WorldWideScience

Sample records for space center medical

  1. Johnson Space Center Health and Medical Technical Authority

    Science.gov (United States)

    Fogarty, Jennifer A.

    2010-01-01

    1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

  2. The Manned Spacecraft Center and medical technology

    Science.gov (United States)

    Johnston, R. S.; Pool, S. L.

    1974-01-01

    A number of medically oriented research and hardware development programs in support of manned space flights have been sponsored by NASA. Blood pressure measuring systems for use in spacecraft are considered. In some cases, complete new bioinstrumentation systems were necessary to accomplish a specific physiological study. Plans for medical research during the Skylab program are discussed along with general questions regarding space-borne health service systems and details concerning the Health Services Support Control Center.

  3. Human Factors in Training: Space Medical Proficiency Training

    Science.gov (United States)

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

    2010-01-01

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

  4. Military Construction: Renovation Plans at the Portsmouth Naval Medical Center

    National Research Council Canada - National Science Library

    1997-01-01

    The Portsmouth Naval Medical Center is a teaching hospital that provides comprehensive health care services to active duty forces and, when space is available, provides medical services to other DOD beneficiaries (i.e...

  5. Aerial view of the Kennedy Space Center Visitor Center

    Science.gov (United States)

    1998-01-01

    The Kennedy Space Center Visitor Center, shown in this aerial view looking south, sprawls across 70 acres on Florida's Space Coast , and is located off State Road 405, NASA Parkway, six miles inside the Space Center entrance. SR 405 can be seen at the bottom of the photo. Just above the roadway, from left can be seen the Shuttle/Gantry mockup; the Post Show Dome; the Astronaut Memorial; and to the far right, the Center for Space Education. Behind the Memorial are a cluster of buildings that include the Theater Complex, Cafeteria, Space Flight Exhibit Building, Souvenir Sales Building, Spaceport Central, and Ticket Pavilion. At the upper right are various rockets that have played a significant role in the growth of the space program.

  6. Actions Needed to Ensure Scientific and Technical Information is Adequately Reviewed at Goddard Space Flight Center, Johnson Space Center, Langley Research Center, and Marshall Space Flight Center

    Science.gov (United States)

    2008-01-01

    This audit was initiated in response to a hotline complaint regarding the review, approval, and release of scientific and technical information (STI) at Johnson Space Center. The complainant alleged that Johnson personnel conducting export control reviews of STI were not fully qualified to conduct those reviews and that the reviews often did not occur until after the STI had been publicly released. NASA guidance requires that STI, defined as the results of basic and applied scientific, technical, and related engineering research and development, undergo certain reviews prior to being released outside of NASA or to audiences that include foreign nationals. The process includes technical, national security, export control, copyright, and trade secret (e.g., proprietary data) reviews. The review process was designed to preclude the inappropriate dissemination of sensitive information while ensuring that NASA complies with a requirement of the National Aeronautics and Space Act of 1958 (the Space Act)1 to provide for the widest practicable and appropriate dissemination of information resulting from NASA research activities. We focused our audit on evaluating the STI review process: specifically, determining whether the roles and responsibilities for the review, approval, and release of STI were adequately defined and documented in NASA and Center-level guidance and whether that guidance was effectively implemented at Goddard Space Flight Center, Johnson Space Center, Langley Research Center, and Marshall Space Flight Center. Johnson was included in the review because it was the source of the initial complaint, and Goddard, Langley, and Marshall were included because those Centers consistently produce significant amounts of STI.

  7. Medical service plans in academic medical centers.

    Science.gov (United States)

    Siegel, B

    1978-10-01

    Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.

  8. INFINITY at NASA Stennis Space Center

    Science.gov (United States)

    2010-01-01

    Flags are planted on the roof of the new INFINITY at NASA Stennis Space Center facility under construction just west of the Mississippi Welcome Center at exit 2 on Interstate 10. Stennis and community leaders celebrated the 'topping out' of the new science center Nov. 17, marking a construction milestone for the center. The 72,000-square-foot science and education center will feature space and Earth galleries to showcase the science that underpins the missions of the agencies at Stennis Space Center. The center is targeted to open in 2012.

  9. Advertising by academic medical centers.

    Science.gov (United States)

    Larson, Robin J; Schwartz, Lisa M; Woloshin, Steven; Welch, H Gilbert

    2005-03-28

    Many academic medical centers have increased their use of advertising to attract patients. While the content of direct-to-consumer pharmaceutical advertisements (ads) has been studied, to our knowledge, advertising by academic medical centers has not. We aimed to characterize advertising by the nation's top academic medical centers. We contacted all 17 medical centers named to the US News & World Report 2002 honor roll of "America's Best Hospitals" for a semistructured interview regarding their advertising practices. In addition, we obtained and systematically analyzed all non-research-related print ads placed by these institutions in their 5 most widely circulating local newspapers during 2002. Of the 17 institutions, 16 reported advertising to attract patients; 1 stated, "We're just word of mouth." While all 17 centers confirmed the presence of an institutional review board process for approving advertising to attract research subjects, none reported a comparable process for advertising to attract patients. We identified 127 unique non-research-related print ads for the 17 institutions during 2002 (mean, 7.5; range, 0-39). Three ads promoted community events with institution sponsorship, 2 announced genuine public services, and 122 were aimed at attracting patients. Of the latter group, 36 ads (29.5%) promoted the medical center as a whole, while 65 (53.3%) promoted specific clinical departments and 21 (17.2%) promoted single therapeutic interventions or diagnostic tests. The most commonly used marketing strategies included appealing to emotions (61.5%), highlighting institution prestige (60.7%), mentioning a symptom or disease (53.3%), and promoting introductory lectures or special offers likely to lead to further business (47.5%). Of the 21 ads for single interventions, most were for unproved (38.1%) or cosmetic (28.6%) procedures. While more than half of these ads presented benefits, none quantified their positive claims and just 1 mentioned potential harms

  10. Marshall Space Flight Center Faculty Fellowship Program

    Science.gov (United States)

    Six, N. F.; Karr, G.

    2017-01-01

    The research projects conducted by the 2016 Faculty Fellows at NASA Marshall Space Flight Center included propulsion studies on propellant issues, and materials investigations involving plasma effects and friction stir welding. Spacecraft Systems research was conducted on wireless systems and 3D printing of avionics. Vehicle Systems studies were performed on controllers and spacecraft instruments. The Science and Technology group investigated additive construction applied to Mars and Lunar regolith, medical uses of 3D printing, and unique instrumentation, while the Test Laboratory measured pressure vessel leakage and crack growth rates.

  11. Characterizing customers at medical center farmers' markets.

    Science.gov (United States)

    Kraschnewski, Jennifer L; George, Daniel R; Rovniak, Liza S; Monroe, Diana L; Fiordalis, Elizabeth; Bates, Erica

    2014-08-01

    Approximately 100 farmers' markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010 and October 2011 at three medical centers in different geographic regions of the US (Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center) were conducted. Markets reported serving 180-2,000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n = 585) across markets were similar in sociodemographic characteristics--most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers' markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers' markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health.

  12. Performance Support Tools for Space Medical Operations

    Science.gov (United States)

    Byrne, Vicky E.; Schmidt, Josef; Barshi, Immanuel

    2009-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Human factors personnel at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground. This area of research involved the feasibility of Just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction were captured. Information needed by the FS during ISS mission support, especially for an emergency situation (e.g. fire onboard ISS), may be located in many different places around the FS s console. A performance support tool prototype is being developed to address this issue by bringing all of the relevant information together in one place. The tool is designed to include procedures and other information needed by a FS

  13. A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

    Science.gov (United States)

    1983-12-01

    In A COMPARATIVE ANALYSIS OF PATIENT ACCESS MODES AT WILFORD HALL UNITED STATES AIR FORCE MEDICAL CENTER N AND SELECTED CIVILIAN MEDICAL CENTERS0 N...current patient access modes at WHMC and several civilian medical centers of comparable size. This project has pursued the subject of patient access in...selected civilian medical centers which are comparable to WHMC in size, specialty mix, workload, and mission, providing responsive and efficient patient

  14. Academic Medical Centers as digital health catalysts.

    Science.gov (United States)

    DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida

    2014-09-01

    Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Characterizing customers at medical center farmers’ markets1

    Science.gov (United States)

    Kraschnewski, Jennifer L.; George, Daniel R.; Rovniak, Liza S.; Monroe, Diana L.; Fiordalis, Elizabeth; Bates, Erica

    2014-01-01

    Approximately 100 farmers’ markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010-October 2011 at three medical centers in different geographic regions of the US: Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center were conducted. Markets reported serving 180–2000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n=585) across markets were similar in sociodemographic characteristics – most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers’ markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers’ markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health. PMID:24421001

  16. Evaluating the Medical Kit System for the International Space Station(ISS) - A Paradigm Revisited

    Science.gov (United States)

    Hailey, Melinda J.; Urbina, Michelle C.; Hughlett, Jessica L.; Gilmore, Stevan; Locke, James; Reyna, Baraquiel; Smith, Gwyn E.

    2010-01-01

    Medical capabilities aboard the International Space Station (ISS) have been packaged to help astronaut crew medical officers (CMO) mitigate both urgent and non-urgent medical issues during their 6-month expeditions. Two ISS crewmembers are designated as CMOs for each 3-crewmember mission and are typically not physicians. In addition, the ISS may have communication gaps of up to 45 minutes during each orbit, necessitating medical equipment that can be reliably operated autonomously during flight. The retirement of the space shuttle combined with ten years of manned ISS expeditions led the Space Medicine Division at the NASA Johnson Space Center to reassess the current ISS Medical Kit System. This reassessment led to the system being streamlined to meet future logistical considerations with current Russian space vehicles and future NASA/commercial space vehicle systems. Methods The JSC Space Medicine Division coordinated the development of requirements, fabrication of prototypes, and conducted usability testing for the new ISS Medical Kit System in concert with implementing updated versions of the ISS Medical Check List and associated in-flight software applications. The teams constructed a medical kit system with the flexibility for use on the ISS, and resupply on the Russian Progress space vehicle and future NASA/commercial space vehicles. Results Prototype systems were developed, reviewed, and tested for implementation. Completion of Preliminary and Critical Design Reviews resulted in a streamlined ISS Medical Kit System that is being used for training by ISS crews starting with Expedition 27 (June 2011). Conclusions The team will present the process for designing, developing, , implementing, and training with this new ISS Medical Kit System.

  17. When the library is located in prime real estate: a case study on the loss of space from the Duke University Medical Center Library and Archives.

    Science.gov (United States)

    Thibodeau, Patricia L

    2010-01-01

    The Duke University Medical Center Library and Archives is located in the heart of the Duke Medicine campus, surrounded by Duke Hospital, ambulatory clinics, and numerous research facilities. Its location is considered prime real estate, given its adjacency to patient care, research, and educational activities. In 2005, the Duke University Library Space Planning Committee had recommended creating a learning center in the library that would support a variety of educational activities. However, the health system needed to convert the library's top floor into office space to make way for expansion of the hospital and cancer center. The library had only five months to plan the storage and consolidation of its journal and book collections, while working with the facilities design office and architect on the replacement of key user spaces on the top floor. Library staff worked together to develop plans for storing, weeding, and consolidating the collections and provided input into renovation plans for users spaces on its mezzanine level. The library lost 15,238 square feet (29%) of its net assignable square footage and a total of 16,897 (30%) gross square feet. This included 50% of the total space allotted to collections and over 15% of user spaces. The top-floor space now houses offices for Duke Medicine oncology faculty and staff. By storing a large portion of its collection off-site, the library was able to remove more stacks on the remaining stack level and convert them to user spaces, a long-term goal for the library. Additional space on the mezzanine level had to be converted to replace lost study and conference room spaces. While this project did not match the recommended space plans for the library, it underscored the need for the library to think creatively about the future of its facility and to work toward a more cohesive master plan.

  18. Activities of the Center for Space Construction

    Science.gov (United States)

    1993-01-01

    The Center for Space Construction (CSC) at the University of Colorado at Boulder is one of eight University Space Engineering Research Centers established by NASA in 1988. The mission of the center is to conduct research into space technology and to directly contribute to space engineering education. The center reports to the Department of Aerospace Engineering Sciences and resides in the College of Engineering and Applied Science. The college has a long and successful track record of cultivating multi-disciplinary research and education programs. The Center for Space Construction is prominent evidence of this record. At the inception of CSC, the center was primarily founded on the need for research on in-space construction of large space systems like space stations and interplanetary space vehicles. The scope of CSC's research has now evolved to include the design and construction of all spacecraft, large and small. Within this broadened scope, our research projects seek to impact the underlying technological basis for such spacecraft as remote sensing satellites, communication satellites, and other special purpose spacecraft, as well as the technological basis for large space platforms. The center's research focuses on three areas: spacecraft structures, spacecraft operations and control, and regolith and surface systems. In the area of spacecraft structures, our current emphasis is on concepts and modeling of deployable structures, analysis of inflatable structures, structural damage detection algorithms, and composite materials for lightweight structures. In the area of spacecraft operations and control, we are continuing our previous efforts in process control of in-orbit structural assembly. In addition, we have begun two new efforts in formal approach to spacecraft flight software systems design and adaptive attitude control systems. In the area of regolith and surface systems, we are continuing the work of characterizing the physical properties of lunar

  19. Innovative Educational Aerospace Research at the Northeast High School Space Research Center

    Science.gov (United States)

    Luyet, Audra; Matarazzo, Anthony; Folta, David

    1997-01-01

    Northeast High Magnet School of Philadelphia, Pennsylvania is a proud sponsor of the Space Research Center (SPARC). SPARC, a model program of the Medical, Engineering, and Aerospace Magnet school, provides talented students the capability to successfully exercise full simulations of NASA manned missions. These simulations included low-Earth Shuttle missions and Apollo lunar missions in the past, and will focus on a planetary mission to Mars this year. At the end of each scholastic year, a simulated mission, lasting between one and eight days, is performed involving 75 students as specialists in seven teams The groups are comprised of Flight Management, Spacecraft Communications (SatCom), Computer Networking, Spacecraft Design and Engineering, Electronics, Rocketry, Robotics, and Medical teams in either the mission operations center or onboard the spacecraft. Software development activities are also required in support of these simulations The objective of this paper is to present the accomplishments, technology innovations, interactions, and an overview of SPARC with an emphasis on how the program's educational activities parallel NASA mission support and how this education is preparing student for the space frontier.

  20. Medical Waste Management in Community Health Centers.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

    2018-02-01

    Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

  1. Stennis Space Center observes 2009 Safety and Health Day

    Science.gov (United States)

    2009-01-01

    Sue Smith, a medical clinic employee at NASA's John C. Stennis Space Center, takes the temperature of colleague Karen Badon during 2009 Safety and Health Day activities Oct. 22. Safety Day activities included speakers, informational sessions and a number of displays on safety and health issues. Astronaut Dominic Gorie also visited the south Mississippi rocket engine testing facility during the day to address employees and present several Silver Snoopy awards for outstanding contributions to flight safety and mission success. The activities were part of an ongoing safety and health emphasis at Stennis.

  2. The medical implications of space tourism.

    Science.gov (United States)

    Tarzwell, R

    2000-06-01

    Commercial space travel may soon be a reality. If so, microgravity, high acceleration, and radiation exposure, all known hazards, will be accessible to the general public. Therefore, space tourism has medical implications. Even though the first flights will feature space exposure times of only a few minutes, the potential may someday exist for exposure times long enough to warrant careful consideration of the potential hazards to the space-faring public. The effects of acceleration and microgravity exposure are well known on the corps of astronauts and cosmonauts. The effects of space radiation are partially known on astronauts, but much remains to be discovered. However, there are problems using astronaut data to make inferences about the general public. Astronauts are not necessarily representative of the general public, since they are highly fit, highly screened individuals. Astronaut data can tell us very little about the potential hazards of microgravity in pediatric, obstetric and geriatric populations, all of whom are potential space tourists. Key issues in standard setting will be determining acceptable limits of pre-existing disease and inferring medical standards from mission profiles. It will not be a trivial task drafting minimal medical standards for commercial space travel. It will require the collaboration of space medicine physicians, making the best guesses possible, based on limited amounts of data, with limited applicability. A helpful departure point may be the USAF Class 3 medical standard, applicable to NASA payload specialists. It is time to begin preliminary discussions toward defining those standards. acceleration, aerospace medicine, medical standards, microgravity, radiation, space, space tourism, environmental hazards, environmental medicine.

  3. Biological and Medical Experiments on the Space Shuttle, 1981 - 1985

    Science.gov (United States)

    Halstead, Thora W. (Editor); Dufour, Patricia A. (Editor)

    1986-01-01

    This volume is the first in a planned series of reports intended to provide a comprehensive record of all the biological and medical experiments and samples flown on the Space Shuttle. Experiments described have been conducted over a five-year period, beginning with the first plant studies conducted on STS-2 in November 1981, and extending through STS 61-C, the last mission to fly before the tragic Challenger accident of January 1986. Experiments were sponsored within NASA not only by the Life Sciences Division of the Office of Space Science and Applications, but also by the Shuttle Student Involvement Program (SSIP) and the Get Away Special (GAS) Program. Independent medical studies were conducted as well on the Shuttle crew under the auspices of the Space Biomedical Research Institute at Johnson Space Center. In addition, cooperative agreements between NASA and foreign government agencies led to a number of independent experiments and also paved the way for the joint US/ESA Spacelab 1 mission and the German (DFVLR) Spacelab D-1. Experiments included: (1) medically oriented studies of the crew aimed at identifying, preventing, or treating health problems due to space travel; (2) projects to study morphological, physiological, or behavioral effects of microgravity on animals and plants; (3) studies of the effects of microgravity on cells and tissues; and (4) radiation experiments monitoring the spacecraft environment with chemical or biological dosimeters or testing radiation effects on simple organisms and seeds.

  4. National Space Science Data Center Master Catalog

    Data.gov (United States)

    National Aeronautics and Space Administration — The National Space Science Data Center serves as the permanent archive for NASA space science mission data. 'Space science' means astronomy and astrophysics, solar...

  5. Health services at the Kennedy Space Center

    Science.gov (United States)

    Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.

    1992-01-01

    Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.

  6. Estate of Behringer v. Medical Center at Princeton.

    Science.gov (United States)

    1991-04-25

    Dr. William Behringer, a staff member at the Medical Center at Princeton, was diagnosed with AIDS. Afterwards, Behringer received numerous phone calls from various people expressing awareness of his illness, and his surgical privileges at the Center were suspended. He sued the Medical Center, alleging a breach of confidentiality and discrimination. The Superior Court of New Jersey, Mercer County, held that the Medical Center had breached its duty of confidentiality when it failed to take reasonable precautions to prevent Behringer's AIDS diagnosis from becoming public knowledge. Nevertheless, although New Jersey's anti-discrimination statutes protected Dr. Behringer from having his surgical privileges revoked, the Medical Center demonstrated a reasonable risk to patients that justified suspending Dr. Behringer's privileges, or alternatively, requiring his patients' informed consent before operating. The court found that the risk included not only actual HIV transmission, but also the possibility of surgical accidents.

  7. [Factors related to the life space of daycare center users].

    Science.gov (United States)

    Kawamura, Koki; Kato, Chikako; Kondo, Izumi

    2018-01-01

    We examined the factors related to life space and changes in the care level after one year in daycare center users. The participants were 83 older adults (age, > 65 years; mean age, 79.5±6.8 years) with MMSE scores of ≥20, who could walk independently, who needed support (1-2) or care (1), and who underwent rehabilitation at a daycare center. The life space was evaluated by the Life Space Assessment (LSA). The subjects' basic information (i.e., age, medical history.) was collected, and their physical function (i.e., grip strength, timed up and go test [TUG]), mental function (i.e., vitality, fear of falls), and social function (i.e., friends, hobbies, public transportation) were assessed to investigate the factors associated with their LSA scores. In addition, a follow-up survey was conducted on the care level at approximately one year later. A multiple regression analysis indicated that TUG scores (β=-0.33), hobbies (β=0.30), friends (β=0.29), public transportation (β=0.26), and grip strength (β=0.24) were related to the life space. Next, the participants were divided into LSA-high and LSA-low groups, and changes in the care level (improvement, maintenance, deterioration) at approximately one year after the initial assessment were examined using a chi-squared test. A significant difference was observed in the distribution of the groups (p=0.03). Multiple factors were related to the life space. Moreover, it is possible that improvements in the level of care may be achieved by improving the life space.

  8. Medical technology advances from space research

    Science.gov (United States)

    Pool, S. L.

    1972-01-01

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

  9. SPACE MEDICINE and Medical Operations Overview

    Science.gov (United States)

    Dervay, Joe

    2009-01-01

    This presentation is an overview of the function of the work of the Space Medicine & Health Care Systems Office. The objective of the medical operations is to ensure the health, safety and well being of the astronaut corps and ground support team during all phases of space flight. There are many issues that impact the health of the astronauts. Some of them are physiological, and others relate to behavior, psychological issues and issues of the environment of space itself. Reviews of the medical events that have affected both Russian, and Americans while in space are included. Some views of shuttle liftoff, and ascent, the medical training aboard NASA's KC-135 and training in weightlessness, the Shuttle Orbiter Medical system (SOMS), and some of the medical equipment are included. Also included are a graphs showing Fluid loading countermeasures, and vertical pursuit tracking with head and eye. The final views are representations of the future crew exploration vehicle (CEV) approaching the International Space Station, and the moon, and a series of perspective representations of the earth in comparison to the other planets and the Sun, the Sun in relation to other stars, and a view of where in the galaxy the Sun is.

  10. Kennedy Space Center Spaceport Analysis

    Science.gov (United States)

    Wary, Samantha A.

    2013-01-01

    Until the Shuttle Atlantis' final landing on July 21, 2011, Kennedy Space Center (KSC) served as NASA's main spaceport, which is a launch and landing facility for rockets and spacecraft that are attempting to enter orbit. Many of the facilities at KSC were created to assist the Shuttle Program. One of the most important and used facilities is the Shuttle Landing Facility (SLF), This was the main landing area for the return of the shuttle after her mission in space. · However, the SLF has also been used for a number of other projects including straight-line testing by Gibbs Racing, weather data collection by NOAA, and an airfield for the KSC helicopters. This runway is three miles long with control tower at midfield and a fire department located at the end in care of an emergency. This facility, which was part of the great space race, will continue to be used for historical events as Kennedy begins to commercialize its facilities. KSC continues to be an important spaceport to the government, and it will transform into an important spaceport for the commercial industry as well. During my internship at KSC's Center Planning and Development Directorate, I had the opportunity to be a part of the negotiation team working on the agreement for Space Florida to control the Shuttle Landing Facility. This gave me the opportunity to learn about all the changes that are occurring here at Kennedy Space Center. Through various meetings, I discovered the Master Plan and its focus is to transform the existing facilities that were primarily used for the Shuttle Program, to support government operations and commercial flights in the future. This. idea is also in a new strategic business plan and completion of a space industry market analysis. All of these different documentations were brought to my attention and I. saw how they came together in the discussions of transitioning the SLF to a commercial operator, Space Florida. After attending meetings and partaking in discussions for

  11. NASA Johnson Space Center Usability Testing and Analysis Facility (WAF) Overview

    Science.gov (United States)

    Whitmore, M.

    2004-01-01

    The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility provides support to the Office of Biological and Physical Research, the Space Shuttle Program, the International Space Station Program, and other NASA organizations. In addition, there are ongoing collaborative research efforts with external businesses and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes. This presentation will provide an overview of ongoing activities, and will address how the projects will evolve to meet new space initiatives.

  12. Medical waste management in Jordan: A study at the King Hussein Medical Center

    International Nuclear Information System (INIS)

    Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

    2005-01-01

    As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that the center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel

  13. Microbiology and Crew Medical Events on the International Space Station

    Science.gov (United States)

    Oubre, Cherie; Charvat, Jacqueline M.; Kadwa, Biniafer; Taiym, Wafa; Ott, C. Mark; Pierson, Duane; Baalen, Mary Van

    2014-01-01

    The closed environment of the International Space Station (ISS) creates an ideal environment for microbial growth. Previous studies have identified the ubiquitous nature of microorganisms throughout the space station environment. To ensure safety of the crew, microbial monitoring of air and surface within ISS began in December 2000 and continues to be monitored on a quarterly basis. Water monitoring began in 2009 when the potable water dispenser was installed on ISS. However, it is unknown if high microbial counts are associated with inflight medical events. The microbial counts are determined for the air, surface, and water samples collected during flight operations and samples are returned to the Microbiology laboratory at the Johnson Space Center for identification. Instances of microbial counts above the established microbial limit requirements were noted and compared inflight medical events (any non-injury event such as illness, rashes, etc.) that were reported during the same calendar-quarter. Data were analyzed using repeated measures logistic regression for the forty-one US astronauts flew on ISS between 2000 and 2012. In that time frame, instances of microbial counts being above established limits were found for 10 times for air samples, 22 times for surface samples and twice for water. Seventy-eight inflight medical events were reported among the astronauts. A three times greater risk of a medical event was found when microbial samples were found to be high (OR = 3.01; p =.007). Engineering controls, crew training, and strict microbial limits have been established to mitigate the crew medical events and environmental risks. Due to the timing issues of sampling and the samples return to earth, identification of particular microorganisms causing a particular inflight medical event is difficult. Further analyses are underway.

  14. NASA Johnson Space Center SBIR STTR Program Technology Innovations

    Science.gov (United States)

    Krishen, Kumar

    2007-01-01

    The Small Business Innovation Research (SBIR) Program increases opportunities for small businesses to participate in research and development (R&D), increases employment, and improves U.S. competitiveness. Specifically the program stimulates U.S. technological innovation by using small businesses to meet federal R&D needs, increasing private-sector commercialization of innovations derived from federal R&D, and fostering and encouraging the participation of socially disadvantaged businesses. In 2000, the Small Business Technology Transfer (STTR) Program extended and strengthened the SBIR Program, increasing its emphasis on pursuing commercial applications by awarding contracts to small business concerns for cooperative R&D with a nonprofit research institution. Modeled after the SBIR Program, STTR is nevertheless a separately funded activity. Technologies that have resulted from the Johnson Space Center SBIR STTR Program include: a device for regenerating iodinated resin beds; laser-assisted in-situ keratomileusis or LASIK; a miniature physiological monitoring device capable of collecting and analyzing a multitude of real-time signals to transmit medical data from remote locations to medical centers for diagnosis and intervention; a new thermal management system for fibers and fabrics giving rise to new line of garments and thermal-enhancing environments; and a highly electropositive material that attracts and retains electronegative particles in water.

  15. An Artist in the University Medical Center. Review.

    Science.gov (United States)

    James, A. Everette, Jr.

    1991-01-01

    Reviews "An Artist in the University Medical Center" (M. Lesser, New Orleans: Tulane University Press, 1989), in which the artist captures the human side of the complex Tulane Medical Center in New Orleans (Louisiana). The interplay of drawings, etchings, watercolors, and prose conveys traditions of nurturing in the hospital. (SLD)

  16. Networking at NASA. Johnson Space Center

    Science.gov (United States)

    Garman, John R.

    1991-01-01

    A series of viewgraphs on computer networks at the Johnson Space Center (JSC) are given. Topics covered include information resource management (IRM) at JSC, the IRM budget by NASA center, networks evolution, networking as a strategic tool, the Information Services Directorate charter, and SSC network requirements, challenges, and status.

  17. U.S. academic medical centers under the managed health care environment.

    Science.gov (United States)

    Guo, K

    1999-06-01

    This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

  18. NASA Johnson Space Center Usability Testing and Analysis facility (UTAF) Overview

    Science.gov (United States)

    Whitmore, Mihriban; Holden, Kritina L.

    2005-01-01

    The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility performs research for NASA's HumanSystems Integration Program, under the HumanSystems Research and Technology Division. Specifically, the UTAF provides human factors support for space vehicles, including the International Space Station, the Space Shuttle, and the forthcoming Crew Exploration Vehicle. In addition, there are ongoing collaborative research efforts with external corporations and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes and requirements. This presentation will provide an overview of ongoing activities, and will address how the UTAF projects will evolve to meet new space initiatives.

  19. Kennedy Space Center Coronary Heart Disease Risk Screening Program

    Science.gov (United States)

    Tipton, David A.; Scarpa, Philip J.

    1999-01-01

    The number one cause of death in the U.S. is coronary heart disease (CHD). It is probably a major cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial mathematical formula from the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population that required medical evaluation for job certification. Those assessed to be high-risk probabilities will be targeted for intervention. Every year, several thousand KSC employees require medical evaluations for job related certifications. Most medical information for these evaluations is gathered on-site at one of the KSC or Cape Canaveral Air Station (CCAS) medical clinics. The formula used in the Framingham Heart Study allows calculation of a person's probability of acquiring CHD within 10 years. The formula contains the following variables: Age, Diabetes, Smoking, Left Ventricular Hypertrophy, Blood Pressure (Systolic or Diastolic), Cholesterol, and HDL cholesterol. The formula is also gender specific. It was used to calculate the 10-year probabilities of CHD in KSC employees who required medical evaluations for job certifications during a one-year time frame. This KSC population was profiled and CHD risk reduction interventions could be targeted to those at high risk. Population risk could also be periodically reevaluated to determine the effectiveness of intervention. A 10-year CHD risk probability can be calculated for an individual quite easily while gathering routine medical information. An employee population's CHD risk probability can be profiled graphically revealing high risk segments of the population which can be targeted for risk reduction intervention. The small audience of NASA/contractor physicians, nurses and exercise/fitness professionals at the breakout session received the lecture very well. Approximately one third indicated by a show of hands that they would be

  20. Medical and surgical applications of space biosensor technology

    Science.gov (United States)

    Hines, J. W.

    1996-01-01

    Researchers in space life sciences are rapidly approaching a technology impasse. Many of the critical questions on the impact of spaceflight on living systems simply cannot be answered with the limited available technologies. Research subjects, particularly small animal models like the rat, must be allowed to function relatively untended and unrestrained for long periods to fully reflect the impact of microgravity and spaceflight on their behavior and physiology. These requirements preclude the use of present hard-wired instrumentation techniques and limited data acquisition systems. Implantable sensors and miniaturized biotelemetry are the only means of capturing the fundamental and critical data. This same biosensor and biotelemetry technology has direct application to Earth-based medicine and surgery. Continuous, on-line data acquisition and improved measurement capabilities combined with the ease and flexibility offered by automated, wireless, and portable instruments and data systems, should provide a boon to the health care industry. Playing a key role in this technology revolution is the Sensors 2000! (S2K!) Program at NASA Ames Research Center. S2K!, in collaboration with space life sciences researchers and managers, provides an integrated capability for sensor technology development and applications, including advanced biosensor technology development, spaceflight hardware development, and technology transfer and commercialization. S2K! is presently collaborating on several spaceflight projects with dual-use medical applications. One prime example is a collaboration with the Fetal Treatment Center (FTC) at the University of California at San Francisco. The goal is to develop and apply implantable chemical sensor and biotelemetry technology to continuously monitor fetal patients during extra-uterine surgery, replacement into the womb, through birth and beyond. Once validated for ground use, the method will be transitioned to spaceflight applications to

  1. Medical and surgical applications of space biosensor technology

    Science.gov (United States)

    Hines, John W.

    1996-02-01

    Researchers in space life sciences are rapidly approaching a technology impasse. Many of the critical questions on the impact of spaceflight on living systems simply cannot be answered with the limited available technologies. Research subjects, particularly small animal models like the rat, must be allowed to function relatively untended and unrestrained for long periods to fully reflect the impact of microgravity and spaceflight on their behavior and physiology. These requirements preclude the use of present hard-wired instrumentation techniques and limited data acquisition systems. Implantable sensors and miniaturized biotelemetry are the only means of capturing the fundamental and critical data. This same biosensor and biotelemetry technology has direct application to Earth-based medicine and surgery. Continuous, on-line data acquisition and improved measurement capabilities combined with the ease and flexibility offered by automated, wireless, and portable instruments and data systems, should provide a boon to the health care industry. Playing a key role in this technology revolution is the Sensors 2000! (S2K!) Program at NASA Ames Research Center. S2K!, in collaboration with space life sciences researchers and managers, provides an integrated capability for sensor technology development and applications, including advanced biosensor technology development, spaceflight hardware development, and technology transfer and commercialization. S2K! is presently collaborating on several spaceflight projects with dual-use medical applications. One prime example is a collaboration with the Fetal Treatment Center (FTC) at the University of California at San Francisco. The goal is to develop and apply implantable chemical sensor and biotelemetry technology to continuously monitor fetal patients during extra-uterine surgery, replacement into the womb, through birth and beyond. Once validated for ground use, the method will be transitioned to spaceflight applications to

  2. An academic medical center under prolonged rocket attack--organizational, medical, and financial considerations.

    Science.gov (United States)

    Bar-El, Yaron; Michaelson, Moshe; Hyames, Gila; Skorecki, Karl; Reisner, Shimon A; Beyar, Rafael

    2009-09-01

    The Rambam Medical Center, the major academic health center in northern Israel, serving a population of two million and providing specialized tertiary care, was exposed to an unprecedented experience during the Second Lebanon War in the summer of 2006. For more than one month, it was subjected to continuous rocket attacks, but it continued to provide emergency and routine medical services to the civilian population and also served the military personnel who were evacuated from the battlefront. To accomplish the goals of serving the population while itself being under fire, the Rambam Medical Center had to undertake major organizational decisions, which included maximizing safety within the hospital by shifting patients and departments, ensuring that the hospital was properly fortified, managing the health professional teams' work schedules, and providing needed services for the families of employees. The Rambam Medical Center's Level I trauma center expertise included multidisciplinary teams and extensive collaborations; modern imaging modalities usually reserved for peacetime medical practice were frequently used. The function of the hospital teams during the war was efficient and smooth, based on the long-term actions taken to prepare for disasters and wartime conditions. Routine hospital services continued, although at 60% of normal occupancy. Financial losses incurred were primarily due to the decrease in revenue-generating activity. The two most important components of managing the hospital under these conditions are (1) the ability to arrive at prompt and meaningful decisions with respect to the organizational and medical hospital operations and (2) the leadership and management of the professional staff and teams.

  3. [NEURO-ONCOLOGY A NEW FIELD IN DAVIDOFF CANCER CENTER AT RABIN MEDICAL CENTER].

    Science.gov (United States)

    Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali

    2017-08-01

    Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

  4. Marshall Space Flight Center Technology Investments Overview

    Science.gov (United States)

    Tinker, Mike

    2014-01-01

    NASA is moving forward with prioritized technology investments that will support NASA's exploration and science missions, while benefiting other Government agencies and the U.S. aerospace enterprise. center dotThe plan provides the guidance for NASA's space technology investments during the next four years, within the context of a 20-year horizon center dotThis plan will help ensure that NASA develops technologies that enable its 4 goals to: 1.Sustain and extend human activities in space, 2.Explore the structure, origin, and evolution of the solar system, and search for life past and present, 3.Expand our understanding of the Earth and the universe and have a direct and measurable impact on how we work and live, and 4.Energize domestic space enterprise and extend benefits of space for the Nation.

  5. Organization, Management and Function of International Space Station (ISS) Multilateral Medical Operations

    Science.gov (United States)

    Duncan, James M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

    2007-01-01

    Long duration crews have inhabited the ISS since November of 2000. The favorable medical outcomes of its missions can be largely attributed to sustained collective efforts of all ISS Partners medical organizations. In-flight medical monitoring and support, although crucial, is just a component of the ISS system of Joint Medical Operations. The goal of this work is to review the principles, design, and function of the multilateral medical support of the ISS Program. The governing documents, which describe the relationships among all ISS partner medical organizations, were evaluated, followed by analysis of the roles, responsibilities, and decision-making processes of the ISS medical boards, panels, and working groups. The degree of integration of the medical support system was evaluated by reviewing the multiple levels of the status reviews and mission assurance activities carried out throughout the last six years. The Integrated Medical Group, consisting of physicians and other essential personnel in the mission control centers represents the front-line medical support of the ISS. Data from their day-to-day activities are presented weekly at the Space Medicine Operations Team (SMOT), where known or potential concerns are addressed by an international group of physicians. A broader status review is conducted monthly to project the state of crew health and medical support for the following month, and to determine measures to return to nominal state. Finally, a comprehensive readiness review is conducted during preparations for each ISS mission. The Multilateral Medical Policy Board (MMPB) issues medical policy decisions and oversees all health and medical matters. The Multilateral Space Medicine Board (MSMB) certifies crewmembers and visitors for training and space flight to the Station, and physicians to practice space medicine for the ISS. The Multilateral Medical Operations Panel (MMOP) develops medical requirements, defines and supervises implementation of

  6. [Patient-centered medicine for tuberculosis medical services].

    Science.gov (United States)

    Fujita, Akira; Narita, Tomoyo

    2012-12-01

    The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other

  7. Consumerism: forcing medical practices toward patient-centered care.

    Science.gov (United States)

    Ozmon, Jeff

    2007-01-01

    Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

  8. Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

    Science.gov (United States)

    Flieger, Signe Peterson

    This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and

  9. Ethical and medical dilemmas of space tourism

    Science.gov (United States)

    Marsh, Melinda

    Space tourism is an important new venture, however it raises several issues that must be addressed; namely, the medical implications associated with space flight and potential for ethical problems surrounding the safety of such travel. It seems highly likely that businesses involved in space tourism could find themselves liable for any passenger deaths or injuries, if they are found to have been negligent. This paper, therefore, discusses such issues as the medical facilities that need to be made available on board a space facility, and the companies' duty to disclose to potential passengers the risks associated with microgravity and the likelihood of space sickness, loss of bone density, disease, and pregnancy.

  10. The Space Medicine Exploration Medical Condition List

    Science.gov (United States)

    Watkins, Sharmi; Barr, Yael; Kerstman, Eric

    2011-01-01

    Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC's goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this risk. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to define the set of medical conditions that are most likely to occur during exploration space flight missions. The list was derived from the International Space Station Medical Checklist, the Shuttle Medical Checklist, in-flight occurrence data from the Lifetime Surveillance of Astronaut Health, and NASA subject matter experts. The list of conditions was further prioritized for eight specific design reference missions with the assistance of the ExMC Advisory Group. The purpose of the SMEMCL is to serve as an evidence-based foundation for the conditions that could affect a crewmember during flight. This information is used to ensure that the appropriate medical capabilities are available for exploration missions.

  11. Commercial Crew Medical Ops

    Science.gov (United States)

    Heinbaugh, Randall; Cole, Richard

    2016-01-01

    Provide commercial partners with: center insight into NASA spaceflight medical experience center; information relative to both nominal and emergency care of the astronaut crew at landing site center; a basis for developing and sharing expertise in space medical factors associated with returning crew.

  12. Esrange Space Center, a Gate to Space

    Science.gov (United States)

    Widell, Ola

    Swedish Space Corporation (SSC) is operating the Esrange Space Center in northern Sweden. Space operations have been performed for more than 40 years. We have a unique combination of maintaining balloon and rocket launch operations, and building payloads, providing space vehicles and service systems. Sub-orbital rocket flights with land recovery and short to long duration balloon flights up to weeks are offered. The geographical location, land recovery area and the long term experience makes Swedish Space Corporation and Esrange to an ideal gate for space activities. Stratospheric balloons are primarily used in supporting atmospheric research, validation of satellites and testing of space systems. Balloon operations have been carried out at Esrange since 1974. A large number of balloon flights are yearly launched in cooperation with CNES, France. Since 2005 NASA/CSBF and Esrange provide long duration balloon flights to North America. Flight durations up to 5 days with giant balloons (1.2 Million cubic metres) carrying heavy payload (up to 2500kg) with astronomical instruments has been performed. Balloons are also used as a crane for lifting space vehicles or parachute systems to be dropped and tested from high altitude. Many scientific groups both in US, Europe and Japan have indicated a great need of long duration balloon flights. Esrange will perform a technical polar circum balloon flight during the summer 2008 testing balloon systems and flight technique. We are also working on a permission giving us the opportunity on a circular stratospheric balloon flight around the North Pole.

  13. The Center for Space Telemetering and Telecommunications Systems

    Science.gov (United States)

    Horan, S.; DeLeon, P.; Borah, D.; Lyman, R.

    2003-01-01

    This report comprises the final technical report for the research grant 'Center for Space Telemetering and Telecommunications Systems' sponsored by the National Aeronautics and Space Administration's Goddard Space Flight Center. The grant activities are broken down into the following technology areas: (1) Space Protocol Testing; (2) Autonomous Reconfiguration of Ground Station Receivers; (3) Satellite Cluster Communications; and (4) Bandwidth Efficient Modulation. The grant activity produced a number of technical reports and papers that were communicated to NASA as they were generated. This final report contains the final summary papers or final technical report conclusions for each of the project areas. Additionally, the grant supported students who made progress towards their degrees while working on the research.

  14. Lessons learned: mobile device encryption in the academic medical center.

    Science.gov (United States)

    Kusche, Kristopher P

    2009-01-01

    The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs.

  15. Characteristics of medical teachers using student-centered teaching methods.

    Science.gov (United States)

    Kim, Kyong-Jee; Hwang, Jee-Young

    2017-09-01

    This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

  16. NASA Space Weather Center Services: Potential for Space Weather Research

    Science.gov (United States)

    Zheng, Yihua; Kuznetsova, Masha; Pulkkinen, Antti; Taktakishvili, A.; Mays, M. L.; Chulaki, A.; Lee, H.; Hesse, M.

    2012-01-01

    The NASA Space Weather Center's primary objective is to provide the latest space weather information and forecasting for NASA's robotic missions and its partners and to bring space weather knowledge to the public. At the same time, the tools and services it possesses can be invaluable for research purposes. Here we show how our archive and real-time modeling of space weather events can aid research in a variety of ways, with different classification criteria. We will list and discuss major CME events, major geomagnetic storms, and major SEP events that occurred during the years 2010 - 2012. Highlights of major tools/resources will be provided.

  17. Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach.

    Science.gov (United States)

    Wang, Su-Chen; Tsai, Chi-Cheng; Huang, Shun-Te; Hong, Yu-Jue

    2002-12-01

    Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in private medical centers was more appropriate than those in public medical centers. In the sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.

  18. [Scientific and research experimentation center of aviation and space medicine and human engineeing celebrates 80th anniversary].

    Science.gov (United States)

    Zhdanko, I M; Vorona, A A; Lapa, V V; Khomenko, M N

    2015-03-01

    The article is devoted to the history of the Research Test Center Aviation and Space Medicine and military ergonomics, now included in the Central Research Institute of the Air Force Defense Ministry. The center throughout 80 years history is a leding research organization in the country for the integrated study of the human factor in aviation and problems connected with it. The world-famous scientific schools in aviation physiology, hygiene and radiolorgy, emergency medicine, aviation psychology and ergonomics have been grounded on the basis of this center. With a high qualified scientific staff and laboratory-and-bench-scale base including unique seminatural airplanes and helicopters complexes, posters and installation simulating the impact of flight factors (centrifuge, hyperbaric chambers, shakenr vestibulyar-WIDE stands, etc.) the center has. successfully slved tasks concerning an improvement of flight crews protection from occupational hazards, ergonomic demands to capabilities of aircraft, professional and psycho-physiological training. Automatic systems of medical decision-making on assessment of the health status in the medical-flight expertise and dynamic medical supervision, planning, treatment and preventive and remedial actions aircrew training are currently 'being developed

  19. Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

    Science.gov (United States)

    Barsten, Kristina; Hurst, Victor, IV; Scheuring, Richard; Baumann, David K.; Johnson-Throop, Kathy

    2010-01-01

    Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

  20. Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

    Science.gov (United States)

    Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

    2017-08-01

    The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

  1. Space The New Medical Frontier / NASA Spinoffs Milestones in Space Research

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Space The New Medical Frontier Past Issues / Fall 2007 ... the occasion. Photo courtesy of NIH Long-Term Space Research Until the advent of the ISS, research ...

  2. Academic medical center libraries on the Web.

    Science.gov (United States)

    Tannery, N H; Wessel, C B

    1998-10-01

    Academic medical center libraries are moving towards publishing electronically, utilizing networked technologies, and creating digital libraries. The catalyst for this movement has been the Web. An analysis of academic medical center library Web pages was undertaken to assess the information created and communicated in early 1997. A summary of present uses and suggestions for future applications is provided. A method for evaluating and describing the content of library Web sites was designed. The evaluation included categorizing basic information such as description and access to library services, access to commercial databases, and use of interactive forms. The main goal of the evaluation was to assess original resources produced by these libraries.

  3. Comprehensive report of aeropropulsion, space propulsion, space power, and space science applications of the Lewis Research Center

    Science.gov (United States)

    1988-01-01

    The research activities of the Lewis Research Center for 1988 are summarized. The projects included are within basic and applied technical disciplines essential to aeropropulsion, space propulsion, space power, and space science/applications. These disciplines are materials science and technology, structural mechanics, life prediction, internal computational fluid mechanics, heat transfer, instruments and controls, and space electronics.

  4. St. Luke's Medical Center: technologizing health care

    International Nuclear Information System (INIS)

    Tumanguil, S.S.

    1994-01-01

    The computerization of the St. Luke's Medical Center improved the hospital administration and management, particularly in nuclear medicine department. The use of computer-aided X-ray simulator machine and computerized linear accelerator machine in diagnosing and treating cancer are the most recent medical technological breakthroughs that benefited thousands of Filipino cancer patients. 4 photos

  5. NASA GSFC Space Weather Center - Innovative Space Weather Dissemination: Web-Interfaces, Mobile Applications, and More

    Science.gov (United States)

    Maddox, Marlo; Zheng, Yihua; Rastaetter, Lutz; Taktakishvili, A.; Mays, M. L.; Kuznetsova, M.; Lee, Hyesook; Chulaki, Anna; Hesse, Michael; Mullinix, Richard; hide

    2012-01-01

    The NASA GSFC Space Weather Center (http://swc.gsfc.nasa.gov) is committed to providing forecasts, alerts, research, and educational support to address NASA's space weather needs - in addition to the needs of the general space weather community. We provide a host of services including spacecraft anomaly resolution, historical impact analysis, real-time monitoring and forecasting, custom space weather alerts and products, weekly summaries and reports, and most recently - video casts. There are many challenges in providing accurate descriptions of past, present, and expected space weather events - and the Space Weather Center at NASA GSFC employs several innovative solutions to provide access to a comprehensive collection of both observational data, as well as space weather model/simulation data. We'll describe the challenges we've faced with managing hundreds of data streams, running models in real-time, data storage, and data dissemination. We'll also highlight several systems and tools that are utilized by the Space Weather Center in our daily operations, all of which are available to the general community as well. These systems and services include a web-based application called the Integrated Space Weather Analysis System (iSWA http://iswa.gsfc.nasa.gov), two mobile space weather applications for both IOS and Android devices, an external API for web-service style access to data, google earth compatible data products, and a downloadable client-based visualization tool.

  6. Patient Workload Profile: National Naval Medical Center (NNMC), Bethesda, MD.

    Science.gov (United States)

    1980-06-01

    AD-A09a 729 WESTEC SERVICES NC SAN DIEGOCA0S / PATIENT WORKLOAD PROFILE: NATIONAL NAVAL MEDICAL CENTER NNMC),- ETC(U) JUN 80 W T RASMUSSEN, H W...provides site workload data for the National Naval Medical Center (NNMC) within the following functional support areas: Patient Appointment...on managing medical and patient data, thereby offering the health care provider and administrator more powerful capabilities in dealing with and

  7. Defining the medical imaging requirements for a rural health center

    CERN Document Server

    2017-01-01

    This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....

  8. Medical Optimization Network for Space Telemedicine Resources

    Science.gov (United States)

    Shah, R. V.; Mulcahy, R.; Rubin, D.; Antonsen, E. L.; Kerstman, E. L.; Reyes, D.

    2017-01-01

    INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. NASA recognizes the need to improve capabilities for autonomous care on such missions. As the medical system is developed, it is important to have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources was developed for this reason, and is now a system to gauge the relative importance of medical resources in addressing medical conditions. METHODS: A list of medical conditions of potential concern for an exploration mission was referenced from the Integrated Medical Model, a probabilistic model designed to quantify in-flight medical risk. The diagnostic and treatment modalities required to address best and worst-case scenarios of each medical condition, at the terrestrial standard of care, were entered into a database. This list included tangible assets (e.g. medications) and intangible assets (e.g. clinical skills to perform a procedure). A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program ranked each of the items listed according to its criticality. Data was then obtained from the IMM for the probability of occurrence of the medical conditions, including a breakdown of best case and worst case, during a Mars reference mission. The probability of occurrence information and criticality for each resource were taken into account during analytics performed using Tableau software. RESULTS: A database and weighting system to evaluate all the diagnostic and treatment modalities was created by combining the probability of condition occurrence data with the criticalities assigned by the physician team. DISCUSSION: Exploration Medical Capabilities research at NASA is focused on providing a medical system to

  9. Stennis Space Center celebrates Native American culture

    Science.gov (United States)

    2009-01-01

    Famie Willis (left), 2009-2010 Choctaw Indian Princess, displays artifacts during Native American Heritage Month activities at Stennis Space Center on Nov. 24. The celebration featured various Native American cultural displays for Stennis employees to view. Shown above are (l to r): Willis, Elaine Couchman of NASA Shared Services Center, John Cecconi of NSSC and Lakeisha Robertson of the Environmental Protection Agency.

  10. In-Space Manufacturing at NASA Marshall Space Flight Center: Enabling Technologies for Exploration

    Science.gov (United States)

    Bean, Quincy; Johnston, Mallory; Ordonez, Erick; Ryan, Rick; Prater, Tracie; Werkeiser, Niki

    2015-01-01

    NASA Marshall Space Flight Center is currently engaged in a number of in-space manufacturing(ISM)activities that have the potential to reduce launch costs, enhance crew safety, and provide the capabilities needed to undertake long duration spaceflight safely and sustainably.

  11. Assessing the Academic Medical Center as a Supportive Learning Community

    Science.gov (United States)

    Gannon, Sam C.

    2011-01-01

    Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…

  12. ["AGAINST ALL ODDS" - PROMOTING RESEARCH, CLINICAL DEVELOPMENT AND MEDICAL SERVICES OF THE CONFLICT IN THE GALILEE MEDICAL CENTER].

    Science.gov (United States)

    Bornstein, Jacob

    2017-05-01

    The Galilee Medical Center (GMC) is unique in several aspects. Firstly, in the clinical aspect: In recent years, led by the Director of Medical Center, Dr. Masad Barhoum, a considerable momentum of development has taken place to reduce health discrepancies between the center and the periphery. Despite the under- financing of the health system in the Galilee, the GMC opened new clinical departments, introduced advanced medical technology and key staff members were added. This approach is depicted in publications presented in the current issue. Secondly, the aspect of medicine standoff: The GMC is the nearest hospital to the border with neighboring countries. It is also a tertiary center for trauma, due to the establishment of the Department of Neurosurgery, Department of Oral and Maxillofacial Surgery and the Departments of Orthopedic Surgery, general invasive radiology and invasive radiology of the brain. In recent years, the medical center treated hundreds of victims of the civil war in Syria, a third of them - women and children. The injured patients presented unique medical problems that are described in the papers in this issue. Thirdly, the research aspect: The medical center is the main teaching facility of medical students of the Faculty of Medicine in the Galilee of Bar-Ilan University. The Faculty of Medicine, led by the Dean, Prof. Ran Tur-Kaspa, promotes research and teaching in the medical center. Even before the establishment of the Faculty of Medicine, former hospital director, Prof. Shaul Shasha, not only extolled the importance of research, but established a research laboratory years ago. The laboratory continues to pursue translational research by the physicians of the medical center, led by Dr. Shifra Sela and Prof. Batya Kristal, and supported by the current medical center director, Dr. Masad Barhoum. Several studies conducted in this research laboratory are published herewith. With these unique aspects and despite the discrimination in funding

  13. Drug Information in Space Medicine

    Science.gov (United States)

    Bayuse, Tina M.

