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Sample records for thompson launches telehealth

  1. Telehealth

    Science.gov (United States)

    ... role of telehealth in an evolving health care environment. Washington DC: The National Academies Press; 2012. Review ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  2. Telehealth Education in Nursing Curricula.

    Science.gov (United States)

    Ali, Nagia S; Carlton, Kay Hodson; Ali, Omar S

    2015-01-01

    Telehealth care is a fast-growing avenue of providing health care services at a distance. A descriptive study was conducted to identify trends of telehealth education in 43 schools of nursing. Findings reflected inadequate integration of telehealth in classroom content, simulation, and clinical experiences. Interviews with 4 nursing leaders of telehealth provided some recommendations on how to integrate telehealth education in nursing curricula.

  3. Caring in telehealth.

    Science.gov (United States)

    Varghese, Shainy B; Phillips, Carolyn A

    2009-12-01

    The overall goal of this study was to explore and describe the perceptions of advanced practice nurses (APNs) about caring while providing primary care using telehealth technology. This study used naturalistic inquiry methodology to elicit the subjective perceptions and reflections of a sample of APNs about how they convey caring in the context of telehealth. Thirteen APNs, selected by purposive and snowball sampling, participated in the study. The data for the study consisted of interviews conducted by e-mail using a semistructured interview guide. Data analysis used the constant comparison method; rigor and trustworthiness of the study procedures were established using the criteria of credibility, confirmability, dependability, and transferability. The findings of this study revealed that the APNs conveyed caring to their telehealth patients by (1) being with them, (2) personifying the images, and (3) possessing certain attributes. The major constructs that emerged from the data together formed a model of how APNs conveyed caring in telehealth. The findings provide insights and increase the understanding of how caring in telehealth was perceived by APNs. The findings of the study can make important contributions in improving our profession's preparation of future telehealth APNs. The study findings also can lend themselves to developing an instrument to measure caring in telehealth. The study findings also contribute to the nursing literature in a number of ways.

  4. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  5. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  6. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  7. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    .... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

  8. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    .... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

  9. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    .... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

  10. Personalized telehealth in the future

    DEFF Research Database (Denmark)

    Dinesen, B.; Nonnecke, B.; Lindeman, David

    2016-01-01

    of telehealth services and benefits, presents fundamental principles that must be addressed to advance the status quo, and provides a framework for current and future research initiatives within telehealth for personalized care, treatment, and prevention. A broad, multinational research agenda can provide...... research agenda for future telehealth applications within chronic disease management....

  11. Personalized telehealth in the future

    DEFF Research Database (Denmark)

    Dinesen, Birthe Irene; Nonnecke, Brandie; Lindeman, David

    2016-01-01

    As telehealth plays an even greater role in global health care delivery, it will be increasingly important to develop a strong evidence base of successful, innovative telehealth solutions that can lead to scalable and sustainable telehealth programs. This paper has two aims: (1) to describe the c...

  12. Nursing Telehealth Applications Initiative

    Science.gov (United States)

    2011-01-01

    promotion, diagnosis, consultation, education, and/or therapy " (5). Telehealth encompasses videoconferencing, transmission of still images, e-health, remote...one 16 ounce chocolate milkshake at McDonalds has 580 calories and 102 grams of carbohydrate, one Minute Maid apple juice box has 90 calories and

  13. The Ottawa telehealth project.

    Science.gov (United States)

    Cheung, S T; Davies, R F; Smith, K; Marsh, R; Sherrard, H; Keon, W J

    1998-01-01

    To examine the telehealth system as a means of improving access to cardiac consultations and specialized health services in remote areas of Ontario. The University of Ottawa Heart Institute has set up a telehealth test program, Healthcare and Education Access for Remote Residents by Telecommunications (HEARRT), in collaboration with industry and the provincial and federal government, as well as several remote clinical test sites. The program makes off-site cardiology consultations possible. History taking and physical examinations are conducted by video and electronic stethoscope. Laboratory results and echocardiograms are transmitted by document camera and VCR. The technology is being tested in both stable outpatient and emergency situations. Various telecommunications bandwidths and encoding systems are being evaluated, including satellite and terrestrial-based asynchronous transfer-mode circuits. Patient satisfaction and cost-effectiveness are also being assessed. Bandwidths from as low as 384 kbps using H.320 encoders to 40 Mbps using digital transport of NTSC video signals have been evaluated. Although lower bandwidths are sufficient for sending echocardiographic and electrocardiogram data, bandwidths with transport speeds of 4 to 6 Mbps appear necessary to capture the nuances of the cardiac physical examination. A preliminary satisfaction survey of 19 patients noted that all felt that they could communicate effectively with the cardiologist by video, and each had confidence in the advice offered. None reported that he or she would rather have traveled to the doctor in person. Initial and projected examination of the costs suggested that telehealth will effectively reduce overall health care spending while decreasing travel expenses for rural patients. Telehealth technology is sufficiently sophisticated to allow off-site cardiology assessments. Preliminary results suggest there is a sound business case for the implementation of telehealth technology to meet

  14. Still Reading Edward P. Thompson

    Directory of Open Access Journals (Sweden)

    Elena Hernández Sandoica

    2017-05-01

    Full Text Available During the final decades of the 20th century, the reading of the works of E.P. Thompson was a necessary exercise for many historians. The object of these reflections, starting from the changes occurred in historiography, is to assert its force as a historian and to reiterate its status of “classic”.

  15. Making a case for telehealth

    DEFF Research Database (Denmark)

    Ellis, I.; Cheek, C.; Jaffray, L.

    2013-01-01

    Background: Telehealth services are promoted to reduce the cost of travel for people living in rural areas. The previous Australian Government, through the national Digital Economy Strategy, invested heavily in telehealth service development, at the same time introducing a carbon pricing mechanis...

  16. Telehealth coordinators in hospital based telehealth services: Who are they and what do they do?

    Science.gov (United States)

    Edirippulige, Sisira; Armfield, Nigel R; Greenup, Phil; Bryett, Andrew

    2016-12-01

    Many studies have identified the importance of 'telehealth coordinators' for successful telehealth implementation and operation. However, little is known about the telehealth coordinators' functions, the skills and competencies required and the reasons for their influence. This study aimed to examine the key functions of telehealth coordinators in the Queensland public health system, their perceptions about their role, and the level of competencies to support this role. All telehealth coordinators within Queensland Health Telehealth Services were invited to complete a questionnaire. We collected: (i) demographic information; (ii) details of their telehealth work; and (iii) information about knowledge and skills relevant to their telehealth coordinator role. Eighteen of 20 (90%) participants completed and submitted the survey. Telehealth coordinators were responsible for a range of tasks relating to telehealth consultations, technical assistance, administration, research, promotion and marketing. Nearly all telehealth coordinators (n = 17, 94%) were confident in carrying out the tasks of their job. The majority of telehealth coordinators (n = 13, 72%) thought education and training relating to telehealth would help improve their job. The top three topics that telehealth coordinators were keen to learn about were: (i) examples of clinical use of telehealth; (ii) types of technologies used; and (iii) telehealth clinical and business models. Our participants were all hospital-based; as the use of telehealth is growing outside of the traditional hospital settings, the role of telehealth coordinators is likely to change. © The Author(s) 2016.

  17. Telehealth on advanced networks.

    Science.gov (United States)

    Wilson, Laurence S; Stevenson, Duncan R; Cregan, Patrick

    2010-01-01

    We address advanced Internet for complex telehealth applications by reviewing four hospital-based broadband telehealth projects and identifying common threads. These projects were conducted in Australia under a 6-year research project on broadband Internet applications. Each project addressed specific clinical needs and its development was guided by the clinicians involved. Each project was trialed in the field and evaluated against the initial requirements. The four projects covered remote management of a resuscitation team in a district hospital, remote guidance and interpretation of echocardiography, virtual-reality-based instructor-student surgical training, and postoperative outpatient consultations following pediatric surgery. Each was characterized by a high level of interpersonal communication, a high level of clinical expertise, and multiple participants. Each made use of multiple high-quality video and audio links and shared real-time access to clinical data. Four common threads were observed. Each application provided a high level of usability and task focus because the design and use of broadband capability was aimed directly to meet the clinicians' needs. Each used the media quality available over broadband to convey words, gestures, body movements, and facial expressions to support communication and a sense of presence among the participants. Each required a complex information space shared among the participants, including real-time access to stored patient data and real-time interactive access to the patients themselves. Finally, each application supported the social and organizational aspects of their healthcare focus, creating and maintaining relationships between the various participants, and this was done by placing the telehealth application into a wider functioning clinical context. These findings provide evidence for a significantly enhanced role for appropriate telemedicine systems running on advanced networks, in a wider range of clinical

  18. Covering and Reimbursing Telehealth Services.

    Science.gov (United States)

    Blackman, Kate

    2016-01-01

    Policymakers who are striving to achieve better health care, improved health outcomes and lower costs are considering new strategies and technologies. Telehealth is a tool that uses technology to provide health services remotely, and state leaders are looking to it now more than ever as a way to address workforce gaps and reach underserved patients. Among the challenges facing state lawmakers who are working to introduce or expand telehealth is how to handle covering patients and reimbursing providers.

  19. Mixed methods for telehealth research.

    Science.gov (United States)

    Caffery, Liam J; Martin-Khan, Melinda; Wade, Victoria

    2017-10-01

    Mixed methods research is important to health services research because the integrated qualitative and quantitative investigation can give a more comprehensive understanding of complex interventions such as telehealth than can a single-method study. Further, mixed methods research is applicable to translational research and program evaluation. Study designs relevant to telehealth research are described and supported by examples. Quality assessment tools, frameworks to assist in the reporting and review of mixed methods research, and related methodologies are also discussed.

  20. Telehealth and Medicare - Payment Policy, Current Use...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Despite legislative changes from 2001 to 2008 that increased Medicare payment rates for telehealth and decreased regulatory burdens, the study Telehealth and...

  1. Evaluation of the Thompson articular index

    NARCIS (Netherlands)

    van den Brink, H. R.; van der Heide, A.; Jacobs, J. W.; van der Veen, M. J.; Bijlsma, J. W.

    1993-01-01

    Three articular indices for measuring disease activity are compared. In a cross sectional study the Thompson articular index (a modified Lansbury index) correlated better with laboratory variables than the Ritchie articular index or a swollen joint score (Thompson 0.74-0.77; Ritchie 0.57-0.58;

  2. Categorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy.

    Science.gov (United States)

    Varghese, Sunil; Scott, Richard E

    2004-01-01

    Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend.

  3. Attitudes to telehealth use among rural residents

    DEFF Research Database (Denmark)

    Sørensen, Jens Fyhn Lykke

    2008-01-01

    . One prerequisite for successful delivery of health care by means of telehealth is the existence of positive attitudes toward telehealth solutions among the potential end beneficiaries. Purpose: The purpose of this study was to examine the attitudes toward telehealth use among residents in a Danish...... rural area. Method: A representative sample from the island of Ærø (n=1000) was selected and attitudes toward two telehealth applications were examined by structured telephone interviews regarding: 1) video consultation between patient and specialist, and 2) transfer of work tasks from local hospital...

  4. Practical aspects of telehealth: financial considerations.

    Science.gov (United States)

    Loh, P K; Sabesan, S; Allen, D; Caldwell, P; Mozer, R; Komesaroff, P A; Talman, P; Williams, M; Shaheen, N; Grabinski, O; Withnall, D

    2013-07-01

    The second in a series of articles about the practical aspects of telehealth, this paper includes information and a case history on the cost-benefits for patients and practitioners using telehealth. The case history demonstrates that telehealth can save travel time for patients, carers and specialists, and can reduce out-of-pocket expenses. The practical aspects of telehealth article series considers the contextual, clinical, technical and ethical components of online video consultations. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  5. Thompson Test in Achilles Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Spencer Albertson

    2016-07-01

    Full Text Available HPI: A 26-year old male presented to the emergency department after experiencing the acute onset of left ankle pain while playing basketball. Upon jumping, he felt a “pop” in his left posterior ankle, followed by pain and difficulty ambulating. His exam was notable for a defect at the left Achilles tendon on palpation. The practitioner performed a Thompson test, which was positive (abnormal on the left. Significant Findings: The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected calf, the ankle spontaneously plantar flexed, indicating a negative (normal Thompson test. Upon squeeze of the left (affected calf, the ankle did not plantar flex, signifying a positive (abnormal Thompson test. The diagnosis of left Achilles tendon rupture was confirmed intraoperatively one week later. Discussion: The Achilles tendon (also: calcaneal tendon or heel cord is derived from the medial and lateral heads of the gastrocnemius muscle, as well as the soleus muscle. Rupture of the Achilles tendon most commonly occurs in the distal tendon, approximately 2-6 cm from its attachment to the calcaneal tuberosity, in an area of hypovascularity known as the “watershed” or “critical” zone.1-3 The Thompson test (also: Simmonds-Thompson test, described by Simmonds in 1957 and Thompson in 1962, is done while the patient is in the prone position, with feet hanging over the end of a table/gurney, or with the patient kneeling on a stool or chair.4-5 Squeezing the calf of an unaffected limb will cause the ankle to plantar flex, but squeezing the calf of a limb with an Achilles tendon rupture will cause no motion. The sensitivity of the Thompson’s test for the diagnosis of a complete Achilles tendon rupture is 96-100% and the specificity is 93-100%, but data is limited.6-8

  6. Patient Centric Ontology for Telehealth Domain

    DEFF Research Database (Denmark)

    Jørgensen, Daniel Bjerring; Hallenborg, Kasper; Demazeau, Yves

    2015-01-01

    This paper presents an ontology for the telehealth domain, a domain that concerns the use of telecommunication to support and deliver health related services e.g. patient monitoring and rehabilitative training. Our vision for the future of telehealth solutions is that they adapt their behavior to...

  7. Visioning technology for the future of telehealth.

    Science.gov (United States)

    Brennan, David M; Holtz, Bree E; Chumbler, Neale R; Kobb, Rita; Rabinowitz, Terry

    2008-11-01

    By its very nature, telehealth relies on technology. Throughout history, as new technologies emerged and afforded people the ability to send information across distances, it was not long before this capability was applied to the most basic need of all: maintaining health. While much of the early work in telehealth was driven by technology (e.g., making opportunistic use of the systems and devices that were available at the time), recent trends are beginning to push the demand for and the development of new technologies specific to the individual needs of telehealth applications. The future of telehealth will benefit greatly from this technology innovation, in particular, in areas such as home telehealth and remote monitoring, e-health and patient portal applications, personal health records, interactive Internet technologies, and robotics. Telehealth, while not a panacea for all of the challenges facing modern healthcare systems, has a substantial and ever-expanding potential to revolutionize the ways in which people receive medical care while offering the possibility to contain costs, manage chronic diseases, and prevent secondary complications. By demanding innovative solutions and speaking out in support of the field, the telehealth community can and should be leading the charge for greater attention to human factors in technology development, interoperable medical records, staff training and competencies, standards and guidelines, and support for expanded telehealth coverage at the national, state, and local levels.

  8. El discurso intelectual de E. P. Thompson

    Directory of Open Access Journals (Sweden)

    Paulo C. León

    2006-01-01

    Full Text Available El artículo presenta un análisis exploratorio de las estrategias narrativas en el trabajode E. P. Thompson, especialmente en obras como The Making of the English Working Class y Miseria de la teoría. Esto es desarrollado en el marco de una historiografíac

  9. A framework for telehealth program evaluation.

    Science.gov (United States)

    Nepal, Surya; Li, Jane; Jang-Jaccard, Julian; Alem, Leila

    2014-04-01

    Evaluating telehealth programs is a challenging task, yet it is the most sensible first step when embarking on a telehealth study. How can we frame and report on telehealth studies? What are the health services elements to select based on the application needs? What are the appropriate terms to use to refer to such elements? Various frameworks have been proposed in the literature to answer these questions, and each framework is defined by a set of properties covering different aspects of telehealth systems. The most common properties include application, technology, and functionality. With the proliferation of telehealth, it is important not only to understand these properties, but also to define new properties to account for a wider range of context of use and evaluation outcomes. This article presents a comprehensive framework for delivery design, implementation, and evaluation of telehealth services. We first survey existing frameworks proposed in the literature and then present our proposed comprehensive multidimensional framework for telehealth. Six key dimensions of the proposed framework include health domains, health services, delivery technologies, communication infrastructure, environment setting, and socioeconomic analysis. We define a set of example properties for each dimension. We then demonstrate how we have used our framework to evaluate telehealth programs in rural and remote Australia. A few major international studies have been also mapped to demonstrate the feasibility of the framework. The key characteristics of the framework are as follows: (a) loosely coupled and hence easy to use, (b) provides a basis for describing a wide range of telehealth programs, and (c) extensible to future developments and needs.

  10. Transforming home health nursing with telehealth technology.

    Science.gov (United States)

    Farrar, Francisca Cisneros

    2015-06-01

    Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. 42 CFR 410.78 - Telehealth services.

    Science.gov (United States)

    2010-10-01

    ...-based renal dialysis center (including satellites). (vii) A skilled nursing facility (as defined in... as telehealth services. (f) Process for adding or deleting services. Changes to the list of Medicare...

  12. Occupational Therapy Home Safety Intervention via Telehealth

    OpenAIRE

    Lori E. Breeden

    2016-01-01

    Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist.  In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety.  After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions each.  Sessions were recorded and transcribed.  Data were examined using content ...

  13. Paresev in flight with pilot Milt Thompson

    Science.gov (United States)

    1964-01-01

    This movie clip runs 37 seconds in length and begins with a shot from the chase plane of NASA Dryden test pilot Milt Thompson at the controls of the Paresev, then the onboard view from the pilot's seat and finally bringing the Paresev in for a landing on the dry lakebed at Edwards AFB. The Paresev (Paraglider Rescue Vehicle) was an indirect outgrowth of kite-parachute studies by NACA Langley engineer Francis M. Rogallo. In early 1960's the 'Rogallo wing' seemed an excellent means of returning a spacecraft to Earth. The delta wing design was patented by Mr. Rogallo. In May 1961, Robert R. Gilruth, director of the NASA Space Task Group, requested studies of an inflatable Rogallo-type 'Parawing' for spacecraft. Several companies responded; North American Aviation, Downey, California, produced the most acceptable concept and development was contracted to that company. In November 1961 NASA Headquarters launched a paraglider development program, with Langley doing wind tunnel studies and the NASA Flight Research Center supporting the North American test program. The North American concept was a capsule-type vehicle with a stowed 'parawing' that could be deployed and controlled from within for a landing more like an airplane instead of a 'splash down' in the ocean. The logistics became enormous and the price exorbitant, plus NASA pilots and engineers felt some baseline experience like building a vehicle and flying a Parawing should be accomplished first. The Paresev (Paraglider Research Vehicle) was used to gain in-flight experience with four different membranes (wings), and was not used to develop the more complicated inflatable deployment system. The Paresev was designed by Charles Richard, of the Flight Research Center Vehicle and System Dynamics Branch, with the rest of the team being: engineers, Richard Klein, Gary Layton, John Orahood, and Joe Wilson; from the Maintenance and Manufacturing Branch: Frank Fedor, LeRoy Barto; Victor Horton as Project Manager, with

  14. The Interpretive Approach to Religious Education: Challenging Thompson's Interpretation

    Science.gov (United States)

    Jackson, Robert

    2012-01-01

    In a recent book chapter, Matthew Thompson makes some criticisms of my work, including the interpretive approach to religious education and the research and activity of Warwick Religions and Education Research Unit. Against the background of a discussion of religious education in the public sphere, my response challenges Thompson's account,…

  15. A Note on Information-Directed Sampling and Thompson Sampling

    OpenAIRE

    Zhou, Li

    2015-01-01

    This note introduce three Bayesian style Multi-armed bandit algorithms: Information-directed sampling, Thompson Sampling and Generalized Thompson Sampling. The goal is to give an intuitive explanation for these three algorithms and their regret bounds, and provide some derivations that are omitted in the original papers.

  16. The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia

    NARCIS (Netherlands)

    Thorsen, Patricia; Jansen-van der Weide, Martine C; Groenendaal, Floris; Onland, Wes; van Straaten, Henrika L M; Zonnenberg, Inge; Vermeulen, Jeroen R.; Dijk, Peter H; Dudink, Jeroen; Rijken, Monique; van Heijst, Arno; Dijkman, Koen P; Cools, Filip; Zecic, Alexandra; van Kaam, Anton H; de Haan, Timo R

    BACKGROUND: The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson

  17. The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia

    NARCIS (Netherlands)

    Thorsen, Patricia; Jansen-van der Weide, Martine C.; Groenendaal, Floris; Onland, Wes; van Straaten, Henrika L. M.; Zonnenberg, Inge; Vermeulen, Jeroen R.; Dijk, Peter H.; Dudink, Jeroen; Rijken, Monique; van Heijst, Arno; Dijkman, Koen P.; Cools, Filip; Zecic, Alexandra; van Kaam, Anton H.; de Haan, Timo R.

    2016-01-01

    The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson encephalopathy score

  18. Proposal for a telehealth concept in the translational research model.

    Science.gov (United States)

    Silva, Angélica Baptista; Morel, Carlos Médicis; Moraes, Ilara Hämmerli Sozzi de

    2014-04-01

    To review the conceptual relationship between telehealth and translational research. Bibliographical search on telehealth was conducted in the Scopus, Cochrane BVS, LILACS and MEDLINE databases to find experiences of telehealth in conjunction with discussion of translational research in health. The search retrieved eight studies based on analysis of models of the five stages of translational research and the multiple strands of public health policy in the context of telehealth in Brazil. The models were applied to telehealth activities concerning the Network of Human Milk Banks, in the Telemedicine University Network. The translational research cycle of human milk collected, stored and distributed presents several integrated telehealth initiatives, such as video conferencing, and software and portals for synthesizing knowledge, composing elements of an information ecosystem, mediated by information and communication technologies in the health system. Telehealth should be composed of a set of activities in a computer mediated network promoting the translation of knowledge between research and health services.

  19. Occupational Therapy Home Safety Intervention via Telehealth

    Science.gov (United States)

    BREEDEN, LORI E.

    2016-01-01

    Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist. In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety. After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions. Sessions were recorded and transcribed. Data were examined using content analysis. The content analysis identified the following themes: the value of photos to support learning; the value of narrative learning related to home safety education; and abstract versus concrete learners. Procedural findings are included to support future endeavors. Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention. PMID:27563389

  20. Telehealth innovations in health education and training.

    Science.gov (United States)

    Conde, José G; De, Suvranu; Hall, Richard W; Johansen, Edward; Meglan, Dwight; Peng, Grace C Y

    2010-01-01

    Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences.

  1. User Authentication in Smartphones for Telehealth

    Directory of Open Access Journals (Sweden)

    Katherine A. Smith

    2017-11-01

    Full Text Available Many functions previously conducted on desktop computers are now performed on smartphones. Smartphones provide convenience, portability, and connectivity.  When smartphones are used in the conduct of telehealth, sensitive data is invariably accessed, rendering the devices in need of user authentication to ensure data protection. User authentication of smartphones can help mitigate potential Health Insurance Portability and Accountability Act (HIPAA breaches and keep sensitive patient information protected, while also facilitating the convenience of smartphones within everyday life and healthcare. This paper presents and examines several types of authentication methods available to smartphone users to help ensure security of sensitive data from attackers. The applications of these authentication methods in telehealth are discussed.  Keywords: Authentication, Biometrics, HIPAA, Mobile security, Telehealth

  2. User Authentication in Smartphones for Telehealth.

    Science.gov (United States)

    Smith, Katherine A; Zhou, Leming; Watzlaf, Valerie J M

    2017-01-01

    Many functions previously conducted on desktop computers are now performed on smartphones. Smartphones provide convenience, portability, and connectivity. When smartphones are used in the conduct of telehealth, sensitive data is invariably accessed, rendering the devices in need of user authentication to ensure data protection. User authentication of smartphones can help mitigate potential Health Insurance Portability and Accountability Act (HIPAA) breaches and keep sensitive patient information protected, while also facilitating the convenience of smartphones within everyday life and healthcare. This paper presents and examines several types of authentication methods available to smartphone users to help ensure security of sensitive data from attackers. The applications of these authentication methods in telehealth are discussed.

  3. Personalized Telehealth in the Future: A Global Research Agenda.

    Science.gov (United States)

    Dinesen, Birthe; Nonnecke, Brandie; Lindeman, David; Toft, Egon; Kidholm, Kristian; Jethwani, Kamal; Young, Heather M; Spindler, Helle; Oestergaard, Claus Ugilt; Southard, Jeffrey A; Gutierrez, Mario; Anderson, Nick; Albert, Nancy M; Han, Jay J; Nesbitt, Thomas

    2016-03-01

    As telehealth plays an even greater role in global health care delivery, it will be increasingly important to develop a strong evidence base of successful, innovative telehealth solutions that can lead to scalable and sustainable telehealth programs. This paper has two aims: (1) to describe the challenges of promoting telehealth implementation to advance adoption and (2) to present a global research agenda for personalized telehealth within chronic disease management. Using evidence from the United States and the European Union, this paper provides a global overview of the current state of telehealth services and benefits, presents fundamental principles that must be addressed to advance the status quo, and provides a framework for current and future research initiatives within telehealth for personalized care, treatment, and prevention. A broad, multinational research agenda can provide a uniform framework for identifying and rapidly replicating best practices, while concurrently fostering global collaboration in the development and rigorous testing of new and emerging telehealth technologies. In this paper, the members of the Transatlantic Telehealth Research Network offer a 12-point research agenda for future telehealth applications within chronic disease management.

  4. Telehealth ICT Infrastructures in the Nordic Countries

    DEFF Research Database (Denmark)

    Jørgensen, Daniel Bjerring; Hallenborg, Kasper

    2015-01-01

    This paper presents an overview and recommendations of ICT infrastructures and reference architectures for telehealth in the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden). This study shows that so far only Denmark has designed a complete reference architecture, and by the end...

  5. Research Ship T. G. Thompson Underway Meteorological Data, Quality Controlled

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Research Ship T. G. Thompson Underway Meteorological Data (delayed ~10 days for quality control) are from the Shipboard Automated Meteorological and Oceanographic...

  6. The Third National Telemedicine & Telehealth Service Provider Showcase Conference: Advancing Telehealth Partnerships.

    Science.gov (United States)

    Alverson, Dale C; Krupinski, Elizabeth A; Erps, Kristine A; Rowe, Nancy S; Weinstein, Ronald S

    2018-05-31

    As telemedicine and telehealth services are experiencing increasing rates of adoption, industry leaders and healthcare service providers are becoming increasingly focused on human resource issues encountered in the delivery of a broad range of telehealth services. To create a forum for the discussion of many interrelated elements of telehealth service industry, a national conference entitled "Telemedicine & Telehealth Service Provider Showcase" (SPS) Conference was established in 2014, and repeated in 2016 and 2017, in Arizona. These SPS Conferences include thought leaders, telehealth service providers, government administrators, and academicians from leading programs addressing service provider workforce issues. This report summarizes the content of SPS 2017 conference, held in Phoenix, AZ, October 2-3, 2017. The topics covered at SPS 2017 include using telehealth services as a strategic asset; development of appropriate effective partnerships; direct-to-consumer initiatives; important reimbursement, legislative, and regulatory issues (i.e., Centers for Medicare & Medicaid Services [CMS] approaches, financial models, and return on investment [ROI]); marketing; evaluation and applied metrics; remote monitoring and sensors; integration with electronic health records; and overall lessons learned. The content of SPS 2017 is summarized in the body of this report. The SPS 2017 program evaluators included attendees, speakers, and exhibitors. The knowledge attendees gained at SPS 2017 was characterized, by all three groups, as forward-looking and practical. SPS 2017 succeeded in identifying, and focusing on, solutions for issues, challenges, and barriers impacting the rapidly expanding telehealth service segment of the healthcare industry. The growing interest in this annual SPS Conference series apparently reflects, in part, the program committee's successes in identifying practical issues and their potential solutions.

  7. Extent of telehealth use in rural and urban hospitals.

    Science.gov (United States)

    Ward, Marcia M; Ullrich, Fred; Mueller, Keith

    2014-01-01

    Key Findings. Data from 4,727 hospitals in the 2013 HIMSS Analytics database yielded these findings: (1) Two-thirds (66.0% of rural defined as nonmetropolitan and 68.0% of urban) had no telehealth services or were only in the process of implementing a telehealth application. One-third (34.0%rural and 32.0% urban) had at least one telehealth application currently in use. (2) Among hospitals with "live and operational" telehealth services, 61.4% indicated only a single department/program with an operational telehealth service, and 38.6% indicated two or more departments/programs with operational telehealth services. Rural hospitals were significantly less likely to have multiple services (35.2%) than were urban hospitals (42.1%) (3) Hospitals that were more likely to have implemented at least one telehealth service were academic medical centers, not-for-profit institutions, hospitals belonging to integrated delivery systems, and larger institutions (in terms of FTEs but not licensed beds). Rural and urban hospitals did not differ significantly in overall telehealth implementation rates. (4) Urban and rural hospitals did differ in the department where telehealth was implemented. Urban hospitals were more likely than rural hospitals to have operational telehealth implementations in cardiology/stroke/heart attack programs (7.4% vs. 6.2%), neurology (4.4% vs. 2.1%), and obstetrics/gynecology/NICU/pediatrics (3.8% vs. 2.5%). In contrast, rural hospitals were more likely than urban hospital to have operational telehealth implementations in radiology departments (17.7% vs. 13.9%) and in emergency/trauma care (8.8% vs. 6.3%).

  8. A Review of Telehealth Service Implementation Frameworks

    Directory of Open Access Journals (Sweden)

    Liezl Van Dyk

    2014-01-01

    Full Text Available Despite the potential of telehealth services to increase the quality and accessibility of healthcare, the success rate of such services has been disappointing. The purpose of this paper is to find and compare existing frameworks for the implementation of telehealth services that can contribute to the success rate of future endeavors. After a thorough discussion of these frameworks, this paper outlines the development methodologies in terms of theoretical background, methodology and validation. Finally, the common themes and formats are identified for consideration in future implementation. It was confirmed that a holistic implementation approach is needed, which includes technology, organizational structures, change management, economic feasibility, societal impacts, perceptions, user-friendliness, evaluation and evidence, legislation, policy and governance. Furthermore, there is some scope for scientifically rigorous framework development and validation approaches.

  9. Occupational Therapy Home Safety Intervention via Telehealth

    Directory of Open Access Journals (Sweden)

    Lori E. Breeden

    2016-07-01

    Full Text Available Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist.  In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety.  After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions each.  Sessions were recorded and transcribed.  Data were examined using content analysis.  A content analysis identified the following themes as well as an understanding of the learning process.  Analyses yielded themes of: the value of photos to support learning, the value of narrative learning related to home safety education, abstract versus concrete learners.  Procedural findings are included to support future endeavors.  Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention.

  10. Telehealth in the Developing World | CRDI - Centre de recherches ...

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

    Telehealth in the Developing World. Book cover Telehealth in the Developing World. Directeur(s) : Richard Wootton, Nivritti G. Patil, Richard E. Scott, and Kendall Ho. Maison(s) d'édition : Royal Society of Medicine Press, IDRC. 24 février 2009. ISBN : 9781853157844. 324 pages. e-ISBN : 9781552503966. Téléchargez le ...

  11. Telehealth in the Developing World | CRDI - Centre de recherches ...

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

    Telehealth in the Developing World. Couverture du livre Telehealth in the Developing World. Directeur(s) : Richard Wootton, Nivritti G. Patil, Richard E. Scott, et Kendall Ho. Maison(s) d'édition : Royal Society of Medicine Press, CRDI. 24 février 2009. ISBN : 9781853157844. 324 pages. e-ISBN : 9781552503966.

  12. End-to-End Security for Personal Telehealth

    NARCIS (Netherlands)

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

    2011-01-01

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

  13. Competencies required for nursing telehealth activities: A Delphi-study

    NARCIS (Netherlands)

    Dr. H.S.M. Kort; Olle ten Cate; Thijs van Houwelingen; Anna H. Moerman; Roelof G.A. Ettema

    2016-01-01

    Background: Telehealth is viewed as a major strategy to address the increasing demand for care and a shrinking care professional population. However, most nurses are not trained or are insufficiently trained to use these technologies effectively. Therefore, the potential of telehealth fails to reach

  14. Competencies required for nursing telehealth activities: a Delphi-study

    NARCIS (Netherlands)

    van Houwelingen, C.T.M.; Moerman, A.H.; Ettema, R.G.A.; Kort, H.S.M.; ten Cate, O.

    2016-01-01

    Background: Telehealth is viewed as a major strategy to address the increasing demand for care and a shrinking care professional population. However, most nurses are not trained or are insufficiently trained to use these technologies effectively. Therefore, the potential of telehealth fails to reach

  15. Environment for Telehealth Applications on Top of BDI4JADE

    DEFF Research Database (Denmark)

    Jørgensen, Daniel Bjerring; Hallenborg, Kasper; Demazeau, Yves

    2015-01-01

    Patients using telehealth systems have different needs and hence their treatments must differ accordingly. Different compositions of smart home sensors, telehealth devices, and services are used depending on the needs of the individual. This paper presents an open and flexible infrastructure...

  16. Competencies required for nursing telehealth activities: A Delphi-study.

    Science.gov (United States)

    van Houwelingen, Cornelis T M; Moerman, Anna H; Ettema, Roelof G A; Kort, Helianthe S M; Ten Cate, Olle

    2016-04-01

    Telehealth is viewed as a major strategy to address the increasing demand for care and a shrinking care professional population. However, most nurses are not trained or are insufficiently trained to use these technologies effectively. Therefore, the potential of telehealth fails to reach full utilization. A better understanding of nursing telehealth entrustable professional activities (NT-EPAs) and the required competencies can contribute to the development of nursing telehealth education. In a four-round Delphi-study, a panel of experts discussed which NT-EPAs are relevant for nurses and which competencies nurses need to possess to execute these activities effectively. The 51 experts, including nurses, nursing faculty, clients and technicians all familiar with telehealth, were asked to select items from a list of 52 competencies based on the literature and on a previous study. Additionally, the panelists could add competencies based on their experience in practice. The threshold used for consensus was set at 80%. Consensus was achieved on the importance of fourteen NT-EPAs, requiring one or more of the following core competencies; coaching skills, the ability to combine clinical experience with telehealth, communication skills, clinical knowledge, ethical awareness, and a supportive attitude. Each NT-EPA requires a specific set of competencies (at least ten). In total, 52 competencies were identified as essential in telehealth. Many competencies for telehealth, including clinical knowledge and communication skills, are not novel competencies. They are fundamental to nursing care as a whole and therefore are also indispensable for telehealth. Additionally, the fourteen NT-EPAs appeared to require additional subject specific competencies, such as the ability to put patients at ease when they feel insecure about using technology. The NT-EPAs and related competencies presented in this study can be used by nursing schools that are considering including or expanding

  17. The use of telehealth for diabetes management: a qualitative study of telehealth provider perceptions

    Directory of Open Access Journals (Sweden)

    Woodbridge Peter A

    2007-05-01

    Full Text Available Abstract Background Monitoring and Messaging Devices (MMDs are telehealth systems used by patients in their homes, and are designed to promote patient self-management, patient education, and clinical monitoring and follow-up activities. Although these systems have been widely promoted by health care systems, including the Veterans Health Administration, very little information is available on factors that facilitate use of the MMD system, or on barriers to use. Methods We conducted in-depth qualitative interviews with clinicians using MMD-based telehealth programs at two Veterans Affairs Medical Centers in the Midwestern United States. Results Findings suggest that MMD program enrollment is limited by both clinical and non-clinical factors, and that patients have varying levels of program participation and system use. Telehealth providers see MMDs as a useful tool for monitoring patients who are interested in working on management of their disease, but are concerned with technical challenges and the time commitment required to use MMDs. Conclusion Telehealth includes a rapidly evolving and potentially promising range of technologies for meeting the growing number of patients and clinicians who face the challenges of diabetes care, and future research should explore the most effective means of ensuring successful program implementation.

  18. Telehealth: current practices and future directions

    Science.gov (United States)

    David, Yadin B.

    1996-02-01

    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  19. The use of Thompson sampling to increase estimation precision

    NARCIS (Netherlands)

    Kaptein, M.C.

    2015-01-01

    In this article, we consider a sequential sampling scheme for efficient estimation of the difference between the means of two independent treatments when the population variances are unequal across groups. The sampling scheme proposed is based on a solution to bandit problems called Thompson

  20. The relationship between telehealth and information technology ranges from that of uneasy bedfellows to creative partnerships.

    Science.gov (United States)

    Wade, Victoria A; Hamlyn, Jeremy S

    2013-10-01

    The relationship between the clinical and technical aspects of a telehealth operation is frequently problematic, and technically-driven projects often fail to achieve sustainability. Qualitative data from a study of 37 Australian telehealth services were analysed to understand how the relationship between telehealth providers and information technology (IT) departments helps or hinders the development of telehealth. The most frequent difficulties reported were between telehealth services and the internal IT departments of health services, rather than with external vendors. The difficulties included barriers to installing telehealth over IT networks, a lack of priority given to telehealth services, and IT departments insisting on standardised approach. Alternatively, when IT staff were assigned to supporting clinical staff and had a close working relationship with them, they were major enablers of telehealth services. Authorising dedicated IT support and encouraging joint problem solving should provide a strong foundation for a healthy relationship which contributes to the growth and sustainability of telehealth.

  1. An overview of the national telehealth initiative in Malaysia.

    Science.gov (United States)

    Maon, Siti N; Edirippulige, Sisira

    2010-01-01

    Malaysia's national health statistics for the last half century show a remarkable improvement in the nation's health status. One important factor for this improvement is the Malaysian government's proactive intervention in the health sector. Among others, e-health has played a vital role in delivering and managing healthcare services in Malaysia. While the Government has integrated telehealth in its national digital infrastructure re-design, it has heavily invested in telehealth. The enactment of new laws to facilitate telehealth practices can also be noted as an important measure.

  2. Exploring telehealth opportunities in domestic violence shelters.

    Science.gov (United States)

    Mattson, Susan; Shearer, Nelma; Long, Carol

    2002-10-01

    To determine the degree of interest in using a computer for the purpose of accessing services from a nurse practitioner (NP) at domestic violence shelters (DVSs); and to identify issues of privacy and confidentiality that might arise from participation by victims of intimate partner violence (IPV) in a Telehealth intervention. Focus groups with 19 women residing in two DVSs. Interviews were recorded, transcribed and themes were identified that answered the questions posed in the interviews. Most of the women understood the term NP and were favorably inclined to seek services from one. Over half of the women were not familiar with computer use, but were willing to learn in order to receive health care services, both for episodic needs and for maintenance of chronic conditions. After learning of the method proposed to allow them to access an NP through the internet while still protecting their privacy and confidentiality, the women felt comfortable with this approach to meeting their health care needs. Results from this study can be used to support the development and testing of Telehealth interventions for these victims of IPV.

  3. Ethical practice in Telehealth and Telemedicine.

    Science.gov (United States)

    Chaet, Danielle; Clearfield, Ron; Sabin, James E; Skimming, Kathryn

    2017-10-01

    This article summarizes the report of the American Medical Association's (AMA) Council on Ethical and Judicial Affairs (CEJA) on ethical practice in telehealth and telemedicine. Through its reports and recommendations, CEJA is responsible for maintaining and updating the AMA Code of Medical Ethics (Code). CEJA reports are developed through an iterative process of deliberation with input from multiple stakeholders; report recommendations, once adopted by the AMA House of Delegates, become ethics policy of the AMA and are issued as Opinions in the Code. To provide enduring guidance for the medical profession as a whole, CEJA strives to articulate expectations for conduct that are as independent of specific technologies or models of practice as possible. The present report, developed at the request of the House of Delegates, provides broad guidance for ethical conduct relating to key issues in telehealth/telemedicine. The report and recommendations were debated at meetings of the House in June and November 2015; recommendations were adopted in June 2016 and published as Opinion E-1.2.12, Ethical Practice in Telemedicine, in November 2016. A summary of the key points of the recommendations can be found in Appendix A (online), and the full text of the opinion can be found in Appendix B (online).

  4. Diffusion of innovation: Telehealth for care at home.

    Science.gov (United States)

    Levy, Sharon

    2015-01-01

    The 'care at home' study focused on a Scottish telehealth service, which was designed to support children with palliative and complex care needs. Using the diffusion of innovation theory, this poster highlights the differences between the way telehealth is used in the public sector and in a third sector or a voluntary organization. Analysis of the data, taken from interviews with key stakeholders, illuminate barriers and solutions as noted by clinicians who see the clear benefits and potential risks of telehealth use at home. In conclusion, it is argued that a strategic steer towards a culture of innovation is needed to support effective use of telehealth in clinical practice. Senior managers in the National Health Service in the United Kingdom need to 'unleash' the goodwill of staff who are eager to exploit innovation in clinical practice.

  5. Telehealth in the developing world: current status and future prospects

    Directory of Open Access Journals (Sweden)

    Scott RE

    2015-02-01

    Full Text Available Richard E Scott,1,2 Maurice Mars11Department of TeleHealth, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; 2NT Consulting - Global e-Health Inc., Calgary, AB, CanadaAbstract: In a setting of constant change and confusing terminology, telehealth continues to gain ground in both developed and developing countries within the overarching milieu of e-health. Evidence shows telehealth has been used in essentially all countries of the world, but is embedded in few. Uses and needs of telehealth vary between the developed and developing world; the latter struggles with both communicable diseases and noncommunicable diseases, and with very few resources. Common clinical applications include teleconsultation, telecardiology (transmission of ECGs, teleradiology, and teledermatology. Many telehealth projects exist throughout Latin America and the Caribbean, Asia, and Africa, but there is little published evidence and only isolated examples of sustained programs, although several sustained humanitarian networks exist. Application of mobile solutions (m-health is on the rise in many developing countries. Telehealth is still not integrated into existing health care systems globally. Reasons vary: lack of proven large-scale operations, poor evidence base, inadequate implementation, lack of attention to the “soft side” of implementation (readiness, change management, and many others. For the developing world, reasons can be more pragmatic, including limited resources, unreliable power, poor connectivity, and high cost for the poverty stricken – those most in need. Telehealth is poised to improve health and health care in the developing world, driven by both altruistic and profit motives. But to have the desired effect, telehealth must address very specific and evidence-based health “needs” of each facility, region, or country; the shortage of health workers and specialist services; and the required skills upgrading and training

  6. Preparing for success: Readiness models for rural telehealth

    Directory of Open Access Journals (Sweden)

    Jennett P

    2005-01-01

    Full Text Available Background: Readiness is an integral and preliminary step in the successful implementation of telehealth services into existing health systems within rural communities. Methods and Materials: This paper details and critiques published international peer-reviewed studies that have focused on assessing telehealth readiness for rural and remote health. Background specific to readiness and change theories is provided, followed by a critique of identified telehealth readiness models, including a commentary on their readiness assessment tools. Results: Four current readiness models resulted from the search process. The four models varied across settings, such as rural outpatient practices, hospice programs, rural communities, as well as government agencies, national associations, and organizations. All models provided frameworks for readiness tools. Two specifically provided a mechanism by which communities could be categorized by their level of telehealth readiness. Discussion: Common themes across models included: an appreciation of practice context, strong leadership, and a perceived need to improve practice. Broad dissemination of these telehealth readiness models and tools is necessary to promote awareness and assessment of readiness. This will significantly aid organizations to facilitate the implementation of telehealth.

  7. Embryologie précoce de Sacculina carcini Thompson

    NARCIS (Netherlands)

    Bocquet-Védrine, J.

    1964-01-01

    INTRODUCTION Dans sa monographie pourtant très complète de Sacculina carcini Thompson, publiée en 1884, Delage ne traite pas de l'étude embryologique de cette espèce. Il ne se désintéressait pas pour autant de ce sujet sur lequel il exprimait son intention de revenir „plus tard, dans un moment

  8. Yawning, fatigue and cortisol: expanding the Thompson Cortisol Hypothesis.

    OpenAIRE

    Thompson, Simon

    2014-01-01

    Yawning and its involvement in neurological disorders has become the new scientific conundrum. Cortisol levels are known to rise during stress and fatigue; yawning may occur when we are under stress or tired. However, the link between yawning, fatigue, and cortisol has not been fully understood. Expansion of the Thompson Cortisol Hypothesis proposes that the stress hormone, cortisol, is responsible for yawning and fatigue especially in people with incomplete innervation such as multiple sclero...

  9. Telehealth technology: consequences for structure through use.

    Science.gov (United States)

    Cornford, T; Klecun-Dabrowska, E

    2001-01-01

    In recent years the focus of ICTs in healthcare has changed from the â back office' to the front end of patient care. These changes have been brought about by a number of factors including the potential of technologies, pressures for modernisation and administrative reforms, including blurring of the boundaries between different organisations (within and beyond the health sector), and which break down traditional barriers between administration of health services and the practice of medicine In this paper we explore in particular how technology is implicated in such changes, focussing on the consequences of the use of the new telehealth technologies, as seen in a set of linked case studies from an inner city borough in London. The paper addresses the way these technologies, through routine use, become (or not) resources and rules that embody new structures for health care.

  10. Being Spontaneous: The Future of Telehealth Implementation?

    Science.gov (United States)

    Mars, Maurice; Scott, Richard E

    2017-09-01

    The smartphone simplifies interprofessional communication, and smartphone applications can facilitate telemedicine activity. Much has been written about the steps that need to be followed to implement and establish a successful telemedicine service that is integrated into everyday clinical practice. A traditional and systematic approach has evolved incorporating activities such as strategy development, needs assessment, business cases and plans, readiness assessment, implementation plans, change management interventions, and ongoing monitoring and evaluation. This "best practice" has been promoted in the telehealth literature for many years. In contrast, several recent initiatives have arisen without any such formal undertakings. This article describes the strengths and weaknesses of two "spontaneous" telemedicine services in dermatology and burn management that have evolved in South Africa. Two spontaneous services were identified and reviewed. In one unsolicited service, doctors at rural referring hospitals have been taking photographs of skin lesions and sending them with a brief text message history to dermatologists using the instant messaging smartphone app, WhatsApp. In the other, burns service, admissions to the burns unit or the clinic were triaged by telephonic description of the case and completion of a preadmission questionnaire. More recently, management and referral decisions are made only after completion of the questionnaire and subsequent submission of photographs of the burn sent by WhatsApp, with the decision transmitted by text message. Although efficient and effective, potential legal and ethical shortcomings have been identified. These "spontaneous" telehealth services challenge traditional best practice, yet appear to lead to truly integrated practice and, therefore, are successful and warrant further study.

  11. Telehealth and Autism: Treating Challenging Behavior at Lower Cost.

    Science.gov (United States)

    Lindgren, Scott; Wacker, David; Suess, Alyssa; Schieltz, Kelly; Pelzel, Kelly; Kopelman, Todd; Lee, John; Romani, Patrick; Waldron, Debra

    2016-02-01

    To determine whether challenging behavior in young children with autism and other developmental disabilities can be treated successfully at lower cost by using telehealth to train parents to implement applied behavior analysis (ABA). We compared data on the outcomes and costs for implementing evidence-based ABA procedures to reduce problem behavior by using 3 service delivery models: in-home therapy, clinic-based telehealth, and home-based telehealth. Participants were 107 young children diagnosed with autism or other neurodevelopmental disorders, and data analysis focused on the 94 children who completed treatment. All 3 service delivery models demonstrated successful reduction of problem behavior by training parents to conduct functional analysis and functional communication training. The mean percentage reduction in problem behavior was >90% in all 3 groups after treatment, and treatment acceptability based on parent ratings was high for all groups. Total costs for implementing treatment were lowest for home telehealth, but both telehealth models were significantly less costly than in-home therapy. This research demonstrated that parents can use ABA procedures to successfully treat behavior problems associated with autism spectrum disorders regardless of whether treatment is directed by behavior consultants in person or via remote video coaching. Because ABA telehealth can achieve similar outcomes at lower cost compared with in-home therapy, geographic barriers to providing access to ABA for treating problem behavior can be minimized. These findings support the potential for using telehealth to provide research-based behavioral treatment to any family that has access to the Internet. Copyright © 2016 by the American Academy of Pediatrics.

