to take part if they had had a close relationship (either as friend, colleague or family member) with a woman who had experienced DV, and were aged 16 or over during the time they knew the survivor. Participants were recruited via posters in community venues, social media and radio advertisement. 23 participants were recruited and interviewed; the majority were women, most were white and ages ranged from mid-20s to 80. Generated themes included: negative impacts on psychological and emotional well-being of informal supporters, and related physical health impacts. Some psychological impacts were over a limited period; others were chronic and had the potential to be severe and enduring. The impacts described suggested that those providing informal support to survivors may be experiencing secondary traumatic stress as they journey alongside the survivor. Friends and relatives of DV survivors experience substantial impact on their own health and well-being. There are no direct services to support this group. These findings have practical and policy implications, so that the needs of informal supporters are legitimised and met. Published by the BMJ Publishing Group Limited. For permission to

  16. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    TECHNICAL TRAINING Monique Duval tel. 74924 technical.training@cern.ch Tuesday 3 February 2004 From 09:00 to 13:30 - Training Centre Auditorium - bldg. 593, room 11 USB (Universal Serial Bus) CYPRESS Seminar Claudia Colombini, Field Application Engineer CYPRESS ActiveComp Electronic GmbH D-85077 MANCHING, Germany As a pioneer in USB, CYPRESS sets the standard for cost-effective solutions without sacrificing functionality, performance or reliability. Having shipped over 200 million USB devices, Cypress is the undisputed market leader and demonstrates unmatched USB expertise. With the industry's broadest selection of USB solutions, Cypress has the right silicon, software and support for every USB application, from Low-speed to High-Speed and USB On-The-Go (OTG). 9:00 - 10:30 Overview of USB systems. USB CYPRESS product overview. Peripherals: Low Speed, Full Speed, High Speed (1.1 and 2.0). Hub Solutions, Embedded Host Solutions, On-The-Go (OTG) and wireless USB. USB Development Tools (first part) 10:30 -...

  17. Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing cEssation (IC-SMOKE) interventions: a systematic review protocol.

    Science.gov (United States)

    de Bruin, Marijn; Viechtbauer, Wolfgang; Eisma, Maarten C; Hartmann-Boyce, Jamie; West, Robert; Bull, Eleanor; Michie, Susan; Johnston, Marie

    2016-05-04

    Systematic reviews of behaviour change interventions for smoking cessation vary in scope, quality, and applicability. The current review aims to generate more accurate and useful findings by (1) a detailed analysis of intervention elements that change behaviour (i.e. behaviour change techniques (BCTs)) and potential moderators of behaviour change (i.e. other intervention and sample characteristics) and (2) assessing and controlling for variability in support provided to comparison groups in smoking cessation trials. A systematic review will be conducted of randomized controlled trials of behaviour change interventions for smoking cessation in adults (with or without pharmacological support), with a minimum follow-up of 6 months, published after 1995. Eligible articles will be identified through the Cochrane Tobacco Addiction Group Specialized Register. Study authors will be asked for detailed descriptions of smoking cessation support provided to intervention and comparison groups. All data will be independently coded by two researchers. The BCT taxonomy v1 (tailored to smoking cessation interventions) and template for intervention description and replication criteria will be used to code intervention characteristics. Data collection will further include sample and trial characteristics and outcome data (smoking cessation rates). Multilevel mixed-effects meta-regression models will be used to examine which BCTs and/or BCT clusters delivered to intervention and comparison groups explain smoking cessation rates in treatment arms (and effect sizes) and what key moderators of behaviour change are. Predicted effect sizes of each intervention will be computed assuming all interventions are compared against comparison groups receiving the same levels of behavioural support (i.e. low, medium, and high levels). Multi-disciplinary advisory board members (policymakers, health care providers, and (ex-)smokers) will provide strategic input throughout the project to ensure the

  18. Does the use of a university lecturer as a visiting tutor support learning and assessment during physiotherapy students' clinical placements? A survey of higher education institution providers.

    Science.gov (United States)

    Dean, M; Levis, A

    2016-12-01

    To establish the rationale for using a lecturer as a visiting tutor, and to identify the activities undertaken during clinical placements to support student learning and assessment in practice. A secure electronic survey was used to incorporate qualitative and quantitative data collection procedures. Thirty-three higher education institution (HEI) providers of physiotherapy education in the UK, registered with the Chartered Society of Physiotherapy. UK HEI physiotherapy placement coordinators. A questionnaire was used to examine HEI perceptions. A pilot focus group consultation informed the questionnaire content. Surveys were analysed based on the proportion of responses to closed questions on an adapted Likert scale, with further thematic analysis of open questions. All 25 respondents (25/33, 76%) indicated their provision of support for students and clinical educators throughout their clinical placements. 'Face-to-face' engagement during the placement visit was viewed as essential to guide the clinical educator to provide a consistent approach to learning and assessment strategies; ensuring cohesion between theoretical and clinical components of the curriculum was viewed as a core objective by visiting academic tutors. However, the emergent themes highlighted key differences between HEIs' perspectives of what this support for clinical placement learning should entail. The majority of HEIs endorse the use of a lecturer as a visiting tutor to inform and maintain the standard of learning and assessment within the clinical placement. However, the value of this interaction requires confirmation via other stakeholders, and exploration of other forms of non-face-to-face support processes warrant further investigation. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  19. A CONTEXT AWARE BASED PRE-HANDOFF SUPPORT APPROACH TO PROVIDE OPTIMAL QOS FOR STREAMING APPLICATIONS OVER VEHICULAR AD HOC NETWORKS – HOSA

    Directory of Open Access Journals (Sweden)

    K. RAMESH BABU

    2015-06-01

    Full Text Available Large variations in network Quality of Service (QoS such as bandwidth, latency, jitter, and reliability may occur during media transfer over vehicular ad hoc networks (VANET. Usage of VANET over mobile and wireless computing applications experience “bursty” QoS behavior during the execution over distributed network scenarios. Applications such as streaming media services need to adapt their functionalities to any change in network status. Moreover, an enhanced software platform is necessary to provide adaptive network management services to upper software components. HOSA, a handoff service broker based architecture for QoS adaptation over VANET supports in providing awareness. HOSA is structured as a middleware platform both to provide QoS awareness to streaming applications as well to manage dynamic ad hoc network resources with support over handoff in an adaptive fashion. HOSA is well analyzed over routing schemes such as TIBSCRPH, SIP and ABSRP where performance of HOSA was measured using throughput, traffic intensity and end to end delay. HOSA has been analyzed using JXTA development toolkit over C++ implemented classes to demonstrate its performance over varying node mobility established using vehicular mobility based conference application.

  20. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sandra Haider

    Full Text Available The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35 conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23 received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2 to 3.0 pg/l (min-max = 2.0-20.8, and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9 to 0.3 mg/dl (min-max = 0.1-3.0 after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45 were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.