    2009-01-01

    Published drug information is widely available for terrestrial conditions. However, information on dosing, administration, drug interactions, stability, and side effects is scant as it relates to use in Space Medicine. Multinational crews on board the International Space Station present additional challenges for drug information because medication nomenclature, information available for the drug as well as the intended use for the drug is not standard across countries. This presentation will look at unique needs for drug information and how the information is managed in Space Medicine. A review was conducted of the drug information requests submitted to the Johnson Space Center Pharmacy by Space Medicine practitioners, astronaut crewmembers and researchers. The information requested was defined and cataloged. A list of references used was maintained. The wide range of information was identified. Due to the information needs for the medications in the on-board medical kits, the Drug Monograph Project was created. A standard method for answering specific drug information questions was generated and maintained by the Johnson Space Center Pharmacy. The Drug Monograph Project will be presented. Topic-centered requests, including multinational drug information, drug-induced adverse reactions, and medication events due to the environment will be highlighted. Information management of the drug information will be explained. Future considerations for drug information needs will be outlined.

  14. Business Plan: The Virginia Space Flight Center

    Science.gov (United States)

    Reed, Billie M.

    1997-01-01

    The Virginia Commercial Space Flight Authority (VCSFA) was established on July 1, 1995 and codified at Sections 9-266.1 et seq., Code of Virginia. It is governed by an eleven person Board of Directors representing industry, state and local government and academia. VCSFA has designated the Center for Commercial Space Infrastructure as its Executive Directorate and Operating Agent. This Business Plan has been developed to provide information to prospective customers, prospective investors, state and federal government agencies, the VCSFA Board and other interested parties regarding development and operation of the Virginia Space Flight Center (VSFC) at Wallops Island. The VSFC is an initiative sponsored by VCSFA to achieve its stated objectives in the areas of economic development and education. Further, development of the VSFC is in keeping with the state's economic goals set forth in Opportunity Virginia, the strategic plan for jobs and prosperity, which are to: (1) Strengthen the rapidly growing aerospace industry in space based services including launch services, remote sensing, satellite manufacturing and telecommunications; and (2) Capitalize on intellectual and technical resources throughout the state and become a leader in the development of advanced technology businesses.

  15. The Alabama Space and Rocket Center: The Second Decade.

    Science.gov (United States)

    Buckbee, Edward O.

    1983-01-01

    The Alabama Space and Rocket Center in Huntsville, the world's largest rocket and space museum, includes displays illustrating American rocket history, exhibits and demonstrations on rocketry principles and experiences, and simulations of space travel. A new project includes an integrated recreational-educational complex, described in the three…

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

    Science.gov (United States)

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

    2009-01-01

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

  17. Patient-centered medical home model: do school-based health centers fit the model?

    Science.gov (United States)

    Larson, Satu A; Chapman, Susan A

    2013-01-01

    School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.

  18. [Patient-centered care. Improvement of communication between university medical centers and general practitioners for patients in neuro-oncology].

    Science.gov (United States)

    Renovanz, M; Keric, N; Richter, C; Gutenberg, A; Giese, A

    2015-12-01

    Communication between university medical centers and general practitioners (GP) is becoming increasingly more important in supportive patient care. A survey among GPs was performed with the primary objective to assess their opinion on current workflow and communication between GPs and the university medical center. The GPs were asked to score (grades 1-6) their opinion on the current interdisciplinary workflow in the care of patients with brain tumors, thereby rating communication between a university medical center in general and the neuro-oncology outpatient center in particular. Questionnaires were sent to1000 GPs and the response rate was 15 %. The mean scored evaluation of the university medical center in general was 2.62 and of the neuro-oncological outpatient clinic 2.28 (range 1-6). The most often mentioned issues to be improved were easier/early telephone information (44 %) and a constantly available contact person (49 %). Interestingly, > 60 % of the GPs indicated they would support web-based tumor boards for interdisciplinary and palliative neuro-oncological care. As interdisciplinary care for neuro-oncology patients is an essential part of therapy, improvement of communication between GPs and university medical centers is indispensable. Integrating currently available electronic platforms under data protection aspects into neuro-oncological palliative care could be an interesting tool in order to establish healthcare networks and could find acceptance with GPs.

  19. Supply chain optimization at an academic medical center.

    Science.gov (United States)

    Labuhn, Jonathan; Almeter, Philip; McLaughlin, Christopher; Fields, Philip; Turner, Benjamin

    2017-08-01

    A successful supply chain optimization project that leveraged technology, engineering principles, and a technician workflow redesign in the setting of a growing health system is described. With continued rises in medication costs, medication inventory management is increasingly important. Proper management of central pharmacy inventory and floor-stock inventory in automated dispensing cabinets (ADCs) can be challenging. In an effort to improve control of inventory costs in the central pharmacy of a large academic medical center, the pharmacy department implemented a supply chain optimization project in collaboration with the medical center's inhouse team of experts on process improvement and industrial engineering. The project had 2 main components: (1) upgrading and reconfiguring carousel technology within an expanded central pharmacy footprint to generate accurate floor-stock inventory replenishment reports, which resulted in efficiencies within the medication-use system, and (2) implementing a technician workflow redesign and algorithm to right-size the ADC inventory, which decreased inventory stockouts (i.e., incidents of depletion of medication stock) and improved ADC user satisfaction. Through a multifaceted approach to inventory management, the number of stockouts per month was decreased and ADC inventory was optimized, resulting in a one-time inventory cost savings of $220,500. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. Moral dilemmas faced by hospitals in time of war: the Rambam Medical Center during the second Lebanon war.

    Science.gov (United States)

    Bar-El, Yaron; Reisner, Shimon; Beyar, Rafael

    2014-02-01

    Rambam Medical Center, the only tertiary care center and largest hospital in northern Israel, was subjected to continuous rocket attacks in 2006. This extreme situation posed serious and unprecedented ethical dilemmas to the hospital management. An ambiguous situation arose that required routine patient care in a tertiary modern hospital together with implementation of emergency measures while under direct fire. The physicians responsible for hospital management at that time share some of the moral dilemmas faced, the policy they chose to follow, and offer a retrospective critical reflection in this paper. The hospital's first priority was defined as delivery of emergency surgical and medical services to the wounded from the battlefields and home front, while concomitantly providing the civilian population with all elective medical and surgical services. The need for acute medical service was even more apparent as the situation of conflict led to closure of many ambulatory clinics, while urgent or planned medical care such as open heart surgery and chemotherapy continued. The hospital management took actions to minimize risks to patients, staff, and visitors during the ongoing attacks. Wards were relocated to unused underground spaces and corridors. However due to the shortage of shielded spaces, not all wards and patients could be relocated to safer areas. Modern warfare will most likely continue to involve civilian populations and institutes, blurring the division between peaceful high-tech medicine and the rough battlefront. Hospitals in high war-risk areas must be prepared to function and deliver treatment while under fire or facing similar threats.

  1. Kodak Mirror Assembly Tested at Marshall Space Flight Center

    Science.gov (United States)

    2003-01-01

    This photo (a frontal view) is of one of many segments of the Eastman-Kodak mirror assembly being tested for the James Webb Space Telescope (JWST) project at the X-Ray Calibration Facility at Marshall Space Flight Center (MSFC). MSFC is supporting Goddard Space Flight Center (GSFC) in developing the JWST by taking numerous measurements to predict its future performance. The tests are conducted in a vacuum chamber cooled to approximate the super cold temperatures found in space. During its 27 years of operation, the facility has performed testing in support of a wide array of projects, including the Hubble Space Telescope (HST), Solar A, Chandra technology development, Chandra High Resolution Mirror Assembly and science instruments, Constellation X-Ray Mission, and Solar X-Ray Imager, currently operating on a Geostationary Operational Environment Satellite. The JWST is NASA's next generation space telescope, a successor to the Hubble Space Telescope, named in honor of NASA's second administrator, James E. Webb. It is scheduled for launch in 2010 aboard an expendable launch vehicle. It will take about 3 months for the spacecraft to reach its destination, an orbit of 940,000 miles in space.

  2. Walt Disney visited Marshall Space Flight Center (MSFC)

    Science.gov (United States)

    1965-01-01

    Walt Disney toured the West Test Area during his visit to the Marshall Space Flight Center on April 13, 1965. The three in center foreground are Karl Heimburg, Director, Test Division; Dr. von Braun, Director, MSFC; and Walt Disney. The Dynamic Test Stand with the S-1C stage being installed is in the background.

  3. Connecticut Children's Medical Center multi-year branding campaign.

    Science.gov (United States)

    Botvin, J

    2000-01-01

    As the only children's hospital in the state, Connecticut Children's Medical Center was challenged by the inherent complacency of parents. It met the challenge through a multi-level marketing effort which included television and radio, community outreach and strong media relations. By emphasizing the unique nature of children, the campaign affirms the need for a specialized children's health center.

  4. Space and Missile Systems Center Standard: Systems Engineering Requirements and Products

    Science.gov (United States)

    2013-07-01

    MISSILE SYSTEMS CENTER Air Force Space Command 483 N. Aviation Blvd. El Segundo, CA 90245 4. This standard has been approved for use on all Space...Any RF receiver with a burnout level of less than 30 dBm (1 mW). b. A summary of all significant areas are addressed in the EMC Control Plan...address 7. Date Submitted 8. Preparing Activity Space and Missile Systems Center AIR FORCE SPACE COMMAND 483 N. Aviation Blvd. El Segundo, CA 91245 Attention: SMC/EN February 2013

  5. Medical Practice Makes Perfect

    Science.gov (United States)

    1998-01-01

    Cedaron Medical Inc., was founded in 1990 as a result of a NASA SBIR (Small Business Innovative Research) grant from Johnson Space Center to develop a Hand Testing and Exercise Unit for use in space. From that research came Dexter, a comprehensive workstation that creates a paperless environment for medical data management.

  6. Advanced Life Support Project: Crop Experiments at Kennedy Space Center

    Science.gov (United States)

    Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil

    2004-01-01

    Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and

  7. Wooden Spaceships: Human-Centered Vehicle Design for Space

    Science.gov (United States)

    Twyford, Evan

    2009-01-01

    Presentation will focus on creative human centered design solutions in relation to manned space vehicle design and development in the NASA culture. We will talk about design process, iterative prototyping, mockup building and user testing and evaluation. We will take an inside look at how new space vehicle concepts are developed and designed for real life exploration scenarios.

  8. MCNP6 simulation of reactions of interest to FRIB, medical, and space applications

    International Nuclear Information System (INIS)

    Mashnik, Stepan G.

    2015-01-01

    The latest production-version of the Los Alamos Monte Carlo N-Particle transport code MCNP6 has been used to simulate a variety of particle-nucleus and nucleus-nucleus reactions of academic and applied interest to research subjects at the Facility for Rare Isotope Beams (FRIB), medical isotope production, space-radiation shielding, cosmic-ray propagation, and accelerator applications, including several reactions induced by radioactive isotopes, analyzing production of both stable and radioactive residual nuclei. Here, we discuss examples of validation and verification of MCNP6 by comparing with recent neutron spectra measured at the Heavy Ion Medical Accelerator in Chiba, Japan; spectra of light fragments from several reactions measured recently at GANIL, France; INFN Laboratori Nazionali del Sud, Catania, Italy; COSY of the Jülich Research Center, Germany; and cross sections of products from several reactions measured lately at GSI, Darmstadt, Germany; ITEP, Moscow, Russia; and, LANSCE, LANL, Los Alamos, U.S.A. As a rule, MCNP6 provides quite good predictions for most of the reactions we analyzed so far, allowing us to conclude that it can be used as a reliable and useful simulation tool for various applications for FRIB, medical, and space applications involving stable and radioactive isotopes. (author)

  9. Discovery: Under the Microscope at Kennedy Space Center

    Science.gov (United States)

    Howard, Philip M.

    2013-01-01

    The National Aeronautics & Space Administration (NASA) is known for discovery, exploration, and advancement of knowledge. Since the days of Leeuwenhoek, microscopy has been at the forefront of discovery and knowledge. No truer is that statement than today at Kennedy Space Center (KSC), where microscopy plays a major role in contamination identification and is an integral part of failure analysis. Space exploration involves flight hardware undergoing rigorous "visually clean" inspections at every step of processing. The unknown contaminants that are discovered on these inspections can directly impact the mission by decreasing performance of sensors and scientific detectors on spacecraft and satellites, acting as micrometeorites, damaging critical sealing surfaces, and causing hazards to the crew of manned missions. This talk will discuss how microscopy has played a major role in all aspects of space port operations at KSC. Case studies will highlight years of analysis at the Materials Science Division including facility and payload contamination for the Navigation Signal Timing and Ranging Global Positioning Satellites (NA VST AR GPS) missions, quality control monitoring of monomethyl hydrazine fuel procurement for launch vehicle operations, Shuttle Solids Rocket Booster (SRB) foam processing failure analysis, and Space Shuttle Main Engine Cut-off (ECO) flight sensor anomaly analysis. What I hope to share with my fellow microscopists is some of the excitement of microscopy and how its discoveries has led to hardware processing, that has helped enable the successful launch of vehicles and space flight missions here at Kennedy Space Center.

  10. Experts warn against cutting NOAA Space Weather Center

    Science.gov (United States)

    Showstack, Randy

    A well-timed congressional hearing, coming in the midst of fierce geomagnetic storms, could help to restore funding to the U.S. National Oceanic and Atmospheric Administration's Space Environment Center (SEC).The center, which is the nation's official source of space weather alerts and warnings, currently is funded at $5.24 million for fiscal year 2003. That amount is $2 million less than it received the previous year. The Bush Administration has requested $8.02 million in funding. The appropriations bill, for the departments of Commerce, Justice, and State for fiscal year 2004, passed on 23 July by the House of Representatives, calls for funding the SEC at the $5.29 million level.

  11. Patient-Centered Tools for Medication Information Search.

    Science.gov (United States)

    Wilcox, Lauren; Feiner, Steven; Elhadad, Noémie; Vawdrey, David; Tran, Tran H

    2014-05-20

    Recent research focused on online health information seeking highlights a heavy reliance on general-purpose search engines. However, current general-purpose search interfaces do not necessarily provide adequate support for non-experts in identifying suitable sources of health information. Popular search engines have recently introduced search tools in their user interfaces for a range of topics. In this work, we explore how such tools can support non-expert, patient-centered health information search. Scoping the current work to medication-related search, we report on findings from a formative study focused on the design of patient-centered, medication-information search tools. Our study included qualitative interviews with patients, family members, and domain experts, as well as observations of their use of Remedy, a technology probe embodying a set of search tools. Post-operative cardiothoracic surgery patients and their visiting family members used the tools to find information about their hospital medications and were interviewed before and after their use. Domain experts conducted similar search tasks and provided qualitative feedback on their preferences and recommendations for designing these tools. Findings from our study suggest the importance of four valuation principles underlying our tools: credibility, readability, consumer perspective, and topical relevance.

  12. Space Operations Learning Center

    Science.gov (United States)

    Lui, Ben; Milner, Barbara; Binebrink, Dan; Kuok, Heng

    2012-01-01

    The Space Operations Learning Center (SOLC) is a tool that provides an online learning environment where students can learn science, technology, engineering, and mathematics (STEM) through a series of training modules. SOLC is also an effective media for NASA to showcase its contributions to the general public. SOLC is a Web-based environment with a learning platform for students to understand STEM through interactive modules in various engineering topics. SOLC is unique in its approach to develop learning materials to teach schoolaged students the basic concepts of space operations. SOLC utilizes the latest Web and software technologies to present this educational content in a fun and engaging way for all grade levels. SOLC uses animations, streaming video, cartoon characters, audio narration, interactive games and more to deliver educational concepts. The Web portal organizes all of these training modules in an easily accessible way for visitors worldwide. SOLC provides multiple training modules on various topics. At the time of this reporting, seven modules have been developed: Space Communication, Flight Dynamics, Information Processing, Mission Operations, Kids Zone 1, Kids Zone 2, and Save The Forest. For the first four modules, each contains three components: Flight Training, Flight License, and Fly It! Kids Zone 1 and 2 include a number of educational videos and games designed specifically for grades K-6. Save The Forest is a space operations mission with four simulations and activities to complete, optimized for new touch screen technology. The Kids Zone 1 module has recently been ported to Facebook to attract wider audience.

  13. Strategic Project Management at the NASA Kennedy Space Center

    Science.gov (United States)

    Lavelle, Jerome P.

    2000-01-01

    This paper describes Project Management at NASA's Kennedy Space Center (KSC) from a strategic perspective. It develops the historical context of the agency and center's strategic planning process and illustrates how now is the time for KSC to become a center which has excellence in project management. The author describes project management activities at the center and details observations on those efforts. Finally the author describes the Strategic Project Management Process Model as a conceptual model which could assist KSC in defining an appropriate project management process system at the center.

  14. Repurposing With Purpose: Creating a Collaborative Learning Space to Support Institutional Interprofessional Initiatives.

    Science.gov (United States)

    Young, Lauren M; Machado, Connie K; Clark, Susan B

    2015-01-01

    When the University of Mississippi Medical Center embraced a didactic shift to patient-centered, interprofessional education of its medical, dental, nursing, pharmacy, and allied health students, the Rowland Medical Library repurposed space to support the cause and created a collaborative learning space designated for campus-wide utility.

  15. Medical impact analysis for the space station.

    Science.gov (United States)

    Nelson, B D; Gardner, R M; Ostler, D V; Schulz, J M; Logan, J S

    1990-02-01

    Since the Space Station Health Maintenance Facility can house only a relatively limited quantity of supplies and equipment, the decisions about what should be included must be based on documented research. In this study, Space Station medical care priorities were determined by a medical impact analysis of two analog populations, U.S. Army and U.S. Navy personnel. Diseases and injuries in the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) were ranked, using a Medical Impact Score (MIS) combining modified incidence rate and a function of disease outcome. The validity of the analysis method was tested by measuring rank order correlation between the two analog populations. Despite virtually identical age and sex distributions, Army and Navy incidence rates differed significantly for half of the ICD-9-CM categories, p less than 0.05. Disability rates differed for 76%, p less than 0.05. Nevertheless, Army and Navy MIS rank orders for categories and sections were not significantly different, p less than 0.001. In critical ways, the Space Station will be a safer environment than Earth. Cardiac events, musculoskeletal injuries, affective psychoses, and renal calculi were among the highest scoring categories.

  16. System security in the space flight operations center

    Science.gov (United States)

    Wagner, David A.

    1988-01-01

    The Space Flight Operations Center is a networked system of workstation-class computers that will provide ground support for NASA's next generation of deep-space missions. The author recounts the development of the SFOC system security policy and discusses the various management and technology issues involved. Particular attention is given to risk assessment, security plan development, security implications of design requirements, automatic safeguards, and procedural safeguards.

  17. Center for Advanced Space Propulsion Second Annual Technical Symposium Proceedings

    Science.gov (United States)

    1990-01-01

    The proceedings for the Center for Advanced Space Propulsion Second Annual Technical Symposium are divided as follows: Chemical Propulsion, CFD; Space Propulsion; Electric Propulsion; Artificial Intelligence; Low-G Fluid Management; and Rocket Engine Materials.

  18. Kennedy Space Center environmental health program

    International Nuclear Information System (INIS)

    Marmaro, G.M.; Cardinale, M.A.; Summerfield, B.R.; Tipton, D.A.

    1992-01-01

    The Kennedy Space Center's environmental health organization is responsible for programs which assure its employees a healthful workplace under diverse and varied working conditions. These programs encompass the disciplines of industrial hygiene, radiation protection (health physics), and environmental sanitation/pollution control. Activities range from the routine, such as normal office work, to the highly specialized, such as the processing of highly toxic and hazardous materials

  19. Die Ärztliche Zentralbibliothek des Universitätsklinikums Hamburg-Eppendorf / The Medical Library of the University Medical Center Hamburg-Eppendorf

    Directory of Open Access Journals (Sweden)

    Kintzel, Melanie

    2009-12-01

    Full Text Available This article introduces the Medical Library of the University Medical Center Hamburg-Eppendorf. Firstly, history, role and status of the library within the University Medical Center are illustrated, followed by a description of the library’s facilities and services. Finally, recent projects are presented as well as a selection of key figures.

  20. Marketing the academic medical center group practice.

    Science.gov (United States)

    Eudes, J A; Divis, K L

    1992-01-01

    From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

  1. Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home

    Science.gov (United States)

    2011-01-01

    Redesign, and Team Solutions to Achieve the Patient Centered Medical Home LTC Nicole Kerkenbush, MHA, MN Army Medical Department, Office of the...TITLE AND SUBTITLE Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home 5a. CONTRACT...Describe how these tools are being used to implement the Patient Centered Medical Home care model 2 2011 MHS Conference MEDCOM AHLTA Provider Satisfaction

  2. Example of Occupational Surveillance in a Telemedicine Setting: Application of Epidemiologic Methods at NASA Johnson Space Center

    Science.gov (United States)

    Babiak-Vazquez, Adriana; Ruffaner, Lanie M.; Wear, Mary L.; Crucian, Brian; Sams, Clarence; Lee, Lesley R.; Van Baalen, Mary

    2016-01-01

    In 2010, NASA implemented Lifetime Surveillance of Astronaut Health, a formal occupational surveillance program for the U.S. astronaut corps. Because of the nature of the space environment, space medicine presents unique challenges and opportunities for epidemiologists. One such example is the use of telemedicine while crewmembers are in flight, where the primary source of information about crew health is verbal communication between physicians and their crewmembers. Due to restricted medical capabilities, the available health information is primarily crewmember report of signs and symptoms, rather than diagnoses. As epidemiologists at NASA, Johnson Space Center, we have shifted our paradigm from tracking diagnoses based on traditional terrestrial clinical practice to one in which we also incorporate reported symptomology as potential antecedents of disease. In this presentation we describe how characterization of reported signs and symptoms can be used to establish incidence rates for inflight immunologic events. We describe interdisciplinary data sources of information that are used in combination with medical information to analyze the data. We also delineate criteria for symptom classification inclusion. Finally, we present incidence tables and graphs to illustrate the final outcomes. Using signs and symptoms reported via telemedicine, the epidemiologists provide summary evidence regarding incidence of potential inflight medical conditions. These results inform our NASA physicians and scientists, and support evaluation of the occupational health risks associated with spaceflight.

  3. Research and Technology at the John F. Kennedy Space Center 1993

    Science.gov (United States)

    1993-01-01

    As the NASA Center responsible for assembly, checkout, servicing, launch, recovery, and operational support of Space Transportation System elements and payloads, the John F. Kennedy Space Center is placing increasing emphasis on its advanced technology development program. This program encompasses the efforts of the Engineering Development Directorate laboratories, most of the KSC operations contractors, academia, and selected commercial industries - all working in a team effort within their own areas of expertise. This edition of the Kennedy Space Center Research and Technology 1993 Annual Report covers efforts of all these contributors to the KSC advanced technology development program, as well as our technology transfer activities. Major areas of research include material science, advanced software, industrial engineering, nondestructive evaluation, life sciences, atmospheric sciences, environmental technology, robotics, and electronics and instrumentation.

  4. An Analysis of Medication Errors at the Military Medical Center: Implications for a Systems Approach for Error Reduction

    National Research Council Canada - National Science Library

    Scheirman, Katherine

    2001-01-01

    An analysis was accomplished of all inpatient medication errors at a military academic medical center during the year 2000, based on the causes of medication errors as described by current research in the field...

  5. Kennedy Space Center Five Year Sustainability Plan

    Science.gov (United States)

    Williams, Ann T.

    2016-01-01

    The Federal Government is committed to following sustainable principles. At its heart, sustainability integrates environmental, societal and economic solutions for present needs without compromising the ability of future generations to meet their needs. Building upon its pledge towards environmental stewardship, the Administration generated a vision of sustainability spanning ten goals mandated within Executive Order (EO) 13693, Planning for Federal Sustainability in the Next Decade. In November 2015, the National Aeronautics and Space Administration (NASA) responded to this EO by incorporating it into a new release of the NASA Strategic Sustainability Performance Plan (SSPP). The SSPP recognizes the importance of aligning environmental practices in a manner that preserves, enhances and strengthens NASA's ability to perform its mission indefinitely. The Kennedy Space Center (KSC) is following suit with KSC's Sustainability Plan (SP) by promoting, maintaining and pioneering green practices in all aspects of our mission. KSC's SP recognizes that the best sustainable solutions use an interdisciplinary, collaborative approach spanning civil servant and contractor personnel from across the Center. This approach relies on the participation of all employees to develop and implement sustainability endeavors connected with the following ten goals: Reduce greenhouse gas (GHG) emissions. Design, build and maintain sustainable buildings, facilities and infrastructure. Leverage clean and renewable energy. Increase water conservation. Improve fleet and vehicle efficiency and management. Purchase sustainable products and services. Minimize waste and prevent pollution. Implement performance contracts for Federal buildings. Manage electronic equipment and data centers responsibly. Pursue climate change resilience. The KSC SP details the strategies and actions that address the following objectives: Reduce Center costs. center dot Increase energy and water efficiencies. Promote smart

  6. National Space Transportation System telemetry distribution and processing, NASA-JFK Space Center/Cape Canaveral

    Science.gov (United States)

    Jenkins, George

    1986-01-01

    Prelaunch, launch, mission, and landing distribution of RF and hardline uplink/downlink information between Space Shuttle Orbiter/cargo elements, tracking antennas, and control centers at JSC, KSC, MSFC, GSFC, ESMC/RCC, and Sunnyvale are presented as functional block diagrams. Typical mismatch problems encountered during spacecraft-to-project control center telemetry transmissions are listed along with new items for future support enhancement.

  7. Supporting Multiple Programs and Projects at NASA's Kennedy Space Center

    Science.gov (United States)

    Stewart, Camiren L.

    2014-01-01

    With the conclusion of the shuttle program in 2011, the National Aeronautics and Space Administration (NASA) had found itself at a crossroads for finding transportation of United States astronauts and experiments to space. The agency would eventually hand off the taxiing of American astronauts to the International Space Station (ISS) that orbits in Low Earth Orbit (LEO) about 210 miles above the earth under the requirements of the Commercial Crew Program (CCP). By privatizing the round trip journey from Earth to the ISS, the space agency has been given the additional time to focus funding and resources to projects that operate beyond LEO; however, adding even more stress to the agency, the premature cancellation of the program that would succeed the Shuttle Program - The Constellation Program (CxP) -it would inevitably delay the goal to travel beyond LEO for a number of years. Enter the Space Launch System (SLS) and the Orion Multipurpose Crew Vehicle (MPCV). Currently, the SLS is under development at NASA's Marshall Spaceflight Center in Huntsville, Alabama, while the Orion Capsule, built by government contractor Lockheed Martin Corporation, has been assembled and is currently under testing at the Kennedy Space Center (KSC) in Florida. In its current vision, SLS will take Orion and its crew to an asteroid that had been captured in an earlier mission in lunar orbit. Additionally, this vehicle and its configuration is NASA's transportation to Mars. Engineers at the Kennedy Space Center are currently working to test the ground systems that will facilitate the launch of Orion and the SLS within its Ground Services Development and Operations (GSDO) Program. Firing Room 1 in the Launch Control Center (LCC) has been refurbished and outfitted to support the SLS Program. In addition, the Spaceport Command and Control System (SCCS) is the underlying control system for monitoring and launching manned launch vehicles. As NASA finds itself at a junction, so does all of its

  8. New Cryogenic Optical Test Capability at Marshall Space Flight Center's Space Optics Manufacturing Technology Center

    Science.gov (United States)

    Kegley, Jeff; Burdine, Robert V. (Technical Monitor)

    2002-01-01

    A new cryogenic optical testing capability exists at Marshall Space Flight Center's Space Optics Manufacturing Technology Center (SOMTC). SOMTC has been performing optical wavefront testing at cryogenic temperatures since 1999 in the X-ray Cryogenic Test Facility's (XRCF's) large vacuum chamber. Recently the cryogenic optical testing capability has been extended to a smaller vacuum chamber. This smaller horizontal cylindrical vacuum chamber has been outfitted with a helium-cooled liner that can be connected to the facility's helium refrigeration system bringing the existing kilowatt of refrigeration capacity to bear on a 1 meter diameter x 2 meter long test envelope. Cryogenic environments to less than 20 Kelvin are now possible in only a few hours. SOMTC's existing instruments (the Instantaneous Phase-shifting Interferometer (IPI) from ADE Phase-Shift Technologies and the PhaseCam from 4D Vision Technologies) view the optic under test through a 150 mm clear aperture BK-7 window. Since activation and chamber characterization tests in September 2001, the new chamber has been used to perform a cryogenic (less than 30 Kelvin) optical test of a 22.5 cm diameter x 127 cm radius of curvature Si02 mirror, a cryogenic survival (less than 30 Kelvin) test of an adhesive, and a cryogenic cycle (less than 20 Kelvin) test of a ULE mirror. A vibration survey has also been performed on the test chamber. Chamber specifications and performance data, vibration environment data, and limited test results will be presented.

  9. Space Weather Forecasting and Research at the Community Coordinated Modeling Center

    Science.gov (United States)

    Aronne, M.

    2015-12-01

    The Space Weather Research Center (SWRC), within the Community Coordinated Modeling Center (CCMC), provides experimental research forecasts and analysis for NASA's robotic mission operators. Space weather conditions are monitored to provide advance warning and forecasts based on observations and modeling using the integrated Space Weather Analysis Network (iSWA). Space weather forecasters come from a variety of backgrounds, ranging from modelers to astrophysicists to undergraduate students. This presentation will discuss space weather operations and research from an undergraduate perspective. The Space Weather Research, Education, and Development Initiative (SW REDI) is the starting point for many undergraduate opportunities in space weather forecasting and research. Space weather analyst interns play an active role year-round as entry-level space weather analysts. Students develop the technical and professional skills to forecast space weather through a summer internship that includes a two week long space weather boot camp, mentorship, poster session, and research opportunities. My unique development of research projects includes studying high speed stream events as well as a study of 20 historic, high-impact solar energetic particle events. This unique opportunity to combine daily real-time analysis with related research prepares students for future careers in Heliophysics.

  10. New Center Links Earth, Space, and Information Sciences

    Science.gov (United States)

    Aswathanarayana, U.

    2004-05-01

    Broad-based geoscience instruction melding the Earth, space, and information technology sciences has been identified as an effective way to take advantage of the new jobs created by technological innovations in natural resources management. Based on this paradigm, the University of Hyderabad in India is developing a Centre of Earth and Space Sciences that will be linked to the university's super-computing facility. The proposed center will provide the basic science underpinnings for the Earth, space, and information technology sciences; develop new methodologies for the utilization of natural resources such as water, soils, sediments, minerals, and biota; mitigate the adverse consequences of natural hazards; and design innovative ways of incorporating scientific information into the legislative and administrative processes. For these reasons, the ethos and the innovatively designed management structure of the center would be of particular relevance to the developing countries. India holds 17% of the world's human population, and 30% of its farm animals, but only about 2% of the planet's water resources. Water will hence constitute the core concern of the center, because ecologically sustainable, socially equitable, and economically viable management of water resources of the country holds the key to the quality of life (drinking water, sanitation, and health), food security, and industrial development of the country. The center will be focused on interdisciplinary basic and pure applied research that is relevant to the practical needs of India as a developing country. These include, for example, climate prediction, since India is heavily dependent on the monsoon system, and satellite remote sensing of soil moisture, since agriculture is still a principal source of livelihood in India. The center will perform research and development in areas such as data assimilation and validation, and identification of new sensors to be mounted on the Indian meteorological

  11. University of Tennessee Center for Space Transportation and Applied Research (CSTAR)

    Science.gov (United States)

    1995-10-01

    The Center for Space Transportation and Applied Research had projects with space applications in six major areas: laser materials processing, artificial intelligence/expert systems, space transportation, computational methods, chemical propulsion, and electric propulsion. The closeout status of all these projects is addressed.

  12. University of Tennessee Center for Space Transportation and Applied Research (CSTAR)

    Science.gov (United States)

    1995-01-01

    The Center for Space Transportation and Applied Research had projects with space applications in six major areas: laser materials processing, artificial intelligence/expert systems, space transportation, computational methods, chemical propulsion, and electric propulsion. The closeout status of all these projects is addressed.

  13. Calibration and application of medical particle accelerators to space radiation experiments

    International Nuclear Information System (INIS)

    Ryu, Kwangsun; Park, Miyoung; Chae, Jangsoo; Yoon, Sangpil; Shin, Dongho

    2012-01-01

    In this paper, we introduce radioisotope facilities and medical particle accelerators that can be applied to space radiation experiments and the experimental conditions required by the space radiation experiments. Space radiation experiments on the ground are critical in determining the lifetimes of satellites and in choosing or preparing the appropriate electrical parts to assure the designated mission lifetime. Before the completion of building the 100-MeV proton linear accelerator in Gyeongju, or even after the completion, the currently existing proton accelerators for medical purposes could suggest an alternative plan. We have performed experiments to calibrate medical proton beam accelerators to investigate whether the beam conditions are suitable for applications to space radiation experiments. Based on the calibration results, we propose reference beam operation conditions for space radiation experiments.

  14. Gregory Merkel Tours Marshall Space Flight Center (MSFC)

    Science.gov (United States)

    1972-01-01

    Gregory A. Merkel (left), high school student from Springfield, Massachusetts, is pictured here with Harry Coons of the Marshall Space Flight Center (MSFC) during a visit to the center. Merkel was among 25 winners of a contest in which some 3,500 high school students proposed experiments for the following year's Skylab mission. The nationwide scientific competition was sponsored by the National Science Teachers Association and the National Aeronautics and Space Administration (NASA). The winning students, along with their parents and sponsor teachers, visited MSFC where they met with scientists and engineers, participated in design reviews for their experiments, and toured MSFC facilities. Of the 25 students, 6 did not see their experiments conducted on Skylab because the experiments were not compatible with Skylab hardware and timelines. Of the 19 remaining, 11 experiments required the manufacture of additional equipment.

  15. Investigating Medication Errors in Educational Health Centers of Kermanshah

    Directory of Open Access Journals (Sweden)

    Mohsen Mohammadi

    2015-08-01

    Full Text Available Background and objectives : Medication errors can be a threat to the safety of patients. Preventing medication errors requires reporting and investigating such errors. The present study was conducted with the purpose of investigating medication errors in educational health centers of Kermanshah. Material and Methods: The present research is an applied, descriptive-analytical study and is done as a survey. Error Report of Ministry of Health and Medical Education was used for data collection. The population of the study included all the personnel (nurses, doctors, paramedics of educational health centers of Kermanshah. Among them, those who reported the committed errors were selected as the sample of the study. The data analysis was done using descriptive statistics and Chi 2 Test using SPSS version 18. Results: The findings of the study showed that most errors were related to not using medication properly, the least number of errors were related to improper dose, and the majority of errors occurred in the morning. The most frequent reason for errors was staff negligence and the least frequent was the lack of knowledge. Conclusion: The health care system should create an environment for detecting and reporting errors by the personnel, recognizing related factors causing errors, training the personnel and create a good working environment and standard workload.

  16. Space Utilization Management within William Beaumont Army Medical Center

    Science.gov (United States)

    2007-04-01

    coupons, drives a Toyota, and stays in low-priced motels when he travels on business. Keirlin does not, however, pinch pennies. The market value of...care can be provided today and tomorrow. (Nevidjon, 2006) One technique used to improve office space is photo mapping. This term was coined by marketing ...scholar Phillip Kotler who suggests that walking through the facility and photographing the key areas of the patient’s areas can produce clues to

  17. A Milestone in Commercial Space Weather: USTAR Center for Space Weather

    Science.gov (United States)

    Tobiska, W.; Schunk, R. W.; Sojka, J. J.; Thompson, D. C.; Scherliess, L.; Zhu, L.; Gardner, L. C.

    2009-12-01

    As of 2009, Utah State University (USU) hosts a new organization to develop commercial space weather applications using funding that has been provided by the State of Utah’s Utah Science Technology and Research (USTAR) initiative. The USTAR Center for Space Weather (UCSW) is located on the USU campus in Logan, Utah and is developing innovative applications for mitigating adverse space weather effects in technological systems. Space weather’s effects upon the near-Earth environment are due to dynamic changes in the Sun’s photons, particles, and fields. Of the space environment domains that are affected by space weather, the ionosphere is the key region that affects communication and navigation systems. The UCSW has developed products for users of systems that are affected by space weather-driven ionospheric changes. For example, on September 1, 2009 USCW released, in conjunction with Space Environment Technologies, the world’s first real-time space weather via an iPhone app. Space WX displays the real-time, current global ionosphere total electron content along with its space weather drivers; it is available through the Apple iTunes store and is used around the planet. The Global Assimilation of Ionospheric Measurements (GAIM) system is now being run operationally in real-time at UCSW with the continuous ingestion of hundreds of global data streams to dramatically improve the ionosphere’s characterization. We discuss not only funding and technical advances that have led to current products but also describe the direction for UCSW that includes partnering opportunities for moving commercial space weather into fully automated specification and forecasting over the next half decade.

  18. Nanomaterials Work at NASA-Johnson Space Center

    Science.gov (United States)

    Arepalli, Sivaram

    2005-01-01

    Nanomaterials activities at NASA-Johnson Space Center focus on single wall carbon nanotube production, characterization and their applications for aerospace. Nanotubes are produced by arc and laser methods and the growth process is monitored by in-situ diagnostics using time resolved passive emission and laser induced fluorescence of the active species. Parametric study of both these processes are conducted to monitor the effect of production parameters including temperature, buffer gas, flow rate, pressure, laser fluence and arc current. Characterization of the nanotube material is performed using the NASA-JSC protocol developed by combining analytical techniques of SEM, TEM, UV-VIS-NIR absorption, Raman, and TGA. Efforts at JSC over the past five years in composites have centered on structural polymernanotube systems. Recent activities broadened this focus to multifunctional materials, supercapacitors, fuel cells, regenerable CO2 absorbers, electromagnetic shielding, radiation dosimetry and thermal management systems of interest for human space flight. Preliminary tests indicate improvement of performance in most of these applications because of the large surface area as well as high conductivity exhibited by SWCNTs.

  19. Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, A.S.; Badhwar, G.D.; Golightly, M.J.; Hardy, A.C.; Konradi, A.; Yang, T.C.

    1993-12-01

    The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk.

  20. Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

    International Nuclear Information System (INIS)

    Johnson, A.S.; Badhwar, G.D.; Golightly, M.J.; Hardy, A.C.; Konradi, A.; Yang, T.C.

    1993-12-01

    The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk

  1. The new Athens Center applied to Space Weather Forecasting

    International Nuclear Information System (INIS)

    Mavromichalaki, H.; Sarlanis, C.; Souvatzoglou, G.; Mariatos, G.; Gerontidou, M.; Plainaki, C.; Papaioannou, A.; Tatsis, S.; Belov, A.; Eroshenko, E.; Yanke, V.

    2006-01-01

    The Sun provides most of the initial energy driving space weather and modulates the energy input from sources outside the solar system, but this energy undergoes many transformations within the various components of the solar-terrestrial system, which is comprised of the solar wind, magnetosphere and radiation belts, the ionosphere, and the upper and lower atmospheres of Earth. This is the reason why an Earth's based neutron monitor network can be used in order to produce a real time forecasting of space weather phenomena.Since 2004 a fully functioned new data analysis Center in real-time is in operation in Neutron Monitor Station of Athens University (ANMODAP Center) suitable for research applications. It provides a multi sided use of twenty three neutron monitor stations distributing in all world and operating in real-time given crucial information on space weather phenomena. In particular, the ANMODAP Center can give a preliminary alert of ground level enhancements (GLEs) of solar cosmic rays which can be registered around 20 to 30 minutes before the main part of lower energy particles. Therefore these energetic solar cosmic rays provide the advantage of forth warning. Moreover, the monitoring of the precursors of cosmic rays gives a forehand estimate on that kind of events should be expected (geomagnetic storms and/or Forbush decreases)

  2. Space Environment Testing of Photovoltaic Array Systems at NASA's Marshall Space Flight Center

    Science.gov (United States)

    Phillips, Brandon S.; Schneider, Todd A.; Vaughn, Jason A.; Wright, Kenneth H., Jr.

    2015-01-01

    To successfully operate a photovoltaic (PV) array system in space requires planning and testing to account for the effects of the space environment. It is critical to understand space environment interactions not only on the PV components, but also the array substrate materials, wiring harnesses, connectors, and protection circuitry (e.g. blocking diodes). Key elements of the space environment which must be accounted for in a PV system design include: Solar Photon Radiation, Charged Particle Radiation, Plasma, and Thermal Cycling. While solar photon radiation is central to generating power in PV systems, the complete spectrum includes short wavelength ultraviolet components, which photo-ionize materials, as well as long wavelength infrared which heat materials. High energy electron radiation has been demonstrated to significantly reduce the output power of III-V type PV cells; and proton radiation damages material surfaces - often impacting coverglasses and antireflective coatings. Plasma environments influence electrostatic charging of PV array materials, and must be understood to ensure that long duration arcs do not form and potentially destroy PV cells. Thermal cycling impacts all components on a PV array by inducing stresses due to thermal expansion and contraction. Given such demanding environments, and the complexity of structures and materials that form a PV array system, mission success can only be ensured through realistic testing in the laboratory. NASA's Marshall Space Flight Center has developed a broad space environment test capability to allow PV array designers and manufacturers to verify their system's integrity and avoid costly on-orbit failures. The Marshall Space Flight Center test capabilities are available to government, commercial, and university customers. Test solutions are tailored to meet the customer's needs, and can include performance assessments, such as flash testing in the case of PV cells.

  3. Space Flight Operations Center local area network

    Science.gov (United States)

    Goodman, Ross V.

    1988-01-01

    The existing Mission Control and Computer Center at JPL will be replaced by the Space Flight Operations Center (SFOC). One part of the SFOC is the LAN-based distribution system. The purpose of the LAN is to distribute the processed data among the various elements of the SFOC. The SFOC LAN will provide a robust subsystem that will support the Magellan launch configuration and future project adaptation. Its capabilities include (1) a proven cable medium as the backbone for the entire network; (2) hardware components that are reliable, varied, and follow OSI standards; (3) accurate and detailed documentation for fault isolation and future expansion; and (4) proven monitoring and maintenance tools.

  4. Stennis Space Center celebrates Diversity Day

    Science.gov (United States)

    2009-01-01

    Kendall Mitchell of the Naval Oceanographic Office (right) learns about the culture of Bolivia from Narda Inchausty, president of the Foreign Born Wives Association in Slidell, La., during 2009 Diversity Day events at NASA's John Stennis Space Center. Stennis hosted Diversity Day activities for employees on Oct. 7. The day's events included cultural and agency exhibits, diversity-related performances, a trivia contest and a classic car and motorcycle show. It also featured the first-ever sitewide Stennis Employee Showcase.

  5. Operation of medical accelerator PATRO at Hyogo Ion Beam Medical Center

    International Nuclear Information System (INIS)

    Itano, A.; Akagi, T.; Higashi, A.; Fukushima, S.; Fujita, A.; Honda, Y.; Isa, H.; Nishikigouri, K.

    2004-01-01

    PATRO (Particle Accelerator for Therapy, Radiology and Oncology) is a medical accelerator facility for hadrontherapy of cancer at Hyogo Ion Beam Medical Center (HIBMC). Beam particles are proton (230 MeV) and carbon (320 MeV/u). After the beam commissioning and the tuning of irradiation system in 2000, we performed the clinical trials with proton and carbon beams from May 2001 until July 2002. We operated the accelerator for about 11,000 hours since the beginning of the beam tuning until the end of the clinical trials and for about 5,000 hours during the clinical trials. No serious troubles happened during the clinical trials. The stability and the reproducibility of the beams were well proved. (author)

  6. Using Web 2.0 (and Beyond?) in Space Flight Operations Control Centers

    Science.gov (United States)

    Scott, David W.

    2010-01-01

    Word processing was one of the earliest uses for small workstations, but we quickly learned that desktop computers were far more than e-typewriters. Similarly, "Web 2.0" capabilities, particularly advanced search engines, chats, wikis, blogs, social networking, and the like, offer tools that could significantly improve our efficiency at managing the avalanche of information and decisions needed to operate space vehicles in realtime. However, could does not necessarily equal should. We must wield two-edged swords carefully to avoid stabbing ourselves. This paper examines some Web 2.0 tools, with an emphasis on social media, and suggests which ones might be useful or harmful in real-time space operations co rnotl environments, based on the author s experience as a Payload Crew Communicator (PAYCOM) at Marshall Space Flight Center s (MSFC) Payload Operations Integration Center (POIC) for the International Space Station (ISS) and on discussions with other space flight operations control organizations and centers. There is also some discussion of an offering or two that may come from beyond the current cyber-horizon.

  7. Crowd-Sourced Radio Science at Marshall Space Flight Center

    Science.gov (United States)

    Fry, C. D.; McTernan, J. K.; Suggs, R. M.; Rawlins, L.; Krause, L. H.; Gallagher, D. L.; Adams, M. L.

    2018-01-01

    August 21, 2017 provided a unique opportunity to investigate the effects of the total solar eclipse on high frequency (HF) radio propagation and ionospheric variability. In Marshall Space Flight Center's partnership with the US Space and Rocket Center (USSRC) and Austin Peay State University (APSU), we engaged citizen scientists and students in an investigation of the effects of an eclipse on the mid-latitude ionosphere. Activities included fieldwork and station-based data collection of HF Amateur Radio frequency bands and VLF radio waves before, during, and after the eclipse to build a continuous record of changing propagation conditions as the moon's shadow marched across the United States. Post-eclipse radio propagation analysis provided insights into ionospheric variability due to the eclipse.

  8. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  9. R and T report: Goddard Space Flight Center

    Science.gov (United States)

    Soffen, Gerald A. (Editor)

    1993-01-01

    The 1993 Research and Technology Report for Goddard Space Flight Center is presented. Research covered areas such as (1) flight projects; (2) space sciences including cosmology, high energy, stars and galaxies, and the solar system; (3) earth sciences including process modeling, hydrology/cryology, atmospheres, biosphere, and solid earth; (4) networks, planning, and information systems including support for mission operations, data distribution, advanced software and systems engineering, and planning/scheduling; and (5) engineering and materials including spacecraft systems, material and testing, optics and photonics and robotics.

  10. Early experiences with big data at an academic medical center.

    Science.gov (United States)

    Halamka, John D

    2014-07-01

    Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Marshall Space Flight Center Faculty Fellowship Program

    Science.gov (United States)

    Six, N. F.; Damiani, R. (Compiler)

    2017-01-01

    The 2017 Marshall Faculty Fellowship Program involved 21 faculty in the laboratories and departments at Marshall Space Flight Center. These faculty engineers and scientists worked with NASA collaborators on NASA projects, bringing new perspectives and solutions to bear. This Technical Memorandum is a compilation of the research reports of the 2017 Marshall Faculty Fellowship program, along with the Program Announcement (Appendix A) and the Program Description (Appendix B). The research affected the following six areas: (1) Materials (2) Propulsion (3) Instrumentation (4) Spacecraft systems (5) Vehicle systems (6) Space science The materials investigations included composite structures, printing electronic circuits, degradation of materials by energetic particles, friction stir welding, Martian and Lunar regolith for in-situ construction, and polymers for additive manufacturing. Propulsion studies were completed on electric sails and low-power arcjets for use with green propellants. Instrumentation research involved heat pipes, neutrino detectors, and remote sensing. Spacecraft systems research was conducted on wireless technologies, layered pressure vessels, and two-phase flow. Vehicle systems studies were performed on life support-biofilm buildup and landing systems. In the space science area, the excitation of electromagnetic ion-cyclotron waves observed by the Magnetospheric Multiscale Mission provided insight regarding the propagation of these waves. Our goal is to continue the Marshall Faculty Fellowship Program funded by Center internal project offices. Faculty Fellows in this 2017 program represented the following minority-serving institutions: Alabama A&M University and Oglala Lakota College.

  12. Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center.

    Science.gov (United States)

    Repplinger, Michael D; Weber, Andrew C; Pickhardt, Perry J; Rajamanickam, Victoria P; Svenson, James E; Ehlenbach, William J; Westergaard, Ryan P; Reeder, Scott B; Jacobs, Elizabeth A

    2016-09-01

    To quantify the trends in imaging use for the diagnosis of appendicitis. A retrospective study covering a 22-year period was conducted at an academic medical center. Patients were identified by International Classification of Diseases-9 diagnosis code for appendicitis. Medical record data extraction of these patients included imaging test used (ultrasound, CT, or MRI), gender, age, and body mass index (BMI). The proportion of patients undergoing each scan was calculated by year. Regression analysis was performed to determine whether age, gender, or BMI affected imaging choice. The study included a total of 2,108 patients, including 967 (43.5%) females and 599 (27%) children (imaging used for the diagnosis of appendicitis decreased over time (P medical center, CT use increased more than 20-fold. However, no statistically significant trend was found for increased use of ultrasound or MRI. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. Space Environmental Effects Testing Capability at the Marshall Space Flight Center

    Science.gov (United States)

    DeWittBurns, H.; Craven, Paul; Finckenor, Miria; Nehls, Mary; Schneider, Todd; Vaughn, Jason

    2012-01-01

    Understanding the effects of the space environment on materials and systems is fundamental and essential for mission success. If not properly understood and designed for, the effects of the environment can lead to degradation of materials, reduction of functional lifetime, and system failure. In response to this need, the Marshall Space Flight Center has developed world class Space Environmental Effects (SEE) expertise and test facilities to simulate the space environment. Capabilities include multiple unique test systems comprising the most complete SEE testing capability available. These test capabilities include charged particle radiation (electrons, protons, ions), ultraviolet radiation (UV), vacuum ultraviolet radiation (VUV), atomic oxygen, plasma effects, space craft charging, lunar surface and planetary effects, vacuum effects, and hypervelocity impacts as well as the combination of these capabilities. In addition to the uniqueness of the individual test capabilities, MSFC is the only NASA facility where the effects of the different space environments can be tested in one location. Combined with additional analytical capabilities for pre- and post-test evaluation, MSFC is a one-stop shop for materials testing and analysis. The SEE testing and analysis are performed by a team of award winning experts nationally recognized for their contributions in the study of the effects of the space environment on materials and systems. With this broad expertise in space environmental effects and the variety of test systems and equipment available, MSFC is able to customize tests with a demonstrated ability to rapidly adapt and reconfigure systems to meet customers needs. Extensive flight experiment experience bolsters this simulation and analysis capability with a comprehensive understanding of space environmental effects.

  14. Patient-centered medical homes for patients with disabilities.

    Science.gov (United States)

    Hernandez, Brigida; Damiani, Marco; Wang, T Arthur; Driscoll, Carolyn; Dellabella, Peter; LePera, Nicole; Mentari, Michael

    2015-01-01

    The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.

  15. The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

    Science.gov (United States)

    Kerstman, Eric; Walton, Marlei; Minard, Charles; Saile, Lynn; Myers, Jerry; Butler, Doug; Lyengar, Sriram; Fitts, Mary; Johnson-Throop, Kathy

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of

  16. 97 Medical Apparatuses tested at the Academic Medical Center (AMC) Amsterdam for interference by WLAN/WiFi signals

    NARCIS (Netherlands)

    Hensbroek, R.