  12. 2014 Mid-Atlantic Telehealth Resource Center Annual Summit

    Directory of Open Access Journals (Sweden)

    Katharine Hsu Wibberly

    2013-12-01

    Full Text Available The Mid-Atlantic Resource Center (MATRC; http://www.matrc.org/ advances the adoption and utilization of telehealth within the MATRC region and works collaboratively with the other federally funded Telehealth Resource Centers to accomplish the same nationally. MATRC offers technical assistance and other resources within the following mid-Atlantic states: Delaware, District of Columbia, Kentucky, Maryland, North Carolina, Pennsylvania, Virginia and West Virginia.   The 2014 MATRC Summit “Adding Value through Sustainable Telehealth” will be held March 30-April 1, 2014, at the Fredericksburg Expo & Conference Center, Fredericksburg, VA. The Summit will explore how telehealth adds value to patients, practitioners, hospitals, health systems, and other facilities. Participants will experience a highly interactive program built around the case history of “Mr. Doe” as he progresses through the primary care, inpatient hospitalization, and post-discharge environments. The Summit will conclude with a session on financial and business models for providing sustainable telehealth services.   For further information and registration, visit: http://matrc.org/component/content/article/2-uncategorised/80-mid-atlantic-telehealth-resource-summit-2014    

  13. Business models for telehealth in the US: analyses and insights

    Directory of Open Access Journals (Sweden)

    Pereira F

    2017-02-01

    Full Text Available Francis Pereira Data Sciences and Operations, Marshall School of Business, University of Southern, Los Angeles, CA, USAAbstract: A growing shortage of medical doctors and nurses, globally, coupled with increasing life expectancy, is generating greater cost pressures on health care, in the US and globally. In this respect, telehealth can help alleviate these pressures, as well as extend medical services to underserved or unserved areas. However, its relatively slow adoption in the US, as well as in other markets, suggests the presence of barriers and challenges. The use of a business model framework helps identify the value proposition of telehealth as well as these challenges, which include identifying the right revenue model, organizational structure, and, perhaps more importantly, the stakeholders in the telehealth ecosystem. Successful and cost-effective deployment of telehealth require a redefinition of the ecosystem and a comprehensive review of all benefits and beneficiaries of such a system; hence a reassessment of all the stakeholders that could benefit from such a system, beyond the traditional patient–health provider–insurer model, and thus “who should pay” for such a system, and the driving efforts of a “keystone” player in developing this initiative would help. Keywords: telehealth, business model framework, stakeholders, ecosystem, VISOR business Model

  14. A MODIFIED GIFFLER AND THOMPSON ALGORITHM COMBINED WITH DYNAMIC SLACK TIME FOR SOLVING DYNAMIC SCHEDULE PROBLEMS

    Directory of Open Access Journals (Sweden)

    Tanti Octavia

    2003-01-01

    Full Text Available A Modified Giffler and Thompson algorithm combined with dynamic slack time is used to allocate machines resources in dynamic nature. It was compared with a Real Time Order Promising (RTP algorithm. The performance of modified Giffler and Thompson and RTP algorithms are measured by mean tardiness. The result shows that modified Giffler and Thompson algorithm combined with dynamic slack time provides significantly better result compared with RTP algorithm in terms of mean tardiness.

  15. Endomorphisms of the Cuntz algebras and the Thompson groups

    DEFF Research Database (Denmark)

    Barlak, Selcuk; Hong, Jeong Hee; Szymanski, Wojciech

    2017-01-01

    We investigate the relationship between endomorphisms of the Cuntz algebra O_2 and endomorphisms of the Thompson groups F, T and V represented inside the unitary group of O_2. For an endomorphism λ_u of O_2, we show that λ_u(V) is contained in V if and only if uεV. If λ_u is an automorphism of O_2...... then uεV is equivalent to the containment of λ_u(F) in V. Our investigations are facilitated by introduction of the concept of modestly scaling endomorphism of O_n, whose properties and examples are investigated....

  16. D'Arcy Thompson and the theory of transformations.

    Science.gov (United States)

    Arthur, Wallace

    2006-05-01

    D'Arcy Thompson was a biologist, a mathematician and a classicist. His writing was great literature as well as great science. He is primarily known for a single book--On Growth and Form--and indeed for a single chapter within it, on his 'theory of transformations', which shows how the differences between the forms of related species can be represented geometrically. This theory cries out for causal explanation, which is something the great man eschewed. Perhaps the time is close when comparative developmental genetics will be able to provide such an explanation.

  17. Towards Patient-Centric Telehealth: a Journey into ICT Infrastructures and User Modeling

    DEFF Research Database (Denmark)

    Jørgensen, Daniel Bjerring

    Problem setting: The problem setting for this thesis is the telehealth domain. Telehealth is addressed from two perspectives: ICT infrastructures and personalized telehealth. ICT infrastructures are addressed on both the local level concerning the systems that are deployed in patients’ homes......, and on the national level concerning the transmission of data in end-to-end infrastructural scenarios. Personalized telehealth concerns the design of telehealth systems that are able to fit the everyday life of their patients. Problem and Research questions: The problem setting was formalized in a principal research...... events in the CASAS datasets. New ideas for research directions have been spawned by the ICT infrastructure: tools to strengthen and supporting telehealth patients’ motivation and identification of patterns, if such exist, indicating correlations between changes to a telehealth patient’s behavioral...

  18. Testing telehealth using technology-enhanced nurse monitoring.

    Science.gov (United States)

    Grant, Leslie A; Rockwood, Todd; Stennes, Leif

    2014-10-01

    Technology-enhanced nurse monitoring is a telehealth solution that helps nurses with assessment, diagnosis, and triage of older adults living in community-based settings. This technology links biometric and nonbiometric sensors to a data management system that is monitored remotely by RNs and unlicensed support staff. Nurses faced a number of challenges related to data interpretation, including making clinical inferences from nonbiometric data, integrating data generated by three different telehealth applications into a clinically meaningful cognitive framework, and figuring out how best to use nursing judgment to make valid inferences from online reporting systems. Nurses developed expertise over the course of the current study. The sponsoring organization achieved a high degree of organizational knowledge about how to use these systems more effectively. Nurses saw tremendous value in the telehealth applications. The challenges, learning curve, and organizational improvements are described. Copyright 2014, SLACK Incorporated.

  19. A product-service system approach to telehealth application design.

    Science.gov (United States)

    Flores-Vaquero, Paul; Tiwari, Ashutosh; Alcock, Jeffrey; Hutabarat, Windo; Turner, Chris

    2016-06-01

    A considerable proportion of current point-of-care devices do not offer a wide enough set of capabilities if they are to function in any telehealth system. There is a need for intermediate devices that lie between healthcare devices and service networks. The development of an application is suggested that allows for a smartphone to take the role of an intermediate device. This research seeks to identify the telehealth service requirements for long-term condition management using a product-service system approach. The use of product-service system has proven to be a suitable methodology for the design and development of telehealth smartphone applications. © The Author(s) 2014.

  20. Quantum electrical and chromodynamics treated through Thompson's approach

    International Nuclear Information System (INIS)

    Nassif, Claudio; Silva, P.R.

    2006-09-01

    In this work we apply Thompson's method (of the dimensions and scales) to study some features of the Quantum Electro and Chromodynamics. This heuristic method can be considered as a simple and alternative way to the Renormalisation Group (R.G.) approach and when applied to QED-Lagrangian is able to obtain in a first approximation both the running coupling constant behavior of α(μ) and the mass m(μ). The calculations are evaluated just at d c = 4, where d c is the upper critical dimension of the problem, so that we obtain the logarithmic behavior both for the coupling α and the excess of mass Δm on the energy scale μ. Although our results are well-known in the vast literature of field theories, the advantage of Thompson's method, beyond its simplicity is that it is able to extract directly from QED-Lagrangian the physical (finite) behavior of α(μ) and m(μ), bypassing hard problems of divergences which normally appear in the conventional renormalisation schemes applied to field theories like QED. Quantum Chromodynamics (QCD) is also treated by the present method in order to obtain the quark condensate value. Besides this, the method is also able to evaluate the vacuum pressure at the boundary of the nucleon. This is done by assuming a step function behavior for the running coupling constant of the QCD, which fits nicely to some quantities related to the strong interaction evaluated through the MIT-bag model. (author)

  1. The Telehealth Satisfaction Scale (TeSS): Reliability, validity, and satisfaction with telehealth in a rural memory clinic population

    Science.gov (United States)

    Morgan, Debra G; Kosteniuk, Julie; Stewart, Norma; O’Connell, Megan E; Karunanyake, Chandima; Beever, Rob

    2015-01-01

    Introduction Patient satisfaction is a key aspect of quality of care and can inform continuous quality improvement. Of the few studies that have reported on patient satisfaction with telehealth in programs aimed at individuals with memory problems, none has reported on the psychometric properties of the user satisfaction scales employed. Methods We evaluated the construct validity and internal consistency reliability of the Telehealth Satisfaction Scale (TeSS), a 10-item scale adapted for use in a Rural and Remote Memory Clinic (RRMC). The RRMC is a one-stop interprofessional clinic for rural and remote seniors with suspected dementia, located in a tertiary care hospital. Telehealth videoconferencing is used for pre-clinic assessment and for follow-up. Patients and caregivers completed the TeSS after each telehealth appointment. With data from 223 patients, exploratory factor analysis was conducted using the principal components analysis extraction method. Results The eigenvalue for the first factor (5.2) was greater than 1 and much larger than the second eigenvalue (.92), supporting a one-factor solution that was confirmed by the scree plot. The total variance explained by factor 1 was 52.1%. Factor loadings (range 0.54 – 0.84) were above recommended cutoffs. The TeSS items demonstrated high internal consistency reliability (Cronbach’s alpha = 0.90). Satisfaction scores on the TeSS items ranged from 3.43 to 3.72 on a 4-point Likert scale, indicating high satisfaction with telehealth. Conclusions The study findings demonstrate high user satisfaction with telehealth in a rural memory clinic, and sound psychometric properties of the TeSS in this population. PMID:25272141

  2. Rural Family Physicians Are Twice as Likely to Use Telehealth as Urban Family Physicians.

    Science.gov (United States)

    Jetty, Anuradha; Moore, Miranda A; Coffman, Megan; Petterson, Stephen; Bazemore, Andrew

    2018-04-01

    Telehealth has the potential to reduce health inequities and improve health outcomes among rural populations through increased access to physicians, specialists, and reduced travel time for patients. Although rural telehealth services have expanded in several specialized areas, little is known about the attitudes, beliefs, and uptake of telehealth use in rural American primary care. This study characterizes the differences between rural and urban family physicians (FPs), their perceptions of telehealth use, and barriers to further adoption. Nationally representative randomly sampled survey of 5,000 FPs. Among the 31.3% of survey recipients who completed the survey, 83% practiced in urban areas and 17% in rural locations. Rural FPs were twice as likely to use telehealth as urban FPs (22% vs. 10%). Logistic regressions showed rural FPs had greater odds of reporting telehealth use to connect their patients to specialists and to care for their patients. Rural FPs were less likely to identify liability concerns as a barrier to using telehealth. Telemedicine allows rural patients to see specialists without leaving their communities and permits rural FPs to take advantage of specialist expertise, expand their scope of practice, and reduce the feeling of isolation experienced by rural physicians. Efforts to raise awareness of current payment policies for telehealth services, addressing the limitations of current reimbursement policies and state regulations, and creating new avenues for telehealth reimbursement and technological investments are critical to increasing primary care physician use of telehealth services.

  3. The Role of School Nursing in Telehealth. Position Statement

    Science.gov (United States)

    Haynie, Kathey M.; Mauter, Elaine; Lindahl, Brenda; Simons-Major, Keisha; Meadows, Lynne; Maughan, Erin D.

    2017-01-01

    It is the position of the National Association of School Nurses (NASN) that utilization of telehealth technology may be a valuable tool to assist registered professional school nurses (herein referred to as a school nurse) to provide school health services. The health of many students is impacted by lack of access to primary care and specialty…

  4. eConsent management and enforcement in personal telehealth

    NARCIS (Netherlands)

    Asim, M.; Koster, R.P.; Petkovic, M.; Rosner, M.; Reimer, H.; Pohlmann, N.; Schneider, W.

    2013-01-01

    Advances in information and communication technologies are expected to bring large benefits in the healthcare domain. Personal telehealth is one such example that has the potential to address some of the important challenges currently faced by healthcare such as improvement in the quality of

  5. World Federation of Occupational Therapists' Position Statement on Telehealth

    Directory of Open Access Journals (Sweden)

    World Federation of Occupational Therapists

    2014-09-01

    Full Text Available The purpose of this document is to state the World Federation of Occupational Therapists’ (WFOT position on the use of telehealth for the delivery of occupational therapy services. Telehealth is the use of information and communication technologies (ICT to deliver health-related services when the provider and client are in different physical locations. Additional terms used to describe this service delivery model include: tele-occupational therapy, telerehabilitation, teletherapy, telecare, telemedicine, and telepractice, among other terms. Telehealth may be used by occupational therapy practitioners for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy.Occupational therapy services via telehealth should be appropriate to the individuals, groups and cultures served,and contextualized to the occupations and interests of clients. Important considerations related to licensure/registration, collaboration with local occupational therapists, client selection, consent to treat, professional liability insurance, confidentiality, personal and cultural attributes, provider competence/standards of care, reimbursement/payer guidelines, and authentic occupational therapy practice are discussed.

  6. Telehealth Business: Boom Times, but Profits May Wait.

    Science.gov (United States)

    Calandra, Robert

    2017-04-01

    What we have here is irrational telehealth exuberance. Investors are plowing millions into startups. And even though millennials could be eager adopters, these are still early days for the industry. It may take years-and some regulatory changes-for profits to materialize.

  7. Thompson Receives 2013 Early Career Hydrologic Science Award: Citation

    Science.gov (United States)

    Katul, Gabriel

    2014-08-01

    Sally Thompson grew up in Perth, where she was trained as an environmental engineer at the University of Western Australia. She graduated with honors in 2003 and worked for a few years as an environmental engineering consultant. Following the award of the Sir John Monash Fellowship in Australia, Sal accepted the admissions offer from the Nicholas School of the Environment at Duke University in 2006, completing her Ph.D. within 4 years and defending her dissertation in 2010. I was most fortunate to have Sal join me at Duke after an enthusiastic recommendation from Siva. Upon her arrival at Duke University, it was immediately clear to all that Sal is a special person with the remarkable skill of being able to identify the main aspects of a problem and throw at them the best that theory, experiment, and modeling tools offer.

  8. Integrating telemedicine and telehealth: putting it all together.

    Science.gov (United States)

    Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

    2008-01-01

    Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care

  9. The organising vision for telehealth and telecare: discourse analysis.

    Science.gov (United States)

    Greenhalgh, Trisha; Procter, Rob; Wherton, Joe; Sugarhood, Paul; Shaw, Sara

    2012-01-01

    To (1) map how different stakeholders understand telehealth and telecare technologies and (2) explore the implications for development and implementation of telehealth and telecare services. Discourse analysis. 68 publications representing diverse perspectives (academic, policy, service, commercial and lay) on telehealth and telecare plus field notes from 10 knowledge-sharing events. Following a familiarisation phase (browsing and informal interviews), we studied a systematic sample of texts in detail. Through repeated close reading, we identified assumptions, metaphors, storylines, scenarios, practices and rhetorical positions. We added successive findings to an emerging picture of the whole. Telehealth and telecare technologies featured prominently in texts on chronic illness and ageing. There was no coherent organising vision. Rather, four conflicting discourses were evident and engaged only minimally with one another's arguments. Modernist discourse presented a futuristic utopian vision in which assistive technologies, implemented at scale, would enable society to meet its moral obligations to older people by creating a safe 'smart' home environment where help was always at hand, while generating efficiency savings. Humanist discourse emphasised the uniqueness and moral worth of the individual and tailoring to personal and family context; it considered that technologies were only sometimes fit for purpose and could create as well as solve problems. Political economy discourse envisaged a techno-economic complex of powerful vested interests driving commodification of healthcare and diversion of public funds into private business. Change management discourse recognised the complicatedness of large-scale technology programmes and emphasised good project management and organisational processes. Introduction of telehealth and telecare is hampered because different stakeholders hold different assumptions, values and world views, 'talk past' each other and compete for

  10. Social acceptance and population confidence in telehealth in Quebec.

    Science.gov (United States)

    Poder, Thomas G; Bellemare, Christian A; Bédard, Suzanne K; Lemieux, Renald

    2015-02-21

    Access to healthcare in remote areas is difficult and telehealth could be a promising avenue if accepted by the population. The aim of this study is to assess social acceptance and population confidence in telehealth in the Province of Quebec. We conducted a survey using a questionnaire assessing the social acceptance of and confidence level in telehealth. Two strategies were used: 1) paper questionnaires were sent to two hospitals in Quebec; and 2) online questionnaires were randomly sent by a firm specialized in online survey to a representative sample of the population of the Province of Quebec. Respondents were all residents of the Province of Quebec and 18 years and older. Questions were scored with a four-level Likert scale. A total of 1816 questionnaires were analyzed (229 written and 1,587 online questionnaires). The socio-demographic variables in our samples, especially the online questionnaires, were fairly representative of Quebec's population. Overall, social acceptance scored at 77.71% and confidence level at 65.76%. Both scores were higher in the case of treatment (3 scenarios were proposed) vs. diagnosis (p < 0.05). No difference was found when respondents were asked to respond for themselves and for a member of their family, which demonstrates a true interest in telehealth in Quebec. In addition, we found a significant difference (p < 0.05) between written and online questionnaires regarding social acceptance (80.75% vs. 77.33%) and confidence level (74.84% vs. 64.55%). These differences may be due to social desirability or avidity bias in the written questionnaires. Our results suggest that the population in Quebec encourages the development of telehealth for real time diagnosis and long distance treatment for regions deprived of healthcare professionals.

  11. A case study detailing key considerations for implementing a telehealth approach to office ergonomics.

    Science.gov (United States)

    Ritchie, Catherine L W; Miller, Linda L; Antle, David M

    2017-01-01

    Telehealth approaches to delivering ergonomics assessment hold great potential to improve service delivery in rural and remote settings. This case study describes a telehealth-based ergonomics service delivery process, and compares in-person and telehealth-based ergonomics approaches at an Alberta-based non-profit advocacy group. This project demonstrates that telehealth approaches to ergonomics do not lead to significantly different scoring outcomes for assessment of ergonomics issues, when compared to in-person assessments. This project also outlines the importance of live real-time video conferencing to improving communication, attaining key assessment information, and demonstrating ergonomic adjustments. However, some key considerations of bandwidth and hardware capabilities need to be taken into account. Key communication strategies are outlined to improve rapport, maintain employee confidentiality, and reduce client anxiety around telehealth ergonomics assessments. This project provides further support for telehealth approaches to office ergonomics, and outlines some key implementation strategies and barriers that should be considered.

  12. The Church as a Bridge to Deliver Health Resources Via Telehealth

    Science.gov (United States)

    2017-10-25

    Obesity; Diet, Food, and Nutrition; Church; Healthcare Disparities; Minority Health; Mobile Health; Telehealth; Community-based Participatory Research; Primary Health Care; Weight Loss Programs; Health Behavior

  13. Use of telehealth for health care of Indigenous peoples with chronic conditions: a systematic review.

    Science.gov (United States)

    Fraser, Sarah; Mackean, Tamara; Grant, Julian; Hunter, Kate; Towers, Kurt; Ivers, Rebecca

    2017-01-01

    Telehealth may be a cost effective modality in healthcare delivery, but how well used or how appropriate it is for the care of Indigenous peoples is unclear. This review examines the evidence for telehealth in facilitating chronic conditions management with Indigenous peoples. Databases were systematically searched for qualitative or quantitative primary research studies that investigated telehealth use for chronic conditions management with Indigenous peoples worldwide. Evidence of effectiveness was by consumer health outcomes, evidence of acceptability was through consumer and user perception, and health service feasibility was evident by service impact. Data were assessed for quality and data extracted using pre-defined tools. Articles (n=32) examined effectiveness (n=11), critiqued telehealth from the perspectives of the client (n=10) and healthcare professionals (n=8), and examined feasibility (n=12). Studies reported Indigenous people tend to be satisfied with telehealth, but are sceptical about its cultural safety. Evidence for the effectiveness of telehealth from a western biomedical perspective was found. Telehealth is promising; however, a lack of robust studies in this review make tangible conclusions difficult. A better overall understanding of telehealth use with Indigenous peoples, including delivery of culturally competent health care, true consultation and cultural competency of the professionals involved, would be helpful. Telehealth may have the potential to improve health care for Indigenous people, however the modality needs to be culturally competent and the care received must be culturally safe.

  14. Telehealth, Mobile Applications, and Wearable Devices are Expanding Cancer Care Beyond Walls.

    Science.gov (United States)

    Cannon, Carol

    2018-05-01

    To review telehealth solutions, mobile applications, and wearable devices that are currently impacting patients, caregivers, and providers who work in the oncology setting. A literature search was conducted using the terms (Telehealth, Mobile Health, mHealth, Wearable Devices) + (Oncology, Cancer Care). There are many current applications of telehealth and mobile health in the oncology setting. Nurses who care for patients with cancer should be aware of the pervasiveness and impact of telehealth and mobile health to this unique population. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Extending Agent Based Telehealth Platform with Activities of Daily Living Reasoning Capabilities

    DEFF Research Database (Denmark)

    Jørgensen, Daniel Bjerring; Hallenborg, Kasper; Demazeau, Yves

    2016-01-01

    it will influence his or her everyday live. Therefore we believe that a telehealth system shall adapt its behavior so that it will not be a burden for the patient/resident to use. To this aim we have extended an existing telehealth platform to reason about activities of daily living in a smart home scenario......In the future patients will have a more active role in strengthening and maintaining their own health. Telehealth can empower and motivate patients by giving them the chance to stay in their own homes instead of going to the hospital. A telehealth system is deployed in a patient’s home hence...

  16. The Malaysian Telehealth Flagship Application: a national approach to health data protection and utilisation and consumer rights.

    Science.gov (United States)

    Mohan, Jai; Razali Raja Yaacob, Raja

    2004-03-31

    Telehealth refers to the integration of information, telecommunication, human-machine interface technologies and health technologies to deliver health care, to promote the heath status of the people and to create health. The Malaysian Telehealth Application will, on completion, provide every resident of the country an electronic Lifetime Health Record (LHR) and Lifetime Health Plan (LHP). He or she will also hold a smart card that will contain a subset of the data in the Lifetime Health Record. These will be the means by which Malaysians will receive "seamless continuous quality care" across a range of health facilities and health care providers, and by which Malaysia's health goal of a nation of "healthy individuals, families and communities" is achieved. The challenges to security and privacy in providing access to an electronic Lifetime Health Record at private and government health facilities and to the electronic Lifetime Health Plan at homes of consumers require not only technical mechanisms but also national policies and practices addressing threats while facilitating access to health data during health encounters in different care settings. Organisational policies establish the goals that technical mechanisms serve. They should outline appropriate uses and access to information, create mechanisms for preventing and detecting violations, and set sanctions for violations. Some interesting innovations have been used to address these issues against the background of the launching of the multimedia supercorridor (MSC) in Malaysia.

  17. Benjamin Thompson, Count Rumford Count Rumford on the nature of heat

    CERN Document Server

    Brown, Sanborn C

    1967-01-01

    Men of Physics: Benjamin Thompson - Count Rumford: Count Rumford on the Nature of Heat covers the significant contributions of Count Rumford in the fields of physics. Count Rumford was born with the name Benjamin Thompson on March 23, 1753, in Woburn, Massachusetts. This book is composed of two parts encompassing 11 chapters, and begins with a presentation of Benjamin Thompson's biography and his interest in physics, particularly as an advocate of an """"anti-caloric"""" theory of heat. The subsequent chapters are devoted to his many discoveries that profoundly affected the physical thought

  18. Final 2014 Remedial Action Report Project Chariot, Cape Thompson, Alaska

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2015-03-01

    This report was prepared to document remedial action (RA) work performed at the former Project Chariot site located near Cape Thompson, Alaska during 2014. The work was managed by the U.S. Army Corps of Engineers (USACE) Alaska District for the U.S. Department of Energy (DOE) Office of Legacy Management (LM). Due to the short field season and the tight barge schedule, all field work was conducted at the site July 6 through September 12, 2014. Excavation activities occurred between July 16 and August 26, 2014. A temporary field camp was constructed at the site prior to excavation activities to accommodate the workers at the remote, uninhabited location. A total of 785.6 tons of petroleum, oil, and lubricants (POL)-contaminated soil was excavated from four former drill sites associated with test holes installed circa 1960. Diesel was used in the drilling process during test hole installations and resulted in impacts to surface and subsurface soils at four of the five sites (no contamination was identified at Test Hole Able). Historic information is not definitive as to the usage for Test Hole X-1; it may have actually been a dump site and not a drill site. In addition to the contaminated soil, the steel test hole casings were decommissioned and associated debris was removed as part of the remedial effort.

  19. Thompson e Gramsci: história, política e processos de formação Thompson and Gramsci: history, politics and educational processes

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Vieira

    2010-06-01

    Full Text Available Pretende-se apresentar e explorar as conexões entre as ideias de dois destacados pensadores sociais do século xx, o italiano Antonio Gramsci e o inglês Edward Thompson. O intuito é refletir sobre a centralidade conferida pelas obras desses intelectuais à política, à cultura e à formação humana. Considerando que uma das fontes do pensamento historiográfico de Thompson é a obra de Gramsci, pretendemos dimensionar os pontos de contato entre as duas obras com o fim de pensar nas possibilidades heurísticas que este diálogo poderá ensejar no campo educacional. Concluímos demonstrando que as reflexões de Thompson e de Gramsci convergem em três aspectos principais: a ênfase na história das classes subalternas, a opção pela abordagem historicista do conhecimento e a problematização das concepções de cultura e de formação.This paper investigates the connections between the ideas of two prominent twentieth century's social thinkers, the Italian Antonio Gramsci and the English Edward Thompson. It sets a discussion on the importance these intellectuals granted to politics, culture and human education to highlight similar aspects in both works yet considering that one of the main sources of Thompson's historiographic thought is Gramsci's work. It then reflects on the heuristic possibilities this dialogue may bring to the field of education. It concludes that Gramsci and Thompson's reflections converge on three main aspects: the emphasis on working class history, the option for a historical approach of knowledge and the discussion on the conceptions of culture and education.

  20. Tablet PC Enabled Body Sensor System for Rural Telehealth Applications

    Directory of Open Access Journals (Sweden)

    Nitha V. Panicker

    2016-01-01

    Full Text Available Telehealth systems benefit from the rapid growth of mobile communication technology for measuring physiological signals. Development and validation of a tablet PC enabled noninvasive body sensor system for rural telehealth application are discussed in this paper. This system includes real time continuous collection of physiological parameters (blood pressure, pulse rate, and temperature and fall detection of a patient with the help of a body sensor unit and wireless transmission of the acquired information to a tablet PC handled by the medical staff in a Primary Health Center (PHC. Abnormal conditions are automatically identified and alert messages are given to the medical officer in real time. Clinical validation is performed in a real environment and found to be successful. Bland-Altman analysis is carried out to validate the wrist blood pressure sensor used. The system works well for all measurements.

  1. Exploring challenges to telehealth communication by specialists in poison information.

    Science.gov (United States)

    Rothwell, Erin; Ellington, Lee; Planalp, Sally; Crouch, Barbara

    2012-01-01

    The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty managing caller misunderstandings, maintaining distinctive assessments for routine calls, and managing the multifaceted aspects of job stress. The desire for training to enhance telehealth and cultural competency skills was also mentioned, and these findings might provide guidance for the development of training opportunities for telehealth professionals.

  2. Success factors for telehealth--a case study.

    Science.gov (United States)

    Moehr, J R; Schaafsma, J; Anglin, C; Pantazi, S V; Grimm, N A; Anglin, S

    2006-01-01

    To present the lessons learned from an evaluation of a comprehensive telehealth project regarding success factors and evaluation methodology for such projects. A recent experience with the evaluation of new telehealth services in BC, Canada, is summarized. Two domains of clinical applications, as well as educational and administrative uses, and the project environment were evaluated. In order to contribute to the success of the project, the evaluation included formative and summative approaches employing qualitative and quantitative methods with data collection from telehealth events, participants and existing databases. The evaluation had to be carried out under severe budgetary and time constraints. We therefore deliberately chose a broad ranging exploratory approach within a framework provided, and generated questions to be answered on the basis of initial observations and participant driven interviews with progressively more focused and detailed data gathering, including perusal of a variety of existing data sources. A unique feature was an economic evaluation using static simulation models. The evaluation yielded rich and detailed data, which were able to explain a number of unanticipated findings. One clinical application domain was cancelled after 6 months, the other continues. The factors contributing to success include: Focus on chronic conditions which require visual information for proper management. Involvement of established teams in regular scheduled visits or in sessions scheduled well in advance. Problems arose with: Ad hoc applications, in particular under emergency conditions. Applications that disregard established referral patterns. Applications that support only part of a unit's services. The latter leads to the service mismatch dilemma (SMMD) with the end result that even those e-health services provided are not used. The problems encountered were compounded by issues arising from the manner in which the telehealth services had been introduced

  3. WATER TEMPERATURE and Other Data from THOMAS G. THOMPSON from 19920323 to 19921020 (NODC Accession 9700194)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Oxygen production, abundance of marine snow, and other data were collected from bottle and video camera casts in the Pacific Ocean from the THOMAS G. THOMPSON from...

  4. The Golden-Thompson inequality: Historical aspects and random matrix applications

    International Nuclear Information System (INIS)

    Forrester, Peter J.; Thompson, Colin J.

    2014-01-01

    The Golden-Thompson inequality, Tr (e A+B ) ⩽ Tr (e A e B ) for A, B Hermitian matrices, appeared in independent works by Golden and Thompson published in 1965. Both of these were motivated by considerations in statistical mechanics. In recent years the Golden-Thompson inequality has found applications to random matrix theory. In this article, we detail some historical aspects relating to Thompson's work, giving in particular a hitherto unpublished proof due to Dyson, and correspondence with Pólya. We show too how the 2 × 2 case relates to hyperbolic geometry, and how the original inequality holds true with the trace operation replaced by any unitarily invariant norm. In relation to the random matrix applications, we review its use in the derivation of concentration type lemmas for sums of random matrices due to Ahlswede-Winter, and Oliveira, generalizing various classical results

  5. Electrocardiogram signal quality measures for unsupervised telehealth environments

    International Nuclear Information System (INIS)

    Redmond, S J; Xie, Y; Chang, D; Lovell, N H; Basilakis, J

    2012-01-01

    The use of telehealth paradigms for the remote management of patients suffering from chronic conditions has become more commonplace with the advancement of Internet connectivity and enterprise software systems. To facilitate clinicians in managing large numbers of telehealth patients, and in digesting the vast array of data returned from the remote monitoring environment, decision support systems in various guises are often utilized. The success of decision support systems in interpreting patient conditions from physiological data is dependent largely on the quality of these recorded data. This paper outlines an algorithm to determine the quality of single-lead electrocardiogram (ECG) recordings obtained from telehealth patients. Three hundred short ECG recordings were manually annotated to identify movement artifact, QRS locations and signal quality (discrete quality levels) by a panel of three experts, who then reconciled the annotation as a group to resolve any discrepancies. After applying a published algorithm to remove gross movement artifact, the proposed method was then applied to estimate the remaining ECG signal quality, using a Parzen window supervised statistical classifier model. The three-class classifier model, using a number of time-domain features and evaluated using cross validation, gave an accuracy in classifying signal quality of 78.7% (κ = 0.67) when using fully automated preprocessing algorithms to remove gross motion artifact and detect QRS locations. This is a similar level of accuracy to the reported human inter-scorer agreement when generating the gold standard annotation (accuracy = 70–89.3%, κ = 0.54–0.84). These results indicate that the assessment of the quality of single-lead ECG recordings, acquired in unsupervised telehealth environments, is entirely feasible and may help to promote the acceptance and utility of future decision support systems for remotely managing chronic disease conditions. (paper)

  6. Health care on demand: four telehealth priorities for 2016.

    Science.gov (United States)

    Grube, Mark E; Kaufman, Kenneth; Clarin, Dan; O'Riordan, Jason

    2016-01-01

    Consumers who are accustomed to on-demand, virtual services are looking for more convenient ways to access health care. Giving patients the opportunity to connect with physicians remotely can promote higher patient satisfaction and engagement. Telehealth options may have a high start-up cost, but that cost is likely well-justified by the potential to enhance quality, outcomes, and customer attraction and satisfaction/retention over the long-term.

  7. Telehealth Stroke Dysphagia Evaluation Is Safe and Effective.

    Science.gov (United States)

    Morrell, Kate; Hyers, Megan; Stuchiner, Tamela; Lucas, Lindsay; Schwartz, Karissa; Mako, Jenniffer; Spinelli, Kateri J; Yanase, Lisa

    2017-01-01

    Rapid evaluation of dysphagia poststroke significantly lowers rates of aspiration pneumonia. Logistical barriers often significantly delay in-person dysphagia evaluation by speech language pathologists (SLPs) in remote and rural hospitals. Clinical swallow evaluations delivered via telehealth have been validated in a number of clinical contexts, yet no one has specifically validated a teleswallow evaluation for in-hospital post-stroke dysphagia assessment. A team of 6 SLPs experienced in stroke care and a telestroke neurologist designed, implemented, and tested a teleswallow evaluation for acute stroke patients, in which 100 patients across 2 affiliated, urban certified stroke centers were sequentially evaluated by a bedside and telehealth SLP. Inter-rater reliability was analyzed using percent agreement, Cohen's kappa, Kendall's tau-b, and Wilcoxon matched-pairs signed rank tests. Logistic regression models accounting for age and gender were used to test the impact of stroke severity and stroke location on agreement. We found excellent agreement for both liquid (91% agreement; kappa = 0.808; Kendall's tau-b = 0.813, p Dysphagia evaluation by a remote SLP via telehealth is safe and effective following stroke. We plan to implement teleswallow across our multistate telestroke network as standard practice for poststroke dysphagia evaluation. © 2017 S. Karger AG, Basel.

  8. Leveraging Telehealth to Bring Volunteer Physicians Into Underserved Communities.

    Science.gov (United States)

    Uscher-Pines, Lori; Rudin, Robert; Mehrotra, Ateev

    2017-06-01

    Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute. Given the projected shortfall of physicians in the United States, recruiting retired and semiretired physicians to provide care through telehealth increases the total supply of active physicians and the capacity of the existing workforce. However, programs typically use volunteers in a limited capacity because of uncertainty about the level and duration of commitment. Acknowledging this reality, most programs only use volunteer physicians for curbside consults rather than fully integrating them into longitudinal patient care. The part-time availability of volunteers may also be difficult to incorporate into the workflow of busy safety net clinics. As more physicians volunteer in a growing number of telehealth programs, the dual benefits of enriching the professional lives of volunteers and improving care for underserved communities will make further development of these programs worthwhile.

  9. Telehealth application on the rehabilitation of children and adolescents

    Directory of Open Access Journals (Sweden)

    Maria Tereza N. dos Santos

    2014-03-01

    Full Text Available Objective: To systematically review the literature on the telehealth initiatives in telerehabilitation practices in children and adolescents from zero to 18 years old. Data sources: Randomized and controlled clinical trials published in the past ten years (January 2002 to February 2012 in Medline/PubMed, Medline/BVS, PEDro and Cochrane Library databases. The descriptors "telemedicine", "rehabilitation" and "telehealth" were used in three different languages (English, Portuguese and Spanish. Data synthesis: From the 20 studies found in the literature, nine were included in this review. Most of the studies showed that telerehabilitation is able to produce better results in the treatment when compared to the traditional methods, providing less frequency of symptoms, better disease control, better quality of life and greater adherence to treatment. Conclusions: Telerehabilitation is a viable and effective strategy in the treatment of common diseases in children and adolescents. However, there are few studies on the subject in this age group. Although telehealth is already consolidated worldwide, there are no studies in Brazil that used the telerehabilitation in children and adolescents, which reinforces the need for more research and investments.

  10. Pediatric Obesity Management in Rural Clinics in California and the Role of Telehealth in Distance Education

    Science.gov (United States)

    Shaikh, Ulfat; Nettiksimmons, Jasmine; Romano, Patrick

    2011-01-01

    Objective: To determine health care provider needs related to pediatric obesity management in rural California and to explore strategies to improve care through telehealth. Methods: Cross-sectional survey of health care providers who treated children and adolescents at 41 rural clinics with existing telehealth connectivity. Results: Most of the…

  11. Increasing Access to an ASD Imitation Intervention via a Telehealth Parent Training Program

    Science.gov (United States)

    Wainer, Allison L.; Ingersoll, Brooke R.

    2015-01-01

    Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…

  12. Technology support to a telehealth in the home service: Qualitative observations.

    Science.gov (United States)

    Taylor, Alan; Wade, Victoria; Morris, Greg; Pech, Joanne; Rechter, Stuart; Kidd, Michael; Carati, Colin

    2016-07-01

    The Flinders University Telehealth in the Home (FTH) trial was an action research initiative that introduced and evaluated the impact of telehealth services on palliative care patients living in the community, home-based rehabilitation services for the elderly, and services to the elderly in residential aged care. The aim of this study was to understand the issues encountered during the provision of technology services that supported this trial. A mixed methods approach was undertaken to analyse the roles of information and communication technology (ICT) and clinical staff in design, technology management and training. The data sources were staff observations and documents including job logs, meetings, emails and technology descriptions. Use of consumer technology for telehealth required customisation of applications and services. Clinicians played a key role in definition of applications and the embedding of workflow into applications. Usability of applications was key to their subsequent use. Management of design creep and technology services, coupled with support and training for clinicians were important to maintenance of a telehealth service. In the setting described, an iterative approach to the development of telehealth services to the home using consumer technologies was needed. The efficient management of consumer devices in multiple settings will become critical as telehealth services grow in scale. Effective collaboration between clinical and technical stakeholders and further workforce education in telehealth can be key enablers for the transition of face-to-face care to a telehealth mode of delivery. © The Author(s) 2015.

  13. An evaluation of telehealth websites for design, literacy, information and content.

    Science.gov (United States)

    Whitten, Pamela; Holtz, Bree; Cornacchione, Jennifer; Wirth, Christina

    2011-01-01

    We examined 62 telehealth websites using four assessment criteria: design, literacy, information and telehealth content. The websites came from the member list of the American Telemedicine Association and the Office for the Advancement of Telehealth and partner sites, and were included if they were currently active and at least three clicks deep. Approximately 130 variables were examined for each website by two independent researchers. The websites reviewed contained most of the design variables (mean 74%, SD 6), but fewer of those relating to literacy (mean 26%, SD 6), website information (mean 35%, SD 16) and telehealth content (mean 37%, SD 18). Only 29% of websites encouraged users to ask about telehealth, and 19% contained information on overcoming telehealth barriers. Nonetheless, 84% promoted awareness of telehealth. All evaluation assessments were significantly correlated with each other except for literacy and information. The present study identified various matters that should be addressed when developing telehealth websites. Although much of this represents simple common sense in website design, our evaluation demonstrates that there is still much room for improvement.

  14. 78 FR 53506 - Proposed Information Collection (Care Coordination Home Telehealth (CCHT) Patient Satisfaction...

    Science.gov (United States)

    2013-08-29

    ... Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481); Activity: Comment Request... required to obtain patient perspective on satisfaction with the CCHT program and messaging devices. DATES.... Titles: Care Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481. OMB...

  15. 78 FR 76193 - Agency Information Collection (Care Coordination Home Telehealth (CCHT) Patient Satisfaction...

    Science.gov (United States)

    2013-12-16

    ... Coordination Home Telehealth (CCHT) Patient Satisfaction Survey) Activities Under OMB Review AGENCY: Veterans... patient perspective on satisfaction with the CCHT program and messaging devices. DATES: Comments must be...: Care Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481. Type of Review...

  16. For telehealth to succeed, privacy and security risks must be identified and addressed.

    Science.gov (United States)

    Hall, Joseph L; McGraw, Deven

    2014-02-01

    The success of telehealth could be undermined if serious privacy and security risks are not addressed. For example, sensors that are located in a patient's home or that interface with the patient's body to detect safety issues or medical emergencies may inadvertently transmit sensitive information about household activities. Similarly, routine data transmissions from an app or medical device, such as an insulin pump, may be shared with third-party advertisers. Without adequate security and privacy protections for underlying telehealth data and systems, providers and patients will lack trust in the use of telehealth solutions. Although some federal and state guidelines for telehealth security and privacy have been established, many gaps remain. No federal agency currently has authority to enact privacy and security requirements to cover the telehealth ecosystem. This article examines privacy risks and security threats to telehealth applications and summarizes the extent to which technical controls and federal law adequately address these risks. We argue for a comprehensive federal regulatory framework for telehealth, developed and enforced by a single federal entity, the Federal Trade Commission, to bolster trust and fully realize the benefits of telehealth.

  17. Interpersonal Communication in Behavioral Telehealth: What Can We Learn from Other Fields?

    Science.gov (United States)

    Collie, Katharine R.

    In this paper, research about mediated communication is used to shed light on questions that have arisen in relation to behavioral telehealth about the relative merits of different modes of distance communication for the transaction of behavioral telehealth services. The paper is in two parts. The first part contains a presentation of questions…

  18. Audit of primary care electrocardiograms sent as emergency to a telehealth service - the Telehealth Network of Minas Gerais, Brazil.

    Science.gov (United States)

    Marcolino, Milena S; Carvalho, Bárbara C; Lucena, Aline M; França, Ana Luiza N; Pessoa, Cristiane G; Neves, Daniel S; Alkmim, Maria Beatriz M

    2015-01-01

    The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that has performed electrocardiogram (ECG) analysis since 2005. From February to March 2014, 28% of ECGs were classified as "emergency" by the primary care tele-health sites. This quasi-experimental study aimed to investigate the reasons behind the high number of emergency ECGs being sent in, the implementation of corrective actions, and an assessment of the impact of these actions. In the 1st phase, primary care units that sent >70% of ECGs as emergency from February to March 2014 were selected. The 2nd phase consisted of the intervention. In the 3rd phase, the proportion of ECGs sent as an emergency during the 1st and 2nd months post intervention were assessed. Of the 63 cities selected during the 1st phase, 50% of the practitioners did not know the proper definition of emergency. After the intervention, 67% of the cities had a significant reduction in the proportion of ECGs sent as an emergency during the 1st month, and 17% had a significant reduction during the 2nd month.

  19. Telehealth: seven strategies to successfully implement disruptive technology and transform health care.

    Science.gov (United States)

    Schwamm, Lee H

    2014-02-01

    "Telehealth" refers to the use of electronic services to support a broad range of remote services, such as patient care, education, and monitoring. Telehealth must be integrated into traditional ambulatory and hospital-based practices if it is to achieve its full potential, including addressing the six domains of care quality defined by the Institute of Medicine: safe, effective, patient-centered, timely, efficient, and equitable. Telehealth is a disruptive technology that appears to threaten traditional health care delivery but has the potential to reform and transform the industry by reducing costs and increasing quality and patient satisfaction. This article outlines seven strategies critical to successful telehealth implementation: understanding patients' and providers' expectations, untethering telehealth from traditional revenue expectations, deconstructing the traditional health care encounter, being open to discovery, being mindful of the importance of space, redesigning care to improve value in health care, and being bold and visionary.

  20. The Process for the Formulation of the International Telehealth Position Statement for Occupational Therapy

    Science.gov (United States)

    JACOBS, KAREN; CASON, JANA; MCCULLOUGH, ANN

    2015-01-01

    The World Federation of Occupational Therapists (WFOT) consists of 84 member organizations representing over 420,000 occupational therapists internationally (WFOT, 2014). In 2014, WFOT published the WFOT Telehealth Position Statement on the use of telehealth in occupational therapy. The process for the formulation of the official document involved reviewing WFOT member organizations’ telehealth position statements and data collected from a survey sent to member organizations’ delegates in April 2014. Qualitative data from 39 countries yielded factors to consider in five key areas: licensure/registration requirements, the cost of technology, privacy and security, reimbursement/payment models, and other issues (e.g., need for collaboration/transfer of knowledge, client selection, provider competencies, standard of care). The WFOT Telehealth Position Statement addressed each of these areas. The collaborative effort resulting in the development of the WFOT Telehealth Position Statement serves as a model for other international organizations. PMID:27563380

  1. Use of telehealth to treat and manage chronic viral hepatitis in regional Queensland.

    Science.gov (United States)

    Keogh, Kandice; Clark, Paul; Valery, Patricia C; McPhail, Steven M; Bradshaw, Candise; Day, Melany; Smith, Anthony C

    2016-12-01

    For regional and rural Queenslanders, chronic viral hepatitis treatment is a major unmet health need, with restricted access to specialists outside of tertiary, largely metropolitan hospitals. To increase treatment of chronic viral hepatitis in regional Queensland, a team-based telehealth model was expanded. This expansion embedded an initial nursing consultation prior to specialist telehealth consultation. We conducted a retrospective audit of the introduction and expansion of hepatology telehealth services. Activity from July 2014-June 2015 (pre-expansion) was compared with July 2015- June 2016 (post-expansion). Interviews were conducted with key staff to determine factors contributing to success of the service and identify ongoing challenges to the service model. A greater than four-fold increase in clinical consultation was observed (131 telehealth consultations pre-expansion vs 572 post-expansion; p Queensland. It may serve as a model to further expand telehealth management of chronic disease for regional Queenslanders. © The Author(s) 2016.

  2. Optimal control of information epidemics modeled as Maki Thompson rumors

    Science.gov (United States)

    Kandhway, Kundan; Kuri, Joy

    2014-12-01

    We model the spread of information in a homogeneously mixed population using the Maki Thompson rumor model. We formulate an optimal control problem, from the perspective of single campaigner, to maximize the spread of information when the campaign budget is fixed. Control signals, such as advertising in the mass media, attempt to convert ignorants and stiflers into spreaders. We show the existence of a solution to the optimal control problem when the campaigning incurs non-linear costs under the isoperimetric budget constraint. The solution employs Pontryagin's Minimum Principle and a modified version of forward backward sweep technique for numerical computation to accommodate the isoperimetric budget constraint. The techniques developed in this paper are general and can be applied to similar optimal control problems in other areas. We have allowed the spreading rate of the information epidemic to vary over the campaign duration to model practical situations when the interest level of the population in the subject of the campaign changes with time. The shape of the optimal control signal is studied for different model parameters and spreading rate profiles. We have also studied the variation of the optimal campaigning costs with respect to various model parameters. Results indicate that, for some model parameters, significant improvements can be achieved by the optimal strategy compared to the static control strategy. The static strategy respects the same budget constraint as the optimal strategy and has a constant value throughout the campaign horizon. This work finds application in election and social awareness campaigns, product advertising, movie promotion and crowdfunding campaigns.