    2009-01-01

    This research describes the influence of WLAN 1 signals on medical apparatuses in the Academic Medical Center (AMC) Amsterdam. The results in this report were obtained by testing medical equipment with WLAN signals. A comparable research was reported earlier. See TNO report KvL/P&Z 2007.117 dated

  17. Medical support and technology for long-duration space missions

    Science.gov (United States)

    Furukawa, S.; Nicogossian, A.; Buchanan, P.; Pool, S. L.

    1982-01-01

    The current philosophy and development directions being taken towards realization of medical systems for use on board space stations are discussed. Data was gained on the performance of physical examinations, venipuncture and blood flow, blood smear and staining, white blood cell differential count, throat culture swab and colony count, and microscopy techniques during a 28-day period of the Skylab mission. It is expected that the advent of Shuttle flights will rapidly increase the number of persons in space, create a demand for in-space rather than on-earth medical procedures, and necessitate treatments for disorders without the provision for an early return to earth. Attention is being given to pressurized environment and extravehicular conditions of treatment, the possibilities of the use of the OTV for moving injured or ill crewmembers to other space stations, and to isolation of persons with communicable diseases from station crews.

  18. System Engineering Processes at Kennedy Space Center for Development of SLS and Orion Launch Systems

    Science.gov (United States)

    Schafer, Eric; Stambolian, Damon; Henderson, Gena

    2013-01-01

    There are over 40 subsystems being developed for the future SLS and Orion Launch Systems at Kennedy Space Center. These subsystems are developed at the Kennedy Space Center Engineering Directorate. The Engineering Directorate at Kennedy Space Center follows a comprehensive design process which requires several different product deliverables during each phase of each of the subsystems. This Presentation describes this process with examples of where the process has been applied.

  19. Center for Space Transportation and Applied Research Fifth Annual Technical Symposium Proceedings

    Science.gov (United States)

    1993-01-01

    This Fifth Annual Technical Symposium, sponsored by the UT-Calspan Center for Space Transportation and Applied Research (CSTAR), is organized to provide an overview of the technical accomplishments of the Center's five Research and Technology focus areas during the past year. These areas include chemical propulsion, electric propulsion, commerical space transportation, computational methods, and laser materials processing. Papers in the area of artificial intelligence/expert systems are also presented.

  20. PASTE: patient-centered SMS text tagging in a medication management system.

    Science.gov (United States)

    Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

    2012-01-01

    To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

  1. Robotic Technology Efforts at the NASA/Johnson Space Center

    Science.gov (United States)

    Diftler, Ron

    2017-01-01

    The NASA/Johnson Space Center has been developing robotic systems in support of space exploration for more than two decades. The goal of the Center’s Robotic Systems Technology Branch is to design and build hardware and software to assist astronauts in performing their mission. These systems include: rovers, humanoid robots, inspection devices and wearable robotics. Inspection systems provide external views of space vehicles to search for surface damage and also maneuver inside restricted areas to verify proper connections. New concepts in human and robotic rovers offer solutions for navigating difficult terrain expected in future planetary missions. An important objective for humanoid robots is to relieve the crew of “dull, dirty or dangerous” tasks allowing them more time to perform their important science and exploration missions. Wearable robotics one of the Center’s newest development areas can provide crew with low mass exercise capability and also augment an astronaut’s strength while wearing a space suit.This presentation will describe the robotic technology and prototypes developed at the Johnson Space Center that are the basis for future flight systems. An overview of inspection robots will show their operation on the ground and in-orbit. Rovers with independent wheel modules, crab steering, and active suspension are able to climb over large obstacles, and nimbly maneuver around others. Humanoid robots, including the First Humanoid Robot in Space: Robonaut 2, demonstrate capabilities that will lead to robotic caretakers for human habitats in space, and on Mars. The Center’s Wearable Robotics Lab supports work in assistive and sensing devices, including exoskeletons, force measuring shoes, and grasp assist gloves.

  2. Space Technology for Medical Aids

    Science.gov (United States)

    1982-01-01

    Under one of the earliest contracts awarded in the Apollo lunar landing program, Parker Hannifin Corporation developed and produced equipment for controlling the flow of propellants into the mammoth engines of the Saturn moonbooster. Today, Parker is supplying the huge valves that control propellant flow from the Space Shuttle's external fuel tank to the engines of the Shuttle Orbiter as well as the "peanut valve," named for its small size. In 1977, NASA, recognizing the company's special expertise in miniature systems, asked Parker to participate in the development of an implantable artificial sphincter for control of urinary incontinence. The company's peanut valve experience provided an ideal base for a new biomedical project, the Programmable Implantable Medication System (PIMS) for continuous, computer-directed delivery of precisely metered medication -- insulin, for example -- within a patient's body. The work on PIMS also inspired development of Micromed, a related programmable medication device for external, rather than implantable use. The Biomedical Products Division has also applied its fluid handling expertise to a drugless therapy system called Cryomax for the treatment of such disorders as rheumatoid arthritis and lupus.

  3. Joint Space Operations Center (JSpOC) Mission System (JMS)

    Science.gov (United States)

    Morton, M.; Roberts, T.

    2011-09-01

    US space capabilities benefit the economy, national security, international relationships, scientific discovery, and our quality of life. Realizing these space responsibilities is challenging not only because the space domain is increasingly congested, contested, and competitive but is further complicated by the legacy space situational awareness (SSA) systems approaching end of life and inability to provide the breadth of SSA and command and control (C2) of space forces in this challenging domain. JMS will provide the capabilities to effectively employ space forces in this challenging domain. Requirements for JMS were developed based on regular, on-going engagement with the warfighter. The use of DoD Architecture Framework (DoDAF) products facilitated requirements scoping and understanding and transferred directly to defining and documenting the requirements in the approved Capability Development Document (CDD). As part of the risk reduction efforts, the Electronic System Center (ESC) JMS System Program Office (SPO) fielded JMS Capability Package (CP) 0 which includes an initial service oriented architecture (SOA) and user defined operational picture (UDOP) along with force status, sensor management, and analysis tools. Development efforts are planned to leverage and integrate prototypes and other research projects from Defense Advanced Research Projects Agency, Air Force Research Laboratories, Space Innovation and Development Center, and Massachusetts Institute of Technology/Lincoln Laboratories. JMS provides a number of benefits to the space community: a reduction in operational “transaction time” to accomplish key activities and processes; ability to process the increased volume of metric observations from new sensors (e.g., SBSS, SST, Space Fence), as well as owner/operator ephemerides thus enhancing the high accuracy near-real-time catalog, and greater automation of SSA data sharing supporting collaboration with government, civil, commercial, and foreign

  4. The Patient-Centered Medical Home Neighbor: A Critical Concept for a Redesigned Healthcare Delivery System

    Science.gov (United States)

    2011-01-25

    Sharing Knowledge: Achieving Breakthrough Performance 2010 Military Health System Conference The Patient -Centered Medical Home Neighbor: A Critical...DATE 25 JAN 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE The Patient -Centered Medical Home Neighbor: A...Conference What is the Patient -Centered Medical Home?  …a vision of health care as it should be  …a framework for organizing systems of care at both the

  5. Nanotechnology Concepts at Marshall Space Flight Center: Engineering Directorate

    Science.gov (United States)

    Bhat, B.; Kaul, R.; Shah, S.; Smithers, G.; Watson, M. D.

    2001-01-01

    Nanotechnology is the art and science of building materials and devices at the ultimate level of finesse: atom by atom. Our nation's space program has need for miniaturization of components, minimization of weight, and maximization of performance, and nanotechnology will help us get there. Marshall Space Flight Center's (MSFC's) Engineering Directorate is committed to developing nanotechnology that will enable MSFC missions in space transportation, space science, and space optics manufacturing. MSFC has a dedicated group of technologists who are currently developing high-payoff nanotechnology concepts. This poster presentation will outline some of the concepts being developed including, nanophase structural materials, carbon nanotube reinforced metal and polymer matrix composites, nanotube temperature sensors, and aerogels. The poster will outline these concepts and discuss associated technical challenges in turning these concepts into real components and systems.

  6. Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

    Science.gov (United States)

    Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

    2013-06-01

    Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.

  7. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  8. NASA Pathways Co-op Tour Johnson Space Center Fall 2013

    Science.gov (United States)

    Masood, Amir; Osborne-Lee, Irwin W.

    2013-01-01

    This report outlines the tasks and objectives completed during a co-operative education tour with National Aeronautics and Space Association (NASA) at the Johnson Space Center in Houston, Texas. I worked for the Attitude & Pointing group of the Flight Dynamics Division within the Mission Operations Directorate at Johnson Space Center. NASA's primary mission is to support and expand the various ongoing space exploration programs and any research and development activities associated with it. My primary project required me to develop and a SharePoint web application for my group. My secondary objective was to become familiar with the role of my group which was primarily to provide spacecraft attitude and line of sight determination, including Tracking and Data Relay Satellite (TDRS) communications coverage for various NASA, International, and commercial partner spacecraft. My projects required me to become acquainted with different software systems, fundamentals of aerospace engineering, project management, and develop essential interpersonal communication skills. Overall, I accomplished multiple goals which included laying the foundations for an updated SharePoint which will allow for an organized platform to communicate and share data for group members and external partners. I also successfully learned about the operations of the Attitude & Pointing Group and how it contributes to the Missions Operations Directorate and NASA's Space Program as a whole

  9. The patient-centered medical home neighbor: A primary care physician's view.

    Science.gov (United States)

    Sinsky, Christine A

    2011-01-04

    The American College of Physicians' position paper on the patient-centered medical home neighbor (PCMH-N) extends the work of the patient-centered medical home (PCMH) as a means of improving the delivery of health care. Recognizing that the PCMH does not exist in isolation, the PCMH-N concept outlines expectations for comanagement, communication, and care coordination and broadens responsibility for safe, effective, and efficient care beyond primary care to include physicians of all specialties. As such, it is a fitting follow-up to the PCMH and moves further down the road toward improved care for complex patients. Yet, there is more work to be done. Truly transforming the U.S. health care system around personalized medical homes embedded in highly functional medical neighborhoods will require better staffing models; more robust electronic information tools; aligned incentives for quality and efficiency within payment and regulatory policies; and a culture of greater engagement of patients, their families, and communities.

  10. Johnson Space Center's Solar and Wind-Based Renewable Energy System

    Science.gov (United States)

    Vasquez, A.; Ewert, M.; Rowlands, J.; Post, K.

    2009-01-01

    The NASA Johnson Space Center (JSC) in Houston, Texas has a Sustainability Partnership team that seeks ways for earth-based sustainability practices to also benefit space exploration research. A renewable energy gathering system was installed in 2007 at the JSC Child Care Center (CCC) which also offers a potential test bed for space exploration power generation and remote monitoring and control concepts. The system comprises: 1) several different types of photovoltaic panels (29 kW), 2) two wind-turbines (3.6 kW total), and 3) one roof-mounted solar thermal water heater and tank. A tie to the JSC local electrical grid was provided to accommodate excess power. The total first year electrical energy production was 53 megawatt-hours. A web-based real-time metering system collects and reports system performance and weather data. Improvements in areas of the CCC that were detected during subsequent energy analyses and some concepts for future efforts are also presented.

  11. Human Factors in Training - Space Medicine Proficiency Training

    Science.gov (United States)

    Connell, Erin; Arsintescu, Lucia

    2009-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1

  12. 76 FR 71045 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

    Science.gov (United States)

    2011-11-16

    ...] Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... period for the notice on its report of scientific and medical literature and information concerning the... ``Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information...

  13. Walter Reed Army Medical Center's Internet-based electronic health portal.

    Science.gov (United States)

    Abbott, Kevin C; Boocks, Carl E; Sun, Zhengyi; Boal, Thomas R; Poropatich, Ronald K

    2003-12-01

    Use of the World Wide Web (WWW) and electronic media to facilitate medical care has been the subject of many reports in the popular press. However, few reports have documented the results of implementing electronic health portals for essential medical tasks, such as prescription refills and appointments. At Walter Reed Army Medical Center, "Search & Learn" medical information, Internet-based prescription refills and patient appointments were established in January 2001. A multiphase retrospective analysis was conducted to determine the use of the "Search & Learn" medical information and the relative number of prescription refills and appointments conducted via the WWW compared with conventional methods. From January 2001 to May 2002, there were 34,741 refills and 819 appointments made over the Internet compared with 2,275,112 refills and approximately 500,000 appointments made conventionally. WWW activity accounted for 1.52% of refills and 0.16% of appointments. There was a steady increase in this percentage over the time of the analysis. In April of 2002, the monthly average of online refills had risen to 4.57% and online appointments were at 0.27%. Online refills were projected to account for 10% of all prescriptions in 2 years. The "Search & Learn" medical information portion of our web site received 147,429 unique visits during this same time frame, which was an average of 326 visitors per day. WWW-based methods of conducting essential medical tasks accounted for a small but rapidly increasing percentage of total activity at Walter Reed Army Medical Center. Subsequent phases of analysis will assess demographic and geographic factors and aid in the design of future systems to increase use of the Internet-based systems.

  14. Space-Proven Medical Monitor: The Total Patient-Care Package

    Science.gov (United States)

    2006-01-01

    The primary objective of the Gemini Program was to develop techniques that would allow for advanced, long-duration space travel, a prerequisite of the ensuing Apollo Program that would put man safely on the Moon before the end of the decade. In order to carry out this objective, NASA worked with a variety of innovative companies to develop propulsion systems, onboard computers, and docking capabilities that were critical to the health of Gemini spacecraft, as well as life-support systems and physiological-monitoring devices that were critical to the health of Gemini astronauts. One of these companies was Spacelabs Medical, Inc., the pioneer of what is commonly known today as medical telemetry. Spacelabs Medical helped NASA better understand man s reaction to space through a series of bioinstrumentation devices that, for the first time ever, were capable of monitoring orbiting astronauts physical conditions in real time, from Earth. The company went on to further expand its knowledge of monitoring and maintaining health in space, and then brought it down to Earth, to dramatically change the course of patient monitoring in the field of health care.

  15. 78 FR 74163 - Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice...

    Science.gov (United States)

    2013-12-10

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-83,070] Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice of Negative Determination... workers of Harrison Medical Center, a subsidiary of Franciscan Health System, Bremerton, Washington...

  16. 78 FR 10610 - TRICARE; Demonstration Project for Participation in Maryland Multi-Payer Patient Centered Medical...

    Science.gov (United States)

    2013-02-14

    ... National Committee on Quality Assurance Patient Centered Medical Home (PPC-PCMH) recognition criteria... quality improvements. TMA Defense Health Cost Assessment and Evaluation (DHCAPE) staff will calculate... Maryland Multi-Payer Patient Centered Medical Home Program (MMPCMHP) Demonstration AGENCY: Department of...

  17. Roles of Medical Record and Statistic Staff on Research at the Tawanchai Center.

    Science.gov (United States)

    Pattaranit, Rumpan; Chantachum, Vasana; Lekboonyasin, Orathai; Pradubwong, Suteera

    2015-08-01

    The medical record and statistic staffs play a crucial role behind the achievements of treatment and research of physicians, nurses and other health care professionals. The medical record and statistic staff are in charge of keeping patient medical records; creating databases; presenting information; sorting patient's information; providing patient medical records and related information for various medical teams and researchers; Besides, the medical record and statistic staff have collaboration with the Center of Cleft Lip-Palate, Khon Kaen University in association with the Tawanchai Project. The Tawanchai Center is an organization, involving multidisciplinary team which aims to continuing provide care for patients with cleft lip and palate and craniofacial deformities who need a long term of treatment since newborns until the age of 19 years. With support and encouragement from the Tawanchai team, the medical record and statistic staff have involved in research under the Tawanchai Centre since then and produced a number of publications locally and internationally.

  18. Critical Care Organizations in Academic Medical Centers in North America: A Descriptive Report.

    Science.gov (United States)

    Pastores, Stephen M; Halpern, Neil A; Oropello, John M; Kostelecky, Natalie; Kvetan, Vladimir

    2015-10-01

    With the exception of a few single-center descriptive reports, data on critical care organizations are relatively sparse. The objectives of our study were to determine the structure, governance, and experience to date of established critical care organizations in North American academic medical centers. A 46-item survey questionnaire was electronically distributed using Survey Monkey to the leadership of 27 identified critical care organizations in the United States and Canada between September 2014 and February 2015. A critical care organization had to be headed by a physician and have primary governance over the majority, if not all, of the ICUs in the medical center. We received 24 responses (89%). The majority of the critical care organizations (83%) were called departments, centers, systems, or operations committees. Approximately two thirds of respondents were from larger (> 500 beds) urban institutions, and nearly 80% were primary university medical centers. On average, there were six ICUs per academic medical center with a mean of four ICUs under critical care organization governance. In these ICUs, intensivists were present in-house 24/7 in 49%; advanced practice providers in 63%; hospitalists in 21%; and telemedicine coverage in 14%. Nearly 60% of respondents indicated that they had a separate hospital budget to support data management and reporting, oversight of their ICUs, and rapid response teams. The transition from the traditional model of ICUs within departmentally controlled services or divisions to a critical care organization was described as gradual in 50% and complete in only 25%. Nearly 90% indicated that their critical care organization governance structure was either moderately or highly effective; a similar number suggested that their critical care organizations were evolving with increasing domain and financial control of the ICUs at their respective institutions. Our survey of the very few critical care organizations in North American

  19. Taxonomy, Ontology and Semantics at Johnson Space Center

    Science.gov (United States)

    Berndt, Sarah Ann

    2011-01-01

    At NASA Johnson Space Center (JSC), the Chief Knowledge Officer has been developing the JSC Taxonomy to capitalize on the accomplishments of yesterday while maintaining the flexibility needed for the evolving information environment of today. A clear vision and scope for the semantic system is integral to its success. The vision for the JSC Taxonomy is to connect information stovepipes to present a unified view for information and knowledge across the Center, across organizations, and across decades. Semantic search at JSC means seemless integration of disparate information sets into a single interface. Ever increasing use, interest, and organizational participation mark successful integration and provide the framework for future application.

  20. Research and technology: 1994 annual report of the John F. Kennedy Space Center

    Science.gov (United States)

    1994-01-01

    As the NASA Center responsible for assembly, checkout, servicing, launch, recovery, and operational support of Space Transportation System elements and payloads, the John F. Kennedy Space Center is placing increasing emphasis on its advanced technology development program. This program encompasses the efforts of the Engineering Development Directorate laboratories, most of the KSC operations contractors, academia, and selected commercial industries - all working in a team effort within their own areas of expertise. This edition of the Kennedy Space Center Research and Technology 1994 Annual Report covers efforts of all these contributors to the KSC advanced technology development program, as well as our technology transfer activities. The Technology Programs and Commercialization Office (DE-TPO), (407) 867-3017, is responsible for publication of this report and should be contacted for any desired information regarding the advanced technology program.

  1. Marshall Space Flight Center - Launching the Future of Science and Exploration

    Science.gov (United States)

    Shivers, Alisa; Shivers, Herbert

    2010-01-01

    Topics include: NASA Centers around the country, launching a legacy (Explorer I), Marshall's continuing role in space exploration, MSFC history, lifting from Earth, our next mission STS 133, Space Shuttle propulsion systems, Space Shuttle facts, Space Shuttle and the International Space Station, technologies/materials originally developed for the space program, astronauts come from all over, potential future missions and example technologies, significant accomplishments, living and working in space, understanding our world, understanding worlds beyond, from exploration to innovation, inspiring the next generation, space economy, from exploration to opportunity, new program assignments, NASA's role in education, and images from deep space including a composite of a galaxy with a black hole, Sagittarius A, Pillars of Creation, and an ultra deep field

  2. Development of a longitudinal integrated clerkship at an academic medical center.

    Science.gov (United States)

    Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

    2011-04-04

    In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

  3. Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

    National Research Council Canada - National Science Library

    Markot, Peter B

    2007-01-01

    ...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...

  4. The National Aeronautics and Space Administration (NASA)/Goddard Space Flight Center (GSFC) sounding-rocket program

    Science.gov (United States)

    Guidotti, J. G.

    1976-01-01

    An overall introduction to the NASA sounding rocket program as managed by the Goddard Space Flight Center is presented. The various sounding rockets, auxiliary systems (telemetry, guidance, etc.), launch sites, and services which NASA can provide are briefly described.

  5. Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

    Science.gov (United States)

    Kinlaw, Dennis C.; Eads, Jeannette

    1992-01-01

    It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

  6. Spaced education in medical residents: An electronic intervention to improve competency and retention of medical knowledge.

    Directory of Open Access Journals (Sweden)

    Jason Matos

    Full Text Available Spaced education is a novel method that improves medical education through online repetition of core principles often paired with multiple-choice questions. This model is a proven teaching tool for medical students, but its effect on resident learning is less established. We hypothesized that repetition of key clinical concepts in a "Clinical Pearls" format would improve knowledge retention in medical residents.This study investigated spaced education with particular emphasis on using a novel, email-based reinforcement program, and a randomized, self-matched design, in which residents were quizzed on medical knowledge that was either reinforced or not with electronically-administered spaced education. Both reinforced and non-reinforced knowledge was later tested with four quizzes.Overall, respondents incorrectly answered 395 of 1008 questions (0.39; 95% CI, 0.36-0.42. Incorrect response rates varied by quiz (range 0.34-0.49; p = 0.02, but not significantly by post-graduate year (PGY1 0.44, PGY2 0.33, PGY3 0.38; p = 0.08. Although there was no evidence of benefit among residents (RR = 1.01; 95% CI, 0.83-1.22; p = 0.95, we observed a significantly lower risk of incorrect responses to reinforced material among interns (RR = 0.83, 95% CI, 0.70-0.99, p = 0.04.Overall, repetition of Clinical Pearls did not statistically improve test scores amongst junior and senior residents. However, among interns, repetition of the Clinical Pearls was associated with significantly higher test scores, perhaps reflecting their greater attendance at didactic sessions and engagement with Clinical Pearls. Although the study was limited by a low response rate, we employed test and control questions within the same quiz, limiting the potential for selection bias. Further work is needed to determine the optimal spacing and content load of Clinical Pearls to maximize retention amongst medical residents. This particular protocol of spaced education, however, was unique and

  7. Patient-Centered Medical Home in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ortiz G

    2011-10-01

    Full Text Available Gabriel Ortiz1, Len Fromer21Pediatric Pulmonary Services, El Paso, TX; 2Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH, which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.Keywords: Patient-Centered Medical Home, chronic care model, chronic obstructive pulmonary disease, patient education, physician assistants, nurse practitioners

  8. Lewis Research Center space station electric power system test facilities

    Science.gov (United States)

    Birchenough, Arthur G.; Martin, Donald F.

    1988-01-01

    NASA Lewis Research Center facilities were developed to support testing of the Space Station Electric Power System. The capabilities and plans for these facilities are described. The three facilities which are required in the Phase C/D testing, the Power Systems Facility, the Space Power Facility, and the EPS Simulation Lab, are described in detail. The responsibilities of NASA Lewis and outside groups in conducting tests are also discussed.

  9. Optical Fiber Assemblies for Space Flight from the NASA Goddard Space Flight Center, Photonics Group

    Science.gov (United States)

    Ott, Melanie N.; Thoma, William Joe; LaRocca, Frank; Chuska, Richard; Switzer, Robert; Day, Lance

    2009-01-01

    The Photonics Group at NASA Goddard Space Flight Center in the Electrical Engineering Division of the Advanced Engineering and Technologies Directorate has been involved in the design, development, characterization, qualification, manufacturing, integration and anomaly analysis of optical fiber subsystems for over a decade. The group supports a variety of instrumentation across NASA and outside entities that build flight systems. Among the projects currently supported are: The Lunar Reconnaissance Orbiter, the Mars Science Laboratory, the James Webb Space Telescope, the Express Logistics Carrier for the International Space Station and the NASA Electronic Parts. and Packaging Program. A collection of the most pertinent information gathered during project support over the past year in regards to space flight performance of optical fiber components is presented here. The objective is to provide guidance for future space flight designs of instrumentation and communication systems.

  10. Industrial Engineering Lifts Off at Kennedy Space Center

    Science.gov (United States)

    Barth, Tim

    1998-01-01

    When the National Aeronautics and Space Administration (NASA) began the Space Shuttle Program, it did not have an established industrial engineering (IE) capability for several probable reasons. For example, it was easy for some managers to dismiss IE principles as being inapplicable at NASA's John F. Kennedy Space Center (KSC). When NASA was formed by the National Aeronautics and Space Act of 1958, most industrial engineers worked in more traditional factory environments. The primary emphasis early in the shuttle program, and during previous human space flight programs such as Mercury and Apollo, was on technical accomplishments. Industrial engineering is sometimes difficult to explain in NASA's highly technical culture. IE is different in many ways from other engineering disciplines because it is devoted to process management and improvement, rather than product design. Images of clipboards and stopwatches still come to the minds of many people when the term industrial engineering is mentioned. The discipline of IE has only recently begun to gain acceptance and understanding in NASA. From an IE perspective today, the facilities used for flight hardware processing at KSC are NASA's premier factories. The products of these factories are among the most spectacular in the world: safe and successful launches of shuttles and expendable vehicles that carry tremendous payloads into space.

  11. Center for Space Power, Texas A and M University

    Science.gov (United States)

    Jones, Ken

    Johnson Controls is a 106 year old company employing 42,000 people worldwide with $4.7 billion annual sales. Though we are new to the aerospace industry we are a world leader in automobile battery manufacturing, automotive seating, plastic bottling, and facilities environment controls. The battery division produces over 24,000,000 batteries annually under private label for the new car manufacturers and the replacement market. We are entering the aerospace market with the nickel hydrogen battery with the help of NASA's Center for Space Power at Texas A&M. Unlike traditional nickel hydrogen battery manufacturers, we are reaching beyond the space applications to the higher volume markets of aircraft starting and utility load leveling. Though space applications alone will not provide sufficient volume to support the economies of scale and opportunities for statistical process control, these additional terrestrial applications will. For example, nickel hydrogen batteries do not have the environmental problems of nickel cadmium or lead acid and may someday start your car or power your electric vehicle. However you envision the future, keep in mind that no manufacturer moves into a large volume market without fine tuning their process. The Center for Space Power at Texas A&M is providing indepth technical analysis of all of the materials and fabricated parts of our battery as well as thermal and mechanical design computer modeling. Several examples of what we are doing with nickel hydrogen chemistry to lead to these production efficiencies are presented.

  12. Establishment of exposure dose assessment laboratory in National Radiation Emergency Medical Center (NREMC)

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Jae Ryong; Ha, Wi Ho; Yoon, Seok Won; Han, Eun Ae; Lee, Seung Sook [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2011-10-15

    As unclear industry grown, 432 of the nuclear power plants are operating and 52 of NPPs are under construction currently. Increasing use of radiation or radioisotopes in the field of industry, medical purpose and research such as non-destructive examination, computed tomography and x-ray, etc. constantly. With use of nuclear or radiation has incidence possibility for example the Fukushima NPP incident, the Goiania accident and the Chernobyl Nuclear accident. Also the risk of terror by radioactive material such as Radiological Dispersal Device(RDD) etc. In Korea, since the 'Law on protection of nuclear facilities and countermeasure for radioactive preparedness was enacted in 2003, the Korean institute of Radiological and Medical Sciences(KIRAMS) was established for the radiation emergency medical response in radiological disaster due to nuclear accident, radioactive terror and so on. Especially National Radiation Emergency Medical Center(NREMC) has the duty that is protect citizens from nuclear, radiological accidents or radiological terrors through the emergency medical preparedness. The NREMC was established by the 39-article law on physical protection of nuclear material and facilities and measures for radiological emergencies. Dose assessment or contamination survey should be performed which provide the radiological information for medical response. For this reason, the NREMC establish and re-organized dose assessment system based on the existing dose assessment system of the NREMC recently. The exposure dose could be measured by physical and biological method. With these two methods, we can have conservative dose assessment result. Therefore the NREMC established the exposure dose assessment laboratory which was re-organized laboratory space and introduced specialized equipment for dose assessment. This paper will report the establishment and operation of exposure dose assessment laboratory for radiological emergency response and discuss how to enhance

  13. Inference in media space. The case of IBM Software Executive Briefing Center - Rome

    Directory of Open Access Journals (Sweden)

    Toni Marino

    2014-11-01

    Full Text Available In our paper we apply Peirce's model of Arguments (Statistical Deduction, Probabilistic Deduction, Induction and Abduction to a communication process where negotiating sense and meanings is emphasized. We selected a communication space where everything is planned as a medium of sense (video terminals, screens, lights, etc. namely the IBM Software Executive Briefing Center in Italy, a workplace used to exchange views, negotiate or transact. It is based in Rome in the same building as the International Development Laboratory of the IBM Software Group. The Software Center is the place where IBM welcomes its potential customers and has the opportunity to show them its technology and offer solutions. This paper focuses on "media space" in the Center which is structured by the seller according to his/her idea of the buyer's interpretive process. This paper analyzes the roles of visual codes in the allocation of functions. It also looks into the relation between the symbolism of the company with its marketing, past history and media space in order to define the buyer's typology of inference (deduction, induction or abduction in relation to the communication strategy of the media space design. The research is conducted directly in the field by interviewing the Manager of the IBM Center as well as asking people who use it to fill in an anonymous questionnaire, which analyses both the media space and the plan of the building.

  14. DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

    Energy Technology Data Exchange (ETDEWEB)

    Jacques, S.L.

    1998-01-01

    An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

  15. Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

    Science.gov (United States)

    Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

    2016-03-01

    The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

  16. Marshall Space Flight Center Faculty Fellowship Program

    Science.gov (United States)

    Six, N. F. (Compiler)

    2015-01-01

    The Faculty Fellowship program was revived in the summer of 2015 at NASA Marshall Space Flight Center, following a period of diminished faculty research activity here since 2006 when budget cuts in the Headquarters' Education Office required realignment. Several senior Marshall managers recognized the need to involve the Nation's academic research talent in NASA's missions and projects to the benefit of both entities. These managers invested their funds required to establish the renewed Faculty Fellowship program in 2015, a 10-week residential research involvement of 16 faculty in the laboratories and offices at Marshall. These faculty engineers and scientists worked with NASA collaborators on NASA projects, bringing new perspectives and solutions to bear. This Technical Memorandum is a compilation of the research reports of the 2015 Marshall Faculty Fellowship program, along with the Program Announcement (appendix A) and the Program Description (appendix B). The research touched on seven areas-propulsion, materials, instrumentation, fluid dynamics, human factors, control systems, and astrophysics. The propulsion studies included green propellants, gas bubble dynamics, and simulations of fluid and thermal transients. The materials investigations involved sandwich structures in composites, plug and friction stir welding, and additive manufacturing, including both strength characterization and thermosets curing in space. The instrumentation projects involved spectral interfero- metry, emissivity, and strain sensing in structures. The fluid dynamics project studied the water hammer effect. The human factors project investigated the requirements for close proximity operations in confined spaces. Another team proposed a controls system for small launch vehicles, while in astrophysics, one faculty researcher estimated the practicality of weather modification by blocking the Sun's insolation, and another found evidence in satellite data of the detection of a warm

  17. Hospital CIO Explains Blockchain Potential: An Interview with Beth Israel Deaconess Medical Center's John Halamka.

    Science.gov (United States)

    Mertz, Leslie

    2018-01-01

    Work is already underway to bring blockchain technology to the healthcare industry, and hospital administrators are trying to figure out what it can do for them, their clinicians, and their patients. That includes administrators at Beth Israel Deaconess Medical Center, a leading academic medical center located in Boston.

  18. A Study to Determine Patient Waiting Time at the Outpatient Pharmacy at Wilford Hall USAF Medical Center

    Science.gov (United States)

    1988-06-01

    at Wilford Hall USAF Medical Center significantly reduced the patient wait time at the main outpatient pharmacy. Satellite pharmacies have been ).’l...PRESENTING TO WINDOW 1, 19 MAR 88. 47 C:. A’.’E-:A: -ESCRIRTIONS PER PATIENT ...........48 H. WILFORD HALL MEDICAL CENTER OUTPATIENT QUESTIONNAIRE...that wait times at tne outpatient pharmacy were excessive. It was this concern that motivated the Medical Center Administrator to request that patient

  19. Final Environmental Assessment for the California Space Center at Vandenberg Air Force Base, California

    Science.gov (United States)

    2010-06-02

    rooted , mesophylic plant species that Chapter 3. Affected Environment Final Environmental Assessment - California Space Center, Vandenberg Air...Chapter 3. Affected Environment 3-12 Final Environmental Assessment - California Space Center, Vandenberg Air Force Base the root and debris zone of the...protruding objects, slippery soils or mud, and biological hazards including vegetation (i.e. poison oak and stinging nettle ), animals (i.e. insects

  20. Development of a longitudinal integrated clerkship at an academic medical center

    Directory of Open Access Journals (Sweden)

    Ann Poncelet

    2011-04-01

    Full Text Available In 2005, medical educators at the University of California, San Francisco (UCSF, began developing the Parnassus Integrated Student Clinical Experiences (PISCES program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants’ career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

  1. National Space Science Data Center and World Data Center A for Rockets and Satellites - Ionospheric data holdings and services

    Science.gov (United States)

    Bilitza, D.; King, J. H.

    1988-01-01

    The activities and services of the National Space Science data Center (NSSDC) and the World Data Center A for Rockets and Satellites (WDC-A-R and S) are described with special emphasis on ionospheric physics. The present catalog/archive system is explained and future developments are indicated. In addition to the basic data acquisition, archiving, and dissemination functions, ongoing activities include the Central Online Data Directory (CODD), the Coordinated Data Analysis Workshopps (CDAW), the Space Physics Analysis Network (SPAN), advanced data management systems (CD/DIS, NCDS, PLDS), and publication of the NSSDC News, the SPACEWARN Bulletin, and several NSSD reports.

  2. Community Coordinated Modeling Center: A Powerful Resource in Space Science and Space Weather Education

    Science.gov (United States)

    Chulaki, A.; Kuznetsova, M. M.; Rastaetter, L.; MacNeice, P. J.; Shim, J. S.; Pulkkinen, A. A.; Taktakishvili, A.; Mays, M. L.; Mendoza, A. M. M.; Zheng, Y.; Mullinix, R.; Collado-Vega, Y. M.; Maddox, M. M.; Pembroke, A. D.; Wiegand, C.

    2015-12-01

    Community Coordinated Modeling Center (CCMC) is a NASA affiliated interagency partnership with the primary goal of aiding the transition of modern space science models into space weather forecasting while supporting space science research. Additionally, over the past ten years it has established itself as a global space science education resource supporting undergraduate and graduate education and research, and spreading space weather awareness worldwide. A unique combination of assets, capabilities and close ties to the scientific and educational communities enable this small group to serve as a hub for raising generations of young space scientists and engineers. CCMC resources are publicly available online, providing unprecedented global access to the largest collection of modern space science models (developed by the international research community). CCMC has revolutionized the way simulations are utilized in classrooms settings, student projects, and scientific labs and serves hundreds of educators, students and researchers every year. Another major CCMC asset is an expert space weather prototyping team primarily serving NASA's interplanetary space weather needs. Capitalizing on its unrivaled capabilities and experiences, the team provides in-depth space weather training to students and professionals worldwide, and offers an amazing opportunity for undergraduates to engage in real-time space weather monitoring, analysis, forecasting and research. In-house development of state-of-the-art space weather tools and applications provides exciting opportunities to students majoring in computer science and computer engineering fields to intern with the software engineers at the CCMC while also learning about the space weather from the NASA scientists.

  3. Integration of pharmacists into a patient-centered medical home.

    Science.gov (United States)

    Scott, Mollie Ashe; Hitch, Bill; Ray, Lisa; Colvin, Gaye

    2011-01-01

    To define the joint principles of the patient-centered medical home (PCMH) and describe the integration of pharmacists into a PCMH. Family medicine residency training program in North Carolina from 2001 to 2011. Mountain Area Health Education Family Health Center is a family medicine residency training program that is part of the North Carolina Area Health Education Center system. The goal of the organization is to train and retain health care students and residents. The practice is recognized as a level III PCMH by the National Committee for Quality Assurance (NCQA) and seeks to provide quality, safe, patient-centered care according to the joint principles of PCMH. Pharmacists, nurses, nutritionists, care managers, Spanish translators, and behavioral medicine specialists work collaboratively with physicians to provide seamless, comprehensive care. The Department of Pharmacotherapy is embedded in the family medicine clinic. Three pharmacists and two pharmacy residents are involved in providing direct patient care services, ensuring access to community resources, assisting patients with transitions of care, providing interprofessional education, and participating in continuous quality improvement initiatives. The pharmacists serve as clinical pharmacist practitioners and provide medication therapy management services in a pharmacotherapy clinic, anticoagulation clinics, and an osteoporosis clinic and via an inpatient family medicine service. Multiple learners such as student pharmacists, pharmacy residents, and family medicine residents rotate through the various pharmacy clinics to learn about pharmacotherapeutic principles and the role of the pharmacist in PCMH. PCMH is a comprehensive, patient-centered, team-based approach to population management in the primary care setting. Pharmacists play a vital role in PCMH and make fundamental contributions to patient care across health care settings. Such innovations in the ambulatory care setting create a unique niche

  4. Synaptic changes in rat maculae in space and medical imaging: the link

    Science.gov (United States)

    Ross, M. D.

    1998-01-01

    Two different space life sciences missions (SLS-1 and SLS-2) have demonstrated that the synapses of the hair cells of rat vestibular maculae increase significantly in microgravity. The results also indicate that macular synapses are sensitive to stress. These findings argue that vestibular maculae exhibit neuroplasticity to macroenvironmental and microenvironmental changes. This capability should be clinically relevant to rehabilitative training and/or pharmacological treatments for vestibular disease. The results of this ultrastructural research also demonstrated that type I and type II hair cells are integrated into the same neuronal circuitry. The findings were the basis for development of three-dimensional reconstruction software to learn details of macular wiring. This software, produced for scientific research, has now been adapted to reconstruct the face and skull directly from computerized tomography scans. In collaboration with craniofacial reconstructive surgeons at Stanford University Medical Center, an effort is under way to produce a virtual environment workbench for complex craniofacial surgery. When completed, the workbench will help surgeons train for and simulate surgery. The methods are patient specific. This research illustrates the value of basic research in leading to unanticipated medical applications.

  5. Ecological Impacts of the Space Shuttle Program at John F. Kennedy Space Center, Florida

    Science.gov (United States)

    Hall, Carlton R.; Schmalzer, Paul A.; Breininger, David R.; Duncan, Brean W.; Drese, John H.; Scheidt, Doug A.; Lowers, Russ H.; Reyier, Eric A.; Holloway-Adkins, Karen G.; Oddy, Donna M.; hide

    2014-01-01

    The Space Shuttle Program was one of NASAs first major undertakings to fall under the environmental impact analysis and documentation requirements of the National Environmental Policy Act of 1969 (NEPA). Space Shuttle Program activities at John F. Kennedy Space Center (KSC) and the associated Merritt Island National Wildlife Refuge (MINWR) contributed directly and indirectly to both negative and positive ecological trends in the region through the long-term, stable expenditure of resources over the 40 year program life cycle. These expenditures provided support to regional growth and development in conjunction with other sources that altered land use patterns, eliminated and modified habitats, and contributed to cultural eutrophication of the Indian River Lagoon. At KSC, most Space Shuttle Program related actions were conducted in previously developed facilities and industrial areas with the exception of the construction of the shuttle landing facility (SLF) and the space station processing facility (SSPF). Launch and operations impacts were minimal as a result of the low annual launch rate. The majority of concerns identified during the NEPA process such as potential weather modification, acid rain off site, and local climate change did not occur. Launch impacts from deposition of HCl and particulates were assimilated as a result of the high buffering capacity of the system and low launch and loading rates. Metals deposition from exhaust deposition did not display acute impacts. Sub-lethal effects are being investigated as part of the Resource Conservation and Recovery Act (RCRA) regulatory process. Major positive Space Shuttle Program effects were derived from the adequate resources available at the Center to implement the numerous environmental laws and regulations designed to enhance the quality of the environment and minimize impacts from human activities. This included reduced discharges of domestic and industrial wastewater, creation of stormwater management

  6. Early Lessons on Bundled Payment at an Academic Medical Center.

    Science.gov (United States)

    Jubelt, Lindsay E; Goldfeld, Keith S; Blecker, Saul B; Chung, Wei-Yi; Bendo, John A; Bosco, Joseph A; Errico, Thomas J; Frempong-Boadu, Anthony K; Iorio, Richard; Slover, James D; Horwitz, Leora I

    2017-09-01

    Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group). We examined total episode costs and costs by service category. We included 2,940 intervention episodes and 1,474 control episodes. Relative to the trend in the control group, lower extremity joint arthroplasty episodes achieved the greatest savings: adjusted average episode cost during the intervention period decreased by $3,017 (95% confidence interval [CI], -$6,066 to $31). For cardiac procedures, the adjusted average episode cost decreased by $2,999 (95% CI, -$8,103 to $2,105), and for spinal fusion, it increased by $8,291 (95% CI, $2,879 to $13,703). Savings were driven predominantly by shifting postdischarge care from inpatient rehabilitation facilities to home. Spinal fusion index admission costs increased because of changes in surgical technique. Under bundled payment, New York University Langone Medical Center decreased total episode costs in patients undergoing lower extremity joint arthroplasty. For patients undergoing cardiac valve procedures, evidence of savings was not as strong, and for patients undergoing spinal fusion, total episode costs increased. For all three conditions, the proportion of patients referred to inpatient rehabilitation facilities upon discharge decreased. These changes were not associated with an increase in index hospital length of stay or readmission rate

  7. TRW Ships NASA's Chandra X-ray Observatory To Kennedy Space Center

    Science.gov (United States)

    1999-04-01

    Two U.S. Air Force C-5 Galaxy transport planes carrying the observatory and its ground support equipment landed at Kennedy's Space Shuttle Landing Facility at 2:40 p.m. EST this afternoon. REDONDO BEACH, CA.--(Business Wire)--Feb. 4, 1999--TRW has shipped NASA's Chandra X-ray Observatory ("Chandra") to the Kennedy Space Center (KSC), in Florida, in preparation for a Space Shuttle launch later this year. The 45-foot-tall, 5-ton science satellite will provide astronomers with new information on supernova remnants, the surroundings of black holes, and other celestial phenomena that produce vast quantities of X-rays. Cradled safely in the cargo hold of a tractor-trailer rig called the Space Cargo Transportation System (SCTS), NASA's newest space telescope was ferried on Feb. 4 from Los Angeles International Airport to KSC aboard an Air Force C-5 Galaxy transporter. The SCTS, an Air Force container, closely resembles the size and shape of the Shuttle cargo bay. Over the next few months, Chandra will undergo final tests at KSC and be mated to a Boeing-provided Inertial Upper Stage for launch aboard Space Shuttle Columbia. A launch date for the Space Shuttle STS-93 mission is expected to be announced later this week. The third in NASA's family of Great Observatories that includes the Hubble Space Telescope and the TRW-built Compton Gamma Ray observatory, Chandra will use the world's most powerful X-ray telescope to allow scientists to "see" and monitor cosmic events that are invisible to conventional optical telescopes. Chandra's X-ray images will yield new insight into celestial phenomena such as the temperature and extent of gas clouds that comprise clusters of galaxies and the superheating of gas and dust particles as they swirl into black holes. A TRW-led team that includes the Eastman Kodak Co., Raytheon Optical Systems Inc., and Ball Aerospace & Technologies Corp. designed and built the Chandra X-ray Observatory for NASA's Marshall Space Flight Center. The

  8. Copper Disk Manufactured at the Space Optics Manufacturing and Technology Center

    Science.gov (United States)

    2001-01-01

    This photograph shows Wes Brown, Marshall Space Flight Center's (MSFC's) lead diamond tuner, an expert in the science of using diamond-tipped tools to cut metal, inspecting the mold's physical characteristics to ensure the uniformity of its more than 6,000 grooves. This king-size copper disk, manufactured at the Space Optics Manufacturing and Technology Center (SOMTC) at MSFC, is a special mold for making high resolution monitor screens. This master mold will be used to make several other molds, each capable of forming hundreds of screens that have a type of lens called a fresnel lens. Weighing much less than conventional optics, fresnel lenses have multiple concentric grooves, each formed to a precise angle, that together create the curvature needed to focus and project images. The MSFC leads NASA's space optics manufacturing technology development as a technology leader for diamond turning. The machine used to manufacture this mold is among many one-of-a-kind pieces of equipment of MSFC's SOMTC.

  9. Dealing With Deans and Academic Medical Center Leadership: Advice From Leaders.

    Science.gov (United States)

    Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

    2018-01-01

    The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important.

  10. Physician Payment Methods and the Patient-Centered Medical Home: Comment on "A Troubled Asset Relief Program for the Patient-Centered Medical Home".

    Science.gov (United States)

    Quinn, Kevin

    This commentary analyzes the patient-centered medical home (PCMH) model within a framework of the 8 basic payment methods in health care. PCMHs are firmly within the fee-for-service tradition. Changes to the process and structure of the Resource Based Relative Value Scale, which underlies almost all physician fee schedules, could make PCMHs more financially viable. Of the alternative payment methods being considered, shared savings models are unlikely to transform medical practice whereas capitation models place unrealistic expectations on providers to accept epidemiological risk. Episode payment may strike a feasible balance for PCMHs, with newly available episode definitions presenting opportunities not previously available.

  11. Center for commercial applications of combustion in space (CCACS); A partnership for space commercialization at the Colorado School of Mines

    Science.gov (United States)

    Schowengerdt, F. D.; Kee, Bob; Linne, Mark; McKinnon, Tom; Moore, John; Parker, Terry; Readey, Dennis; Tilton, John E.; Helble, Joe

    1997-01-01

    The Center for Commercial Applications of Combustion in Space (CCACS) is a NASA/Industry/University consortium at the Colorado School of Mines (CSM). The mission of the Center is to assist industry in developing commercial products by conducting combustion research which takes advantage of the unique properties of space. By conducting experiments in near-zero gravity, convection and buoyancy effects can be minimized and new fundamental design-related knowledge can be gained which can be used to improve combustion-related products and processes on earth. Companies, government laboratories and universities most actively involved in CCACS at present include ABB Combustion, ADA Technologies, Advanced Refractory Technologies, Golden Technologies, Lockheed-Martin, Southwest Sciences, Space Systems/Lora, NASA-Lewis, JPL, the Baylor Dental School and the University of Connecticut. Products and processes of interest to the Center participants include industrial process combustors; catalytic combustion; Halon replacements; ceramic powders, whiskers and fibers; metal-matrix composites; NiTi for bone replacement; diamond coatings for oil-well drill bits; zeolites; imaging sensor arrays and other instrumentation for flame and particulate diagnostics. The center also assists member companies in marketing the resulting products and processes.

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

    Science.gov (United States)

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

    2014-11-01

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

  13. Emergency Operations Center ribbon cutting

    Science.gov (United States)

    2009-01-01

    Center Director Gene Goldman and special guests celebrate the opening of the site's new Emergency Operations Center on June 2. Participants included (l t r): Steven Cooper, deputy director of the National Weather Service Southern Region; Tom Luedtke, NASA associate administrator for institutions and management; Charles Scales, NASA associate deputy administrator; Mississippi Gov. Haley Barbour; Gene Goldman, director of Stennis Space Center; Jack Forsythe, NASA assistant administrator for the Office of Security and Program Protection; Dr. Richard Williams, NASA chief health and medical officer; and Weldon Starks, president of Starks Contracting Company Inc. of Biloxi.

  14. Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach.

    Science.gov (United States)

    McCoy, Lise; Pettit, Robin K; Kellar, Charlyn; Morgan, Christine

    2018-01-01

    Medical education is moving toward active learning during large group lecture sessions. This study investigated the saturation and breadth of active learning techniques implemented in first year medical school large group sessions. Data collection involved retrospective curriculum review and semistructured interviews with 20 faculty. The authors piloted a taxonomy of active learning techniques and mapped learning techniques to attributes of learning-centered instruction. Faculty implemented 25 different active learning techniques over the course of 9 first year courses. Of 646 hours of large group instruction, 476 (74%) involved at least 1 active learning component. The frequency and variety of active learning components integrated throughout the year 1 curriculum reflect faculty familiarity with active learning methods and their support of an active learning culture. This project has sparked reflection on teaching practices and facilitated an evolution from teacher-centered to learning-centered instruction.

  15. Structural Analysis Peer Review for the Static Display of the Orbiter Atlantis at the Kennedy Space Center Visitors Center

    Science.gov (United States)

    Minute, Stephen A.

    2013-01-01

    Mr. Christopher Miller with the Kennedy Space Center (KSC) NASA Safety & Mission Assurance (S&MA) office requested the NASA Engineering and Safety Center's (NESC) technical support on March 15, 2012, to review and make recommendations on the structural analysis being performed for the Orbiter Atlantis static display at the KSC Visitor Center. The principal focus of the assessment was to review the engineering firm's structural analysis for lifting and aligning the orbiter and its static display configuration

  16. United States academic medical centers: priorities and challenges amid market transformation.

    Science.gov (United States)

    Thompson, Irene M; Anason, Barbara

    2012-01-01

    United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation.

  17. The Sharjah Center for Astronomy and Space Sciences (SCASS 2015): Concept and Resources

    Science.gov (United States)

    Naimiy, Hamid M. K. Al

    2015-08-01

    The Sharjah Center for Astronomy and Space Sciences (SCASS) was launched this year 2015 at the University of Sharjah in the UAE. The center will serve to enrich research in the fields of astronomy and space sciences, promote these fields at all educational levels, and encourage community involvement in these sciences. SCASS consists of:The Planetarium: Contains a semi-circle display screen (18 meters in diameter) installed at an angle of 10° which displays high-definition images using an advanced digital display system consisting of seven (7) high-performance light-display channels. The Planetarium Theatre offers a 200-seat capacity with seats placed at highly calculated angles. The Planetarium also contains an enormous star display (Star Ball - 10 million stars) located in the heart of the celestial dome theatre.The Sharjah Astronomy Observatory: A small optical observatory consisting of a reflector telescope 45 centimeters in diameter to observe the galaxies, stars and planets. Connected to it is a refractor telescope of 20 centimeters in diameter to observe the sun and moon with highly developed astronomical devices, including a digital camera (CCD) and a high-resolution Echelle Spectrograph with auto-giving and remote calibration ports.Astronomy, space and physics educational displays for various age groups include:An advanced space display that allows for viewing the universe during four (4) different time periods as seen by:1) The naked eye; 2) Galileo; 3) Spectrographic technology; and 4) The space technology of today.A space technology display that includes space discoveries since the launching of the first satellite in 1940s until now.The Design Concept for the Center (450,000 sq. meters) was originated by HH Sheikh Sultan bin Mohammed Al Qasimi, Ruler of Sharjah, and depicts the dome as representing the sun in the middle of the center surrounded by planetary bodies in orbit to form the solar system as seen in the sky.

  18. Results of an Institutional LGBT Climate Survey at an Academic Medical Center.

    Science.gov (United States)

    Chester, Sean D; Ehrenfeld, Jesse M; Eckstrand, Kristen L

    2014-12-01

    The purpose of this study was to characterize the climate and culture experienced by lesbian, gay, bisexual, and transgender (LGBT) employees and students at one large academic medical center. An anonymous, online institutional climate survey was used to assess the attitudes and experiences of LGBT employees and students. There were 42 LGBT and 14 non-LGBT survey participants. Results revealed that a surprisingly large percentage of LGBT individuals experienced pressure to remain "closeted" and were harassed despite medical center policies of non-discrimination. Continuing training, inclusive policies and practices, and the development of mechanisms to address LGBT-specific harassment are necessary for improving institutional climate.

  19. NASA Glenn Research Center Solar Cell Experiment Onboard the International Space Station

    Science.gov (United States)

    Myers, Matthew G.; Wolford, David S.; Prokop, Norman F.; Krasowski, Michael J.; Parker, David S.; Cassidy, Justin C.; Davies , William E.; Vorreiter, Janelle O.; Piszczor, Michael F.; Mcnatt, Jeremiah S.; hide

    2016-01-01

    Accurate air mass zero (AM0) measurement is essential for the evaluation of new photovoltaic (PV) technology for space solar cells. The NASA Glenn Research Center (GRC) has flown an experiment designed to measure the electrical performance of several solar cells onboard NASA Goddard Space Flight Center's (GSFC) Robotic Refueling Missions (RRM) Task Board 4 (TB4) on the exterior of the International Space Station (ISS). Four industry and government partners provided advanced PV devices for measurement and orbital environment testing. The experiment was positioned on the exterior of the station for approximately eight months, and was completely self-contained, providing its own power and internal data storage. Several new cell technologies including four-junction (4J) Inverted Metamorphic Multi-junction (IMM) cells were evaluated and the results will be compared to ground-based measurement methods.

  20. Space Station Environmental Control and Life Support System Test Facility at Marshall Space Flight Center

    Science.gov (United States)

    Springer, Darlene

    1989-01-01

    Different aspects of Space Station Environmental Control and Life Support System (ECLSS) testing are currently taking place at Marshall Space Flight Center (MSFC). Unique to this testing is the variety of test areas and the fact that all are located in one building. The north high bay of building 4755, the Core Module Integration Facility (CMIF), contains the following test areas: the Subsystem Test Area, the Comparative Test Area, the Process Material Management System (PMMS), the Core Module Simulator (CMS), the End-use Equipment Facility (EEF), and the Pre-development Operational System Test (POST) Area. This paper addresses the facility that supports these test areas and briefly describes the testing in each area. Future plans for the building and Space Station module configurations will also be discussed.

  1. NASA Space Engineering Research Center for VLSI systems design

    Science.gov (United States)

    1991-01-01

    This annual review reports the center's activities and findings on very large scale integration (VLSI) systems design for 1990, including project status, financial support, publications, the NASA Space Engineering Research Center (SERC) Symposium on VLSI Design, research results, and outreach programs. Processor chips completed or under development are listed. Research results summarized include a design technique to harden complementary metal oxide semiconductors (CMOS) memory circuits against single event upset (SEU); improved circuit design procedures; and advances in computer aided design (CAD), communications, computer architectures, and reliability design. Also described is a high school teacher program that exposes teachers to the fundamentals of digital logic design.

  2. Marion duPont Scott Equine Medical Center uses innovative lameness treatment

    OpenAIRE

    Lee, Kate

    2009-01-01

    Virginia Tech's Marion duPont Scott Equine Medical Center is now offering an equine lameness therapy that prevents further degeneration of the affected joint and offers a longer-lasting benefit than traditional steroid treatment.

  3. Meeting changing conditoins at the Rhode Island Medical Center cogeneration plant

    International Nuclear Information System (INIS)

    Galamaga, D.P.; Bowen, P.T.

    1993-01-01

    The Rhode Island Department of Mental Health, Retardation and Hospitals is one state department in Rhode Island whose basic function is to provide services to seriously disabled individuals throughout the state. Savings in operating expenses from the Rhode Island Medical Center Central Power Plant have accruded to provide operating funds for the major programs. Operating under a Director who reports to the Governor of Rhode Island, the Department has three major divisions, approximately 2500 employees, and a budget of 200 million dollars. Its operations extend throughout the state and the major focus for hospital or institutional levels of care reside in three major locations, the Dr. U.E. Zambarano Memorial Hospital in northern Rhode Island, the Dr. Joseph Ladd Center in southern Rhode Island, and the Rhode Island Medical Center in the middle of the state. Besides these institution-based operations, the Department sponsors a wide range of rehabilitative programming in the community other through direct operations of facilities such as group homes or through contracts with private non-profit providers of service

  4. Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach

    Science.gov (United States)

    McCoy, Lise; Pettit, Robin K; Kellar, Charlyn; Morgan, Christine

    2018-01-01

    Background: Medical education is moving toward active learning during large group lecture sessions. This study investigated the saturation and breadth of active learning techniques implemented in first year medical school large group sessions. Methods: Data collection involved retrospective curriculum review and semistructured interviews with 20 faculty. The authors piloted a taxonomy of active learning techniques and mapped learning techniques to attributes of learning-centered instruction. Results: Faculty implemented 25 different active learning techniques over the course of 9 first year courses. Of 646 hours of large group instruction, 476 (74%) involved at least 1 active learning component. Conclusions: The frequency and variety of active learning components integrated throughout the year 1 curriculum reflect faculty familiarity with active learning methods and their support of an active learning culture. This project has sparked reflection on teaching practices and facilitated an evolution from teacher-centered to learning-centered instruction. PMID:29707649

  5. A User-Centered Cooperative Information System for Medical Imaging Diagnosis.

    Science.gov (United States)

    Gomez, Enrique J.; Quiles, Jose A.; Sanz, Marcos F.; del Pozo, Francisco

    1998-01-01

    Presents a cooperative information system for remote medical imaging diagnosis. General computer-supported cooperative work (CSCW) problems addressed are definition of a procedure for the design of user-centered cooperative systems (conceptual level); and improvement of user feedback and optimization of the communication bandwidth in highly…

  6. The financial management of research centers and institutes at U.S. medical schools: findings from six institutions.

    Science.gov (United States)

    Mallon, William T

    2006-06-01

    To explore three questions surrounding the financial management of research centers and institutes at U.S. medical schools: How do medical schools allocate institutional funds to centers and institutes? How and by whom are those decisions made? What are the implications of these decision-making models on the future of the academic biomedical research enterprise? Using a qualitative research design, the author and associates interviewed over 150 faculty members and administrators at six medical schools and their parent universities in 2004. Interview data were transcribed, coded, and analyzed using a grounded theory approach. This methodology generated rich descriptions and explanations of the six medical schools, which can produce extrapolations to, but not necessarily generalizable findings to, other institutions and settings. An examination of four dimensions of financial decision-making-funding timing, process, structure, and culture-produces two essential models of how medical schools approach the financial management of research centers. In the first, a "charity" model, center directors make hat-in-hand appeals directly to the dean, the result of which may depend on individual negotiation skills and personal relationships. In the second, a "planned-giving" model, the process for obtaining and renewing funds is institutionalized, agreed upon, and monitored. The ways in which deans, administrators, department chairs, and center directors attend to, decide upon, and carry out financial decisions can influence how people throughout the medical school think about interdisciplinary and collaborative activities marshalled though centers and institutes.

  7. The National Space Science Data Center guide to international rocket data

    Science.gov (United States)

    Dubach, L. L.

    1972-01-01

    Background information is given which briefly describes the mission of the National Space Science Data Center (NSSDC), including its functions and systems, along with its policies and purposes for collecting rocket data. The operation of a machine-sensible rocket information system, which allows the Data Center to have convenient access to information and data concerning all rocket flights carrying scientific experiments, is also described. The central feature of this system, an index of rocket flights maintained on magnetic tape, is described. Standard outputs for NSSDC and for the World Data Center A (WDC-A) for Rockets and Satellites are described.

  8. The Johnson Space Center management information systems: User's guide to JSCMIS

    Science.gov (United States)

    Bishop, Peter C.; Erickson, Lloyd

    1990-01-01

    The Johnson Space Center Management Information System (JSCMIS) is an interface to computer data bases at the NASA Johnson Space Center which allows an authorized user to browse and retrieve information from a variety of sources with minimum effort. The User's Guide to JSCMIS is the supplement to the JSCMIS Research Report which details the objectives, the architecture, and implementation of the interface. It is a tutorial on how to use the interface and a reference for details about it. The guide is structured like an extended JSCMIS session, describing all of the interface features and how to use them. It also contains an appendix with each of the standard FORMATs currently included in the interface. Users may review them to decide which FORMAT most suits their needs.

  9. On deformation of foliations with a center in the projective space

    Directory of Open Access Journals (Sweden)

    MOVASATI HOSSEIN

    2001-01-01

    Full Text Available Let be a foliation in the projective space of dimension two with a first integral of the type , where F and G are two polynomials on an affine coordinate, = and g.c.d.(p, q = 1. Let z be a nondegenerate critical point of , which is a center singularity of , and be a deformation of in the space of foliations of degree deg( such that its unique deformed singularity near z persists in being a center. We will prove that the foliation has a first integral of the same type of . Using the arguments of the proof of this result we will give a lower bound for the maximum number of limit cycles of real polynomial differential equations of a fixed degree in the real plane.

  10. Satellite medical centers project

    Science.gov (United States)

    Aggarwal, Arvind

    2002-08-01

    World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

  11. NASA's astrophysics archives at the National Space Science Data Center

    Science.gov (United States)

    Vansteenberg, M. E.

    1992-01-01

    NASA maintains an archive facility for Astronomical Science data collected from NASA's missions at the National Space Science Data Center (NSSDC) at Goddard Space Flight Center. This archive was created to insure the science data collected by NASA would be preserved and useable in the future by the science community. Through 25 years of operation there are many lessons learned, from data collection procedures, archive preservation methods, and distribution to the community. This document presents some of these more important lessons, for example: KISS (Keep It Simple, Stupid) in system development. Also addressed are some of the myths of archiving, such as 'scientists always know everything about everything', or 'it cannot possibly be that hard, after all simple data tech's do it'. There are indeed good reasons that a proper archive capability is needed by the astronomical community, the important question is how to use the existing expertise as well as the new innovative ideas to do the best job archiving this valuable science data.

  12. Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations.

    Science.gov (United States)

    Kraus, Sarah K; Sen, Sanchita; Murphy, Michelle; Pontiggia, Laura

    2017-01-01

    To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR) program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%), non-formulary omission (16.2%), dose discrepancy (10.1%), and frequency discrepancy (4.1%). Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

  13. Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations

    Directory of Open Access Journals (Sweden)

    Kraus SK

    2017-06-01

    Full Text Available Objectives: To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. Methods: A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Results: Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%, non-formulary omission (16.2%, dose discrepancy (10.1%, and frequency discrepancy (4.1%. Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. Conclusion: A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

  14. NASA Goddard Space Flight Center Supply Chain Management Program

    Science.gov (United States)

    Kelly, Michael P.

    2011-01-01

    This slide presentation reviews the working of the Supplier Assessment Program at NASA Goddard Space Flight Center. The program supports many GSFC projects to ensure suppliers are aware of and are following the contractual requirements, to provide an independent assessment of the suppliers' processes, and provide suppliers' safety and mission assurance organizations information to make the changes within their organization.

  15. An Architecture for Continuous Data Quality Monitoring in Medical Centers.

    Science.gov (United States)

    Endler, Gregor; Schwab, Peter K; Wahl, Andreas M; Tenschert, Johannes; Lenz, Richard

    2015-01-01

    In the medical domain, data quality is very important. Since requirements and data change frequently, continuous and sustainable monitoring and improvement of data quality is necessary. Working together with managers of medical centers, we developed an architecture for a data quality monitoring system. The architecture enables domain experts to adapt the system during runtime to match their specifications using a built-in rule system. It also allows arbitrarily complex analyses to be integrated into the monitoring cycle. We evaluate our architecture by matching its components to the well-known data quality methodology TDQM.

  16. Disbursement of $65 million to the State of Texas for construction of a Regional Medical Technology Center at the former Superconducting Super Collider Site, Waxahachie, Texas

    International Nuclear Information System (INIS)

    1995-05-01

    As part of a settlement agreement between the US DOE and the State of Texas, DOE proposes to transfer $65 million of federal funds to the Texas National Research Laboratory Commission (TNLRC) for construction of the Regional Medical Technology Center (RMTC) to be located in Ellis County, Texas. The RMTC would be a state-of-the-art medical facility for proton cancer therapy, operated by the State of Texas in conjunction with the University of Texas Southwestern Medical Center. The RMTC would use the linear accelerator assets of the recently terminated DOE Superconducting Super Collider Project to accelerate protons to high energies for the treatment of cancer patients. The current design provides for treatment areas, examination rooms, support laboratories, diagnostic imaging equipment, and office space as well as the accelerators (linac and synchrotron) and beam steering and shaping components. The potential environmental consequences of the proposed action are expected to be minor

  17. Students build glovebox at Space Science Center

    Science.gov (United States)

    2001-01-01

    Students in the Young Astronaut Program at the Coca-Cola Space Science Center in Columbus, GA, constructed gloveboxes using the new NASA Student Glovebox Education Guide. The young astronauts used cardboard copier paper boxes as the heart of the glovebox. The paper boxes transformed into gloveboxes when the students pasted poster-pictures of an actual NASA microgravity science glovebox inside and outside of the paper boxes. The young astronauts then added holes for gloves and removable transparent top covers, which completed the construction of the gloveboxes. This image is from a digital still camera; higher resolution is not available.

  18. The economic impact and multiplier effect of a family practice clinic on an academic medical center.

    Science.gov (United States)

    Schneeweiss, R; Ellsbury, K; Hart, L G; Geyman, J P

    1989-07-21

    Academic medical centers are facing the need to expand their primary care referral base in an increasingly competitive medical environment. This study describes the medical care provided during a 1-year period to 6304 patients registered with a family practice clinic located in an academic medical center. The relative distribution of primary care, secondary referrals, inpatient admissions, and their associated costs are presented. The multiplier effect of the primary care clinic on the academic medical center was substantial. For every $1 billed for ambulatory primary care, there was $6.40 billed elsewhere in the system. Each full-time equivalent family physician generated a calculated sum of $784,752 in direct, billed charges for the hospital and $241,276 in professional fees for the other specialty consultants. The cost of supporting a primary care clinic is likely to be more than offset by the revenues generated from the use of hospital and referral services by patients who received care in the primary care setting.

  19. NCERA-101 Station Report from Kennedy Space Center, FL, USA

    Science.gov (United States)

    Massa, Gioia D.; Wheeler, Raymond M.

    2014-01-01

    This is our annual report to the North Central Extension Research Activity, which is affiliated with the USDA and Land Grant University Agricultural Experiment Stations. I have been a member of this committee for 25 years. The presentation will be given by Dr. Gioia Massa, Kennedy Space Center

  20. Promoting cancer screening within the patient centered medical home.

    Science.gov (United States)

    Sarfaty, Mona; Wender, Richard; Smith, Robert

    2011-01-01

    While consensus has grown that primary care is the essential access point in a high-performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the most promising approach to addressing the burden of chronic disease, improving health outcomes, and reducing health spending. However, the potential for the medical home to improve the delivery of cancer screening (and preventive services in general) has received limited attention in both conceptualization and practice. Medical home demonstrations to date have included few evidence-based preventive services in their outcome measures, and few have evaluated the effect of different payment models. Decreasing use of hospitals and emergency rooms and an emphasis on improving chronic care represent improvements in effective delivery of healthcare, but leave opportunities for reducing the burden of cancer untouched. Data confirm that what does or does not happen in the primary care setting has a substantial impact on cancer outcomes. Insofar as cancer is the leading cause of death before age 80, the PCMH model must prioritize adherence to cancer screening according to recommended guidelines, and systems, financial incentives, and reimbursements must be aligned to achieve that goal. This article explores capacities that are needed in the medical home model to facilitate the integration of cancer screening and other preventive services. These capacities include improved patient access and communication, health risk assessments, periodic preventive health exams, use of registries that store cancer risk information and screening history, ability to track and follow up on tests and referrals, feedback on performance, and payment models that reward cancer screening. Copyright © 2011 American Cancer Society, Inc.

  1. Towards a person-centered medical education: challenges and imperatives (I

    Directory of Open Access Journals (Sweden)

    Andrew Miles

    2015-01-01

    Full Text Available It is increasingly claimed that modern medicine has entered into crisis —a crisis of knowledge (uncertainty over what counts as “evidence” for decision-making and what does not, care (a deficit in sympathy, empathy, compassion, dignity, autonomy, patient safety (neglect, iatrogenic injury, malpractice, excess deaths, economic costs (which threaten to bankrupt health systems worldwide and clinical and institutional governance (a failure of basic and advanced management, inspirational and transformational leadership. We believe such a contention to be essentially correct. In the current article, we ask how the delineated components of the crisis can be individually understood in order to allow them to be collectively addressed. We ask how a transition can be effected away from impersonal, decontextualized and fragmented services in the direction of newer models of service provision that are personalized, contextualized and integrated. How, we ask, can we improve healthcare outcomes while simultaneously containing or lowering their costs? In initial answer to such questions —which are of considerable political as well as clinical significance— we assert that a new approach has become necessary, particularly in the context of the current epidemic of multi-morbid and socially complex long term illness. This new approach, we argue, is represented by the development and application of the concepts and methods of person-centered healthcare (PCH, a philosophy and technique in the care of the sick that enables clinicians and health systems to re-introduce humanistic ideals into clinical practice alongside continuing scientific advance, thereby restoring to medicine the humanism it has lost in over a century of empiricism. But the delivery of a person-centered healthcare within health systems requires a person-centered education and training. In this article we consider, then, why person-centered teaching innovations in the undergraduate medical

  2. Environmental control and life support testing at the Marshall Space Flight Center

    Science.gov (United States)

    Schunk, Richard G.; Humphries, William R.

    1987-01-01

    The Space Station Environmental Control and Life Support System (ECLSS) test program at the Marshall Space Flight Center (MSFC) is addressed. The immediate goals and current activities of the test program are discussed. Also described are the Core Module Integration Facility (CMIF) and the initial ECLSS test configuration. Future plans for the ECLSS test program and the CMIF are summarized.

  3. Marshall Space Flight Center's Virtual Reality Applications Program 1993

    Science.gov (United States)

    Hale, Joseph P., II

    1993-01-01

    A Virtual Reality (VR) applications program has been under development at the Marshall Space Flight Center (MSFC) since 1989. Other NASA Centers, most notably Ames Research Center (ARC), have contributed to the development of the VR enabling technologies and VR systems. This VR technology development has now reached a level of maturity where specific applications of VR as a tool can be considered. The objectives of the MSFC VR Applications Program are to develop, validate, and utilize VR as a Human Factors design and operations analysis tool and to assess and evaluate VR as a tool in other applications (e.g., training, operations development, mission support, teleoperations planning, etc.). The long-term goals of this technology program is to enable specialized Human Factors analyses earlier in the hardware and operations development process and develop more effective training and mission support systems. The capability to perform specialized Human Factors analyses earlier in the hardware and operations development process is required to better refine and validate requirements during the requirements definition phase. This leads to a more efficient design process where perturbations caused by late-occurring requirements changes are minimized. A validated set of VR analytical tools must be developed to enable a more efficient process for the design and development of space systems and operations. Similarly, training and mission support systems must exploit state-of-the-art computer-based technologies to maximize training effectiveness and enhance mission support. The approach of the VR Applications Program is to develop and validate appropriate virtual environments and associated object kinematic and behavior attributes for specific classes of applications. These application-specific environments and associated simulations will be validated, where possible, through empirical comparisons with existing, accepted tools and methodologies. These validated VR analytical

  4. Selection and construction of nuclear and radiation emergency medical center in a region

    International Nuclear Information System (INIS)

    Wang Guojun; He Xu; Liao Li; Gao Dong

    2014-01-01

    Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

  5. The Context of Creating Space: Assessing the Likelihood of College LGBT Center Presence

    Science.gov (United States)

    Fine, Leigh E.

    2012-01-01

    LGBT (lesbian, gay, bisexual, and transgender) resource centers are campus spaces dedicated to the success of sexual minority students. However, only a small handful of American colleges and universities have such spaces. Political opportunity and resource mobilization theory can provide a useful framework for understanding what contextual factors…

  6. Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

    National Research Council Canada - National Science Library

    Diehl, Diane S

    2004-01-01

    The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...

  7. Key Elements of Clinical Physician Leadership at an Academic Medical Center

    Science.gov (United States)

    Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

    2011-01-01

    Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

  8. Gender Disparities in Faculty Rank: Factors that Affect Advancement of Women Scientists at Academic Medical Centers

    Directory of Open Access Journals (Sweden)

    Cristina M. López

    2018-04-01

    Full Text Available While a significant portion of women within academic science are employed within medical schools, women faculty in these academic medical centers are disproportionately represented in lower faculty ranks. The medical school setting is a critical case for both understanding and advancing women in basic sciences. This study highlights the findings from focus groups conducted with women faculty across Assistant, Associate, and Full Professor ranks (n = 35 in which they discussed barriers and facilitators for advancement of women basic scientists at an academic medical center. Qualitative analysis demonstrated several emergent themes that affect women’s advancement, including gendered expectation norms (e.g., good citizenship, volunteerism, work-life balance, mentorship/sponsorship, adoption of a team science approach, tenure process milestones, soft money research infrastructure, institution specific policies (or lack thereof, and operating within an MD-biased culture. These findings are compared with the extant literature of women scientists in STEM institutions. Factors that emerged from these focus groups highlight the need for evidence-based interventions in the often overlooked STEM arena of academic medical centers.

  9. The NASA Community Coordinated Modeling Center (CCMC) Next Generation Space Weather Data Warehouse

    Science.gov (United States)

    Maddox, M. M.; Kuznetsova, M. M.; Pulkkinen, A. A.; Zheng, Y.; Rastaetter, L.; Chulaki, A.; Pembroke, A. D.; Wiegand, C.; Mullinix, R.; Boblitt, J.; Mendoza, A. M. M.; Swindell, M. J., IV; Bakshi, S. S.; Mays, M. L.; Shim, J. S.; Hesse, M.; Collado-Vega, Y. M.; Taktakishvili, A.; MacNeice, P. J.

    2014-12-01

    The Community Coordinated Modeling Center (CCMC) at NASA Goddard Space Flight Center enables, supports, and performs research and development for next generation space science and space weather models. The CCMC currently hosts a large and expanding collection of state-or-the-art, physics-based space weather models that have been developed by the international research community. There are many tools and services provided by the CCMC that are currently available world-wide, along with the ongoing development of new innovative systems and software for research, discovery, validation, visualization, and forecasting. Over the history of the CCMC's existence, there has been one constant engineering challenge - describing, managing, and disseminating data. To address the challenges that accompany an ever-expanding number of models to support, along with a growing catalog of simulation output - the CCMC is currently developing a flexible and extensible space weather data warehouse to support both internal and external systems and applications. This paper intends to chronicle the evolution and future of the CCMC's data infrastructure, and the current infrastructure re-engineering activities that seek to leverage existing community data model standards like SPASE and the IMPEx Simulation Data Model.

  10. MEANINGS OF SPACE OF COTTAGE-TYPE RESIDENTIAL CENTER IN MILIEU THERAPY FOR EMOTIONALLY DISTURBED CHILDREN

    OpenAIRE

    Ishigaki, Aya; Kanno, Minoru; Onoda, Yasuaki; Sakaguchi, Taiyo

    2004-01-01

    The number of emotionally disturbed children in Japan has been increasing recently; However, only few attempts with an aim at improving children's living space have been made at treatment centers. We conducted some field surveys on the cottage-type residential center to examine the relationship among space, communication, and the effectiveness of therapy. In addition, to clarify conditions of treatment for children with emotional disturbances, the children's daily life with milieu therapy was...

  11. CCSDS telemetry systems experience at the Goddard Space Flight Center

    Science.gov (United States)

    Carper, Richard D.; Stallings, William H., III

    1990-01-01

    NASA Goddard Space Flight Center (GSFC) designs, builds, manages, and operates science and applications spacecraft in near-earth orbit, and provides data capture, data processing, and flight control services for these spacecraft. In addition, GSFC has the responsibility of providing space-ground and ground-ground communications for near-earth orbiting spacecraft, including those of the manned spaceflight programs. The goal of reducing both the developmental and operating costs of the end-to-end information system has led the GSFC to support and participate in the standardization activities of the Consultative Committee for Space Data Systems (CCSDS), including those for packet telemetry. The environment in which such systems function is described, and the GSFC experience with CCSDS packet telemetry in the context of the Gamma-Ray Observatory project is discussed.

  12. 38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

    Science.gov (United States)

    2010-07-01

    ... replacement and upgrading of equipment at Veterans Memorial Medical Center. 17.351 Section 17.351 Pensions... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

  13. Clinical skill center: a review of present situation and importance in medical education curriculum

    Directory of Open Access Journals (Sweden)

    Haleh Talaei

    2002-07-01

    Full Text Available Clinical skill centers were designed in 1960, offers innovative, more effective clinical health care and treatment curriculum. Clinical skill center (CSC can provide a special facility for clinical and communication skills practice in a setting outside hospital wards in order to train students with enough confidence of confronting real patients. Learning clinical skills in these centers are not patient-dependent and by practicing on manikins and simulated models errors in real patients can be prevented. Moreover, possible feedback of this method can be used for evaluation and can improve quality and quantity of the education. This review intends to determine the purpose, undertaking, and structure of CSC. The study emphasizes the importance of integrating the clinical skill centers into the teaching curriculum of medical universities. Apparently, organizing clinical skill centers can play an important role for improving the quality and quantity of the educational system and consequently post-graduate performance. The authors recommend this program can be a solution for having both the knowledge and skill of diagnosis and treatment seasonal and rare diseases. Key words clinical skill center, medical education, curriculum

  14. Space and Missile Systems Center Standard: Test Requirements for Launch, Upper-Stage and Space Vehicles

    Science.gov (United States)

    2014-09-05

    Aviation Blvd. El Segundo, CA 90245 4. This standard has been approved for use on all Space and Missile Systems Center/Air Force Program...140 Satellite Hardness and Survivability; Testing Rationale for Electronic Upset and Burnout Effects 30. JANNAF-GL-2012-01-RO Test and Evaluation...vehicle, subsystem, and unit lev- els . Acceptance testing shall be conducted on all subsequent flight items. The protoqualification strategy shall require

  15. A Detailed Assessment for the Potential use of Waste Hydrogen Gas at Stennis Space Center

    Data.gov (United States)

    National Aeronautics and Space Administration — Stennis Space Center (SSC) is NASA’s primary liquid rocket engine test facility. As such, large amounts of liquid hydrogen are used as a rocket propellant. This...

  16. Responding to the Concerns of Student Cultural Groups: Redesigning Spaces for Cultural Centers

    Science.gov (United States)

    McDowell, Anise Mazone; Higbee, Jeanne L.

    2014-01-01

    This paper describes the engagement of a student committee in redesigning an entire floor of a university union to accommodate student cultural centers and provide space in a fair and equitable manner. The reorganization focused on the process as well as the task of allocating space, with an emphasis on the opportunity to foster the development of…

  17. En Route Care in Confined Spaces: Impact of Transport, Immobilization Practices, Space Constraints, and Medical Awareness Enhancements

    Science.gov (United States)

    2017-10-01

    physical space , ergonomics , and enhancement of medical awareness. Outcomes of the project will provide significant information and tools that can be...This group of research projects was designed to look at various aspects of transport, immobilization, optimal physical space , ergonomics , and...Devereux, J. 2002. The nature of work -related neck and upper limb musculoskeletal disorders. Applied Ergonomics . 33(3): 207-17. Chaffin, D.B

  18. Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

    Science.gov (United States)

    2008-06-06

    Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

  19. [HIGH VELOCITY PENETRATING HEAD AND NECK INJURIES OF SYRIAN CIVIL WAR CASUALTIES TREATED IN THE GALILEE MEDICAL CENTER].

    Science.gov (United States)

    Ronen, Ohad; Assadi, Nidal; Sela, Eyal

    2017-05-01

    For two years the State of Israel has been treating casualties from the Syrian civil war. The Galilee Medical Center in Nahariya is the main hospital for this humanitarian mission. Objectives: To evaluate the demographic and clinical characteristics of the casualties that were treated in our department. Information from medical records of all Syrian casualties evacuated to the Galilee Medical Center were evaluated. Between March 2013 and December 2014, 450 casualties were evacuated to the Galilee Medical Center. Of those, 45 were treated in the Department of Otolaryngology - Head and Neck Surgery. Of the 45 cases, 43 were male (95.5%) and the mean age was 30.4 years (range 1-79 years). There was a significant difference in terms of gender (p Syria, and 12 died. Of all Syrian injured treated in the ENT department, the vast majority were young men. The main cause of injury was gunshot wounds. It is likely that the lack of protective gear that exist in western armies is a factor in the complex injuries treated at the Galilee Medical Center.

  20. System Engineering Processes at Kennedy Space Center for Development of the SLS and Orion Launch Systems

    Science.gov (United States)

    Schafer, Eric J.

    2012-01-01

    There are over 40 subsystems being developed for the future SLS and Orion Launch Systems at Kennedy Space Center. These subsystems developed at the Kennedy Space Center Engineering Directorate follow a comprehensive design process which requires several different product deliverables during each phase of each of the subsystems. This Paper describes this process and gives an example of where the process has been applied.

  1. A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

    Science.gov (United States)

    Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

    2015-01-01

    Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

  2. The Institute for Safe Medication Practices and Poison Control Centers: Collaborating to Prevent Medication Errors and Unintentional Poisonings.

    Science.gov (United States)

    Vaida, Allen J

    2015-06-01

    This article provides an overview on the Institute for Safe Medication Practices (ISMP), the only independent nonprofit organization in the USA devoted to the prevention of medication errors. ISMP developed the national Medication Errors Reporting Program (MERP) and investigates and analyzes errors in order to formulate recommendations to prevent further occurrences. ISMP works closely with the US Food and Drug Administration (FDA), drug manufacturers, professional organizations, and others to promote changes in package design, practice standards, and healthcare practitioner and consumer education. By collaborating with ISMP to share and disseminate information, Poison Control centers, emergency departments, and toxicologists can help decrease unintentional and accidental poisonings.

  3. Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

    Science.gov (United States)

    Cole, Evan S; Campbell, Claudia; Diana, Mark L; Webber, Larry; Culbertson, Richard

    2015-01-01

    The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

  4. 76 FR 59407 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

    Science.gov (United States)

    2011-09-26

    ...] Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... Administration (FDA) is announcing the availability of its report of scientific and medical literature and... Research Report of Scientific and Medical Literature and Information on Non-Standardized Allergenic...

  5. Activities of an ethics consultation service in a Tertiary Military Medical Center.

    Science.gov (United States)

    Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

    2000-07-01

    The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.

  6. Center of Excellence for Laser Applications in Medicine, Microlaser Microscope

    Energy Technology Data Exchange (ETDEWEB)

    Webb, R. H.

    2003-01-17

    The Center of Excellence for Laser Applications in Medicine at the Schepens Eye Research Institute (SERI) is a Center for: A core group of researchers who support each other and their various projects for real-time medical imaging and diagnostics in contiguous space at SERI. Clinical collaborators who participate in the core research at SERI, MEEI, and local ophthalmology practices, and at associated sites around the world. Industrial partners who transfer our technology to commercial products that will reach clinical usage everywhere. Students, post-doctoral associates and medical fellows who work with us and learn how to practice real-time medical imaging and diagnostics.

  7. Implementation of epic beaker anatomic pathology at an academic medical center

    Directory of Open Access Journals (Sweden)

    John Larry Blau

    2017-01-01

    Full Text Available Background: Beaker is a relatively new laboratory information system (LIS offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015. Methods: This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document. Results: We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time. Conclusions: The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by

  8. Burnout among nurses working in medical and educational centers in Shahrekord, Iran

    Science.gov (United States)

    Moghaddasi, Jaefar; Mehralian, Hossein; Aslani, Yousef; Masoodi, Reza; Amiri, Masoud

    2013-01-01

    Background: Nursing burnout is the main characteristic of job stress that is a delayed reaction to chronic stressful situations in the workplace which could affect nurses who do not have sufficient emotional energy to cope and communicate with different types of patients. There is also sometimes this belief that they do not have the required capabilities for their jobs. The aim of this study was the evaluation of burnout among nurses working in medical and educational centers in Shahrekord. Materials and Methods: This descriptive study was performed on 340 nurses working in medical and educational centers in Shahrekord in 2009. Samples were selected using proportionate random sampling. Demographic information and the Maslach Burnout Inventory (MBI) were filled in for all nurses. Results: Burnout was considerable among nurses. The results showed that 34.6, 28.8, and 95.7% of the nurses had emotional exhaustion (EE), high depersonalization (DP), and high reduced personal accomplishment (PA), respectively. The mean scores (± standard deviation) for EE, DP, and PA were 22.77 (12.44), 6.99 (6.23), and 32.20 (9.26), respectively. Conclusions: Our results showed that burnout was noticeable among nurses working in medical and educational centers in Shahrekord. Disproportionate relationship between the number of nurses, workload, and income was the most important factor affecting nursing burnout. Due to the importance of nursing in the health-care system, policy makers should adopt suitable strategies for increasing the satisfaction of nurses. PMID:24403925

  9. User-centered design of a mobile medication management.

    Science.gov (United States)

    Sedlmayr, Brita; Schöffler, Jennifer; Prokosch, Hans-Ulrich; Sedlmayr, Martin

    2018-03-05

    The use of a nationwide medication plan has been promoted as an effective strategy to improve patient safety in Germany. However, the medication plan only exists as a paper-based version, which is related to several problems, that could be circumvented by an electronic alternative. The main objective of this study was to report on the development of a mobile interface concept to support the management of medication information. The human-centered design (UCD) process was chosen. First the context of use was analyzed, and personas and an interaction concept were designed. Next, a paper prototype was developed and evaluated by experts. Based on those results, a medium-fidelity prototype was created and assessed by seven end-users who performed a thinking-aloud test in combination with a questionnaire based on the System Usability Scale (SUS). Initially for one persona/user type, an interface design concept was developed, which received an average SUS-Score of 92.1 in the user test. Usability problems have been solved so that the design concept could be fixed for a future implementation. Contribution: The approach of the UCD process and the methods involved can be applied by other researchers as a framework for the development of similar applications.

  10. A dual use case study of space technologies for terrestrial medical applications (Conference Presentation)

    Science.gov (United States)

    Cozmuta, Ioana

    2017-05-01

    Many challenges exist in understanding the human body as a whole, its adaptability, its resilience, its immunological response, its healing and regeneration power. New knowledge is usually obtained by exploring unique conditions and environments and space is one such variable. Primarily, these attributes have been studied in space for the purpose of understanding the effect of the space environment on long duration space travel. However a myriad of lessons learned have emerged that are important for terrestrial medicine problems such as cardiovascular changes, intracranial pressure changes, vision changes, reduced immunity, etc. For medical study purposes, the changes induced by the space environment on the human body are in general fast and predictable; they persist while in the space environment but also revert to the initial pre-flight healthy state upon return to Earth. This provides a unique cycle to study wellness and disease prediction as well as to develop more effective countermeasures for the benefit of people on earth. At a scientific level, the environment of space can be used to develop new lines of investigations and new knowledge to push the terrestrial state of the art (i.e. study of phase diagrams, identification of new system's states, etc). Moreover, the specialized requirements for space medicine have driven advances in terrestrial medical technologies in areas such as monitoring, diagnostic, prevention and treatment. This talk will provide an overview of compelling examples in key areas of interest for terrestrial medical applications.

  11. Friction Stir Welding Development at National Aeronautics and Space Administration-Marshall Space Flight Center

    Science.gov (United States)

    Bhat, Biliyar N.; Carter, Robert W.; Ding, Robert J.; Lawless, Kirby G.; Nunes, Arthur C., Jr.; Russell, Carolyn K.; Shah, Sandeep R.; Munafo, Paul M. (Technical Monitor)

    2001-01-01

    This paper presents an over-view of friction stir welding (FSW) process development and applications at Marshall Space Flight Center (MSFC). FSW process development started as a laboratory curiosity but soon found support from many users. The FSW process advanced very quickly and has found many applications both within and outside the aerospace industry. It is currently being adapted for joining key elements of the Space Shuttle External Tank for improved producibility and reliability. FSW process modeling is done to better understand and improve the process. Special tools have been developed to weld variable thickness materials including very thin and very thick materials. FSW is now being applied to higher temperature materials such as copper and to advanced materials such as metal matrix composites. FSW technology is being successfully transferred from MSFC laboratory to shop floors of many commercial companies.

  12. Quality improvement in healthcare delivery utilizing the patient-centered medical home model.

    Science.gov (United States)

    Akinci, Fevzi; Patel, Poonam M

    2014-01-01

    Despite the fact that the United States dedicates so much of its resources to healthcare, the current healthcare delivery system still faces significant quality challenges. The lack of effective communication and coordination of care services across the continuum of care poses disadvantages for those requiring long-term management of their chronic conditions. This is why the new transformation in healthcare known as the patient-centered medical home (PCMH) can help restore confidence in our population that the healthcare services they receive is of the utmost quality and will effectively enhance their quality of life. Healthcare using the PCMH model is delivered with the patient at the center of the transformation and by reinvigorating primary care. The PCMH model strives to deliver effective quality care while attempting to reduce costs. In order to relieve some of our healthcare system distresses, organizations can modify their delivery of care to be patient centered. Enhanced coordination of services, better provider access, self-management, and a team-based approach to care represent some of the key principles of the PCMH model. Patients that can most benefit are those that require long-term management of their conditions such as chronic disease and behavioral health patient populations. The PCMH is a feasible option for delivery reform as pilot studies have documented successful outcomes. Controversy about the lack of a medical neighborhood has created concern about the overall sustainability of the medical home. The medical home can stand independently and continuously provide enhanced care services as a movement toward higher quality care while organizations and government policy assess what types of incentives to put into place for the full collaboration and coordination of care in the healthcare system.

  13. Cross-cultural medical education: can patient-centered cultural competency training be effective in non-Western countries?

    Science.gov (United States)

    Ho, Ming-Jung; Yao, Grace; Lee, Keng-Lin; Beach, Mary Catherine; Green, Alexander R

    2008-01-01

    No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings. To examine whether a patient-centered cultural competency curriculum improves medical students' skills in eliciting the patients' perspective and exploring illness-related social factors. Fifty-seven medical students in Taiwan were randomly assigned to either the control (n = 27) or one of two intervention groups: basic (n = 15) and extensive (n = 15). Both intervention groups received two 2-hour patient-centered cultural competency workshops. In addition, the extensive intervention group received a 2-hour practice session. The control group received no training. At the end of the clerkship, all students were evaluated with an objective structured clinical examination (OSCE). Students in the extensive intervention group scored significantly higher than the basic intervention and control groups in eliciting the patient's perspective (F = 18.38, p social factors (F = 6.66, p = 0.003, eta(2) = 0.20). Patient-centered cultural competency training can produce improvement in medical students' cross-cultural communication skills in non-Western settings, especially when adequate practice is provided.

  14. Spectrum of tablet computer use by medical students and residents at an academic medical center

    Directory of Open Access Journals (Sweden)

    Robert Robinson

    2015-07-01

    Full Text Available Introduction. The value of tablet computer use in medical education is an area of considerable interest, with preliminary investigations showing that the majority of medical trainees feel that tablet computers added value to the curriculum. This study investigated potential differences in tablet computer use between medical students and resident physicians.Materials & Methods. Data collection for this survey was accomplished with an anonymous online questionnaire shared with the medical students and residents at Southern Illinois University School of Medicine (SIU-SOM in July and August of 2012.Results. There were 76 medical student responses (26% response rate and 66 resident/fellow responses to this survey (21% response rate. Residents/fellows were more likely to use tablet computers several times daily than medical students (32% vs. 20%, p = 0.035. The most common reported uses were for accessing medical reference applications (46%, e-Books (45%, and board study (32%. Residents were more likely than students to use a tablet computer to access an electronic medical record (41% vs. 21%, p = 0.010, review radiology images (27% vs. 12%, p = 0.019, and enter patient care orders (26% vs. 3%, p < 0.001.Discussion. This study shows a high prevalence and frequency of tablet computer use among physicians in training at this academic medical center. Most residents and students use tablet computers to access medical references, e-Books, and to study for board exams. Residents were more likely to use tablet computers to complete clinical tasks.Conclusions. Tablet computer use among medical students and resident physicians was common in this survey. All learners used tablet computers for point of care references and board study. Resident physicians were more likely to use tablet computers to access the EMR, enter patient care orders, and review radiology studies. This difference is likely due to the differing educational and professional demands placed on

  15. Maximizing the Patient-Centered Medical Home (PCMH) by Choosing Words Wisely.

    Science.gov (United States)

    Howard, Jenna; Etz, Rebecca S; Crocker, J Benjamin; Skinner, Daniel; Kelleher, Kelly J; Hahn, Karissa A; Miller, William L; Crabtree, Benjamin F

    2016-01-01

    Culture is transmitted through language and reflects a group's values, yet much of the current language used to describe the new patient-centered medical home (PCMH) is a carryover from the traditional, physician-centric model of care. This language creates a subtle yet powerful force that can perpetuate the status quo, despite transformation efforts. This article describes new terminology that some innovative primary care practices are using to support the transformational culture of the PCMH. Data come from the Agency for Healthcare Research and Quality-funded Working Conference for PCMH Innovation 2013, which convened 10 innovative practices and interdisciplinary content experts to discuss innovative practice redesign. Session and interview transcripts were analyzed using a grounded theory approach to identify patterns and explore their significance. Language innovations are used by 5 practices. Carefully selected terms facilitate creative reimagining of traditional roles and spaces through connotations that highlight practice goals. Participants felt that the language used was important for reinforcing substantive changes. Reworking well-established vernacular requires openness to change. True transformation does not, however, occur through a simple relabeling of old concepts. New terminology must represent values to which practices genuinely aspire, although caution is advised when using language to support cultural and clinical change. © Copyright 2016 by the American Board of Family Medicine.

  16. Community pharmacist collaboration with a patient-centered medical home: Establishment of a patient-centered medical neighborhood and payment model.

    Science.gov (United States)

    Luder, Heidi R; Shannon, Pam; Kirby, James; Frede, Stacey M

    To determine the feasibility of a partnership between a community pharmacy and a patient-centered medical home (PCMH) by measuring the impact on office- and patient-level clinical outcomes. Kroger Pharmacy and a PCMH practice in Cincinnati, OH. The Kroger Co. is a large grocery store chain that operates 102 pharmacies in the Cincinnati-Dayton marketing area. The PCMH practice is an accredited PCMH office serving more than 9000 patients in the Cincinnati area. In a medical neighborhood, a PCMH coordinates care with other local specialty practices or partners. A partnership between the community pharmacy chain and the PCMH was established to create a medical neighborhood. The pharmacist spent 2 half-days per week at the PCMH. The pharmacist provided initial medication therapy management appointments in the PCMH and offered follow-up services in the office, the pharmacy, or both, depending on patient preference. The pharmacy received a capitated payment per patient per month for a predetermined number of 1000 high-risk patients. Office-level changes in clinical outcomes such as A1C, blood pressure, and lipid measures were collected and compared with those of a similar control office. In addition, patient-level outcomes such as change in A1C, blood pressure, lipids, and weight were measured. One hundred five patients were seen by the pharmacist during the study period, with 1.5% of the total managed at the office. There was a statistically significant increase in influenza vaccinations received. On a patient level, A1C and systolic blood pressure significantly improved. This project represents an exciting opportunity for community pharmacists to expand their scope of services through direct partnership with PCMHs and maintain a sustainable reimbursement structure. Copyright © 2018. Published by Elsevier Inc.

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

    Science.gov (United States)

    McCoy, Keegan

    2010-01-01

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

  18. Electric Vehicles at Kennedy Space Center

    Science.gov (United States)

    Chesson, Bruce E.

    2007-01-01

    The story of how the transportation office began by introducing low speed electric cars (LSEV) to the fleet managers and employees. This sparked and interest in purchasing some of these LSEV and the usage on KSC. Transportation was approached by a vender of High Speed Electric Vehicle (HSEV) we decided to test the HSEV to see if they would meet our fleet vehicle needs. Transportation wrote a Space Act Agreement (SAA) for the loan of three Lithium Powered Electric vehicles for a one year test. The vehicles have worked very well and we have extended the test for another year. The use of HSEV has pushed for an independent Electric Vehicle Study to be performed to consider ways to effectively optimize the use of electric vehicles in replacement of gasoline vehicles in the KSC vehicle fleet. This will help the center to move closer to meeting the Executive Order 13423.

  19. Development of a Hospital-based Massage Therapy Course at an Academic Medical Center.

    Science.gov (United States)

    Dion, Liza J; Cutshall, Susanne M; Rodgers, Nancy J; Hauschulz, Jennifer L; Dreyer, Nikol E; Thomley, Barbara S; Bauer, Brent

    2015-03-01

    Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment.

  20. The patient-centered medical home: an ethical analysis of principles and practice.

    Science.gov (United States)

    Braddock, Clarence H; Snyder, Lois; Neubauer, Richard L; Fischer, Gary S

    2013-01-01

    The patient-centered medical home (PCMH), with its focus on patient-centered care, holds promise as a way to reinvigorate the primary care of patients and as a necessary component of health care reform. While its tenets have been the subject of review, the ethical dimensions of the PCMH have not been fully explored. Consideration of the ethical foundations for the core principles of the PCMH can and should be part of the debate concerning its merits. The PCMH can align with the principles of medical ethics and potentially strengthen the patient-physician relationship and aspects of health care that patients value. Patient choice and these ethical considerations are central and at least as important as the economic and practical arguments in support of the PCMH, if not more so. Further, the ethical principles that support key concepts of the PCMH have implications for the design and implementation of the PCMH. This paper explores the PCMH in light of core principles of ethics and professionalism, with an emphasis both on how the concept of the PCMH may reinforce core ethical principles of medical practice and on further implications of these principles.

  1. Evaluation of the ASCO Value Framework for Anticancer Drugs at an Academic Medical Center.

    Science.gov (United States)

    Wilson, Leslie; Lin, Tracy; Wang, Ling; Patel, Tanuja; Tran, Denise; Kim, Sarah; Dacey, Katie; Yuen, Courtney; Kroon, Lisa; Brodowy, Bret; Rodondi, Kevin

    2017-02-01

    Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center. The High Cost Oncology Drug Initiative at the MOC aims to assess and adopt tools for the critical assessment and amelioration of high-cost cancer drugs. The American Society of Clinical Oncology (ASCO) Value Framework (2016 update) and a cost-effectiveness analysis (CEA) framework were identified as potential tools for adoption. To assess 1 prominent value framework, the study investigators (a) asked 8 clinicians to complete the ASCO Value Framework for 11 anticancer medications selected by the MOC; (b) reviewed CEAs assessing the drugs; (c) generated descriptive statistics; and (d) analyzed inter-rater reliability, convergence validity, and ranking consistency. On the scale of -20 to 180, the mean ASCO net health benefit (NHB) total score across 11 drugs ranged from 7.6 (SD = 7.8) to 53 (SD = 9.8). The Kappa coefficient (κ) for NHB scores across raters was 0.11, which is categorized as "slightly reliable." The combined κ score was 0.22, which is interpreted as low to fair inter-rater reliability. Convergent validity indicates that the correlation between NHB scores and CEA-based incremental cost-effectiveness ratios (ICERs) was low (-0.215). Ranking of ICERs, ASCO scores, and wholesale acquisition costs indicated different results

  2. Development of a Risk-Based Decision-Support-Model for Protecting an Urban Medical Center from a Nuclear Explosion

    International Nuclear Information System (INIS)

    Ben-Dor, G.; Shohet, I.M.; Ornai, D.; Brosh, B.

    2014-01-01

    Nuclear explosion is the worst man-made physical threat on the human society. The nuclear explosion includes several consequences, some of them are immediate and others are long term. The major influences are: long duration blast, extreme thermal release, nuclear radiations, and electro-magnetic pulse (EMP). Their damage range is very wide. When nuclear explosion occurs above or in an urban area it is possible that one or more medical centers will be affected. Medical centers include several layers of structures defined by their resistance capacity to the nuclear explosion influences, beginning with the structure's frame and ending with different systems and with vulnerable medical critical infrastructures such as communications, medical gas supply, etc. A comprehensive literature survey revealed that in spite of the necessity and the importance of medical centers in the daily life and especially in emergency and post nuclear explosion, there is a lack of research on this topic

  3. Marion duPont Scott Equine Medical Center offers new treatment for lameness

    OpenAIRE

    Musick, Marjorie

    2006-01-01

    The Virginia-Maryland Regional College of Veterinary Medicine's Marion duPont Scott Equine Medical Center has begun offering a new therapy for treating lameness associated with osteoarthritis and cartilage damage in horses, a problem that affects all segments of the equine industry.

  4. Creating and sustainable development of specialized centers as a way to improve quality of medical care

    Directory of Open Access Journals (Sweden)

    V. I. Guzeva

    2016-01-01

    Full Text Available Quality of care is evaluated on the completeness of the survey, the correct diagnosis, treatment efficacy, and its duration. Improving the quality and efficiency of medical care for children with paroxysmal disorders of consciousness is one of topical problems of neurology.Aim. The aim of the work is to justify the relationship between improving the quality of health care and sustainable development in the modern conditions of specialized medical centers on the example of the work on the identification and treatment of children with paroxysmal disorders of consciousness of the Center for diagnosis and treatment of epilepsy, and sleep disorders in children and adolescents at the department neurology, neurosurgery and medical genetics SPbGPMU.Materials and methods. For more accurate diagnosis and treatment at the Center conducted a comprehensive examination, including video-EEG оf 527 children aged 1 month to 18 years. A clinical trial study included medical cases, assessment of neurological and somatic status, the study of seizure types and forms of the disease. Instrumental methods of examination were determined by EEG and MRI studies of the brain.Main results. Comprehensive survey of sick children with monitoring video-EEG revealed that 317 children (60,1% had epileptic paroxysms and 210 children (39,8% – non-epileptic paroxysms. Correction treatment was performed in 284 (89,5% children with epileptic paroxysms and altered the treatment in 190 (90,4% children with epileptic paroxysms.Conclusion. The presented clinical data show the high effectiveness of the Centre in the diagnosis and treatment of children with paroxysmal disorders of consciousness. The accumulated experience in the Center confirms the relevance of the creation of the structure of scientific and educational institutions specialized centers in which patients will be given to high-quality medical care.

  5. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.

    Science.gov (United States)

    Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

    2015-01-01

    To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  6. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    Directory of Open Access Journals (Sweden)

    Yunbo Qing

    2015-07-01

    Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  7. Innovative Partnerships Program Accomplishments: 2009-2010 at NASA's Kennedy Space Center

    Science.gov (United States)

    Makufka, David

    2010-01-01

    This document reports on the accomplishments of the Innovative Partnerships Program during the two years of 2009 and 2010. The mission of the Innovative Partnerships Program is to provide leveraged technology alternatives for mission directorates, programs, and projects through joint partnerships with industry, academia, government agencies, and national laboratories. As outlined in this accomplishments summary, the IPP at NASA's Kennedy Space Center achieves this mission via two interdependent goals: (1) Infusion: Bringing external technologies and expertise into Kennedy to benefit NASA missions, programs, and projects (2) Technology Transfer: Spinning out space program technologies to increase the benefits for the nation's economy and humanity

  8. Prospects for rebuilding primary care using the patient-centered medical home.

    Science.gov (United States)

    Landon, Bruce E; Gill, James M; Antonelli, Richard C; Rich, Eugene C

    2010-05-01

    Existing research suggests that models of enhanced primary care lead to health care systems with better performance. What the research does not show is whether such an approach is feasible or likely to be effective within the U.S. health care system. Many commentators have adopted the model of the patient-centered medical home as policy shorthand to address the reinvention of primary care in the United States. We analyze potential barriers to implementing the medical home model for policy makers and practitioners. Among others, these include developing new payment models, as well as the need for up-front funding to assemble the personnel and infrastructure required by an enhanced non-visit-based primary care practice and methods to facilitate transformation of existing practices to functioning medical homes.