  3. The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia.

    Science.gov (United States)

    Thorsen, Patricia; Jansen-van der Weide, Martine C; Groenendaal, Floris; Onland, Wes; van Straaten, Henrika L M; Zonnenberg, Inge; Vermeulen, Jeroen R; Dijk, Peter H; Dudink, Jeroen; Rijken, Monique; van Heijst, Arno; Dijkman, Koen P; Cools, Filip; Zecic, Alexandra; van Kaam, Anton H; de Haan, Timo R

    2016-07-01

    The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson encephalopathy score was developed before the use of therapeutic hypothermia, its value was reassessed. The purpose of this study was to assess the association of the Thompson encephalopathy score with adverse short-term outcomes, defined as death before discharge, development of severe epilepsy, or the presence of multiple organ failure in asphyxiated newborns undergoing therapeutic hypothermia. The study period ranged from November 2010 to October 2014. A total of 12 tertiary neonatal intensive care units participated. Demographic and clinical data were collected from the "PharmaCool" multicenter study, an observational cohort study analyzing pharmacokinetics of medication during therapeutic hypothermia. With multiple logistic regression analyses the association of the Thompson encephalopathy scores with outcomes was studied. Data of 142 newborns were analyzed (male: 86; female: 56). Median Thompson score was 9 (interquartile range: 8 to 12). Median gestational age was 40 weeks (interquartile range 38 to 41), mean birth weight was 3362 grams (standard deviation: 605). All newborns manifested perinatal asphyxia and underwent therapeutic hypothermia. Death before discharge occurred in 23.9% and severe epilepsy in 21.1% of the cases. In total, 59.2% of the patients had multiple organ failure. The Thompson encephalopathy score was not associated with multiple organ failure, but a Thompson encephalopathy score ≥12 was associated with death before discharge (odds ratio: 3.9; confidence interval: 1.3 to 11.2) and with development of severe epilepsy (odds ratio: 8.4; confidence interval: 2.5 to 27.8). The Thompson encephalopathy score is a useful clinical tool, even in cooled asphyxiated

  4. Telehealth and eHealth in nurse practitioner training: current perspectives

    Directory of Open Access Journals (Sweden)

    Rutledge CM

    2017-06-01

    Full Text Available Carolyn M Rutledge,1 Karen Kott,2 Patty A Schweickert,3 Rebecca Poston,1 Christianne Fowler,1 Tina S Haney1 1College of Health Sciences, School of Nursing, 2College of Health Sciences, School of Physical Therapy, Old Dominion University, Norfolk, 3Department of Neuroradiology, University of Virginia, Charlottesville, VA, USA Abstract: Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this article focuses on topics including 1 defining telehealth, 2 telehealth etiquette, 3 interprofessional collaboration, 4 regulations, 5 reimbursement, 6 security/Health Insurance Portability and Accountability Act (HIPAA, 7 ethical practice in telehealth, and 8 satisfaction of patients and providers. A multimodal approach based on a review of the literature is presented for providing the training: 1 didactics, 2 simulations including standardized patient encounters, 3 practice immersions, and 4 telehealth projects. Studies found that training using the multimodal approach allowed the students to develop comfort, knowledge, and skills needed to embrace the utilization of telehealth in health care. Keywords: telehealth, nurse practitioner education, telemedicine, simulation, health care

  5. An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator

    Science.gov (United States)

    2012-01-01

    Background To investigate organisational factors influencing the implementation challenges of redesigning services for people with long term conditions in three locations in England, using remote care (telehealth and telecare). Methods Case-studies of three sites forming the UK Department of Health’s Whole Systems Demonstrator (WSD) Programme. Qualitative research techniques were used to obtain data from various sources, including semi-structured interviews, observation of meetings over the course programme and prior to its launch, and document review. Participants were managers and practitioners involved in the implementation of remote care services. Results The implementation of remote care was nested within a large pragmatic cluster randomised controlled trial (RCT), which formed a core element of the WSD programme. To produce robust benefits evidence, many aspect of the trial design could not be easily adapted to local circumstances. While remote care was successfully rolled-out, wider implementation lessons and levels of organisational learning across the sites were hindered by the requirements of the RCT. Conclusions The implementation of a complex innovation such as remote care requires it to organically evolve, be responsive and adaptable to the local health and social care system, driven by support from front-line staff and management. This need for evolution was not always aligned with the imperative to gather robust benefits evidence. This tension needs to be resolved if government ambitions for the evidence-based scaling-up of remote care are to be realised. PMID:23153014

  6. An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator.

    Science.gov (United States)

    Hendy, Jane; Chrysanthaki, Theopisti; Barlow, James; Knapp, Martin; Rogers, Anne; Sanders, Caroline; Bower, Peter; Bowen, Robert; Fitzpatrick, Ray; Bardsley, Martin; Newman, Stanton

    2012-11-15

    To investigate organisational factors influencing the implementation challenges of redesigning services for people with long term conditions in three locations in England, using remote care (telehealth and telecare). Case-studies of three sites forming the UK Department of Health's Whole Systems Demonstrator (WSD) Programme. Qualitative research techniques were used to obtain data from various sources, including semi-structured interviews, observation of meetings over the course programme and prior to its launch, and document review. Participants were managers and practitioners involved in the implementation of remote care services. The implementation of remote care was nested within a large pragmatic cluster randomised controlled trial (RCT), which formed a core element of the WSD programme. To produce robust benefits evidence, many aspect of the trial design could not be easily adapted to local circumstances. While remote care was successfully rolled-out, wider implementation lessons and levels of organisational learning across the sites were hindered by the requirements of the RCT. The implementation of a complex innovation such as remote care requires it to organically evolve, be responsive and adaptable to the local health and social care system, driven by support from front-line staff and management. This need for evolution was not always aligned with the imperative to gather robust benefits evidence. This tension needs to be resolved if government ambitions for the evidence-based scaling-up of remote care are to be realised.

  7. Are people with chronic diseases interested in using telehealth? A cross-sectional postal survey.

    Science.gov (United States)

    Edwards, Louisa; Thomas, Clare; Gregory, Alison; Yardley, Lucy; O'Cathain, Alicia; Montgomery, Alan A; Salisbury, Chris

    2014-05-08

    There is growing interest in telehealth-the use of technology to support the remote delivery of health care and promote self-management-as a potential alternative to face-to-face care for patients with chronic diseases. However, little is known about what precipitates interest in the use of telehealth among these patients. This survey forms part of a research program to develop and evaluate a telehealth intervention for patients with two exemplar chronic diseases: depression and raised cardiovascular disease (CVD) risk. The survey was designed to explore the key factors that influence interest in using telehealth in these patient groups. Thirty-four general practices were recruited from two different regions within England. Practice records were searched for patients with (1) depression (aged 18+ years) or (2) 10-year risk of CVD ≥20% and at least one modifiable risk factor (aged 40-74 years). Within each general practice, 54 patients in each chronic disease group were randomly selected to receive a postal questionnaire. Questions assessed five key constructs: sociodemographics, health needs, difficulties accessing health care, technology-related factors (availability, confidence using technology, perceived benefits and drawbacks of telehealth), and satisfaction with prior use of telehealth. Respondents also rated their interest in using different technologies for telehealth (phone, email and Internet, or social media). Relationships between the key constructs and interest in using the three mediums of telehealth were examined using multivariable regression models. Of the 3329 patients who were sent a study questionnaire, 44.40% completed it (872/1740, 50.11% CVD risk; 606/1589, 38.14% depression). Overall, there was moderate interest in using phone-based (854/1423, 60.01%) and email/Internet-based (816/1425, 57.26%) telehealth, but very little interest in social media (243/1430, 16.99%). After adjusting for health needs, access difficulties, technology

  8. Task-technology fit of video telehealth for nurses in an outpatient clinic setting.

    Science.gov (United States)

    Cady, Rhonda G; Finkelstein, Stanley M

    2014-07-01

    Incorporating telehealth into outpatient care delivery supports management of consumer health between clinic visits. Task-technology fit is a framework for understanding how technology helps and/or hinders a person during work processes. Evaluating the task-technology fit of video telehealth for personnel working in a pediatric outpatient clinic and providing care between clinic visits ensures the information provided matches the information needed to support work processes. The workflow of advanced practice registered nurse (APRN) care coordination provided via telephone and video telehealth was described and measured using a mixed-methods workflow analysis protocol that incorporated cognitive ethnography and time-motion study. Qualitative and quantitative results were merged and analyzed within the task-technology fit framework to determine the workflow fit of video telehealth for APRN care coordination. Incorporating video telehealth into APRN care coordination workflow provided visual information unavailable during telephone interactions. Despite additional tasks and interactions needed to obtain the visual information, APRN workflow efficiency, as measured by time, was not significantly changed. Analyzed within the task-technology fit framework, the increased visual information afforded by video telehealth supported the assessment and diagnostic information needs of the APRN. Telehealth must provide the right information to the right clinician at the right time. Evaluating task-technology fit using a mixed-methods protocol ensured rigorous analysis of fit within work processes and identified workflows that benefit most from the technology.

  9. Education and training to support the use of clinical telehealth: A review of the literature.

    Science.gov (United States)

    Edirippulige, S; Armfield, N R

    2017-02-01

    Introduction Despite a growing literature base, substantial investment, and policy changes within governments, the integration of telehealth into routine clinical care has been limited. The availability of appropriate systematic education and training for practitioners has been highlighted as necessary for strong adoption. However, the availability and nature of telehealth-related education and training for practitioners is not understood. By reviewing the literature, we aimed to describe the delivery of education and training in telehealth, with particular focus on content, modes of delivery, types of institutions, and target clinician groups. Methods We performed searches using PubMed, Scopus, Embase, Web of Science, PsycINFO, the Cochrane Library, and ERIC. We included studies that were focused on the delivery of telehealth-related academic or vocational education and training. We extracted information pertaining to country, programs and their participants, and tabulated the results. Results Altogether 388 articles were identified, of which nine studies were selected for final review. Programs from five countries were represented and articles were spread across telemedicine and clinically oriented journals. Education and training in telehealth has been provided as both university level and vocational courses using conventional classroom based delivery methods and e-learning. Reported curriculum items included terminology, clinical applications, the evidence-base, and technological aspects. Conclusions Published evidence in peer-reviewed literature on telehealth education and training is limited. According to this review, a number of topics relating to telehealth have been covered by existing education programs both within tertiary and professional development levels.

  10. Resilient Systemics to Telehealth Support for Clinical Psychiatry and Psychology.

    Science.gov (United States)

    Fiorini, Rodolfo A; De Giacomo, Piero; L'Abate, Luciano

    2015-01-01

    Reliably expanding our clinical practice and lowering our overhead with telepsychiatry, telepsychology, distance counseling and online therapy, requires resilient and antifragile system and tools. When utilized appropriately these technologies may provide greater access to needed services to include more reliable treatment, consultation, supervision, and training. The wise and proper use of technology is fundamental to create and boost outstanding social results. We present, as an example, the main steps to achieve application resilience and antifragility at system level, for diagnostic and therapeutic telepractice and telehealth support, devoted to psychiatry and psychology application. This article presents a number of innovations that can take psychotherapy treatment, supervision, training, and research forward, towards increased effectiveness application.

  11. Discovering untapped relationship potential with patients in telehealth: a qualitative interview study.

    Science.gov (United States)

    Heckemann, Birgit; Wolf, Axel; Ali, Lilas; Sonntag, Steffen Mark; Ekman, Inger

    2016-03-02

    To explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective. 4 focus group interviews were conducted in June 2014. Digital recordings were transcribed verbatim and qualitative content analysis was performed using an iterative process of 3 coding rounds. 20 telehealth professionals. A telehealth service centre in the south of Germany that provided care for 12,000 patients with chronic heart failure across Germany. Non-video telehealth technology creates an atmosphere that fosters sharing of personal information and a non-judgemental attitude. This facilitates the delivery of fair and equal healthcare. A combination of a protocol-driven service structure along with shared team and organisational values provide a basis for establishing long-term healthcare relationships. However, each contact between a telehealth professional and a patient has an uncertain outcome and requires skillful negotiation of the relationship. Although care provision was personalised, there was scope to include the patients as 'experts on their own illness' to a greater extent as advocated by person-centred care. Currently, provision of person-centred care is not sufficiently addressed in telehealth professional training. Telehealth offers a viable environment for the delivery of person-centred care for patients with long-standing disease. Current telehealth training programmes may be enhanced by teaching person-centred care skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

    Science.gov (United States)

    Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

    2013-01-01

    Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (ppatient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

  13. Corrections to the Walker-Thompson estimate of the cascade volume

    International Nuclear Information System (INIS)

    Swaminarayan, S.; Nastasi, M.

    2009-01-01

    Sigmund [P. Sigmund, Appl. Phys. Lett. 25 (1974) 169] analytically predicted that the ratio of cascade volume to energy distribution volume should follow a universal curve that is sigmoidal in shape. Subsequent Monte Carlo simulations by Walker and Thompson [R.S. Walker, D.A. Thompson, Radiat. Eff. 37 (1978) 113] showed that although this curve is sigmoidal in shape, the curve is different for different materials with large deviations from Sigmund's prediction at high M 2 /M 1 . Our analysis of the Walker and Thompson approach has revealed an error in the analytical equations used. A correct analysis of volume ratios using a different set of equations is presented. Analysis of data produced by SRIM [J.F. Ziegler, J.P. Biersack, U. Littmark, in: The Stopping and Range of Ions in solids, Pergamon, New York, 1985] (Monte Carlo) simulations gives results that are in good agreement with Sigmund's predictions.

  14. Environmental Restoration of Diesel-Range Organics from Project Chariot, Cape Thompson, Alaska

    Energy Technology Data Exchange (ETDEWEB)

    Kautsky, Mark [U.S. Department of Energy, Office of Legacy Management; Hutton, Rick [Navarro Research & Engineering; Miller, Judy [Navarro Research & Engineering

    2016-03-06

    The Chariot site is located in the Ogotoruk Valley in the Cape Thompson region of northwest Alaska. Project Chariot was part of the Plowshare Program, created in 1957 by the US Atomic Energy Commission (AEC), a predecessor agency of the US Department of Energy (DOE), to study peaceful uses for atomic energy. Project Chariot began in 1958 when a scientific field team chose Cape Thompson as a potential site to excavate a harbor using a series of nuclear explosions. AEC, with assistance from other agencies, conducted more than 40 pretest bioenvironmental studies of the Cape Thompson area between 1959 and 1962; however, the Plowshare Program work at the Project Chariot site (Figure 1) was cancelled because of strong public opposition [1]. No nuclear explosions were ever conducted at the site.

  15. Are People With Chronic Diseases Interested in Using Telehealth? A Cross-Sectional Postal Survey

    Science.gov (United States)

    Thomas, Clare; Gregory, Alison; Yardley, Lucy; O'Cathain, Alicia; Montgomery, Alan A; Salisbury, Chris

    2014-01-01

    Background There is growing interest in telehealth—the use of technology to support the remote delivery of health care and promote self-management—as a potential alternative to face-to-face care for patients with chronic diseases. However, little is known about what precipitates interest in the use of telehealth among these patients. Objective This survey forms part of a research program to develop and evaluate a telehealth intervention for patients with two exemplar chronic diseases: depression and raised cardiovascular disease (CVD) risk. The survey was designed to explore the key factors that influence interest in using telehealth in these patient groups. Methods Thirty-four general practices were recruited from two different regions within England. Practice records were searched for patients with (1) depression (aged 18+ years) or (2) 10-year risk of CVD ≥20% and at least one modifiable risk factor (aged 40-74 years). Within each general practice, 54 patients in each chronic disease group were randomly selected to receive a postal questionnaire. Questions assessed five key constructs: sociodemographics, health needs, difficulties accessing health care, technology-related factors (availability, confidence using technology, perceived benefits and drawbacks of telehealth), and satisfaction with prior use of telehealth. Respondents also rated their interest in using different technologies for telehealth (phone, email and Internet, or social media). Relationships between the key constructs and interest in using the three mediums of telehealth were examined using multivariable regression models. Results Of the 3329 patients who were sent a study questionnaire, 44.40% completed it (872/1740, 50.11% CVD risk; 606/1589, 38.14% depression). Overall, there was moderate interest in using phone-based (854/1423, 60.01%) and email/Internet-based (816/1425, 57.26%) telehealth, but very little interest in social media (243/1430, 16.99%). After adjusting for health needs

  16. "Miríades por toda a eternidade": a atualidade de E. P. Thompson "Myriads of eternity": the actuality of E. P. Thompson

    Directory of Open Access Journals (Sweden)

    Alexandre Fortes

    2006-06-01

    Full Text Available O artigo reexamina o trabalho clássico de E. P. Thompson, nele identificando elementos relevantes para o estudo do contexto histórico contemporâneo. Critica as abordagens que buscaram sintetizar um "método thompsoniano" em algumas fórmulas do prefácio da obra recorrentemente citadas. Defende ainda que a compreensão do persistente apelo do livro deve ser buscada na análise de sua estrutura narrativa.The article re-examines the classic work by E. P. Thompson, The making of the English working class, identifying many elements relevant to the study of the contemporary historical context. It criticizes those approaches that look to synthesize a 'Thompsonian method' in a number of recurrently cited formulas found in the preface to the work. It also argues that the persistent appeal of the book can be explained through an analysis of its narrative structure.

  17. Iraq Radiosonde Launch Records

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Iraqi upper air records loaned to NCDC from the Air Force 14th Weather Squadron. Scanned notebooks containing upper air radiosonde launch records and data. Launches...

  18. Launching technological innovations

    DEFF Research Database (Denmark)

    Talke, Katrin; Salomo, Søren

    2009-01-01

    have received less attention. This study considers the interdependencies between strategic, internally and externally, directed tactical launch activities and investigates both direct and indirect performance effects. The analysis is based upon data from 113 technological innovations launched...

  19. Maquinações Satânicas: Edward Thompson e as leituras do sistema fabril

    Directory of Open Access Journals (Sweden)

    Adalberto Marson

    1989-12-01

    Full Text Available The author elaborates Ihroagh the writings of Andrew Ure different interpretations of labor changes as interpreted by Marx and by the historian Edward P. Thompson. From the scientificist argument of the invention of a technological mechanism for re-organizing human relation, Marx detected the dialectical process of exploitation of the working class. Thompson, on the other hand, discerns different mediations in this process, mainly the role of religious faith in the UiscipHnnrizalion of industrial labor. The historian is mainly interested in reconstituting antagonistic values that opposed entrepreuneurial hegemony and the making of the working classes.

  20. Edith Marie Thompson (1877–1961), sports and empire settlement administrator

    OpenAIRE

    Williams, Jean

    2012-01-01

    Thompson, Edith Marie (1877–1961), sports and empire settlement administrator, was born at 44 Russell Road, Kensington, London, on 19 May 1877, the only daughter of William Frederic Thompson (1847/8–1921), barrister and mineral and chemical merchant, and his wife, Marie Charlotte, née Warde (1849/50–1900). She was educated at Norland Place School and was a boarder at Cheltenham Ladies' College in 1892–3, at a period when there was still very little sport played at the school. In January 1895,...

  1. Test pilots 1962 - Armstrong, Walker, Dana, Peterson, McKay, Thompson, Butchart

    Science.gov (United States)

    1962-01-01

    The research pilots at what in 1962 was called the Flight Research Center standing in front of the X-1E. They are (left to right) Neil Armstrong, Joe Walker, Bill Dana, Bruce Peterson, Jack McKay, Milt Thompson, and Stan Butchart. of the group, Armstrong, Walker, Dana, McKay and Thompson all flew the X-15. Bruce Peterson flew the M2-F2 and HL-10 lifting bodies, while Stan Butchart was the B-29 drop plane pilot for many of the D-558-II and X-1 series research aircraft.

  2. Role of telehealth in renal replacement therapy education.

    Science.gov (United States)

    Malkina, Anna; Tuot, Delphine S

    2018-03-01

    The prevalence of end-stage renal disease is rising in the United States, which bears high financial and public health burden. The most common modality of renal replacement therapy (RRT) in the United States is in-center hemodialysis. Many patients report lack of comprehensive and timely education about their treatment options, which may preclude them from participating in home-based dialysis therapies and kidney transplantation evaluation. While RRT education has traditionally been provided in-person, the rise of telehealth has afforded new opportunities to improve upon the status quo. For example, technology-augmented RRT education has recently been implemented into telehealth nephrology clinics, informational websites and mobile applications maintained by professional organizations, patient-driven forums on social media, and multimodality programs. The benefits of technology in RRT education are increased access for geographically isolated and/or medically frail patients, versatility of content delivery, information repetition to enhance knowledge retention, and interpersonal connection for educational content and emotional support. Challenges center around privacy and accuracy of information sharing, in addition to differential access to technology due to age and socioeconomic status. A review of available scholarly and social media resources suggests that technology-aided delivery of education about treatment options for end-stage renal disease provides an important alternative and/or supplemental resource for patients and families. © 2018 Wiley Periodicals, Inc.

  3. Home-Based Telehealth Hospitalization for Exacerbation of Chronic Obstructive Pulmonary Disease

    DEFF Research Database (Denmark)

    Jakobsen, Anna Svarre; Laursen, Lars C; Rydahl-Hansen, Susan

    2015-01-01

    Background: Telehealth interventions for patients with chronic obstructive pulmonary disease (COPD) have focused primarily on stable outpatients. Telehealth designed to handle the acute exacerbation that normally requires hospitalization could also be of interest. The aim of this study...... was to compare the effect of home-based telehealth hospitalization with conventional hospitalization for exacerbation in severe COPD. Materials and Methods: A two-center, noninferiority, randomized, controlled effectiveness trial was conducted between June 2010 and December 2011. Patients with severe COPD...... admitted because of exacerbation were randomized 1:1 either to home-based telehealth hospitalization or to continue standard treatment and care at the hospital. The primary outcome was treatment failure defined as re-admission due to exacerbation in COPD within 30 days after initial discharge...

  4. [Nursing contributions to the development of the Brazilian Telehealth Lactation Support Program].

    Science.gov (United States)

    Prado, Cláudia; Silva, Isília Aparecida; Soares, Alda Valéria Neves; Aragaki, Ilva Marico Mizumoto; Shimoda, Gilcéria Tochika; Zaniboni, Vanessa Forte; Padula, Camila Brolezzi; Muller, Fabiana Swain; Salve, Jeanine Maria; Daré, Sergio Junior; Wen, Chao Lung; Peres, Heloísa Helena Ciqueto; Leite, Maria Madalena Januário

    2013-08-01

    The National Telehealth Program was founded by the Ministry of Health, in partnership with the Ministry of Education (Ministério da Educação - MEC) and the Ministry of Science and Technology (Ministério da Ciência e Tecnologia - MCT), to support the development of family healthcare teams throughout the country. The São Paulo Telehealth Center has developed the Telehealth Lactation Support program, which provides primary healthcare professionals with information on diverse aspects of breastfeeding. This paper reports the development of the Lactation Support program and the nursing contributions. Project methodology included the formation of a multidisciplinary group of pediatricians, nurses, speech and language therapists, nutritionists, and dentists. Multimedia teaching resources were prepared for inclusion in the Cybertutor platform. Telehealth Lactation Support is an innovative and promising addition to continuing education for healthcare professionals and provides a framework for the development of other programs.

  5. Telehealth Cognitive Behavior Therapy for Co-Occurring Insomnia and Depression Symptoms in Older Adults

    Science.gov (United States)

    Lichstein, Kenneth L.; Scogin, Forrest; Thomas, S. Justin; DiNapoli, Elizabeth A.; Dillon, Haley R.; McFadden, Anna

    2015-01-01

    Objective Telehealth has proven effective with a wide range of disorders, but there is a paucity of data on the use of telehealth using cognitive-behavior therapy (CBT) with late-life insomnia and depression. This pilot study was designed to examine the feasibility and effectiveness of using telehealth to treat older adults with comorbid insomnia and depression living in rural Alabama. Method Five patients received 10 sessions of CBT for insomnia and depression. Patients were engaged in treatment via Skype from their primary care physician’s office. Assessments were conducted at baseline, posttreatment, and 2-month follow-up. Results Patients exhibited clinically significant improvement in both insomnia (sleep diaries and Insomnia Severity Index) and depression (Hamilton Rating Scale for Depression) at posttreatment, and these gains were well maintained at 2-month follow-up. Conclusions These preliminary data suggest that telehealth may be an effective means of providing treatment to older adults, including underserved populations. PMID:24014056

  6. The Development of Statewide Policies and Procedures to Implement Telehealth for Part C Service Delivery

    Directory of Open Access Journals (Sweden)

    Beth Cole

    2016-12-01

    Full Text Available The use of telehealth has been discussed nationally as an option to address provider shortages for children, birth through two, enrolled in Part C of the Individuals with Disabilities Education Act (IDEA Early Intervention (EI programs. Telehealth is an evidence-based service delivery model which can be used to remove barriers in providing EI services to children and their families. In 2016, Colorado’s Part C Early Intervention (EI program began allowing the use of telehealth as an option for providers to conduct sessions with children and their caregivers. This article outlines the process taken to develop the necessary requirements and supports for telehealth to be incorporated into EI current practice.

  7. A Pilot Investigation of Speech Sound Disorder Intervention Delivered by Telehealth to School-Age Children

    Directory of Open Access Journals (Sweden)

    Sue Grogan-Johnson

    2011-05-01

    Full Text Available This article describes a school-based telehealth service delivery model and reports outcomes made by school-age students with speech sound disorders in a rural Ohio school district. Speech therapy using computer-based speech sound intervention materials was provided either by live interactive videoconferencing (telehealth, or conventional side-by-side intervention.  Progress was measured using pre- and post-intervention scores on the Goldman Fristoe Test of Articulation-2 (Goldman & Fristoe, 2002. Students in both service delivery models made significant improvements in speech sound production, with students in the telehealth condition demonstrating greater mastery of their Individual Education Plan (IEP goals. Live interactive videoconferencing thus appears to be a viable method for delivering intervention for speech sound disorders to children in a rural, public school setting. Keywords:  Telehealth, telerehabilitation, videoconferencing, speech sound disorder, speech therapy, speech-language pathology; E-Helper

  8. Carers' perceptions of the impact of home telehealth monitoring on the provision of care and sustainability of use.

    Science.gov (United States)

    Wade, Rachael; Cartwright, Colleen; Shaw, Kelly

    2015-06-01

    This paper aims to report carers' perceptions of the impact of home telehealth on the provision of care and the sustainability of home telehealth use. This paper is reporting on a sample of 15 carers who were involved in the telehealth arm of a larger controlled trial. Carers primarily believed that telehealth helped to provide better care. None of the carers had organised, or planned to organise, ongoing telehealth monitoring beyond the study. The main reason given for non-sustained usage was the belief that the person they cared for no longer required, or would benefit from, the monitoring. As the person being cared for was a frail older person with multiple chronic diseases and a history of recent hospitalisation, the non-sustained usage of home telehealth by carers raises questions about what is needed to ensure sustainability of use; this requires further investigation. © 2014 AJA Inc.

  9. Telehealth at the US Department of Veterans Affairs after Hurricane Sandy.

    Science.gov (United States)

    Der-Martirosian, Claudia; Griffin, Anne R; Chu, Karen; Dobalian, Aram

    2018-01-01

    Background Like other integrated health systems, the US Department of Veterans Affairs has widely implemented telehealth during the past decade to improve access to care for its patient population. During major crises, the US Department of Veterans Affairs has the potential to transition healthcare delivery from traditional care to telecare. This paper identifies the types of Veterans Affairs telehealth services used during Hurricane Sandy (2012), and examines the patient characteristics of those users. Methods This study conducted both quantitative and qualitative analyses. Veterans Affairs administrative and clinical data files were used to illustrate the use of telehealth services 12 months pre- and 12 months post- Hurricane Sandy. In-person interviews with 31 key informants at the Manhattan Veterans Affairs Medical Center three-months post- Hurricane Sandy were used to identify major themes related to telecare. Results During the seven-month period of hospital closure at the Manhattan Veterans Affairs Medical Center after Hurricane Sandy, in-person patient visits decreased dramatically while telehealth visits increased substantially, suggesting that telecare was used in lieu of in-person care for some vulnerable patients. The most commonly used types of Veterans Affairs telehealth services included primary care, triage, mental health, home health, and ancillary services. Using qualitative analyses, three themes emerged from the interviews regarding the use of Veterans Affairs telecare post- Hurricane Sandy: patient safety, provision of telecare, and patient outreach. Conclusion Telehealth offers the potential to improve post-disaster access to and coordination of care. More information is needed to better understand how telehealth can change the processes and outcomes during disasters. Future studies should also evaluate key elements, such as adequate resources, regulatory and technology issues, workflow integration, provider resistance, diagnostic fidelity and

  10. Telehealth exercise-based cardiac rehabilitation: a systematic review and meta-analysis.

    Science.gov (United States)

    Rawstorn, Jonathan C; Gant, Nicholas; Direito, Artur; Beckmann, Christina; Maddison, Ralph

    2016-08-01

    Despite proven effectiveness, participation in traditional supervised exercise-based cardiac rehabilitation (exCR) remains low. Telehealth interventions that use information and communication technologies to enable remote exCR programme delivery can overcome common access barriers while preserving clinical supervision and individualised exercise prescription. This meta-analysis aimed to determine the benefits of telehealth exCR on exercise capacity and other modifiable cardiovascular risk factors compared with traditional exCR and usual care, among patients with coronary heart disease (CHD). CINAHL, The Cochrane Library, Embase, MEDLINE, PubMed and PsycINFO were searched from inception through 31 May 2015 for randomised controlled trials comparing telehealth exCR with centre-based exCR or usual care among patients with CHD. Outcomes included maximal aerobic exercise capacity, modifiable cardiovascular risk factors and exercise adherence. 11 trials (n=1189) met eligibility criteria and were included in the review. Physical activity level was higher following telehealth exCR than after usual care. Compared with centre-based exCR, telehealth exCR was more effective for enhancing physical activity level, exercise adherence, diastolic blood pressure and low-density lipoprotein cholesterol. Telehealth and centre-based exCR were comparably effective for improving maximal aerobic exercise capacity and other modifiable cardiovascular risk factors. Telehealth exCR appears to be at least as effective as centre-based exCR for improving modifiable cardiovascular risk factors and functional capacity, and could enhance exCR utilisation by providing additional options for patients who cannot attend centre-based exCR. Telehealth exCR must now capitalise on technological advances to provide more comprehensive, responsive and interactive interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Association of comorbidities with home care service utilization of patients with heart failure while receiving telehealth.

    Science.gov (United States)

    Radhakrishnan, Kavita; Jacelon, Cynthia S; Bigelow, Carol; Roche, Joan P; Marquard, Jenna L; Bowles, Kathryn H

    2013-01-01

    Comorbidities adversely impact heart failure (HF) outcomes. Telehealth can assist healthcare providers, especially nurses, in guiding their patients to follow the HF regimen. However, factors, including comorbidity patterns, that act in combination with telehealth to reduce home care nursing utilization are still unclear. The purpose of this article was to examine the association of the comorbidity characteristics of HF patients with nursing utilization along with withdrawal from telehealth service during an episode of tele-home care. A descriptive, correlational study design using retrospective chart review was used. The sample comprised Medicare patients admitted to a New England home care agency who had HF as a diagnosis and had used telehealth from 2008 to 2010. The electronic documentation at the home care agency served as the data source, which included Outcome and Assessment Information Set data of patients with HF. Logistic and multiple regression analyses were used to analyze data. The sample consisted of 403 participants, of whom 70% were older than 75 years, 55% were female, and 94% were white. Comorbidities averaged 5.19 (SD, 1.92), ranging from 1 to 11, and nearly 40% of the participants had 5 or more comorbidities. The mean (SD) nursing contacts in the sample was 9.9 (4.7), ranging from 1 to 26, and 52 (12.7%) patients withdrew from telehealth service. For patients with HF on telehealth, comorbidity characteristics of anemia, anxiety, musculoskeletal, and depression were significantly associated with nursing utilization patterns, and renal failure, cancer, and depression comorbidities were significantly associated with withdrawal from telehealth service. Knowledge of the association of comorbidity characteristics with the home care service utilization patterns of patients with HF on telehealth can assist the home health nurse to develop a tailored care plan that attains optimal patient outcomes. Knowledge of such associations would also focus home

  12. Generating new telehealth services using a whole of community approach: experience in regional Queensland.

    Science.gov (United States)

    Smith, Anthony C; Caffery, Liam J; Saunders, Ruth; Bradford, Natalie K; Gray, Leonard C

    2014-10-01

    We implemented a community telehealth project in the three towns in the Darling Downs area of Queensland over a 2-year period starting in July 2012. The purpose of the project was to generate telehealth activity in hospitals, general practice and selected residential aged care facilities. Telehealth education and training was provided to clinicians in the three towns and a community awareness campaign was delivered using advertisements in newspapers, messages in social media and presentations at community events. A total of 55 stakeholders were engaged with during 61 site visits to health care facilities during the first two years of the project. During the study period, telehealth activity in Queensland increased in the hospital sector by 39% and in the non-hospital sector by 99%. In the Darling Downs region, telehealth activity in the hospital sector increased by 104%, compared to 28% in the rest of Queensland. However, in the non-hospital sector, the increase in telehealth activity in the Darling Downs region was similar to the rest of Queensland. Telehealth services established and/or facilitated by the project included specialist geriatric ward rounds in Dalby, Chinchilla and Miles for patients in the local hospitals and nursing homes; and ad-hoc teleconsultations for children and adults living in these communities, with specialists at Toowoomba and hospitals in Brisbane. An increase in telehealth implies better access to a range of clinical services, which may result in improved clinical outcomes for patients. © The Author(s) 2014 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  13. Participatory design methods for the development of a clinical telehealth service for neonatal homecare.

    Science.gov (United States)

    Garne Holm, Kristina; Brødsgaard, Anne; Zachariassen, Gitte; Smith, Anthony C; Clemensen, Jane

    2017-01-01

    Neonatal homecare delivered during home visits by neonatal nurses is a common method for supporting families of preterm infants following discharge. Telehealth has been introduced for the provision of neonatal homecare, resulting in positive feedback from parents of preterm infants. While the benefits are beginning to be realised, widespread uptake of telehealth has been limited due to a range of logistical challenges. Understanding user requirements is important when planning and developing a clinical telehealth service. We therefore used participatory design to develop a clinical telehealth service for neonatal homecare. The study adopted a participatory design approach to engage users in the development and design of a new telehealth service. Participatory design embraces qualitative research methods. Creative and technical workshops were conducted as part of the study. Tests of the telehealth service were conducted in the neonatal unit. Participants in this study were former and current parents of preterm infants eligible for neonatal homecare, and clinical staff (medical and nursing) from the neonatal unit. Preterm infants accompanied their parents. Based on the results obtained during the workshops and subsequent testing, we developed an application (app), which was integrated into the medical record at the neonatal unit. The app was used to initiate videoconferences and chat messages between the family at home and the neonatal unit, and to share information regarding infant growth and well-being. Results obtained from the workshops and testing demonstrated the importance of involving users when developing new telehealth applications. The workshops helped identify the challenges associated with delivery of the service, and helped instruct the design of a new telehealth service for neonatal homecare based on the needs of parents and clinical staff.

  14. E. P. Thompson, un marxista contra el marxismo como “materialismo histórico”

    OpenAIRE

    Omar Acha

    2013-01-01

    Análisis de la obra de Thompson como historiador marxista. Fil: Acha, José Omar. Consejo Nacional de Invest.cientif.y Tecnicas. Oficina de Coordinacion Administrativa Saavedra 15. Instituto de Historia Argentina y Americana "dr. Emilio Ravignani";

  15. Matrix algebra and sampling theory : The case of the Horvitz-Thompson estimator

    NARCIS (Netherlands)

    Dol, W.; Steerneman, A.G.M.; Wansbeek, T.J.

    Matrix algebra is a tool not commonly employed in sampling theory. The intention of this paper is to help change this situation by showing, in the context of the Horvitz-Thompson (HT) estimator, the convenience of the use of a number of matrix-algebra results. Sufficient conditions for the

  16. Dr. Steve Thompson, Chief Executive, The Royal Society of New Zealand

    CERN Multimedia

    Maximilien Brice

    2002-01-01

    L. to r.: Dr Austin Ball, Deputy Technical Coordinator, CMS experiment; Dr Roland Horisberger, Paul Scherrer Institute and CERN, CMS experiment; Dr Steve Thompson, Chief Executive, The Royal Society of New Zealand; Dr Michel Della Negra, Spokesman, CMS experiment and Dr Alick Macpherson, Paul Scherrer Institute and CERN, CMS experiment, in the CMS Silicon Tracker assembly hall.

  17. MOMFER: A Search Engine of Thompson's Motif-Index of Folk Literature

    NARCIS (Netherlands)

    Karsdorp, F.B.; van der Meulen, Marten; Meder, Theo; van den Bosch, Antal

    2015-01-01

    More than fifty years after the first edition of Thompson's seminal Motif-Indexof Folk Literature, we present an online search engine tailored to fully disclose the index digitally. This search engine, called MOMFER, greatly enhances the searchability of the Motif-Index and provides exciting new

  18. Simplified solutions of the Cox-Thompson inverse scattering method at fixed energy

    International Nuclear Information System (INIS)

    Palmai, Tamas; Apagyi, Barnabas; Horvath, Miklos

    2008-01-01

    Simplified solutions of the Cox-Thompson inverse quantum scattering method at fixed energy are derived if a finite number of partial waves with only even or odd angular momenta contribute to the scattering process. Based on new formulae various approximate methods are introduced which also prove applicable to the generic scattering events

  19. CARBON TRACE GASES IN LAKE AND BEAVER POND ICE NEAR THOMPSON, MANITOBA, CANADA

    Science.gov (United States)

    Concentrations of CO2, CO, and CH4 were measured in beaver pond and lake ice in April 1996 near Thompson, Manitoba to derive information on possible impacts of ice melting on corresponding atmospheric trace gas concentrations. CH4 concentrations in beaver pond and lake ice ranged...

  20. Designing clinically valuable telehealth resources: processes to develop a community-based palliative care prototype.

    Science.gov (United States)

    Tieman, Jennifer Joy; Morgan, Deidre Diane; Swetenham, Kate; To, Timothy Hong Man; Currow, David Christopher

    2014-09-04

    Changing population demography and patterns of disease are increasing demands on the health system. Telehealth is seen as providing a mechanism to support community-based care, thus reducing pressure on hospital services and supporting consumer preferences for care in the home. This study examined the processes involved in developing a prototype telehealth intervention to support palliative care patients involved with a palliative care service living in the community. The challenges and considerations in developing the palliative care telehealth prototype were reviewed against the Center for eHealth Research (CeHRes) framework, a telehealth development model. The project activities to develop the prototype were specifically mapped against the model's first four phases: multidisciplinary project management, contextual inquiry, value specification, and design. This project has been developed as part of the Telehealth in the Home: Aged and Palliative Care in South Australia initiative. Significant issues were identified and subsequently addressed during concept and prototype development. The CeHRes approach highlighted the implicit diversity in views and opinions among participants and stakeholders and enabled issues to be considered, resolved, and incorporated during design through continuous engagement. The CeHRes model provided a mechanism that facilitated "better" solutions in the development of the palliative care prototype by addressing the inherent but potentially unrecognized differences in values and beliefs of participants. This collaboration enabled greater interaction and exchange among participants resulting in a more useful and clinically valuable telehealth prototype.

  1. Conceptualizing Telehealth in Nursing Practice: Advancing a Conceptual Model to Fill a Virtual Gap.

    Science.gov (United States)

    Nagel, Daniel A; Penner, Jamie L

    2016-03-01

    Increasingly nurses use various telehealth technologies to deliver health care services; however, there has been a lag in research and generation of empirical knowledge to support nursing practice in this expanding field. One challenge to generating knowledge is a gap in development of a comprehensive conceptual model or theoretical framework to illustrate relationships of concepts and phenomena inherent to adoption of a broad range of telehealth technologies to holistic nursing practice. A review of the literature revealed eight published conceptual models, theoretical frameworks, or similar entities applicable to nursing practice. Many of these models focus exclusively on use of telephones and four were generated from qualitative studies, but none comprehensively reflect complexities of bridging nursing process and elements of nursing practice into use of telehealth. The purpose of this article is to present a review of existing conceptual models and frameworks, discuss predominant themes and features of these models, and present a comprehensive conceptual model for telehealth nursing practice synthesized from this literature for consideration and further development. This conceptual model illustrates characteristics of, and relationships between, dimensions of telehealth practice to guide research and knowledge development in provision of holistic person-centered care delivery to individuals by nurses through telehealth technologies. © The Author(s) 2015.

  2. The use of telehealth in early autism training for parents: a scoping review

    Directory of Open Access Journals (Sweden)

    Boisvert M

    2014-03-01

    Full Text Available Michelle Boisvert,1 Nerissa Hall2 1WorldTide, Inc., Williamsburg, MA, USA; 2Communicare, LLC, Ludlow, MA, USA Abstract: Telehealth involves the application of technology to deliver services over a geographical distance. Studies in which telehealth procedures were used in the training or coaching of parents with young children (aged 6 years and under who were diagnosed with autism were reviewed. Scoping searches identified two studies that met the inclusion criteria. These studies were evaluated in terms of the: 1 characteristics of the participants; 2 technology utilized; 3 services delivered via telehealth; 4 research methodology; and 5 results and conclusions of the study. Telehealth was used by speech–language pathologists and university researchers to provide training to parents on specific intervention approaches to facilitate targeted communication initiations and responses by gestures, picture pointing, or verbalizations, as well as the delivery and evaluation of the Early Start Denver Model. While the available literature is limited on this topic, this review suggests that the use of telehealth is a viable means to provide training to parents with young children diagnosed with autism. Keywords: autism spectrum disorder, telehealth, training, education, caregivers, parents

  3. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

    Science.gov (United States)

    Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

    2006-08-24

    Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering

  4. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2006-08-01

    Full Text Available Abstract Background Telehealth, as other information and communication technologies (ICTs introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and

  5. COSMOS Launch Services

    Science.gov (United States)

    Kalnins, Indulis

    2002-01-01

    COSMOS-3M is a two stage launcher with liquid propellant rocket engines. Since 1960's COSMOS has launched satellites of up to 1.500kg in both circular low Earth and elliptical orbits with high inclination. The direct SSO ascent is available from Plesetsk launch site. The very high number of 759 launches and the achieved success rate of 97,4% makes this space transportation system one of the most reliable and successful launchers in the world. The German small satellite company OHB System co-operates since 1994 with the COSMOS manufacturer POLYOT, Omsk, in Russia. They have created the joint venture COSMOS International and successfully launched five German and Italian satellites in 1999 and 2000. The next commercial launches are contracted for 2002 and 2003. In 2005 -2007 COSMOS will be also used for the new German reconnaissance satellite launches. This paper provides an overview of COSMOS-3M launcher: its heritage and performance, examples of scientific and commercial primary and piggyback payload launches, the launch service organization and international cooperation. The COSMOS launch service business strategy main points are depicted. The current and future position of COSMOS in the worldwide market of launch services is outlined.

  6. CE: Telehealth: a case study in disruptive innovation.

    Science.gov (United States)

    Grady, Janet

    2014-04-01

    Technologic advances in health care have often outpaced our ability to integrate the technology efficiently, establish best practices for its use, and develop policies to regulate and evaluate its effectiveness. However, these may be insufficient reasons to put the brakes on innovation-particularly those "disruptive innovations" that challenge the status quo and have the potential to produce better outcomes in a number of important areas. This article discusses the concept of disruptive innovation and highlights data supporting its necessity within health care in general and nursing in particular. Focusing on telehealth as a case study in disruptive innovation, the author provides examples of its application and reviews literature that examines its effectiveness in both nursing practice and education.

  7. Propagação por enxertia de atemoia 'Thompson' sobre espécies de Rollinia 'Thompson' atemoya grafting onto Rollinia rootstocks

    Directory of Open Access Journals (Sweden)

    Luis Felipe Paes de Almeida

    2010-06-01

    Full Text Available Este estudo teve por finalidade avaliar o índice de sobrevivência do enxerto de atemoia 'Thompson' sobre dois porta-enxertos. O delineamento experimental foi em blocos casualizados, em esquema fatorial 2 x 2, dois porta-enxertos [araticum-de-terra-fria (Rollinia sp. e biribá (Rollinia mucosa] e dois métodos de enxertia (topo em fenda lateral e topo à inglesa simples, em 6 blocos, 4 tratamentos e 5 plantas por parcela, totalizando 120 plantas. Para as condições locais, verificou-se que a atemoia pode ser propagada com sucesso via enxertia, usando o porta-enxerto araticum-de-terra-fria, com diferença significativa em relação ao biribá. O melhor método de enxertia para araticum-de-terra-fria foi o inglês simples, com índice de sobrevivência do enxerto de 90%. Observou-se baixo índice de sobrevivência do enxerto, utilizando-se de ambos os métodos de enxertia para o porta-enxerto biribá.This study aimed to evaluate the survival rate of atemoya 'Thompson' on two rootstocks.The experimental design used was in randomized blocks with factorial scheme 2 x 2 consisting of 6 blocks, 4 treatments and 5 replicates per parcel totaling 120 plants. Two grafting methods (side cleft graft and whip graft and two rootstocks [araticum-de-terra-fria (Rollinia sp. and biriba (Rollinia mucosa] were evaluated for propagation of 'Thompson' atemoya. Scion survival rate was evaluated and analyzed by Tukey test, with 5% of significance level. Atemoya tree under local conditions can be propagated successfully by grafting using araticum-de-terra-fria rootstock. Whip graft was the best grafting method for araticum-de-terra-fria rootstock with 90% survival. Both grafting methods for biriba rootstock resulted in low scion survival rate.

  8. Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C Services

    Directory of Open Access Journals (Sweden)

    Jana Cason

    2012-12-01

    Full Text Available Background: Early intervention (EI services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC 2011.  EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA; however, personnel shortages, particularly in rural areas, limit access for children who qualify.  Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community.  Method:  A survey sent by the National Early Childhood Technical Assistance Center (NECTAC to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs.  Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified.  Results:  Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey.  Of these, 30% (n=9 indicated that they are either currently using telehealth as an adjunct service delivery model (n=6 or plan to incorporate telehealth within the next 1-2 years (n=3.  Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH, speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters.  Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance.  Expressed barriers and concerns for

  9. Cost-benefit analysis of telehealth in pre-hospital care.

    Science.gov (United States)

    Langabeer, James R; Champagne-Langabeer, Tiffany; Alqusairi, Diaa; Kim, Junghyun; Jackson, Adria; Persse, David; Gonzalez, Michael

    2017-09-01

    Objective There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. Methods Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention. The intervention consisted of telehealth-based consultation between the 911 patient and an EMS physician, to evaluate and triage the necessity for patient transport to a hospital emergency department (ED). Patients with non-urgent, primary care-related conditions were then scheduled and transported by alternative means to an affiliated primary care clinic. We measured CBA as both total cost savings and cost per ED visit averted, in US Dollars ($USD). Results In total, 5570 patients were treated over the first full 12 months with a telehealth-enabled care model. We found a 6.7% absolute reduction in potentially medically unnecessary ED visits, and a 44-minute reduction in total ambulance back-in-service times. The average cost for a telehealth patient was $167, which was a statistically significantly $103 less than the control group ( p cost savings from the societal perspective, or $2468 cost savings per ED visit averted (benefit). Conclusion Patient care enabled by telehealth in a pre-hospital environment, is a more cost effective alternative compared to the traditional EMS 'treat and transport to ED' model.

  10. Foreign launch competition growing

    Science.gov (United States)

    Brodsky, R. F.; Wolfe, M. G.; Pryke, I. W.