  9. Collaborating to improve the global competitiveness of US academic medical centers.

    Science.gov (United States)

    Allen, Molly; Garman, Andrew; Johnson, Tricia; Hohmann, Samuel; Meurer, Steve

    2012-01-01

    President Obama announced the National Export Initiative in his 2010 State of the Union address and set the ambitious goal of doubling US exports by the end of 2014 to support millions of domestic jobs. Understanding the competitive position of US health care in the global market for international patients, University Health System Consortium (UHC), an alliance of 116 academic medical centers and 272 of their affiliated hospitals, representing 90 percent of the nation's non-profit academic medical centers partnered with Rush University, a private University in Chicago, IL and the International Trade Administration of the US Department of Commerce International Trade Administration (ITA) to participate in the Market Development Cooperator Program. The goal of this private-public partnership is to increase the global competitiveness of the US health care industry, which represents over 16 percent of the GDP, amongst foreign health care providers. This article provides an overview of the US health care market and outlines the aims of the US Cooperative for International Patient Programs, the end result of the partnership between UHC, ITA and Rush University.

  10. Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

    Science.gov (United States)

    Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

    2017-11-01

    Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Positron-Electron Pairs in Astrophysics (Goddard Space Flight Center, 1983)

    International Nuclear Information System (INIS)

    Burns, M.L.; Harding, A.K.; Ramaty, R.

    1983-01-01

    A workshop on Position-Electron Pairs in Astrophysics was held in 1983 at the Goddard Space Flight Center. This workshop brought together observers and theorists actively engaged in the study of astrophysical sites, as well as physical processes therein where position-electron pairs have a profound influence on both the overall dynamics of the source region and the properties of the emitted radiation. This volume consists of the workshop proceedings

  12. Program review of the USDA Center for Medical, Agricultural and Veterinary Entomology

    Science.gov (United States)

    The USDA-ARS Center for Medical, Agricultural and Veterinary Entomology (CMAVE) has a history that starts in 1932 in Orlando to develop methods to control mosquitoes, including malaria vectors under conditions simulating those of the south Pacific jungles, and other insects affecting man and animals...

  13. History of Reliability and Quality Assurance at Kennedy Space Center

    Science.gov (United States)

    Childers, Frank M.

    2004-01-01

    This Kennedy Historical Document (KHD) provides a unique historical perspective of the organizational and functional responsibilities for the manned and un-manned programs at Kennedy Space Center, Florida. As systems become more complex and hazardous, the attention to detailed planning and execution continues to be a challenge. The need for a robust reliability and quality assurance program will always be a necessity to ensure mission success. As new space missions are defined and technology allows for continued access to space, these programs cannot be compromised. The organizational structure that has provided the reliability and quality assurance functions for both the manned and unmanned programs has seen many changes since the first group came to Florida in the 1950's. The roles of government and contractor personnel have changed with each program and organizational alignment has changed based on that responsibility. The organizational alignment of the personnel performing these functions must ensure independent assessment of the processes.

  14. Creating Processes Associated with Providing Government Goods and Services Under the Commercial Space Launch Act at Kennedy Space Center

    Science.gov (United States)

    Letchworth, Janet F.

    2011-01-01

    Kennedy Space Center (KSC) has decided to write its agreements under the Commercial Space Launch Act (CSLA) authority to cover a broad range of categories of support that KSC could provide to our commercial partner. Our strategy was to go through the onerous process of getting the agreement in place once and allow added specificity and final cost estimates to be documented on a separate Task Order Request (TOR). This paper is written from the implementing engineering team's perspective. It describes how we developed the processes associated with getting Government support to our emerging commercial partners, such as SpaceX and reports on our success to date.

  15. Marshall Space Flight Center Ground Systems Development and Integration

    Science.gov (United States)

    Wade, Gina

    2016-01-01

    Ground Systems Development and Integration performs a variety of tasks in support of the Mission Operations Laboratory (MOL) and other Center and Agency projects. These tasks include various systems engineering processes such as performing system requirements development, system architecture design, integration, verification and validation, software development, and sustaining engineering of mission operations systems that has evolved the Huntsville Operations Support Center (HOSC) into a leader in remote operations for current and future NASA space projects. The group is also responsible for developing and managing telemetry and command configuration and calibration databases. Personnel are responsible for maintaining and enhancing their disciplinary skills in the areas of project management, software engineering, software development, software process improvement, telecommunications, networking, and systems management. Domain expertise in the ground systems area is also maintained and includes detailed proficiency in the areas of real-time telemetry systems, command systems, voice, video, data networks, and mission planning systems.

  16. Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

    Directory of Open Access Journals (Sweden)

    Olga Moshkovich

    2015-01-01

    Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

  17. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  18. The Common information space of the Training and Consulting Center design

    Directory of Open Access Journals (Sweden)

    Dorofeeva N.S.

    2017-04-01

    Full Text Available the article describes the relevance of the research, such as the assessment of the educational and consulting services market and also the competitive environment based on the analysis of the regional innovative infrastructure. The results of the center activity design are presented, and the basis of the concept of this center functioning is TRIZ (the Theory of Invention Tasks Solving. The basic functional capabilities of the common information space (CIS are formulated and justified in this research, the CIS-structure is formed, the interfaces of the information resources in the CIS for the interaction with potential users have been developed, and data modeling has been carried out.

  19. Information technology leadership in academic medical centers: a tale of four cultures.

    Science.gov (United States)

    Friedman, C P

    1999-07-01

    Persons and groups within academic medical centers bring consistent and predictable viewpoints to planning and decision making. The varied professional and academic cultures of these individuals appear to account primarily for the diversity of their viewpoints. Understanding these professional cultures can help leaders achieve some predictability in the complex environments for which they are responsible. Leaders in information technology in particular, in order to be successful, must become part-time anthropologists, immersing themselves in the varied workplaces of their constituents to understand the work they do and the cultures that have grown up around this work. Only in this way will they be able to manage the challenges that arise continuously as the technology and the needs it can address change over time. In this article, the author briefly describes the concept of culture, portrays four specific professional cultures that typically coexist in academic medical centers, and argues that understanding these cultures is absolutely critical to effective management and use of information resources.

  20. NASA University Research Centers Technical Advances in Education, Aeronautics, Space, Autonomy, Earth and Environment

    Science.gov (United States)

    Jamshidi, M. (Editor); Lumia, R. (Editor); Tunstel, E., Jr. (Editor); White, B. (Editor); Malone, J. (Editor); Sakimoto, P. (Editor)

    1997-01-01

    This first volume of the Autonomous Control Engineering (ACE) Center Press Series on NASA University Research Center's (URC's) Advanced Technologies on Space Exploration and National Service constitute a report on the research papers and presentations delivered by NASA Installations and industry and Report of the NASA's fourteen URC's held at the First National Conference in Albuquerque, New Mexico from February 16-19, 1997.

  1. Environmental Physiology at the Johnson Space Center: Past, Present, and Future

    Science.gov (United States)

    Conkin, Johnny

    2007-01-01

    This viewgraph presentation reviews the work in environmental physiology done at Johnson Space Center (JSC). The work is aimed at keeping astronauts healthy. This is a different approach than treating the sick, and is more of an occupational health model. The reduction of risks is the main emphasis for this work. They emphasis is to reduce the risk of decompression sickness (DCS) and acute mountain sickness (AMS). The work in environmental physiology encompasses the following areas: (1) Pressure: hypobaric and hyperbaric (2) Gases: hypoxia and hyperoxia, hypercapnia--closed space issues, inert gas physiology / respiration (3) Temperature: hypothermia and hyperthermia, thermal comfort, Protective clothing diving, aviation, mountaineering, and space (4) Acceleration (5) Noise and Vibration (6) Exercise / Performance (6) Acclimatization / Adaptation: engineering solutions when necessary. This presentation reviews the work done at JSC in the areas of DCS and AMS.

  2. Robotic and automatic welding development at the Marshall Space Flight Center

    Science.gov (United States)

    Jones, C. S.; Jackson, M. E.; Flanigan, L. A.

    1988-01-01

    Welding automation is the key to two major development programs to improve quality and reduce the cost of manufacturing space hardware currently undertaken by the Materials and Processes Laboratory of the NASA Marshall Space Flight Center. Variable polarity plasma arc welding has demonstrated its effectiveness on class 1 aluminum welding in external tank production. More than three miles of welds were completed without an internal defect. Much of this success can be credited to automation developments which stabilize the process. Robotic manipulation technology is under development for automation of welds on the Space Shuttle's main engines utilizing pathfinder systems in development of tooling and sensors for the production applications. The overall approach to welding automation development undertaken is outlined. Advanced sensors and control systems methodologies are described that combine to make aerospace quality welds with a minimum of dependence on operator skill.

  3. Renewable Energy at NASA's Johnson Space Center

    Science.gov (United States)

    McDowall, Lindsay

    2014-01-01

    NASA's Johnson Space Center has implemented a great number of renewable energy systems. Renewable energy systems are necessary to research and implement if we humans are expected to continue to grow and thrive on this planet. These systems generate energy using renewable sources - water, wind, sun - things that we will not run out of. Johnson Space Center is helping to pave the way by installing and studying various renewable energy systems. The objective of this report will be to examine the completed renewable energy projects at NASA's Johnson Space Center for a time span of ten years, beginning in 2003 and ending in early 2014. This report will analyze the success of each project based on actual vs. projected savings and actual vs. projected efficiency. Additionally, both positive and negative experiences are documented so that lessons may be learned from past experiences. NASA is incorporating renewable energy wherever it can, including into buildings. According to the 2012 JSC Annual Sustainability Report, there are 321,660 square feet of green building space on JSC's campus. The two projects discussed here are major contributors to that statistic. These buildings were designed to meet various Leadership in Energy and Environmental Design (LEED) Certification criteria. LEED Certified buildings use 30 to 50 percent less energy and water compared to non-LEED buildings. The objectives of this project were to examine data from the renewable energy systems in two of the green buildings onsite - Building 12 and Building 20. In Building 12, data was examined from the solar photovoltaic arrays. In Building 20, data was examined from the solar water heater system. By examining the data from the two buildings, it could be determined if the renewable energy systems are operating efficiently. Objectives In Building 12, the data from the solar photovoltaic arrays shows that the system is continuously collecting energy from the sun, as shown by the graph below. Building 12

  4. Use of IKONOS Data for Mapping Cultural Resources of Stennis Space Center, Mississippi

    Science.gov (United States)

    Spruce, Joseph P.; Giardino, Marco

    2002-01-01

    Cultural resource surveys are important for compliance with Federal and State law. Stennis Space Center (SSC) in Mississippi is researching, developing, and validating remote sensing and Geographical Information System (GIS) methods for aiding cultural resource assessments on the center's own land. The suitability of IKONOS satellite imagery for georeferencing scanned historic maps is examined in this viewgraph presentation. IKONOS data can be used to map historic buildings and farmland in Gainsville, MS, and plan archaeological surveys.

  5. International Space Station Aeromedical Support in Star City, Russia

    Science.gov (United States)

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

    2010-01-01

    The Space Medicine Division at Johnson Space Center works with the International Space Station s international partners (IP) to accomplish assigned health care tasks. Each IP may assign a flight surgeon to support their assigned crewmembers during all phases of training, in-flight operations, and postflight activities. Because of the extensive amount of astronaut training conducted in Star City; NASA, in collaboration with its IPs, has elected to keep a flight surgeon assigned to NASA s Star City office to provide support to the U.S., Canadian, Japanese, and European astronauts during hazardous training activities and provide support for any contingency landings of Soyuz spacecraft in Kazakhstan. The physician also provides support as necessary to the Mission Control Center in Moscow for non-Russian crew-related activities. In addition, the physician in Star City provides ambulatory medical care to the non-Russian-assigned personnel in Star City and visiting dependents. Additional work involves all medical supplies, administration, and inventory. The Star City physician assists in medical evacuation and/or in obtaining support from western clinics in Moscow when required care exceeds local resources. Overall, the Russians are responsible for operations and the medical care of the entire crew when training in Star City and during launch/landing operations. However, they allow international partner flight surgeons to care for their crewmembers as agreed to in the ISS Medical Operations Requirements Document. Medical support focuses on pressurized, monitored, and other hazardous training activities. One of the most important jobs is to act as a medical advocate for the astronauts and to reduce the threat that these hazardous activities pose. Although the Russians have a robust medical system, evacuation may be needed to facilitate ongoing medical care. There are several international medical evacuation companies that provide this care.

  6. Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

    Science.gov (United States)

    Johnson, Bill

    2014-01-01

    Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.

  7. An approach to human-centered design of nuclear medical equipment: the system of caption of the thyroid

    International Nuclear Information System (INIS)

    Santos, Isaac J.A. Luquetti; Silva, Carlos Borges da; Santana, Marcos; Carvalho, Paulo Victor R.; Oliveira, Mauro Vitor de; Mol, Antonio Carlos Mol; Grecco, Claudio Henrique; Augusto, Silas Cordeiro

    2005-01-01

    Technology plays an important role in modern medical centers, making health care increasingly complex, relying on complex technical equipment. This technical complexity is particularly noticeable in the nuclear medicine and can increase the risks for human error. Human error has many causes such as performance shaping factors, organizational factors and user interface design. Poorly design human system interfaces of nuclear medical equipment can increase the risks for human error. If all nuclear medical equipment had been designed with good user interfaces, incidents and accidents could be reduced as well as he time required to learn how to use the equipment. Although some manufacturers of nuclear medical equipment have already integrate human factors principles in their products, there is still a need to steer the development of nuclear medical technology toward more human-centered approach. The aim of this paper is to propose a methodology that contributes to the design, development and evaluation of nuclear medical equipment and human system interface, towards a human-centered approach. This methodology includes the ergonomic approach, based on the operator activity analysis, together with human factors standards and guidelines, questionnaires and user based testing. We describe a case study in which this methodology is being applied in evaluation of the thyroid uptake system, getting essential information and data, that ill be used in development of a new system. (author)

  8. Space Solar Power Satellite Technology Development at the Glenn Research Center: An Overview

    Science.gov (United States)

    Dudenhoefer, James E.; George, Patrick J.

    2000-01-01

    NASA Glenn Research Center (GRC). is participating in the Space Solar Power Exploratory Research and Technology program (SERT) for the development of a solar power satellite concept. The aim of the program is to provide electrical power to Earth by converting the Sun's energy and beaming it to the surface. This paper will give an overall view of the technologies being pursued at GRC including thin film photovoltaics, solar dynamic power systems, space environmental effects, power management and distribution, and electric propulsion. The developmental path not only provides solutions to gigawatt sized space power systems for the future, but provides synergistic opportunities for contemporary space power architectures. More details of Space Solar Power can be found by reading the references sited in this paper and by connecting to the web site http://moonbase.msfc.nasa.gov/ and accessing the "Space Solar Power" section "Public Access" area.

  9. Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

    Science.gov (United States)

    Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

    2014-01-01

    The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

  10. Implementing the patient-centered medical home in residency education.

    Science.gov (United States)

    Doolittle, Benjamin R; Tobin, Daniel; Genao, Inginia; Ellman, Matthew; Ruser, Christopher; Brienza, Rebecca

    2015-01-01

    In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training. Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.

  11. Smart Medical Systems with Application to Nutrition and Fitness in Space

    Science.gov (United States)

    Soller, Babs R.; Cabrera, Marco; Smith, Scott M.; Sutton, Jeffrey P.

    2002-01-01

    Smart medical systems are being developed to allow medical treatments to address alterations in chemical and physiological status in real time. In a smart medical system sensor arrays assess subject status, which are interpreted by computer processors which analyze multiple inputs and recommend treatment interventions. The response of the subject to the treatment is again assessed by the sensor arrays, closing the loop. An early form of "smart medicine" has been practiced in space to assess nutrition. Nutrient levels are assessed with food frequency questionnaires, which are interpreted by flight surgeons to recommend in-flight alterations in diet. In the future, sensor arrays will directly probe body chemistry. Near infrared spectroscopy can be used to noninvasively measure several blood and tissue parameters which are important in the assessment of nutrition and fitness. In particular, this technology can be used to measure blood hematocrit and interstitial fluid pH. The noninvasive measurement of interstitial pH is discussed as a surrogate for blood lactate measurement for the development and real-time assessment of exercise protocols in space. Earth-based application of these sensors are also described.

  12. Diversity leadership: the Rush University Medical Center experience.

    Science.gov (United States)

    Clapp, J R

    2010-01-01

    Meeting the challenges of diversity is crucial, and within healthcare organizations a particularly strong case exists for a diversity strategy. Rush University Medical Center in 2006 was at an important juncture. Since its founding, the organization had made notable progress toward advancing diversity and inclusiveness. On the other hand, many diversity-related problems continued. Rush convened a committee to review the work of the institution in this area. The committee's report called for changes, and a Diversity Leadership Group (DLG) model was established. This article documents the progress made since 2006 through implementation of the DLG model. The changes prescribed for Rush are presented as recommendations and challenges that other healthcare organizations may find applicable to their own institutions.

  13. Regional Super ESPC Saves Energy and Dollars at NASA's Johnson Space Center

    International Nuclear Information System (INIS)

    Federal Energy Management Program

    2001-01-01

    This case study about energy saving performance contacts (ESPCs) presents an overview of how the NASA's Johnson Space Flight Center established an ESPC contract and the benefits derived from it. The Federal Energy Management Program instituted these special contracts to help federal agencies finance energy-saving projects at their facilities

  14. Modernization of NASA's Johnson Space Center Chamber: A Payload Transport Rail System to Support Cryogenic Vacuum Optical Testing of the James Webb Space Telescope (JWST)

    Science.gov (United States)

    Garcia, Sam; Homan, Jonathan; Speed, John

    2016-01-01

    NASA is the mission lead for the James Webb Space Telescope (JWST), the next of the "Great Observatories", scheduled for launch in 2018. It is directly responsible for the integration and test (I&T) program that will culminate in an end-to-end cryo vacuum optical test of the flight telescope and instrument module in Chamber A at NASA Johnson Space Center. Historic Chamber A is the largest thermal vacuum chamber at Johnson Space Center and one of the largest space simulation chambers in the world. Chamber A has undergone a major modernization effort to support the deep cryogenic, vacuum and cleanliness requirements for testing the JWST. This paper describe the challenges of developing, integrating and modifying new payload rails capable of transporting payloads within the thermal vacuum chamber up to 65,000 pounds. Ambient and Cryogenic Operations required to configure for testing will be explained. Lastly review historical payload configurations stretching from the Apollo program era to current James Webb Space Telescope testing.

  15. SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

    International Nuclear Information System (INIS)

    Weir, V; Zhang, J

    2014-01-01

    Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department

  16. SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

    Energy Technology Data Exchange (ETDEWEB)

    Weir, V [Baylor Health Care System, Dallas, TX (United States); Zhang, J [University of Kentucky, Lexington, KY (United States)

    2014-06-01

    Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.

  17. Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

    Science.gov (United States)

    Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

    2015-08-01

    There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. © The Author(s) 2015.

  18. Human Systems Engineering for Launch processing at Kennedy Space Center (KSC)

    Science.gov (United States)

    Henderson, Gena; Stambolian, Damon B.; Stelges, Katrine

    2012-01-01

    Launch processing at Kennedy Space Center (KSC) is primarily accomplished by human users of expensive and specialized equipment. In order to reduce the likelihood of human error, to reduce personal injuries, damage to hardware, and loss of mission the design process for the hardware needs to include the human's relationship with the hardware. Just as there is electrical, mechanical, and fluids, the human aspect is just as important. The focus of this presentation is to illustrate how KSC accomplishes the inclusion of the human aspect in the design using human centered hardware modeling and engineering. The presentations also explain the current and future plans for research and development for improving our human factors analysis tools and processes.

  19. Environmental monitoring and research at the John F. Kennedy Space Center

    Science.gov (United States)

    Hall, C. R.; Hinkle, C. R.; Knott, W. M.; Summerfield, B. R.

    1992-01-01

    The Biomedical Operations and Research Office at the NASA John F. Kennedy Space Center has been supporting environmental monitoring and research since the mid-1970s. Program elements include monitoring of baseline conditions to document natural variability in the ecosystem, assessments of operations and construction of new facilities, and ecological research focusing on wildlife habitat associations. Information management is centered around development of a computerized geographic information system that incorporates remote sensing and digital image processing technologies along with traditional relational data base management capabilities. The proactive program is one in which the initiative is to anticipate potential environmental concerns before they occur and, by utilizing in-house expertise, develop impact minimization or mitigation strategies to reduce environmental risk.

  20. Integration of pharmacists into patient-centered medical homes in federally qualified health centers in Texas.

    Science.gov (United States)

    Wong, Shui Ling; Barner, Jamie C; Sucic, Kristina; Nguyen, Michelle; Rascati, Karen L

    To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005. All 4 FQHCs have pharmacists as an integral part of the health care team. Pharmacists have prescriptive authority to initiate and adjust diabetes medications. The PCMH FQHCs instituted co-visits, where patients see both the physician and the pharmacist on the same day. PCMH pharmacists are routinely proactive in collaborating with physicians regarding medication management, compared with UC in which pharmacists see patients only when referred by a physician. Four face-to-face, one-on-one semistructured interviews were conducted with pharmacists working in 3 PCMH FQHCs and 1 UC FQHC to compare the implementation of PCMH with emphasis on 1) structure and workflow, 2) pharmacists' roles, and 3) benefits and challenges. On co-visit days, the pharmacist may see the patient before or after physician consultation. Pharmacists in 2 of the PCMH facilities proactively screen to identify diabetes patients who may benefit from pharmacist services, although the UC clinic pharmacists see only referred patients. Strengths of the co-visit model include more collaboration with physicians and more patient convenience. Payment that recognizes the value of PCMH is one PCMH principle that is not fully implemented. PCMH pharmacists in FQHCs were integrated into the workflow to address specific patient needs. Specifically, full-time in-house pharmacists, flexible referral criteria, proactive screening, well defined collaborative practice agreement, and open scheduling were successful strategies for the underserved populations in this study. However, reimbursement plans and provider

  1. Energy Survey of Eisenhower Army Medical Center, Fort Gordon, Augusta, Georgia. Volume 2. Appendices

    National Research Council Canada - National Science Library

    1996-01-01

    ...) including low cost/no cost ECO's and perform complete evaluations of each. Energy equipment replacement projects already underway, approved, or planned by the Medical Center staff will be factored into the evaluations...

  2. Communications and Collaboration Keep San Francisco VA Medical Center Project on Track

    International Nuclear Information System (INIS)

    Federal Energy Management Program

    2001-01-01

    This case study about energy saving performance contacts (ESPCs) presents an overview of how the Veterans Affairs Medical Center in San Francisco established an ESPC contract and the benefits derived from it. The Federal Energy Management Program instituted these special contracts to help federal agencies finance energy-saving projects at their facilities

  3. Making lemonade from lemons: a case study on loss of space at the Dolph Briscoe, Jr. Library, University of Texas Health Science Center at San Antonio.

    Science.gov (United States)

    Tobia, Rajia C; Feldman, Jonquil D

    2010-01-01

    The setting for this case study is the Dolph Briscoe, Jr. Library, University of Texas Health Science Center at San Antonio, a health sciences campus with medical, dental, nursing, health professions, and graduate schools. During 2008-2009, major renovations to the library building were completed including office space for a faculty development department, multipurpose classrooms, a 24/7 study area, study rooms, library staff office space, and an information commons. The impetus for changes to the library building was the decreasing need to house collections in an increasingly electronic environment, the need for office space for other departments, and growth of the student body. About 40% of the library building was remodeled or repurposed, with a loss of approximately 25% of the library's original space. Campus administration proposed changes to the library building, and librarians worked with administration, architects, and construction managers to seek renovation solutions that meshed with the library's educational mission.

  4. Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

    Science.gov (United States)

    Engels, Melanie J; Chaffee, Bruce W; Clark, John S

    2015-12-01

    An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  5. Experimental study of high density foods for the Space Operations Center

    Science.gov (United States)

    Ahmed, S. M.

    1981-01-01

    The experimental study of high density foods for the Space Operations Center is described. A sensory evaluation of the high density foods was conducted first to test the acceptability of the products. A shelf-life study of the high density foods was also conducted for three different time lengths at three different temperatures. The nutritional analysis of the high density foods is at present incomplete.

  6. Marshall Space Flight Center's Impact Testing Facility Capabilities

    Science.gov (United States)

    Finchum, Andy; Hubbs, Whitney; Evans, Steve

    2008-01-01

    Marshall Space Flight Center s (MSFC) Impact Testing Facility (ITF) serves as an important installation for space and missile related materials science research. The ITF was established and began its research in spacecraft debris shielding in the early 1960s, then played a major role in the International Space Station debris shield development. As NASA became more interested in launch debris and in-flight impact concerns, the ITF grew to include research in a variety of impact genres. Collaborative partnerships with the DoD led to a wider range of impact capabilities being relocated to MSFC as a result of the closure of Particle Impact Facilities in Santa Barbara, California. The Particle Impact Facility had a 30 year history in providing evaluations of aerospace materials and components during flights through rain, ice, and solid particle environments at subsonic through hypersonic velocities. The facility s unique capabilities were deemed a "National Asset" by the DoD. The ITF now has capabilities including environmental, ballistic, and hypervelocity impact testing utilizing an array of air, powder, and two-stage light gas guns to accommodate a variety of projectile and target types and sizes. Numerous upgrades including new instrumentation, triggering circuitry, high speed photography, and optimized sabot designs have been implemented. Other recent research has included rain drop demise characterization tests to obtain data for inclusion in on-going model development. The current and proposed ITF capabilities range from rain to micrometeoroids allowing the widest test parameter range possible for materials investigations in support of space, atmospheric, and ground environments. These test capabilities including hydrometeor, single/multi-particle, ballistic gas guns, exploding wire gun, and light gas guns combined with Smooth Particle Hydrodynamics Code (SPHC) simulations represent the widest range of impact test capabilities in the country.

  7. EAC training and medical support for International Space Station astronauts.

    Science.gov (United States)

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

    2000-11-01

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

  8. Development of a pharmacy student research program at a large academic medical center.

    Science.gov (United States)

    McLaughlin, Milena M; Skoglund, Erik; Bergman, Scott; Scheetz, Marc H

    2015-11-01

    A program to promote research by pharmacy students created through the collaboration of an academic medical center and a college of pharmacy is described. In 2009, Midwestern University Chicago College of Pharmacy and Northwestern Memorial Hospital (NMH) expanded their existing partnership by establishing a program to increase opportunities for pharmacy students to conduct clinical-translational research. All professional year 1, 2, or 3 students at the college, as well as professional year 4 students on rotation at NMH, can participate in the program. Central to the program's infrastructure is the mentorship of student leads by faculty- and hospital-based pharmacists. The mentors oversee the student research projects and guide development of poster presentations; student leads mentor junior students and assist with orientation and training activities. Publication of research findings in the peer-reviewed literature is a key program goal. In the first four years after program implementation, participation in a summer research program grew nearly 10-fold (mainly among incoming professional year 2 or 3 students, and student poster presentations at national pharmacy meetings increased nearly 20-fold; the number of published research articles involving student authors increased from zero in 2009 to three in 2012 and two in 2013. A collaborative program between an academic medical center and a college of pharmacy has enabled pharmacy students to conduct research at the medical center and has been associated with increases in the numbers of poster presentations and publications involving students. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  9. Phased implementation of AT and T PACS at Duke University Medical Center

    International Nuclear Information System (INIS)

    Stockbridge, C.; Ravin, C.E.

    1986-01-01

    ''Help me communicate more quickly and more effectively with referring clinicians''. This request was the driving behind the installation of the AT and T CommView System at Duke. The CommView System is a type of Digital Image Management System and Picture Archival Communication System whose chief purpose is to deliver interpolated diagnostic images to referring clinicians and attending physicians. The system acquires electronic images from modalities in a diagnostic imaging facility, stores these images in computer managed patient files and distributes these on demand over fiber optic cable to Display Consoles. The CommView System was designed at AT and T Bell Labs; it uses fiber optic ribbon cable between buildings fused to multistrand lightguide building cables to distribute images, typically around a medical center or campus at data transfer rates of 40 Mbps. This paper gives the rationale used in designing a start-up network and placing the initial equipment for a field of the AT and T CommView System in the Radiology Department of Duke University Medical Center

  10. Estimating the Need for Medical Intervention due to Sleep Disruption on the International Space Station

    Science.gov (United States)

    Myers, Jerry G.; Lewandowski, Beth E.; Brooker, John E.; Hurst, S. R.; Mallis, Melissa M.; Caldwell, J. Lynn

    2008-01-01

    During ISS and shuttle missions, difficulties with sleep affect more than half of all US crews. Mitigation strategies to help astronauts cope with the challenges of disrupted sleep patterns can negatively impact both mission planning and vehicle design. The methods for addressing known detrimental impacts for some mission scenarios may have a substantial impact on vehicle specific consumable mass or volume or on the mission timeline. As part of the Integrated Medical Model (IMM) task, NASA Glenn Research Center is leading the development of a Monte Carlo based forecasting tool designed to determine the consumables required to address risks related to sleep disruption. The model currently focuses on the International Space Station and uses an algorithm that assembles representative mission schedules and feeds this into a well validated model that predicts relative levels of performance, and need for sleep (SAFTE Model, IBR Inc). Correlation of the resulting output to self-diagnosed needs for hypnotics, stimulants, and other pharmaceutical countermeasures, allows prediction of pharmaceutical use and the uncertainty of the specified prediction. This paper outlines a conceptual model for determining a rate of pharmaceutical utilization that can be used in the IMM model for comparison and optimization of mitigation methods with respect to all other significant medical needs and interventions.

  11. Strategies for the Integration of Medical and Health Representation within Law Enforcement Intelligence Fusion Centers

    National Research Council Canada - National Science Library

    Morrissey, James F

    2007-01-01

    Terrorism-related intelligence gathering, analysis and information dissemination would be improved and enhanced by including a medical and health element in law enforcement intelligence fusion centers...

  12. The University of Nebraska at Omaha Center for Space Data Use in Teaching and Learning

    Science.gov (United States)

    Grandgenett, Neal

    2000-01-01

    Within the context of innovative coursework and other educational activities, we are proposing the establishment of a University of Nebraska at Omaha (UNO) Center for the Use of Space Data in Teaching and Learning. This Center will provide an exciting and motivating process for educators at all levels to become involved in professional development and training which engages real life applications of mathematics, science, and technology. The Center will facilitate innovative courses (including online and distance education formats), systematic degree programs, classroom research initiatives, new instructional methods and tools, engaging curriculum materials, and various symposiums. It will involve the active participation of several Departments and Colleges on the UNO campus and be well integrated into the campus environment. It will have a direct impact on pre-service and in-service educators, the K12 (kindergarten through 12th grade) students that they teach, and other college students of various science, mathematics, and technology related disciplines, in which they share coursework. It is our belief that there are many exciting opportunities represented by space data and imagery, as a context for engaging mathematics, science, and technology education. The UNO Center for Space Data Use in Teaching and Learning being proposed in this document will encompass a comprehensive training and dissemination strategy that targets the improvement of K-12 education, through changes in the undergraduate and graduate preparation of teachers in science, mathematics and technology education.

  13. Friction Stir Welding Development at NASA-Marshall Space Flight Center

    Science.gov (United States)

    Bhat, Biliyar N.; Carter, Robert W.; Ding, Robert J.; Lawless, Kirby G.; Nunes, Arthur C., Jr.; Russell, Carolyn K.; Shah, Sandeep R.

    2001-01-01

    This paper presents an overview of friction stir welding (FSW) process development and applications at Marshall Space Flight Center (MSFC). FSW process development started as a laboratory curiosity but soon found support from many users. The FSW process advanced very quickly and has found many applications both within and outside the aerospace industry. It is currently being adapted for joining key elements of the Space Shuttle External Tank for improved producibility and reliability. FSW process modeling is done to better understand and improve the process. Special tools have been developed to weld variable thickness materials including thin and thick materials. FSW is now being applied to higher temperature materials such as copper and to advanced materials such as metal matrix composites. FSW technology is being successfully transferred from MSFC laboratory to shop floors of many commercial companies.

  14. Parental Perceptions of Family Centered Care in Medical Homes of Children with Neurodevelopmental Disabilities.

    Science.gov (United States)

    Zajicek-Farber, Michaela L; Lotrecchiano, Gaetano R; Long, Toby M; Farber, Jon Matthew

    2015-08-01

    Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers.

  15. On the scene: American University of Beirut Medical Center, Beirut, Lebanon.

    Science.gov (United States)

    Mouro, Gladys; Tashjian, Hera; Daaboul, Tania; Kozman, Katia; Alwan, Farah; Shamoun, Anthony

    2011-01-01

    American University of Beirut Medical Center is the first Magnet hospital in the Middle East. In this article, authors reflect back on the journey to excellence, specifically in establishing shared governance in a challenging cultural and organizational milieu. Perspectives from nurses at different levels are included to highlight their experiences throughout the journey. Evolution of the organization's shared governance model is described and initiatives of the councils are illustrated.

  16. Innovative Near Real-Time Data Dissemination Tools Developed by the Space Weather Research Center

    Science.gov (United States)

    Mullinix, R.; Maddox, M. M.; Berrios, D.; Kuznetsova, M.; Pulkkinen, A.; Rastaetter, L.; Zheng, Y.

    2012-12-01

    Space weather affects virtually all of NASA's endeavors, from robotic missions to human exploration. Knowledge and prediction of space weather conditions are therefore essential to NASA operations. The diverse nature of currently available space environment measurements and modeling products compels the need for a single access point to such information. The Integrated Space Weather Analysis (iSWA) System provides this single point access along with the capability to collect and catalog a vast range of sources including both observational and model data. NASA Goddard Space Weather Research Center heavily utilizes the iSWA System daily for research, space weather model validation, and forecasting for NASA missions. iSWA provides the capabilities to view and analyze near real-time space weather data from any where in the world. This presentation will describe the technology behind the iSWA system and describe how to use the system for space weather research, forecasting, training, education, and sharing.

  17. A new concept for medical imaging centered on cellular phone technology.

    Directory of Open Access Journals (Sweden)

    Yair Granot

    2008-04-01

    Full Text Available According to World Health Organization reports, some three quarters of the world population does not have access to medical imaging. In addition, in developing countries over 50% of medical equipment that is available is not being used because it is too sophisticated or in disrepair or because the health personnel are not trained to use it. The goal of this study is to introduce and demonstrate the feasibility of a new concept in medical imaging that is centered on cellular phone technology and which may provide a solution to medical imaging in underserved areas. The new system replaces the conventional stand-alone medical imaging device with a new medical imaging system made of two independent components connected through cellular phone technology. The independent units are: a a data acquisition device (DAD at a remote patient site that is simple, with limited controls and no image display capability and b an advanced image reconstruction and hardware control multiserver unit at a central site. The cellular phone technology transmits unprocessed raw data from the patient site DAD and receives and displays the processed image from the central site. (This is different from conventional telemedicine where the image reconstruction and control is at the patient site and telecommunication is used to transmit processed images from the patient site. The primary goal of this study is to demonstrate that the cellular phone technology can function in the proposed mode. The feasibility of the concept is demonstrated using a new frequency division multiplexing electrical impedance tomography system, which we have developed for dynamic medical imaging, as the medical imaging modality. The system is used to image through a cellular phone a simulation of breast cancer tumors in a medical imaging diagnostic mode and to image minimally invasive tissue ablation with irreversible electroporation in a medical imaging interventional mode.

  18. Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

    Science.gov (United States)

    Behkami, Nima A.

    2012-01-01

    It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

  19. Transformation of an academic medical center: lessons learned from restructuring and downsizing.

    Science.gov (United States)

    Woodard, B; Fottler, M D; Kilpatrick, A O

    1999-01-01

    This article reviews management literature on health care transformation and describes the processes, including restructuring, job redesign, and downsizing, involved in one academic medical center's experience. The article concludes with lessons learned at each of the stages of the transformation process: planning, implementation, and process continuation. Managerial implications for similar transformation efforts in other health care organizations are suggested.

  20. Perspectives from the Wearable Electronics and Applications Research (WEAR) Lab, NASA, Johnson Space Center

    Science.gov (United States)

    Moses, Haifa R.

    2017-01-01

    As NASA moves beyond exploring low earth orbit and into deep space exploration, increased communication delays between astronauts and earth drive a need for crew to become more autonomous (earth-independent). Currently crew on board the International Space Station (ISS) have limited insight into specific vehicle system performance because of the dependency on monitoring and real-time communication with Mission Control. Wearable technology provides a method to bridge the gap between the human (astronaut) and the system (spacecraft) by providing mutual monitoring between the two. For example, vehicle or environmental information can be delivered to astronauts through on-body devices and in return wearables provide data to the spacecraft regarding crew health, location, etc. The Wearable Electronics and Applications Research (WEAR) Lab at the NASA Johnson Space Center utilizes a collaborative approach between engineering and human factors to investigate the use of wearables for spaceflight. Zero and partial gravity environments present unique challenges to wearables that require collaborative, user-centered, and iterative approaches to the problems. Examples of the WEAR Lab's recent wearable projects for spaceflight will be discussed.

  1. Analysis of the drug formulary and the purchasing process at a Moroccan university medical center.

    Science.gov (United States)

    Lachhab, Z; Serragui, S; Hassar, M; Cherrah, Y; Errougani, A; Ahid, S

    2018-05-31

    To give an overview of the pharmaceutical policy in the largest medical center in Morocco, a developing country in socio-economic transition. This is an analytical descriptive study of the drug formulary and the purchasing process carried out at the Ibn Sina University Medical Center. Our formulary included 830 drugs belonging to 14 classes according to the Anatomical, Therapeutic and Chemical (ATC) Classification System. There was a respective predominance of class N (21.8%), class B (13.5%), and class J (12.6%). Injectable route was dominant (46%). Drugs had a significant actual benefit in 70% (according to the French Data), reimbursable in 42.8%, essential in 29.2% according to World Health Organization (WHO) list, and in 36.9% according to the Moroccan list. The calls for tenders included 542 drugs representing 65% of the formulary, and the attribution rate was 71%. The main reason for non-attribution was the lack of offers. Generics accounted for 45% by volume and 26.5% by value. With this first study, we were able to identify key indicators on drugs used in the largest medical center in Morocco. The current challenge is to introduce pharmacoeconomics in decision making concerning the updates of the drug formulary.

  2. Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

    Science.gov (United States)

    Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.

    2008-01-01

    An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

  3. Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

    Directory of Open Access Journals (Sweden)

    H Zare Ahmadabadi

    2007-07-01

    Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

  4. Patient-centered communication in digital medical encounters.

    Science.gov (United States)

    Alpert, Jordan M; Dyer, Karen E; Lafata, Jennifer Elston

    2017-10-01

    Patients are increasingly using the secure messaging function available through online patient portals to communicate with their health care providers, yet little is known about the characteristics of conversations that occur. The goal of this study is to describe the types of messages initiated by patients communicating via patient portals and to assess whether providers employ patient-centered strategies in their electronic responses. A total of 193 messages from 58 message threads between patients and providers were collected during a one-week period in a large health care system. Content analysis of patient messages was conducted and deductive analysis of provider responses was employed for two types of patient-centered communication, provider use of supportive talk and partnership building. Patients sent nearly double the number of messages compared to providers (65% versus 35%). Patient messages expressed concern, sought medical solutions and requested assistance with administrative tasks. Over half (53.4%) of provider replies did not contain language reflective of either partnership building or supportive talk. Partnership building language and supportive talk occurred at lower rates than documented in the literature on in-person encounters. This may represent a lost opportunity to strengthen the patient-provider relationship. As secure messaging is increasingly utilized as a form of patient-provider communication, it is important to understand how aspects of this communication channel, including the patient-centeredness of the language used by providers, impact patient-provider relationships and patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

    Science.gov (United States)

    Sasnett, Bonita; Harris, Susie T; White, Shelly

    Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

  6. Thermal Stir Welding Development at Marshall Space Flight Center

    Science.gov (United States)

    Ding, Robert J.

    2008-01-01

    Solid state welding processes have become the focus of welding process development at NASA's Marshall Space Flight Center. Unlike fusion weld processes such as tungsten inert gas (TIG), variable polarity plasma arc (VPPA), electron beam (EB), etc., solid state welding processes do not melt the material during welding. The resultant microstructure can be characterized as a dynamically recrystallized morphology much different than the casted, dentritic structure typical of fusion weld processes. The primary benefits of solid state processes over fusion weld processes include superior mechanic properties and the elimination of thermal distortion and residual stresses. These solid state processes attributes have profoundly influenced the direction of advanced welding research and development within the NASA agency. Thermal Stir Welding (TSW) is a new solid state welding process being developed at the Marshall Space Flight Center. Unlike friction stir welding, the heating, stirring and forging elements of the weld process can be decoupled for independent control. An induction coil induces energy into a workpiece to attain a desired plastic temperature. An independently controlled stir rod, captured within non-rotating containment plates, then stirs the plasticized material followed by forging plates/rollers that work the stirred weld joint. The independent control (decoupling) of heating, stirring and forging allows, theoretically, for the precision control of microstructure morphology. The TSW process is being used to evaluate the solid state joining of Haynes 230 for ARES J-2X applications. It is also being developed for 500-in (12.5 mm) thick commercially pure grade 2 titanium for navy applications. Other interests include Inconel 718 and stainless steel. This presentation will provide metallurgical and mechanical property data for these high melting temperature alloys.

  7. Lessons Learned from Implementing the Patient-Centered Medical Home

    Directory of Open Access Journals (Sweden)

    Ellen P. Green

    2012-01-01

    Full Text Available The Patient-Centered Medical Home (PCMH is a primary care model that provides coordinated and comprehensive care to patients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary care practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA. Individual organizations' experiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their experiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are responsive to the practice and patients’ needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic medical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out the intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many specifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this vagueness as allowing for greater flexibility in how a practice implements PCMH.

  8. Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

    Science.gov (United States)

    Tsai, Jack; Middleton, Margaret; Villegas, Jennifer; Johnson, Cindy; Retkin, Randye; Seidman, Alison; Sherman, Scott; Rosenheck, Robert A

    2017-12-01

    Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

  9. An analytics approach to designing patient centered medical homes.

    Science.gov (United States)

    Ajorlou, Saeede; Shams, Issac; Yang, Kai

    2015-03-01

    Recently the patient centered medical home (PCMH) model has become a popular team based approach focused on delivering more streamlined care to patients. In current practices of medical homes, a clinical based prediction frame is recommended because it can help match the portfolio capacity of PCMH teams with the actual load generated by a set of patients. Without such balances in clinical supply and demand, issues such as excessive under and over utilization of physicians, long waiting time for receiving the appropriate treatment, and non-continuity of care will eliminate many advantages of the medical home strategy. In this paper, by using the hierarchical generalized linear model with multivariate responses, we develop a clinical workload prediction model for care portfolio demands in a Bayesian framework. The model allows for heterogeneous variances and unstructured covariance matrices for nested random effects that arise through complex hierarchical care systems. We show that using a multivariate approach substantially enhances the precision of workload predictions at both primary and non primary care levels. We also demonstrate that care demands depend not only on patient demographics but also on other utilization factors, such as length of stay. Our analyses of a recent data from Veteran Health Administration further indicate that risk adjustment for patient health conditions can considerably improve the prediction power of the model.

  10. Research Strategies for Academic Medical Centers: A Framework for Advancements toward Translational Excellence

    Science.gov (United States)

    Haley, Rand; Champagne, Thomas J., Jr.

    2017-01-01

    This review article presents a simplified framework for thinking about research strategy priorities for academic medical centers (AMCs). The framework can serve as a precursor to future advancements in translational medicine and as a set of planning guideposts toward ultimate translational excellence. While market pressures, reform uncertainties,…

  11. Development of a NEW Vector Magnetograph at Marshall Space Flight Center

    Science.gov (United States)

    West, Edward; Hagyard, Mona; Gary, Allen; Smith, James; Adams, Mitzi; Rose, M. Franklin (Technical Monitor)

    2001-01-01

    This paper will describe the Experimental Vector Magnetograph that has been developed at the Marshall Space Flight Center (MSFC). This instrument was designed to improve linear polarization measurements by replacing electro-optic and rotating waveplate modulators with a rotating linear analyzer. Our paper will describe the motivation for developing this magnetograph, compare this instrument with traditional magnetograph designs, and present a comparison of the data acquired by this instrument and original MSFC vector magnetograph.

  12. Modernization of NASA's Johnson Space Center Chamber: A Liquid Nitrogen System to Support Cryogenic Vacuum Optical Testing of the James Webb Space Telescope (JWST)

    Science.gov (United States)

    Garcia, Sammy; Homan, Jonathan; Montz, Michael

    2016-01-01

    NASA is the mission lead for the James Webb Space Telescope (JWST), the next of the “Great Observatories”, scheduled for launch in 2018. It is directly responsible for the integration and test (I&T) program that will culminate in an end-to-end cryo vacuum optical test of the flight telescope and instrument module in Chamber A at NASA Johnson Space Center. Historic Chamber A is the largest thermal vacuum chamber at Johnson Space Center and one of the largest space simulation chambers in the world. Chamber A has undergone a major modernization effort to support the deep cryogenic, vacuum and cleanliness requirements for testing the JWST. This paper describes the steps performed in efforts to convert the existing the 60’s era Liquid Nitrogen System from a forced flow (pumped) process to a natural circulation (thermo-siphon) process. In addition, the paper will describe the dramatic conservation of liquid nitrogen to support the long duration thermal vacuum testing. Lastly, describe the simplistic and effective control system which results in zero to minimal human inputs during steady state conditions.

  13. Joint marketing cites excellence: Fairview-University Medical Center advertises cooperatively with University of Minnesota Physicians.

    Science.gov (United States)

    Botvin, Judith D

    2004-01-01

    Fairview-University Medical Center and University of Minnesota Physicians, both in Minneapolis, are enjoying the benefits of a co-branded advertising campaign. It includes print ads, brochures, and other marketing devices.

  14. The elderly in the shopping centers: the usability study of semipublic spaces as attractiveness generator.

    Science.gov (United States)

    Bittencourt, Maria Cristina; do Valle Pereira, Vera Lúcia Duarte; Pacheco, Waldemar

    2012-01-01

    This article aims to study the importance of the attributes of usability and attractiveness for the semi-public spaces of Shopping Centers considering the elderly users, the psycho-cognitive and bio-physiological changes resulting from the aging process, as well as their expectations of the built space. Through a qualitative study of theoretical review with a multidisciplinary focus in architecture, ergonomics, gerontology, environmental psychology and management, the conditions of the elderly users were identified, and also the attributes related to usability and attractiveness, collected in order to understand and organize their interrelationships, to suggest recommendations about the drafting of Shopping Centers, aiming to generate projects and environments that should promote the efficient and satisfactory use for elderly and may also create a competitive advantage for these enterprises.

  15. Master's Level Graduate Training in Medical Physics at the University of Colorado Health Sciences Center.

    Science.gov (United States)

    Ibbott, Geoffrey S.; Hendee, William R.

    1980-01-01

    Describes the master's degree program in medical physics developed at the University of Colorado Health Sciences Center. Required courses for the program, and requirements for admission are included in the appendices. (HM)

  16. Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home.

    Science.gov (United States)

    O'Donnell, Alison J; Bogner, Hillary R; Cronholm, Peter F; Kellom, Katherine; Miller-Day, Michelle; McClintock, Heather F de Vries; Kaye, Elise M; Gabbay, Robert

    2016-02-25

    Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n = 47), medical assistants (n = 26), office administrators (n = 12), care managers (n = 11), front office staff (n = 7), patient educators (n = 4), nurses (n = 4), social workers (n = 4), and other administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.

  17. Benefits of the effective dose equivalent concept at a medical center

    International Nuclear Information System (INIS)

    Vetter, R.J.; Classic, K.L.

    1991-01-01

    A primary objective of the recommendations of the International Committee on Radiological Protection Publication 26 is to insure that no source of radiation exposure is unjustified in relation to its benefits. This objective is consistent with goals of the Radiation Safety Committee and Institutional Review Board at medical centers where research may involve radiation exposure of human subjects. The effective dose equivalent concept facilitates evaluation of risk by those who have little or no knowledge of quantities or biological effects of radiation. This paper presents effective dose equivalent data used by radiation workers and those who evaluate human research protocols as these data relate to personal dosimeter reading, entrance skin exposure, and target organ dose. The benefits of using effective dose equivalent to evaluate risk of medical radiation environments and research protocols are also described

  18. Health Care Provider Burnout in a United States Military Medical Center During a Period of War.

    Science.gov (United States)

    Sargent, Paul; Millegan, Jeffrey; Delaney, Eileen; Roesch, Scott; Sanders, Martha; Mak, Heather; Mallahan, Leonard; Raducha, Stephanie; Webb-Murphy, Jennifer

    2016-02-01

    Provider burnout can impact efficiency, empathy, and medical errors. Our study examines burnout in a military medical center during a period of war. A survey including the Maslach Burnout Inventory (MBI), deployment history, and work variables was distributed to health care providers. MBI subscale means were calculated and associations between variables were analyzed. Approximately 60% of 523 respondents were active duty and 34% had deployed. MBI subscale means were 19.99 emotional exhaustion, 4.84 depersonalization, and 40.56 personal accomplishment. Frustration over administrative support was associated with high emotional exhaustion and depersonalization; frustration over life/work balance was associated with high emotional exhaustion. Levels of burnout in our sample were similar to civilian medical centers. Sources of frustration were related to administrative support and life/work balance. Deployment had no effect on burnout levels. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  19. Patient-centered medical home initiatives expanded in 2009-13: providers, patients, and payment incentives increased.

    Science.gov (United States)

    Edwards, Samuel T; Bitton, Asaf; Hong, Johan; Landon, Bruce E

    2014-10-01

    Patient-centered medical home initiatives are central to many efforts to reform the US health care delivery system. To better understand the extent and nature of these initiatives, in 2013 we performed a nationwide cross-sectional survey of initiatives that included payment reform incentives in their models, and we compared the results to those of a similar survey we conducted in 2009. We found that the number of initiatives featuring payment reform incentives had increased from 26 in 2009 to 114 in 2013. The number of patients covered by these initiatives had increased from nearly five million to almost twenty-one million. We also found that the proportion of time-limited initiatives--those with a planned end date--was 20 percent in 2013, a decrease from 77 percent in 2009. Finally, we found that the dominant payment model for patient-centered medical homes remained fee-for-service payments augmented by per member per month payments and pay-for-performance bonuses. However, those payments and bonuses were higher in 2013 than they were in 2009, and the use of shared-savings models was greater. The patient-centered medical home model is likely to continue both to become more common and to play an important role in delivery system reform. Project HOPE—The People-to-People Health Foundation, Inc.

  20. 33 CFR 334.1130 - Pacific Ocean, Western Space and Missile Center (WSMC), Vandenberg AFB, Calif.; danger zones.

    Science.gov (United States)

    2010-07-01

    ... Missile Center (WSMC), Vandenberg AFB, Calif.; danger zones. 334.1130 Section 334.1130 Navigation and... RESTRICTED AREA REGULATIONS § 334.1130 Pacific Ocean, Western Space and Missile Center (WSMC), Vandenberg AFB... (WSMC) at Vandenberg AFB, California. (3) The impacting of missile debris from launch operations will...

  1. Recent Pharmacology Studies on the International Space Station

    Science.gov (United States)

    Wotring, Virginia

    2014-01-01

    The environment on the International Space Station (ISS) includes a variety of potential stressors including the absence of Earth's gravity, elevated exposure to radiation, confined living and working quarters, a heavy workload, and high public visibility. The effects of this extreme environment on pharmacokinetics, pharmacodynamics, and even on stored medication doses, are not yet understood. Dr. Wotring will discuss recent analyses of medication doses that experienced long duration storage on the ISS and a recent retrospective examination of medication use during long-duration spaceflights. She will also describe new pharmacology experiments that are scheduled for upcoming ISS missions. Dr. Virginia E. Wotring is a Senior Scientist in the Division of Space Life Sciences in the Universities Space Research Association, and Pharmacology Discipline Lead at NASA's Johnson Space Center, Human Heath and Countermeasures Division. She received her doctorate in Pharmacological and Physiological Science from Saint Louis University after earning a B.S. in Chemistry at Florida State University. She has published multiple studies on ligand gated ion channels in the brain and spinal cord. Her research experience includes drug mechanisms of action, drug receptor structure/function relationships and gene & protein expression. She joined USRA (and spaceflight research) in 2009. In 2012, her book reviewing pharmacology in spaceflight was published by Springer: Space Pharmacology, Space Development Series.

  2. Academic season does not influence cardiac surgical outcomes at US Academic Medical Centers.

    Science.gov (United States)

    Lapar, Damien J; Bhamidipati, Castigliano M; Mery, Carlos M; Stukenborg, George J; Lau, Christine L; Kron, Irving L; Ailawadi, Gorav

    2011-06-01

    Previous studies have demonstrated the influence of academic season on outcomes in select surgical populations. However, the influence of academic season has not been evaluated nationwide in cardiac surgery. We hypothesized that cardiac surgical outcomes were not significantly influenced by time of year at both cardiothoracic teaching hospitals and non-cardiothoracic teaching hospitals nationwide. From 2003 to 2007, a weighted 1,614,394 cardiac operations were evaluated using the Nationwide Inpatient Sample database. Patients undergoing cardiac operations at cardiothoracic teaching and non-cardiothoracic teaching hospitals were identified using the Association of American Medical College's Graduate Medical Education Tracking System. Hierarchic multivariable logistic regression analyses were used to estimate the effect of academic quarter on risk-adjusted outcomes. Mean patient age was 65.9 ± 10.9 years. Women accounted for 32.8% of patients. Isolated coronary artery bypass grafting was the most common operation performed (64.7%), followed by isolated valve replacement (19.3%). The overall incidence of operative mortality and composite postoperative complication rate were 2.9% and 27.9%, respectively. After accounting for potentially confounding risk factors, timing of operation by academic quarter did not independently increase risk-adjusted mortality (p = 0.12) or morbidity (p = 0.24) at academic medical centers. Risk-adjusted mortality and morbidity for cardiac operations were not associated with time of year in the US at teaching and nonteaching hospitals. Patients should be reassured of the safety of performance of cardiac operations at academic medical centers throughout a given academic year. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Between Community Spaces: Squares of Minor Centers of Calabria

    Directory of Open Access Journals (Sweden)

    Mauro Francini

    2017-08-01

    Full Text Available The theme of open “community spaces” in recent years has to the development of important interdisci­plinary issues. Nevertheless, the reading of smaller towns, in urbanistic, historical-anthropological and geographical terms appears less extended, considering the declination of public spaces as "squares." Starting from this declension we would like to introduce the first results of a research. The research had the aim of (reinterpreting the particular characteristics of these areas in specific areas such as small towns, using the region of Calabria for the case of analytic application. These communities have diverse and stratified living cultures, altered by settlement processes that have triggered two different types of urban contexts. The former often lead either to urban areas in depopulated decay or, in contrast, in places of memories: empty containers of relationships, sterile and crystallized museum objects, reduced to scenarios on which passing groups of visitors move necessarily from those realities. The latter often encircle primitive nuclei, asphyxiating them, or characterizing the so-called "dual" or "satellites" towns, completely detached from the original urban center in which all public functions are decentralized. The applied methodology is based on the reading of the historical-functional evolution of squares by the identification of codified compositional criteria. Through this research we seek to verify how urban planning, in synergy with other disciplines, can define processes of regeneration aimed at restoring the meaning of "center", and thus of an urban-community reference center.

  4. Space Technology Demonstrations Using Low Cost, Short-Schedule Airborne and Range Facilities at the Dryden Flight Research Center

    Science.gov (United States)

    Carter, John; Kelly, John; Jones, Dan; Lee, James

    2013-01-01

    There is a national effort to expedite advanced space technologies on new space systems for both government and commercial applications. In order to lower risk, these technologies should be demonstrated in a relevant environment before being installed in new space systems. This presentation introduces several low cost, short schedule space technology demonstrations using airborne and range facilities available at the Dryden Flight Research Center.

  5. Creating the Deep Space Environment for Testing the James Webb Space Telescope at NASA Johnson Space Center's Chamber A

    Science.gov (United States)

    Homan, Jonathan L.; Cerimele, Mary P.; Montz, Michael E.; Bachtel, Russell; Speed, John; O'Rear, Patrick

    2013-01-01

    Chamber A is the largest thermal vacuum chamber at the Johnson Space Center and is one of the largest space environment chambers in the world. The chamber is 19.8 m (65 ft.) in diameter and 36.6 m (120 ft.) tall and is equipped with cryogenic liquid nitrogen panels (shrouds) and gaseous helium shrouds to create a simulated space environment. It was originally designed and built in the mid 1960 s to test the Apollo Command and Service Module and several manned tests were conducted on that spacecraft, contributing to the success of the program. The chamber has been used since that time to test spacecraft active thermal control systems, Shuttle DTO, DOD, and ESA hardware in simulated Low Earth Orbit (LEO) conditions. NASA is now moving from LEO towards exploration of locations with environments approaching those of deep space. Therefore, Chamber A has undergone major modifications to enable it to simulate these deeper space environments. Environmental requirements were driven, and modifications were funded by the James Webb Space Telescope program, and this telescope, which will orbit Solar/Earth L2, will be the first test article to benefit from the chamber s new capabilities. To accommodate JWST, the Chamber A high vacuum system has been modernized, additional LN2 shrouds have been installed, the liquid nitrogen system has been modified to minimize dependency on electrical power and increase its reliability, a new helium shroud/refrigeration system has been installed to create a colder more stable and uniform heat sink, and the controls have been updated to increase the level of automation and improve operator interfaces. Testing of these major modifications was conducted in August of 2012 and this initial test was very successful, with all major systems exceeding their performance requirements. This paper will outline the changes in overall environmental requirements, discuss the technical design data that was used in the decisions leading to the extensive

  6. Creating the Deep Space Environment for Testing the James Webb Space Telescope at the Johnson Space Center's Chamber A

    Science.gov (United States)

    Homan, Jonathan L.; Cerimele, Mary P.; Montz, Michael E.

    2012-01-01

    Chamber A is the largest thermal vacuum chamber at the Johnson Space Center and is one of the largest space environment chambers in the world. The chamber is 19.8 m (65 ft) in diameter and 36.6 m (120 ft) tall and is equipped with cryogenic liquid nitrogen panels (shrouds) and gaseous helium shrouds to create a simulated space environment. It was originally designed and built in the mid 1960's to test the Apollo Command and Service Module and several manned tests were conducted on that spacecraft, contributing to the success of the program. The chamber has been used since that time to test spacecraft active thermal control systems, Shuttle DTO, DOD, and ESA hardware in simulated Low Earth Orbit (LEO) conditions. NASA is now moving from LEO towards exploration of locations with environments approaching those of deep space. Therefore, Chamber A has undergone major modifications to enable it to simulate these deeper space environments. Environmental requirements were driven, and the modifications were funded, by the James Webb Space Telescope program, and this telescope which will orbit Solar/Earth L2, will be the first test article to benefit from the chamber s new capabilities. To accommodate JWST, the Chamber A high vacuum system has been modernized, additional LN2 shrouds have been installed, the liquid nitrogen system has been modified to remove dependency on electrical power and increase its reliability, a new helium shroud/refrigeration system has been installed to create a colder more stable and uniform heat sink and, the controls have been updated to increase the level of automation and improve operator interfaces. Testing of these major modifications was conducted in August 2012 and this initial test was very successful, with all major systems exceeding their performance requirements. This paper will outline the changes in the overall environmental requirements, discuss the technical design data that was used in the decisions leading to the extensive

  7. Current neurotrauma treatment practice in secondary medical service centers

    International Nuclear Information System (INIS)

    Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu

    2011-01-01

    Despite neurotrauma treatment practices comprising a significant amount of neurosurgical work for secondary medical service centers, little attention has been placed on neurotrauma cases and evaluation of current neurotrauma treatment practices is limited. Therefore we investigated current neurotrauma practices in our hospital located in a Japanese suburban city. We analyzed 439 patients with traumatic brain injury (TBI) admitted to our hospital between April 2004 and October 2010. Patients were divided into three groups based on the Glasgow Coma Scale (GCS) score on admission: mild TBI (GCS 14-15) in 252 patients (57.4%), moderate TBI (GCS 9-13) in 116 patients (26.4%), and severe TBI (GCS 3-8) in 71 patients (16.2%). Age, gender, alcohol consumption, cause of injury, cranial CT findings, neurosurgical procedure, length of hospital stay, and clinical outcome were analyzed. The average age of the patients was 59.2 years old. Male patients comprised 65%. Alcohol consumption was reported in 81 cases (18.5%), most of them with moderate TBI. Fall (208 cases, 47.4%) was the most frequent cause of injury, followed by traffic accident (115 cases, 26.2%) and high fall (73 cases, 16.6%). Acute subdural hematoma (174 cases, 39.6%) was most frequently seen in cranial CT findings on admission, which significantly increased with severity. A neurosurgical procedure was performed for 70 cases (15.9%), of which 15 (6.0%) were mild TBI and 18 (15.5%) were moderate TBI. The average hospital stay was 20.8 days, which significantly increased with severity. The overall rate of favorable outcome was 82.7%, and mortality was 8.2%; outcome deteriorated with severity. Some mild and moderate TBI cases had deteriorated and required surgery or resulted in death. These findings suggest that cautious treatment is necessary even in mild to moderate TBI cases which are often encountered in secondary medical service centers. (author)

  8. Impact of Mobile Dose-Tracking Technology on Medication Distribution at an Academic Medical Center.

    Science.gov (United States)

    Kelm, Matthew; Campbell, Udobi

    2016-05-01

    Medication dose-tracking technologies have the potential to improve efficiency and reduce costs associated with re-dispensing doses reported as missing. Data describing this technology and its impact on the medication use process are limited. The purpose of this study is to assess the impact of dose-tracking technology on pharmacy workload and drug expense at an academic, acute care medical center. Dose-tracking technology was implemented in June 2014. Pre-implementation data were collected from February to April 2014. Post-implementation data were collected from July to September 2014. The primary endpoint was the percent of re-dispensed oral syringe and compounded sterile product (CSP) doses within the pre- and post-implementation periods per 1,000 discharges. Secondary endpoints included pharmaceutical expense generated from re-dispensing doses, labor costs, and staff satisfaction with the medication distribution process. We observed an average 6% decrease in re-dispensing of oral syringe and CSP doses from pre- to post-implementation (15,440 vs 14,547 doses; p = .047). However, when values were adjusted per 1,000 discharges, this trend did not reach statistical significance (p = .074). Pharmaceutical expense generated from re-dispensing doses was significantly reduced from pre- to post-implementation ($834,830 vs $746,466 [savings of $88,364]; p = .047). We estimated that $2,563 worth of technician labor was avoided in re-dispensing missing doses. We also saw significant improvement in staff perception of technology assisting in reducing missing doses (p = .0003), as well as improvement in effectiveness of resolving or minimizing missing doses (p = .01). The use of mobile dose-tracking technology demonstrated meaningful reductions in both the number of doses re-dispensed and cost of pharmaceuticals dispensed.

  9. Unique strategies for technical information management at Johnson Space Center

    Science.gov (United States)

    Krishen, Vijay

    1994-01-01

    In addition to the current NASA manned programs, the maturation of Space Station and the introduction of the Space Exploration programs are anticipated to add substantially to the number and variety of data and documentation at NASA Johnson Space Center (JSC). This growth in the next decade has been estimated at five to ten fold compared to the current numbers. There will be an increased requirement for the tracking and currency of space program data and documents with National pressures to realize economic benefits from the research and technological developments of space programs. From a global perspective the demand for NASA's technical data and documentation is anticipated to increase at local, national, and international levels. The primary users will be government, industry, and academia. In our present national strategy, NASA's research and technology will assume a great role in the revitalization of the economy and gaining international competitiveness. Thus, greater demand will be placed on NASA's data and documentation resources. In this paper the strategies and procedures developed by DDMS, Inc., to accommodate the present and future information utilization needs are presented. The DDMS, Inc., strategies and procedures rely on understanding user requirements, library management issues, and technological applications for acquiring, searching, storing, and retrieving specific information accurately and quickly. The proposed approach responds to changing customer requirements and product deliveries. The unique features of the proposed strategy include: (1) To establish customer driven data and documentation management through an innovative and unique methods to identify needs and requirements. (2) To implement a structured process which responds to user needs, aimed at minimizing costs and maximizing services, resulting in increased productivity. (3) To provide a process of standardization of services and procedures. This standardization is the central

  10. Liquid hydrogen production and economics for NASA Kennedy Space Center

    Science.gov (United States)

    Block, D. L.

    1985-12-01

    Detailed economic analyses for the production of liquid hydrogen used to power the Space Shuttle are presented. The hydrogen production and energy needs of the NASA Kennedy Space Center are reviewed, and steam reformation, polygeneration, and electrolysis for liquid hydrogen production are examined on an equal economic basis. The use of photovoltaics as an electrolysis power source is considered. The 1985 present worth is calculated based on life cycle costs over a 21-year period beginning with full operation in 1990. Two different sets of escalation, inflation, and discount rates are used, with revenue credit being given for energy or other products of the hydrogen production process. The results show that the economic analyses are very dependent on the escalation rates used. The least net present value is found for steam reformation of natural gas, while the best net present value is found for the electrolysis process which includes the phasing of photovoltaics.

  11. [Management of medical care for the victims of road accidents in traumatology centers of Saint-Petersburg].

    Science.gov (United States)

    Tulupov, A N; Afonchikov, V Iu; Chikin, A E; Taniia, S Sh; Ganin, A S

    2014-01-01

    The number of road accidents, fatal outcomes and victims exceeded in 1.5 times in Saint-Petersburg in comparison with Moscow. At the average, 600 victims were treated in each of 6 first-level traumatology centers every year. The quantity of patients, who were admitted to 3 second-level traumatology centers, numbered 10 times less. About 300 people entered to others hospitals. The lethality consisted of 15%, 20% and 37%, respectively. There are a lot of matters, that should be discussed, such as an importance of better treatment financing of multitrauma by using compulsory medical insurance system, an optimization of pre-admission treatment and a necessity of patient delivery by mobile medical team using the anaesthesiology and resuscitation.

  12. Tool for evaluating the evolution Space Weather Regional Warning Centers under the innovation point of view: the Case Study of the Embrace Space Weather Program Early Stages

    Science.gov (United States)

    Denardini, Clezio Marcos

    2016-07-01

    We have developed a tool for measuring the evolutional stage of the space weather regional warning centers using the approach of the innovative evolution starting from the perspective presented by Figueiredo (2009, Innovation Management: Concepts, metrics and experiences of companies in Brazil. Publisher LTC, Rio de Janeiro - RJ). It is based on measuring the stock of technological skills needed to perform a certain task that is (or should) be part of the scope of a space weather center. It also addresses the technological capacity for innovation considering the accumulation of technological and learning capabilities, instead of the usual international indices like number of registered patents. Based on this definition, we have developed a model for measuring the capabilities of the Brazilian Study and Monitoring Program Space Weather (Embrace), a program of the National Institute for Space Research (INPE), which has gone through three national stages of development and an international validation step. This program was created in 2007 encompassing competence from five divisions of INPE in order to carry out the data collection and maintenance of the observing system in space weather; to model processes of the Sun-Earth system; to provide real-time information and to forecast space weather; and provide diagnostic their effects on different technological systems. In the present work, we considered the issues related to the innovation of micro-processes inherent to the nature of the Embrace program, not the macro-economic processes, despite recognizing the importance of these. During the development phase, the model was submitted to five scientists/managers from five different countries member of the International Space Environment Service (ISES) who presented their evaluations, concerns and suggestions. It was applied to the Embrace program through an interview form developed to be answered by professional members of regional warning centers. Based on the returning

  13. Publications in academic medical centers: technology-facilitated culture clash.

    Science.gov (United States)

    Berner, Eta S

    2014-05-01

    Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed.

  14. The Research-to-Operations-to-Research Cycle at NOAA's Space Weather Prediction Center

    Science.gov (United States)

    Singer, H. J.

    2017-12-01

    The provision of actionable space weather products and services by NOAA's Space Weather Prediction Center relies on observations, models and scientific understanding of our dynamic space environment. It also depends on a deep understanding of the systems and capabilities that are vulnerable to space weather, as well as national and international partnerships that bring together resources, skills and applications to support space weather forecasters and customers. While these activities have been evolving over many years, in October 2015, with the release of the National Space Weather Strategy and National Space Weather Action Plan (NSWAP) by National Science and Technology Council in the Executive Office of the President, there is a new coordinated focus on ensuring the Nation is prepared to respond to and recover from severe space weather storms. One activity highlighted in the NSWAP is the Operations to Research (O2R) and Research to Operations (R2O) process. In this presentation we will focus on current R2O and O2R activities that advance our ability to serve those affected by space weather and give a vision for future programs. We will also provide examples of recent research results that lead to improved operational capabilities, lessons learned in the transition of research to operations, and challenges for both the science and operations communities.

  15. Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

    Science.gov (United States)

    Detweiler, Mark B.; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S.; Detweiler, Jonna G.; Lutgens, Brian W.

    2016-01-01

    The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. PMID:27999253

  16. Inspiring the Next Generation in Space Life Sciences

    Science.gov (United States)

    Hayes, Judith

    2010-01-01

    Competitive summer internships in space life sciences at NASA are awarded to college students every summer. Each student is aligned with a NASA mentor and project that match his or her skills and interests, working on individual projects in ongoing research activities. The interns consist of undergraduate, graduate, and medical students in various majors and disciplines from across the United States. To augment their internship experience, students participate in the Space Life Sciences Summer Institute (SLSSI). The purpose of the Institute is to offer a unique learning environment that focuses on the current biomedical issues associated with human spaceflight; providing an introduction of the paradigms, problems, and technologies of modern spaceflight cast within the framework of life sciences. The Institute faculty includes NASA scientists, physicians, flight controllers, engineers, managers, and astronauts; and fosters a multi-disciplinary science approach to learning with a particular emphasis on stimulating experimental creativity and innovation within an operational environment. This program brings together scientists and students to discuss cutting-edge solutions to problems in space physiology, environmental health, and medicine; and provides a familiarization of the various aspects of space physiology and environments. In addition to the lecture series, behind-the-scenes tours are offered that include the Neutral Buoyancy Laboratory, Mission Control Center, space vehicle training mockups, and a hands-on demonstration of the Space Shuttle Advanced Crew Escape Suit. While the SLSSI is managed and operated at the Johnson Space Center in Texas, student interns from the other NASA centers (Glenn and Ames Research Centers, in Ohio and California) also participate through webcast distance learning capabilities.

  17. Dreams, Hopes, Realities: NASA's Goddard Space Flight Center, the First Forty Years

    Science.gov (United States)

    Wallace, Lane E.

    1999-01-01

    Throughout history, the great achievements of civilizations and cultures have been recorded in lists of dates and events. But to look only at the machinery, discoveries, or milestones is to miss the value of these achievements. Each goal achieved or discovery or made represents a supreme effort on the part of individual people who came and worked together for a purpose greater than themselves. Driven by an innate curiosity of the spirit, we have built civilizations and discovered new worlds, always reaching out beyond what we knew or thought was possible. These efforts may have used ships or machinery, but the achievement was that of the humans who made those machines possible- remarkable people willing to endure discomfort, frustration, fatigue, and the risk of failure in the hope of finding out something new. This is the case with the history of the Goddard Space Flight Center. This publication traces the legacy of successes, risks, disappointments and internationally recognized triumphs of the Center's first 40 years. It is a story of technological achievement and scientific discovery; of reaching back to the dawn of time and opening up a new set of eyes on our own planet Earth. In the end, it is not a story about machinery or discoveries, but a story about ourselves. If we were able to step off our planet, and if we continue to discover new mysteries and better technology, it is because the people who work at Goddard always had a passion for exploration and the dedication to make it happen. The text that follows is a testimony to the challenges people at the Goddard Space Flight Center have faced and overcome over almost half a century. Today, we stand on the threshold of a new and equally challenging era. It will once again test our ingenuity, skills, and flexibility as we find new ways of working with our colleagues in industry, government, and academia. Doing more with less is every bit as ambitious as designing the first science instrument to study the

  18. Rocket ranch the nuts and bolts of the Apollo Moon program at Kennedy Space Center

    CERN Document Server

    Ward, Jonathan H

    2015-01-01

    Jonathan Ward takes the reader deep into the facilities at Kennedy Space Center to describe NASA’s first computer systems used for spacecraft and rocket checkout and explain how tests and launches proceeded. Descriptions of early operations include a harrowing account of the heroic efforts of pad workers during the Apollo 1 fire. A companion to the author’s book Countdown to a Moon Launch: Preparing Apollo for Its Historic Journey, this explores every facet of the facilities that served as the base for the Apollo/Saturn missions. Hundreds of illustrations complement the firsthand accounts of more than 70 Apollo program managers and engineers. The era of the Apollo/Saturn missions was perhaps the most exciting period in American space exploration history. Cape Canaveral and Kennedy Space Center were buzzing with activity. Thousands of workers came to town to build the facilities and launch the missions needed to put an American on the Moon before the end of the decade. Work at KSC involved much more than j...

  19. Patient-Centered Medical Home and Family Burden in Attention-Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Ronis, Sarah D; Baldwin, Constance D; Blumkin, Aaron; Kuhlthau, Karen; Szilagyi, Peter G

    2015-01-01

    Attention-deficit hyperactivity disorder (ADHD) can impair child health and functioning, but its effects on the family's economic burden are not well understood. The authors assessed this burden in US families of children with ADHD, and the degree to which access to a patient-centered medical home (PCMH) might reduce this burden. We conducted cross-sectional analyses of 2005-2006 and 2009-2010 National Surveys of Children with Special Health Care Needs, focusing on families of children with ADHD. They defined family economic burden as (1) family financial problems (annual expenses for the child's health care or illness-related financial problems for the family) and/or (2) family employment problems (job loss, work time loss, or failure to change jobs to avoid insurance loss). Relative risk models assessed associations between PCMH and family economic burden, adjusted for child age, sex, ethnicity, ADHD severity, poverty status, caregiver education, and insurance. In 2009, 26% of families reported financial problems because of the child's ADHD, 2.1% reported out-of-pocket expenses >5% of income, and 36% reported employment problems. Only 38% reported care that met all 5 criteria for a PCMH (similar to rates in 2005-2006). In multivariable analysis, care in a PCMH was associated with 48% lower relative risk (RR) of financial problems (RR = 0.52, p family-centered care and care coordination were more strongly associated with lower burden. The economic burdens of families with ADHD are significant but may be alleviated by family-centered care and care coordination in a medical home.

  20. INSPACE CHEMICAL PROPULSION SYSTEMS AT NASA's MARSHALL SPACE FLIGHT CENTER: HERITAGE AND CAPABILITIES

    Science.gov (United States)

    McRight, P. S.; Sheehy, J. A.; Blevins, J. A.

    2005-01-01

    NASA s Marshall Space Flight Center (MSFC) is well known for its contributions to large ascent propulsion systems such as the Saturn V rocket and the Space Shuttle external tank, solid rocket boosters, and main engines. This paper highlights a lesser known but very rich side of MSFC-its heritage in the development of in-space chemical propulsion systems and its current capabilities for spacecraft propulsion system development and chemical propulsion research. The historical narrative describes the flight development activities associated with upper stage main propulsion systems such as the Saturn S-IVB as well as orbital maneuvering and reaction control systems such as the S-IVB auxiliary propulsion system, the Skylab thruster attitude control system, and many more recent activities such as Chandra, the Demonstration of Automated Rendezvous Technology (DART), X-37, the X-38 de-orbit propulsion system, the Interim Control Module, the US Propulsion Module, and multiple technology development activities. This paper also highlights MSFC s advanced chemical propulsion research capabilities, including an overview of the center s Propulsion Systems Department and ongoing activities. The authors highlight near-term and long-term technology challenges to which MSFC research and system development competencies are relevant. This paper concludes by assessing the value of the full range of aforementioned activities, strengths, and capabilities in light of NASA s exploration missions.

  1. Surface to 90 km winds for Kennedy Space Center, Florida, and Vandenberg AFB, California

    Science.gov (United States)

    Johnson, D. L.; Brown, S. C.

    1979-01-01

    Bivariate normal wind statistics for a 90 degree flight azimuth, from 0 through 90 km altitude, for Kennedy Space Center, Florida, and Vandenberg AFB, California are presented. Wind probability distributions and statistics for any rotation of axes can be computed from the five given parameters.

  2. [Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

    Science.gov (United States)

    Halidou Doudou, M; Manzo, M L; Guero, D

    2014-12-01

    In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Customer satisfaction in medical service encounters -- a comparison between obstetrics and gynecology patients and general medical patients.

    Science.gov (United States)

    Chang, Ching-Sheng; Weng, Hui-Ching; Chang, Hsin-Hsin; Hsu, Tsuen-Ho

    2006-03-01

    This study is concerned with the "service encounter", and seeks to describe, by use of the Service Encounter Evaluation Model, how the processes involved in the service encounter affect customer satisfaction. Its findings have implications for management practice and research directions, and recommendations are made. With the implementation of a national health insurance scheme, an ever-prospering economy and continually improving educational levels in Taiwan, demand among citizens for good health and medical care is ever increasing. Obstetrics and gynecology patients often differ greatly from general patients, in terms of their moods and emotions. This research involved an empirical study, whose subjects were 590 customers of general clinics and 339 customers of gynecology clinics, in various medical centers in southern Taiwan. By factor analysis, the study established four influencing factors, which were "Medical professionals", "Nursing professionals", "Service personnel" and "Space and facilities". Using the Linear Structural Relation Model (LISREL), it found that medical professionals, nursing professionals, service personnel and space and facilities were effective predictors of medical treatment satisfaction. We also found that the greatest positive impact on overall medical treatment satisfaction resulted from rises in satisfaction with medical professionals, but that the least impact was achieved in relation to service personnel in the general and gynecology clinics.

  4. The National Space Science and Technology Center's Education and Public Outreach Program

    Science.gov (United States)

    Cox, G. N.; Denson, R. L.

    2004-12-01

    The objective of the National Space Science and Technology Center's (NSSTC) Education and Public Outreach program (EPO) is to support K-20 education by coalescing academic, government, and business constituents awareness, implementing best business/education practices, and providing stewardship over funds and programs that promote a symbiotic relationship among these entities, specifically in the area of K-20 Science, Technology, Engineering, and Mathematics (STEM) education. NSSTC EPO Program's long-term objective is to showcase its effective community-based integrated stakeholder model in support of STEM education and to expand its influence across the Southeast region for scaling ultimately across the United States. The Education and Public Outreach program (EPO) is coordinated by a supporting arm of the NSSTC Administrative Council called the EPO Council (EPOC). The EPOC is funded through federal, state, and private grants, donations, and in-kind contributions. It is comprised of representatives of NSSTC Research Centers, both educators and scientists from the Alabama Space Science and Technology Alliance (SSTA) member institutions, the Alabama Space Grant Consortium and the NASA Marshall Space Flight Center's (MSFC) Education Office. Through its affiliation with MSFC and the SSTA - a consortium of Alabama's research universities that comprise the NSSTC, EPO fosters the education and development of the next generation of Alabama scientists and engineers by coordinating activities at the K-20 level in cooperation with the Alabama Department of Education, the Alabama Commission on Higher Education, and Alabama's businesses and industries. The EPO program's primary objective is to be Alabama's premiere organization in uniting academia, government, and private industry by way of providing its support to the State and Federal Departments of Education involved in systemic STEM education reform, workforce development, and innovative uses of technology. The NSSTC EPO

  5. Impact of a Patient-Centered Medical Home on Access, Quality, and Cost

    Science.gov (United States)

    2013-02-01

    Effec- tiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communica- tion, and customer service...reduced health care costs. The patient -centered medical home (PCMH) concept is “an approach to providing comprehensive primary care [in] a health care... patient at the right place and right time” is vital to the appro- priate utilization of health care services across a broad spec- trum of patient needs

  6. Constraint based scheduling for the Goddard Space Flight Center distributed Active Archive Center's data archive and distribution system

    Science.gov (United States)

    Short, Nick, Jr.; Bedet, Jean-Jacques; Bodden, Lee; Boddy, Mark; White, Jim; Beane, John

    1994-01-01

    The Goddard Space Flight Center (GSFC) Distributed Active Archive Center (DAAC) has been operational since October 1, 1993. Its mission is to support the Earth Observing System (EOS) by providing rapid access to EOS data and analysis products, and to test Earth Observing System Data and Information System (EOSDIS) design concepts. One of the challenges is to ensure quick and easy retrieval of any data archived within the DAAC's Data Archive and Distributed System (DADS). Over the 15-year life of EOS project, an estimated several Petabytes (10(exp 15)) of data will be permanently stored. Accessing that amount of information is a formidable task that will require innovative approaches. As a precursor of the full EOS system, the GSFC DAAC with a few Terabits of storage, has implemented a prototype of a constraint-based task and resource scheduler to improve the performance of the DADS. This Honeywell Task and Resource Scheduler (HTRS), developed by Honeywell Technology Center in cooperation the Information Science and Technology Branch/935, the Code X Operations Technology Program, and the GSFC DAAC, makes better use of limited resources, prevents backlog of data, provides information about resources bottlenecks and performance characteristics. The prototype which is developed concurrently with the GSFC Version 0 (V0) DADS, models DADS activities such as ingestion and distribution with priority, precedence, resource requirements (disk and network bandwidth) and temporal constraints. HTRS supports schedule updates, insertions, and retrieval of task information via an Application Program Interface (API). The prototype has demonstrated with a few examples, the substantial advantages of using HTRS over scheduling algorithms such as a First In First Out (FIFO) queue. The kernel scheduling engine for HTRS, called Kronos, has been successfully applied to several other domains such as space shuttle mission scheduling, demand flow manufacturing, and avionics communications

  7. Johnson Space Center's Risk and Reliability Analysis Group 2008 Annual Report

    Science.gov (United States)

    Valentine, Mark; Boyer, Roger; Cross, Bob; Hamlin, Teri; Roelant, Henk; Stewart, Mike; Bigler, Mark; Winter, Scott; Reistle, Bruce; Heydorn,Dick

    2009-01-01

    The Johnson Space Center (JSC) Safety & Mission Assurance (S&MA) Directorate s Risk and Reliability Analysis Group provides both mathematical and engineering analysis expertise in the areas of Probabilistic Risk Assessment (PRA), Reliability and Maintainability (R&M) analysis, and data collection and analysis. The fundamental goal of this group is to provide National Aeronautics and Space Administration (NASA) decisionmakers with the necessary information to make informed decisions when evaluating personnel, flight hardware, and public safety concerns associated with current operating systems as well as with any future systems. The Analysis Group includes a staff of statistical and reliability experts with valuable backgrounds in the statistical, reliability, and engineering fields. This group includes JSC S&MA Analysis Branch personnel as well as S&MA support services contractors, such as Science Applications International Corporation (SAIC) and SoHaR. The Analysis Group s experience base includes nuclear power (both commercial and navy), manufacturing, Department of Defense, chemical, and shipping industries, as well as significant aerospace experience specifically in the Shuttle, International Space Station (ISS), and Constellation Programs. The Analysis Group partners with project and program offices, other NASA centers, NASA contractors, and universities to provide additional resources or information to the group when performing various analysis tasks. The JSC S&MA Analysis Group is recognized as a leader in risk and reliability analysis within the NASA community. Therefore, the Analysis Group is in high demand to help the Space Shuttle Program (SSP) continue to fly safely, assist in designing the next generation spacecraft for the Constellation Program (CxP), and promote advanced analytical techniques. The Analysis Section s tasks include teaching classes and instituting personnel qualification processes to enhance the professional abilities of our analysts

  8. Space Operations Center system analysis. Volume 3, book 2: SOC system definition report, revision A

    Science.gov (United States)

    1982-01-01

    The Space Operations Center (SOC) orbital space station program operations are described. A work breakdown structure for the general purpose support equipment, construction and transportation support, and resupply and logistics support systems is given. The basis for the design of each element is presented, and a mass estimate for each element supplied. The SOC build-up operation, construction, flight support, and satellite servicing operations are described. Detailed programmatics and cost analysis are presented.

  9. Technology Development for Hydrogen Propellant Storage and Transfer at the Kennedy Space Center (KSC)

    Science.gov (United States)

    Youngquist, Robert; Starr, Stanley; Krenn, Angela; Captain, Janine; Williams, Martha

    2016-01-01

    The National Aeronautics and Space Administration (NASA) is a major user of liquid hydrogen. In particular, NASA's John F. Kennedy (KSC) Space Center has operated facilities for handling and storing very large quantities of liquid hydrogen (LH2) since the early 1960s. Safe operations pose unique challenges and as a result NASA has invested in technology development to improve operational efficiency and safety. This paper reviews recent innovations including methods of leak and fire detection and aspects of large storage tank health and integrity. We also discuss the use of liquid hydrogen in space and issues we are addressing to ensure safe and efficient operations should hydrogen be used as a propellant derived from in-situ volatiles.

  10. Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach.

    Science.gov (United States)

    Lieberthal, Robert D; Payton, Colleen; Sarfaty, Mona; Valko, George

    To explore the cost for individual practices to become more patient-centered, we inventoried and calculated the cost of costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance. There were 3 key findings. The cost of each PCMH-related clinical activity can be classified in 1 of 3 major categories. Cost offsets can be used to defray part of the cost recognition. The cost of PCMH transformation varied by practice with no clear level or pattern of costs. Our study suggests that small- and medium-sized practices may experience difficulty with the financial burden of PCMH recognition.

  11. [Medical centers--methods, purpose and benefits].

    Science.gov (United States)

    Schrappe, Matthias

    2007-01-01

    The German hospital sector is characterized by a profound deficit in organizational integration. The implementation of centers as one way to improve the situation is complicated by the heterogeneity of the concept and understanding of the term "center". The author proposes to distinguish between functional, divisional and process-oriented centers. In German hospitals where the transition from functional to divisional organization is under way matrix elements can be expected to be introduced into organizational practice. Process-oriented centers like breast centers represent matrix components by simultaneously applying functional and process-oriented perspectives. Matrix components map the complexity of clinical structures, but increase coordination and management load and should be applied only to a limited number of care processes.

  12. USBI Booster Production Company's Hazardous Waste Management Program at the Kennedy Space Center, FL

    Science.gov (United States)

    Venuto, Charles

    1987-01-01

    In response to the hazardous-waste generating processes associated with the launch of the Space Shuttle, a hazardous waste management plan has been developed. It includes waste recycling, product substitution, waste treatment, and waste minimization at the source. Waste material resulting from the preparation of the nonmotor segments of the solid rocket boosters include waste paints (primer, topcoats), waste solvents (methylene chloride, freon, acetone, toluene), waste inorganic compounds (aluminum anodizing compound, fixer), and others. Ways in which these materials are contended with at the Kennedy Space Center are discussed.

  13. The proposed EROSpace institute, a national center operated by space grant universities

    Science.gov (United States)

    Smith, Paul L.; Swiden, LaDell R.; Waltz, Frederick A.

    1993-01-01

    The "EROSpace Institute" is a proposed visiting scientist program in associated with the U.S. Geological Survey's EROS Data Center (EDC). The Institute would be operated by a consortium of universities, possible drawn from NASA's Space Grant College and Fellowship Program consortia and the group of 17 capability-enhancement consortia, or perhaps from consortia though out the nation with a topical interest in remote sensing. The National Center for Atmospheric Research or the Goddard Institute for Space Studies provide models for the structure of such an institute. The objectives of the Institute are to provide ready access to the body of data housed at the EDC and to increase the cadre of knowledgeable and trained scientists able to deal with the increasing volume of remote sensing data to become available from the Earth Observing System. The Institute would have a staff of about 100 scientists at any one time, about half permanent staff, and half visiting scientists. The latter would include graduate and undergraduate students, as well as faculty on temporary visits, summer fellowships, or sabbatical leaves. The Institute would provide office and computing facilities, as well as Internet linkages to the home institutions so that scientists could continue to participate in the program from their home base.

  14. ONAV - An Expert System for the Space Shuttle Mission Control Center

    Science.gov (United States)

    Mills, Malise; Wang, Lui

    1992-01-01

    The ONAV (Onboard Navigation) Expert System is being developed as a real-time console assistant to the ONAV flight controller for use in the Mission Control Center at the Johnson Space Center. Currently, Oct. 1991, the entry and ascent systems have been certified for use on console as support tools, and were used for STS-48. The rendezvous system is in verification with the goal to have the system certified for STS-49, Intelsat retrieval. To arrive at this stage, from a prototype to real-world application, the ONAV project has had to deal with not only Al issues but operating environment issues. The Al issues included the maturity of Al languages and the debugging tools, verification, and availability, stability and size of the expert pool. The environmental issues included real time data acquisition, hardware suitability, and how to achieve acceptance by users and management.

  15. Detecting Postpartum Depression in Referents to Medical and Health Centers in Hamadan City

    Directory of Open Access Journals (Sweden)

    F. Shobeiri

    2007-10-01

    Full Text Available Introduction & Objective: Pregnancy and childbirth are significant developmental excitable for most women. Physical, intrapersonal and relational adaptations are needed to adjust successfully to pregnancy and delivery. Postpartum depression is a serious psychiatric disorder and the adverse impact on infants has been noted. The purpose of this study was to detect postpartum depression in referents to medical and health centers in Hamadan city.Materials & Methods: A descriptive and cross-sectional study involving 400 women completed the Beck Depression Inventory (BDI within 2-8 weeks of delivery was conducted in urban health centers in Hamadan city, Iran. Data were collected through interviews with women in the clinics in the health centers. Data processing and statistical analysis were performed using SPSS 10.0.Results: The results revealed that majority of women (68.0% were considered normal. Depression was detected in 32.0% of women. Out of these 19.0, 4.0 and 9.0% were mild, moderate and severe depression, respectively. There were statistically significant differences between postpartum depression and age, number of delivery, education, job and husband's job (P=0.000.Conclusion: Nearly 32.0% of selected women had depression. Therefore, it is important for medical personnel to be well versed in the course and treatment of postpartum depression. Post partum depression should be screened and treated as early as possible for several reasons. It can cause significant suffering for the woman who experiences it, and it can have deleterious consequences for the newborn.

  16. Strategi Public Relations Dalam Membangun Branding Rumah Sakit Telogorejo Menjadi Semarang Medical Center

    OpenAIRE

    Pertiwi, Rifka Ayu; Naryoso, Agus; Luqman, Yanuar

    2013-01-01

    ViiiSTRATEGI PUBLIC RELATIONS DALAM MEMBANGUN BRANDINGRUMAH SAKIT TELOGOREJO MENJADI SEMARANG MEDICALCENTERAbstrakPerubahan brand merupakan hal yang sering terjadi pada sebuah institusi atauperusahaan. Hal ini menjadi salah satu pekerjaan humas yang bersangkutan dalammendapatkan kesadaran target audiens terhadap Perubahan brand tersebut.RS Telogorejo melakukan Perubahan brand menjadi Semarang MedicalCenter. Sedangkan brand RS Telogorejo sudah melekat di benak target audienssebagai rumah sakit...

  17. STRESSFUL SITUATIONS IN THE WORK OF A MULTIPROFILE PEDIATRIC MEDICAL FACILITY'S CALL CENTER

    Directory of Open Access Journals (Sweden)

    I. M. Spivak

    2015-01-01

    Full Text Available Stressful situations in the work of a pediatric medical facility's call center are associated with patients' violation of social communication norms and aggressive behavior, as well as the operator's professional/maternal conflict. The following psychological resources facilitate better stress resistance of operators: self-confidence, mature and rational attitude, personal activity, inner satisfaction, optimism, emotional breadth and emotional colleague support. 

  18. The Cambridge encyclopedia of space (revised edition)

    Science.gov (United States)

    D'Allest, Frederic; Arets, Jean; Baker, Phillip J.; Balmino, Georges; Barth, Hans; Benson, Robert H.

    1990-01-01

    A comprehensive and intensively illustrated development history is presented for spaceflight, ranging over its basic concepts' speculative and fictional origins, the historical roots of rocket-related technologies, and the scientific accomplishments of earth orbit and interplanetary missions to date. Attention is given to propulsion systems, spaceflight launch centers, satellite systems, and solar system exploration by the U.S. and the Soviet Union. Current space-related activities encompass the meteorology, remote sensing, telecommunications and direct broadcasting, and navigation functions of unmanned satellites, as well as such manned spacecraft roles as medical and materials science research. The military uses of space, and increasingly important space industrialization concepts, are discussed as well.

  19. Creating the Deep Space Environment for Testing the James Webb Space Telescope (JWST) at NASA Johnson Space Center's Chamber A

    Science.gov (United States)

    Homan, Jonathan L.; Cerimele, Mary P.; Montz, Michael E.; Bachtel, Russell; Speed, John; O'Rear, Patrick

    2013-01-01

    Chamber A is the largest thermal vacuum chamber at the Johnson Space Center and is one of the largest space environment chambers in the world. The chamber is 19.8 m (65 ft) in diameter and 36.6 m (120 ft) tall and is equipped with cryogenic liquid nitrogen panels (shrouds) and gaseous helium shrouds to create a simulated space environment. It was originally designed and built in the mid 1960 s to test the Apollo Command and Service Module and several manned tests were conducted on that spacecraft, contributing to the success of the program. The chamber has been used since that time to test spacecraft active thermal control systems, Shuttle DTO, DOD, and ESA hardware in simulated Low Earth Orbit (LEO) conditions. NASA is now moving from LEO towards exploration of locations with environments approaching those of deep space. Therefore, Chamber A has undergone major modifications to enable it to simulate these deeper space environments. Environmental requirements were driven, and modifications were funded by the James Webb Space Telescope program, and this telescope which will orbit Solar/Earth L2, will be the first test article to benefit from the chamber s new capabilities. To accommodate JWST, the Chamber A high vacuum system has been modernized, additional LN2 shrouds have been installed, the liquid nitrogen system has been modified to remove dependency on electrical power and increase its reliability, a new helium shroud/refrigeration system has been installed to create a colder more stable and uniform heat sink, and the controls have been updated to increase the level of automation and improve operator interfaces. Testing of these major modifications was conducted in August of 2012 and this initial test was very successful, with all major systems exceeding their performance requirements. This paper will outline the changes in overall environmental requirements, discuss the technical design data that was used in the decisions leading to the extensive modifications

  20. Developing empirical lightning cessation forecast guidance for the Kennedy Space Center

    Science.gov (United States)

    Stano, Geoffrey T.

    The Kennedy Space Center in east Central Florida is one of the few locations in the country that issues lightning advisories. These forecasts are vital to the daily operations of the Space Center and take on even greater significance during launch operations. The U.S. Air Force's 45th Weather Squadron (45WS), who provides forecasts for the Space Center, has a good record of forecasting the initiation of lightning near their locations of special concern. However, the remaining problem is knowing when to cancel a lightning advisory. Without specific scientific guidelines detailing cessation activity, the Weather Squadron must keep advisories in place longer than necessary to ensure the safety of personnel and equipment. This unnecessary advisory time costs the Space Center millions of dollars in lost manpower each year. This research presents storm and environmental characteristics associated with lightning cessation that then are utilized to create lightning cessation guidelines for isolated thunderstorms for use by the 45WS during the warm season months of May through September. The research uses data from the Lightning Detection and Ranging (LDAR) network at the Kennedy Space Center, which can observe intra-cloud and portions of cloud-to-ground lightning strikes. Supporting data from the Cloud-to-Ground Lightning Surveillance System (CGLSS), radar observations from the Melbourne WSR-88D, and Cape Canaveral morning radiosonde launches also are included. Characteristics of 116 thunderstorms comprising our dataset are presented. Most of these characteristics are based on LDAR-derived spark and flash data and have not been described previously. In particular, the first lightning activity is quantified as either cloud-to-ground (CG) or intra-cloud (IC). Only 10% of the storms in this research are found to initiate with a CG strike. Conversely, only 16% of the storms end with a CG strike. Another characteristic is the average horizontal extent of all the flashes

  1. Financial impact of hand surgery programs on academic medical centers.

    Science.gov (United States)

    Hasan, Jafar S; Chung, Kevin C; Storey, Amy F; Bolg, Mary L; Taheri, Paul A

    2007-02-01

    This study analyzes the financial performance of hand surgery in the Department of Surgery at the University of Michigan. This analysis can serve as a reference for other medical centers in the financial evaluation of a hand surgery program. Fiscal year 2004 billing records for all patients (n = 671) who underwent hand surgery procedures were examined. The financial data were separated into professional revenues and costs (relating to the hand surgery program in the Section of Plastic Surgery) and into facility revenues and costs (relating to the overall University of Michigan Health System). Professional net revenue was calculated by applying historical collection rates to procedural and clinic charges. Facility revenue was calculated by applying historical collection rates to the following charge categories: inpatient/operating room, clinic facility, neurology/electromyography, radiology facilities, and occupational therapy. Total professional costs were calculated by adding direct costs and allocated overhead costs. Facility costs were obtained from the hospital's cost accounting system. Professional and facility incomes were calculated by subtracting costs from revenues. The net professional revenue and total costs were 1,069,836 and 1,027,421 dollars, respectively. Professional operating income was 42,415 dollars, or 3.96 percent of net professional revenue. Net facility revenue and total costs were 5,500,606 and 4,592,534 dollars, respectively. Facility operating income was 908,071 dollars, or 16.51 percent of net facility revenues. While contributing to the academic mission of the institution, hand surgery is financially rewarding for the Department of Surgery. In addition, hand surgery activity contributes substantially to the financial well-being of the academic medical center.

  2. Building Brains, Forging Futures: A Call to Action for the Family-Centered Medical Home

    Science.gov (United States)

    Kraft, Colleen

    2013-01-01

    The family-centered medical home describes an approach to providing comprehensive primary care. Research advances in developmental neuroscience, genetics, and epigenetics offer a framework for understanding the dynamic process of brain development. It is this process that sets the life-course trajectory for an individual; in turn, a child's…

  3. Environmental Assessment for the California Space Center at Vandenberg Air Force Base, California

    Science.gov (United States)

    2010-04-08

    shallow- rooted , mesophylic plant species that Chapter 3. Affected Environment Final Draft Environmental Assessment - California Space Center...buckwheat flowers and buds where the larvae feed until maturation. Upon maturation larvae burrow into the soil and pupate, usually within the root and...terrain, sharp or protruding objects, slippery soils or mud, and biological hazards including vegetation (i.e. poison oak and stinging nettle

  4. Opportunities for social workers in the patient centered medical home.

    Science.gov (United States)

    Hawk, Mary; Ricci, Edmund; Huber, George; Myers, Marcella

    2015-01-01

    The Patient Centered Medical Home (PCMH) has been hailed as one method of improving chronic care outcomes in the United States. A number of studies have underscored the importance of the social work role within the PCMH, yet little existing research explores the social worker as a driver of improved patient care. The Pennsylvania Chronic Care Initiative was created with a primary goal of increasing the number of practices that were recognized as PCMH by the National Committee for Quality Assurance. This article describes findings from in-depth qualitative interviews with representatives from seven primary care practices, in which the authors examined barriers and facilitators to implementation of the initiative. Barriers to implementation included small practice size, payer-driven care, not having a strong physician champion, variability within patient populations, and high implementation costs. Facilitators included having a social worker coordinate behavioral health services, clinical nurse case managers, preexisting models of outcomes-driven care, and being part of an integrated health delivery and financing system. Recommendations strengthening the role of medical social workers in primary care practices are discussed.

  5. Collaboration between a college of pharmacy and a for-profit health system at an academic medical center.

    Science.gov (United States)

    Bird, Matthew L; Dunn, Rebecca L; Hagemann, Tracy M; Burton, Michael E; Britton, Mark L; St Cyr, Mark B

    2012-07-01

    The genesis and growth of a successful 14-year partnership between the University of Oklahoma (OU) college of pharmacy and the OU Medical Center (OUMC) department of pharmacy are described. Pursuant to a 1998 joint operating agreement, the medical center and pharmacy school have achieved a high degree of collaboration on a wide range of educational and clinical initiatives. The close relationship has conferred a number of benefits on both institutions, including (1) expanded experiential education opportunities for pharmacy students, (2) joint faculty and staff funding arrangements that have facilitated the development and accreditation of OU pharmacy residency programs, and (3) patient care initiatives that have increased awareness of pharmacists' important contributions in areas such as venous thromboembolism prophylaxis, antibiotic stewardship, and core measures compliance. In addition to the formal integration of the college of pharmacy into the OUMC organizational structure, ongoing teamwork by clinicians and administrators at the two institutions has strengthened the 14-year partnership while helping to identify creative solutions to evolving communications, technology, and reimbursement challenges. Potential growth opportunities include the expansion of pharmacy services into additional service areas and greater involvement by OU pharmacy school faculty in the training of medical, nursing, and allied health professionals. A large for-profit academic medical center and a college of pharmacy developed a successful collaboration that is mutually beneficial and provides increased clinical, educational, and scholarly opportunities, advancing the mission of both institutions.

  6. X-space MPI: magnetic nanoparticles for safe medical imaging.

    Science.gov (United States)

    Goodwill, Patrick William; Saritas, Emine Ulku; Croft, Laura Rose; Kim, Tyson N; Krishnan, Kannan M; Schaffer, David V; Conolly, Steven M

    2012-07-24

    One quarter of all iodinated contrast X-ray clinical imaging studies are now performed on Chronic Kidney Disease (CKD) patients. Unfortunately, the iodine contrast agent used in X-ray is often toxic to CKD patients' weak kidneys, leading to significant morbidity and mortality. Hence, we are pioneering a new medical imaging method, called Magnetic Particle Imaging (MPI), to replace X-ray and CT iodinated angiography, especially for CKD patients. MPI uses magnetic nanoparticle contrast agents that are much safer than iodine for CKD patients. MPI already offers superb contrast and extraordinary sensitivity. The iron oxide nanoparticle tracers required for MPI are also used in MRI, and some are already approved for human use, but the contrast agents are far more effective at illuminating blood vessels when used in the MPI modality. We have recently developed a systems theoretic framework for MPI called x-space MPI, which has already dramatically improved the speed and robustness of MPI image reconstruction. X-space MPI has allowed us to optimize the hardware for fi ve MPI scanners. Moreover, x-space MPI provides a powerful framework for optimizing the size and magnetic properties of the iron oxide nanoparticle tracers used in MPI. Currently MPI nanoparticles have diameters in the 10-20 nanometer range, enabling millimeter-scale resolution in small animals. X-space MPI theory predicts that larger nanoparticles could enable up to 250 micrometer resolution imaging, which would represent a major breakthrough in safe imaging for CKD patients.