    1986-07-01

    A survey is given of progress made by other nations in providing or preparing to provide satellite launch services. The European Space Agency has four generations of Ariane vehicles, with a fifth recently approved; a second launch facility in French Guiana that has become operational has raised the possible Ariane launch rate to 10 per year, although a May failure of an Ariane 2 put launches on hold. The French Hermes spaceplane and the British HOTOL are discussed. Under the auspices of the Italian National Space Plane, the Iris orbital transfer vehicle is developed and China's Long March vehicles and the Soviet Protons and SL-4 vehicles are discussed; the Soviets moreover are apparently developing not only a Saturn V-class heavy lift vehicle with a 150,000-kg capacity (about five times the largest U.S. capacity) but also a space shuttle and a spaceplane. Four Japanese launch vehicles and some vehicles in an Indian program are also ready to provide launch services. In this new, tough market for launch services, the customers barely outnumber the suppliers. The competition develops just as the Challenger and Titan disasters place the U.S. at a disadvantage and underline the hard work ahead to recoup its heretofore leading position in launch services.

  11. Solution of the Cox-Thompson inverse scattering problem using finite set of phase shifts

    CERN Document Server

    Apagyi, B; Scheid, W

    2003-01-01

    A system of nonlinear equations is presented for the solution of the Cox-Thompson inverse scattering problem (1970 J. Math. Phys. 11 805) at fixed energy. From a given finite set of phase shifts for physical angular momenta, the nonlinear equations determine related sets of asymptotic normalization constants and nonphysical (shifted) angular momenta from which all quantities of interest, including the inversion potential itself, can be calculated. As a first application of the method we use input data consisting of a finite set of phase shifts calculated from Woods-Saxon and box potentials representing interactions with diffuse or sharp surfaces, respectively. The results for the inversion potentials, their first moments and asymptotic properties are compared with those provided by the Newton-Sabatier quantum inversion procedure. It is found that in order to achieve inversion potentials of similar quality, the Cox-Thompson method requires a smaller set of phase shifts than the Newton-Sabatier procedure.

  12. Solution of the Cox-Thompson inverse scattering problem using finite set of phase shifts

    International Nuclear Information System (INIS)

    Apagyi, Barnabas; Harman, Zoltan; Scheid, Werner

    2003-01-01

    A system of nonlinear equations is presented for the solution of the Cox-Thompson inverse scattering problem (1970 J. Math. Phys. 11 805) at fixed energy. From a given finite set of phase shifts for physical angular momenta, the nonlinear equations determine related sets of asymptotic normalization constants and nonphysical (shifted) angular momenta from which all quantities of interest, including the inversion potential itself, can be calculated. As a first application of the method we use input data consisting of a finite set of phase shifts calculated from Woods-Saxon and box potentials representing interactions with diffuse or sharp surfaces, respectively. The results for the inversion potentials, their first moments and asymptotic properties are compared with those provided by the Newton-Sabatier quantum inversion procedure. It is found that in order to achieve inversion potentials of similar quality, the Cox-Thompson method requires a smaller set of phase shifts than the Newton-Sabatier procedure

  13. "Miríades por toda a eternidade": a atualidade de E. P. Thompson

    OpenAIRE

    Fortes,Alexandre

    2006-01-01

    O artigo reexamina o trabalho clássico de E. P. Thompson, nele identificando elementos relevantes para o estudo do contexto histórico contemporâneo. Critica as abordagens que buscaram sintetizar um "método thompsoniano" em algumas fórmulas do prefácio da obra recorrentemente citadas. Defende ainda que a compreensão do persistente apelo do livro deve ser buscada na análise de sua estrutura narrativa.

  14. An Exploration of Intent to Use Telehealth at Home for Patients with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Shu-Lin Uei

    2017-12-01

    Full Text Available Telecare is defined as care practiced at a distance. It is an effective strategy for improving the self-health care management of home-patients with chronic diseases. The purpose of this study was to explore the intent to use of telehealth patients. The correlation between the self-care behaviors, the intent to use of telehealth, and the effects on physiological indicators of patients with chronic disease at home were studied. A cross-sectional study design employing purposive sampling was selected. The structured questionnaire ‘Telecare Usage Intention Scale and Self-Care Behavior Scale’ were used, ‘HbA1c, glucose levels and monthly blood pressure measurements’ were analyzed in this thirteen month study. The self-care behaviors of the participants were positively correlated with their intent to use telehealth (p < 0.01. The results also indicated that HbA1c, glucose levels and frequency BP measurement of the participants improved significantly after using telecare (p < 0.005. The results indicated a strong intent to use telehealth and positive perception of telecare services by in-home patients with a chronic disease. Telehealth improves the self-care behavior of in-home chronic disease patients and enhances medical professionals’ ability to deliver quality and effective healthcare.

  15. The diffusion of telehealth in rural American Indian communities: a retrospective survey of key stakeholders.

    Science.gov (United States)

    Brooks, Elizabeth; Manson, Spero M; Bair, Byron; Dailey, Nancy; Shore, Jay H

    2012-01-01

    Mental health issues are a serious concern for many American Indian Veterans, especially for post-traumatic stress disorder and related psychiatric conditions. Yet, acquiring mental health treatment can be a challenge in Native communities where specialized services are largely unavailable. Consequently, telehealth is increasingly being suggested as a way to expand healthcare access on or near reservation lands. In this study, we wanted to understand the factors affecting the diffusion of telehealth clinics that provided mental health care to rural, American Indian Veterans. We surveyed 39 key personnel and stakeholders who were involved in the decision-making process, technological infrastructure, and implementation of three clinics. Using Roger Everett's Diffusion Theory as a framework, we gathered information about specific tasks, factors hindering progress, and personal reactions to telehealth both before and after implementation. Many participants expressed initial concerns about using telehealth; however, most became positive over time. Factors that influenced participants' viewpoint largely included patient and staff feedback and witnessing the fulfillment of a community health need. The use of outside information to support the implementation of the clinics and personal champions also showed considerable influence in the clinics' success. The findings presented here address critical gaps in our understanding of telehealth diffusion and inform research strategies regarding the cultural issues and outcomes related to telemental health services. Information contained in this report serves as a long overdue guide for developing telemental health programs and policies among American Indians, specifically, and rural populations in general.

  16. Nurses' and community support workers' experience of telehealth: a longitudinal case study.

    Science.gov (United States)

    Sharma, Urvashi; Clarke, Malcolm

    2014-04-10

    Introduction of telehealth into the healthcare setting has been recognised as a service that might be experienced as disruptive. This paper explores how this disruption is experienced. In a longitudinal qualitative study, we conducted focus group discussions prior to and semi structured interviews post introduction of a telehealth service in Nottingham, U.K. with the community matrons, congestive heart failure nurses, chronic obstructive pulmonary disease nurses and community support workers that would be involved in order to elicit their preconceptions and reactions to the implementation. Users experienced disruption due to the implementation of telehealth as threatening. Three main factors add to the experience of threat and affect the decision to use the technology: change in clinical routines and increased workload; change in interactions with patients and fundamentals of face-to-face nursing work; and change in skills required with marginalisation of clinical expertise. Since the introduction of telehealth can be experienced as threatening, managers and service providers should aim at minimising the disruption caused by taking the above factors on board. This can be achieved by employing simple yet effective measures such as: providing timely, appropriate and context specific training; provision of adequate technical support; and procedures that allow a balance between the use of telehealth and personal visit by nurses delivering care to their patients.

  17. Mixed Methods Approach for Measuring the Impact of Video Telehealth on Outpatient Clinic Triage Nurse Workflow

    Science.gov (United States)

    Cady, Rhonda G.; Finkelstein, Stanley M.

    2015-01-01

    Nurse-delivered telephone triage is a common component of outpatient clinic settings. Adding new communication technology to clinic triage has the potential to not only transform the triage process, but also alter triage workflow. Evaluating the impact of new technology on an existing workflow is paramount to maximizing efficiency of the delivery system. This study investigated triage nurse workflow before and after the implementation of video telehealth using a sequential mixed methods protocol that combined ethnography and time-motion study to provide a robust analysis of the implementation environment. Outpatient clinic triage using video telehealth required significantly more time than telephone triage, indicating a reduction in nurse efficiency. Despite the increased time needed to conduct video telehealth, nurses consistently rated it useful in providing triage. Interpretive analysis of the qualitative and quantitative data suggests the increased depth and breadth of data available during video triage alters the assessment triage nurses provide physicians. This in turn could impact the time physicians spend formulating a diagnosis and treatment plan. While the immediate impact of video telehealth is a reduction in triage nurse efficiency, what is unknown is the impact of video telehealth on physician and overall clinic efficiency. Future studies should address this area. PMID:24080753

  18. Review of "Echinococcus and Echinococcosis, Part A." edited by R. C. Andrew Thompson, Alan J. Lymbery and Peter Deplazes.

    Science.gov (United States)

    Ito, Akira

    2017-09-04

    Thompson RCA, Deplazes P, Lymbery AJ, Editors. Echinococcus and Echinococcosis, Part A. Volume 95, Advances in Parasitology 95. Academic Press; 2017. 525 pages, ISBN 978-0-12-8114711 (hardcover); 9780128114728 (eBook).

  19. Genomic Data Commons launches

    Science.gov (United States)

    The Genomic Data Commons (GDC), a unified data system that promotes sharing of genomic and clinical data between researchers, launched today with a visit from Vice President Joe Biden to the operations center at the University of Chicago.

  20. Big Bang launch

    CERN Multimedia

    2008-01-01

    Physicists from the University, along with scientists and engineers around the world, watched with fevered anticipation as the world's biggest scientific experiment was launched in September. (1/1 page)

  1. Home telehealth in older patients with heart failure – costs, adherence, and outcomes

    Directory of Open Access Journals (Sweden)

    Spinsante S

    2014-09-01

    Full Text Available Susanna Spinsante Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, Ancona, Italy Abstract: This short review discusses the role of telehealth technologies in the management of older patients with heart failure, from different perspectives. Instead of providing a systematic overview of existing literature in the field, this paper provides evidence for a simple, but effective, paradigm upon which a telehealth system may be built, and highlights how such a model may successfully apply to heart failure management, to improve patients' quality of life after discharge, increase independency, and reduce readmissions and costs for the public health institutions. A few examples are discussed, to show the real applicability of the proposed model and further confirm the effectiveness of telehealth, when properly designed and tailored to users' needs. Keywords: remote health care, workflow, requirements

  2. Participatory design methods for the development of a clinical telehealth service for neonatal homecare

    DEFF Research Database (Denmark)

    Garne Holm, Kristina; Brødsgaard, Anne; Zachariassen, Gitte

    2017-01-01

    . While the benefits are beginning to be realised, widespread uptake of telehealth has been limited due to a range of logistical challenges. Understanding user requirements is important when planning and developing a clinical telehealth service. We therefore used participatory design to develop a clinical...... on the results obtained during the workshops and subsequent testing, we developed an application (app), which was integrated into the medical record at the neonatal unit. The app was used to initiate videoconferences and chat messages between the family at home and the neonatal unit, and to share information...... regarding infant growth and well-being. CONCLUSION: Results obtained from the workshops and testing demonstrated the importance of involving users when developing new telehealth applications. The workshops helped identify the challenges associated with delivery of the service, and helped instruct the design...

  3. A cost-benefit analysis of preventative management for zebra and quagga mussels in the Colorado-Big Thompson System

    Science.gov (United States)

    Thomas, Catherine M.

    2010-01-01

    Zebra and quagga mussels are fresh water invaders that have the potential to cause severe ecological and economic damage. It is estimated that mussels cause $1 billion dollars per year in damages to water infrastructure and industries in the United States (Pimentel et al., 2004). Following their introduction to the Great Lakes in the late 1980s, mussels spread rapidly throughout the Mississippi River Basin and the Eastern U.S. The mussel invasion in the West is young. Mussels were first identified in Nevada in 2007, and have since been identified in California, Arizona, Colorado, Utah, and Texas. Western water systems are very different from those found in the East. The rapid spread of mussels through the eastern system was facilitated by connected and navigable waterways. Western water systems are less connected and are characterized by man-made reservoirs and canals. The main vector of spread for mussels in the West is overland on recreational boats (Bossenbroek et al., 2001). In response to the invasion, many western water managers have implemented preventative management programs to slow the overland spread of mussels on recreational boats. In Colorado, the Colorado Department of Wildlife (CDOW) has implemented a mandatory boat inspection program that requires all trailered boats to be inspected before launching in any Colorado water body. The objective of this study is to analyze the costs and benefits of the CDOW boat inspection program in Colorado, and to identify variables that affect the net benefits of preventative management. Predicting the potential economic benefits of slowing the spread of mussels requires integrating information about mussel dispersal potential with estimates of control costs (Keller et al., 2009). Uncertainty surrounding the probabilities of establishment, the timing of invasions, and the damage costs associated with an invasion make a simulation model an excellent tool for addressing "what if" scenarios and shedding light on the

  4. Thirty Years Later: Reflections of the Big Thompson Flood, Colorado, 1976 to 2006

    Science.gov (United States)

    Jarrett, R. D.; Costa, J. E.; Brunstein, F. C.; Quesenberry, C. A.; Vandas, S. J.; Capesius, J. P.; O'Neill, G. B.

    2006-12-01

    Thirty years ago, over 300 mm of rain fell in about 4 to 6 hours in the middle reaches of the Big Thompson River Basin during the devastating flash flood on July 31, 1976. The rainstorm produced flood discharges that exceeded 40 m3/s/km2. A peak discharge of 883 m3/s was estimated at the Big Thompson River near Drake streamflow-gaging station. The raging waters left 144 people dead, 250 injured, and over 800 people were evacuated by helicopter. Four-hundred eighteen homes and businesses were destroyed, as well as 438 automobiles, and damage to infrastructure left the canyon reachable only via helicopter. Total damage was estimated in excess of $116 million (2006 dollars). Natural hazards similar to the Big Thompson flood are rare, but the probability of a similar event hitting the Front Range, other parts of Colorado, or other parts of the Nation is real. Although much smaller in scale than the Big Thompson flood, several flash floods have happened during the monsoon in early July 2006 in the Colorado foothills that reemphasized the hazards associated with flash flooding. The U.S. Geological Survey (USGS) conducts flood research to help understand and predict the magnitude and likelihood of large streamflow events such as the Big Thompson flood. A summary of hydrologic conditions of the 1976 flood, what the 1976 flood can teach us about flash floods, a description of some of the advances in USGS flood science as a consequence of this disaster, and lessons that we learned to help reduce loss of life from this extraordinary flash flood are discussed. In the 30 years since the Big Thompson flood, there have been important advances in streamflow monitoring and flood warning. The National Weather Service (NWS) NEXRAD radar allows real-time monitoring of precipitation in most places in the United States. The USGS currently (2006) operates about 7,250 real-time streamflow-gaging stations in the United States that are monitored by the USGS, the NWS, and emergency managers

  5. A Systematic Review of Research Studies Examining Telehealth Privacy and Security Practices Used By Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Valerie J.M. Watzlaf

    2017-11-01

    Full Text Available The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P. PubMed, CINAHL and INSPEC from 2003 – 2016 were searched and returned 25,404 papers (after duplications were removed. Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth.  Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen’s kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more studies with specific information about the use of privacy and security practices when using telehealth technologies as well as studies that examine patient and provider preferences on how data is kept private and secure during and after telehealth sessions. Keywords: Computer security, Health personnel, Privacy, Systematic review, Telehealth

  6. The Use of Telehealth to Teach Reproductive Health to Female Rural High School Students.

    Science.gov (United States)

    Yoost, Jennie Lee; Starcher, Rachael Whitley; King-Mallory, Rebecca Ann; Hussain, Nafeeza; Hensley, Christina Ann; Gress, Todd William

    2017-04-01

    To evaluate the use of telehealth to teach reproductive health to rural areas with high rates of teen pregnancy. Prospective cohort study. Two high schools in rural West Virginia. High school female students who attended telehealth sessions. Teleconferencing equipment connected rural high schools to a distal academic institution. Telehealth sessions included reproductive health and life skills topics. Demographic information, session pre- and post-tests, and 6- month assessment was obtained. Reproductive health knowledge, behavior, and self-efficacy were assessed at intervention and at 6 months, along with Likert scale evaluation of telehealth as an educational tool. Fifty-five students participated in the program with an average age of 16.14 (SD 1.24) years. Only 20% (10/50) of subjects' mothers and 12% (6/50) of subjects' fathers had achieved education beyond high school, and 20% (10/50) of subject's mothers had experienced teen pregnancies (age 18 or younger). Sexual activity was reported among 52% (26/50) of subjects, 4/50 (8%) reported desire to become pregnant within the next year, and 4/50 (8%) reported already pregnant. Thirty-seven students completed the 6-month follow-up survey. Reported condom use increased from 20% (10/50) at baseline to 40% (15/37) at 6 months (P = .04) and hormonal contraception use increased from 22% (11/50) to 38% (14/37) (P = .12). Report of human papillomavirus vaccination increased from 38% (10/26) to 70% (26/37) (P = .001) among all subjects. At 6 months, 91.8% (34/37) reported the use of telehealth was "very effective" as a means to teach the material. Telehealth is an effective tool to teach reproductive health to rural areas. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  7. Clinical Examination Component of Telemedicine, Telehealth, mHealth, and Connected Health Medical Practices.

    Science.gov (United States)

    Weinstein, Ronald S; Krupinski, Elizabeth A; Doarn, Charles R

    2018-05-01

    Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Telehealth for Hepatitis C Care in the DAA Era; Ensuring Everyone Can Access a Cure

    Science.gov (United States)

    Schulz, Thomas Ray; Kanhutu, Kudzai; Sasadeusz, Joe; Watkinson, Sally; Biggs, Beverley Ann

    2017-01-01

    Abstract Background The Victorian Infectious Diseases Service currently provides telehealth care for rural and regional patients with hepatitis C. From March 2016 direct acting antiviral therapy (DAA) for Hepatitis C has been subsidised for all Australian adults with Hepatitis C. The wide geographic distribution of Australia’s population means patients have to travel considerable distances to access specialist care. The increasing availability of web-based videoconferencing platforms have provided unprecedented capacity to manage patients remotely. The primary aim of this study is to determine whether telehealth delivered hepatitis C management achieves virological outcomes comparable to that achieved in randomised clinical trials. Methods The study is part of a quality audit of the hepatitis and outreach service. Measured outcomes were; (i) proportion of patients achieving a sustained virological response (SVR); (ii) failure to attend rate (FTA); (iii) frequency of technical difficulties; (iv) patient travel kilometres saved through not attending clinic in person; (v) Reduced carbon production due to reduced travel; and (vi) Consultation duration time. Results In 1 year from March 1, 2016, 58 patients have been commenced on Hepatitis C treatment and managed either partially or completely via telehealth. Of those who have so far completed therapy (29 patients) an SVR rate of 97% has been achieved. Expected SVR genotype 1 (>95%); genotype 3 (>85%). The average travel avoided for each telehealth consultation was 616km and each patient had a 
median of two telehealth consultations. Technical difficulties occurred in less than 10% of consultations with FTA of 17%. Consult duration averaged 15 minutes or less. Conclusion Our completed patient cohort results demonstrate comparable virological outcomes for telehealth managed patients as compared with onsite management, even when adjusted for age, gender and hepatic fibrosis status. This suggests efforts to

  9. Transitioning a home telehealth project into a sustainable, large-scale service: a qualitative study.

    Science.gov (United States)

    Wade, Victoria A; Taylor, Alan D; Kidd, Michael R; Carati, Colin

    2016-05-16

    This study was a component of the Flinders Telehealth in the Home project, which tested adding home telehealth to existing rehabilitation, palliative care and geriatric outreach services. Due to the known difficulty of transitioning telehealth projects services, a qualitative study was conducted to produce a preferred implementation approach for sustainable and large-scale operations, and a process model that offers practical advice for achieving this goal. Initially, semi-structured interviews were conducted with senior clinicians, health service managers and policy makers, and a thematic analysis of the interview transcripts was undertaken to identify the range of options for ongoing operations, plus the factors affecting sustainability. Subsequently, the interviewees and other decision makers attended a deliberative forum in which participants were asked to select a preferred model for future implementation. Finally, all data from the study was synthesised by the researchers to produce a process model. 19 interviews with senior clinicians, managers, and service development staff were conducted, finding strong support for home telehealth but a wide diversity of views on governance, models of clinical care, technical infrastructure operations, and data management. The deliberative forum worked through these options and recommended a collaborative consortium approach for large-scale implementation. The process model proposes that the key factor for large-scale implementation is leadership support, which is enabled by 1) showing solutions to the problems of service demand, budgetary pressure and the relationship between hospital and primary care, 2) demonstrating how home telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Two key actions to enable change were marketing telehealth to patients, clinicians and policy-makers, and building a community of

  10. Revisiting Intel Xeon Phi optimization of Thompson cloud microphysics scheme in Weather Research and Forecasting (WRF) model

    Science.gov (United States)

    Mielikainen, Jarno; Huang, Bormin; Huang, Allen

    2015-10-01

    The Thompson cloud microphysics scheme is a sophisticated cloud microphysics scheme in the Weather Research and Forecasting (WRF) model. The scheme is very suitable for massively parallel computation as there are no interactions among horizontal grid points. Compared to the earlier microphysics schemes, the Thompson scheme incorporates a large number of improvements. Thus, we have optimized the speed of this important part of WRF. Intel Many Integrated Core (MIC) ushers in a new era of supercomputing speed, performance, and compatibility. It allows the developers to run code at trillions of calculations per second using the familiar programming model. In this paper, we present our results of optimizing the Thompson microphysics scheme on Intel Many Integrated Core Architecture (MIC) hardware. The Intel Xeon Phi coprocessor is the first product based on Intel MIC architecture, and it consists of up to 61 cores connected by a high performance on-die bidirectional interconnect. The coprocessor supports all important Intel development tools. Thus, the development environment is familiar one to a vast number of CPU developers. Although, getting a maximum performance out of MICs will require using some novel optimization techniques. New optimizations for an updated Thompson scheme are discusses in this paper. The optimizations improved the performance of the original Thompson code on Xeon Phi 7120P by a factor of 1.8x. Furthermore, the same optimizations improved the performance of the Thompson on a dual socket configuration of eight core Intel Xeon E5-2670 CPUs by a factor of 1.8x compared to the original Thompson code.

  11. Cancer Survivors’ Experience With Telehealth: A Systematic Review and Thematic Synthesis

    Science.gov (United States)

    Lucas, Grace; Marcu, Afrodita; Piano, Marianne; Grosvenor, Wendy; Mold, Freda; Maguire, Roma; Ream, Emma

    2017-01-01

    Background Net survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors—individuals living with and beyond cancer—to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are “complex,” and understanding patient experiences of them is important in evaluating their impact. However, a wider view of patient experience is lacking as qualitative studies detailing cancer survivor engagement with telehealth are yet to be synthesized. Objective To systematically identify, appraise, and synthesize qualitative research evidence on the experiences of adult cancer survivors participating in telehealth interventions, to characterize the patient experience of telehealth interventions for this group. Methods Medline (PubMed), PsychINFO, Cumulative Index for Nursing and Allied Health Professionals (CINAHL), Embase, and Cochrane Central Register of Controlled Trials were searched on August 14, 2015, and March 8, 2016, for English-language papers published between 2006 and 2016. Inclusion criteria were as follows: adult cancer survivors aged 18 years and over, cancer diagnosis, experience of participating in a telehealth intervention (defined as remote communication or remote monitoring with an HCP delivered by telephone, Internet, or hand-held or mobile technology), and reporting qualitative data including verbatim quotes. An adapted Critical Appraisal Skill Programme (CASP) checklist for qualitative research was used to assess paper quality. The results section of each included article was coded line by line, and all papers underwent inductive analysis, involving comparison, reexamination, and grouping of codes to develop descriptive themes

  12. Use of telehealth in the management of non-critical emergencies in rural or remote emergency departments: a systematic review.

    Science.gov (United States)

    du Toit, Marie; Malau-Aduli, Bunmi; Vangaveti, Venkat; Sabesan, Sabe; Ray, Robin A

    2017-01-01

    Background Telehealth has been used extensively in emergency departments to improve healthcare provision. However, its impact on the management of non-critical emergency presentations within rural and remote emergency department settings has not been adequately explored. The objective of this systematic review is to identify how telehealth has been used to assist in the management of non-critical presentations in rural and remote emergency departments and the outcomes. Methods Articles were identified through database searches of CINAHL, Cochrane, MEDLINE (OVID), Informit and SCOPUS, as well as the screening of relevant article reference and citation lists. To determine how telehealth can assist in the management of non-critical emergencies, information was extracted relating to telehealth programme model, the scope of service and participating health professionals. The outcomes of telehealth programmes were determined by analysing the uptake and usage of telehealth, the impact on altering a diagnosis or management plan as well as patient disposition including patient transfer, discharge, local hospital admission and rates of discharge against medical advice. Results Of the 2532 identified records, 15 were found to match the eligibility criteria and were included in the review. Uptake and usage increased for telehealth programmes predominantly utilised by nursing staff with limited local medical support. Teleconsultation conservatively altered patient diagnosis or management in 18-66% of consultations. Although teleconsultation was associated with increased patient transfer rates, unnecessary transfers were reduced. Simultaneously, an increase in local hospital admission was noted and fewer patients were discharged home. Discharge against medical advice rates were low at 0.9-1.1%. Conclusion The most widely implemented hub-and-spoke telehealth model could be incorporated into existing referral frameworks. Telehealth programmes may assist in reducing unnecessary

  13. The influence of a telehealth project on healthcare professional recruitment and retention in remote areas in Mali: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Gisèle Irène Claudine Mbemba

    2016-05-01

    Full Text Available Objectives: The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable aux Ressources Humaines en Santé aimed to contribute to more equitable access to care and support practice in remote regions in Mali. This study explored the evolution of perceptions concerning telehealth among healthcare professionals in the four district health centres that participated in the EQUI-ResHus project and identified variables influencing their perceptions of telehealth impact on recruitment and retention of health professionals. Methods: One year after a first survey (T1, a second data collection (T2 was carried out among healthcare professionals using a 91-item questionnaire. Questions assessing telehealth use and perceptions and perceived impact on recruitment and retention of healthcare professionals were rated on a 5-point Likert scale. A total of 10 independent variables were considered for the analyses. A Wilcoxon signed-rank test was performed to detect differences between T1 and T2, and a bivariate linear regression model for repeated measures was carried out to assess the impact of independent variables on dependent variables. Results: There were no noticeable changes in perceptions related to telehealth influence on recruitment and retention. Only access to information and communication technology significantly differed between T1 and T2 according the Wilcoxon rank test (p = 0.001. Perceived influence of telehealth on recruitment and retention was mostly explained by attitude towards telehealth, perceived effect on recruitment and retention and barriers to recruitment and retention. Conclusion: Based on our results, telehealth was perceived as having a positive influence but mostly indirect influence on healthcare professional recruitment and retention. Also, there were no major changes after 1 year of telehealth use.

  14. Land use, fishing, climate change, and decline of Thompson River, British Columbia, coho salmon

    Energy Technology Data Exchange (ETDEWEB)

    Bradford, M. J.; Irvine, J. R. [Fisheries and Oceans Canada, Pacific Biological Station, Nanaimo, BC (Canada)

    2000-01-01

    Reasons for the decline in abundance of Pacific salmon population in the Thompson River watershed in British Columbia was investigated. Results suggests that the decline could be the result of a declining trend in productivity related to changes in ocean conditions, overfishing, and changes in the freshwater habitat. The abundance of salmon correlated with agricultural land use, road density, and qualitative changes in stream habitat status; logging appeared to have had no such effect. It was concluded that salmon populations will continue to decline unless limits on fishing are strictly enforced, and unless salmon producing watersheds are restored and ocean conditions are significantly improved . 12 refs., 2 figs.

  15. NanoLaunch

    Science.gov (United States)

    Jones, Jonathan; Harris, Lawanna

    2015-01-01

    NASA's NanoLaunch effort will provide the framework to mature both Earth-to-orbit and on-orbit propulsion and avionics technologies while also providing affordable, dedicated access to low-Earth orbit for CubeSat-class payloads. The project will also serve as an early career personnel training opportunity with mentors to gain hands-on project experience.

  16. 77 FR 50549 - Agency Information Collection: Emergency Submission for OMB Review (Telehealth in the Parkinson's...

    Science.gov (United States)

    2012-08-21

    ... Collection: Emergency Submission for OMB Review (Telehealth in the Parkinson's Disease Research, Education... needed to improve the care and clinical outcomes of patients with Parkinson's disease. DATES: Comments... Parkinson's Disease Research, Education and Clinical Center (PADRECC): The Key to the Patient-Centered...

  17. Telehealth--an effective delivery method for diabetes self-management education?

    Science.gov (United States)

    Fitzner, Karen; Moss, Gail

    2013-06-01

    Diabetes is a chronic disease that is often comorbid with cardiovascular disease, hypertension, kidney disease, and neuropathy. Its management is complex, requiring ongoing clinical management, lifestyle changes, and self-care. This article examines recent literature on telehealth and emerging technological tools for supporting self-management of diabetes and identifies best practices. The authors conducted a PubMed search (January 2008-2012) that was supplemented by review of meeting materials and a scan of the Internet to identify emerging technologies. Fifty-eight papers were reviewed; 12 were selected for greater analysis. This review supports earlier findings that the delivery of diabetes self-management and training (DSME/T) via telehealth is useful, appropriate, and acceptable to patients and providers. Best practices are emerging; not all technology is appropriate for all populations--interactive technology needs to be appropriate to the patient's age, abilities, and sensitivities. Telehealth is scalable and sustainable provided that it adds value, does not add to the provider's workload, and is fairly reimbursed. However, there are multiple barriers (patient, provider, health system) to remotely provided DSME/T. DSME/T delivered via telehealth offers effective, efficient, and affordable ways to reach and support underserved minorities and other people with diabetes and related comorbidities. The new generation of smartphones, apps, and other technologies increase access, and the newest interventions are designed to meet patient needs, do not increase workloads, are highly appropriate, enhance self-management, and are desired by patients.

  18. Steps to Offering Low Vision Rehabilitation Services through Clinical Video Telehealth

    Science.gov (United States)

    Ihirig, Carolyn

    2016-01-01

    Telehealth clinical applications, which allow medical professionals to use telecommunications technologies to provide services to individuals remotely, continue to expand in areas such as low vision rehabilitation, where evaluations are provided to patients who live in rural areas. As with face-to-face low vision rehabilitation, the goal of…

  19. Telehealth Applications to Enhance CKD Knowledge and Awareness Among Patients and Providers.

    Science.gov (United States)

    Tuot, Delphine S; Boulware, L Ebony

    2017-01-01

    CKD affects 13% of the US adult population, causes excess mortality, and is associated with significant sociodemographic disparities. Optimal CKD management slows progression of disease and reduces cardiovascular-related outcomes. Resources for patients and primary care providers, major stakeholders in preventive CKD care, are critically needed to enhance understanding of the disease and to optimize CKD health, particularly because of the asymptomatic nature of kidney disease. Telehealth is defined as the use of electronic communication and telecommunications technology to support long-distance clinical health care, patient and professional health-related education, and public health and health administration. It provides new opportunities to enhance awareness and understanding among these important stakeholders. This review will examine the role of telehealth within existing educational theories, identify telehealth applications that can enhance CKD knowledge and behavior change among patients and primary care providers, and examine the advantages and disadvantages of telehealth vs usual modalities for education. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  20. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments.

    Science.gov (United States)

    Langabeer, James R; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

    2016-11-01

    Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  1. A Modeled Analysis of Telehealth Methods for Treating Pressure Ulcers after Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Mark W. Smith

    2012-01-01

    Full Text Available Home telehealth can improve clinical outcomes for conditions that are common among patients with spinal cord injury (SCI. However, little is known about the costs and potential savings associated with its use. We developed clinical scenarios that describe common situations in treatment or prevention of pressure ulcers. We calculated the cost implications of using telehealth for each scenario and under a range of reasonable assumptions. Data were gathered primarily from US Department of Veterans Affairs (VA administrative records. For each scenario and treatment method, we multiplied probabilities, frequencies, and costs to determine the expected cost over the entire treatment period. We generated low-, medium-, and high-cost estimates based on reasonable ranges of costs and probabilities. Telehealth care was less expensive than standard care when low-cost technology was used but often more expensive when high-cost, interactive devices were installed in the patient’s home. Increased utilization of telehealth technology (particularly among rural veterans with SCI could reduce the incidence of stage III and stage IV ulcers, thereby improving veterans' health and quality of care without increasing costs. Future prospective studies of our present scenarios using patients with various healthcare challenges are recommended.

  2. Dutch nurses' willingness to use home telehealth : implications for practice and education

    NARCIS (Netherlands)

    van Houwelingen, C.T.M.; Barakat, A.; Best, R.; Boot, W.R.; Charness, N.; Kort, H.S.M.

    Home telehealth (HT) refers to the use of videoconferencing to provide care to patients remotely and can help older adults age in place. However, these technologies are unlikely to impact care unless health care providers are motivated to use them. Education may play a key role in increasing

  3. Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study.

    Science.gov (United States)

    Bashir, Ayisha; Bastola, Dhundy R

    2018-05-25

    Telehealth nursing, or the delivery, management, and coordination of nursing care services provided via telecommunications technology, is one of the methods of delivering health care to patients in the United States. It is important to assess the service quality of the involved health professionals as well as the telehealth nursing process. The focus of this study is the innovative model of telehealth care delivery by nurses for managing patients with chronic disease while they are living in their own residence. The primary objective of this pilot study was to examine whether telehealth technology impacts the perceived level of internal service quality delivered by nurses within a telehealth organization. To address this research goal, the notion of telehealth nursing service quality (TNSQ) is empirically tested and validated with a survey instrument. Data were collected from nurses belonging to a home care agency based on interview questions inquiring about facilitators and inhibitors to TNSQ. A survey to measure TNSQ based on the SERVQUAL instrument was completed by adjusting descriptions of the original instrument to suit the context. Follow-up interviews were conducted to validate questions on the revised instrument. The findings of this survey research were positive, based on mean differences between expectations and perceptions of TNSQ. This indicates satisfaction with TNSQ and shows that the quality of the service is higher than what the respondents expect. The Wilcoxon signed-rank test using the P value for the test, which is .35, did not show a statistically significant change between the median differences of perception and expectation. The total number of respondents was 13. Results indicate that overall perceived service quality is a positive value (0.05332). This means the perceptions of the level of service are slightly higher than what they expect, indicating there is satisfaction with TNSQ. The responses to the interview questions and data gathered

  4. Implementation of telehealth support for patients with type 2 diabetes using insulin treatment: an exploratory study.

    Science.gov (United States)

    Turner, Jane; Larsen, Mark; Tarassenko, Lionel; Neil, Andrew; Farmer, Andrew

    2009-01-01

    Initiating and adjusting insulin treatment for people with type 2 diabetes (T2D) requires frequent clinician contacts both face-to-face and by telephone. We explored the use of a telehealth system to offer additional support to these patients. Twenty-three patients with uncontrolled T2D were recruited from nine general practices to assess the feasibility and acceptability of telehealth monitoring and support for insulin initiation and adjustment. The intervention included a standard algorithm for self-titration of insulin dose, a Bluetooth enabled glucose meter linked to a mobile phone, an integrated diary to record insulin dose, feedback of charted blood glucose data and telehealth nurse review with telephone follow-up. Additional contact with patients was initiated when no readings were transmitted for >3 days or when persistent hyper- or hypoglycaemia was identified. Reponses of patients and clinicians to the system were assessed informally. The mean (SD) patient age was 58 years (12) with 78% male. The mean (SD) diabetes duration was 6.4 years (4.5), HbA1c at baseline was 9.5% (2.2), and the decrease in HbA1c at three months was 0.52% (0.91) with an insulin dose increase of 9 units (26). A mean (SD) of 160 (93) blood glucose readings was transmitted per patient in these three months. Practice nurses and general practitioners (GPs) viewed the technology as having the potential to improve patient care. Most patients were able to use the equipment with training and welcomed review of their blood glucose readings by a telehealth nurse. Although the concept of telehealth monitoring is unfamiliar to most patients and practice nurses, the technology improved the support available for T2D patients commencing insulin treatment.

  5. Developing next-generation telehealth tools and technologies: patients, systems, and data perspectives.

    Science.gov (United States)

    Ackerman, Michael J; Filart, Rosemarie; Burgess, Lawrence P; Lee, Insup; Poropatich, Ronald K

    2010-01-01

    The major goals of telemedicine today are to develop next-generation telehealth tools and technologies to enhance healthcare delivery to medically underserved populations using telecommunication technology, to increase access to medical specialty services while decreasing healthcare costs, and to provide training of healthcare providers, clinical trainees, and students in health-related fields. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers. In the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization are critical pieces to the process. Next-generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity. To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service. Toward that end, our group addressed three overarching questions: (1) What are the high-impact topics? (2) What are the barriers to progress? and (3) What roles can the National Institutes of Health and its various institutes and centers play in fostering the future development of telehealth?

  6. Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health.

    Science.gov (United States)

    Silva, Andressa Sharllene Carneiro da; Rizzante, Fabio Antonio Piola; Picolini, Mirela Machado; Campos, Karis de; Corrêa, Camila de Castro; Franco, Elen Caroline; Pardo-Fanton, Cássia de Souza; Blasca, Wanderléia Quinhoneiro; Berretin-Felix, Giédre

    2011-01-01

    Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP) has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL), in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%), and by the performance of tests and paperwork about the theoretical content provided. In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%), an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. The results showed that the TLFOB-USP members, adjoining to the professor's participants, develop projects

  7. Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health

    Directory of Open Access Journals (Sweden)

    Andressa Sharllene Carneiro da Silva

    2011-12-01

    Full Text Available Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL, in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. Objective: The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. Material and Methods: The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%, and by the performance of tests and paperwork about the theoretical content provided. Results: In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%, an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. Conclusions: The results showed that the TLFOB

  8. Consul Thompson, the Bostonians and the Formation of the Chichen Galaxy, 1893-1903

    Directory of Open Access Journals (Sweden)

    Guillermo Palacios

    2015-07-01

    Full Text Available This article continues the narrative of the experiences of the businessmen-academics and collectors connected to Harvard University –the so-called Bostonians– in the archaeological sites of Yucatán, which were explored towards the end of the 1880s by Edward H. Thompson under their patronage, including his appointment as the U.S. consul in Mérida – as a form of protection – on their recommendation. This article reconstructs the loss of control of the strategic consulate by the Bostonians between 1893 and 1897. This narrative covers the occupation and the beginning of the looting of Chichen Itza, as well as the pseudo-scientific narrative the excavation provokes. It also analyzes the networks of alliances and rivalries resulting from the arrival of other U.S. archaeologists and archaeological institutions. It concludes with the paths Thompson pursued to undertake the adventure of his lifetime: the dredging of Chichen Itza’s Sacred Cenote.

  9. Experiences with tele-health follow-up in patients with rheumatoid arthritis: a qualitative interview study

    DEFF Research Database (Denmark)

    Raunsbæk Knudsen, Line; Thurah, Annette De; Lomborg, Kirsten

    2017-01-01

    the patients' different needs, wishes and abilities to take part in tele-health follow-up. Our findings reveal a need for more insight into how tele-health follow-up could be integrated in routine clinical practice, paying special attention to how reluctant patients may be supported.......: Adopting a strategy of interpretive description, we conducted individual, semi-structured interviews with 15 RA patients participating in a tele-health follow-up. Participants were selected purposively and consecutive from both genders and with various ages, disease durations and disease severity....... The analysis was inductive with a constant comparative approach. First, we identified the main themes conveying the participants' experiences. Then, we constructed patient typologies to explain different perspectives on the tele-health follow-up. RESULTS: Five themes covered the participants' experiences: 'A...

  10. Hype, harmony and human factors: applying user-centered design to achieve sustainable telehealth program adoption and growth.

    Science.gov (United States)

    Rossos, P G; St-Cyr, O; Purdy, B; Toenjes, C; Masino, C; Chmelnitsky, D

    2015-01-01

    Despite decades of international experience with the use of information and communication technologies in healthcare delivery, widespread telehealth adoption remains limited and progress slow. Escalating health system challenges related to access, cost and quality currently coincide with rapid advancement of affordable and reliable internet based communication technologies creating unprecedented opportunities and incentives for telehealth. In this paper, we will describe how Human Factors Engineering (HFE) and user-centric elements have been incorporated into the establishment of telehealth within a large academic medical center to increase acceptance and sustainability. Through examples and lessons learned we wish to increase awareness of HFE and its importance in the successful implementation, innovation and growth of telehealth programs.

  11. Launch of Zoological Letters.

    Science.gov (United States)

    Fukatsu, Takema; Kuratani, Shigeru

    2016-02-01

    A new open-access journal, Zoological Letters, was launched as a sister journal to Zoological Science, in January 2015. The new journal aims at publishing topical papers of high quality from a wide range of basic zoological research fields. This review highlights the notable reviews and research articles that have been published in the first year of Zoological Letters, providing an overview on the current achievements and future directions of the journal.

  12. Space Logistics: Launch Capabilities

    Science.gov (United States)

    Furnas, Randall B.

    1989-01-01

    The current maximum launch capability for the United States are shown. The predicted Earth-to-orbit requirements for the United States are presented. Contrasting the two indicates the strong National need for a major increase in Earth-to-orbit lift capability. Approximate weights for planned payloads are shown. NASA is studying the following options to meet the need for a new heavy-lift capability by mid to late 1990's: (1) Shuttle-C for near term (include growth versions); and (2) the Advanced Lauching System (ALS) for the long term. The current baseline two-engine Shuttle-C has a 15 x 82 ft payload bay and an expected lift capability of 82,000 lb to Low Earth Orbit. Several options are being considered which have expanded diameter payload bays. A three-engine Shuttle-C with an expected lift of 145,000 lb to LEO is being evaluated as well. The Advanced Launch System (ALS) is a potential joint development between the Air Force and NASA. This program is focused toward long-term launch requirements, specifically beyond the year 2000. The basic approach is to develop a family of vehicles with the same high reliability as the Shuttle system, yet offering a much greater lift capability at a greatly reduced cost (per pound of payload). The ALS unmanned family of vehicles will provide a low end lift capability equivalent to Titan IV, and a high end lift capability greater than the Soviet Energia if requirements for such a high-end vehicle are defined.In conclusion, the planning of the next generation space telescope should not be constrained to the current launch vehicles. New vehicle designs will be driven by the needs of anticipated heavy users.

  13. Space Shuttle Endeavour launch

    Science.gov (United States)

    1992-01-01

    A smooth countdown culminated in a picture-perfect launch as the Space Shuttle Endeavour (STS-47) climbed skyward atop a ladder of billowing smoke. Primary payload for the plarned seven-day flight was Spacelab-J science laboratory. The second flight of Endeavour marks a number of historic firsts: the first space flight of an African-American woman, the first Japanese citizen to fly on a Space Shuttle, and the first married couple to fly in space.

  14. Telehealth language assessments using consumer grade equipment in rural and urban settings: Feasible, reliable and well tolerated.

    Science.gov (United States)

    Sutherland, Rebecca; Trembath, David; Hodge, Antoinette; Drevensek, Suzi; Lee, Sabrena; Silove, Natalie; Roberts, Jacqueline

    2017-01-01

    Introduction Telehealth can be an effective way to provide speech pathology intervention to children with speech and language impairments. However, the provision of reliable and feasible standardised language assessments via telehealth to establish children's needs for intervention and to monitor progress has not yet been well established. Further, there is limited information about children's reactions to telehealth. This study aimed to examine the reliability and feasibility of conducting standardised language assessment with school-aged children with known or suspected language impairment via a telehealth application using consumer grade computer equipment within a public school setting. Method Twenty-three children (aged 8-12 years) participated. Each child was assessed using a standardised language assessment comprising six subtests. Two subtests were administered by a speech pathologist face-to-face (local clinician) and four subtests were administered via telehealth. All subtests were completed within a single visit to the clinic service, with a break between the face to face and telehealth sessions. The face-to-face clinician completed behaviour observation checklists in the telehealth and face to face conditions and provided feedback on the audio and video quality of the application from the child's point of view. Parent feedback about their child's experience was elicited via survey. Results There was strong inter-rater reliability in the telehealth and face-to-face conditions (correlation coefficients ranged from r = 0.96-1.0 across the subtests) and good agreement on all measures. Similar levels of attention, distractibility and anxiety were observed in the two conditions. Clinicians rated only one session of 23 as having poor audio quality and no sessions were rated as having poor visual quality. Parent and child reactions to the use of telehealth were largely positive and supportive of using telehealth to assess rural children. Discussion The

  15. Effect of telehealth-to-home interventions on quality of life for individuals with depressive and anxiety disorders

    Directory of Open Access Journals (Sweden)

    Durl

    2014-11-01

    Full Text Available Logan Durland,1 Alejandro Interian,1,2 Ingrid Pretzer-Aboff,3 Roseanne D Dobkin11Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School, Department of Psychiatry, Piscataway, NJ, 2The New Jersey Healthcare System, Veteran Affairs Medical Center, Lyons, NJ, 3University of Delaware, School of Nursing and Biomechanics and Movement Sciences Program, Newark, DE, USAAbstract: Although millions of individuals suffer from mental health problems worldwide, only a small fraction receives adequate treatment. The high prevalence of depression and anxiety observed worldwide, in conjunction with very low rates of treatment utilization, are of great clinical significance, as these psychiatric conditions are two of the most important determinants of quality of life (QoL. Telehealth interventions have been touted as potential solutions to these mental health care disparities, with great interest and utility demonstrated across a diverse array of medical and psychiatric populations. Telehealth interventions may be clinic-based or home-based. The primary objective of this paper is to highlight the extent to which telehealth-to-home interventions positively impact multiple facets of QoL for individuals with depression and anxiety disorders, including those with comorbid medical conditions. While QoL outcomes are important to consider in any assessment of treatment effectiveness, QoL enhancement has received limited attention in the telemental health literature to date. All studies included in the present review evaluate telehealth-to-home treatments, assess QoL outcomes, and incorporate some degree of live, synchronous therapist-patient contact. Recommendations to advance the application of telehealth-to-home approaches are proposed and include: additional research on video-to-home telehealth platforms, strategies to increase the adoption of telehealth-to-home interventions amongst mental health treatment providers, national legislative

  16. Launch Control Network Engineer

    Science.gov (United States)

    Medeiros, Samantha

    2017-01-01

    The Spaceport Command and Control System (SCCS) is being built at the Kennedy Space Center in order to successfully launch NASA’s revolutionary vehicle that allows humans to explore further into space than ever before. During my internship, I worked with the Network, Firewall, and Hardware teams that are all contributing to the huge SCCS network project effort. I learned the SCCS network design and the several concepts that are running in the background. I also updated and designed documentation for physical networks that are part of SCCS. This includes being able to assist and build physical installations as well as configurations. I worked with the network design for vehicle telemetry interfaces to the Launch Control System (LCS); this allows the interface to interact with other systems at other NASA locations. This network design includes the Space Launch System (SLS), Interim Cryogenic Propulsion Stage (ICPS), and the Orion Multipurpose Crew Vehicle (MPCV). I worked on the network design and implementation in the Customer Avionics Interface Development and Analysis (CAIDA) lab.

  17. Overcoming the tyranny of distance: An audit of process and outcomes from a pilot telehealth spinal assessment clinic.

    Science.gov (United States)

    Beard, Matthew; Orlando, Joseph F; Kumar, Saravana

    2017-09-01

    Introduction There is consistent evidence to indicate people living in rural and remote regions have limited access to healthcare and poorer health outcomes. One way to address this inequity is through innovative models of care such as telehealth. The aim of this pilot trial was to determine the feasibility, appropriateness and access to a telehealth clinic. In this pilot trial, the telehealth clinic outcomes are compared with the outreach clinic. Both models of care are commonly utilised means of providing healthcare to meet the needs of people living in rural and remote regions. Methods A prospective audit was conducted on a Spinal Assessment Clinic Telehealth pilot trial for patients with spinal disorders requiring non-urgent surgical consultation. Data were recorded from all consultations managed using videoconferencing technology between the Royal Adelaide Hospital and Port Augusta Community Health Service, South Australia between September 2013 and January 2014. Outcomes included analysis of process, service activity, clinical actions, safety and costs. Data were compared to a previous spinal assessment outreach clinic in the same area between August and December 2012. Results There were 25 consultations with 22 patients over the five-month telehealth pilot trial. Spinal disorders were predominantly of the lumbar region (88%); the majority of initial consultations (64%) were discharged to the general practitioner. There were three requests for further imaging, five for minor interventions and three for other specialist/surgical consultation. Patient follow-up post telehealth pilot trial revealed no adverse outcomes. The total cost of AUD$11,187 demonstrated a 23% reduction in favour of the spinal assessment telehealth pilot trial, with the greatest savings in travel costs. Discussion The telehealth model of care demonstrated the efficient management of patients with spinal disorders in rural regions requiring non-urgent surgical consultation at low costs with

  18. Balancing Health Information Exchange and Privacy Governance from a Patient-Centred Connected Health and Telehealth Perspective.

    Science.gov (United States)

    Kuziemsky, Craig E; Gogia, Shashi B; Househ, Mowafa; Petersen, Carolyn; Basu, Arindam

    2018-04-22

     Connected healthcare is an essential part of patient-centred care delivery. Technology such as telehealth is a critical part of connected healthcare. However, exchanging health information brings the risk of privacy issues. To better manage privacy risks we first need to understand the different patterns of patient-centred care in order to tailor solutions to address privacy risks.  Drawing upon published literature, we develop a business model to enable patient-centred care via telehealth. The model identifies three patient-centred connected health patterns. We then use the patterns to analyse potential privacy risks and possible solutions from different types of telehealth delivery.  Connected healthcare raises the risk of unwarranted access to health data and related invasion of privacy. However, the risk and extent of privacy issues differ according to the pattern of patient-centred care delivery and the type of particular challenge as they enable the highest degree of connectivity and thus the greatest potential for privacy breaches.  Privacy issues are a major concern in telehealth systems and patients, providers, and administrators need to be aware of these privacy issues and have guidance on how to manage them. This paper integrates patient-centred connected health care, telehealth, and privacy risks to provide an understanding of how risks vary across different patterns of patient-centred connected health and different types of telehealth delivery. Georg Thieme Verlag KG Stuttgart.

  19. Launch Vehicle Control Center Architectures

    Science.gov (United States)

    Watson, Michael D.; Epps, Amy; Woodruff, Van; Vachon, Michael Jacob; Monreal, Julio; Williams, Randall; McLaughlin, Tom

    2014-01-01

    This analysis is a survey of control center architectures of the NASA Space Launch System (SLS), United Launch Alliance (ULA) Atlas V and Delta IV, and the European Space Agency (ESA) Ariane 5. Each of these control center architectures have similarities in basic structure, and differences in functional distribution of responsibilities for the phases of operations: (a) Launch vehicles in the international community vary greatly in configuration and process; (b) Each launch site has a unique processing flow based on the specific configurations; (c) Launch and flight operations are managed through a set of control centers associated with each launch site, however the flight operations may be a different control center than the launch center; and (d) The engineering support centers are primarily located at the design center with a small engineering support team at the launch site.

  20. Launching Garbage-Bag Balloons.

    Science.gov (United States)

    Kim, Hy

    1997-01-01

    Presents a modification of a procedure for making and launching hot air balloons made out of garbage bags. Student instructions for balloon construction, launching instructions, and scale diagrams are included. (DDR)

  1. Expendable launch vehicle studies

    Science.gov (United States)

    Bainum, Peter M.; Reiss, Robert

    1995-01-01

    Analytical support studies of expendable launch vehicles concentrate on the stability of the dynamics during launch especially during or near the region of maximum dynamic pressure. The in-plane dynamic equations of a generic launch vehicle with multiple flexible bending and fuel sloshing modes are developed and linearized. The information from LeRC about the grids, masses, and modes is incorporated into the model. The eigenvalues of the plant are analyzed for several modeling factors: utilizing diagonal mass matrix, uniform beam assumption, inclusion of aerodynamics, and the interaction between the aerodynamics and the flexible bending motion. Preliminary PID, LQR, and LQG control designs with sensor and actuator dynamics for this system and simulations are also conducted. The initial analysis for comparison of PD (proportional-derivative) and full state feedback LQR Linear quadratic regulator) shows that the split weighted LQR controller has better performance than that of the PD. In order to meet both the performance and robustness requirements, the H(sub infinity) robust controller for the expendable launch vehicle is developed. The simulation indicates that both the performance and robustness of the H(sub infinity) controller are better than that for the PID and LQG controllers. The modelling and analysis support studies team has continued development of methodology, using eigensensitivity analysis, to solve three classes of discrete eigenvalue equations. In the first class, the matrix elements are non-linear functions of the eigenvector. All non-linear periodic motion can be cast in this form. Here the eigenvector is comprised of the coefficients of complete basis functions spanning the response space and the eigenvalue is the frequency. The second class of eigenvalue problems studied is the quadratic eigenvalue problem. Solutions for linear viscously damped structures or viscoelastic structures can be reduced to this form. Particular attention is paid to

  2. Launch team training system

    Science.gov (United States)

    Webb, J. T.

    1988-01-01

    A new approach to the training, certification, recertification, and proficiency maintenance of the Shuttle launch team is proposed. Previous training approaches are first reviewed. Short term program goals include expanding current training methods, improving the existing simulation capability, and scheduling training exercises with the same priority as hardware tests. Long-term goals include developing user requirements which would take advantage of state-of-the-art tools and techniques. Training requirements for the different groups of people to be trained are identified, and future goals are outlined.

  3. Evolved Expendable Launch Vehicle (EELV)

    Science.gov (United States)

    2015-12-15

    FY13+ Phase I Buy Contractor: United Launch Services, LLC Contractor Location: 9501 East Panorama Circle Centennial , CO 80112 Contract Number...Contract Name: FY13+ Phase I Buy Contractor: United Launch Services, LLC Contractor Location: 9501 East Panorama Circle Centennial , CO 80112 Contract...FY12 EELV Launch Services (ELS5) Contractor: United Launch Services, LLC. Contractor Location: 9501 East Panorama Circle Centennial , CO 80112

  4. Balloon launching station, Mildura, Victoria

    International Nuclear Information System (INIS)

    The Mildura Balloon Launching Station was established in 1960 by the Department of Supply (now the Department of Manufacturing Industry) on behalf of the United States Atomic Energy Commission (USAEC) to determine the content of radioactive material in the upper atmosphere over Australia. The Station location and layout, staffing, balloon launching equipment, launching, tracking and recovery are described. (R.L.)

  5. Relationship between Root Growth of 'Thompson Seedless' Grapevines and Soil Temperature Relación entre el Crecimiento Radical de Vid 'Thompson Seedless' y la Temperatura del Suelo

    Directory of Open Access Journals (Sweden)

    Rodrigo Callejas R

    2009-12-01

    Full Text Available With the purpose of characterizing the growth of the root system of table grapes (Vitis vinifera L. cv. Thompson Seedless and its relationship with soil temperature, research was carried out during the 2004-2005 growing season in vineyards in the Copiapó and Huasco Valleys. Four plants were chosen and rhizotrons were used to measure the growth of the root system. Measurements were performed once a week from September 2004 to September 2005, estimating the intensity of root growth and its annual distribution in the ranges of 0 to 40, 40 to 80 and 80 to 120 cm of soil depth. Temperature sensors were installed in four plants at 25, 50, 75 and 100 cm of soil depth, and the temperature was registered every 1 h. The thermal diffusivity of the soil was calculated based on the annual mean temperature and annual thermal amplitude values. Root growth occurred throughout the year, presenting lower intensity in July (winter. Root systems presented different patterns in the distribution of growth intensity in the three soil depths, with variations in the order of five times in maximum annual growth intensity among sites. High thermal diffusivity in soils favored root growth.Con el objetivo de caracterizar el crecimiento del sistema radical de la vid (Vitis vinifera L. cv. Thompson Seedless y su relación con la temperatura del suelo, durante la temporada 2004-2005 se llevó a cabo un estudio en parronales ubicados en los valles de Copiapó y Huasco. Se instalaron cuatro cámaras de observación de raíces o rizotrones en plantas homogéneas, en plena producción, pie franco, sanas, y ubicadas en diferentes localidades de la región. Las mediciones del crecimiento de las raíces se efectuaron semanalmente, desde septiembre de 2004 hasta completar 1 año, estimándose la intensidad de crecimiento radical anual y su distribución en los rangos de 0 a 40, 40 a 80 y 80 a 120 cm de profundidad. Adicionalmente, se instalaron sensores de temperatura a 25, 50, 75 y

  6. Lazer, modernidade, capitalismo: um olhar a partir da obra de Edward Palmer Thompson

    Directory of Open Access Journals (Sweden)

    Victor Andrade de Melo

    2010-06-01

    Full Text Available O processo de consolidação do modo de produção fabril paulatinamente configurou uma clara distinção entre a jornada de trabalho e um tempo livre. Que relação se pode estabelecer entre essa nova dinâmica dos tempos sociais e as tensões relacionadas à construção de um novo conjunto de comportamentos considerados adequados para a consolidação do capitalismo? Esse estudo tem por objetivo discutir o trato dessa questão na obra de Edward Palmer Thompson. Parece possível afirmar que, para ele, o controle do tempo do não-trabalho e das práticas de lazer foi compreendido como uma dimensão fundamental para garantir o "progresso".

  7. Materialismo histórico, cultura e educação: Gramsci, Thompson e Williams

    Directory of Open Access Journals (Sweden)

    Angela Martins

    2013-09-01

    Full Text Available Este artigo destaca pontos de confluência das contribuições de Antonio Gramsci, Edward Palmer Thompson e Raymond Williams para romper com a tradição do materialismo histórico, denominada por eles, respectivamente, de materialismo economicista, marxismo idealista e materialismo mecânico. Ao recuperar a historicidade do materialismo histórico no século XX, os três autores ampliam as noções de cultura e de educação, atribuindo-lhes um papel estratégico nos processos de dominação de classe, de transformação social e de emancipação humana.

  8. Os alicerces metateóricos da teoria social de John B. Thompson

    Directory of Open Access Journals (Sweden)

    Lopes, Felipe Tavares Paes

    2010-01-01

    Full Text Available Neste trabalho, objetivamos discutir os pressupostos metateóricos que embasam a teoria social de John B. Thompson. Para tanto, estruturamos o trabalho em três partes. Num primeiro momento, apresentamos e analisamos os pressupostos dessa teoria que dizem respeito à filosofia da ciência, ou seja, aqueles que se referem à ontologia, à epistemologia, à natureza humana e à metodologia. Num segundo momento, abordamos aqueles referentes à teoria sobre a sociedade, isto é, aqueles que se referem à natureza do mundo social. Num terceiro e último momento, analisamos a forma como a teoria social em questão amarra esses dois conjuntos de pressupostos e as implicações éticas decorrentes dessa amarra

  9. New Product Launching Ideas

    Science.gov (United States)

    Kiruthika, E.

    2012-09-01

    Launching a new product can be a tense time for a small or large business. There are those moments when you wonder if all of the work done to develop the product will pay off in revenue, but there are many things are can do to help increase the likelihood of a successful product launch. An open-minded consumer-oriented approach is imperative in todayís diverse global marketplace so a firm can identify and serve its target market, minimize dissatisfaction, and stay ahead of competitors. Final consumers purchase for personal, family, or household use. Finally, the kind of information that the marketing team needs to provide customers in different buying situations. In high-involvement decisions, the marketer needs to provide a good deal of information about the positive consequences of buying. The sales force may need to stress the important attributes of the product, the advantages compared with the competition; and maybe even encourage ìtrialî or ìsamplingî of the product in the hope of securing the sale. The final stage is the post-purchase evaluation of the decision. It is common for customers to experience concerns after making a purchase decision. This arises from a concept that is known as ìcognitive dissonance

  10. Quantum electrical and chromodynamics treated through Thompson's approach

    Energy Technology Data Exchange (ETDEWEB)

    Nassif, Claudio [Centro Brasileiro de Pesquisas Fisicas (CBPF), Rio de Janeiro, RJ (Brazil)]. E-mails: cnassifCBPF@yahoo.com.br; Silva, P.R. [Minas Gerais Univ. (UFMG), Belo Horizonte, MG (Brazil). Inst. de Ciencias Exatas. Dept. de Fisica]. E-mail: prsilva@fisica.ufmg.br

    2006-09-15

    In this work we apply Thompson's method (of the dimensions and scales) to study some features of the Quantum Electro and Chromodynamics. This heuristic method can be considered as a simple and alternative way to the Renormalisation Group (R.G.) approach and when applied to QED-Lagrangian is able to obtain in a first approximation both the running coupling constant behavior of {alpha}({mu}) and the mass m({mu}). The calculations are evaluated just at d{sub c} = 4, where d{sub c} is the upper critical dimension of the problem, so that we obtain the logarithmic behavior both for the coupling {alpha} and the excess of mass {delta}m on the energy scale {mu}. Although our results are well-known in the vast literature of field theories, the advantage of Thompson's method, beyond its simplicity is that it is able to extract directly from QED-Lagrangian the physical (finite) behavior of {alpha}({mu}) and m({mu}), bypassing hard problems of divergences which normally appear in the conventional renormalisation schemes applied to field theories like QED. Quantum Chromodynamics (QCD) is also treated by the present method in order to obtain the quark condensate value. Besides this, the method is also able to evaluate the vacuum pressure at the boundary of the nucleon. This is done by assuming a step function behavior for the running coupling constant of the QCD, which fits nicely to some quantities related to the strong interaction evaluated through the MIT-bag model. (author)

  11. Psychosocial health coaching for chronically ill in a telehealth context: a pilot study

    Directory of Open Access Journals (Sweden)

    Lenneke Van Genugten

    2015-10-01

    The results show that the structured, partly automated approach can be used in a telehealth context by means of health coaches. MAY appeared to be a suitable tool for providing input for psychosocial care. HCs attitudes towards the structured approach were positive, which is crucial to the success of the implementation of MAY. Based on these results, we recommend to continue this approach as it may strengthen the wellbeing of patients (to be evaluated in future work. However, improvements are necessary. The tool should get a better fit in the current working procedures, and support the translation from recommendations to action. Further automation may facilitate this. In conclusion, this study shows that it is possible for HCs to implement structured psychosocial care in a telehealth program but that combining digitalized and human efforts in one structure is a challenge. The appreciation of the health coaches is an important first step in this process.

  12. Towards Resilient Telehealth Support for Clinical Psychiatry and Psychology: A Strategic Review.

    Science.gov (United States)

    Fiorini, Rodolfo A; De Giacomo, Piero; L'Abate, Luciano

    2015-01-01

    Human beings have increasingly shown a willingness to adopt Internet, mHealth and telehealth applications as a part of managing their health. Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. The major issue in such a development is whether online interventions will be structured or unstructured. The proper use of technology is fundamental to create and boost outstanding results. We present a strategic review and, as an example, the main steps to develop and achieve application resilience and antifragility at system level, for diagnostic and therapeutic telepractice and telehealth support. This article presents a number of innovations that can take psychotherapy treatment, supervision, training, and research forward, towards increased effectiveness application.

  13. Launch vehicle selection model

    Science.gov (United States)

    Montoya, Alex J.

    1990-01-01

    Over the next 50 years, humans will be heading for the Moon and Mars to build scientific bases to gain further knowledge about the universe and to develop rewarding space activities. These large scale projects will last many years and will require large amounts of mass to be delivered to Low Earth Orbit (LEO). It will take a great deal of planning to complete these missions in an efficient manner. The planning of a future Heavy Lift Launch Vehicle (HLLV) will significantly impact the overall multi-year launching cost for the vehicle fleet depending upon when the HLLV will be ready for use. It is desirable to develop a model in which many trade studies can be performed. In one sample multi-year space program analysis, the total launch vehicle cost of implementing the program reduced from 50 percent to 25 percent. This indicates how critical it is to reduce space logistics costs. A linear programming model has been developed to answer such questions. The model is now in its second phase of development, and this paper will address the capabilities of the model and its intended uses. The main emphasis over the past year was to make the model user friendly and to incorporate additional realistic constraints that are difficult to represent mathematically. We have developed a methodology in which the user has to be knowledgeable about the mission model and the requirements of the payloads. We have found a representation that will cut down the solution space of the problem by inserting some preliminary tests to eliminate some infeasible vehicle solutions. The paper will address the handling of these additional constraints and the methodology for incorporating new costing information utilizing learning curve theory. The paper will review several test cases that will explore the preferred vehicle characteristics and the preferred period of construction, i.e., within the next decade, or in the first decade of the next century. Finally, the paper will explore the interaction

  14. The Contradictions of Telehealth User Experience in Chronic Obstructive Pulmonary Disease (COPD): A Qualitative Meta-Synthesis.

    Science.gov (United States)

    Brunton, Lisa; Bower, Peter; Sanders, Caroline

    2015-01-01

    As the global burden of chronic disease rises, policy makers are showing a strong interest in adopting telehealth technologies for use in long term condition management, including COPD. However, there remain barriers to its implementation and sustained use. To date, there has been limited qualitative investigation into how users (both patients/carers and staff) perceive and experience the technology. We aimed to systematically review and synthesise the findings from qualitative studies that investigated user perspectives and experiences of telehealth in COPD management, in order to identify factors which may impact on uptake. Systematic review and meta-synthesis of published qualitative studies of user (patients, their carers and clinicians) experience of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease. ASSIA, CINAHL, Embase, Medline, PsychInfo and Web of Knowledge databases were searched up to October 2014. Reference lists of included studies and reference lists of key papers were also searched. Quality appraisal was guided by an adapted version of the CASP qualitative appraisal tool. 705 references (after duplicates removed) were identified and 10 papers, relating to 7 studies were included in the review. Most authors of included studies had identified both positive and negative experiences of telehealth use in the management of COPD. Through a line of argument synthesis we were able to derive new insights from the data to identify three overarching themes that have the ability to either impede or promote positive user experience of telehealth in COPD: the influence on moral dilemmas of help seeking-(enables dependency or self-care); transforming interactions (increases risk or reassurance) and reconfiguration of 'work' practices (causes burden or empowerment). Findings from this meta-synthesis have implications for the future design and implementation of telehealth services. Future research needs to include potential users at

  15. The Contradictions of Telehealth User Experience in Chronic Obstructive Pulmonary Disease (COPD: A Qualitative Meta-Synthesis.

    Directory of Open Access Journals (Sweden)

    Lisa Brunton

    Full Text Available As the global burden of chronic disease rises, policy makers are showing a strong interest in adopting telehealth technologies for use in long term condition management, including COPD. However, there remain barriers to its implementation and sustained use. To date, there has been limited qualitative investigation into how users (both patients/carers and staff perceive and experience the technology. We aimed to systematically review and synthesise the findings from qualitative studies that investigated user perspectives and experiences of telehealth in COPD management, in order to identify factors which may impact on uptake.Systematic review and meta-synthesis of published qualitative studies of user (patients, their carers and clinicians experience of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease. ASSIA, CINAHL, Embase, Medline, PsychInfo and Web of Knowledge databases were searched up to October 2014. Reference lists of included studies and reference lists of key papers were also searched. Quality appraisal was guided by an adapted version of the CASP qualitative appraisal tool.705 references (after duplicates removed were identified and 10 papers, relating to 7 studies were included in the review. Most authors of included studies had identified both positive and negative experiences of telehealth use in the management of COPD. Through a line of argument synthesis we were able to derive new insights from the data to identify three overarching themes that have the ability to either impede or promote positive user experience of telehealth in COPD: the influence on moral dilemmas of help seeking-(enables dependency or self-care; transforming interactions (increases risk or reassurance and reconfiguration of 'work' practices (causes burden or empowerment.Findings from this meta-synthesis have implications for the future design and implementation of telehealth services. Future research needs to include

  16. Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2007-01-01

    Full Text Available Abstract Background The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions. Methods A case study in Eastern Quebec was performed to explore this complex phenomenon. The analytical framework was based on two literature reviews and a Delphi study. Data were collected from semi-structured interviews with 41 physicians and 22 managers. Transcripts were produced and interview content was coded independently by two judges and validated by an expert panel. Results Interviews have highlighted the potential impact of telehealth on several factors influencing the recruitment and retention of physicians in rural and remote regions. The potential effects of telehealth on physicians' choice of practice location could be seen at the professional, organizational, educational and individual levels. For instance, telehealth could improve work satisfaction by allowing a regional on-call duty system and a better follow-up of patients. However, there are also certain limits related to telehealth, such as the fear that it would eventually replace all continuing medical education activities and onsite specialists in remoteregions. Conclusion Telehealth is likely to have an impact on several factors related to medical workforce supply in remote and rural regions. However, the expected benefits will materialize if and only if this technology is properly integrated into organizations as a support to professional practice.

  17. Speech-language pathology telehealth in rural and remote schools: the experience of school executive and therapy assistants.

    Science.gov (United States)

    Fairweather, Glenn C; Lincoln, Michelle A; Ramsden, Robyn

    2017-01-01

    Difficulties in accessing allied health services, especially in rural and remote areas, appear to be driving the use of telehealth services to children in schools. The objectives of this study were to investigate the experiences and views of school executive staff and therapy assistants regarding the feasibility and acceptability of a speech-language pathology telehealth program for children attending schools in rural and remote New South Wales, Australia. The program, called Come N See, provided therapy interventions remotely via low-bandwidth videoconferencing, with email follow-up. Over a 12-week period, children were offered therapy blocks of six fortnightly sessions, each lasting a maximum of 30 minutes. School executives (n=5) and therapy assistants (n=6) described factors that promoted or threatened the program's feasibility and acceptability, during semistructured interviews. Thematic content analysis with constant comparison was applied to the transcribed interviews to identify relationships in the data. Emergent themes related to (a) unmet speech pathology needs, (b) building relationships, (c) telehealth's advantages, (d) telehealth's disadvantages, (e) anxiety replaced by joy and confidence in growing skills, and (f) supports. School executive staff and therapy assistants verified that the delivery of the school-based telehealth service was feasible and acceptable. However, the participants saw significant opportunities to enhance this acceptability through building into the program stronger working relationships and supports for stakeholders. These findings are important for the future development of allied health telehealth programs that are sustainable as well as effective and fit the needs of all crucial stakeholders. The results have significant implications for speech pathology clinical practice relating to technology, program planning and teamwork within telehealth programs.

  18. Personalised telehealth intervention for chronic disease management: A pilot randomised controlled trial.

    Science.gov (United States)

    Bohingamu Mudiyanselage, Shalika; Stevens, Jo; Watts, Jennifer J; Toscano, Julian; Kotowicz, Mark A; Steinfort, Christopher L; Bell, Jennifer; Byrnes, Janette; Bruce, Stephanie; Carter, Sarah; Hunter, Claire; Barrand, Chris; Hayles, Robyn

    2018-01-01

    Introduction The aim of this study was to assess the impact of home-based telehealth monitoring on health outcomes, quality of life and costs over 12 months for patients with diabetes and/or chronic obstructive pulmonary disease (COPD) who were identified as being at high risk of readmission to hospital. Methods This pilot study was a randomised controlled trial combined with an economic analysis to examine the outcomes of standard care versus home-based telehealth for people with diabetes and/or COPD who were at risk of hospital readmission within one year. The primary outcomes were (i) hospital admission and length of stay (LOS); and (ii) health-related quality of life (HRQOL); and the secondary outcomes were (i) health-related clinical outcomes; (ii) anxiety and depression scores; and (iii) health literacy. The costs of the intervention and hospitalisations were included. Results A total of 86 and 85 participants were randomised to the intervention and control groups respectively. The difference between groups in hospital LOS was -3.89 (95% confidence interval (CI): -9.40, 1.62) days, and for HRQOL, 0.09 (95% CI: 0.05, 0.14) in favour of the telehealth monitoring group. There was a saving of AUD$6553 (95% CI: -12145, -961) in the cost of hospitalisation over 12 months, which offset the increased cost of tele-monitoring. The intervention group showed an improvement in anxiety, depression and health literacy at 12 months, and in the diabetes group, a reduction in microalbuminuria. Discussion The telehealth monitoring intervention improved patient's health outcomes and quality of life at no additional cost.

  19. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

    OpenAIRE

    Langabeer, James R.; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

    2016-01-01

    Introduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. T...

  20. Comparing Web, Group and Telehealth Formats of a Military Parenting Program

    Science.gov (United States)

    2016-06-01

    materials are available upon request: • Online questionnaire for baseline data collection (9 pages) • Online parent survey for time point 1 (69 pages...web-based parenting intervention for military families with school-aged children, we expect to strengthen parenting practices in families and...AWARD NUMBER: W81XWH-14-1-0143 TITLE: Comparing Web, Group and Telehealth Formats of a Military Parenting Program PRINCIPAL INVESTIGATOR

  1. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

    Directory of Open Access Journals (Sweden)

    James Robert Langabeer

    2016-11-01

    Full Text Available Introduction Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  2. LHCb launches new website

    CERN Multimedia

    2008-01-01

    A new public website for the LHCb experiment was launched last Friday to coincide with CERN’s Open Day weekend. Designed to provide accessible information on all aspects of the experiment, the website contains images and key facts about the LHCb detector, its design and installation and the international team behind the project. "LHCb is going to be one of the most important b-physics experiments in the world when it starts taking data later this year", explains Roger Forty, the experiment’s deputy spokesperson. "We hope the website will be a valuable resource, enabling people to learn about this fascinating area of research." The new website can be found at: http://cern.ch/lhcb-public

  3. Payload Launch Lock Mechanism

    Science.gov (United States)

    Young, Ken (Inventor); Hindle, Timothy (Inventor)

    2014-01-01

    A payload launch lock mechanism includes a base, a preload clamp, a fastener, and a shape memory alloy (SMA) actuator. The preload clamp is configured to releasibly restrain a payload. The fastener extends, along an axis, through the preload clamp and into the base, and supplies a force to the preload clamp sufficient to restrain the payload. The SMA actuator is disposed between the base and the clamp. The SMA actuator is adapted to receive electrical current and is configured, upon receipt of the electrical current, to supply a force that causes the fastener to elongate without fracturing. The preload clamp, in response to the fastener elongation, either rotates or pivots to thereby release the payload.

  4. Environmental aspects of health care in the Grampian NHS region and the place of telehealth

    Science.gov (United States)

    Wootton, Richard; Tait, Alex; Croft, Amanda

    2010-01-01

    Detailed information about the composition of the carbon footprint of the NHS in the Grampian health region, and in Scotland generally, is not available at present. Based on the limited information available, our best guess is that travel emissions in Grampian are substantial, perhaps 49,000 tonnes CO2 per year. This is equivalent to 233 million km of car travel per year. A well-established telemedicine network in the Grampian region, which saves over 2000 patient journeys a year from community hospitals, avoids about 260,000 km travel per year, or about 59 tonnes CO2 per year. Therefore using telehealth as it has been used historically (primarily to facilitate hospital-to-hospital interactions) seems unlikely to have a major environmental impact – although of course there may be other good reasons for persevering with conventional telehealth. On the other hand, telehealth might be useful in reducing staff travel and to a lesser extent, visitor travel. It looks particularly promising for reducing outpatient travel, where substantial carbon savings might be made by reconfiguring the way that certain services are provided. PMID:20511579

  5. Telehealth for Expanding the Reach of Early Autism Training to Parents

    Directory of Open Access Journals (Sweden)

    Laurie A. Vismara

    2012-01-01

    Full Text Available Although there is consensus that parents should be involved in interventions designed for young children with autism spectrum disorder (ASD, parent participation alone does not ensure consistent, generalized gains in children’s development. Barriers such as costly intervention, time-intensive sessions, and family life may prevent parents from using the intervention at home. Telehealth integrates communication technologies to provide health-related services at a distance. A 12 one-hour per week parent intervention program was tested using telehealth delivery with nine families with ASD. The goal was to examine its feasibility and acceptance for promoting child learning throughout families’ daily play and caretaking interactions at home. Parents became skilled at using teachable moments to promote children’s spontaneous language and imitation skills and were pleased with the support and ease of telehealth learning. Preliminary results suggest the potential of technology for helping parents understand and use early intervention practices more often in their daily interactions with children.

  6. WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.

    Science.gov (United States)

    Ogasawara, Katsuhiko; Abe, Tamotsu

    2013-01-01

    We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".

  7. Video-conferencing Telehealth Linkage attempts to Schools to Facilitate Mental Health Consultation.

    Science.gov (United States)

    McLennan, John D

    2018-04-01

    Telehealth to schools may be a strategic approach to expand child mental health service delivery, however, there are only a few published examples. This report describes video-conferencing telehealth linkage attempts to schools to facilitate mental health consultation. A series of synchronous video-conferencing linkage strategies were attempted to connect a mental health consultation service to multiple schools in a Canadian setting. Consultation to support the implementation of the Daily Report Card, for students with attentional and behavioural problems, was the core content of this pilot linkage attempt. Synchronous video conference consultations were successfully delivered to six elementary schools across three school districts. Two of three linkage strategies were functional. One used existing health centre-based telehealth units to connect to school-based dedicated tablets with a video collaboration app and reliance on existing school Wi-Fi. A second used existing laptops in both the health and school system linked through a communication platform. A third connection, using 3G/4G hotspots to obviate the need to access school Wi-Fi, was deemed too expensive in this setting. The potential to use existing computer hardware to connect mental health providers and schools could facilitate scale-up. However, it is unknown whether mental health systems and school sectors will invest in such linkages and reorganize core mental health services to be delivered in this way.

  8. APME launches common method

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    A common approach for carrying out ecological balances for commodity thermoplastics is due to be launched by the Association of Plastics Manufacturers in Europe (APME; Brussels) and its affiliate, The European Centre for Plastics in the Environment (PWMI) this week. The methodology report is the latest stage of a program started in 1990 that aims to describe all operations up to the production of polymer powder or granules at the plant gate. Information gathered will be made freely available to companies considering the use of polymers. An industry task force, headed by PWMI executive director Vince Matthews, has gathered information on the plastics production processes from oil to granule, and an independent panel of specialists, chaired by Ian Boustead of the U.K.'s Open University, devised the methodology and analysis. The methodology report stresses the need to define the system being analyzed and discusses how complex chemical processes can be analyzed in terms of consumption of fuels, energy, and raw materials, as well as solid, liquid, and gaseous emissions

  9. AMS ready for launch

    CERN Multimedia

    Katarina Anthony

    2011-01-01

    On 29 April, the Alpha Magnetic Spectrometer (AMS) will complete its long expedition to the International Space Station on board the space shuttle Endeavour. The Endeavour is set to lift off from NASA’s Kennedy Space Station at 15:47 EST (21:47 CET).   Samuel Ting, principal investigator for the AMS project, and Rolf Heuer, CERN Director-General, visit the Kennedy Space Centre before the AMS launch.  Courtesy of NASA and Kennedy Space Center. AMS is a CERN recognised experiment, created by an internal collaboration of 56 institutes. It will be the first large magnetic spectrometer to be used in space, and has been designed to function as an external module on the ISS. AMS will measure cosmic rays without atmospheric interference, allowing researchers on the ground to continue their search for dark matter and antimatter in the Universe. Data collected by AMS will be analysed in CERN’s new AMS Control Centre in Building 946 (due for completion in June 2011). The End...

  10. Peer Review of Launch Environments

    Science.gov (United States)

    Wilson, Timmy R.

    2011-01-01

    Catastrophic failures of launch vehicles during launch and ascent are currently modeled using equivalent trinitrotoluene (TNT) estimates. This approach tends to over-predict the blast effect with subsequent impact to launch vehicle and crew escape requirements. Bangham Engineering, located in Huntsville, Alabama, assembled a less-conservative model based on historical failure and test data coupled with physical models and estimates. This white paper summarizes NESC's peer review of the Bangham analytical work completed to date.

  11. Acoustic Doppler current profiling from the JGOFS Arabian Sea cruises aboard the RV T.G. Thompson

    Energy Technology Data Exchange (ETDEWEB)

    Kim, H.S.; Flagg, C.N.; Shi, Y. [Brookhaven National Lab., Upton, NY (United States). Oceanographic and Atmospheric Sciences Div.

    1996-12-01

    Acoustic Doppler current profiler (ADCP) data is part of the core data for the US JGOFS Arabian Sea project, along with hydrographic and nutrient data. Seventeen cruises are scheduled to take place between September 1994 and January 1996 on the R/V T.G. Thompson. Seven of the cruises follow a standard cruise track, taking hydrographic, chemical and biological measurements. The rest of the cruises, which take place generally within the standard cruise region defined by a set track, are for the deployment and recovery of moored equipment and towing of a SeaSoar. Detailed description of ADCP hardware, the AutoADCP data acquisition system, and the collection of navigation and compass data on the Thompson is documented in Section 2. Followed by data collection for each cruise together with a cruise track, Section 3 presents the processing and analysis of velocity and acoustic backscatter intensity data. Section 5 shows results of profile quality diagnosis.

  12. Transcriptome analysis during ripening of table grape berry cv. Thompson Seedless.

    Directory of Open Access Journals (Sweden)

    Iván Balic

    Full Text Available Ripening is one of the key processes associated with the development of major organoleptic characteristics of the fruit. This process has been extensively characterized in climacteric fruit, in contrast with non-climacteric fruit such as grape, where the process is less understood. With the aim of studying changes in gene expression during ripening of non-climacteric fruit, an Illumina based RNA-Seq transcriptome analysis was performed on four developmental stages, between veraison and harvest, on table grapes berries cv Thompson Seedless. Functional analysis showed a transcriptional increase in genes related with degradation processes of chlorophyll, lipids, macromolecules recycling and nucleosomes organization; accompanied by a decrease in genes related with chloroplasts integrity and amino acid synthesis pathways. It was possible to identify several processes described during leaf senescence, particularly close to harvest. Before this point, the results suggest a high transcriptional activity associated with the regulation of gene expression, cytoskeletal organization and cell wall metabolism, which can be related to growth of berries and firmness loss characteristic to this stage of development. This high metabolic activity could be associated with an increase in the transcription of genes related with glycolysis and respiration, unexpected for a non-climacteric fruit ripening.

  13. A celebration of mechanics: from nano to macro. The J. Michael T. Thompson Festschrift issue.

    Science.gov (United States)

    Elishakoff, Isaac

    2013-06-28

    This Theme Issue is dedicated to the topic 'Mechanics: from nano to macro' and marks the 75th birthday of Dr J. Michael T. Thompson, Fellow of the Royal Society, whose current affiliations are as follows: (i) Honorary Fellow, Department of Applied Mathematics and Theoretical Physics, Centre for Mathematical Sciences, University of Cambridge; (ii) Emeritus Professor of Nonlinear Dynamics, Department of Civil, Environmental and Geomatic Engineering, University College London; and (iii) Professor of Theoretical and Applied Dynamics (Distinguished Sixth Century Chair, part-time), University of Aberdeen. He also serves as Chairman of the Board of Directors at ES-Consult (consulting engineers) in Copenhagen, Denmark. The pertinent question that arises from the very start is: should we first salute Michael and then describe the Theme Issue, or vice versa? Indeed, according to Blaise Pascal (1623-1662), the last thing one discovers in composing a work is what to put first. I would like to take the liberty of deviating from the tradition of the Philosophical Transactions and start with the tribute to Michael; after all he is the prime cause of this Theme Issue.

  14. Communication and Control in Organizations: Applying the Work of James Thompson and Gregory Bateson to Interpretive Research.

    Science.gov (United States)

    1985-07-01

    developing integrated theories of organization and administration . His theoretical lineage and written work is explicitly structuralist . He drew much...1979). ’Unobtrusive Measures in Organizational Theory : A Reminder’. Administrative Science SQarJt .XJly, 24, 650-659. Weick, K. (1974). ’Middle...the work of James Thompson and Gregory Bateson. (3) It is a treatise about the application of interpretive methods and theory to organizational research

  15. Availability, spatial accessibility, utilisation and the role of telehealth for multi-disciplinary paediatric cerebral palsy services in Queensland.

    Science.gov (United States)

    Edirippulige, Sisira; Reyno, John; Armfield, Nigel R; Bambling, Matthew; Lloyd, Owen; McNevin, Elizabeth

    2016-10-01

    The purpose of this study was to understand the methods of current delivery of health care services to cerebral palsy (CP) patients in Queensland, Australia. The study also examines the current use of telehealth by clinicians and their perceptions about telehealth use. Patient records during July 2013-July 2014 were accessed from the Queensland Paediatric Rehabilitation Service (QPRS) to collect information relating to the service delivery for CP patients. Analysis was carried out to examine the patient locations and travel distances using ArcMap geoprocessing software. In addition, 13 face-to-face semi structured interviews were conducted with clinicians from the QPRS and the Cerebral Palsy Health Service (CPHS) to understand the perceptions of clinicians relating to the current level of health care delivery. We also examined the clinicians' current use of telehealth and their opinions about this method. Records of 329 paediatric CP patients were accessed and reviewed. The majority of patients (96%, n = 307) who attended the clinics at the Royal Children's Hospital (RCH), Brisbane, were from remote, rural or regional areas of Queensland. Only 4% of patients (n = 13) were from major cities. During 12 months, patients had attended nine outreach programmes that were conducted by the QPRS and CPHS. The study found that non-local patients were required to travel an average distance of 836 km to access QPRS and CPHS services in Brisbane. The average distance for receiving a consultation at an outreach clinic was 173 km. Clinicians perceived that access to health care services to CP patients in Queensland is inadequate. Nearly all clinicians interviewed had some experience in using telehealth. They had high satisfaction levels with the method. Traditional methods of delivering services to CP patients do not meet their needs. Clinicians have found telehealth is a feasible and satisfactory delivery method. However, the use of telehealth is still limited. © The

  16. PHYTOPLANKTON - WET WEIGHT and Other Data from THOMAS G. THOMPSON From TOGA Area - Pacific (30 N to 30 S) from 19920325 to 19921021 (NODC Accession 9700085)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Picophytoplankton and bacteria were collected from the Thomas G. Thompson as part of the Tropical Ocean and Global Atmosphere (TOGA) program. Data were collected...

  17. WATER TEMPERATURE and Other Data from THOMAS G. THOMPSON From TOGA Area - Pacific (30 N to 30 S) from 19920130 to 19921021 (NODC Accession 9700050)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hydrochemical, hydrophysical, and other data were collected from the THOMAS G. THOMPSON from January 30, 1992 to October 21, 1992. Data were submitted by Dr. Robert...

  18. Chemical data collected from THOMAS G. THOMPSON using CTD and bottle casts in Arabian Sea from 08 January 1995 to 26 November 1995 (NODC Accession 9800161)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Chemical data were collected using CTD and bottle casts in the Arabian Sea from THOMAS G. THOMPSON. Data were collected from 08 January 1995 to 26 November 1995 by...

  19. PHYTOPLANKTON - WET WEIGHT and Other Data from THOMAS G. THOMPSON From TOGA Area - Pacific (30 N to 30 S) from 19920203 to 19921213 (NODC Accession 9700068)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Phytoplankton were collected from the Thomas G. Thompson as part of the Tropical Ocean and Global Atmosphere (TOGA) program to assess biomass and abundance. Data...

  20. ZOOPLANKTON SPECIES IDENTITIES and Other Data from THOMAS G. THOMPSON From TOGA Area - Pacific (30 N to 30 S) from 19920203 to 19921021 (NODC Accession 9700062)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Abundance, biovolume, and biomass of (Cyanobacteria, phototrophic, heterotrophic eucaryotic pico and nanoplanktons) were collected from the THOMAS G. THOMPSON from...

  1. ZOOPLANKTON SPECIES IDENTITIES and Other Data from THOMAS G. THOMPSON From TOGA Area - Pacific (30 N to 30 S) from 19920203 to 19921021 (NODC Accession 9700058)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Depth, abundance and biomass of (Radiolarians, Formainiferans, Acantharians) were collected from the THOMAS G. THOMPSON from February 3, 1992 to October 21, 1992....

  2. Zooplankton, chemical, and other data collected from THOMAS G. THOMPSON in Arabian Sea; 09 January 1995 to 07 April 1995 (NODC Accession 9800109)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Zooplankton, chemical, and other data were collected using zooplankton net casts in Arabian Sea from THOMAS G. THOMPSON. Data were collected from 09 January 1995 to...

  3. Cloud amount/frequency, NITRATE and other data from THOMAS G. THOMPSON from 1983-11-14 to 1984-10-28 (NODC Accession 9000206)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Conductivity, Temperature and Depth (CTD) data were collected during 83 casts from Ship T.G. THOMPSON. The data was collected over a period spanning from...

  4. Viable-but-Nonculturable Listeria monocytogenes and Salmonella enterica Serovar Thompson Induced by Chlorine Stress Remain Infectious

    Directory of Open Access Journals (Sweden)

    Callum J. Highmore

    2018-04-01

    Full Text Available The microbiological safety of fresh produce is monitored almost exclusively by culture-based detection methods. However, bacterial food-borne pathogens are known to enter a viable-but-nonculturable (VBNC state in response to environmental stresses such as chlorine, which is commonly used for fresh produce decontamination. Here, complete VBNC induction of green fluorescent protein-tagged Listeria monocytogenes and Salmonella enterica serovar Thompson was achieved by exposure to 12 and 3 ppm chlorine, respectively. The pathogens were subjected to chlorine washing following incubation on spinach leaves. Culture data revealed that total viable L. monocytogenes and Salmonella Thompson populations became VBNC by 50 and 100 ppm chlorine, respectively, while enumeration by direct viable counting found that chlorine caused a <1-log reduction in viability. The pathogenicity of chlorine-induced VBNC L. monocytogenes and Salmonella Thompson was assessed by using Caenorhabditis elegans. Ingestion of VBNC pathogens by C. elegans resulted in a significant life span reduction (P = 0.0064 and P < 0.0001, and no significant difference between the life span reductions caused by the VBNC and culturable L. monocytogenes treatments was observed. L. monocytogenes was visualized beyond the nematode intestinal lumen, indicating resuscitation and cell invasion. These data emphasize the risk that VBNC food-borne pathogens could pose to public health should they continue to go undetected.

  5. Magnetic Launch Assist Demonstration Test

    Science.gov (United States)

    2001-01-01

    This image shows a 1/9 subscale model vehicle clearing the Magnetic Launch Assist System, formerly referred to as the Magnetic Levitation (MagLev), test track during a demonstration test conducted at the Marshall Space Flight Center (MSFC). Engineers at MSFC have developed and tested Magnetic Launch Assist technologies. To launch spacecraft into orbit, a Magnetic Launch Assist System would use magnetic fields to levitate and accelerate a vehicle along a track at very high speeds. Similar to high-speed trains and roller coasters that use high-strength magnets to lift and propel a vehicle a couple of inches above a guideway, a launch-assist system would electromagnetically drive a space vehicle along the track. A full-scale, operational track would be about 1.5-miles long and capable of accelerating a vehicle to 600 mph in 9.5 seconds. This track is an advanced linear induction motor. Induction motors are common in fans, power drills, and sewing machines. Instead of spinning in a circular motion to turn a shaft or gears, a linear induction motor produces thrust in a straight line. Mounted on concrete pedestals, the track is 100-feet long, about 2-feet wide and about 1.5-feet high. The major advantages of launch assist for NASA launch vehicles is that it reduces the weight of the take-off, the landing gear, the wing size, and less propellant resulting in significant cost savings. The US Navy and the British MOD (Ministry of Defense) are planning to use magnetic launch assist for their next generation aircraft carriers as the aircraft launch system. The US Army is considering using this technology for launching target drones for anti-aircraft training.

  6. Health Insurance Portability and Accountability Act-Compliant Ocular Telehealth Network for the Remote Diagnosis and Management of Diabetic Retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yaquin [University of Tennessee, Knoxville (UTK); Karnowski, Thomas Paul [ORNL; Tobin Jr, Kenneth William [ORNL; Giancardo, Luca [ORNL; Garg, Seema [University of North Carolina; Fox, Karen [Delta Health Alliance; Chaum, Edward [University of Tennessee, Knoxville (UTK)

    2011-01-01

    In this article, we present the design and implementation of a regional ocular telehealth network for remote assessment and management of diabetic retinopathy (DR), including the design requirements, network topology, protocol design, system work flow, graphics user interfaces, and performance evaluation. The Telemedical Retinal Image Analysis and Diagnosis Network is a computer-aided, image analysis telehealth paradigm for the diagnosis of DR and other retinal diseases using fundus images acquired from primary care end users delivering care to underserved patient populations in the mid-South and southeastern United States.

  7. Effects of telehealth by allied health professionals and nurses in rural and remote areas: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Renee Speyer

    2017-12-01

    Full Text Available Objective: To describe telehealth interventions delivered by allied health professionals and nurses in rural and remote areas, and to compare the effects of telehealth interventions with standard face-to-face interventions. Data sources: CINAHL, Embase, PsycINFO and PubMed databases were searched. The content of relevant journals and published articles were also searched. Study selection: Studies examining the effectiveness of allied health and nursing telehealth interventions for rural and remote populations were included in descriptive analyses. Studies comparing telehealth intervention with standard face-to-face interventions grouped by type of intervention approach were used to examine between-groups effect sizes. Data extraction: Methodological quality of studies was rated using the QualSyst critical appraisal tool and the National Health and Medical Research Council (NHMRC Evidence Hierarchy levels. Data synthesis: After quality ratings, 43 studies were included. A majority of studies had strong methodological quality. The disciplines of psychology and nursing were represented most frequently, as were studies using a cognitive intervention approach. Meta-analysis results slightly favoured telehealth interventions compared with face-to-face interventions, but did not show significant differences. Interventions using a combined physical and cognitive approach appeared to be more effective. Conclusion: Telehealth services may be as effective as face-to-face interventions, which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings.

  8. Ostomy telehealth for cancer survivors: Design of the Ostomy Self-management Training (OSMT) randomized trial.

    Science.gov (United States)

    Sun, Virginia; Ercolano, Elizabeth; McCorkle, Ruth; Grant, Marcia; Wendel, Christopher S; Tallman, Nancy J; Passero, Frank; Raza, Sabreen; Cidav, Zuleyha; Holcomb, Michael; Weinstein, Ronald S; Hornbrook, Mark C; Krouse, Robert S

    2018-01-01

    An ostomy adversely affects health-related quality of life (HRQOL) in a diverse population of cancer survivors and their caregivers. Hit-or-miss ostomy care, nurse counseling, and community referral have been the primary modes of self-management education and support in the peri-operative setting. Few evidence-based, systematic ostomy self-management programs are available to ensure optimal post-operative care. This paper describes the study design of a telehealth-based Ostomy Self-management Training (OSMT) program for cancer survivors and their caregivers. The study is a three-year, randomized trial that tests the effectiveness of the OSMT program on survivor activation, self-efficacy, and HRQOL. The intervention integrates goal setting and problem-solving approaches to enhance survivor activation and self-efficacy to carry out ostomy care. The curriculum is delivered via four group sessions administered by trained ostomy certified nurses (WOCNs) and peer ostomates. An additional session is offered to caregivers to address their needs in relation to ostomy care. Telehealth approaches through videoconferencing are used to enhance program delivery to participants in three different geographic areas across two time zones. Participants join sessions via real-time videoconferencing from their homes. The OSMT program has high potential to make a positive impact on the unique physical, psychological, social, and spiritual needs of cancer survivors living with a permanent ostomy. The study design, process, and telehealth approach contributes to the success of future dissemination efforts of the intervention into diverse clinical and community settings. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Nursing care by telehealth: what is the influence of distance on communication?