  7. AN/FSY-3 Space Fence System – Sensor Site One/Operations Center Integration Status and Sensor Site Two Planned Capability

    Science.gov (United States)

    Fonder, G. P.; Hack, P. J.; Hughes, M. R.

    This paper covers two topics related to Space Fence System development: Sensor Site One / Operations Center construction and integration status including risk reduction integration and test efforts at the Moorestown, NJ Integrated Test Bed (ITB); and the planned capability of Sensor Site Two. The AN/FSY-3 Space Fence System is a ground-based system of S-band radars integrated with an Operations Center designed to greatly enhance the Air Force Space Surveillance network. The radar architecture is based on Digital Beam-forming. This capability permits tremendous user-defined flexibility to customize volume surveillance and track sectors instantaneously without impacting routine surveillance functions. Space Fence provides unprecedented sensitivity, coverage and tracking accuracy, and contributes to key mission threads with the ability to detect, track and catalog small objects in LEO, MEO and GEO. The system is net-centric and will seamlessly integrate into the existing Space Surveillance Network, providing services to external users—such as JSpOC—and coordinating handoffs to other SSN sites. Sensor Site One construction on the Kwajalein Atoll is in progress and nearing completion. The Operations Center in Huntsville, Alabama has been configured and will be integrated with Sensor Site One in the coming months. System hardware, firmware, and software is undergoing integration testing at the Mooretown, NJ ITB and will be deployed at Sensor Site One and the Operations Center. The preliminary design for Sensor Site Two is complete and will provide critical coverage, timeliness, and operational flexibility to the overall system.

  8. Dual-Use Space Technology Transfer Conference and Exhibition. Volume 2

    Science.gov (United States)

    Krishen, Kumar (Compiler)

    1994-01-01

    This is the second volume of papers presented at the Dual-Use Space Technology Transfer Conference and Exhibition held at the Johnson Space Center February 1-3, 1994. Possible technology transfers covered during the conference were in the areas of information access; innovative microwave and optical applications; materials and structures; marketing and barriers; intelligent systems; human factors and habitation; communications and data systems; business process and technology transfer; software engineering; biotechnology and advanced bioinstrumentation; communications signal processing and analysis; medical care; applications derived from control center data systems; human performance evaluation; technology transfer methods; mathematics, modeling, and simulation; propulsion; software analysis and decision tools; systems/processes in human support technology; networks, control centers, and distributed systems; power; rapid development; perception and vision technologies; integrated vehicle health management; automation technologies; advanced avionics; and robotics technologies.

  9. Ontario pharmacists practicing in family health teams and the patient-centered medical home.

    Science.gov (United States)

    Dolovich, Lisa

    2012-04-01

    The patient-centered medical home (PCMH) approach continues to gather momentum in the United States and Canada as a broad approach to reform the delivery of the complete primary care system. The family health team (FHT) model implemented in Ontario, Canada, best mirrors the PCMH approach of the United States. The integration of pharmacists as key members of the health care team providing on-site, in-office coordinated care to FHT patients was included from the start of planning the FHT model and represents a substantial opportunity for pharmacists to realize their professional vision. Several research projects in Canada and elsewhere have contributed to providing evidence to support the integration of pharmacists into primary care practice sites. Two major research programs, the Seniors Medication Assessment Research Trial (SMART) cluster randomized controlled trial and the Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) multipronged demonstration project made substantial contributions to evidence-informed policy decisions supporting the integration of pharmacists into FHTs. These projects can provide useful information to support the integration of pharmacists into the PCMH and to encourage further research to better measure the effect of the pharmacist from the holistic patient-centered perspective.

  10. Independence of automorphism group, center, and state space of quantum logics

    International Nuclear Information System (INIS)

    Navara, M.

    1992-01-01

    We prove that quantum logics (-orthomodular posets) admit full independence of the attributes important within the foundations of quantum mechanics. Namely, we present the construction of quantum logics with given sublogics (=physical subsystems), automorphism groups, centers (=open-quotes classical partsclose quotes of the systems), and state spaces. Thus, all these open-quotes parametersclose quotes are independent. Our result is rooted in the line of investigation carried out by Greechie; Kallus and Trnkova; Kalmbach; and Navara and Ptak; and considerably enriches the known algebraic methods in orthomodular posets. 19 refs., 1 fig

  11. EUROLAUNCH - a cooperation between DLR, German Aerospace Center and SSC, Swedish Space Corporation in sounding rocket launches

    Science.gov (United States)

    Kemi, S.; Turner, P.; Norberg, O.

    Sounding rocket and balloon launches have been conducted since more than 30 years at ESRANGE - the European Sounding Rocket Launching Range of SSC, the Swedish Space Corporation of Kiruna in North-Sweden. MORABA - the Mobile Rocket Base of DLR German Aerospace Center at München-Oberpfaffenhofen, Germany, has planned and implemented sounding rocket and balloon launches on occasions throughout the globe during more than 30 years. An evolutionary step of sounding rocket launches is undertaken with the creation of EuroLaunch. EuroLaunch has recently been formed by SSC, the Swedish Space Corporation, and DLR, the German Aerospace Center. With EuroLaunch the long-lasting co-operation of the two complementary technical centers ESRANGE and MORABA is being enhanced and intensified, and this co-operation may also be the start of a future European Network of Center for sounding rockets. The comprehensive competence within the scope of the Network of Centers in Europa will be presented. The consolidation of competencies and work distribution among the partners shall be detailed. The managerial structure of EuroLaunch and the embedding in the mother organizations SSC and DLR respectively will be explained. The newly organized EuroLaunch is expected to provide improved services to experimenters in Europe and worldwide with improved competence, capability and efficiency.

  12. [Medical equipment companies and their ties with technology development centers in Mexico].

    Science.gov (United States)

    Hernández, B; Arredondo, A; Cruz, C; Sánchez, E; Damián, T

    1993-10-01

    The purpose of this study was to determine the characteristics of the companies that produce, distribute, and service medical equipment in Mexico and the factors related to whether or not they had established ties with research and technology development centers. The data analyzed came from a survey of such companies carried out in Mexico City and environs in 1989. The information was updated in 1991. Multivariate analyses were carried out in order to identify the characteristics of companies that had established ties or wished to do so and the areas of interest of those companies. Of 208 companies surveyed, only 23% had ties with research centers. The companies that had such ties or were interested in establishing them tended to invest in research and to have made plans for expansion. The establishment of ties appeared to be a two-way process, with positive consequences for the companies involved, the research centers, and the health sector. It was concluded that it would be advantageous to design programs to promote ties with companies having the characteristics mentioned.

  13. Putting patients first: a novel patient-centered model for medical enterprise success.

    Science.gov (United States)

    Dhawan, Naveen

    2014-01-01

    This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises. The author introduces a model that directs all business activities toward the end consumer with an underlying guidance by patient needs. A business is advised to understand its customer, design a patient-directed vision, and focus on creating a unique customer experience. The article delineates key action items for physicians and administrators that will allow them to better meet their patient-customers' needs and develop loyalty. By practicing a patient-centered approach and following these guidelines, one may ensure greater success of the medical enterprise.

  14. Positioning academic medical centers and teaching hospitals to thrive in the next decade.

    Science.gov (United States)

    Morris, D E

    1985-06-01

    Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification.

  15. Technology for the Stars: Extending Our Reach. [Research and Technology: 1995 Annual Report of the Marshall Space Flight Center.

    Science.gov (United States)

    1996-01-01

    Marshall Space Flight Center's (MSFC's) Advanced Studies, Research, Technology, and Technology Transfer projects are summarized in this report. The focus of the report is on the three spotlights at MSFC in 1995: space transportation technology, microgravity research, and technology transfer.

  16. Cerebral angioplasty practice at major medical centers in the United States

    International Nuclear Information System (INIS)

    Chaturvedi, S.; St Pierre, M.E.; Bertasio, B.

    2000-01-01

    Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. (orig.)

  17. Creating the Thermal Environment for Safely Testing the James Webb Space Telescope at the Johnson Space Center's Chamber A

    Science.gov (United States)

    Homan, Jonathan L.; Lauterbach, John; Garcia, Sam

    2016-01-01

    Chamber A is the largest thermal vacuum chamber at the Johnson Space Center and is one of the largest space environment chambers in the world. The chamber is 19.8 m (65 ft) in diameter and 36.6 m (120 ft) tall and is equipped with cryogenic liquid nitrogen panels (shrouds) and gaseous helium shrouds to create a simulated space environment. The chamber was originally built to support testing of the Apollo Service and Command Module for lunar missions, but underwent major modifications to be able to test the James Webb Space Telescope in a simulated deep space environment. To date seven tests have been performed in preparation of testing the flight optics for the James Webb Space Telescope (JWST). Each test has had a uniquie thermal profile and set of thermal requirements for cooling down and warming up, controlling contamination, and releasing condensed air. These range from temperatures from 335K to 15K, with tight uniformity and controllability for maintining thermal stability and pressure control. One unique requirement for two test was structurally proof loading hardware by creating thermal gradients at specific temperatures. This paper will discuss the thermal requirements and goals of the tests, the original requirements of the chamber thermal systems for planned operation, and how the new requirements were met by the team using the hardware, system flexiblilty, and engineering creativity. It will also discuss the mistakes and successes to meet the unique goals, especially when meeting the thermal proof load.

  18. Historical perspectives - The role of the NASA Lewis Research Center in the national space nuclear power programs

    Science.gov (United States)

    Bloomfield, H. S.; Sovie, R. J.

    1991-01-01

    The history of the NASA Lewis Research Center's role in space nuclear power programs is reviewed. Lewis has provided leadership in research, development, and the advancement of space power and propulsion systems. Lewis' pioneering efforts in nuclear reactor technology, shielding, high temperature materials, fluid dynamics, heat transfer, mechanical and direct energy conversion, high-energy propellants, electric propulsion and high performance rocket fuels and nozzles have led to significant technical and management roles in many natural space nuclear power and propulsion programs.

  19. Historical perspectives: The role of the NASA Lewis Research Center in the national space nuclear power programs

    Science.gov (United States)

    Bloomfield, H. S.; Sovie, R. J.

    1991-01-01

    The history of the NASA Lewis Research Center's role in space nuclear power programs is reviewed. Lewis has provided leadership in research, development, and the advancement of space power and propulsion systems. Lewis' pioneering efforts in nuclear reactor technology, shielding, high temperature materials, fluid dynamics, heat transfer, mechanical and direct energy conversion, high-energy propellants, electric propulsion and high performance rocket fuels and nozzles have led to significant technical and management roles in many national space nuclear power and propulsion programs.

  20. Impact on Seniors of the Patient-Centered Medical Home: Evidence from a Pilot Study

    Science.gov (United States)

    Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.

    2012-01-01

    Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…

  1. Radiation safety knowledge of medical center radiology technologists in southern Taiwan

    Energy Technology Data Exchange (ETDEWEB)

    Su Wen-Chuan; Huang Ying-Fong; Chen Cheng-Chung; Chang Pao-Shu [Kaohsiung Medical University, Taiwan (China)

    2000-05-01

    People who live in Taiwan are getting more and more afraid of radiation. Sometimes the phobia results from distorted knowledge. Radiology technologists, in one hand, are more well-educated in radiation and, in the other hand, have more chance to expose to radiation when they are operating radiation producing medical instruments in their daily life. So we are interested in whether they have enough knowledge to protect themselves. We pick up the radiology technology board examination to make the questionnaire for this study. The population is the radiology technologists who work at department of diagnostic radiology, of radiation therapy and nuclear medicine in medical centers. Statistics is then used to see the relationship between knowledge and the factors including gender, age and career period. Based on statistics, we find out that there is significant correlation between the knowledge with age or education level. Elder or lower education level ones has worse knowledge. Continued education may be highly recommended for radiology technologists to avoid occupational radiation injury. (author)

  2. Radiation safety knowledge of medical center radiology technologists in southern Taiwan

    International Nuclear Information System (INIS)

    Su Wen-Chuan; Huang Ying-Fong; Chen Cheng-Chung; Chang Pao-Shu

    2000-01-01

    People who live in Taiwan are getting more and more afraid of radiation. Sometimes the phobia results from distorted knowledge. Radiology technologists, in one hand, are more well-educated in radiation and, in the other hand, have more chance to expose to radiation when they are operating radiation producing medical instruments in their daily life. So we are interested in whether they have enough knowledge to protect themselves. We pick up the radiology technology board examination to make the questionnaire for this study. The population is the radiology technologists who work at department of diagnostic radiology, of radiation therapy and nuclear medicine in medical centers. Statistics is then used to see the relationship between knowledge and the factors including gender, age and career period. Based on statistics, we find out that there is significant correlation between the knowledge with age or education level. Elder or lower education level ones has worse knowledge. Continued education may be highly recommended for radiology technologists to avoid occupational radiation injury. (author)

  3. Surgeon leadership in the coding, billing, and contractual negotiations for fenestrated endovascular aortic aneurysm repair increases medical center contribution margin and physician reimbursement.

    Science.gov (United States)

    Aiello, Francesco; Durgin, Jonathan; Daniel, Vijaya; Messina, Louis; Doucet, Danielle; Simons, Jessica; Jenkins, James; Schanzer, Andres

    2017-10-01

    Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement. At the UMass Memorial Center for Complex Aortic Disease, a vascular surgeon with experience in medical finances is supported to manage the billing and coding of FEVAR procedures for medical center and physician reimbursement. A comprehensive financial analysis was performed for all FEVAR procedures (2011-2015), independent of insurance status, patient presentation, or type of device used. Medical center CM (actual reimbursement minus direct costs) was determined for each index FEVAR procedure and for all related subsequent procedures, inpatient or outpatient, 3 months before and 1 year subsequent to the index FEVAR procedure. Medical center CM for outpatient clinic visits, radiology examinations, vascular laboratory studies, and cardiology and pulmonary evaluations related to FEVAR were also determined. Surgeon reimbursement for index FEVAR procedure, related adjunct procedures, and assistant surgeon reimbursement were also calculated. All financial analyses were performed and adjudicated by the UMass Department of Finance. The index hospitalization for 63 FEVAR procedures incurred $2,776,726 of direct costs and generated $3,027,887 in reimbursement, resulting in a positive CM of $251,160. Subsequent related hospital procedures (n = 26) generated a CM of $144,473. Outpatient clinic visits, radiologic examinations, and vascular laboratory studies generated an additional CM of $96,888. Direct cost analysis revealed that grafts

  4. A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas

    Science.gov (United States)

    1979-08-01

    15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

  5. Kennedy Space Center ITC-1 Internship Overview

    Science.gov (United States)

    Ni, Marcus

    2011-01-01

    As an intern for Priscilla Elfrey in the ITC-1 department, I was involved in many activities that have helped me to develop many new skills. I supported four different projects during my internship, which included the Center for Life Cycle Design (CfLCD), SISO Space Interoperability Smackdown, RTI Teacher Mentor Program, and the Discrete Event Simulation Integrated Visualization Environment Team (DIVE). I provided the CfLCD with web based research on cyber security initiatives involving simulation, education for young children, cloud computing, Otronicon, and Science, Technology, Engineering, and Mathematics (STEM) education initiatives. I also attended STEM meetings regarding simulation courses, and educational course enhancements. To further improve the SISO Simulation event, I provided observation feedback to the technical advisory board. I also helped to set up a chat federation for HLA. The third project involved the RTI Teacher Mentor program, which I helped to organize. Last, but not least, I worked with the DIVE team to develop new software to help visualize discrete event simulations. All of these projects have provided experience on an interdisciplinary level ranging from speech and communication to solving complex problems using math and science.

  6. An Analysis of Information Technology Adoption by IRBs of Large Academic Medical Centers in the United States.

    Science.gov (United States)

    He, Shan; Botkin, Jeffrey R; Hurdle, John F

    2015-02-01

    The clinical research landscape has changed dramatically in recent years in terms of both volume and complexity. This poses new challenges for Institutional Review Boards' (IRBs) review efficiency and quality, especially at large academic medical centers. This article discusses the technical facets of IRB modernization. We analyzed the information technology used by IRBs in large academic institutions across the United States. We found that large academic medical centers have a high electronic IRB adoption rate; however, the capabilities of electronic IRB systems vary greatly. We discuss potential use-cases of a fully exploited electronic IRB system that promise to streamline the clinical research work flow. The key to that approach utilizes a structured and standardized information model for the IRB application. © The Author(s) 2014.

  7. Improvements in self-efficacy for engaging in patient-centered communication following a course in peer-supervision and communication for medical students

    DEFF Research Database (Denmark)

    Lassesen, Berit; O Connor, Maja; Kjær, Louise Binow

    and Department of Psychology and Behavioral Science, Aarhus University, Aarhus, Denmark; 3Center for Medical Education, Aarhus University, Aarhus, Denmark.; belas@clu.au.dk Aim: The aim was to evaluate the outcome of a training course in peer-supervision and communication with the aim of improving medical...... student self-efficacy for engaging in patient-centered communication and examine the influence of course-related motivation to learn, course-related self-efficacy, and medical student well-being at baseline. Methods: A total of 127 graduate school medical students in clinical clerkship who participated...... in a course in peer-supervision and communication completed a pre-course questionnaire package including: 1) The Patient-Centeredness Self-Efficacy Questionnaire (PCSEQ), 2) Course-Related Motivation to Learn (CRML), 3) Course-Related Self-Efficacy (CRSE), and 4) the Medical Student Well-Being Index (MSWBI...

  8. Development of the CELSS emulator at NASA. Johnson Space Center

    Science.gov (United States)

    Cullingford, Hatice S.

    1990-01-01

    The Closed Ecological Life Support System (CELSS) Emulator is under development. It will be used to investigate computer simulations of integrated CELSS operations involving humans, plants, and process machinery. Described here is Version 1.0 of the CELSS Emulator that was initiated in 1988 on the Johnson Space Center (JSC) Multi Purpose Applications Console Test Bed as the simulation framework. The run model of the simulation system now contains a CELSS model called BLSS. The CELSS simulator empowers us to generate model data sets, store libraries of results for further analysis, and also display plots of model variables as a function of time. The progress of the project is presented with sample test runs and simulation display pages.

  9. Cognitive Assessment During Long-Duration Space Flight

    Science.gov (United States)

    Seaton, Kimberly; Kane, R. L.; Sipes, Walter

    2010-01-01

    The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a computer-based, self-administered battery of five cognitive assessment tests developed for medical operations at NASA's Johnson Space Center in Houston, Texas. WinSCAT is a medical requirement for U.S. long-duration astronauts and has been implemented with U.S. astronauts from one NASA/Mir mission (NASA-7 mission) and all expeditions to date on the International Space Station (ISS). Its purpose is to provide ISS crew surgeons with an objective clinical tool after an unexpected traumatic event, a medical condition, or the cumulative effects of space flight that could negatively affect an astronaut's cognitive status and threaten mission success. WinSCAT was recently updated to add network capability to support a 6-person crew on the station support computers. Additionally, WinSCAT Version 2.0.28 has increased difficulty of items in Mathematics, increased number of items in Match-to-Sample, incorporates a moving rather than a fixed baseline, and implements stricter interpretation rules. ISS performance data were assessed to compare initial to modified interpretation rules for detecting potential changes in cognitive functioning during space flight. WinSCAT tests are routinely taken monthly during an ISS mission. Performance data from these ISS missions do not indicate significant cognitive decrements due to microgravity/space flight alone but have shown decrements. Applying the newly derived rules to ISS data results in a number of off-nominal performances at various times during and after flight.. Correlation to actual events is needed, but possible explanations for off-nominal performances could include actual physical factors such as toxic exposure, medication effects, or fatigue; emotional factors including stress from the mission or life events; or failure to exert adequate effort on the tests.

  10. Health information security: a case study of three selected medical centers in iran.

    Science.gov (United States)

    Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

    2013-03-01

    Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients' electronic records and health information systems have become a source for hackers. This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts' points of view. Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of "verification and system design, user access management, access control system", Al Zahra Hospital in two indicators of "access management and network access control" and Amin Hospital in "equipment safety and system design". In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place.

  11. Survey on prevalence and causes of self-medication in women referring to health centers in Ahwaz, in 2013

    Directory of Open Access Journals (Sweden)

    Pourandoght Afshary

    2015-11-01

    Full Text Available Background: Today, considerable advances achieved in different scientific fields have led to an ever-increasing access of people to various medications and their unauthorized consumption, which negatively affects the healthcare and treatment system. Thus, this study was conducted to determine the Prevalence and causes of this phenomenon in the female population of Ahwaz. Material and Methods: In this Cross-sectional study364 Women referring to seven health centers in Ahwaz were selected randomly and based on the family medical file number and by proportional distribution to each center and semi-structured questionnaires were completed through interviews. The data were analyzed by Chi square test and logistic regression. P<0.05 was considered significant. Results: Self-medication was observed in 70.1% of women. The most frequent group  was those above the age of 30. The most common self-medication case was urogenitaldisorders (58.7%. there was a significant relation between education (p<0.003 and number of births (p=0.003 and unauthorized drug consumption. The most causes for synthetic drug use were previous illness background (48.6% and high medication costs (50.6%, and about herbal drugs were high medication costs (41.1%, and the effectiveness of these products about medicinal herbs (38.1 %. Conclusion: High rate of self-medication in the studied society necessitates training on proper use of drugs through the use of social media.

  12. An evaluation of the Goddard Space Flight Center Library

    Science.gov (United States)

    Herner, S.; Lancaster, F. W.; Wright, N.; Ockerman, L.; Shearer, B.; Greenspan, S.; Mccartney, J.; Vellucci, M.

    1979-01-01

    The character and degree of coincidence between the current and future missions, programs, and projects of the Goddard Space Flight Center and the current and future collection, services, and facilities of its library were determined from structured interviews and discussions with various classes of facility personnel. In addition to the tabulation and interpretation of the data from the structured interview survey, five types of statistical analyses were performed to corroborate (or contradict) the survey results and to produce useful information not readily attainable through survey material. Conclusions reached regarding compatability between needs and holdings, services and buildings, library hours of operation, methods of early detection and anticipation of changing holdings requirements, and the impact of near future programs are presented along with a list of statistics needing collection, organization, and interpretation on a continuing or longitudinal basis.

  13. Robust, Radiation Tolerant Command and Data Handling and Power System Electronics from NASA Goddard Space Flight Center

    Science.gov (United States)

    Nguyen, Hanson C.; Fraction, James; Ortiz-Acosta, Melyane; Dakermanji, George; Kercheval, Bradford P.; Hernandez-Pellerano, Amri; Kim, David S.; Jung, David S.; Meyer, Steven E.; Mallik, Udayan; hide

    2016-01-01

    The Goddard Modular Smallsat Architecture (GMSA) is developed at NASA Goddard Space Flight Center (GSFC) to address future reliability along with minimizing cost and schedule challenges for NASA Cubesat and Smallsat missions.

  14. Learning from Primary Health Care Centers in Nepal: reflective writings on experiential learning of third year Nepalese medical students

    OpenAIRE

    Dhital, Rolina; Subedi, Madhusudan; Prasai, Neeti; Shrestha, Karun; Malla, Milan; Upadhyay, Shambhu

    2015-01-01

    Background Medical education can play important role in cultivating the willingness among the medical students to work in underprivileged areas after their graduation. Experiential learning through early exposure to primary health care centers could help students better understand the opportunities and challenges of such settings. However, the information on the real experiences and reflections of medical students on the rural primary health care settings from low-income countries like Nepal ...

  15. Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

    Science.gov (United States)

    Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

    2016-05-01

    Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

  16. Life into Space: Space Life Sciences Experiments, Ames Research Center, Kennedy Space Center, 1991-1998, Including Profiles of 1996-1998 Experiments

    Science.gov (United States)

    Souza, Kenneth (Editor); Etheridge, Guy (Editor); Callahan, Paul X. (Editor)

    2000-01-01

    We have now conducted space life sciences research for more than four decades. The continuing interest in studying the way living systems function in space derives from two main benefits of that research. First, in order for humans to engage in long-term space travel, we must understand and develop measures to counteract the most detrimental effects of space flight on biological systems. Problems in returning to the conditions of Earth must be kept to a manageable level. Second, increasing our understanding of how organisms function in the absence of gravity gives us new understanding of fundamental biological processes. This information can be used to improve human health and the quality of life on Earth.

  17. Development of a EUV Test Facility at the Marshall Space Flight Center

    Science.gov (United States)

    West, Edward; Pavelitz, Steve; Kobayashi, Ken; Robinson, Brian; Cirtain, Johnathan; Gaskin, Jessica; Winebarger, Amy

    2011-01-01

    This paper will describe a new EUV test facility that is being developed at the Marshall Space Flight Center (MSFC) to test EUV telescopes. Two flight programs, HiC - high resolution coronal imager (sounding rocket) and SUVI - Solar Ultraviolet Imager (GOES-R), set the requirements for this new facility. This paper will discuss those requirements, the EUV source characteristics, the wavelength resolution that is expected and the vacuum chambers (Stray Light Facility, Xray Calibration Facility and the EUV test chamber) where this facility will be used.

  18. Systemic lupus erythematosus and thyroid disease - Experience in a single medical center in Taiwan.

    Science.gov (United States)

    Liu, Yu-Chuan; Lin, Wen-Ya; Tsai, Ming-Chin; Fu, Lin-Shien

    2017-06-28

    To investigate the association of systemic lupus erythematosus (SLE) with thyroid diseases in a medical center in central Taiwan. This is a retrospective cohort of 2796 SLE patients in a tertiary referral medical center from 2000 to 2013. We screened SLE by catastrophic illness registration from national insurance bureau; and thyroid diseases by ICD 9 codes, then confirmed by thyroid function test, auto-antibody, medical and/or surgical intervention. We compared the rate of hyperthyroidism, hypothyroidism and autoimmune thyroid disease (AITD) in SLE patients and the 11,184 match controls. We calculated the rate of these thyroid diseases and positive antibodies to thyroglobulin (ATGAb), thyroid peroxidase (TPOAb) in SLE patients grouped by the presence of overlap syndrome and anti-dsDNA antibody. We also compared the association of thyroid diseases to severe SLE conditions, including renal, central nervous system (CNS) involvement, and thrombocytopenia. Compared to the matched controls, the cumulative incidence of thyroid disease, including hyperthyroidism, hypothyroidism and AITD, were all higher in SLE patients (p hyperthyroidism. SLE patients with thyroid diseases also carry higher risk for severe complications such as renal involvement (p = 0.024) central nervous system involvement (p hyperthyroidism, hypothyroidism, and AITD than the matched control. Among lupus patients, the risks of thyroid diseases are even higher in the presence of overlap syndrome. SLE patients with thyroid diseases had higher risk of renal and CNS involvement. Copyright © 2017. Published by Elsevier B.V.

  19. Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis

    OpenAIRE

    Morris, G. Scott

    2015-01-01

    The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...

  20. An intelligent algorithm for identification of optimum mix of demographic features for trust in medical centers in Iran.

    Science.gov (United States)

    Yazdanparast, R; Zadeh, S Abdolhossein; Dadras, D; Azadeh, A

    2018-06-01

    Healthcare quality is affected by various factors including trust. Patients' trust to healthcare providers is one of the most important factors for treatment outcomes. The presented study identifies optimum mixture of patient demographic features with respect to trust in three large and busy medical centers in Tehran, Iran. The presented algorithm is composed of adaptive neuro-fuzzy inference system and statistical methods. It is used to deal with data and environmental uncertainty. The required data are collected from three large hospitals using standard questionnaires. The reliability and validity of the collected data is evaluated using Cronbach's Alpha, factor analysis and statistical tests. The results of this study indicate that middle age patients with low level of education and moderate illness severity and young patients with high level of education, moderate illness severity and moderate to weak financial status have the highest trust to the considered medical centers. To the best of our knowledge this the first study that investigates patient demographic features using adaptive neuro-fuzzy inference system in healthcare sector. Second, it is a practical approach for continuous improvement of trust features in medical centers. Third, it deals with the existing uncertainty through the unique neuro-fuzzy approach. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Using Technology to Enhance Teaching of Patient-Centered Interviewing for Early Medical Students.

    Science.gov (United States)

    Kaltman, Stacey; Talisman, Nicholas; Pennestri, Susan; Syverson, Eleri; Arthur, Paige; Vovides, Yianna

    2018-06-01

    Effective strategies for teaching communication skills to health professions students are needed. This article describes the design and evaluation of immersive and interactive video simulations for medical students to practice basic communication skills. Three simulations were developed, focusing on patient-centered interviewing techniques such as using open-ended questions, reflections, and empathic responses while assessing a patient's history of present illness. First-year medical students were randomized to simulation or education-as-usual arms. Students in the simulation arm were given access to three interactive video simulations developed using Articulate Storyline, an e-learning authoring tool, to practice and receive feedback on patient-centered interviewing techniques to prepare for their Observed Structured Clinical Examination (OSCE). Trained raters evaluated videos of two OSCE cases for each participant to assess specific communication skills used during the history of present illness component of the interview. Eighty-seven percent of the students in the simulation arm interacted with at least one simulation during the history of present illness. For both OSCE cases, students in the simulation arm asked significantly more open-ended questions. Students in the simulation arm asked significantly fewer closed-ended questions and offered significantly more empathic responses in one OSCE case. No differences were found for reflections. Students reported that the simulations helped improve their communication skills. The use of interactive video simulations was found to be feasible to incorporate into the curriculum and was appealing to students. In addition, students in the simulation arm displayed more behaviors consistent with the patient-centered interviewing model practiced in the simulations. Continued development and research are warranted.

  2. Multipayer patient-centered medical home implementation guided by the chronic care model.

    Science.gov (United States)

    Gabbay, Robert A; Bailit, Michael H; Mauger, David T; Wagner, Edward H; Siminerio, Linda

    2011-06-01

    A unique statewide multipayer ini Pennsylvania was undertaken to implement the Patient-Centered Medical Home (PCMH) guided by the Chronic Care Model (CCM) with diabetes as an initial target disease. This project represents the first broad-scale CCM implementation with payment reform across a diverse range of practice organizations and one of the largest PCMH multipayer initiatives. Practices implemented the CCM and PCMH through regional Breakthrough Series learning collaboratives, supported by Improving Performance in Practice (IPIP) practice coaches, with required monthly quality reporting enhanced by multipayer infrastructure payments. Some 105 practices, representing 382 primary care providers, were engaged in the four regional collaboratives. The practices from the Southeast region of Pennsylvania focused on diabetes patients (n = 10,016). During the first intervention year (May 2008-May 2009), all practices achieved at least Level 1 National Committee for Quality Assurance (NCQA) Physician Practice Connections Patient-Centered Medical Home (PPC-PCMH) recognition. There was significant improvement in the percentage of patients who had evidence-based complications screening and who were on therapies to reduce morbidity and mortality (statins, angiotensin-converting enzyme inhibitors). In addition, there were small but statistically significant improvements in key clinical parameters for blood pressure and cholesterol levels, with the greatest absolute improvement in the highest-risk patients. Transforming primary care delivery through implementation of the PCMH and CCM supported by multipayer infrastructure payments holds significant promise to improve diabetes care.

  3. Contamination Control and Hardware Processing Solutions at Marshall Space Flight Center

    Science.gov (United States)

    Burns, DeWitt H.; Hampton, Tammy; Huey, LaQuieta; Mitchell, Mark; Norwood, Joey; Lowrey, Nikki

    2012-01-01

    The Contamination Control Team of Marshall Space Flight Center's Materials and Processes Laboratory supports many Programs/ Projects that design, manufacture, and test a wide range of hardware types that are sensitive to contamination and foreign object damage (FOD). Examples where contamination/FOD concerns arise include sensitive structural bondline failure, critical orifice blockage, seal leakage, and reactive fluid compatibility (liquid oxygen, hydrazine) as well as performance degradation of sensitive instruments or spacecraft surfaces such as optical elements and thermal control systems. During the design phase, determination of the sensitivity of a hardware system to different types or levels of contamination/FOD is essential. A contamination control and FOD control plan must then be developed and implemented through all phases of ground processing, and, sometimes, on-orbit use, recovery, and refurbishment. Implementation of proper controls prevents cost and schedule impacts due to hardware damage or rework and helps assure mission success. Current capabilities are being used to support recent and on-going activities for multiple Mission Directorates / Programs such as International Space Station (ISS), James Webb Space Telescope (JWST), Space Launch System (SLS) elements (tanks, engines, booster), etc. The team also advances Green Technology initiatives and addresses materials obsolescence issues for NASA and external customers, most notably in the area of solvent replacement (e.g. aqueous cleaners containing hexavalent chrome, ozone depleting chemicals (CFC s and HCFC's), suspect carcinogens). The team evaluates new surface cleanliness inspection and cleaning technologies (e.g. plasma cleaning), and maintains databases for processing support materials as well as outgassing and optical compatibility test results for spaceflight environments.

  4. [Work satisfaction, quality of life and leisure time of residents at the Soroka University Medical Center, Beer Sheba, Israel].

    Science.gov (United States)

    Acker, Asaf; Perry, Zvi; Reuveni, Haim; Toker, Asaf

    2009-02-01

    Work dissatisfaction among physicians worldwide continues to rise over the last few decades, mainly due to declining professional prestige, tack of self fulfillment, time pressure and tack of leisure time. Physicians' burnout is a major result of dissatisfaction, causing doctors to leave the medical profession, and to provide lower quality of care. To examine the work satisfaction, quality of life and leisure time of residents in the Soroka University Medical Center. A validated questionnaire was delivered during the second half of 2004 to 252 residents in the Soroka University Medical Center The data was analyzed using the SPSS 12 for windows program. Descriptive analysis, parametric Students' T Test [where pleisure time. Further attention must be given to these matters--a step which will eventually improve patient care, and delay, to some extent, the burnout of physicians.

  5. Plasma Liner Research for MTF at NASA Marshall Space Flight Center

    Science.gov (United States)

    Thio, Y. C. F.; Eskridge, R.; Lee, M.; Martin, A.; Smith, J.; Cassibry, J. T.; Wu, S. T.; Kirkpatrick, R. C.; Knapp, C. E.; Turchi, P. J.; hide

    2002-01-01

    The current research effort at NASA Marshall Space Flight Center (MSFC) in MTF is directed towards exploring the critical physics issues of potential embodiments of MTF for propulsion, especially standoff drivers involving plasma liners for MTF. There are several possible approaches for forming plasma liners. One approach consists of using a spherical array of plasma jets to form a spherical plasma shell imploding towards the center of a magnetized plasma, a compact toroid. Current experimental plan and status to explore the physics of forming a 2-D plasma liner (shell) by merging plasma jets are described. A first-generation coaxial plasma guns (Mark-1) to launch the required plasma jets have been built and tested. Plasma jets have been launched reproducibly with a low jitter, and velocities in excess of 50 km/s for the leading edge of the plasma jet. Some further refinements are being explored for the plasma gun, Successful completion of these single-gun tests will be followed by an experimental exploration of the problems of launching a multiple number of these jets simultaneously to form a cylindrical plasma liner.

  6. Relationships among communication competence, self-efficacy, and job satisfaction in Korean nurses working in the emergency medical center setting.

    Science.gov (United States)

    Park, Min Sook; Jeoung, Yeonok; Lee, Hye Kyung; Sok, Sohyune R

    2015-06-01

    The communication competence of nurses working in emergency medical center settings is essential to establish a therapeutic nurse-patient relationship. Education and strategic development are required to improve the communication competence of emergency room (ER) nurses. This study was conducted to determine the relationships among individual communication competence, self-efficacy, and job satisfaction in Korean nurses in the emergency medical center setting. A cross-sectional descriptive design was adopted. The study sample included 214 nurses at 11 emergency medical centers in Seoul and Kyunggi-Do, Korea. Measures used included the Global Interpersonal Communication Competence, self-efficacy scale, and job satisfaction scale. The collected data were analyzed using the SPSS version 18.0 statistical software program and included descriptive statistics (frequency, percentage, mean, standard deviation, independent t test, analysis of variance, and Pearson's correlation coefficient). The degrees of communication competence and self-efficacy of ER nurses were good, with higher scores than the median values. However, the degree of job satisfaction was poor, indicating a lower score than the median value. Religious affiliation and previous participation in communication education each had a significant impact on communication competence. Religious affiliation and time of worse duty each had a significant impact on self-efficacy. Length of career (year) in the emergency medical center and type of hospital each had a significant impact on job satisfaction. Positive correlations were identified among communication competence, self-efficacy, and job satisfaction. This study supported the presence of significant correlations among communication competence, self-efficacy, and job satisfaction. Thus, it is necessary to develop training programs that are customized to individual characteristics such as self-efficacy and job satisfaction to improve the communicative competence

  7. Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

    Directory of Open Access Journals (Sweden)

    Serkan Toy

    2017-03-01

    Full Text Available Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001. Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t (23 = −2.92, P < .001, and arterial line placement, t (23 = −2.75, P < .001. Procedural performance scores for intubation ( t (23 = −17.29, P < .001, arterial line placement ( t (23 = −19.75, P < .001, lumbar puncture ( t (23 = −16.27, P < .001, and central line placement ( t (23 = −17.25, P < .001 showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

  8. Implementation of Epic Beaker Clinical Pathology at an academic medical center

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2016-01-01

    Full Text Available Background: Epic Beaker Clinical Pathology (CP is a relatively new laboratory information system (LIS operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration. Methods: Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project. Results: We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS. Conclusions: Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS.

  9. Strom Thurmond Biomedical Research Center at the Medical Univesity for South Carolina Charleston, South Carolina

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    The Department of Energy (DOE) has prepared an Environmental Assessment (EA) evaluating the proposed construction and operation of the Strom Thurmond Biomedical Research Center (Center) at the Medical University of South Carolina (MUSC), Charleston, SC. The DOE is evaluating a grant proposal to authorize the MUSC to construct, equip and operate the lower two floors of the proposed nine-story Center as an expansion of on-going clinical research and out-patient diagnostic activities of the Cardiology Division of the existing Gazes Cardiac Research Institute. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major federal action significantly affecting the quality of the human environment within the meaning of the NEPA. Therefore, the preparation of an Environmental Impact Statement is not required.

  10. The management approach to the NASA space station definition studies at the Manned Spacecraft Center

    Science.gov (United States)

    Heberlig, J. C.

    1972-01-01

    The overall management approach to the NASA Phase B definition studies for space stations, which were initiated in September 1969 and completed in July 1972, is reviewed with particular emphasis placed on the management approach used by the Manned Spacecraft Center. The internal working organizations of the Manned Spacecraft Center and its prime contractor, North American Rockwell, are delineated along with the interfacing techniques used for the joint Government and industry study. Working interfaces with other NASA centers, industry, and Government agencies are briefly highlighted. The controlling documentation for the study (such as guidelines and constraints, bibliography, and key personnel) is reviewed. The historical background and content of the experiment program prepared for use in this Phase B study are outlined and management concepts that may be considered for future programs are proposed.

  11. Patient-centered medical homes improve care for adults with chronic conditions.

    Science.gov (United States)

    Pourat, Nadereh; Lavarreda, Shana Alex; Snyder, Sophie

    2013-05-01

    The success of health care reform implementation in 2014 partly depends on more efficient delivery of care to the millions of California residents eligible to gain insurance. Emerging evidence supports the effectiveness of the patient-centered medical home (PCMH) as a potential model of care delivery, which improves health outcomes and reduces costs. Among other principles, PCMH entails receipt of care from a personal doctor, who coordinates the patient's care and develops an individualized treatment plan for the patient. These principles are particularly essential in delivery of care to those with chronic conditions who require more intensive care management. Using the 2009 California Health Interview Survey (CHIS 2009), this policy brief indicates that patients who reported meeting these fundamental PCMH principles were more likely to have visited the doctor and to have received flu shots, and they also had better communication with providers than those who did not report meeting these PCMH principles. The data also showed that uninsured individuals, Medi-Cal beneficiaries, those at or below 133% of the federal poverty level, Latinos, and Asian-Americans were less likely to report meeting all three PCMH principles. These findings highlight the population groups that would most benefit from the PCMH care delivery model, particularly Medi-Cal beneficiaries and those eligible for Covered California, the California health benefits exchange.

  12. NASA Lunar Sample Education Disk Program - Space Rocks for Classrooms, Museums, Science Centers and Libraries

    Science.gov (United States)

    Allen, J. S.

    2009-12-01

    NASA is eager for students and the public to experience lunar Apollo rocks and regolith soils first hand. Lunar samples embedded in plastic are available for educators to use in their classrooms, museums, science centers, and public libraries for education activities and display. The sample education disks are valuable tools for engaging students in the exploration of the Solar System. Scientific research conducted on the Apollo rocks has revealed the early history of our Earth-Moon system. The rocks help educators make the connections to this ancient history of our planet as well as connections to the basic lunar surface processes - impact and volcanism. With these samples educators in museums, science centers, libraries, and classrooms can help students and the public understand the key questions pursued by missions to Moon. The Office of the Curator at Johnson Space Center is in the process of reorganizing and renewing the Lunar and Meteorite Sample Education Disk Program to increase reach, security and accountability. The new program expands the reach of these exciting extraterrestrial rocks through increased access to training and educator borrowing. One of the expanded opportunities is that trained certified educators from science centers, museums, and libraries may now borrow the extraterrestrial rock samples. Previously the loan program was only open to classroom educators so the expansion will increase the public access to the samples and allow educators to make the critical connections of the rocks to the exciting exploration missions taking place in our solar system. Each Lunar Disk contains three lunar rocks and three regolith soils embedded in Lucite. The anorthosite sample is a part of the magma ocean formed on the surface of Moon in the early melting period, the basalt is part of the extensive lunar mare lava flows, and the breccias sample is an important example of the violent impact history of the Moon. The disks also include two regolith soils and

  13. Using an expanded outcomes framework and continuing education evidence to improve facilitation of patient-centered medical home recognition and transformation.

    Science.gov (United States)

    Van Hoof, Thomas J; Kelvey-Albert, Michele; Katz, Matthew; Lalime, Ken; Sacks, Ken; Meehan, Thomas P

    2014-01-01

    The patient-centered medical home is a model for delivering primary care in the United States. Primary care clinicians and their staffs require assistance in understanding the innovation and in applying it to practice. The purpose of this article is to describe and to critique a continuing education program that is relevant to, and will become more common in, primary care. A multifaceted educational strategy prepared 20 primary care private practices to achieve National Committee for Quality Assurance Level 3 recognition as Patient-Centered Medical Homes. Eighteen (90%) practices submitted an application to the National Committee for Quality Assurance. On the first submission attempt, 13 of 18 (72%) achieved Level 3 recognition and 5 (28%) achieved Level 1 recognition. An interactive multifaceted educational strategy can be successful in preparing primary care practices for Patient-Centered Medical Homes recognition, but the strategy may not ensure transformation. Future educational activities should consider an expanded outcomes framework and the evidence of effective continuing education to be more successful with recognition and transformation.

  14. Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center.

    Science.gov (United States)

    Ross, Kimberly M; Moscoso, Andrea V; Bayer, Lauren R; Rosselli-Risal, Liliana; Orgill, Dennis P

    2018-04-01

    Medical tourism is a growing, multi-billion dollar industry fueled by improvements in the global transportation infrastructure. The authors studied patients living in the United States who travel to other countries for plastic surgical procedures and returned to have their complications treated in the authors' center. A retrospective patient evaluation was performed. Patients who had presented to an urban tertiary academic hospital plastic surgery service with complications or complaints associated with plastic surgery performed in a developing country were studied. The authors collected demographic information, types of surgery performed, destinations, insurance coverage, and complications. Seventy-eight patients were identified over 7 years. Most commonly, complications were seen following abdominoplasty (n = 35), breast augmentation (n = 25), and foreign body injections (n = 15). Eighteen patients underwent multiple procedures in one operative setting. The most common destination country was the Dominican Republic (n = 59). Complications included surgical-site infections (n = 14), pain (n = 14), and wound healing complications (n = 12). Eighty-six percent of patients (n = 67) relied on their medical insurance to pay for their follow-up care or manage their complications, with the most common type of health insurance coverage being Massachusetts Medicaid (n = 48). Cosmetic surgery performed in developing countries can carry substantial risks of complications that can be challenging to patients, primary care providers, insurers, and plastic surgical teams not associated with the original surgery. These complications pose significant burdens on our public health systems.

  15. Further Analyses of the NASA Glenn Research Center Solar Cell and Photovoltaic Materials Experiment Onboard the International Space Station

    Science.gov (United States)

    Myers, Matthew G.; Prokop, Norman F.; Krasowski, Michael J.; Piszczor, Michael F.; McNatt, Jeremiah S.

    2016-01-01

    Accurate air mass zero (AM0) measurement is essential for the evaluation of new photovoltaic (PV) technology for space solar cells. The NASA Glenn Research Center (GRC) has flown an experiment designed to measure the electrical performance of several solar cells onboard NASA Goddard Space Flight Center's (GSFC) Robotic Refueling Mission's (RRM) Task Board 4 (TB4) on the exterior of the International Space Station (ISS). Four industry and government partners provided advanced PV devices for measurement and orbital environment testing. The experiment was positioned on the exterior of the station for approximately eight months, and was completely self-contained, providing its own power and internal data storage. Several new cell technologies including four-junction (4J) Inverted Metamorphic Multi-Junction (IMM) cells were evaluated and the results will be compared to ground-based measurement methods.

  16. National Aeronautics and Space Administration Manned Spacecraft Center data base requirements study

    Science.gov (United States)

    1971-01-01

    A study was conducted to evaluate the types of data that the Manned Spacecraft Center (MSC) should automate in order to make available essential management and technical information to support MSC's various functions and missions. In addition, the software and hardware capabilities to best handle the storage and retrieval of this data were analyzed. Based on the results of this study, recommendations are presented for a unified data base that provides a cost effective solution to MSC's data automation requirements. The recommendations are projected through a time frame that includes the earth orbit space station.

  17. A Study of Civilian Registered Nurse Recruitment at Madigan Army Medical Center, Tacoma, Washington.

    Science.gov (United States)

    1982-06-01

    34 May, 1981, "Nurse, Where Are You?" Judy Armstrong . 5 1nitial Report and Preliminary Recommendations, National Commission on Nursing (September 1981...Interview with Ms. R. Marsh, Staffing Specialist, Force Develop- ment Division, Madigan Army Medical Center, Tacoma, WA (Dec 81) 20Philip Kotler ...Marketing Management. Boston: Allyn and Bacon, Inc., 1980. Kotler , Philip. Marketing for Nonprofit Institutions. Englewood Cliffs, N.D.: Prentice-Hall

  18. Internal Social Media at Marshall Space Flight Center - An Engineer's Snapshot

    Science.gov (United States)

    Scott, David W.

    2013-01-01

    In the brief span of about six years (2004-2010), social media radically enhanced people's ways of maintaining recreational friendships. Social media's impact on public affairs (PAO) and community engagement is equally striking: NASA has involved millions of non-NASA viewers in its activities via outward-facing social media, often in a very two-way street fashion. Use of social media as an internal working tool by NASA's tens of thousands of civil servants, onsite contractor employees, and external stakeholders is evolving more slowly. This paper examines, from an engineer's perspective, Marshall Space Flight Center s (MSFC) efforts to bring the power of social media to the daily working environment. Primary emphasis is on an internal Social Networking Service called Explornet that could be scaled Agency-wide. Other topics include MSFC use of other social media day-to-day for non-PAO purposes, some specialized uses of social techniques in space flight control operations, and how to help a community open up so it can discover and adopt what works well.

  19. Nuclear Thermal Propulsion (NTP) Development Activities at the NASA Marshall Space Flight Center - 2006 Accomplishments

    Science.gov (United States)

    Ballard, Richard O.

    2007-01-01

    In 2005-06, the Prometheus program funded a number of tasks at the NASA-Marshall Space Flight Center (MSFC) to support development of a Nuclear Thermal Propulsion (NTP) system for future manned exploration missions. These tasks include the following: 1. NTP Design Develop Test & Evaluate (DDT&E) Planning 2. NTP Mission & Systems Analysis / Stage Concepts & Engine Requirements 3. NTP Engine System Trade Space Analysis and Studies 4. NTP Engine Ground Test Facility Assessment 5. Non-Nuclear Environmental Simulator (NTREES) 6. Non-Nuclear Materials Fabrication & Evaluation 7. Multi-Physics TCA Modeling. This presentation is a overview of these tasks and their accomplishments

  20. DEVELOPMENT OF SIMULATION CENTER AND TRAINING PROGRAMMES IN IVANO-FRANKIVSK PERINATAL CENTER

    Directory of Open Access Journals (Sweden)

    Zoryana Kocherga

    2017-06-01

    Full Text Available Current system of medical education in Ukraine needs improvement and reforms in order to enhance the proficiency of doctors and paramedics. Training of practical/technical skills, communication, as well as teamwork skills is considerably important.The use of simulation techniques and methods in medical education is called simulation training in medicine. Medical skills are acquired through cognitive (knowledge and psychomotor (practice skills. The first medical simulation centers appeared in Ukraine in 2006 according to the order of the Ministry of Health Care of Ukraine.On June 20, 2013, a new simulation training center was opened in Ivano-Frankivsk on the base of Regional Perinatal Center. Similar medical simulation centers were opened in the second half of 2013 in Volyn and Vinnytsia regions under the Ukrainian-Swiss Mother and Child Health Programme, which started in the area of perinatology. Their goal is to improve the teamwork of all specialists involved in the process of delivery and neonatal intensive care,as well as to engage internship doctors and senior medical students in clinical skills training programmes.The use of simulation techniques and training programs offers a powerful platform to study and practice clinical reasoning behaviors and patterns.

  1. CAPITAL STRUCTURE ANALYSIS OF THE MEDICAL DIAGNOSTIC-CONSULTATIVE CENTERS IN VARNA (absolute indicators

    Directory of Open Access Journals (Sweden)

    Lyubomira Koeva-Dimitrova

    2016-08-01

    Full Text Available The capital structure analysis of medical institutions is related to the assessment of their financial sustainability. The degree of their financial sustainability indicates the extent to which the medical institution is exposed to financial risk. This financial risk is related to the use of foreign capital (debts, loans, etc. and it is defined as the probability of insolvency and possible bankruptcy due to the existence of debts which could not be repaid at some point in the foreseeable future. Objective: To analyze the capital structure of the medical diagnostic-consultative centers in Varna city and on this basis to assess their long-term solvency and existence of financial risk. Materials and Methods: The materials for the study are the published annual financial statements (up to 05. 01. 2016 in the Commercial Register for the period from year 2008 to 2014 of all MDCCs (Medical Diagnostic Consultative centers, registered in Varna - 9 in total. In the study are applied logical-mathematical methods (comparison, grouping, detail, graphical method; financial and accounting analysis (balance sheet analysis; analysis of absolute ratios for financial sustainability. Results: Upon analysis of the capital structure of MDCC's are studied the main absolute indicators characterizing the conditions for financial sustainability and the existence of financial risk regarding the solvency. A table represents the overall assessment of the degree of financial sustainability of the companies according to the type and structure of the fulfilled criteria. It was ascertained that for year 2014, DCC 3, 4, 5 and 8 have met all the conditions and according to them these hospitals have very high financial sustainability. DCC 7 has an average financial sustainability, DCC 1 and 2 are in a financial crisis and DCC 6 and 9 are facing bankruptcy. It must be emphasized that nearly half of the studied health care organizations (DCC 1, 2, 6 and 9 need urgent intervention by

  2. Increasing Therapist Productivity: Using Lean Principles in the Rehabilitation Department of an Academic Medical Center.