    Science.gov (United States)

    Barbosa, Ingrid de Almeida; Silva, Maria Júlia Paes da

    2017-01-01

    Evaluate the perception of nurses regarding interpersonal communication while providing care via telehealth. Qualitative research realized with seven nurses working in telehealth in Brazil, the sample was determined by data saturation. A questionnaire with open questions was applied and then content analysis of the dialogues was conducted, focusing on thematic analysis. Four categories emerged from the dialogues: Understanding the importance of communication; the interpersonal relationship interfering with communication; Communicating via technology; and Learning the communication process. The perception of nurses working in telehealth in Brazil is that technology has facilitated their professional practice; however, in relation to the communication process, they believe it is harder to communicate by telehealth, mainly due to difficulty in perceiving nonverbal signals. To overcome these difficulties, they agreed that interpersonal communication is a skill that must be acquired during their professional training. Avaliar a percepção do enfermeiro referente à Comunicação interpessoal no cuidado por telessaúde. Pesquisa qualitativa, realizada com sete enfermeiros que atuam em telessaúde no Brasil, com amostra determinada pela saturação de dados. Aplicou-se um questionário com perguntas abertas e foi realizada análise de conteúdo dos discursos, com enfoque na análise temática. Dos discursos emergiram quatro categorias: Entendendo a importância da comunicação; O relacionamento interpessoal interferindo na comunicação; Comunicando-se por meio da tecnologia; e Aprendendo o processo de comunicação. A percepção dos enfermeiros que atuam em telessaúde no Brasil é de que a tecnologia tem facilitado sua prática profissional; porém, em relação ao processo de comunicação, creem que seja mais difícil se comunicar pela telessaúde, principalmente devido à dificuldade de percepção de sinais não verbais. Para superar essas dificuldades, concordam

  10. Participatory design methods for the development of a clinical telehealth service for neonatal homecare

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2017-01-01

    on the results obtained during the workshops and subsequent testing, we developed an application (app), which was integrated into the medical record at the neonatal unit. The app was used to initiate videoconferences and chat messages between the family at home and the neonatal unit, and to share information...... regarding infant growth and well-being. Conclusion: Results obtained from the workshops and testing demonstrated the importance of involving users when developing new telehealth applications. The workshops helped identify the challenges associated with delivery of the service, and helped instruct the design...

  11. Hewitt launches Research Councils UK

    CERN Multimedia

    2002-01-01

    "Trade and Industry Secretary Patricia Hewitt today launched 'Research Councils UK' - a new strategic partnership that will champion research in science, engineering and technology across the UK" (1 page).

  12. Aerodynamic Problems of Launch Vehicles

    Directory of Open Access Journals (Sweden)

    Kyong Chol Chou

    1984-09-01

    Full Text Available The airflow along the surface of a launch vehicle together with vase flow of clustered nozzles cause problems which may affect the stability or efficiency of the entire vehicle. The problem may occur when the vehicle is on the launching pad or even during flight. As for such problems, local steady-state loads, overall steady-state loads, buffet, ground wind loads, base heating and rocket-nozzle hinge moments are examined here specifically.

  13. Magnetic Launch Assist Experimental Track

    Science.gov (United States)

    1999-01-01

    In this photograph, a futuristic spacecraft model sits atop a carrier on the Magnetic Launch Assist System, formerly known as the Magnetic Levitation (MagLev) System, experimental track at the Marshall Space Flight Center (MSFC). Engineers at MSFC have developed and tested Magnetic Launch Assist technologies that would use magnetic fields to levitate and accelerate a vehicle along a track at very high speeds. Similar to high-speed trains and roller coasters that use high-strength magnets to lift and propel a vehicle a couple of inches above a guideway, a Magnetic Launch Assist system would electromagnetically drive a space vehicle along the track. A full-scale, operational track would be about 1.5-miles long and capable of accelerating a vehicle to 600 mph in 9.5 seconds. This track is an advanced linear induction motor. Induction motors are common in fans, power drills, and sewing machines. Instead of spinning in a circular motion to turn a shaft or gears, a linear induction motor produces thrust in a straight line. Mounted on concrete pedestals, the track is 100-feet long, about 2-feet wide, and about 1.5-feet high. The major advantages of launch assist for NASA launch vehicles is that it reduces the weight of the take-off, the landing gear, the wing size, and less propellant resulting in significant cost savings. The US Navy and the British MOD (Ministry of Defense) are planning to use magnetic launch assist for their next generation aircraft carriers as the aircraft launch system. The US Army is considering using this technology for launching target drones for anti-aircraft training.

  14. CubeSat Launch Initiative

    Science.gov (United States)

    Higginbotham, Scott

    2016-01-01

    The National Aeronautics and Space Administration (NASA) recognizes the tremendous potential that CubeSats (very small satellites) have to inexpensively demonstrate advanced technologies, collect scientific data, and enhance student engagement in Science, Technology, Engineering, and Mathematics (STEM). The CubeSat Launch Initiative (CSLI) was created to provide launch opportunities for CubeSats developed by academic institutions, non-profit entities, and NASA centers. This presentation will provide an overview of the CSLI, its benefits, and its results.

  15. National Security Space Launch Report

    Science.gov (United States)

    2006-01-01

    Company Clayton Mowry, President, Arianespace Inc., North American—“Launch Solutions” Elon Musk , CEO and CTO, Space Exploration Technologies (SpaceX...technologies to the NASA Exploration Initiative (“…Moon, Mars and Beyond.”).1 EELV Technology Needs The Atlas V and Delta IV vehicles incorporate current... Mars and other destinations.” 46 National Security Space Launch Report Figure 6.1 U.S. Government Liquid Propulsion Rocket Investment, 1991–2005

  16. Reusable Launch Vehicle Technology Program

    Science.gov (United States)

    Freeman, Delma C., Jr.; Talay, Theodore A.; Austin, R. Eugene

    1997-01-01

    Industry/NASA reusable launch vehicle (RLV) technology program efforts are underway to design, test, and develop technologies and concepts for viable commercial launch systems that also satisfy national needs at acceptable recurring costs. Significant progress has been made in understanding the technical challenges of fully reusable launch systems and the accompanying management and operational approaches for achieving a low cost program. This paper reviews the current status of the RLV technology program including the DC-XA, X-33 and X-34 flight systems and associated technology programs. It addresses the specific technologies being tested that address the technical and operability challenges of reusable launch systems including reusable cryogenic propellant tanks, composite structures, thermal protection systems, improved propulsion and subsystem operability enhancements. The recently concluded DC-XA test program demonstrated some of these technologies in ground and flight test. Contracts were awarded recently for both the X-33 and X-34 flight demonstrator systems. The Orbital Sciences Corporation X-34 flight test vehicle will demonstrate an air-launched reusable vehicle capable of flight to speeds of Mach 8. The Lockheed-Martin X-33 flight test vehicle will expand the test envelope for critical technologies to flight speeds of Mach 15. A propulsion program to test the X-33 linear aerospike rocket engine using a NASA SR-71 high speed aircraft as a test bed is also discussed. The paper also describes the management and operational approaches that address the challenge of new cost effective, reusable launch vehicle systems.

  17. Evaluating the Treatment Fidelity of Parents Who Conduct In-Home Functional Communication Training with Coaching via Telehealth

    Science.gov (United States)

    Suess, Alyssa N.; Romani, Patrick W.; Wacker, David P.; Dyson, Shannon M.; Kuhle, Jennifer L.; Lee, John F.; Lindgren, Scott D.; Kopelman, Todd G.; Pelzel, Kelly E.; Waldron, Debra B.

    2014-01-01

    We conducted a retrospective, descriptive evaluation of the fidelity with which parents of three children with autism spectrum disorders conducted functional communication training (FCT) in their homes. All training was provided to the parents via telehealth by a behavior consultant in a tertiary-level hospital setting. FCT trials coached by the…

  18. Telehealth Delivery of Cognitive-Behavioral Intervention to Youth with Autism Spectrum Disorder and Anxiety: A Pilot Study

    Science.gov (United States)

    Hepburn, Susan L.; Blakeley-Smith, Audrey; Wolff, Brian; Reaven, Judy A.

    2016-01-01

    Youth with autism spectrum disorders frequently experience significant symptoms of anxiety. Empirically supported psychosocial interventions exist, yet access is limited, especially for families in rural areas. Telehealth (i.e. videoconferencing) has potential to reduce barriers to access to care; however, little is known about the feasibility or…

  19. HUMANICS 1. A feasibility study to create a home internet based telehealth product to supplement acquired brain injury therapy

    DEFF Research Database (Denmark)

    Brooks, Tony

    2005-01-01

    The goal of the project was to produce a unique, cost effective, and user-friendly computer based telehealth system product which had longevity and the ability to be integrated modularly into a future internet-based health care communication provision. This was conceptualised as an aid to home-ba...

  20. The Impact of Telehealth and Care Coordination on the Number and Type of Clinical Visits for Children With Medical Complexity.

    Science.gov (United States)

    McKissick, Holly D; Cady, Rhonda G; Looman, Wendy S; Finkelstein, Stanley M

    The purpose of this analysis was to evaluate the effects of an advanced practice nurse-delivered telehealth intervention on health care use by children with medical complexity (CMC). Because CMC account for a large share of health care use costs, finding effective ways to care for them is an important challenge requiring exploration. This was a secondary analysis of data from a randomized clinical trial with a control group and two intervention groups. The focus of the analysis was planned and unplanned clinical and therapy visits by CMC over a 30-month data collection period. Nonparametric tests were used to compare visit counts among and within the three groups. The number of unplanned visits decreased over time across all groups, with the greatest decrease in the video telehealth intervention group. Planned visits were higher in the video telehealth group across all time periods. Advanced practice registered nurse-delivered telehealth care coordination may support a shift from unplanned to planned health care service use among CMC. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  1. A qualitative case study of telehealth for in-home monitoring to support the management of type 2 diabetes.

    Science.gov (United States)

    Carlisle, Karen; Warren, Robin

    2013-10-01

    The present study formed part of a randomised controlled trial of telehealth for in-home monitoring to support people with poorly controlled type 2 diabetes. We explored the experiences of patients and healthcare practitioners, and their perceptions of the telehealth model of care used in the trial. In addition to their usual diabetes care, participants receive diabetes care from a diabetes educator nurse via an in-home broadband communication device. On average, each patient participated in 14 videoconferences with a diabetes care coordinator during the 12-month trial period. Qualitative data was collected from two general practices and included semi-structured interviews and document review of patient clinical notes. A total of 12 people were interviewed: 8 health practitioners and 4 patients. Patients and health practitioners expressed a high level of satisfaction with the model of care provided. Patients also reported positive health and social outcomes as a result of being involved in the trial and indicated that in the main they had achieved their goals and were happy with their progress over the 12-month period. Analysis of interviews revealed three broad elements associated with the implementation of telehealth: interpersonal factors, operational problems and the wider health system context within which the general practices and trial team were operating. The findings suggest that adopting telehealth in the management of type 2 diabetes can lead to improved diabetes control, but more support is required to ensure sustainability and widespread implementation.

  2. A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy.

    Science.gov (United States)

    Kantarcigil, Cagla; Sheppard, Justine Joan; Gordon, Andrew M; Friel, Kathleen M; Malandraki, Georgia A

    2016-08-01

    Accurate and timely evaluation of dysphagia in children with cerebral palsy (CP) is critical. For children with limited access to quality healthcare, telehealth is an option; however, its reliability needs to be investigated. To test the reliability of an asynchronous telehealth model for evaluating dysphagia in children with CP using a standardized clinical assessment. Nineteen children (age range 6.9-17.5) were assessed at three mealtimes via the Dysphagia Disorder Survey (DDS) by three clinicians (face-to-face evaluations). Mealtimes were video-recorded to allow asynchronous evaluations by a remote clinician who also completed approximately 1/3 of face-to-face evaluations. Agreement was tested on DDS variables and dysphagia severity. Results revealed substantial to excellent agreement between face-to-face and remote assessments by the same rater (78-100%, KW=0.64-1) on all, but two variables (oral transport and oral pharyngeal swallow) and by different raters (69-89%, KW=0.6-0.86) on all but one variable (orienting). For dysphagia severity, intrarater agreement was excellent (100%, KW=1); interrater agreement was substantial (85%; KW=0.76). Asynchronous clinical swallowing evaluations using standardized tools have acceptable levels of agreement with face-to-face evaluations, and can be an alternative for children with limited access to expert swallowing care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Diagnosis of hearing loss using automated audiometry in an asynchronous telehealth model: A pilot accuracy study.

    Science.gov (United States)

    Brennan-Jones, Christopher G; Eikelboom, Robert H; Swanepoel, De Wet

    2017-02-01

    Introduction Standard criteria exist for diagnosing different types of hearing loss, yet audiologists interpret audiograms manually. This pilot study examined the feasibility of standardised interpretations of audiometry in a telehealth model of care. The aim of this study was to examine diagnostic accuracy of automated audiometry in adults with hearing loss in an asynchronous telehealth model using pre-defined diagnostic protocols. Materials and methods We recruited 42 study participants from a public audiology and otolaryngology clinic in Perth, Western Australia. Manual audiometry was performed by an audiologist either before or after automated audiometry. Diagnostic protocols were applied asynchronously for normal hearing, disabling hearing loss, conductive hearing loss and unilateral hearing loss. Sensitivity and specificity analyses were conducted using a two-by-two matrix and Cohen's kappa was used to measure agreement. Results The overall sensitivity for the diagnostic criteria was 0.88 (range: 0.86-1) and overall specificity was 0.93 (range: 0.86-0.97). Overall kappa ( k) agreement was 'substantial' k = 0.80 (95% confidence interval (CI) 0.70-0.89) and significant at p loss. This method has the potential to improve synchronous and asynchronous tele-audiology service delivery.

  4. Embedded DSP-based telehealth radar system for remote in-door fall detection.

    Science.gov (United States)

    Garripoli, Carmine; Mercuri, Marco; Karsmakers, Peter; Jack Soh, Ping; Crupi, Giovanni; Vandenbosch, Guy A E; Pace, Calogero; Leroux, Paul; Schreurs, Dominique

    2015-01-01

    Telehealth systems and applications are extensively investigated nowadays to enhance the quality-of-care and, in particular, to detect emergency situations and to monitor the well-being of elderly people, allowing them to stay at home independently as long as possible. In this paper, an embedded telehealth system for continuous, automatic, and remote monitoring of real-time fall emergencies is presented and discussed. The system, consisting of a radar sensor and base station, represents a cost-effective and efficient healthcare solution. The implementation of the fall detection data processing technique, based on the least-square support vector machines, through a digital signal processor and the management of the communication between radar sensor and base station are detailed. Experimental tests, for a total of 65 mimicked fall incidents, recorded with 16 human subjects (14 men and two women) that have been monitored for 320 min, have been used to validate the proposed system under real circumstances. The subjects' weight is between 55 and 90 kg with heights between 1.65 and 1.82 m, while their age is between 25 and 39 years. The experimental results have shown a sensitivity to detect the fall events in real time of 100% without reporting false positives. The tests have been performed in an area where the radar's operation was not limited by practical situations, namely, signal power, coverage of the antennas, and presence of obstacles between the subject and the antennas.

  5. The burden of seasonal respiratory infections on a national telehealth service in England.

    Science.gov (United States)

    Morbey, R A; Harcourt, S; Pebody, R; Zambon, M; Hutchison, J; Rutter, J; Thomas, H; Smith, G E; Elliot, A J

    2017-07-01

    Seasonal respiratory illnesses present a major burden on primary care services. We assessed the burden of respiratory illness on a national telehealth system in England and investigated the potential for providing early warning of respiratory infection. We compared weekly laboratory reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and week 29 in 2015. Multiple linear regression was used to identify which pathogens had a significant association with respiratory calls. Children aged respiratory pathogens explained over 83% of the variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons available, the greatest burden was associated with respiratory syncytial virus (RSV) and influenza, with associations found in all age bands. The most sensitive signal for influenza was calls for 'cold/flu', whilst for RSV it was calls for cough. The best-fitting models showed calls increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide early warning of seasonal rises in influenza and RSV, contributing to the national respiratory surveillance programme.

  6. Telehealth in older adults with cancer in the United States: The emerging use of wearable sensors.

    Science.gov (United States)

    Shen, John; Naeim, Arash

    2017-11-01

    As the aging and cancer populations in the world continue to increase, the need for complements to traditional geriatric assessments and the logical incorporation of fast and reliable telehealth tools have become interlinked. In the United States, studies examining the use of telehealth for chronic disease management have shown promising results in small groups. The implementation of health technology on a broader scale requires older adults to both accept and adapt such innovation into routine medical care. Though the commercial and recreational use of new technology has increased in older individuals, the transition into creating a smart and connected home that can interface with both patients and healthcare professionals is in its early phases. Current limitations include an inherent digital divide, as well as concerns regarding privacy, data volume, rapid change, cost and reimbursement. The emergence of low-cost, high-fidelity wearable sensors with a spectrum of clinical utility may be the key to increased use and adaptation by older adults. An opportunity to utilize wearable sensors for objective and real-time assessment of older patients with cancer for baseline functional status and treatment toxicity may be on the horizon. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. A randomized controlled trial of a telehealth parenting intervention: A mixed-disability trial.

    Science.gov (United States)

    Hinton, Sharon; Sheffield, Jeanie; Sanders, Matthew R; Sofronoff, Kate

    2017-06-01

    The quality of parenting a child receives has a major impact on development, wellbeing and future life opportunities. This study examined the efficacy of Triple P Online - Disability (TPOL-D) a telehealth intervention for parents of children with a disability. Ninety-eight parents and carers of children aged 2-12 years diagnosed with a range of developmental, intellectual and physical disabilities were randomly assigned to either the intervention (51) or treatment-as-usual (47) control group. At post-intervention parents receiving the TPOL-D intervention demonstrated significant improvements in parenting practices and parenting self-efficacy, however a significant change in parent-reported child behavioral and emotional problems was not detected. At 3-month follow up intervention gains were maintained and/or enhanced. A significant decrease in parent-reported child behavioral and emotional problems was also detected at this time. The results indicate that TPOL-D is a promising telehealth intervention for a mixed-disability group. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Educational actions in human communication health: telehealth contributions in primary care

    Directory of Open Access Journals (Sweden)

    Gabriela Guedes de Sá Leitão

    Full Text Available ABSTRACT Objective: to characterize educational actions related to human communication health produced at the Tele-Health Center for health professionals in primary care. Methods: a cross-sectional study was conducted at the Tele-Health Center at the Federal University of Pernambuco Clinical Hospital. Educational actions produced by tele-consultants between 2008 and 2014 linked to the health of human communication were considered. Data collection was conducted in two phases. In the first phase, the data were explored and educational actions were selected based on the title and the relationship with human communication. In the second phase, each action was observed and evaluated for content. The data were analyzed using descriptive statistics. Results: a few educational actions related to human communication health were concentrated in 2014. Throughout the period analyzed, the actions were restricted to the field of language and concentrated on the education issue as well as the strategic area of child and adolescent health. The most frequent occupational category among the tele-consultants was nursing. Conclusion: a small number of educational actions addressing the health of human communication was produced and the participation of speech therapists remains incipient.

  9. Water quality and trend analysis of Colorado--Big Thompson system reservoirs and related conveyances, 1969 through 2000

    Science.gov (United States)

    Stevens, Michael R.

    2003-01-01

    The U.S. Geological Survey, in an ongoing cooperative monitoring program with the Northern Colorado Water Conservancy District, Bureau of Reclamation, and City of Fort Collins, has collected water-quality data in north-central Colorado since 1969 in reservoirs and conveyances, such as canals and tunnels, related to the Colorado?Big Thompson Project, a water-storage, collection, and distribution system. Ongoing changes in water use among agricultural and municipal users on the eastern slope of the Rocky Mountains in Colorado, changing land use in reservoir watersheds, and other water-quality issues among Northern Colorado Water Conservancy District customers necessitated a reexamination of water-quality trends in the Colorado?Big Thompson system reservoirs and related conveyances. The sampling sites are on reservoirs, canals, and tunnels in the headwaters of the Colorado River (on the western side of the transcontinental diversion operations) and the headwaters of the Big Thompson River (on the eastern side of the transcontinental diversion operations). Carter Lake Reservoir and Horsetooth Reservoir are off-channel water-storage facilities, located in the foothills of the northern Colorado Front Range, for water supplied from the Colorado?Big Thompson Project. The length of water-quality record ranges from approximately 3 to 30 years depending on the site and the type of measurement or constituent. Changes in sampling frequency, analytical methods, and minimum reporting limits have occurred repeatedly over the period of record. The objective of this report was to complete a retrospective water-quality and trend analysis of reservoir profiles, nutrients, major ions, selected trace elements, chlorophyll-a, and hypolimnetic oxygen data from 1969 through 2000 in Lake Granby, Shadow Mountain Lake, and the Granby Pump Canal in Grand County, Colorado, and Horsetooth Reservoir, Carter Lake, Lake Estes, Alva B. Adams Tunnel, and Olympus Tunnel in Larimer County, Colorado

  10. Telehealth for diabetes self-management education and support in an underserved, free clinic population: A pilot study.

    Science.gov (United States)

    Threatt, Tiffaney B; Ward, Eileen D

    Primary study objectives were to (1) describe mean change in A1c from baseline of a free clinic population enrolled in telehealth diabetes self-management education and support (DSME/S) services and (2) to compare change in A1C and other clinical outcomes measures with free clinic patients enrolled in a traditional face-to-face DSME/S program. An exploratory study design and comparative evaluation of telehealth DSME/S services in a free clinic population was used. Baseline clinical measures were collected upon referral. Diabetes educators met with patients individually over 2-3 months. Clinical outcomes measures were collected within 6 months of program completion. Data from the telehealth group was assessed individually and compared to a free clinic traditional DSME/S program population. Twelve patients completed a telehealth free clinic DSME/S pilot program with a mean ± SD change in A1C from baseline of -1.03 ± 1.53% (P = 0.050). Mean ± SD change in A1C from baseline in the free clinic population participating in traditional face-to-face DSME/S services was -1.42 ± 1.80% (P = 0.001). No significant differences in secondary outcomes measures, including body mass index and blood pressure, were revealed among the study populations. Expanding access to care in populations faced with challenges of socioeconomics, limited education, and lower health literacy is a step toward reducing health disparities and positively affecting care. Mean A1C can be improved with telehealth DSME/S services in an underserved, free clinic population. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  11. Geochronology of the Thompson Creek Mo Deposit: Evidence for the Formation of Arc-related Mo Deposits

    Science.gov (United States)

    Lawrence, C. D.; Coleman, D. S.; Stein, H. J.

    2016-12-01

    The Thompson Creek Mo deposit in central ID, has been categorized as an arc-related Mo deposit due to the location, grade of Mo, and relative lack of enrichments in F, Rb, and Nb, compared to the Climax-type Mo deposits. Geochronology from this arc-related deposit provides an opportunity to compare and contrast magmatism, and mineralization to that in Climax-type deposits. Distinct pulses of magmatism were required to form the Thompson Creek Mo deposit, which is consistent with recent geochronology from Climax-type deposits. Molybdenite Re-Os geochronology from five veins requires at least three pulses of magmatism and mineralization between 89.39 +/- 0.37 and 88.47 +/- 0.16 Ma. Zircon U-Pb ages from these mineralized samples overlap with molybdenite mineralization, but show a much wider range (91.01 +/- 0.37 to 87.27 +/- 0.69). Previous work from Climax-type Mo deposits suggest a correlation between a super eruption, and the subsequent rapid (<1 Ma) onset, and completion of Mo mineralizing intrusions. The longer life (3-4 Ma) for the Thompson Creek Mo deposit suggests that the mineralizing intrusions for arc-related Mo deposits may not need to have as high [Mo] as the Climax-type deposits. This study also finds a shift in the source of magmatism from the pre- to syn-mineralizing intrusions. Zircons from pre-mineralizing intrusions have much higher (15-60 pg) concentrations of radiogenic Pb than zircons from mineralized intrusions, which all have less than 15 pg, though whole rock [U] are similar.

  12. Reply to J. C. Thompson, Jr. 's comments on the paper 'Radiation doses from iodine-129 in the environment'

    Energy Technology Data Exchange (ETDEWEB)

    Soldat, J K [Battelle Pacific Northwest Labs., Richland, Wash. (USA)

    1976-09-01

    Reference is made to comments by Thompson (Health Phys.; 31: 287 (1976)) on the present author's paper on 'Radiation Doses from /sup 129/I in the Environment' (Health Phys; Jan 1976) concerning the human and bovine consumption data that were used to arrive at thyroid dose estimates. Clarification is given of the diet and consumption data used in the original work and the sources of such data cited. Should modified diet data be accepted the thyroid dose estimates from unit concentrations of /sup 129/I in air originally tabulated could easily be altered in proportion to the diet assumed.

  13. Assessment of the cost-effectiveness and clinical outcomes of a fourth-generation synchronous telehealth program for the management of chronic cardiovascular disease.

    Science.gov (United States)

    Ho, Yi-Lwun; Yu, Jiun-Yu; Lin, Yen-Hung; Chen, Ying-Hsien; Huang, Ching-Chang; Hsu, Tse-Pin; Chuang, Pao-Yu; Hung, Chi-Sheng; Chen, Ming-Fong

    2014-06-10

    Telehealth programs are a growing field in the care of patients. The evolution of information technology has resulted in telehealth becoming a fourth-generation synchronous program. However, long-term outcomes and cost-effectiveness analysis of fourth-generation telehealth programs have not been reported in patients with chronic cardiovascular diseases. We conducted this study to assess the clinical outcomes and cost-effectiveness of a fourth-generation synchronous telehealth program for patients with chronic cardiovascular diseases. We retrospectively analyzed 575 patients who had joined a telehealth program and compared them with 1178 patients matched for sex, age, and Charlson comorbidity index. The program included: (1) instant transmission of biometric data, (2) daily telephone interview, and (3) continuous decision-making support. Data on hospitalization, emergency department (ED) visits, and medical costs were collected from the hospital's database and were adjusted to the follow-up months. The mean age was 64.5 years (SD 16.0). The mean number of monthly ED visits (mean 0.06 SD 0.13 vs mean 0.09 SD 0.23, P<.001), hospitalizations (mean 0.05 SD 0.12 vs mean 0.11 SD 0.21, P<.001), length of hospitalization (mean 0.77 days SD 2.78 vs mean 1.4 SD 3.6, P<.001), and intensive care unit admissions (mean 0.01 SD 0.07 vs mean 0.036 SD 0.14, P<.001) were lower in the telehealth group. The monthly mean costs of ED visits (mean US$20.90 SD 66.60 vs mean US$37.30 SD 126.20, P<.001), hospitalizations (mean US$386.30 SD 1424.30 vs mean US$878.20 SD 2697.20, P<.001), and all medical costs (mean US$587.60 SD 1497.80 vs mean US$1163.60 SD 3036.60, P<.001) were lower in the telehealth group. The intervention costs per patient were US$224.80 per month. Multivariate analyses revealed that age, telehealth care, and Charlson index were the independent factors for ED visits, hospitalizations, and length of hospitalization. A bootstrap method revealed the dominant cost

  14. Roles and identities in transition: boundaries of work and inter-professional relationships at the interface between telehealth and primary care.

    Science.gov (United States)

    Segar, Julia; Rogers, Anne; Salisbury, Chris; Thomas, Clare

    2013-11-01

    Shifting the balance of care towards home and community is viewed as requiring interventions which enhance or complement primary care. Technology-based interventions are seen as key to the future in this work. Telehealthcare implicates a new agenda for inter-professional working across boundaries of healthcare. One such interface is between telehealthcare professionals and professionals located in primary care. This study reports the findings from a qualitative study forming part of a broader project examining the potential of developing and implementing telehealth interventions to support patients with long-term conditions. Semi-structured interviews were undertaken with telehealth nurse care managers, practice nurses and general practitioners in their respective work settings (39 interviews with 62 participants). Observation was undertaken at a telehealth call centre. The research took place between April 2010 and March 2011. Thematic analysis of qualitative data was undertaken. Telehealth nurse care managers' interviews suggested narrative constructions of new roles and identities to fit telehealth work, combining a holistic ideal and retro-appeal with 'traditional' values of nursing, which distinguished and distanced them from counterparts in general practices. Practice nurses and general practitioners were ambivalent and often sceptical about the contribution of telehealth to long-term condition work. Practice nurses' accounts suggested a sense of protectiveness about maintaining boundaries around established remits of managing long-term conditions; general practitioners, having devolved much of the care of long-term conditions to nurses, were keen to retain their positions as gatekeepers to resources. Perceptions of shifts of professional roles, new ways of working and how they are valued form a relevant contextual element to the introduction of telehealth interventions. A pre-emptive view and response to how professionals understand and approach increasingly

  15. Launch Pad in a Box

    Science.gov (United States)

    Mantovani, James; Tamasy, Gabor; Mueller, Rob; Townsend, Van; Sampson, Jeff; Lane, Mike

    2016-01-01

    NASA Kennedy Space Center (KSC) is developing a new deployable launch system capability to support a small class of launch vehicles for NASA and commercial space companies to test and launch their vehicles. The deployable launch pad concept was first demonstrated on a smaller scale at KSC in 2012 in support of NASA Johnson Space Center's Morpheus Lander Project. The main objective of the Morpheus Project was to test a prototype planetary lander as a vertical takeoff and landing test-bed for advanced spacecraft technologies using a hazard field that KSC had constructed at the Shuttle Landing Facility (SLF). A steel pad for launch or landing was constructed using a modular design that allowed it to be reconfigurable and expandable. A steel flame trench was designed as an optional module that could be easily inserted in place of any modular steel plate component. The concept of a transportable modular launch and landing pad may also be applicable to planetary surfaces where the effects of rocket exhaust plume on surface regolith is problematic for hardware on the surface that may either be damaged by direct impact of high speed dust particles, or impaired by the accumulation of dust (e.g., solar array panels and thermal radiators). During the Morpheus free flight campaign in 2013-14, KSC performed two studies related to rocket plume effects. One study compared four different thermal ablatives that were applied to the interior of a steel flame trench that KSC had designed and built. The second study monitored the erosion of a concrete landing pad following each landing of the Morpheus vehicle on the same pad located in the hazard field. All surfaces of a portable flame trench that could be directly exposed to hot gas during launch of the Morpheus vehicle were coated with four types of ablatives. All ablative products had been tested by NASA KSC and/or the manufacturer. The ablative thicknesses were measured periodically following the twelve Morpheus free flight tests

  16. Delivering scalable Telehealth: ‘What is Scale?’ with case studies from NHS providers, a perspective on the challenges, constraints and issues associated with ‘scalability’

    OpenAIRE

    Sonia Jane Milburn; Adrian Flowerday

    2012-01-01

    Introduction With local and national evidence highlighting and confirming numerous benefits gained from implementing telehealth, why is it so hard to roll out the technology at scale? Solent NHS Trust has worked alongside Docobo Limited, since 2005, to successfully introduce telehealth to its patients and clinical staff. Our Chronic Obstructive Pulmonary Disease, Chronic Heart Failure and Community Matron teams have utilised Telehealth tools into their normal practice and have delivered signi...

  17. What is quality in assisted living technology? The ARCHIE framework for effective telehealth and telecare services.

    Science.gov (United States)

    Greenhalgh, Trisha; Procter, Rob; Wherton, Joe; Sugarhood, Paul; Hinder, Sue; Rouncefield, Mark

    2015-04-23

    We sought to define quality in telehealth and telecare with the aim of improving the proportion of patients who receive appropriate, acceptable and workable technologies and services to support them living with illness or disability. This was a three-phase study: (1) interviews with seven technology suppliers and 14 service providers, (2) ethnographic case studies of 40 people, 60 to 98 years old, with multi-morbidity and assisted living needs and (3) 10 co-design workshops. In phase 1, we explored barriers to uptake of telehealth and telecare. In phase 2, we used ethnographic methods to build a detailed picture of participants' lives, illness experiences and technology use. In phase 3, we brought users and their carers together with suppliers and providers to derive quality principles for assistive technology products and services. Interviews identified practical, material and organisational barriers to smooth introduction and continued support of assistive technologies. The experience of multi-morbidity was characterised by multiple, mutually reinforcing and inexorably worsening impairments, producing diverse and unique care challenges. Participants and their carers managed these pragmatically, obtaining technologies and adapting the home. Installed technologies were rarely fit for purpose. Support services for technologies made high (and sometimes oppressive) demands on users. Six principles emerged from the workshops. Quality telehealth or telecare is 1) ANCHORED in a shared understanding of what matters to the user; 2) REALISTIC about the natural history of illness; 3) CO-CREATIVE, evolving and adapting solutions with users; 4) HUMAN, supported through interpersonal relationships and social networks; 5) INTEGRATED, through attention to mutual awareness and knowledge sharing; 6) EVALUATED to drive system learning. Technological advances are important, but must be underpinned by industry and service providers following a user-centred approach to design and

  18. Changes in growth, photosynthetic activities, biochemical parameters and amino acid profile of Thompson Seedless grapes (Vitis vinifera L.).

    Science.gov (United States)

    Somkuwar, R G; Bahetwar, Anita; Khan, I; Satisha, J; Ramteke, S D; Itroutwar, Prerna; Bhongale, Aarti; Oulkar, Dashrath

    2014-11-01

    The study on photosynthetic activity and biochemical parameters in Thompson Seedless grapes grafted on Dog Ridge rootstock and its impact on growth, yield and amino acid profile at various stages of berry development was conducted during the year 2012-2013. Leaf and berry samples from ten year old vines of Thompson Seedless were collected at different growth and berry developmental stages. The analysis showed difference in photosynthetic activity, biochemical parameters and amino acid status with the changes in berry development stage. Higher photosynthetic rate of 17.39 umol cm(-2) s(-1) was recorded during 3-4mm berry size and the lowest (10.08 umol cm(-2) s(-1)) was recorded during the veraison stage. The photosynthetic activity showed gradual decrease with the onset of harvest while the different biochemical parameters showed increase and decrease from one stage to another in both berry and leaves. Changes in photosynthetic activity and biochemical parameters thereby affected the growth, yield and amino acid content of the berry. Positive correlation of leaf area and photosynthetic rate was recorded during the period of study. Reducing sugar (352.25 mg g(-1)) and total carbohydrate (132.52 mg g(-1)) was more in berries as compared to leaf. Amino acid profile showed variations in different stages of berry development. Marked variations in photosynthetic as well as biochemical and amino acid content at various berry development stages was recorded and thereby its cumulative effect on the development of fruit quality.

  19. VEGA, a small launch vehicle

    Science.gov (United States)

    Duret, François; Fabrizi, Antonio

    1999-09-01

    Several studies have been performed in Europe aiming to promote the full development of a small launch vehicle to put into orbit one ton class spacecrafts. But during the last ten years, the european workforce was mainly oriented towards the qualification of the heavy class ARIANE 5 launch vehicle.Then, due also to lack of visibility on this reduced segment of market, when comparing with the geosatcom market, no proposal was sufficiently attractive to get from the potentially interrested authorities a clear go-ahead, i.e. a financial committment. The situation is now rapidly evolving. Several european states, among them ITALY and FRANCE, are now convinced of the necessity of the availability of such a transportation system, an important argument to promote small missions, using small satellites. Application market will be mainly scientific experiments and earth observation; some telecommunications applications may be also envisaged such as placement of little LEO constellation satellites, or replacement after failure of big LEO constellation satellites. FIAT AVIO and AEROSPATIALE have proposed to their national agencies the development of such a small launch vehicle, named VEGA. The paper presents the story of the industrial proposal, and the present status of the project: Mission spectrum, technical definition, launch service and performance, target development plan and target recurring costs, as well as the industrial organisation for development, procurement, marketing and operations.

  20. Differential Impact and Use of a Telehealth Intervention by Persons with MS or SCI.

    Science.gov (United States)

    Mercier, Hannah W; Ni, Pensheng; Houlihan, Bethlyn V; Jette, Alan M

    2015-11-01

    The objective of this study was to compare outcomes and patterns of engaging with a telehealth intervention (CareCall) by adult wheelchair users with severe mobility limitations with a diagnosis of multiple sclerosis (MS) or spinal cord injury (SCI). The design of this study is a secondary analysis from a pilot randomized controlled trial with 106 participants with SCI and 36 participants with MS. General linear model results showed that an interaction between baseline depression score and study group significantly predicted reduced depression at 6 mos for subjects with both diagnoses (P = 0.01). For those with MS, CareCall increased participants' physical independence (P SCI (P = 0.005). Those with SCI missed more calls (P SCI, and in increasing health care access and physical independence for those with a diagnosis of MS. Future research should aim to enhance the efficacy of such an intervention for participants with SCI.

  1. A security framework for nationwide health information exchange based on telehealth strategy.

    Science.gov (United States)

    Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

    2015-05-01

    This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

  2. Evaluation of a telehealth training package to remotely train staff to conduct a preference assessment.

    Science.gov (United States)

    Higgins, William J; Luczynski, Kevin C; Carroll, Regina A; Fisher, Wayne W; Mudford, Oliver C

    2017-04-01

    Recent advancements in telecommunication technologies make it possible to conduct a variety of healthcare services remotely (e.g., behavioral-analytic intervention services), thereby bridging the gap between qualified providers and consumers in isolated locations. In this study, web-based telehealth technologies were used to remotely train direct-care staff to conduct a multiple-stimulus-without-replacement preference assessment. The training package included three components: (a) a multimedia presentation; (b) descriptive feedback from previously recorded baseline sessions; and (c) scripted role-play with immediate feedback. A nonconcurrent, multiple-baseline-across-participants design was used to demonstrate experimental control. Training resulted in robust and immediate improvements, and these effects maintained during 1- to 2-month follow-up observations. In addition, participants expressed high satisfaction with the web-based materials and the overall remote-training experience. © 2017 Society for the Experimental Analysis of Behavior.

  3. Space Launch System Development Status

    Science.gov (United States)

    Lyles, Garry

    2014-01-01

    Development of NASA's Space Launch System (SLS) heavy lift rocket is shifting from the formulation phase into the implementation phase in 2014, a little more than three years after formal program approval. Current development is focused on delivering a vehicle capable of launching 70 metric tons (t) into low Earth orbit. This "Block 1" configuration will launch the Orion Multi-Purpose Crew Vehicle (MPCV) on its first autonomous flight beyond the Moon and back in December 2017, followed by its first crewed flight in 2021. SLS can evolve to a130-t lift capability and serve as a baseline for numerous robotic and human missions ranging from a Mars sample return to delivering the first astronauts to explore another planet. Benefits associated with its unprecedented mass and volume include reduced trip times and simplified payload design. Every SLS element achieved significant, tangible progress over the past year. Among the Program's many accomplishments are: manufacture of Core Stage test panels; testing of Solid Rocket Booster development hardware including thrust vector controls and avionics; planning for testing the RS-25 Core Stage engine; and more than 4,000 wind tunnel runs to refine vehicle configuration, trajectory, and guidance. The Program shipped its first flight hardware - the Multi-Purpose Crew Vehicle Stage Adapter (MSA) - to the United Launch Alliance for integration with the Delta IV heavy rocket that will launch an Orion test article in 2014 from NASA's Kennedy Space Center. Objectives of this Earth-orbit flight include validating the performance of Orion's heat shield and the MSA design, which will be manufactured again for SLS missions to deep space. The Program successfully completed Preliminary Design Review in 2013 and Key Decision Point C in early 2014. NASA has authorized the Program to move forward to Critical Design Review, scheduled for 2015 and a December 2017 first launch. The Program's success to date is due to prudent use of proven

  4. An evaluation of the telehealth facilitation of diabetes and cardiovascular care in remote Australian Indigenous communities: - protocol for the telehealth eye and associated medical services network [TEAMSnet] project, a pre-post study design.

    Science.gov (United States)

    Brazionis, Laima; Jenkins, Alicia; Keech, Anthony; Ryan, Chris; Bursell, Sven-Erik

    2017-01-05

    Despite substantial investment in detection, early intervention and evidence-based treatments, current management strategies for diabetes-associated retinopathy and cardiovascular disease are largely based on real-time and face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore, we aim to investigate efficacy of telehealth facilitation of diabetes and cardiovascular disease care in high-risk vulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia. Using a pre-post intervention design, 600 Indigenous Australians with type 2 diabetes will be recruited from three primary-care health-services in the Northern Territory. Diabetes status will be based on clinical records. There will be four technological interventions: 1. Baseline retinal imaging [as a real-time patient education/engagement tool and telehealth screening strategy]. 2. A lifestyle survey tool administered at ≈ 6-months. 3. At ≈ 6- and 18-months, an electronic cardiovascular disease and diabetes decision-support tool based on current guidelines in the Standard Treatment Manual of the Central Australian Rural Practitioner's Association to generate clinical recommendations. 4. Mobile tablet technology developed to enhance participant engagement in self-management. Data will include: Pre-intervention clinical and encounter-history data, baseline retinopathy status, decision-support and survey data/opportunistic mobile tablet encounter data. The primary outcome is increased participant adherence to clinical appointments, a marker of engagement and self-management. A cost-benefit analysis will be performed. Remoteness is a major barrier to provision and uptake of best-practice chronic disease management. Telehealth, beyond videoconferencing of consultations, could facilitate evidence-based management of diabetes and cardiovascular disease in Indigenous Australians and serve as a model for other conditions. Australia

  5. Telehealth Technologies and Applications for Terrorism Response: A Report of the 2002 Coastal North Carolina Domestic Preparedness Training Exercise

    Science.gov (United States)

    Simmons, Scott C.; Murphy, Timothy A.; Blanarovich, Adrian; Workman, Florence T.; Rosenthal, David A.; Carbone, Matthew

    2003-01-01

    Effective response to natural or man-made disasters (i.e., terrorism) is predicated on the ability to communicate among the many organizations involved. Disaster response exercises enable disaster planners and responders to test procedures and technologies and incorporate the lessons learned from past disasters or exercises. On May 31 and June 1, 2002, one such exercise event took place at the Camp Lejeune Marine Corps Base in Jacksonville, North Carolina. During the exercise, East Carolina University tested: (1) in-place Telehealth networks and (2) rapidly deployable communications, networking, and data collection technologies such as satellite communications, local wireless networking, on-scene video, and clinical and environmental data acquisition and telemetry. Exercise participants included local, county, state, and military emergency medical services (EMS), emergency management, specialized response units, and local fire and police units. The technologies and operations concepts tested at the exercise and recommendations for using telehealth to improve disaster response are described. PMID:12595406

  6. Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

    Science.gov (United States)

    Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

    2016-10-01

    Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical

  7. Vertical Launch System Loadout Planner

    Science.gov (United States)

    2015-03-01

    United States Navy USS United States’ Ship VBA Visual Basic for Applications VLP VLS Loadout Planner VLS Vertical Launch System...with 32 gigabytes of random access memory and eight processors, General Algebraic Modeling System (GAMS) CPLEX version 24 (GAMS, 2015) solves this...problem in ten minutes to an integer tolerance of 10%. The GAMS interpreter and CPLEX solver require 75 Megabytes of random access memory for this

  8. Reusable Military Launch Systems (RMLS)

    Science.gov (United States)

    2008-02-01

    shown in Figure 11. The second configuration is an axisymmetric, rocket-based combined cycle (RBCC) powered, SSTO vehicle, similar to the GTX...McCormick, D., and Sorensen, K., “Hyperion: An SSTO Vision Vehicle Concept Utilizing Rocket-Based Combined Cycle Propulsion”, AIAA paper 99-4944...there have been several failedattempts at the development of reusable rocket or air-breathing launch vehicle systems. Single-stage-to-orbit ( SSTO

  9. Collaborative Practice Improvement for Childhood Obesity in Rural Clinics: The Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP)

    OpenAIRE

    Shaikh, U; Nettiksimmons, J; Joseph, JG; Tancredi, D; Romano, PS

    2014-01-01

    © 2013 by the American College of Medical Quality. This study assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. A total of 7 primary care clinics in rural California included in the Healthy Eating Active Living TeleHealth Community of Practice and 288 children seen in these clinics for well-child care participated in this prospective observational pre-post study. Cl...

  10. Growing up with confidence: using telehealth to support continence self-care deficits amongst young people with complex needs

    Directory of Open Access Journals (Sweden)

    Sharon Levy

    2014-05-01

    Full Text Available Background Many young people with chronic ill health use technology for selfcare activities, but little is known about the use of telehealth amongst those with spina bifida. The limited availability of specialist continence nurses in primary care settings, for this client group in the UK, exacerbates their reliance on parents or carers.Objectives1. Exploring the way in which home-based and technology-enabled clinical interventions affect young people’s engagement in continence self-care.2. Articulating the way in which telehealth impacts on nursing practice and the conduct of remote clinical encounters.Methods A virtual nurse-led clinic was established to support a small cohort of service users and their parents from home. Data from participants were collected and analysed alongside a narrative record of a reflective diary, used by the continence specialist nurse.Results Participants reported increased level of self-confidence, which was attributed to interacting remotely with the specialist nurse. The virtual clinic assisted users to attain some self-care goals as well as assert their role as partners in care planning. The specialist nurse gained new valuable skills in mastering telehealth technology and managing remote clinical provision.Conclusions Using Skype™ to support young people with complex needs is an effective intervention to support continence care at home. Dedicated technical support during the initial set-up phase and on-going clinical mentorship are needed to ensure that telehealth is successfully embedded within health care practice.

  11. An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal

    OpenAIRE

    Clarke, M; Mars, M

    2014-01-01

    This article has been made available through the Brunel Open Access Publishing Fund. Abstract Background: We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. Materials and Methods: We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access...

  12. Service provider perceptions of transitioning from audio to video capability in a telehealth system: a qualitative evaluation

    OpenAIRE

    Clay-Williams, Robyn; Baysari, Melissa; Taylor, Natalie; Zalitis, Dianne; Georgiou, Andrew; Robinson, Maureen; Braithwaite, Jeffrey; Westbrook, Johanna

    2017-01-01

    Background Telephone consultation and triage services are increasingly being used to deliver health advice. Availability of high speed internet services in remote areas allows healthcare providers to move from telephone to video telehealth services. Current approaches for assessing video services have limitations. This study aimed to identify the challenges for service providers associated with transitioning from audio to video technology. Methods Using a mixed-method, qualitative approach, w...

  13. A cross-sectional survey and service evaluation of simple telehealth in primary care: what do patients think?

    Science.gov (United States)

    Cottrell, Elizabeth; McMillan, Kate; Chambers, Ruth

    2012-01-01

    To determine the patient experience of using a simple telehealth strategy to manage hypertension in adults. As part of a pragmatic service evaluation, the acceptability of, satisfaction with and ease of use of a simple telehealth strategy was determined via text, cross-sectional questionnaire survey administered by telephone, case studies, discussion groups and informal feedback from practices. This simple telehealth approach required patients to take home blood pressure (BP) readings and text them to a secure server ('Florence') for immediate automatic analysis and individual healthcare professional review. 124 intervention patients who used the Florence system. 10 volunteer general practitioner's (GP) practices in Stoke on Trent, UK, with poor health and high levels of material deprivation took part. Patient satisfaction was high. In particular, patients found the system easy to use, were very satisfied about the feedback from their GP regarding their BP readings, found the advice sent via Florence useful and preferred to send BP readings using Florence rather than having to go to the practice monthly to get BP checked. Overall satisfaction with the system was 4.81/5.00 at week 13 of the programme. Other advantages of being enrolled with Florence were improved education about hypertension, a greater feeling of support and companionship and flexibility which allowed self-care to occur at a time that suited the patient rather than their practice. This simple telehealth strategy for managing hypertension in the community was met with high levels of patient satisfaction and feelings of control and support. This management approach should thus be considered for widespread implementation for clinical management of hypertension and other long-term conditions involving monitoring of patients' bodily measurements and symptoms as a large number of meaningful readings can be obtained from many patients in a prompt, efficient, interactive and acceptable way.

  14. Telehealth clinics increase access to care for adults with cystic fibrosis living in rural and remote Western Australia.

    Science.gov (United States)

    Wood, Jamie; Mulrennan, Siobhain; Hill, Kylie; Cecins, Nola; Morey, Sue; Jenkins, Sue

    2017-08-01

    Introduction A significant proportion (15%, n = 28) of the adults with cystic fibrosis (CF) in Western Australia (WA) live in rural and remote areas and have difficulty accessing specialist care at the state adult CF centre, located in Perth. We aimed to increase access by offering telehealth clinics, and evaluate the impact on health outcomes. Methods Telehealth clinics were offered via videoconference over a 12-month period, with uptake and satisfaction measured at the end of the intervention. Participants could still attend in person clinics at the CF centre if requested. Other outcomes comprised healthcare utilisation (HCU), spirometry, weight and health-related quality of life. Results In 21 participants, total clinic visits increased from 46 (median (range) per participant 2 (0-6)) in the 12-month period preceding the study to 100 (5 (2-8), p vitality domain of the Cystic Fibrosis Questionnaire - Revised ( p < 0.05). Discussion Telehealth had good uptake and increased clinic attendance in adults with CF living in rural and remote WA, and had high satisfaction amongst participants. The increase in HCU, resulting from increased detection and treatment of exacerbations, may improve long-term outcomes in this population.

  15. Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

    Science.gov (United States)

    Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

    2016-08-01

    Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

  16. Integrating social capital theory, social cognitive theory, and the technology acceptance model to explore a behavioral model of telehealth systems.

    Science.gov (United States)

    Tsai, Chung-Hung

    2014-05-07

    Telehealth has become an increasingly applied solution to delivering health care to rural and underserved areas by remote health care professionals. This study integrated social capital theory, social cognitive theory, and the technology acceptance model (TAM) to develop a comprehensive behavioral model for analyzing the relationships among social capital factors (social capital theory), technological factors (TAM), and system self-efficacy (social cognitive theory) in telehealth. The proposed framework was validated with 365 respondents from Nantou County, located in Central Taiwan. Structural equation modeling (SEM) was used to assess the causal relationships that were hypothesized in the proposed model. The finding indicates that elderly residents generally reported positive perceptions toward the telehealth system. Generally, the findings show that social capital factors (social trust, institutional trust, and social participation) significantly positively affect the technological factors (perceived ease of use and perceived usefulness respectively), which influenced usage intention. This study also confirmed that system self-efficacy was the salient antecedent of perceived ease of use. In addition, regarding the samples, the proposed model fitted considerably well. The proposed integrative psychosocial-technological model may serve as a theoretical basis for future research and can also offer empirical foresight to practitioners and researchers in the health departments of governments, hospitals, and rural communities.

  17. Integrating Social Capital Theory, Social Cognitive Theory, and the Technology Acceptance Model to Explore a Behavioral Model of Telehealth Systems

    Directory of Open Access Journals (Sweden)

    Chung-Hung Tsai

    2014-05-01

    Full Text Available Telehealth has become an increasingly applied solution to delivering health care to rural and underserved areas by remote health care professionals. This study integrated social capital theory, social cognitive theory, and the technology acceptance model (TAM to develop a comprehensive behavioral model for analyzing the relationships among social capital factors (social capital theory, technological factors (TAM, and system self-efficacy (social cognitive theory in telehealth. The proposed framework was validated with 365 respondents from Nantou County, located in Central Taiwan. Structural equation modeling (SEM was used to assess the causal relationships that were hypothesized in the proposed model. The finding indicates that elderly residents generally reported positive perceptions toward the telehealth system. Generally, the findings show that social capital factors (social trust, institutional trust, and social participation significantly positively affect the technological factors (perceived ease of use and perceived usefulness respectively, which influenced usage intention. This study also confirmed that system self-efficacy was the salient antecedent of perceived ease of use. In addition, regarding the samples, the proposed model fitted considerably well. The proposed integrative psychosocial-technological model may serve as a theoretical basis for future research and can also offer empirical foresight to practitioners and researchers in the health departments of governments, hospitals, and rural communities.

  18. Designing human centered GeoVisualization application--the SanaViz--for telehealth users: a case study.

    Science.gov (United States)

    Joshi, Ashish; de Araujo Novaes, Magdala; Machiavelli, Josiane; Iyengar, Sriram; Vogler, Robert; Johnson, Craig; Zhang, Jiajie; Hsu, Chiehwen E

    2012-01-01

    Public health data is typically organized by geospatial unit. GeoVisualization (GeoVis) allows users to see information visually on a map. Examine telehealth users' perceptions towards existing public health GeoVis applications and obtains users' feedback about features important for the design and development of Human Centered GeoVis application "the SanaViz". We employed a cross sectional study design using mixed methods approach for this pilot study. Twenty users involved with the NUTES telehealth center at Federal University of Pernambuco (UFPE), Recife, Brazil were enrolled. Open and closed ended questionnaires were used to gather data. We performed audio recording for the interviews. Information gathered included socio-demographics, prior spatial skills and perception towards use of GeoVis to evaluate telehealth services. Card sorting and sketching methods were employed. Univariate analysis was performed for the continuous and categorical variables. Qualitative analysis was performed for open ended questions. Existing Public Health GeoVis applications were difficult to use. Results found interaction features zooming, linking and brushing and representation features Google maps, tables and bar chart as most preferred GeoVis features. Early involvement of users is essential to identify features necessary to be part of the human centered GeoVis application "the SanaViz".

  19. Locating of Rural Health Centers Equipped with Telehealth using GIS: A Case Study on Khorramabad City, Iran

    Directory of Open Access Journals (Sweden)

    Safdari Reza

    2016-10-01

    Full Text Available Residents of the rural and remote area always having limitations on accessing properly required service providers. In such condition, the establishment of rural health centers equipped with telehealth, and also the use of GIS for optimal site selection to the centers, would play an important role in facilitating the achievement of quality health services in desired time factor. This study intended to find the optimal sites for building the Rural Health Centers Equipped with remote health facilities in, Khorramabad City, using GIS. During the pilot study, we identified few effective locating criteria and sub-criteria for rural health centers equipped with telehealth, the priorities was also determined in that descriptive study. Further, we prepared a special layer for each criterion on the site selection, and by integrating such layers based on specified rules and patterns, about the spatial analysis , (like distance and density analysis were done. For such methods, we used Arc Map, Arc Catalog and Arc toolbox environments of Arc GIS (version 9.3. Finally, a map was prepared that indicated the possibility of appropriateness for establishing the centers in the study area. Considering a large number of areas, the research team selected the areas which were the appropriate location for build rural health centers which could be equipped with Telehealth.

  20. Launch Services, a Proven Model

    Science.gov (United States)

    Trafton, W. C.; Simpson, J.

    2002-01-01

    From a commercial perspective, the ability to justify "leap frog" technology such as reusable systems has been difficult to justify because the estimated 5B to 10B investment is not supported in the current flat commercial market coupled with an oversupply of launch service suppliers. The market simply does not justify investment of that magnitude. Currently, next generation Expendable Launch Systems, including Boeing's Delta IV, Lockheed Martin's Atlas 5, Ariane V ESCA and RSC's H-IIA are being introduced into operations signifying that only upgrades to proven systems are planned to meet the changes in anticipated satellite demand (larger satellites, more lifetime, larger volumes, etc.) in the foreseeable future. We do not see a new fleet of ELVs emerging beyond that which is currently being introduced, only continuous upgrades of the fleet to meet the demands. To induce a radical change in the provision of launch services, a Multinational Government investment must be made and justified by World requirements. The commercial market alone cannot justify such an investment. And if an investment is made, we cannot afford to repeat previous mistakes by relying on one system such as shuttle for commercial deployment without having any back-up capability. Other issues that need to be considered are national science and security requirements, which to a large extent fuels the Japanese, Chinese, Indian, Former Soviet Union, European and United States space transportation entries. Additionally, this system must support or replace current Space Transportation Economies with across-the-board benefits. For the next 10 to 20 years, Multinational cooperation will be in the form of piecing together launch components and infrastructure to supplement existing launch systems and reducing the amount of non-recurring investment while meeting the future requirements of the End-User. Virtually all of the current systems have some form of multinational participation: Sea Launch

  1. Semi-analytic equations to the Cox-Thompson inverse scattering method at fixed energy for special cases

    International Nuclear Information System (INIS)

    Palmai, T.; Apagyi, B.; Horvath, M.

    2008-01-01

    Solution of the Cox-Thompson inverse scattering problem at fixed energy 1-3 is reformulated resulting in semi-analytic equations. The new set of equations for the normalization constants and the nonphysical (shifted) angular momenta are free of matrix inversion operations. This simplification is a result of treating only the input phase shifts of partial waves of a given parity. Therefore, the proposed method can be applied for identical particle scattering of the bosonic type (or for certain cases of identical fermionic scattering). The new formulae are expected to be numerically more efficient than the previous ones. Based on the semi-analytic equations an approximate method is proposed for the generic inverse scattering problem, when partial waves of arbitrary parity are considered. (author)

  2. Carbon Dioxide, Hydrographic, and Chemical Data Obtained During the R/V Thomas G. Thompson Cruise in the Pacific Ocean

    Energy Technology Data Exchange (ETDEWEB)

    Sabine, C.L.; Key, R.M.; Hall, M.; Kozyr, A.

    1999-08-01

    This data documentation discusses the procedures and methods used to measure total carbon dioxide (TCO2), total alkalinity (TALK), and radiocarbon (delta 14C), at hydrographic stations, as well as the underway partial pressure of CO2 (pCO2) during the R/V Thomas G. Thompson oceanographic cruise in the Pacific Ocean (Section P10). Conducted as part of the World Ocean Circulation Experiment (WOCE), the cruise began in Suva, Fiji, on October 5, 1993, and ended in Yokohama, Japan, on November 10, 1993. Measurements made along WOCE Section P10 included pressure, temperature, salinity [measured by conductivity temperature, and depth sensor (CTD)], bottle salinity, bottle oxygen, phosphate, nitrate, silicate, chlorofluorocarbons (CFC-11, CFC-12), TCO2, TALK, delta 14C, and underway pCO2.

  3. The old and new faces of morphology: the legacy of D'Arcy Thompson's 'theory of transformations' and 'laws of growth'.

    Science.gov (United States)

    Abzhanov, Arhat

    2017-12-01

    In 1917, the publication of On Growth and Form by D'Arcy Wentworth Thompson challenged both mathematicians and naturalists to think about biological shapes and diversity as more than a confusion of chaotic forms generated at random, but rather as geometric shapes that could be described by principles of physics and mathematics. Thompson's work was based on the ideas of Galileo and Goethe on morphology and of Russell on functionalism, but he was first to postulate that physical forces and internal growth parameters regulate biological forms and could be revealed via geometric transformations in morphological space. Such precise mathematical structure suggested a unifying generative process, as reflected in the title of the book. To Thompson it was growth that could explain the generation of any particular biological form, and changes in ontogeny, rather than natural selection, could then explain the diversity of biological shapes. Whereas adaptationism, widely accepted in evolutionary biology, gives primacy to extrinsic factors in producing morphological variation, Thompson's 'laws of growth' provide intrinsic directives and constraints for the generation of individual shapes, helping to explain the 'profusion of forms, colours, and other modifications' observed in the living world. © 2017. Published by The Company of Biologists Ltd.

  4. Generation of animal form by the Chordin/Tolloid/BMP gradient: 100 years after D'Arcy Thompson.

    Science.gov (United States)

    De Robertis, Edward M; Moriyama, Yuki; Colozza, Gabriele

    2017-09-01

    The classic book "On Growth and Form" by naturalist D'Arcy Thompson was published 100 years ago. To celebrate this landmark, we present experiments in the Xenopus embryo that provide a framework for understanding how simple, quantitative transformations of a morphogen gradient might have affected evolution and morphological diversity of organisms. D'Arcy Thompson proposed that different morphologies might be generated by modifying physical parameters in an underlying system of Cartesian coordinates that pre-existed in Nature and arose during evolutionary history. Chordin is a BMP antagonist secreted by the Spemann organizer located on the dorsal side of the gastrula. Chordin generates a morphogen gradient as first proposed by mathematician Alan Turing. The rate-limiting step of this dorsal-ventral (D-V) morphogen is the degradation of Chordin by the Tolloid metalloproteinase in the ventral side. Chordin is expressed at gastrula on the dorsal side where BMP signaling is low, while at the opposite side peak levels of BMP signaling are reached. In fishes, amphibians, reptiles and birds, high BMP signaling in the ventral region induces transcription of a secreted inhibitor of Tolloid called Sizzled. By depleting Sizzled exclusively in the ventral half of the embryo we were able to expand the ventro-posterior region in an otherwise normal embryo. Conversely, ventral depletion of Tolloid, which stabilizes Chordin, decreased ventral and tail structures, phenocopying the tolloid zebrafish mutation. We explain how historical constraints recorded in the language of DNA become subject to the universal laws of physics when an ancestral reaction-diffusion morphogen gradient dictates form. © 2017 Japanese Society of Developmental Biologists.

  5. Thompson revisited. Ein empirisch fundiertes Modell zur Qualität von „Quality-TV“ aus Nutzersicht

    Directory of Open Access Journals (Sweden)

    Michael Harnischmacher

    2015-07-01

    Full Text Available Was bedeutet das Attribut „Quality-TV“ eigentlich für das Publikum? Nach welchen Kriterien beurteilen Zuschauerinnen und Zuschauer, ob eine Serie Qualitätsfernsehen ist oder nicht? Im Bereich der rezipientenorientierten Qualitätsforschung bezüglich Fernsehserien sind bislang fast ausschließlich qualitativ erhobene Modelle bedeutsam, am bekanntesten sicherlich die bereits 1996 von Robert J. Thompson vorgeschlagenen 12 Kriterien. Die vorliegende Untersuchung widmet sich nun der Frage, ob diese Qualitätskriterien tatsächlich die „richtigen“ sind. Sind sie für die Zuschauer/innen von Serien bedeutsam für die Einschätzung, ob ein Programm „Quality-TV“ ist oder nicht? Bislang fehlt eine empirische Fundierung der einzelnen Merkmale. Ebenso ungeklärt ist bislang, ob es eine Rangfolge dieser Merkmale gibt. Welche sind bedeutsamer, welche weniger wichtig für die Wahrnehmung einer Serie als Qualitätsprodukt? Die Studie hat Thompsons Vorschlag (unter Bezugnahme auf weitere Studien zum Thema (z.B. Cardwell 2007; Feuer 2007; Dreher 2010; Blanchett 2011; Kumpf 2011 operationalisiert und in einer standardisierten Befragung der Nutzer von 13 Onlineforen zu Qualitätsserien (n=1382 getestet. Auf Basis dieser Befragung kann statistisch nachgewiesen werden, welche Merkmale von den Zuschauer/innen als besonders wichtig angesehen werden und wie diese zu Qualitätsfaktoren zusammengefasst werden können, die das Phänomen „Quality-TV“ aus Zuschauersicht tatsächlich beschreiben können.

  6. Being Human: A Qualitative Interview Study Exploring Why a Telehealth Intervention for Management of Chronic Conditions Had a Modest Effect.

    Science.gov (United States)

    O'Cathain, Alicia; Drabble, Sarah J; Foster, Alexis; Horspool, Kimberley; Edwards, Louisa; Thomas, Clare; Salisbury, Chris

    2016-06-30

    Evidence of benefit for telehealth for chronic conditions is mixed. Two linked randomized controlled trials tested the Healthlines Service for 2 chronic conditions: depression and high risk of cardiovascular disease (CVD). This new telehealth service consisted of regular telephone calls from nonclinical, trained health advisers who followed standardized scripts generated by interactive software. Advisors facilitated self-management by supporting participants to use Web-based resources and helped to optimize medication, improve treatment adherence, and encourage healthier lifestyles. Participants were recruited from primary care. The trials identified moderate (for depression) or partial (for CVD risk) effectiveness of the Healthlines Service. An embedded qualitative study was undertaken to help explain the results of the 2 trials by exploring mechanisms of action, context, and implementation of the intervention. Qualitative interview study of 21 staff providing usual health care or involved in the intervention and 24 patients receiving the intervention. Interviewees described improved outcomes in some patients, which they attributed to the intervention, describing how components of the model on which the intervention was based helped to achieve benefits. Implementation of the intervention occurred largely as planned. However, contextual issues in patients' lives and some problems with implementation may have reduced the size of effect of the intervention. For depression, patients' lives and preferences affected engagement with the intervention: these largely working-age patients had busy and complex lives, which affected their ability to engage, and some patients preferred a therapist-based approach to the cognitive behavioral therapy on offer. For CVD risk, patients' motivations adversely affected the intervention whereby some patients joined the trial for general health improvement or from altruism, rather than motivation to make lifestyle changes to address

  7. A mixed methods systematic review of success factors of mhealth and telehealth for maternal health in Sub-Saharan Africa.

    Science.gov (United States)

    Ag Ahmed, Mohamed Ali; Gagnon, Marie-Pierre; Hamelin-Brabant, Louise; Mbemba, Gisele Irène Claudine; Alami, Hassane

    2017-01-01

    Access to health care is still limited for many women in sub-Saharan Africa (SSA), while it remains an important determinant of maternal mortality and morbidity. Information and communication technologies (ICTs), such as mhealth and telehealth, can help to facilitate this access by acting on the various obstacles encountered by women, be they socio-cultural, economic, geographical or organizational. However, various factors contribute to the success of mhealth and telehealth implementation and use, and must be considered for these technologies to go beyond the pilot project stage. The objective of this systematic literature review is to synthesize the empirical knowledge on the success factors of the implementation and use of telehealth and mhealth to facilitate access to maternal care in SSA. The methodology used is based on that of the Cochrane Collaboration, including a documentary search using standardized language in six databases, selection of studies corresponding to the inclusion criteria, data extraction, evaluation of study quality, and synthesis of the results. A total of 93 articles were identified, which allowed the inclusion of seven studies, six of which were on mhealth. Based on the framework proposed by Broens et al ., we synthesized success factors into five categories: (I) technology, such as technical support to maintain, troubleshoot and train users, good network coverage, existence of a source of energy and user friendliness; (II) user acceptance, which is facilitated by factors such as unrestricted use of the device, perceived usefulness to the worker, adequate literacy, or previous experience of use ; (III) short- and long-term funding; (IV) organizational factors, such as the existence of a well-organized health system and effective coordination of interventions; and (V) political or legislative aspects, in this case strong government support to deploy technology on a large scale. Telehealth and mhealth are promising solutions to reduce

  8. A Proposed Criterion for Launch Ramp Availability

    National Research Council Canada - National Science Library

    Dalzell, J

    2003-01-01

    The project under which the present report was produced has as an objective the development of methods for the evaluation and comparison of stem-launch and side-launch systems for small boat deployment from USCG cutters...

  9. Launch of Apollo 8 lunar orbit mission

    Science.gov (United States)

    1968-01-01

    The Apollo 8 (Spacecraft 103/Saturn 503) space vehicle launched from Pad A, Launch Complex 39, Kennedy Space Center, at 7:51 a.m., December 21, 1968. In this view there is water in the foreground and seagulls.

  10. Reusable launch vehicle development research

    Science.gov (United States)

    1995-01-01

    NASA has generated a program approach for a SSTO reusable launch vehicle technology (RLV) development which includes a follow-on to the Ballistic Missile Defense Organization's (BMDO) successful DC-X program, the DC-XA (Advanced). Also, a separate sub-scale flight demonstrator, designated the X-33, will be built and flight tested along with numerous ground based technologies programs. For this to be a successful effort, a balance between technical, schedule, and budgetary risks must be attained. The adoption of BMDO's 'fast track' management practices will be a key element in the eventual success of NASA's effort.

  11. Smart Sensors for Launch Vehicles

    Science.gov (United States)

    Ray, Sabooj; Mathews, Sheeja; Abraham, Sheena; Pradeep, N.; Vinod, P.

    2017-12-01

    Smart Sensors bring a paradigm shift in the data acquisition mechanism adopted for launch vehicle telemetry system. The sensors integrate signal conditioners, digitizers and communication systems to give digital output from the measurement location. Multiple sensors communicate with a centralized node over a common digital data bus. An in-built microcontroller gives the sensor embedded intelligence to carry out corrective action for sensor inaccuracies. A smart pressure sensor has been realized and flight-proven to increase the reliability as well as simplicity in integration so as to obtain improved data output. Miniaturization is achieved by innovative packaging. This work discusses the construction, working and flight performance of such a sensor.

  12. GRYPHON: Air launched space booster

    Science.gov (United States)

    1993-06-01

    The project chosen for the winter semester Aero 483 class was the design of a next generation Air Launched Space Booster. Based on Orbital Sciences Corporation's Pegasus concept, the goal of Aero 483 was to design a 500,000 pound air launched space booster capable of delivering 17,000 pounds of payload to Low Earth Orbit and 8,000 pounds of payload to Geosynchronous Earth Orbit. The resulting launch vehicle was named the Gryphon. The class of forty senior aerospace engineering students was broken down into eight interdependent groups. Each group was assigned a subsystem or responsibility which then became their field of specialization. Spacecraft Integration was responsible for ensuring compatibility between subsystems. This group kept up to date on subsystem redesigns and informed those parties affected by the changes, monitored the vehicle's overall weight and dimensions, and calculated the mass properties of the booster. This group also performed the cost/profitability analysis of the Gryphon and obtained cost data for competing launch systems. The Mission Analysis Group was assigned the task of determining proper orbits, calculating the vehicle's flight trajectory for those orbits, and determining the aerodynamic characteristics of the vehicle. The Propulsion Group chose the engines that were best suited to the mission. This group also set the staging configurations for those engines and designed the tanks and fuel feed system. The commercial satellite market, dimensions and weights of typical satellites, and method of deploying satellites was determined by the Payloads Group. In addition, Payloads identified possible resupply packages for Space Station Freedom and identified those packages that were compatible with the Gryphon. The guidance, navigation, and control subsystems were designed by the Mission Control Group. This group identified required tracking hardware, communications hardware telemetry systems, and ground sites for the location of the Gryphon

  13. Launch Environmental Test for KITSAT-3 FM

    Directory of Open Access Journals (Sweden)

    Sang-Hyun Lee

    1999-06-01

    Full Text Available The satellite experiences the severe launch environment such as vibration, acceleration, shock, and acoustics induced by rocket. Therefore, the satellite should be designed and manufactured to endure such severe launch environments. In this paper, we describe the structure of the KITSAT-3 FM(Flight Model and the processes and results of the launch environmental test to ensure the reliability during launch period.

  14. A human centered GeoVisualization framework to facilitate visual exploration of telehealth data: a case study.

    Science.gov (United States)

    Joshi, Ashish; de Araujo Novaes, Magdala; Machiavelli, Josiane; Iyengar, Sriram; Vogler, Robert; Johnson, Craig; Zhang, Jiajie; Hsu, Chiehwen E

    2012-01-01

    Public health data is typically organized by geospatial units. Routine geographic monitoring of health data enables an understanding of the spatial patterns of events in terms of causes and controls. GeoVisualization (GeoVis) allows users to see information hidden both visually and explicitly on a map. Despite the applicability of GeoVis in public health, it is still underused for visualizing public health data. The objective of this study is to examine the perception of telehealth users' to utilize GeoVis as a proof of concept to facilitate visual exploration of telehealth data in Brazil using principles of human centered approach and cognitive fit theory. A mixed methods approach combining qualitative and quantitative assessments was utilized in this cross sectional study conducted at the Telehealth Center of the Federal University of Pernambuco (NUTE-UFPE), Recife, Brazil. A convenient sample of 20 participants currently involved in NUTES was drawn during a period of Sep-Oct 2011. Data was gathered using previously tested questionnaire surveys and in-person interviews. Socio-demographic Information such as age, gender, prior education, familiarity with the use of computer and GeoVis was gathered. Other information gathered included participants' prior spatial analysis skills, level of motivation and use of GeoVis in telehealth. Audio recording was done for all interviews conducted in both English and Portuguese, and transcription of the audio content to English was done by a certified translator. Univariate analysis was performed and means and standard deviations were reported for the continuous variables and frequency distributions for the categorical variables. For the open-ended questions, we utilized a grounded theory to identify themes and their relationship as they emerge from the data. Analysis of the quantitative data was performed using SAS V9.1 and qualitative data was performed using NVivo9. The average age of participants was 28 years (SD=7), a

  15. Understanding Older People's Readiness for Receiving Telehealth: Mixed-Method Study.

    Science.gov (United States)

    van Houwelingen, Cornelis Tm; Ettema, Roelof Ga; Antonietti, Michelangelo Gef; Kort, Helianthe Sm

    2018-04-06

    The Dutch Ministry of Health has formulated ambitious goals concerning the use of telehealth, leading to subsequent changes compared with the current health care situation, in which 93% of care is delivered face-to-face. Since most care is delivered to older people, the prospect of telehealth raises the question of whether this population is ready for this new way of receiving care. To study this, we created a theoretical framework consisting of 6 factors associated with older people's intention to use technology. The objective of this study was to understand community-dwelling older people's readiness for receiving telehealth by studying their intention to use videoconferencing and capacities for using digital technology in daily life as indicators. A mixed-method triangulation design was used. First, a cross-sectional survey study was performed to investigate older people's intention to use videoconferencing, by testing our theoretical framework with a multilevel path analysis (phase 1). Second, for deeper understanding of older people's actual use of digital technology, qualitative observations of older people executing technological tasks (eg, on a computer, cell phone) were conducted at their homes (phase 2). In phase 1, a total of 256 people aged 65 years or older participated in the survey study (50.0% male; median age, 70 years; Q1-Q3: 67-76). Using a significance level of .05, we found seven significant associations regarding older people's perception of videoconferencing. Older people's (1) intention to use videoconferencing was predicted by their performance expectancy (odds ratio [OR] 1.26, 95% CI 1.13-1.39), effort expectancy (OR 1.23, 95% CI 1.07-1.39), and perceived privacy and security (OR 1.30, 95% CI 1.17-1.43); (2) their performance expectancy was predicted by their effort expectancy (OR 1.38, 95% CI 1.24-1.52); and (3) their effort expectancy was predicted by their self-efficacy (OR 1.55, 95% CI 1.42-1.68). In phase 2, a total of 6 men and 9

  16. How supernovae launch galactic winds?

    Science.gov (United States)

    Fielding, Drummond; Quataert, Eliot; Martizzi, Davide; Faucher-Giguère, Claude-André

    2017-09-01

    We use idealized three-dimensional hydrodynamic simulations of global galactic discs to study the launching of galactic winds by supernovae (SNe). The simulations resolve the cooling radii of the majority of supernova remnants (SNRs) and thus self-consistently capture how SNe drive galactic winds. We find that SNe launch highly supersonic winds with properties that agree reasonably well with expectations from analytic models. The energy loading (η _E= \\dot{E}_wind/ \\dot{E}_SN) of the winds in our simulations are well converged with spatial resolution while the wind mass loading (η _M= \\dot{M}_wind/\\dot{M}_\\star) decreases with resolution at the resolutions we achieve. We present a simple analytic model based on the concept that SNRs with cooling radii greater than the local scaleheight break out of the disc and power the wind. This model successfully explains the dependence (or lack thereof) of ηE (and by extension ηM) on the gas surface density, star formation efficiency, disc radius and the clustering of SNe. The winds our simulations are weaker than expected in reality, likely due to the fact that we seed SNe preferentially at density peaks. Clustering SNe in time and space substantially increases the wind power.

  17. STS-91 Launch of Discovery from Launch Pad 39-A

    Science.gov (United States)

    1998-01-01

    Searing the early evening sky with its near sun-like rocket exhaust, the Space Shuttle Discovery lifts off from Launch Pad 39A at 6:06:24 p.m. EDT June 2 on its way to the Mir space station. On board Discovery are Mission Commander Charles J. Precourt; Pilot Dominic L. Gorie; and Mission Specialists Wendy B. Lawrence, Franklin R. Chang-Diaz, Janet Lynn Kavandi and Valery Victorovitch Ryumin. The nearly 10-day mission will feature the ninth and final Shuttle docking with the Russian space station Mir, the first Mir docking for the Space Shuttle orbiter Discovery, the first on-orbit test of the Alpha Magnetic Spectrometer (AMS), and the first flight of the new Space Shuttle super lightweight external tank. Astronaut Andrew S. W. Thomas will be returning to Earth as a STS-91 crew member after living more than four months aboard Mir.

  18. Relative risk of home hemodialysis attrition in patients using a telehealth platform.

    Science.gov (United States)

    Weinhandl, Eric D; Collins, Allan J

    2017-12-06

    Home hemodialysis (HHD) facilitates increased treatment frequency, which may improve patient outcomes. However, attrition due to technique failure limits the clinical effectiveness of the modality. Nx2me Connected Health is a telehealth platform that enables ongoing assessment of HHD patients using NxStage equipment, and that may reduce patient burden. We aimed to assess whether use of Nx2me was associated with risk of HHD attrition. We compared risks of all-cause attrition, dialysis cessation (i.e., death or transplant), and technique failure in Nx2me users and matched control patients, using a retrospective cohort study. We also compared the likelihood of HHD training graduation in patients who initiated use of Nx2me during training with the likelihood in matched control patients. Matching factors included date of HHD initiation, NxStage treatment duration at initiation of follow-up, and prescribed treatment frequency. We used stratified Fine-Gray and Cox regression to compare risks, with adjustment for demographic factors and vascular access modality, and stratification by matched cluster. We identified 606 Nx2me users; 49.5% initiated use of Nx2me in NxStage equipment. Adjusted hazard ratios (AHRs) of all-cause attrition, dialysis cessation, and technique failure were 0.80 (95% confidence interval, 0.68-0.95), 1.10 (0.86-1.41), and 0.71 (0.57-0.87), respectively, for Nx2me users vs. matched controls. AHRs were similar in patients who initiated use of Nx2me in <3 months after initiation of HHD. The AHR of HHD training graduation was 1.61 (1.10-2.36) in patients who initiated use of Nx2me within 2 weeks of training initiation vs. matched controls. Use of Nx2me was associated with lower risk of all-cause attrition, lower risk of technique failure, and higher likelihood of HHD training graduation. Further studies are needed to identify the mechanisms by which use of a telehealth platform may improve clinical outcomes and reduce patient burden. © 2017 The Authors

  19. 14 CFR 420.21 - Launch site location review-launch site boundary.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Launch site location review-launch site boundary. 420.21 Section 420.21 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... travels given a worst-case launch vehicle failure in the launch area. An applicant must clearly and...

  20. EADS Roadmap for Launch Vehicles

    Science.gov (United States)

    Eymar, Patrick; Grimard, Max

    2002-01-01

    still think about the future, especially at industry level in order to make the most judicious choices in technologies, vehicle types as well as human resources and facilities specialization (especially after recent merger moves). and production as prime contractor, industrial architect or stage provider have taken benefit of this expertise and especially of all the studies ran under national funding and own financing on reusable vehicles and ground/flight demonstrators have analyzed several scenarios. VEHICLES/ASTRIUM SI strategy w.r.t. launch vehicles for the two next decades. Among the main inputs taken into account of course visions of the market evolutions have been considered, but also enlargement of international cooperations and governments requests and supports (e.g. with the influence of large international ventures). 1 patrick.eymar@lanceurs.aeromatra.com 2

  1. CERN & Society launches donation portal

    CERN Multimedia

    Cian O'Luanaigh

    2014-01-01

    The CERN & Society programme brings together projects in the areas of education and outreach, innovation and knowledge exchange, and culture and arts, that spread the CERN spirit of scientific curiosity for the inspiration and benefit of society. Today, CERN & Society is launching its "giving" website – a portal to allow donors to contribute to various projects and forge new relationships with CERN.   "The CERN & Society initiative in its embryonic form began almost three years ago, with the feeling that the laboratory could play a bigger role for the benefit of society," says Matteo Castoldi, Head of the CERN Development Office, who, with his team, is seeking supporters and ambassadors for the CERN & Society initiative. "The concept is not completely new – in some sense it is embedded in CERN’s DNA, as the laboratory helps society by creating knowledge and new technologies – but we would like to d...

  2. Transaction cost analysis of in-clinic versus telehealth consultations for chronic pain: preliminary evidence for rapid and affordable access to interdisciplinary collaborative consultation.

    Science.gov (United States)

    Theodore, Brian R; Whittington, Jan; Towle, Cara; Tauben, David J; Endicott-Popovsky, Barbara; Cahana, Alex; Doorenbos, Ardith Z

    2015-06-01

    With ever increasing mandates to reduce costs and increase the quality of pain management, health care institutions are faced with the challenge of adopting innovative technologies and shifting workflows to provide value-based care. Transaction cost economic analysis can provide comparative evaluation of the consequences of these changes in the delivery of care. The aim of this study was to establish proof-of-concept using transaction cost analysis to examine chronic pain management in-clinic and through telehealth. Participating health care providers were asked to identify and describe two comparable completed transactions for patients with chronic pain: one consultation between patient and specialist in-clinic and the other a telehealth presentation of a patient's case by the primary care provider to a team of pain medicine specialists. Each provider completed two on-site interviews. Focus was on the time, value of time, and labor costs per transaction. Number of steps, time, and costs for providers and patients were identified. Forty-six discrete steps were taken for the in-clinic transaction, and 27 steps were taken for the telehealth transaction. Although similar in costs per patient ($332.89 in-clinic vs. $376.48 telehealth), the costs accrued over 153 business days in-clinic and 4 business days for telehealth. Time elapsed between referral and completion of initial consultation was 72 days in-clinic, 4 days for telehealth. U.S. health care is moving toward the use of more technologies and practices, and the information provided by transaction cost analyses of care delivery for pain management will be important to determine actual cost savings and benefits. Wiley Periodicals, Inc.

  3. Endocrinology Telehealth Consultation Improved Glycemic Control Similar to Face-to-Face Visits in Veterans.

    Science.gov (United States)

    Liu, Winnie; Saxon, David R; McNair, Bryan; Sanagorski, Rebecca; Rasouli, Neda

    2016-09-01

    Rates of diabetes for veterans who receive health care through the Veterans Health Administration are higher than rates in the general population. Furthermore, many veterans live in rural locations, far from Veterans Affairs (VA) hospitals, thus limiting their ability to readily seek face-to-face endocrinology care for diabetes. Telehealth (TH) technologies present an opportunity to improve access to specialty diabetes care for such patients; however, there is a lack of evidence regarding the ability of TH to improve glycemic control in comparison to traditional face-to-face consultations. This was a retrospective cohort study of all new endocrinology diabetes consultations at the Denver VA Medical Center over a 1-year period. A total of 189 patients were included in the analysis. In all, 85 patients had received face-to-face (FTF) endocrinology consultation for diabetes and 104 patients had received TH consultation. Subjects were mostly males (94.7%) and the mean age was 62.8 ± 10.1 years old. HbA1c improved from 9.76% (9.40% to 10.11%) to 8.55% (8.20% to 8.91%) (P Endocrinology TH consultations improved short-term glycemic control as effectively as traditional FTF visits in a veteran population with diabetes. © 2016 Diabetes Technology Society.

  4. The potential of telehealth for 'business as usual' in outpatient clinics.

    Science.gov (United States)

    Day, Karen; Kerr, Patricia

    2012-04-01

    A six-month pilot study was conducted to ascertain the value of using high-definition videoconferencing equipment in an outpatients' setting. The videoconferencing equipment, which included digital biometric equipment, was installed in the outpatient clinics of a remote health service in New Zealand. Use of the equipment was evaluated using action research techniques. Clinicians were interviewed about their assessment of the equipment's usefulness. Patients and their carers completed questionnaires about their clinic experience. During the pilot trial, 109 patients were seen in 25 clinics of six different specialities. Questionnaire results showed that patients and their companions had a good user experience, similar to a face-to-face appointment. Clinicians found that the large screen, sense of proximity, video clarity and definition, and lack of sound/picture lag worked well for certain types of outpatients' clinics, e.g. methadone maintenance clinics. The need for process changes made it difficult to turn telehealth into business as usual in an environment built for face-to-face appointments. We conclude that videoconference equipment has potential to become integral to outpatients' clinics.

  5. [The Telehealth Network of the Americas and its role in primary health care].

    Science.gov (United States)

    Bill, Guillermo; Crisci, Carlos D; Canet, Tomislav

    2014-01-01

    The need to guarantee equitable access to health regardless of geographic, economic, or technological barriers motivated the Member States of the Organization of American States to create the Telehealth Network of the Americas, coordinated by the Inter-American Telecommunication Committee. The Network focuses on the use of new information and communications technology applied to health, based on the values of respect, equity, and solidarity and mandated by the philosophy of primary health. Its members include government agencies, nongovernmental organizations, university forums, hospital federations, and telecommunications companies, and it has already extended its reach to other continents and to different fields in which telemedicine is being used. Among its first achievements, it has implemented an innovative tool to be used in cases of disaster or limited geographic access. This mobile telemedicine station is housed in a portable case that includes a computer, various digital devices (otoscope, ophthalmoscope, microscope, dermatoscope), a high-resolution digital camera, an X-ray film viewer, and a satellite antenna. With this tool, it is possible to provide specialized support for rural physicians and primary health care workers located far from large urban centers.

  6. Applying Evidence-Based Medicine in Telehealth: An Interactive Pattern Recognition Approximation

    Directory of Open Access Journals (Sweden)

    Carlos Fernández-Llatas

    2013-10-01

    Full Text Available Born in the early nineteen nineties, evidence-based medicine (EBM is a paradigm intended to promote the integration of biomedical evidence into the physicians daily practice. This paradigm requires the continuous study of diseases to provide the best scientific knowledge for supporting physicians in their diagnosis and treatments in a close way. Within this paradigm, usually, health experts create and publish clinical guidelines, which provide holistic guidance for the care for a certain disease. The creation of these clinical guidelines requires hard iterative processes in which each iteration supposes scientific progress in the knowledge of the disease. To perform this guidance through telehealth, the use of formal clinical guidelines will allow the building of care processes that can be interpreted and executed directly by computers. In addition, the formalization of clinical guidelines allows for the possibility to build automatic methods, using pattern recognition techniques, to estimate the proper models, as well as the mathematical models for optimizing the iterative cycle for the continuous improvement of the guidelines. However, to ensure the efficiency of the system, it is necessary to build a probabilistic model of the problem. In this paper, an interactive pattern recognition approach to support professionals in evidence-based medicine is formalized.

  7. High Altitude Launch for a Practical SSTO

    Science.gov (United States)

    Landis, Geoffrey A.; Denis, Vincent

    2003-01-01

    Existing engineering materials allow the constuction of towers to heights of many kilometers. Orbital launch from a high altitude has significant advantages over sea-level launch due to the reduced atmospheric pressure, resulting in lower atmospheric drag on the vehicle and allowing higher rocket engine performance. High-altitude launch sites are particularly advantageous for single-stage to orbit (SSTO) vehicles, where the payload is typically 2% of the initial launch mass. An earlier paper enumerated some of the advantages of high altitude launch of SSTO vehicles. In this paper, we calculate launch trajectories for a candidate SSTO vehicle, and calculate the advantage of launch at launch altitudes 5 to 25 kilometer altitudes above sea level. The performance increase can be directly translated into increased payload capability to orbit, ranging from 5 to 20% increase in the mass to orbit. For a candidate vehicle with an initial payload fraction of 2% of gross lift-off weight, this corresponds to 31% increase in payload (for 5-km launch altitude) to 122% additional payload (for 25-km launch altitude).

  8. As contribuições teórico-metodológicas de E. P. Thompson: experiência e cultura

    Directory of Open Access Journals (Sweden)

    Suely Aparecida Martins

    2006-01-01

    Full Text Available O artigo destaca as contribuições teórico-metodológicas do historiador marxista Edward Palmer Thompson e que podem ser úteis para a pesquisa sociológica. A partir de pesquisa bibliográfica, apresenta-se uma breve biografia do autor e em seguida algumas categorias importantes desenvolvidas por ele, como experiência e cultura. Ressalta-se também a ênfase de Thompson em tratar as categorias teóricas considerando-se a processualidade histórica. Por fim, são levantadas algumas possibilidades de análise da juventude do campo na atualidade a partir das contribuições teórico-metodológicas desse autor.

  9. Sam Thompson, Stewart Parker, and the lineage of northern Irish dramaDOI:10.5007/2175-8026.2010n58p179

    Directory of Open Access Journals (Sweden)

    Marilynn Richtarik

    2010-01-01

    Full Text Available Northern Irish dramatist Stewart Parker (1941-1988 wrote plays typically valued for their wit, intellectual content, and formal experimentation. Nonetheless, he was profoundly influenced as a young man by a very different sort of playwright. Sam Thompson (1916-1965, who began his working life in the Belfast shipyards, squarely confronted Northern Irish sectarianism in his plays. His sense of the political potential of drama left an enduring mark on Parker, who organized and edited Thompson's manuscripts several years after his untimely death. Although their dramatic writings bear little resemblance to each other, the two writers should be regarded as united in a common Northern Irish dramatic tradition by virtue of their shared socialist outlook, belief in the importance of individual stands against conformity, and sense of theatre's social mission.

  10. Trends in the commercial launch services industry

    Science.gov (United States)

    Haase, Ethan E.

    2001-02-01

    The market for space launch services has undergone significant development in the last two decades and is poised to change even further. With the introduction of new players in the market, and the development of new vehicles by existing providers, competition has increased. At the same time, customer payloads have been changing as satellites grow in size and capability. Amidst these changes, launch delays have become a concern in the industry, and launch service providers have developed different solutions to avoid delays and satisfy customer needs. This analysis discusses these trends in the launch services market and their drivers. Focus is given to the market for medium, intermediate, and heavy launch services which generally includes launches of GEO communication satellites, large government payloads, and NGSO constellations. .

  11. Distribution of the species of Lucifer Thompson, 1829 in the subtropical South Atlantic between parallels 20º and 30ºs

    Directory of Open Access Journals (Sweden)

    André Marafon-Almeida

    Full Text Available Abstract The distribution of the species of Lucifer Thompson, 1829 (Decapoda: Luciferidae in the South Atlantic Subtropical Gyre was assessed by the Brazil Transatlantic Commission in November and December 2009. The samples were collected at 83 stations on two profiles between Brazil and Africa (20 º and 30 ºS. Oblique hauls were performed with a WP-2 net up to 150 meters deep. A distinct sexual relationship was noted between the two species found and L. faxoni presented a significantly higher number of females relative to males 1:0.5 (X2 = 21.77, p = 0.0001. The L. typus sex ratio had significantly more males than females 1.86:1 (X2=50.84, p = 0.0001. The distribution of L. typus occurred in both the western and the eastern portions of the Mid-Oceanic Ridge. This distribution was significantly related to salinity (R2 = 0:13; F = 3.79, p = 0.009, which was higher in the western portion of the study area. In addition, the recordings of the two species were extended to the Atlantic Subtropical Gyre. Overall, Luciferidae shrimp were more common and abundant at the stations west of the Mid-Oceanic Ridge and L. typus was the most frequent and abundant species.

  12. A PMBGA to Optimize the Selection of Rules for Job Shop Scheduling Based on the Giffler-Thompson Algorithm

    Directory of Open Access Journals (Sweden)

    Rui Zhang

    2012-01-01

    Full Text Available Most existing research on the job shop scheduling problem has been focused on the minimization of makespan (i.e., the completion time of the last job. However, in the fiercely competitive market nowadays, delivery punctuality is more important for maintaining a high service reputation. So in this paper, we aim at solving job shop scheduling problems with the total weighted tardiness objective. Several dispatching rules are adopted in the Giffler-Thompson algorithm for constructing active schedules. It is noticeable that the rule selections for scheduling consecutive operations are not mutually independent but actually interrelated. Under such circumstances, a probabilistic model-building genetic algorithm (PMBGA is proposed to optimize the sequence of selected rules. First, we use Bayesian networks to model the distribution characteristics of high-quality solutions in the population. Then, the new generation of individuals is produced by sampling the established Bayesian network. Finally, some elitist individuals are further improved by a special local search module based on parameter perturbation. The superiority of the proposed approach is verified by extensive computational experiments and comparisons.

  13. Acoustic Doppler current profiling from the JGOFS Arabian sea cruises aboard the RV T.G. Thompson

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun-Sook; Flagg, C.N.; Shi, Yan

    1996-06-01

    Acoustic Doppler current profiler (ADCP) data is part of the core data for the U.S. JGOFS Arabian Sea project, along with hydrographic and nutrient data. Seventeen cruises are scheduled to take place between September 1994 and January 1996 on the R/V T.G. Thompson. They are numbered consecutively from the ship`s commissioning with the first JGOFS cruise designated TN039. Table 1 lists start and end dates of each cruise with its mission. All but the first cruise have been or will be staged from Muscat, Oman. Each cruise is scheduled for a duration of between two weeks and one month. Seven of the cruises, referred to as process cruises, follow a standard cruise track, taking hydrographic, chemical and biological measurements. The rest of the cruises, which take place generally within the standard cruise region defined by a set track, are for the deployment and recovery of moored equipments and towing of a SeaSoar. ADCP data are collected using an autonomous data acquisition system developed for ship-of-opportunity cruises, named the AutoADCP system. The system is an extension of RD instrument`s DAS version 2.48 using enhancements made possible with {open_quotes}user-exit{close_quotes} programs. It makes it possible to collect ADCP data without the constant monitoring usually necessary and insures constant data coverage and uniform data quality.

  14. Inversion of real and complex phase shifts to potentials by the generalized Cox-Thompson inverse scattering method at fixed energy

    International Nuclear Information System (INIS)

    Melchert, O; Scheid, W; Apagyi, B

    2006-01-01

    The Cox-Thompson inverse scattering method at fixed energy has been generalized to treat complex phase shifts derived from experiments. New formulae for relating phase shifts to shifted angular momenta are derived. The method is applied to phase shifts of known potentials in order to test its quality and stability and, further, it is used to invert experimental n-α and n- 12 C phase shifts

  15. Physical and nutrient data from bottle and CTD casts from the THOMAS THOMPSON from the equatorial Pacific Ocean from 30 January 1992 to 09 March 1992 (NODC Accession 9600091)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Physical and nutrient data were collected from bottle and CTD casts from the THOMAS THOMPSON from the equatorial Pacific Ocean. Data were collected by the Bigelow...

  16. Physical, chemical and biological CTD and bottle data from R/V Thomas G. Thompson cruise TN278 in eastern tropical North Pacific Ocean from March 19 to April 20, 2012 (NODC Accession 0109846)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This report contains data from R/V Thomas G. Thompson cruise TN278 to the eastern tropical north pacific oxygen deficient zone. The objective of the cruise was to...

  17. Temperature, salinity and other variables collected from discrete sample and profile observations using CTD, bottle and other instruments from THOMAS G. THOMPSON in the North Pacific Ocean from 1985-08-04 to 1985-09-07 (NCEI Accession 0143394)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0143394 includes discrete sample and profile data collected from THOMAS G. THOMPSON in the North Pacific Ocean from 1985-08-04 to 1985-09-07 and...

  18. Temperature, salinity and other variables collected from discrete sample and profile observations using CTD, bottle and other instruments from THOMAS G. THOMPSON in the South Pacific Ocean from 2013-10-25 to 2013-12-20 (NCEI Accession 0163186)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0163186 includes chemical, discrete sample, physical and profile data collected from THOMAS G. THOMPSON in the South Pacific Ocean from 2013-10-25 to...

  19. Cloud amount/frequency, NITRATE and other data from THOMAS G. THOMPSON in the TOGA Area - Pacific from 1985-06-18 to 1985-07-15 (NODC Accession 9000124)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Conductivity, Temperature and Depth (CTD) data were collected as part of El Nino watch. R/V Thomas G. Thompson was used to collect data from TOGA Area-Pacific...

  20. Nutrients data from the R/V ALPHA HELIX and T.G. THOMPSON as part of the Inner Shelf Transfer and Recycling Project from 17 April 1987 to 21 July 1988 (NODC Accession 0000296)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Nitrate, nitrite, phosphate, silicate, and other data were collected from the R/V ALPHA HELIX and THOMAS G. THOMPSON from April 17, 1987 to July 21, 1988. Data were...