    Science.gov (United States)

    Johnson, Diana; Snedeker, Kristie; Swoboda, Michael; Zalieckas, Cheryl; Dorsey, Rachel; Nohe, Cassandra; Smith, Paige; Roche, Renuka

    The Department of Rehabilitation Services, within the University of Maryland Medical Center's 650-bed academic medical center, was experiencing difficulty in meeting productivity standards. Therapists in the outpatient division believed they were not spending enough time performing billable patient care activities. Therapists in the inpatient division had difficulty keeping pace with the volume of incoming referrals. Collectively, these issues caused dissatisfaction among referral sources and frustration among the staff within the rehabilitation department. The department undertook a phased approach to address these issues that included examining the evidence, using Lean process improvement principles, and employing transformational leadership strategies to drive improvements in productivity and efficiency. The lessons learned support the importance of having meaningful metrics appropriate for the patient population served, the use of Lean as an effective tool for improving productivity in rehabilitation departments, the impact of engaging staff at the grassroots level, and the importance of having commitment from leaders. The study findings have implications for not only rehabilitation and hospital leadership, but CEOs and managers of any business who need to eliminate waste or increase staff productivity.

  3. DEVELOPMENT OF CLINICAL SCENARIO’S INFORMATION MODEL IN THE MEDICAL SIMULATION CENTER

    Directory of Open Access Journals (Sweden)

    I. V. Tolmachyov

    2014-01-01

    Full Text Available There is the big issue in medical education which is students don’t have enough skills. Often even with theoretical knowledge graduate medical students need to improve their skills by working with patients. Obviously it can be a risk for patients and takes quite long time. This situation could be changed with applying simulation technologies in medical education. Medical education with virtual simulators allows reducing the time of skills development and improving the quality of training. The aims of this work are developing informational model and creating clinical scenarios of emergency states in the Medical Simulation Center.Objectives:– to analyze the process of scenario conducting;– to create clinical scenarios of emergency states (anaphylactic shock, hypovolemic shock, obstructive shock with specialist’s help.The scenarios consist of sections such as main aim, skills, required mannequins, preparation of the mannequins, preparation of medical equipment and instruments for the scenario, preparation of special materials, scenario description, guide for operator, information for trainees.By analyzing the process of scenario conducting the key participants were defined who are operator, assistant, trainer, trainees. Also the main scenario stages were defined. Based on the stages diagram of variants of scenario conducting was designed.As an example there are fragments of scenario “Obstructive shock – a pulmonary embolism” in this article. Learn skills are cognitive, technical, social ones.Results. This paper presents an analysis of the clinical scenario conducting. Information model was developed which based on object-oriented decomposition. The model is the diagram of variants of scenario conducting. Scenario’s structure for emergency states was formulated. The scenarios are anaphylactic shock, hypovolemic shock, obstructive shock (pulmonary embolism, tension pneumothorax, pulmonary edema, hypertensive crisis, respiratory

  4. Improvement of the Russian system of medical care at the site of space crew landing

    Science.gov (United States)

    Rukavishnikov, Ilya; Bogomolov, Valery; Polyakov, Alexey

    The crew members are delivered to ISS and return back to the Earth on the space craft "Soyuz TMA" at present time. The technical means providing the safe landing of space crews are reliable enough. In spite of that the complex of negative factors (long lasting alternating and shock overloads, effects of landing apparatus rotation on vestibular system) affects the crew during landing and can reach the extreme values under the certain conditions. According to this fact there is a possibility of appearance of bodily damages of different weight besides the traditional functional disturbances. The group of search and rescue on the landing site includes the medical specialists appropriately equipped to stop the symptoms of medical contingency (strong vestibule-vegetative reactions, traumas of different weight, etc.) Medical evacuation complex which provides the acceptable conditions for the cosmonauts including the conditions for medical care is delivered to the landing site as well. The long term experience of search and rescue assurance at the landing site have shown that the specialists successfully cope with this task. In some cases it was required to give the medical help which allowed to improve the general condition and physical capacity of crewmembers and provide their evacuation to the places of postflight rehabilitation. At the same time the solution of some of the problems from our point of view could increase the efficacy of medical care for the landing crew. The organization of the training on emergency under the field conditions for medical specialists on the regular basis (not less that once a year) is extremely important. The equipment of medical specialists requires the regular improvement and modernization due to the fast changing medical technologies and standards. Wearable medical sets must provide the first aid performing in accordance to the modern medical requirements. It is also necessary to include in the list of equipment the textbook of

  5. Expansion of the consultation-liaison psychiatry paradigm at a university medical center: integration of diversified clinical and funding models.

    Science.gov (United States)

    Bourgeois, James A; Hilty, Donald M; Klein, Sally C; Koike, Alan K; Servis, Mark E; Hales, Robert E

    2003-01-01

    The perspective of the contemporary Consultation-Liason Service (CLS) psychiatrist is increasingly one of consultant to medical and surgical colleagues in models other than inpatient medical and surgical units. Simultaneously, the need for a clinically and educationally robust inpatient CLS persists despite funding pressures. The University of California, Davis Medical Center Department of Psychiatry has made use of creative organizational and financial models to accomplish the inpatient CLS clinical and educational missions in a fiscally responsible manner. In addition, the department has in recent years expanded the delivery of psychiatry consultation-liaison clinical and educational services to other models of care delivery, broadening the role and influence of the CLS. Several of the initiatives described in this paper parallel an overall evolution of the practice of consultation-liaison psychiatry in response to managed care influences and other systems pressures. This consultation-liaison paradigm expansion with diversified sources of funding support facilitates the development of consultation-liaison psychiatry along additional clinical, administrative, research, and educational dimensions. Other university medical centers may consider adaptation of some of the initiatives described here to their institutions.

  6. IT Challenges for Space Medicine or How do We Protect Medical Information and Still Get Useful Work Done?

    Science.gov (United States)

    Johnson-Throop, Kathy A.

    2010-01-01

    Space Medicine provides healthcare services of various types for astronauts throughout their lifetime starting from the time they are selected as astronauts. IT challenges include: protection of private medical information, access from locations both inside and outside NASA, nearly 24x7 access, access during disasters, international partner access, data archiving, off-region backup, secure communication of medical data to people outside the NASA system (e.g. expert consultants), efficient movement of medical record information between locations, search and retrieval of relevant information, and providing all of these services/capabilities within a limited budget. In Space Medicine, we have provided for these in various ways: limit the amount of private medical information stored locally, utilize encryption mechanisms that the international partners can also use, utilize 2-factor authentication, virtualize servers, employ concept-based search, and use of standardized terminologies (SNOMED) and messaging (HL7).

  7. 75 FR 6401 - Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of...

    Science.gov (United States)

    2010-02-09

    ... Biologics Evaluation and Research (HFM-17), Food and Drug Administration, suite 200N, 1401 Rockville Pike... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-M-0513] Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of Summaries...

  8. Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use.

    Science.gov (United States)

    Jones, Audrey L; Cochran, Susan D; Leibowitz, Arleen; Wells, Kenneth B; Kominski, Gerald; Mays, Vickie M

    2015-12-01

    The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders. To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qualities in a usual provider are associated with the use of mental health services (MHS). Using national data from the Medical Expenditure Panel Survey, we conducted a lagged cross-sectional study of MHS use subsequent to participant reports of psychological distress and usual provider and practice characteristics. A total of 2,358 adults, aged 18-64 years, met the criteria for serious psychological distress and reported on their usual provider and practice characteristics. We defined "usual provider" as a primary care provider/practice, and "PCMH provider" as a usual provider that delivered accessible, comprehensive, patient-centered care as determined by patient self-reporting. The dependent variable, MHS, included self-reported mental health visits to a primary care provider or mental health specialist, counseling, and psychiatric medication treatment over a period of 1 year. Participants with a usual provider were significantly more likely than those with no usual provider to have experienced a primary care mental health visit (marginal effect [ME] = 8.5, 95 % CI = 3.2-13.8) and to have received psychiatric medication (ME = 15.5, 95 % CI = 9.4-21.5). Participants with a PCMH were additionally more likely than those with no usual provider to visit a mental health specialist (ME = 7.6, 95 % CI = 0.7-14.4) and receive mental health counseling (ME = 8.5, 95 % CI = 1.5-15.6). Among those who reported having had any type of mental health visit, participants with a PCMH were more likely to have received mental health counseling than those with only a usual provider (ME = 10.0, 95 % CI

  9. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef

    2012-05-01

    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  10. Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

    Science.gov (United States)

    Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

    2017-03-01

    International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

  11. Incorporating the principles of the patient- centered medical home into a student-run free clinic

    Directory of Open Access Journals (Sweden)

    Riddle MC

    2014-09-01

    Full Text Available Megan C Riddle,1,* Jiahui Lin,3,* Jonathan B Steinman,2 Joshua D Salvi,2 Margaret M Reynolds,3 Anne S Kastor,3,† Christina Harris,4 Carla Boutin-Foster3 1Department of Psychiatry and Behavioral Sciences, University of Washington, 2Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD–PhD Program, 3Department of Internal Medicine, Weill Cornell Medical College, New York, NY, 4Department of Medicine, Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, LA, USA *These authors contributed equally to this work †Anne S Kastor passed away on July 5, 2013. Abstract: As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. The authors provide a detailed description of the process by which the Weill Cornell Community Clinic (WCCC, a student-run free clinic, has integrated PCMH principles into a service-learning initiative. The authors assessed patient demographics, diagnoses, and satisfaction along with student satisfaction. During the year after a PCMH model was adopted, 112 students and 19 licensed physicians volunteered their time. A review of the 174 patients seen from July 2011 to June 2012 found that the most common medical reasons for visits included management of hypertension, hyperlipidemia, diabetes, gastrointestinal conditions, arthritis, anxiety, and depression. During the year after the adoption of the PCMH model, 87

  12. NASA's engineering research centers and interdisciplinary education

    Science.gov (United States)

    Johnston, Gordon I.

    1990-01-01

    A new program of interactive education between NASA and the academic community aims to improve research and education, provide long-term, stable funding, and support cross-disciplinary and multi-disciplinary research. The mission of NASA's Office of Aeronautics, Exploration and Technology (OAET) is discussed and it is pointed out that the OAET conducts about 10 percent of its total R&D program at U.S. universities. Other NASA university-based programs are listed including the Office of Commercial Programs Centers for the Commercial Development of Space (CCDS) and the National Space Grant program. The importance of university space engineering centers and the selection of the nine current centers are discussed. A detailed composite description is provided of the University Space Engineering Research Centers. Other specialized centers are described such as the Center for Space Construction, the Mars Mission Research Center, and the Center for Intelligent Robotic Systems for Space Exploration. Approaches to educational outreach are discussed.

  13. Statement of the American Psychological Association in response to the "joint principles: integrating behavioral health care into the patient-centered medical home".

    Science.gov (United States)

    Anderson, Norman B; Belar, Cynthia D; Cubic, Barbara A; Garrison, Ellen G; Johnson, Suzanne Bennett; Kaslow, Nadine J

    2014-06-01

    Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011), presented by the Working Party Group on Integrated Behavioral Healthcare. The American Psychological Association (APA) shares concerns about the lack of reference to behavioral health care in the original 2007 Joint Principles of the Patient-Centered Medical Home for which this new document is intended to supplement but not replace. The decision to support the supplemental Joint Principles was not an easy one for APA, as there is one area of significant concern. That concern is related to the use of the term "physician-directed medical practice"

  14. Using a Lego-based communications simulation to introduce medical students to patient-centered interviewing.

    Science.gov (United States)

    Harding, S R; D'Eon, M F

    2001-01-01

    Teaching patient-centered interviewing skills to medical students can be challenging. We have observed that 1st-year medical students, in particular, do not feel free to concentrate on the interviewing skills because they are preoccupied with complicated technical medical knowledge. The Lego simulation we use with our 1st-year students as part of a professional-skills course overcomes that difficulty. The Lego activity is a role play analogous to a doctor-patient interview that uses identical sets of Legos for the "doctor" and for the "patients" and a small construction that represents a patient history. With a simple questionnaire, data were collected from students at different points during instruction. Results indicate that the Lego activity was very effective in helping students learn the importance of open-ended questioning. It also was rated as highly as the very dynamic interactive part of the instructional session. The effectiveness of the Lego activity may be due to the properties of analogies.

  15. Set up and operation for medical radiation exposure quality control system of health promotion center

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Su; Kim, Jung Min [Korea University,Seoul (Korea, Republic of); Jung, Hae Kyoung [Dept. of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Sungnam (Korea, Republic of)

    2016-03-15

    In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm{sup 2} and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure.

  16. Set up and operation for medical radiation exposure quality control system of health promotion center

    International Nuclear Information System (INIS)

    Kim, Jung Su; Kim, Jung Min; Jung, Hae Kyoung

    2016-01-01

    In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm"2 and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure

  17. Kennedy Space Center Timing and Countdown Interface to Kennedy Ground Control Subsystem

    Science.gov (United States)

    Olsen, James C.

    2015-01-01

    Kennedy Ground Control System (KGCS) engineers at the National Aeronautics and Space Administration (NASA) Kennedy Space Center (KSC) are developing a time-tagging process to enable reconstruction of the events during a launch countdown. Such a process can be useful in the case of anomalies or other situations where it is necessary to know the exact time an event occurred. It is thus critical for the timing information to be accurate. KGCS will synchronize all items with Coordinated Universal Time (UTC) obtained from the Timing and Countdown (T&CD) organization. Network Time Protocol (NTP) is the protocol currently in place for synchronizing UTC. However, NTP has a peak error that is too high for today's standards. Precision Time Protocol (PTP) is a newer protocol with a much smaller peak error. The focus of this project has been to implement a PTP solution on the network to increase timing accuracy while introducing and configuring the implementation of a firewall between T&CD and the KGCS network.

  18. Medical and Rehabilitation Centers in Children’s Houses — New Opportunities for Treatment and Rehabilitation of Children

    Directory of Open Access Journals (Sweden)

    I.V. Balychevtseva

    2014-05-01

    Full Text Available The article presents data on the opening of medical and rehabilitations centers at the children’s houses of Donetsk region. Approaches, terms, possibilities and methods of rehabilitations used during the treatment and restoration of disabled children are provided.

  19. Space Physiology and Operational Space Medicine

    Science.gov (United States)

    Scheuring, Richard A.

    2009-01-01

    The objectives of this slide presentation are to teach a level of familiarity with: the effects of short and long duration space flight on the human body, the major medical concerns regarding future long duration missions, the environmental issues that have potential medical impact on the crew, the role and capabilities of the Space Medicine Flight Surgeon and the environmental impacts experienced by the Apollo crews. The main physiological effects of space flight on the human body reviewed in this presentation are: space motion sickness (SMS), neurovestibular, cardiovascular, musculoskeletal, immune/hematopoietic system and behavioral/psycho-social. Some countermeasures are discussed to these effects.

  20. The Future Medical Science and Colorectal Surgeons.

    Science.gov (United States)

    Kim, Young Jin

    2017-12-01

    Future medical technology breakthroughs will build from the incredible progress made in computers, biotechnology, and nanotechnology and from the information learned from the human genome. With such technology and information, computer-aided diagnoses, organ replacement, gene therapy, personalized drugs, and even age reversal will become possible. True 3-dimensional system technology will enable surgeons to envision key clinical features and will help them in planning complex surgery. Surgeons will enter surgical instructions in a virtual space from a remote medical center, order a medical robot to perform the operation, and review the operation in real time on a monitor. Surgeons will be better than artificial intelligence or automated robots when surgeons (or we) love patients and ask questions for a better future. The purpose of this paper is looking at the future medical science and the changes of colorectal surgeons.

  1. OPERATION OF THE CALL CENTER AT A HIGH-TECHNOLOGY PEDIATRIC MEDICAL INSTITUTION (WITH COMMENTARY BY A.A. MODESTOV

    Directory of Open Access Journals (Sweden)

    I. N. Chernomurov

    2014-01-01

    Full Text Available Introduction of modern information systems is one of the important objectives of medicine, as it contributes to higher availability of medical services for the population. Public relations of medical organizations involve websites of these organizations, outdoor advertising and other information sources. However, obtainment of competent inquiry answers by telephone remains a problem. People often choose between organizations depending on quality of the obtained information. Apparently, the issue can be resolved by establishing call centers that are not merely communications centers, but are staffed with competent trained personnel, who support the organization’s interaction with patients (or the legal representatives thereof. The article presents the authors’ experience of establishing a call center dedicated to the organization’s public image development, as well as higher demand of the available services and promotion thereof. The fulfilled modernization resulted in a sharp increase in the amount of calls received (1,500‑1,600 within the working hours; 900 – before modernization and reduction in the number of complaints of busy line. 

  2. Humanities mini-course curricula for midcareer health professionals at the Penn State Milton S. Hershey Medical Center.

    Science.gov (United States)

    Myers, Kimberly R; George, Daniel R

    2012-08-01

    The field of medical humanities has traditionally focused on medical students and, more recently, on premedical undergraduates. Comparatively little formal humanities pedagogy has been dedicated to midcareer health professionals. To address this lack, the Department of Humanities at the Pennsylvania State University College of Medicine and the Milton S. Hershey Medical Center designed eight annual humanities mini-courses for faculty and staff throughout the college and medical center.These mini-courses fell into four categories: reading, reflection, and discussion; creative expression; technology; and ethics. They were geared toward midcareer health professionals who were seeking new intellectual and creative stimulation and variety in daily routine. They also provided humanities faculty the opportunity to devote attention to topics that capitalize on their professional training and that interest them personally.Participants indicated a high degree of satisfaction with the mini-courses for four principal reasons: (1) learning the tools and methodologies of a new discipline or domain other than biomedicine, (2) using their minds and training in uncustomary ways, (3) forming new alliances with colleagues (which served to lessen the sense of professional isolation), and (4) enjoying a respite from the stressful flow of the workday. Humanities faculty facilitators provided more mixed responses but agreed that conducting the mini-courses had been a positive overall experience.Although this article provides a foundational framework for the development of a humanities mini-course series, the authors encourage others to replicate these curricula in other medical settings as an important step toward a robust pedagogy designed for midcareer health care professionals.

  3. The patient-centered medical home in oncology: from concept to reality.

    Science.gov (United States)

    Page, Ray D; Newcomer, Lee N; Sprandio, John D; McAneny, Barbara L

    2015-01-01

    In recent years, the cost of providing quality cancer care has been subject to an epic escalation causing concerns on the verge of a health care crisis. Innovative patient-management models in oncology based on patient-centered medical home (PCMH) principles, coupled with alternative payments to traditional fee for service (FFS), such as bundled and episodes payment are now showing evidence of effectiveness. These efforts have the potential to bend the cost curve while also improving quality of care and patient satisfaction. However, going forward with FFS alternatives, there are several performance-based payment options with an array of financial risks and rewards. Most novel payment options convey a greater financial risk and accountability on the provider. Therefore, the oncology medical home (OMH) can be a way to mitigate some financial risks by sharing savings with the payer through better global care of the patient, proactively preventing complications, emergency department (ED) visits, and hospitalizations. However, much of the medical home infrastructure that is required to reduced total costs of cancer care comes as an added expense to the provider. As best-of-practice quality standards are being elucidated and refined, we are now at a juncture where payers, providers, policymakers, and other stakeholders should work in concert to expand and implement the OMH framework into the variety of oncology practice environments to better equip them to assimilate into the new payment reform configurations of the future.

  4. Utilization of a Marketing Strategy at Naval Regional Medical Center Great Lakes, Great Lakes, Illinois

    Science.gov (United States)

    1983-06-01

    22 Analysis of the Mare.....................22 Development of the Marketing Mix .. .......... 29 A Marketing Mix --Recommendations...problem. Marketing strategy, marketing mix and ultimately the marketing orientation will allow hospitals to persevere and possibly thrive in a somewhat...market are currently being met at Naval Regional Medical Center Great Lakes. The fourth objective is to demonstrate an appropriate marketing mix for

  5. Recent Activities on the Embrace Space Weather Regional Warning Center: the New Space Weather Data Center

    Science.gov (United States)

    Denardini, Clezio Marcos; Dal Lago, Alisson; Mendes, Odim; Batista, Inez S.; SantAnna, Nilson; Gatto, Rubens; Takahashi, Hisao; Costa, D. Joaquim; Banik Padua, Marcelo; Campos Velho, Haroldo

    2016-07-01

    On August 2007 the National Institute for Space Research started a task force to develop and operate a space weather program, which is known by the acronyms Embrace that stands for the Portuguese statement "Estudo e Monitoramento BRAasileiro de Clima Espacial" Program (Brazilian Space Weather Study and Monitoring program). The mission of the Embrace/INPE program is to monitor the Solar-Terrestrial environment, the magnetosphere, the upper atmosphere and the ground induced currents to prevent effects on technological and economic activities. The Embrace/INPE system monitors the physical parameters of the Sun-Earth environment, such as Active Regions (AR) in the Sun and solar radiation by using radio telescope, Coronal Mass Ejection (CME) information by satellite and ground-based cosmic ray monitoring, geomagnetic activity by the magnetometer network, and ionospheric disturbance by ionospheric sounders and using data collected by four GPS receiver network, geomagnetic activity by a magnetometer network, and provides a forecasting for Total Electronic Content (TEC) - 24 hours ahead - using a version of the SUPIM model which assimilates the two latter data using nudging approach. Most of these physical parameters are daily published on the Brazilian space weather program web portal, related to the entire network sensors available. Regarding outreach, it has being published a daily bulletin in Portuguese and English with the status of the space weather environment on the Sun, the Interplanetary Medium and close to the Earth. Since December 2011, all these activities are carried out at the Embrace Headquarter, a building located at the INPE's main campus. Recently, a comprehensive data bank and an interface layer are under commissioning to allow an easy and direct access to all the space weather data collected by Embrace through the Embrace web Portal. The information being released encompasses data from: (a) the Embrace Digisonde Network (Embrace DigiNet) that monitors

  6. NASA Marshall Space Flight Center Controls Systems Design and Analysis Branch

    Science.gov (United States)

    Gilligan, Eric

    2014-01-01

    Marshall Space Flight Center maintains a critical national capability in the analysis of launch vehicle flight dynamics and flight certification of GN&C algorithms. MSFC analysts are domain experts in the areas of flexible-body dynamics and control-structure interaction, thrust vector control, sloshing propellant dynamics, and advanced statistical methods. Marshall's modeling and simulation expertise has supported manned spaceflight for over 50 years. Marshall's unparalleled capability in launch vehicle guidance, navigation, and control technology stems from its rich heritage in developing, integrating, and testing launch vehicle GN&C systems dating to the early Mercury-Redstone and Saturn vehicles. The Marshall team is continuously developing novel methods for design, including advanced techniques for large-scale optimization and analysis.

  7. Optical Characteristics of the Marshall Space Flight Center Solar Ultraviolet Magnetograph

    Science.gov (United States)

    West, E. A.; Porter, J. G.; Davis, J. M.; Gary, G. A.; Adams, M.; Smith, S.; Hraba, J. F.

    2001-01-01

    This paper will describe the scientific objectives of the Marshall Space Flight Center (MSFC) Solar Ultraviolet Magnetograph Investigation (SUMI) and the optical components that have been developed to meet those objectives. In order to test the scientific feasibility of measuring magnetic fields in the UV, a sounding rocket payload is being developed. This paper will discuss: (1) the scientific measurements that will be made by the SUMI sounding rocket program, (2) how the optics have been optimized for simultaneous measurements of two magnetic lines CIV (1550 Angstroms) and MgII (2800 Angstroms), and (3) the optical, reflectance, transmission and polarization measurements that have been made on the SUMI telescope mirror and polarimeter.

  8. Voltage profile program for the Kennedy Space Center electric power distribution system

    Science.gov (United States)

    1976-01-01

    The Kennedy Space Center voltage profile program computes voltages at all busses greater than 1 Kv in the network under various conditions of load. The computation is based upon power flow principles and utilizes a Newton-Raphson iterative load flow algorithm. Power flow conditions throughout the network are also provided. The computer program is designed for both steady state and transient operation. In the steady state mode, automatic tap changing of primary distribution transformers is incorporated. Under transient conditions, such as motor starts etc., it is assumed that tap changing is not accomplished so that transformer secondary voltage is allowed to sag.

  9. Disruptive innovation in academic medical centers: balancing accountable and academic care.

    Science.gov (United States)

    Stein, Daniel; Chen, Christopher; Ackerly, D Clay

    2015-05-01

    Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care.

  10. Two X-38 Ship Demonstrators in Development at NASA Johnson Space Flight Center

    Science.gov (United States)

    1999-01-01

    This photo shows two X-38 Crew Return Vehicle technology demonstrators under development at NASA's Johnson Space Flight Center, Houston, Texas. The X-38 Crew Return Vehicle (CRV) research project is designed to develop the technology for a prototype emergency crew return vehicle, or lifeboat, for the International Space Station. The project is also intended to develop a crew return vehicle design that could be modified for other uses, such as a joint U.S. and international human spacecraft that could be launched on the French Ariane-5 Booster. The X-38 project is using available technology and off-the-shelf equipment to significantly decrease development costs. Original estimates to develop a capsule-type crew return vehicle were estimated at more than $2 billion. X-38 project officials have estimated that development costs for the X-38 concept will be approximately one quarter of the original estimate. Off-the-shelf technology is not necessarily 'old' technology. Many of the technologies being used in the X-38 project have never before been applied to a human-flight spacecraft. For example, the X-38 flight computer is commercial equipment currently used in aircraft and the flight software operating system is a commercial system already in use in many aerospace applications. The video equipment for the X-38 is existing equipment, some of which has already flown on the space shuttle for previous NASA experiments. The X-38's primary navigational equipment, the Inertial Navigation System/Global Positioning System, is a unit already in use on Navy fighters. The X-38 electromechanical actuators come from previous joint NASA, U.S. Air Force, and U.S. Navy research and development projects. Finally, an existing special coating developed by NASA will be used on the X-38 thermal tiles to make them more durable than those used on the space shuttles. The X-38 itself was an unpiloted lifting body designed at 80 percent of the size of a projected emergency crew return vehicle

  11. Mandibular Fracture Patterns at a Medical Center in Central Taiwan: A 3-Year Epidemiological Review.

    Science.gov (United States)

    Lin, Fu-Yu; Wu, Chao-I; Cheng, Hsu-Tang

    2017-12-01

    Mandibular fractures constitute a major portion of maxillofacial trauma and may lead to considerable functional and aesthetic sequelae if treatment is inadequate or delayed. An epidemiology study on mandibular fractures may guide the preventive efforts of the Taiwan public health care system. Therefore, a retrospective review was conducted at a medical center in central Taiwan to evaluate the current mandibular fracture epidemiology.The medical records and digitized radiographs of 198 patients who received treatment for mandibular fractures during a 3-year period (from October 2010 to September 2013) at a medical center in central Taiwan were reviewed to obtain demographic and injury data.The average age was 29.4 years (3-82 years). Patients aged 21 to 30 years sustained the most mandibular fractures (62 patients, 31.3%). The overall sex distribution (male to female) ratio was 1.8. Motor-vehicle accidents (MVAs) were the most common mechanism of injury (162 patients, 82%), and scooter and motorcycle riders wearing partial-coverage helmets constituted the majority of patients. A chart review identified 198 patients with 335 mandibular fractures; 113 patients (57.1%) had multiple mandibular fractures. The most common fracture sites were the symphysis and parasymphysis regions (38.9%), followed by the condyle (26.0%), angle (14.3%), body (14.3%), and ramus (6.6%).MVAs are the major cause of mandibular fractures in central Taiwan, and patients aged Taiwan. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  12. Dual-Use Space Technology Transfer Conference and Exhibition. Volume 1

    Science.gov (United States)

    Krishen, Kumar (Compiler)

    1994-01-01

    This document contains papers presented at the Dual-Use Space Technology Transfer Conference and Exhibition held at the Johnson Space Center February 1-3, 1994. Possible technology transfers covered during the conference were in the areas of information access; innovative microwave and optical applications; materials and structures; marketing and barriers; intelligent systems; human factors and habitation; communications and data systems; business process and technology transfer; software engineering; biotechnology and advanced bioinstrumentation; communications signal processing and analysis; new ways of doing business; medical care; applications derived from control center data systems; human performance evaluation; technology transfer methods; mathematics, modeling, and simulation; propulsion; software analysis and decision tools systems/processes in human support technology; networks, control centers, and distributed systems; power; rapid development perception and vision technologies; integrated vehicle health management; automation technologies; advanced avionics; ans robotics technologies. More than 77 papers, 20 presentations, and 20 exhibits covering various disciplines were presented b experts from NASA, universities, and industry.

  13. Rethink space: (Re)designing a workspace using human-centered design to support flexibility, collaboration, and engagement among clinical and translational research support services.

    Science.gov (United States)

    Doshi, Aalap; Clay, Christina

    2017-06-01

    Space matters. We read space like we read people's faces. Space is an instrument of collaboration and innovation. At the University of Michigan's Institute for Clinical and Health Research (MICHR), a team was created to creatively and economically enhance our operating space into a flexible workspace that supports privacy, innovation, creativity, and most important, a culture of collaboration. The team used a human-centered design process to creatively engage the staff at large into analyzing our existing space, identifying latent needs, proposing solutions, generating feedback, and economically building the rethought process. The redesigned workspace embraces the differences among MICHR's teams while encouraging collaboration and teamwork and keeping costs at a minimum. It has resulted in a flexible space that includes co-located teams, spaces dedicated to different work goals, an open area for collaboration, quiet zones for focused work, and better wayfinding. Through our Rethink Space project, we hope to have demonstrated that, by initiating the project internally and by engaging the users of the space themselves in an empathetic, visual, and human-centered way, a space redesign can be undertaken economically while also leading to improved levels of employee and team satisfaction.

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

    Science.gov (United States)

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

    2011-01-01

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

  15. General Case in Determining Center-To-Center Spacing Between the Screw and the Roller in a Roller Drive, and Initial Contact Point of Their Mating Thread Turns. Development of Calculation Method and Software

    Directory of Open Access Journals (Sweden)

    D. S. Blinov

    2017-01-01

    Full Text Available One of the most important trends in development of machine engineering is to improve load capacity of mechanisms, assemblies and parts without increasing their overall dimensions and weight. This is also relevant to the most promising items so far, i.e. orbital roller drives (ORD, which are the rotational-to-progressive motion converters widely used in vehicles. The previously published article suggested increasing a load capacity (by about 15% through reducing a thread turn section angle of the threaded ORD components and change of the radius of roller thread turn section outline. Due to such ORD modification, a number of the most critical ORD parameters are to be changed thereby demanding further research. Further, the article published suggests a method considering the abovementioned changes to calculate the dimensions of ORD main components and their tolerance ranges.Though this method being not complete as the increment of ORD center-to-center spacing in relation to its rated value, required for assembly, is unknown; and to determine the ORD center-to-center spacing increment, outer diameters of the roller and screw threads are to be known. Hence, these two methods are interconnected.This article presents the numerical calculation method, mathematical support and method to determine the increment of ORD center-to-center spacing and initial contact point of the mating roller and screw thread turns. Due to considerable scope of calculations, the method was turned into the software.Similar calculation methods and techniques were developed to a particular case, where the thread turn section angle of the threaded components was of 90°, and the roller thread turn section outline was a circular arc centered to the roller axis. Hence the developed numerical calculation method, mathematical support and technique refer to the general case which is to determine the ORD center-to-center spacing increment and initial contact point of the mating roller

  16. 107 Range Commanders Council Meteorology Group Meeting (RCC-MG): NASA Marshall Space Flight Center Range Report

    Science.gov (United States)

    Roberts, Barry C.

    2016-01-01

    The following is a summary of the major meteorological/atmospheric projects and research that have been or currently are being accomplished at Marshall Space Flight Center (MSFC). Listed below are highlights of work done during the past 6 months in the Engineering Directorate (ED) and in the Science and Mission Systems Office (ZP).

  17. Effects of internal marketing on nurse job satisfaction and organizational commitment: example of medical centers in Southern Taiwan.

    Science.gov (United States)

    Chang, Ching-Sheng; Chang, Hsin-Hsin

    2007-12-01

    As nurses typically represent the largest percentage of employees at medical centers, their role in medical care is exceptionally important and becoming more so over time. The quality and functions of nurses impact greatly on medical care quality. The concept of internal marketing, with origins in the field of market research, argues that enterprises should value and respect their employees by treating them as internal customers. Such a marketing concept challenges traditional marketing methods, which focus on serving external customers only. The main objective of internal marketing is to help internal customers (employees) gain greater job satisfaction, which should promote job performance and facilitate the organization accomplishing its ultimate business objectives. A question in the medical service industry is whether internal marketing can similarly increase the job satisfaction of nurses and enhance their commitment to the organization. This study aimed to explore the relational model of nurse perceptions related to internal marketing, job satisfaction, and organizational commitment by choosing nurses from two medical centers in Southern Taiwan as research subjects. Of 450 questionnaire distributed, 300 valid questionnaires were returned, giving a response rate of 66.7%. After conducting statistical analysis and estimation using structural equation modeling, findings included: (1) job satisfaction has positive effects on organizational commitment; (2) nurse perceptions of internal marketing have positive effects on job satisfaction; and (3) nurse perceptions of internal marketing have positive effects on organizational commitment.

  18. A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program.

    Science.gov (United States)

    Duong, David B; Sullivan, Erin E; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L

    2016-01-01

    In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.

  19. Improving access to care through the patient-centered medical home.

    Science.gov (United States)

    North, Stephen W; McElligot, James; Douglas, Gaye; Martin, Amanda

    2014-02-01

    School-based health centers (SBHCs) serve an essential role in providing access to high-quality, comprehensive care to underserved children and adolescents in more than 2,000 schools across the United States. SBHCs are an essential component of the health care safety net, and their role in the patient-centered medical home (PCMH) continues to evolve as both collaborating partners and, when fully functioning, independent PCMHs. The American Academy of Pediatrics (AAP) supports the use of SBHCs, citing the proven benefits and exciting potential as justification, but also offers caution and recommends a focus on communication within the community. Traditional "brick and mortar" SBHCs are more likely to be located in urban communities (54.2% urban versus 18.0% rural) and be in schools with more students, allowing for a greater return on investment. Current SBHCs are located in schools with an average population of 997 students. The need for a large school population to help an SBHC approach financial viability excludes children in rural communities who are more likely to attend a school with fewer than 500 students, be poor, and have difficulty accessing health care.2 The expansion of telehealth technologies allows the creation of solutions to decrease geographic barriers that have limited the growth of SBHCs in rural communities. Telehealth school-based health centers (tSBHCs) that exclusively provide services through telemedicine are operating and developing in communities where geographic barriers and financial challenges have prevented the establishment of brick and mortar SBHCs. TSBHCs are beginning to increase the number and variety of services they provide through the use of telehealth to include behavioral health, nutrition services, and pediatric specialists. Understanding the role of tSBHCs in the growth of the PCMH model is critical for using these tools to continue to improve child and adolescent health. Copyright 2014, SLACK Incorporated.

  20. Lunar and Meteorite Sample Education Disk Program - Space Rocks for Classrooms, Museums, Science Centers, and Libraries

    Science.gov (United States)

    Allen, Jaclyn; Luckey, M.; McInturff, B.; Huynh, P.; Tobola, K.; Loftin, L.

    2010-01-01

    NASA is eager for students and the public to experience lunar Apollo samples and meteorites first hand. Lunar rocks and soil, embedded in Lucite disks, are available for educators to use in their classrooms, museums, science centers, and public libraries for education activities and display. The sample education disks are valuable tools for engaging students in the exploration of the Solar System. Scientific research conducted on the Apollo rocks reveals the early history of our Earth-Moon system and meteorites reveal much of the history of the early solar system. The rocks help educators make the connections to this ancient history of our planet and solar system and the basic processes accretion, differentiation, impact and volcanism. With these samples, educators in museums, science centers, libraries, and classrooms can help students and the public understand the key questions pursued by many NASA planetary missions. The Office of the Curator at Johnson Space Center is in the process of reorganizing and renewing the Lunar and Meteorite Sample Education Disk Program to increase reach, security and accountability. The new program expands the reach of these exciting extraterrestrial rocks through increased access to training and educator borrowing. One of the expanded opportunities is that trained certified educators from science centers, museums, and libraries may now borrow the extraterrestrial rock samples. Previously the loan program was only open to classroom educators so the expansion will increase the public access to the samples and allow educators to make the critical connections to the exciting exploration missions taking place in our solar system. Each Lunar Disk contains three lunar rocks and three regolith soils embedded in Lucite. The anorthosite sample is a part of the magma ocean formed on the surface of Moon in the early melting period, the basalt is part of the extensive lunar mare lava flows, and the breccias sample is an important example of the

  1. A nationwide survey of patient centered medical home demonstration projects.

    Science.gov (United States)

    Bitton, Asaf; Martin, Carina; Landon, Bruce E

    2010-06-01

    The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Cross-sectional key-informant interviews. Leaders from existing PCMH demonstration projects with external payment reform. We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified--consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows.

  2. The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    Abdallat, W [King Hussein Medical Centre, Amman (Jordan). Dept. of Ophthalmology

    2011-07-01

    The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

  3. The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

    International Nuclear Information System (INIS)

    Abdallat, W

    2011-01-01

    The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

  4. Patient-centered medical home transformation with payment reform: patient experience outcomes.

    Science.gov (United States)

    Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

    2014-01-01

    To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

  5. 41 CFR 102-73.225 - What types of special purpose space may the Department of Veterans Affairs lease?

    Science.gov (United States)

    2010-07-01

    ...: (a) Guidance and training centers located at schools and colleges. (b) Space used for veterans hospitals, including outpatient and medical-related clinics, such as drug, mental health, and alcohol. Limitations on the Use of Delegated Authority ...

  6. Introducing quality assurance and medical audit into the UCSF medical center curriculum.

    Science.gov (United States)

    Barbaccia, J C

    1976-05-01

    The experience gained by a medical school faculty in developing and piloting a course for undergraduate medical students in medical care evaluation led to a similar effort for house staff. It is recognized that if the profession is to fulfill the demand by society for social accountability in the use of resources for health care, medical care assessment and quality assurance mechanisms must become an intimate part of the clinical experience of medical students and house officers. Teaching these subjects requires a theoretical framework; introduction of content and skills appropriate to the level of the student and continuation of progressively more advanced training throughout medical education; use of assessment and quality assurance techniques by clinician-teachers themselves to provide models for the student; and continued evolution of pedagogic approach and course content based on developments in the area.

  7. Fall Injuries and Related Factors of Elderly Patients at a Medical Center in Taiwan

    OpenAIRE

    Tsai, Li-Yun; Tsay, Shiow-Luan; Hsieh, Ruey-Kuen; Yu, Shu; Tsai, Jung-Mei; Chien, Hui-Hsien; Liu, Shu-Jung

    2014-01-01

    Background: Elderly patients have a high incidence of falls and injuries in hospitals due to various reasons. The aims of this study were to explore the characteristics and factors associated with fall injuries among elderly patients. Methods: A retrospective survey study was conducted. Data were retrieved from the patient safety reporting system of a medical center in Taiwan query for patient fall incidents of elderly patients aged 65 years or older between 2010 and 2012. Statistics were ...

  8. USRA's NCSEFSE: a new National Center for Space, Earth, and Flight Sciences Education

    Science.gov (United States)

    Livengood, T. A.; Goldstein, J.; Vanhala, H.; Hamel, J.; Miller, E. A.; Pulkkinen, K.; Richards, S.

    2005-08-01

    A new National Center for Space, Earth, and Flight Sciences Education (NCSEFSE) has been created in the Washington, DC metropolitan area under the auspices of the Universities Space Research Association. The NCSEFSE provides education and public outreach services in the areas of NASA's research foci in programs of both national and local scope. Present NCSEFSE programs include: Journey through the Universe, which unites formal and informal education within communities and connects a nationally-distributed network of communities from Hilo, HI to Washington, DC with volunteer Visiting Researchers and thematic education modules; the Voyage Scale Model Solar System exhibition on the National Mall, a showcase for planetary science placed directly outside the National Air and Space Museum; educational module development and distribution for the MESSENGER mission to Mercury through a national cadre of MESSENGER Educator Fellows; Teachable Moments in the News, which capitalizes on current events in space, Earth, and flight sciences to teach the science that underlies students' natural interests; the Voyages Across the Universe Speakers' Bureau; and Family Science Night at the National Air and Space Museum, which reaches audiences of 2000--3000 each year, drawn from the Washington metropolitan area. Staff scientists of NCSEFSE maintain active research programs, presently in the areas of planetary atmospheric composition, structure, and dynamics, and in solar system formation. NCSEFSE scientists thus are able to act as authentic representatives of frontier scientific research, and ensure accuracy, relevance, and significance in educational products. NCSEFSE instructional designers and educators ensure pedagogic clarity and effectiveness, through a commitment to quantitative assessment.

  9. Green Monopropellant Status at Marshall Space Flight Center

    Science.gov (United States)

    Burnside, Christopher G.; Pierce, Charles W.; Pedersen, Kevin W.

    2016-01-01

    NASA Marshall Space Flight Center is continuing investigations into the use of green monopropellants as a replacement for hydrazine in spacecraft propulsion systems. Work to date has been to push technology development through multiple activities designed to understand the capabilities of these technologies. Future work will begin to transition to mission pull as these technologies are mature while still keeping a solid goal of pushing technology development as opportunities become available. The AF-M315E activities began with hot-fire demonstration testing of a 1N monopropellant thruster in FY 14 and FY15. Following successful completion of the preliminary campaign, changes to the test stand to accommodate propellant conditioning capability and better control of propellant operations was incorporated to make testing more streamlined. The goal is to conduct hot-fire testing with warm and cold propellants using the existing feed system and original thruster design. Following the 1N testing, a NASA owned 100 mN thruster will be hot-fire tested in the same facility to show feasibility of scaling to smaller thrusters for cubesat applications. The end goal is to conduct a hot-fire test of an integrated cubesat propulsion system using an SLM printed propellant tank, an MSFC designed propulsion system electronic controller and the 100 mN thruster. In addition to the AF-M315E testing, MSFC is pursuing hot-fire testing with LMP-103S. Following our successful hot-fire testing of the 22N thruster in April 2015, a test campaign was proposed for a 440N LMP-103S thruster with Orbital ATK and Plasma Processes. This activity was funded through the Space Technology Mission Directorate (STMD) ACO funding call in the last quarter of CY15. Under the same funding source a test activity with Busek and Glenn Research Center for testing of 5N AF-M315E thrusters was proposed and awarded. Both activities are in-work with expected completion of hot-fire testing by the end of FY17. MSFC is

  10. The Central Simulation Committee (CSC): a model for centralization and standardization of simulation-based medical education in the U.S. Army healthcare system.

    Science.gov (United States)

    Deering, Shad; Sawyer, Taylor; Mikita, Jeffrey; Maurer, Douglas; Roth, Bernard J

    2012-07-01

    In this report, we describe the organizational framework, operations and current status of the Central Simulation Committee (CSC). The CSC was established in 2007 with the goals of standardizing simulation-based training in Army graduate medical education programs, assisting in redeployment training of physicians returning from war, and improving patient safety within the Army Medical Department. Presently, the CSC oversees 10 Simulation Centers, controls over 21,000 sq ft of simulation center space, and provides specialty-specific training in 14 medical specialties. In the past 2 years, CSC Simulation Centers have trained over 50,000 Army medical students, residents, physician assistants, nurses, Soldiers and DoD civilian medical personnel. We hope this report provides simulation educators within the military, and our civilian simulation colleagues, with insight into the workings of our organization and provides an example of centralized support and oversight of simulation-based medical education.

  11. "Bacterial infections in visceral leishmaniasis in Children’s Medical Center 1966-2000 "

    Directory of Open Access Journals (Sweden)

    "Tabatabaei P "

    2002-07-01

    Full Text Available Background: Bacterial infections are seen in patients with visceral leishmaniasis. This study was conducted to determine the incidence of such infections and the more common infections agents. Materials and Methods: During the 15-years period in a prospective study from 1986 to 2000, 123 patients with visceral leishmaniasis were studied in the Children Medical Center. Results: From all the cases, 41 (33 percent patients had Also bacterial infections. Respiratory tract, urinary system, Middle ear were the most common sites of infection. Conclusion: When bacterial Infection is suspected in these patients, empiric antibiotic therapy should be started immediately after appropriate diagnostic procedures are taken.

  12. Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.

    Science.gov (United States)

    Katz, Michelle L; Laffel, Lori M; Perrin, James M; Kuhlthau, Karen

    2012-05-01

    To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance. With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D. Seventy-five percent of families of children with T1D reported a major impact compared with 45% of families of children with special health care needs (P families of children without special health care needs (P families of children with T1D, 35% reported restricting work, 38% reported financial impact, 41% reported medical expenses >$1000/year, 24% reported spending ≥11 hours/week caring or coordination care, and 20% reported ≥11 school absences/year. The medical home, care coordination, and family-centered care were associated with less work and financial impact. In childhood T1D, most families experience major impact. Better systems of health care delivery may help families reduce some of this impact. Copyright © 2012 Mosby, Inc. All rights reserved.

  13. Constructing Common Information Space across Distributed Emergency Medical Teams

    DEFF Research Database (Denmark)

    Zhang, Zhan; Sarcevic, Aleksandra; Bossen, Claus

    2017-01-01

    This paper examines coordination and real-time information sharing across four emergency medical teams in a high-risk and distributed setting as they provide care to critically injured patients within the first hour after injury. Through multiple field studies we explored how common understanding...... of critical patient data is established across these heterogeneous teams and what coordination mechanisms are being used to support information sharing and interpretation. To analyze the data, we drew on the concept of Common Information Spaces (CIS). Our results showed that teams faced many challenges...... in achieving efficient information sharing and coordination, including difficulties in locating and assembling team members, communicating and interpreting information from the field, and accommodating differences in team goals and information needs, all while having minimal technology support. We reflect...

  14. A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

    Directory of Open Access Journals (Sweden)

    Rakhee Sodhi

    2016-03-01

    Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

  15. Financial impact of tertiary care in an academic medical center.

    Science.gov (United States)

    Huber, T S; Carlton, L M; O'Hern, D G; Hardt, N S; Keith Ozaki, C; Flynn, T C; Seeger, J M

    2000-06-01

    To analyze the financial impact of three complex vascular surgical procedures to both an academic hospital and a department of surgery and to examine the potential impact of decreased reimbursements. The cost of providing tertiary care has been implicated as one potential cause of the financial difficulties affecting academic medical centers. Patients undergoing revascularization for chronic mesenteric ischemia, elective thoracoabdominal aortic aneurysm repair, and treatment of infected aortic grafts at the University of Florida were compared with those undergoing elective infrarenal aortic reconstruction and carotid endarterectomy. Hospital costs and profit summaries were obtained from the Clinical Resource Management Office. Departmental costs and profit summary were estimated based on the procedural relative value units (RVUs), the average clinical cost per RVU ($33.12), surgeon charges, and the collection rate for the vascular surgery division (30.2%) obtained from the Faculty Group Practice. Surgeon work effort was analyzed using the procedural work RVUs and the estimated total care time. The analyses were performed for all payors and the subset of Medicare patients, and the potential impact of a 15% reduction in hospital and physician reimbursement was analyzed. Net hospital income was positive for all but one of the tertiary care procedures, but net losses were sustained by the hospital for the mesenteric ischemia and infected aortic graft groups among the Medicare patients. In contrast, the estimated reimbursement to the department of surgery for all payors was insufficient to offset the clinical cost of providing the RVUs for all procedures, and the estimated losses were greater for the Medicare patients alone. The surgeon work effort was dramatically higher for the tertiary care procedures, whereas the reimbursement per work effort was lower. A 15% reduction in reimbursement would result in an estimated net loss to the hospital for each of the tertiary

  16. Photo-medical valley. 'Photo medical research center'

    International Nuclear Information System (INIS)

    Kawanishi, Shunichi; Daido, Hiroyuki; Tajima, Toshiki

    2008-01-01

    To develop a much more compact cancer diagnosis and therapeutic instrument using high intensity laser technology, Japan Atomic Energy Agency (JAEA) has successfully proposed this novel effort to the Ministry of Education, Culture, Sports, Science and Technology (MEXT) program as the creation of a 'photo-medical industrial valley' base in 2007 fiscal year. In this report, a new laser techniques to drive controlled ion beams is described. It is very important approach to realize a laser-driven ion accelerator. (author)

  17. Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

    Science.gov (United States)

    Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

    2015-08-01

    The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

  18. Performance test of electron cyclotron resonance ion sources for the Hyogo Ion Beam Medical Center

    Science.gov (United States)

    Sawada, K.; Sawada, J.; Sakata, T.; Uno, K.; Okanishi, K.; Harada, H.; Itano, A.; Higashi, A.; Akagi, T.; Yamada, S.; Noda, K.; Torikoshi, M.; Kitagawa, A.

    2000-02-01

    Two electron cyclotron resonance (ECR) ion sources were manufactured for the accelerator facility at the Hyogo Ion Beam Medical Center. H2+, He2+, and C4+ were chosen as the accelerating ions because they have the highest charge to mass ratio among ion states which satisfy the required intensity and quality. The sources have the same structure as the 10 GHz ECR source at the Heavy Ion Medical Accelerator in Chiba except for a few improvements in the magnetic structure. Their performance was investigated at the Sumitomo Heavy Industries factory before shipment. The maximum intensity was 1500 μA for H2+, 1320 μA for He2+, and 580 μA for C4+ at the end of the ion source beam transport line. These are several times higher than required. Sufficient performance was also observed in the flatness and long-term stability of the pulsed beams. These test results satisfy the requirements for medical use.

  19. Characterizing complexity in socio-technical systems: a case study of a SAMU Medical Regulation Center.

    Science.gov (United States)

    Righi, Angela Weber; Wachs, Priscila; Saurin, Tarcísio Abreu

    2012-01-01

    Complexity theory has been adopted by a number of studies as a benchmark to investigate the performance of socio-technical systems, especially those that are characterized by relevant cognitive work. However, there is little guidance on how to assess, systematically, the extent to which a system is complex. The main objective of this study is to carry out a systematic analysis of a SAMU (Mobile Emergency Medical Service) Medical Regulation Center in Brazil, based on the core characteristics of complex systems presented by previous studies. The assessment was based on direct observations and nine interviews: three of them with regulator of emergencies medical doctor, three with radio operators and three with telephone attendants. The results indicated that, to a great extent, the core characteristics of complexity are magnified) due to basic shortcomings in the design of the work system. Thus, some recommendations are put forward with a view to reducing unnecessary complexity that hinders the performance of the socio-technical system.

  20. The Development of a Virtual Company to Support the Reengineering of the NASA/Goddard Hubble Space Telescope Control Center System

    Science.gov (United States)

    Lehtonen, Ken

    1999-01-01

    This is a report to the Third Annual International Virtual Company Conference, on The Development of a Virtual Company to Support the Reengineering of the NASA/Goddard Hubble Space Telescope (HST) Control Center System. It begins with a HST Science "Commercial": Brief Tour of Our Universe showing various pictures taken from the Hubble Space Telescope. The presentation then reviews the project background and goals. Evolution of the Control Center System ("CCS Inc.") is then reviewed. Topics of Interest to "virtual companies" are reviewed: (1) "How To Choose A Team" (2) "Organizational Model" (3) "The Human Component" (4) "'Virtual Trust' Among Teaming Companies" (5) "Unique Challenges to Working Horizontally" (6) "The Cultural Impact" (7) "Lessons Learned".