  1. Physical data from CTD casts in the North Pacific Ocean from the THOMAS G. THOMPSON and the THOMAS WASHINGTON in support of the Marathon 2 Project from 05 May 1985 to 07 September 1987 (NODC Accession 9400131)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Temperature and salinity profiles were collected from CTD casts in the North Pacific Ocean from the THOMAS G. THOMPSON and the THOMAS WASHINGTON. Data were collected...

  2. Turbidity, SOLAR RADIATION - ATMOSPHERIC and other data from THOMAS G. THOMPSON in the TOGA Area - Pacific, North Pacific Ocean and South Pacific Ocean from 1992-03-19 to 1992-09-24 (NODC Accession 9700039)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hydrochemical, hydrophysical, and other data were collected from the THOMAS G. THOMPSON from March 19, 1992 to September 24, 1992. Data were submitted by Dr. Curt...

  3. Finite-Element Investigation of the Structural Behavior of Basalt Fiber Reinforced Polymer (BFRP- Reinforced Self-Compacting Concrete (SCC Decks Slabs in Thompson Bridge

    Directory of Open Access Journals (Sweden)

    Lingzhu Zhou

    2018-06-01

    Full Text Available The need for a sustainable development and improved whole life performance of concrete infrastructure has led to the requirement of more durable and sustainable concrete bridges alongside accurate predictive analysis tools. Using the combination of Self-Compacting Concrete (SCC with industrial by-products and fiber-reinforced polymer (FRP, reinforcement is anticipated to address the concerns of high carbon footprint and corrosion in traditional steel-reinforced concrete structures. This paper presents a numerical investigation of the structural behavior of basalt fiber-reinforced polymer (BFRP-reinforced SCC deck slabs in a real bridge, named Thompson Bridge, constructed in Northern Ireland, U.K. A non-linear finite element (FE model is proposed by using ABAQUS 6.10 in this study, which is aimed at extending the previous investigation of the field test in Thompson Bridge. The results of this field test were used to validate the accuracy of the proposed finite element model. The results showed good agreement between the test results and the numerical results; more importantly, the compressive membrane action (CMA inside the slabs could be well demonstrated by this FE model. Subsequently, a series of parametric studies was conducted to investigate the influence of different parameters on the structural performance of the deck slabs in Thompson Bridge. The results of the analyses are discussed, and conclusions on the behavior of the SCC deck slabs reinforced by BFRP bars are presented.

  4. NASA Exploration Launch Projects Overview: The Crew Launch Vehicle and the Cargo Launch Vehicle Systems

    Science.gov (United States)

    Snoddy, Jimmy R.; Dumbacher, Daniel L.; Cook, Stephen A.

    2006-01-01

    The U.S. Vision for Space Exploration (January 2004) serves as the foundation for the National Aeronautics and Space Administration's (NASA) strategic goals and objectives. As the NASA Administrator outlined during his confirmation hearing in April 2005, these include: 1) Flying the Space Shuttle as safely as possible until its retirement, not later than 2010. 2) Bringing a new Crew Exploration Vehicle (CEV) into service as soon as possible after Shuttle retirement. 3) Developing a balanced overall program of science, exploration, and aeronautics at NASA, consistent with the redirection of the human space flight program to focus on exploration. 4) Completing the International Space Station (ISS) in a manner consistent with international partner commitments and the needs of human exploration. 5) Encouraging the pursuit of appropriate partnerships with the emerging commercial space sector. 6) Establishing a lunar return program having the maximum possible utility for later missions to Mars and other destinations. In spring 2005, the Agency commissioned a team of aerospace subject matter experts to perform the Exploration Systems Architecture Study (ESAS). The ESAS team performed in-depth evaluations of a number of space transportation architectures and provided recommendations based on their findings? The ESAS analysis focused on a human-rated Crew Launch Vehicle (CLV) for astronaut transport and a heavy lift Cargo Launch Vehicle (CaLV) to carry equipment, materials, and supplies for lunar missions and, later, the first human journeys to Mars. After several months of intense study utilizing safety and reliability, technical performance, budget, and schedule figures of merit in relation to design reference missions, the ESAS design options were unveiled in summer 2005. As part of NASA's systems engineering approach, these point of departure architectures have been refined through trade studies during the ongoing design phase leading to the development phase that

  5. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

    Directory of Open Access Journals (Sweden)

    McGee-Hernandez Nancy

    2010-06-01

    Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

  6. Telehealth solutions to enable global collaboration in rheumatic heart disease screening.

    Science.gov (United States)

    Lopes, Eduardo Lv; Beaton, Andrea Z; Nascimento, Bruno R; Tompsett, Alison; Dos Santos, Julia Pa; Perlman, Lindsay; Diamantino, Adriana C; Oliveira, Kaciane Kb; Oliveira, Cassio M; Nunes, Maria do Carmo P; Bonisson, Leonardo; Ribeiro, Antônio Lp; Sable, Craig

    2018-02-01

    Background The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease. Objective We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais. Methods The Programa de Rastreamento da Valvopatia Reumática (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data. Results PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted. Discussion A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle

  7. A Mixed-Method Evaluation of the Feasibility and Acceptability of a Telehealth-Based Parent-Mediated Intervention for Children with Autism Spectrum Disorder

    Science.gov (United States)

    Pickard, Katherine E.; Wainer, Allison L.; Bailey, Kathryn M.; Ingersoll, Brooke R.

    2016-01-01

    Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online.…

  8. On-site customer analytics and reporting (OSCAR) : a portable clinical data warehouse for the in-house linking of hospital and telehealth data

    NARCIS (Netherlands)

    Thomaidis, P.

    2014-01-01

    This document conveys the results of the On-Site Customer Analytics and Reporting (OSCAR) project. This nine-month project started on January 2014 and was conducted at Philips Research in the Chronic Disease Management group as part of the H2H Analytics Project. Philips has access to telehealth data

  9. 14 CFR 417.111 - Launch plans.

    Science.gov (United States)

    2010-01-01

    ... classification and compatibility group as defined by part 420 of this chapter. (3) A graphic depiction of the... authorities, including the Federal Communications Commission. (g) Flight termination system electronic piece... for launch personnel control, handling of intruders, communications and coordination with launch...

  10. Pigeons' Discrimination of Michotte's Launching Effect

    Science.gov (United States)

    Young, Michael E.; Beckmann, Joshua S.; Wasserman, Edward A.

    2006-01-01

    We trained four pigeons to discriminate a Michotte launching animation from three other animations using a go/no-go task. The pigeons received food for pecking at one of the animations, but not for pecking at the others. The four animations featured two types of interactions among objects: causal (direct launching) and noncausal (delayed, distal,…

  11. Preventative tele-health supported services for early stage chronic obstructive pulmonary disease: a protocol for a pragmatic randomized controlled trial pilot

    Directory of Open Access Journals (Sweden)

    Mountain Gail A

    2011-01-01

    Full Text Available Abstract Background Chronic Obstructive Pulmonary Disease (COPD is a prevalent debilitating long term condition. It is the second most common cause of emergency admission to hospital in the UK and remains one of the most costly conditions to treat through acute care. Tele-health monitoring offers potential to reduce the rates of re-hospitalisation and emergency department visits and improve quality of life for people with COPD. However, the current evidence base to support technology adoption and implementation is limited and the resource implications for implementing tele-health in practice can be very high. This trial will employ tele-health monitoring in a preventative capacity for patients diagnosed with early stage COPD following discharge from hospital to determine whether it reduces their need for additional health service support or hospital admission and improves their quality of life. Methods/Design We describe a pilot study for a two arm, one site randomized controlled trial (RCT to determine the effect of tele-health monitoring on self-management, quality of life and patient satisfaction. Sixty patients who have been discharged from one acute trust with a primary diagnosis of COPD and who have agreed to receive community clinical support following discharge from acute care will be randomly assigned to one of two groups: (a Tele-health supported Community COPD Service; or (b Usual Care. The tele-health supported service involves the patient receiving two home visits with a specialist COPD clinician (nurse or physiotherapist then participating in daily tele-monitoring over an eight week period. Usual care consists of six home visits to the patient by specialist COPD clinicians again over eight successive weeks. Health status and quality of life data for all participants will be measured at baseline, on discharge from the service and at six months post discharge from the service. Discussion The tele-health service under study is a

  12. The Role of Telehealth to Assist In-Home tDCS: Opportunities, Promising Results and Acceptability

    Directory of Open Access Journals (Sweden)

    Brenton Hordacre

    2018-06-01

    Full Text Available Transcranial direct current stimulation (tDCS has shown great promise as a neuromodulatory intervention capable of improving behavioral outcomes in a range of neurological and psychiatric populations. Evidence indicates that the neuromodulatory effect of stimulation may be cumulative, with greater improvements in behavior observed following multiple treatment sessions. However, the requirement to attend clinical or research departments for multiple treatment sessions may present a barrier for many people, particularly those with greater disability or living remotely. The portability of tDCS suggests that in-home stimulation may become an avenue for further investigation. However, safe and effective use of tDCS by a participant within their home requires a form of monitoring. This review discusses how telehealth may provide real-time visual monitoring to ensure correct tDCS set-up and adherence to stimulation protocols, manage technical issues and monitor adverse events. The combination of telehealth to supplement in-home tDCS use has potential to transform the way tDCS is delivered.

  13. Randomized Controlled Trial of Nurse-Delivered Cognitive Behavioral Therapy Versus Supportive Psychotherapy Telehealth Interventions for Chronic Back Pain.

    Science.gov (United States)

    Rutledge, Thomas; Atkinson, J Hampton; Holloway, Rachael; Chircop-Rollick, Tatiana; D'Andrea, John; Garfin, Steven R; Patel, Shetal; Penzien, Donald B; Wallace, Mark; Weickgenant, Anne L; Slater, Mark

    2018-04-16

    This study evaluated a nurse-delivered, telehealth intervention of cognitive behavioral therapy versus supportive psychotherapy for chronic back pain. Participants (N=61) had chronic back pain (pain "daily" ≥ 6 months at an intensity ≥4/10 scale) and were randomized to an 8-week, 12-session, Cognitive Behavioral Therapy (CBT) or to Supportive Care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ). Secondary outcomes included the Numerical Rating Scale (NRS) and the Patient Global Impressions Scale (CGI). CBT participants (n=30) showed significant improvements on the RMDQ (means=11.4[5.9] vs. 9.4[6.1] at baseline and post-treatment, respectively, p.10). The results suggest that telehealth, nurse-delivered CBT and SC treatments for chronic back pain can offer significant and relatively comparable benefits. ClinicalTrials.gov: NCT00608530. This article describes the benefits of training primary care nurses to deliver evidence-based behavioral therapies for low back pain. Due to the high prevalence of chronic pain and the growing emphasis on non-opioid therapies, training nurses to provide behavior therapies could be a cost-effective way to improve pain management. Copyright © 2018. Published by Elsevier Inc.

  14. Ceremony celebrates 50 years of rocket launches

    Science.gov (United States)

    2000-01-01

    Ceremony celebrates 50 years of rocket launches PL00C-10364.12 At the 50th anniversary ceremony celebrating the first rocket launch from pad 3 on what is now Cape Canaveral Air Force Station, Norris Gray waves to the audience. Gray was part of the team who successfully launched the first rocket, known as Bumper 8. The ceremony was hosted by the Air Force Space & Missile Museum Foundation, Inc. , and included launch of a Bumper 8 model rocket, presentation of a Bumper Award to Florida Sen. George Kirkpatrick by the National Space Club; plus remarks by Sen. Kirkpatrick, KSC's Center Director Roy Bridges, and the Commander of the 45th Space Wing, Brig. Gen. Donald Pettit. Also attending the ceremony were other members of the original Bumper 8 team. A reception followed at Hangar C. Since 1950 there have been a total of 3,245 launches from Cape Canaveral.

  15. International Launch Vehicle Selection for Interplanetary Travel

    Science.gov (United States)

    Ferrone, Kristine; Nguyen, Lori T.

    2010-01-01

    In developing a mission strategy for interplanetary travel, the first step is to consider launch capabilities which provide the basis for fundamental parameters of the mission. This investigation focuses on the numerous launch vehicles of various characteristics available and in development internationally with respect to upmass, launch site, payload shroud size, fuel type, cost, and launch frequency. This presentation will describe launch vehicles available and in development worldwide, then carefully detail a selection process for choosing appropriate vehicles for interplanetary missions focusing on international collaboration, risk management, and minimization of cost. The vehicles that fit the established criteria will be discussed in detail with emphasis on the specifications and limitations related to interplanetary travel. The final menu of options will include recommendations for overall mission design and strategy.

  16. Recommended Screening Practices for Launch Collision Aviodance

    Science.gov (United States)

    Beaver, Brian A.; Hametz, Mark E.; Ollivierre, Jarmaine C.; Newman, Lauri K.; Hejduk, Matthew D.

    2015-01-01

    The objective of this document is to assess the value of launch collision avoidance (COLA) practices and provide recommendations regarding its implementation for NASA robotic missions. The scope of this effort is limited to launch COLA screens against catalog objects that are either spacecraft or debris. No modifications to manned safety COLA practices are considered in this effort. An assessment of the value of launch COLA can be broken down into two fundamental questions: 1) Does collision during launch represent a significant risk to either the payload being launched or the space environment? 2) Can launch collision mitigation be performed in a manner that provides meaningful risk reduction at an acceptable level of operational impact? While it has been possible to piece together partial answers to these questions for some time, the first attempt to comprehensively address them is documented in reference (a), Launch COLA Operations: an Examination of Data Products, Procedures, and Thresholds, Revision A. This report is the product of an extensive study that addressed fundamental technical questions surrounding launch collision avoidance analysis and practice. The results provided in reference (a) will be cited throughout this document as these two questions are addressed. The premise of this assessment is that in order to conclude that launch COLA is a value-added activity, the answer to both of these questions must be affirmative. A "no" answer to either of these questions points toward the conclusion that launch COLA provides little or no risk mitigation benefit. The remainder of this assessment will focus on addressing these two questions.

  17. Characterizing Epistemic Uncertainty for Launch Vehicle Designs

    Science.gov (United States)

    Novack, Steven D.; Rogers, Jim; Hark, Frank; Al Hassan, Mohammad

    2016-01-01

    NASA Probabilistic Risk Assessment (PRA) has the task of estimating the aleatory (randomness) and epistemic (lack of knowledge) uncertainty of launch vehicle loss of mission and crew risk and communicating the results. Launch vehicles are complex engineered systems designed with sophisticated subsystems that are built to work together to accomplish mission success. Some of these systems or subsystems are in the form of heritage equipment, while some have never been previously launched. For these cases, characterizing the epistemic uncertainty is of foremost importance, and it is anticipated that the epistemic uncertainty of a modified launch vehicle design versus a design of well understood heritage equipment would be greater. For reasons that will be discussed, standard uncertainty propagation methods using Monte Carlo simulation produce counter intuitive results and significantly underestimate epistemic uncertainty for launch vehicle models. Furthermore, standard PRA methods such as Uncertainty-Importance analyses used to identify components that are significant contributors to uncertainty are rendered obsolete since sensitivity to uncertainty changes are not reflected in propagation of uncertainty using Monte Carlo methods.This paper provides a basis of the uncertainty underestimation for complex systems and especially, due to nuances of launch vehicle logic, for launch vehicles. It then suggests several alternative methods for estimating uncertainty and provides examples of estimation results. Lastly, the paper shows how to implement an Uncertainty-Importance analysis using one alternative approach, describes the results, and suggests ways to reduce epistemic uncertainty by focusing on additional data or testing of selected components.

  18. Magnetic Launch Assist System Demonstration Test

    Science.gov (United States)

    2001-01-01

    Engineers at the Marshall Space Flight Center (MSFC) have been testing Magnetic Launch Assist Systems, formerly known as Magnetic Levitation (MagLev) technologies. To launch spacecraft into orbit, a Magnetic Launch Assist system would use magnetic fields to levitate and accelerate a vehicle along a track at a very high speed. Similar to high-speed trains and roller coasters that use high-strength magnets to lift and propel a vehicle a couple of inches above a guideway, the launch-assist system would electromagnetically drive a space vehicle along the track. A full-scale, operational track would be about 1.5-miles long and capable of accelerating a vehicle to 600 mph in 9.5 seconds. This photograph shows a subscale model of an airplane running on the experimental track at MSFC during the demonstration test. This track is an advanced linear induction motor. Induction motors are common in fans, power drills, and sewing machines. Instead of spinning in a circular motion to turn a shaft or gears, a linear induction motor produces thrust in a straight line. Mounted on concrete pedestals, the track is 100-feet long, about 2-feet wide, and about 1.5- feet high. The major advantages of launch assist for NASA launch vehicles is that it reduces the weight of the take-off, the landing gear, the wing size, and less propellant resulting in significant cost savings. The US Navy and the British MOD (Ministry of Defense) are planning to use magnetic launch assist for their next generation aircraft carriers as the aircraft launch system. The US Army is considering using this technology for launching target drones for anti-aircraft training.

  19. Tabletop Experimental Track for Magnetic Launch Assist

    Science.gov (United States)

    2000-01-01

    Marshall Space Flight Center's (MSFC's) Advanced Space Transportation Program has developed the Magnetic Launch Assist System, formerly known as the Magnetic Levitation (MagLev) technology that could give a space vehicle a running start to break free from Earth's gravity. A Magnetic Launch Assist system would use magnetic fields to levitate and accelerate a vehicle along a track at speeds up to 600 mph. The vehicle would shift to rocket engines for launch into orbit. Similar to high-speed trains and roller coasters that use high-strength magnets to lift and propel a vehicle a couple of inches above a guideway, a Magnetic Launch Assist system would electromagnetically propel a space vehicle along the track. The tabletop experimental track for the system shown in this photograph is 44-feet long, with 22-feet of powered acceleration and 22-feet of passive braking. A 10-pound carrier with permanent magnets on its sides swiftly glides by copper coils, producing a levitation force. The track uses a linear synchronous motor, which means the track is synchronized to turn the coils on just before the carrier comes in contact with them, and off once the carrier passes. Sensors are positioned on the side of the track to determine the carrier's position so the appropriate drive coils can be energized. MSFC engineers have conducted tests on the indoor track and a 50-foot outdoor track. The major advantages of launch assist for NASA launch vehicles is that it reduces the weight of the take-off, the landing gear, the wing size, and less propellant resulting in significant cost savings. The US Navy and the British MOD (Ministry of Defense) are planning to use magnetic launch assist for their next generation aircraft carriers as the aircraft launch system. The US Army is considering using this technology for launching target drones for anti-aircraft training.

  20. Launch Processing System. [for Space Shuttle

    Science.gov (United States)

    Byrne, F.; Doolittle, G. V.; Hockenberger, R. W.

    1976-01-01

    This paper presents a functional description of the Launch Processing System, which provides automatic ground checkout and control of the Space Shuttle launch site and airborne systems, with emphasis placed on the Checkout, Control, and Monitor Subsystem. Hardware and software modular design concepts for the distributed computer system are reviewed relative to performing system tests, launch operations control, and status monitoring during ground operations. The communication network design, which uses a Common Data Buffer interface to all computers to allow computer-to-computer communication, is discussed in detail.

  1. Diagram of Saturn V Launch Vehicle

    Science.gov (United States)

    1971-01-01

    This is a good cutaway diagram of the Saturn V launch vehicle showing the three stages, the instrument unit, and the Apollo spacecraft. The chart on the right presents the basic technical data in clear detail. The Saturn V is the largest and most powerful launch vehicle in the United States. The towering 363-foot Saturn V was a multistage, multiengine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams. Development of the Saturn V was the responsibility of the Marshall Space Flight Center at Huntsville, Alabama, directed by Dr. Wernher von Braun.

  2. Supporting work practices through telehealth: impact on nurses in peripheral regions

    Directory of Open Access Journals (Sweden)

    Courcy François

    2011-02-01

    Full Text Available Abstract Background In Canada, workforce shortages in the health care sector constrain the ability of the health care system to meet the needs of its population and of its health care professionals. This issue is of particular importance in peripheral regions of Quebec, where significant inequalities in workforce distribution between regions has lead to acute nursing shortages and increased workloads. Information and communication technologies (ICTs are innovative solutions that can be used to develop strategies to optimise the use of available resources and to design new nursing work practices. However, current knowledge is still limited about the real impact of ICTs on nursing recruitment and retention. Our aim is to better understand how work practice reorganization, supported by ICTs, and particularly by telehealth, may influence professional, educational, and organizational factors relating to Quebec nurses, notably those working in peripheral regions. Methods/Design First, we will conduct a descriptive study on the issue of nursing recruitment. Stratified sampling will be used to select approximately twenty innovative projects relating to the reorganization of work practices based upon ICTs. Semi-structured interviews with key informants will determine professional, educational, and organizational recruitment factors. The results will be used to create a questionnaire which, using a convenience sampling method, will be mailed to 600 third year students and recent graduates of two Quebec university nursing faculties. Descriptive, correlation, and hierarchical regression analyses will be performed to identify factors influencing nursing graduates' intentions to practice in peripheral regions. Secondly, we will conduct five case studies pertaining to the issue of nursing retention. Five ICT projects in semi-urban, rural, and isolated regions have been identified. Qualitative data will be collected through field observation and approximately

  3. Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer.

    Science.gov (United States)

    Hanlon, Peter; Daines, Luke; Campbell, Christine; McKinstry, Brian; Weller, David; Pinnock, Hilary

    2017-05-17

    Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support. We performed a metareview (a systematic review of systematic reviews) of randomized controlled trials (RCTs) of telehealth interventions to support self-management in 6 exemplar long-term conditions. We searched 7 databases for reviews published from January 2000 to May 2016 and screened identified studies against eligibility criteria. We weighted reviews by quality (revised A Measurement Tool to Assess Systematic Reviews), size, and relevance. We then combined our results in a narrative synthesis and using harvest plots. We included 53 systematic reviews, comprising 232 unique RCTs. Reviews concerned diabetes (type 1: n=6; type 2, n=11; mixed, n=19), heart failure (n=9), asthma (n=8), COPD (n=8), and cancer (n=3). Findings varied between and within disease areas. The highest-weighted reviews showed that blood glucose telemonitoring with feedback and some educational and lifestyle interventions improved glycemic control in type 2, but not type 1, diabetes, and that telemonitoring and telephone interventions reduced mortality and hospital admissions in heart failure, but these findings were not consistent in all reviews. Results for the other conditions were mixed, although no reviews showed evidence of harm. Analysis of the mediating role of self-management, and of components of successful

  4. Visits Service Launches New Seminar Series

    CERN Multimedia

    2001-01-01

    The CERN Visits Service is launching a new series of seminars for guides, and they are open to everyone. The series kicks off next week with a talk by Konrad Elsener on the CERN neutrinos to Gran Sasso, CNGS, project.

  5. Air Launch from a Towed Glider

    Data.gov (United States)

    National Aeronautics and Space Administration — This research effort is exploring the concept of launching a rocket from a glider that is towed by an aircraft. The idea is to build a relatively inexpensive...

  6. The Expendable Launch Vehicle Commercialization Act

    Science.gov (United States)

    The Department of Transportation will serve as the lead agency in the transfer of Expendable Launch Vehicles (ELV) to the private sector. The roles of the FAA, Coast Guard and materials Transportation Bureau were discussed.

  7. Minimum Cost Nanosatellite Launch System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Delta Velocity Corporation proposes the development of a very low cost, highly responsive nanosat launch system. We propose to develop an integrated propulsion...

  8. Carbon Nanotube Infused Launch Vehicle Structures

    Data.gov (United States)

    National Aeronautics and Space Administration — For the past 5 years Orbital ATK has been investing in, prototyping, and testing carbon nanotube infused composite structures to evaluate their impact on launch...

  9. Launching PPARC's five year strategy programme

    CERN Document Server

    2003-01-01

    "Over one hundred delegates from Parliament, Whitehall and Industry attended a reception on Tuesday night (25 November) to mark the launch the Particle Physics and Astronomy Research Council's (PPARC) Five Year Plan" (1 page).

  10. STS-114: Discovery Launch Readiness Press Conference

    Science.gov (United States)

    2005-01-01

    Michael Griffin, NASA Administrator; Wayne Hale, Space Shuttle Deputy Program Manager; Mike Wetmore, Director of Shuttle Processing; and 1st Lieutenant Mindy Chavez, Launch Weather Officer-United States Air Force 45th Weather Squadron are in attendance for this STS-114 Discovery launch readiness press conference. The discussion begins with Wayne Hale bringing to the table a low level sensor device for everyone to view. He talks in detail about all of the extensive tests that were performed on these sensors and the completion of these ambient tests. Chavez presents her weather forecast for the launch day of July 26th 2005. Michael Griffin and Wayne Hale answer questions from the news media pertaining to the sensors and launch readiness. The video ends with footage of Pilot Jim Kelly and Commander Eileen Collins conducting test flights in a Shuttle Training Aircraft (STA) that simulates Space Shuttle landing.

  11. National Launch System comparative economic analysis

    Science.gov (United States)

    Prince, A.

    1992-01-01

    Results are presented from an analysis of economic benefits (or losses), in the form of the life cycle cost savings, resulting from the development of the National Launch System (NLS) family of launch vehicles. The analysis was carried out by comparing various NLS-based architectures with the current Shuttle/Titan IV fleet. The basic methodology behind this NLS analysis was to develop a set of annual payload requirements for the Space Station Freedom and LEO, to design launch vehicle architectures around these requirements, and to perform life-cycle cost analyses on all of the architectures. A SEI requirement was included. Launch failure costs were estimated and combined with the relative reliability assumptions to measure the effects of losses. Based on the analysis, a Shuttle/NLS architecture evolving into a pressurized-logistics-carrier/NLS architecture appears to offer the best long-term cost benefit.

  12. Nuclear lobby group launches television ad campaign

    International Nuclear Information System (INIS)

    1992-01-01

    Nuclear power is the green wave of the future, according to a television advertising campaign launched by Canada's nuclear industry and designed to help counter the anti-nuclear messages delivered by groups such as Green peace and Energy Probe

  13. Metric Tracking of Launch Vehicles, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA needs reliable, accurate navigation for launch vehicles and other missions. GPS is the best world-wide navigation system, but operates at low power making it...

  14. Tyura Tam Space Launch Facility, Kazakhstan, CIS

    Science.gov (United States)

    1992-01-01

    Located in Kazakhstan on the Syr Darya River, the Tyura Tam Cosmodrome has been the launch site for 72 cosmonaut crews. The landing runway of the Buran space shuttle can be seen in the left center. Further to the right, near the center is the launch site for the Soyuz. The mission control center is located 1,300 miles away near Moscow. In the lower right, is the city of Leninsk, seen as a dark region next to the river.

  15. Former astronaut Armstrong witnesses STS-83 launch

    Science.gov (United States)

    1997-01-01

    Apollo l1 Commander Neil A. Armstrong and his wife, Carol, were among the many special NASA STS-83 launch guests who witnessed the liftoff of the Space Shuttle Columbia April 4 at the Banana Creek VIP Viewing Site at KSC. Columbia took off from Launch Pad 39A at 2:20:32 p.m. EST to begin the 16-day Microgravity Science Laboratory-1 (MSL-1) mission.

  16. Kevorkian v. Thompson.

    Science.gov (United States)

    1997-01-01

    Court Decision: 947 Federal Supplement 1152; 1997 Jan 6 (date of decision). The United States District Court of the Eastern District of Michigan held that a mentally competent patient who is terminally ill or intractably suffering does not have a liberty interest in assisted suicide under the due process clause of the Fourth Amendment and is not denied equal protection under the Fourteenth Amendment. Plaintiff Jack Kevorkian is a physician who advocates the right to die and assisted patients to commit suicide. Plaintiff Janet Good, the former president of the Michigan Hemlock Society, suffers from terminal pancreatic cancer. The plaintiffs claimed that Michigan's statute prohibiting physician-assisted suicide is unconstitutional. The District Court held that there is no cognizable constitutional right to assisted suicide because the right to suicide or assisted suicide is not deeply rooted in the nation's history and traditions, and because the statute does not infringe on any fundamental right or liberty. The court noted a difference between the withdrawal of life support and acts to hasten death by assisted suicide. The court also held that the law against physician-assisted suicide furthered legitimate state interests in denying to physicians "the role of killers of their patients," in regulating circumstances under which life may be ended, and in protecting the vulnerable but viable from "self-interested importuning of third parties."

  17. Progress Towards a 2012 Landsat Launch

    Science.gov (United States)

    Irons, Jim; Sabelhaus, Phil; Masek, Jeff; Cook, Bruce; Dabney, Phil; Loveland, Tom

    2012-01-01

    The Landsat Data Continuity Mission (LDCM) is on schedule for a December 2012 launch date. The mission is being managed by an interagency partnership between NASA and the U.S. Geological Survey (USGS). NASA leads the development and launch of the satellite observatory while leads ground system development. USGS will assume responsibility for operating the satellite and for collecting, archiving, and distributing the LDCM data following launch. When launched the satellite will carry two sensors into orbit. The Operational Land Imager (OLI) will collect data for nine shortwave spectral bands with a spatial resolution of 30 m (with a 15 m panchromatic band). The Thermal Infrared Sensor (TIRS) will coincidently collect data for two thermal infrared bands with a spatial resolution of 100 m. The OLI is fully assembled and tested and has been shipped by it?s manufacturer, Ball Aerospace and Technology Corporation, to the Orbital Sciences Corporation (Orbital) facility where it is being integrated onto the LDCM spacecraft. Pre-launch testing indicates that OLI will meet all performance specification with margin. TIRS is in development at the NASA Goddard Space Flight Center (GSFC) and is in final testing before shipping to the Orbital facility in January, 2012. The ground data processing system is in development at the USGS Earth Resources Observation and Science (EROS) Center. The presentation will describe the LDCM satellite system, provide the status of system development, and present prelaunch performance data for OLI and TIRS. The USGS has committed to renaming the satellite as Landsat 8 following launch.

  18. Overview of GX launch services by GALEX

    Science.gov (United States)

    Sato, Koji; Kondou, Yoshirou

    2006-07-01

    Galaxy Express Corporation (GALEX) is a launch service company in Japan to develop a medium size rocket, GX rocket and to provide commercial launch services for medium/small low Earth orbit (LEO) and Sun synchronous orbit (SSO) payloads with a future potential for small geo-stationary transfer orbit (GTO). It is GALEX's view that small/medium LEO/SSO payloads compose of medium scaled but stable launch market due to the nature of the missions. GX rocket is a two-stage rocket of well flight proven liquid oxygen (LOX)/kerosene booster and LOX/liquid natural gas (LNG) upper stage. This LOX/LNG propulsion under development by Japan's Aerospace Exploration Agency (JAXA), is robust with comparable performance as other propulsions and have future potential for wider application such as exploration programs. GX rocket is being developed through a joint work between the industries and GX rocket is applying a business oriented approach in order to realize competitive launch services for which well flight proven hardware and necessary new technology are to be introduced as much as possible. It is GALEX's goal to offer “Easy Access to Space”, a highly reliable and user-friendly launch services with a competitive price. GX commercial launch will start in Japanese fiscal year (JFY) 2007 2008.

  19. Conocimientos y aplicación de normas de bioseguridad del servicio de Ginecoobstetricia del Hospital Alberto Leopoldo Barton Thompson, Callao 2016

    OpenAIRE

    Salas Zegarra, Rita Maribel

    2016-01-01

    El objetivo del presente trabajo de investigación es determinar la relación que existe entre los conocimientos de normas de bioseguridad y la aplicación de normas de bioseguridad en el servicio de Ginecoobstetricia en el Hospital Alberto Leopoldo Barton Thompson en el Callao, periodo 2016; la población conformada por los técnicos de enfermería, ginecoobstetrasy obstetras del servicio ginecoobstetricia de 75 trabajadores, la muestra consideró toda la población, en los cuales se ...

  20. At-Home Transcranial Direct Current Stimulation (tDCS With Telehealth Support for Symptom Control in Chronically-Ill Patients With Multiple Symptoms

    Directory of Open Access Journals (Sweden)

    Alexa Riggs

    2018-05-01

    Full Text Available Transcranial direct current stimulation (tDCS delivered in multiple sessions can reduce symptom burden, but access of chronically ill patients to tDCS studies is constrained by the burden of office-based tDCS administration. Expanded access to this therapy can be accomplished through the development of interventions that allow at-home tDCS applications.Objective: We describe the development and initial feasibility assessment of a novel intervention for the chronically ill that combines at-home tDCS with telehealth support.Methods: In the developmental phase, the tDCS procedure was adjusted for easy application by patients or their informal caregivers at home, and a tDCS protocol with specific elements for enhanced safety and remote adherence monitoring was created. Lay language instructional materials were written and revised based on expert feedback. The materials were loaded onto a tablet allowing for secure video-conferencing. The telehealth tablet was paired with an at-home tDCS device that allowed for remote dose control via electronic codes dispensed to patients prior to each session. tDCS was delivered in two phases: once daily on 10 consecutive days, followed by an as needed regimen for 20 days. Initial feasibility of this tDCS-telehealth system was evaluated in four patients with advanced chronic illness and multiple symptoms. Change in symptom burden and patient satisfaction were assessed with the Condensed Memorial Symptom Assessment Scale (CMSAS and a tDCS user survey.Results: The telehealth-tDCS protocol includes one home visit and has seven patient-tailored elements and six elements enhancing safety monitoring. Replicable electrode placement at home without 10–20 EEG measurement is achieved via a headband that holds electrodes in a pre-determined position. There were no difficulties with patients’ training, protocol adherence, or tolerability. A total of 60 tDCS sessions were applied. No session required discontinuation, and

  1. At-Home Transcranial Direct Current Stimulation (tDCS) With Telehealth Support for Symptom Control in Chronically-Ill Patients With Multiple Symptoms.

    Science.gov (United States)

    Riggs, Alexa; Patel, Vaishali; Paneri, Bhaskar; Portenoy, Russell K; Bikson, Marom; Knotkova, Helena

    2018-01-01

    Transcranial direct current stimulation (tDCS) delivered in multiple sessions can reduce symptom burden, but access of chronically ill patients to tDCS studies is constrained by the burden of office-based tDCS administration. Expanded access to this therapy can be accomplished through the development of interventions that allow at-home tDCS applications. Objective: We describe the development and initial feasibility assessment of a novel intervention for the chronically ill that combines at-home tDCS with telehealth support. Methods: In the developmental phase, the tDCS procedure was adjusted for easy application by patients or their informal caregivers at home, and a tDCS protocol with specific elements for enhanced safety and remote adherence monitoring was created. Lay language instructional materials were written and revised based on expert feedback. The materials were loaded onto a tablet allowing for secure video-conferencing. The telehealth tablet was paired with an at-home tDCS device that allowed for remote dose control via electronic codes dispensed to patients prior to each session. tDCS was delivered in two phases: once daily on 10 consecutive days, followed by an as needed regimen for 20 days. Initial feasibility of this tDCS-telehealth system was evaluated in four patients with advanced chronic illness and multiple symptoms. Change in symptom burden and patient satisfaction were assessed with the Condensed Memorial Symptom Assessment Scale (CMSAS) and a tDCS user survey. Results: The telehealth-tDCS protocol includes one home visit and has seven patient-tailored elements and six elements enhancing safety monitoring. Replicable electrode placement at home without 10-20 EEG measurement is achieved via a headband that holds electrodes in a pre-determined position. There were no difficulties with patients' training, protocol adherence, or tolerability. A total of 60 tDCS sessions were applied. No session required discontinuation, and there were no adverse

  2. Space Launch System for Exploration and Science

    Science.gov (United States)

    Klaus, K.

    2013-12-01

    Introduction: The Space Launch System (SLS) is the most powerful rocket ever built and provides a critical heavy-lift launch capability enabling diverse deep space missions. The exploration class vehicle launches larger payloads farther in our solar system and faster than ever before. The vehicle's 5 m to 10 m fairing allows utilization of existing systems which reduces development risks, size limitations and cost. SLS lift capacity and superior performance shortens mission travel time. Enhanced capabilities enable a myriad of missions including human exploration, planetary science, astrophysics, heliophysics, planetary defense and commercial space exploration endeavors. Human Exploration: SLS is the first heavy-lift launch vehicle capable of transporting crews beyond low Earth orbit in over four decades. Its design maximizes use of common elements and heritage hardware to provide a low-risk, affordable system that meets Orion mission requirements. SLS provides a safe and sustainable deep space pathway to Mars in support of NASA's human spaceflight mission objectives. The SLS enables the launch of large gateway elements beyond the moon. Leveraging a low-energy transfer that reduces required propellant mass, components are then brought back to a desired cislunar destination. SLS provides a significant mass margin that can be used for additional consumables or a secondary payloads. SLS lowers risks for the Asteroid Retrieval Mission by reducing mission time and improving mass margin. SLS lift capacity allows for additional propellant enabling a shorter return or the delivery of a secondary payload, such as gateway component to cislunar space. SLS enables human return to the moon. The intermediate SLS capability allows both crew and cargo to fly to translunar orbit at the same time which will simplify mission design and reduce launch costs. Science Missions: A single SLS launch to Mars will enable sample collection at multiple, geographically dispersed locations and a

  3. Achieving a Launch on Demand Capability

    Science.gov (United States)

    Greenberg, Joel S.

    2002-01-01

    The ability to place payloads [satellites] into orbit as and when required, often referred to as launch on demand, continues to be an elusive and yet largely unfulfilled goal. But what is the value of achieving launch on demand [LOD], and what metrics are appropriate? Achievement of a desired level of LOD capability must consider transportation system thruput, alternative transportation systems that comprise the transportation architecture, transportation demand, reliability and failure recovery characteristics of the alternatives, schedule guarantees, launch delays, payload integration schedules, procurement policies, and other factors. Measures of LOD capability should relate to the objective of the transportation architecture: the placement of payloads into orbit as and when required. Launch on demand capability must be defined in probabilistic terms such as the probability of not incurring a delay in excess of T when it is determined that it is necessary to place a payload into orbit. Three specific aspects of launch on demand are considered: [1] the ability to recover from adversity [i.e., a launch failure] and to keep up with the steady-state demand for placing satellites into orbit [this has been referred to as operability and resiliency], [2] the ability to respond to the requirement to launch a satellite when the need arises unexpectedly either because of an unexpected [random] on-orbit satellite failure that requires replacement or because of the sudden recognition of an unanticipated requirement, and [3] the ability to recover from adversity [i.e., a launch failure] during the placement of a constellation into orbit. The objective of this paper is to outline a formal approach for analyzing alternative transportation architectures in terms of their ability to provide a LOD capability. The economic aspect of LOD is developed by establishing a relationship between scheduling and the elimination of on-orbit spares while achieving the desired level of on

  4. The Challenges of a Complex and Innovative Telehealth Project: A Qualitative Evaluation of the Eastern Quebec Telepathology Network.

    Science.gov (United States)

    Alami, Hassane; Fortin, Jean-Paul; Gagnon, Marie-Pierre; Pollender, Hugo; Têtu, Bernard; Tanguay, France

    2017-09-13

    The Eastern Quebec Telepathology Network (EQTN) has been implemented in the province of Quebec (Canada) to support pathology and surgery practices in hospitals that are lack of pathologists, especially in rural and remote areas. This network includes 22 hospitals and serves a population of 1.7 million inhabitants spread over a vast territory. An evaluation of this network was conducted in order to identify and analyze the factors and issues associated with its implementation and deployment, as well as those related to its sustainability and expansion. Qualitative evaluative research based on a case study using: (1) historical analysis of the project documentation (newsletters, minutes of meetings, articles, ministerial documents, etc); (2) participation in meetings of the committee in charge of telehealth programs and the project; and (3) interviews, focus groups, and discussions with different stakeholders, including decision-makers, clinical and administrative project managers, clinicians (pathologists and surgeons), and technologists. Data from all these sources were cross-checked and synthesized through an integrative and interpretative process. The evaluation revealed numerous socio-political, regulatory, organizational, governance, clinical, professional, economic, legal and technological challenges related to the emergence and implementation of the project. In addition to technical considerations, the development of this network was associated with major changes and transformations of production procedures, delivery and organization of services, clinical practices, working methods, and clinicaladministrative processes and cultures (professional/organizational). The EQTN reflects the complex, structuring, and innovative projects that organizations and health systems are required to implement today. Future works should be more sensitive to the complexity associated with the emergence of telehealth networks and no longer reduce them to technological

  5. Low-Cost Launch Systems for the Dual-Launch Concept

    National Research Council Canada - National Science Library

    Pearson, Jerone; Zukauskas, Wally; Weeks, Thomas; Cass, Stein; Stytz, Martin

    2000-01-01

    .... Performing fewer engine tests, designing structures with lower structural margins, parallel processing, eliminating payload clean room requirements and extensive testing before launch, horizontal...

  6. Launch Vehicle Demonstrator Using Shuttle Assets

    Science.gov (United States)

    Threet, Grady E., Jr.; Creech, Dennis M.; Philips, Alan D.; Water, Eric D.

    2011-01-01

    The Marshall Space Flight Center Advanced Concepts Office (ACO) has the leading role for NASA s preliminary conceptual launch vehicle design and performance analysis. Over the past several years the ACO Earth-to-Orbit Team has evaluated thousands of launch vehicle concept variations for a multitude of studies including agency-wide efforts such as the Exploration Systems Architecture Study (ESAS), Constellation, Heavy Lift Launch Vehicle (HLLV), Heavy Lift Propulsion Technology (HLPT), Human Exploration Framework Team (HEFT), and Space Launch System (SLS). NASA plans to continue human space exploration and space station utilization. Launch vehicles used for heavy lift cargo and crew will be needed. One of the current leading concepts for future heavy lift capability is an inline one and a half stage concept using solid rocket boosters (SRB) and based on current Shuttle technology and elements. Potentially, the quickest and most cost-effective path towards an operational vehicle of this configuration is to make use of a demonstrator vehicle fabricated from existing shuttle assets and relying upon the existing STS launch infrastructure. Such a demonstrator would yield valuable proof-of-concept data and would provide a working test platform allowing for validated systems integration. Using shuttle hardware such as existing RS-25D engines and partial MPS, propellant tanks derived from the External Tank (ET) design and tooling, and four-segment SRB s could reduce the associated upfront development costs and schedule when compared to a concept that would rely on new propulsion technology and engine designs. There are potentially several other additional benefits to this demonstrator concept. Since a concept of this type would be based on man-rated flight proven hardware components, this demonstrator has the potential to evolve into the first iteration of heavy lift crew or cargo and serve as a baseline for block upgrades. This vehicle could also serve as a demonstration

  7. Space Launch System Ascent Flight Control Design

    Science.gov (United States)

    Orr, Jeb S.; Wall, John H.; VanZwieten, Tannen S.; Hall, Charles E.

    2014-01-01

    A robust and flexible autopilot architecture for NASA's Space Launch System (SLS) family of launch vehicles is presented. The SLS configurations represent a potentially significant increase in complexity and performance capability when compared with other manned launch vehicles. It was recognized early in the program that a new, generalized autopilot design should be formulated to fulfill the needs of this new space launch architecture. The present design concept is intended to leverage existing NASA and industry launch vehicle design experience and maintain the extensibility and modularity necessary to accommodate multiple vehicle configurations while relying on proven and flight-tested control design principles for large boost vehicles. The SLS flight control architecture combines a digital three-axis autopilot with traditional bending filters to support robust active or passive stabilization of the vehicle's bending and sloshing dynamics using optimally blended measurements from multiple rate gyros on the vehicle structure. The algorithm also relies on a pseudo-optimal control allocation scheme to maximize the performance capability of multiple vectored engines while accommodating throttling and engine failure contingencies in real time with negligible impact to stability characteristics. The architecture supports active in-flight disturbance compensation through the use of nonlinear observers driven by acceleration measurements. Envelope expansion and robustness enhancement is obtained through the use of a multiplicative forward gain modulation law based upon a simple model reference adaptive control scheme.

  8. Rationales for the Lightning Launch Commit Criteria

    Science.gov (United States)

    Willett, John C. (Editor); Merceret, Francis J. (Editor); Krider, E. Philip; O'Brien, T. Paul; Dye, James E.; Walterscheid, Richard L.; Stolzenburg, Maribeth; Cummins, Kenneth; Christian, Hugh J.; Madura, John T.

    2016-01-01

    Since natural and triggered lightning are demonstrated hazards to launch vehicles, payloads, and spacecraft, NASA and the Department of Defense (DoD) follow the Lightning Launch Commit Criteria (LLCC) for launches from Federal Ranges. The LLCC were developed to prevent future instances of a rocket intercepting natural lightning or triggering a lightning flash during launch from a Federal Range. NASA and DoD utilize the Lightning Advisory Panel (LAP) to establish and develop robust rationale from which the criteria originate. The rationale document also contains appendices that provide additional scientific background, including detailed descriptions of the theory and observations behind the rationales. The LLCC in whole or part are used across the globe due to the rigor of the documented criteria and associated rationale. The Federal Aviation Administration (FAA) adopted the LLCC in 2006 for commercial space transportation and the criteria were codified in the FAA's Code of Federal Regulations (CFR) for Safety of an Expendable Launch Vehicle (Appendix G to 14 CFR Part 417, (G417)) and renamed Lightning Flight Commit Criteria in G417.

  9. Quality function deployment in launch operations

    Science.gov (United States)

    Portanova, P. L.; Tomei, E. J., Jr.

    1990-11-01

    The goal of the Advanced Launch System (ALS) is a more efficient launch capability that provides a highly reliable and operable system at substantially lower cost than current launch systems. Total Quality Management (TQM) principles are being emphasized throughout the ALS program. A continuous improvement philosophy is directed toward satisfying users' and customer's requirements in terms of quality, performance, schedule, and cost. Quality Function Deployment (QFD) is interpreted as the voice of the customer (or user), and it is an important planning tool in translating these requirements throughout the whole process of design, development, manufacture, and operations. This report explores the application of QFD methodology to launch operations, including the modification and addition of events (operations planning) in the engineering development cycle, and presents an informal status of study results to date. QFD is a technique for systematically analyzing the customer's (Space Command) perceptions of what constitutes a highly reliable and operable system and functionally breaking down those attributes to identify the critical characteristics that determine an efficient launch system capability. In applying the principle of QFD, a series of matrices or charts are developed with emphasis on the one commonly known as the House of Quality (because of its roof-like format), which identifies and translates the most critical information.

  10. Do we need new personalized emergency telehealth solutions? A survey of 100 emergency department patients and a first report of the swiss limmex emergency wristwatch: an original study.

    Science.gov (United States)

    Tabbara, Malek; Hodel, Thomas; Müller, Urs; Briner, Gabi; Zimmermann, Heinz; Exadaktylos, Aristomenis K

    2012-01-01

    Development of new personal mobile and wireless devices for healthcare has become essential due to our aging population characterized by constant rise in chronic diseases that consequently require a complex treatment and close monitoring. Personal telehealth devices allow patients to adequately receive their appropriate treatment, followup with their doctors, and report any emergency without the need of the presence of any caregivers with them thus increasing their quality of life in a cost-effective fashion. This paper includes a brief overview of personal telehealth systems, a survey of 100 consecutive ED patients aged >65 years, and introduces "Limmex" a new GSM based technology packaged in a wristwatch. Limmex can by a push of a button initiate multiple emergency call and establish mobile communication between the patient and a preselected person, institution, or a search and rescue service. To the best of our knowledge, Limmex is the first of its kind worldwide.

  11. Do We Need New Personalized Emergency Telehealth Solutions? A Survey of 100 Emergency Department Patients and a First Report of the Swiss Limmex Emergency Wristwatch: An Original Study

    Directory of Open Access Journals (Sweden)

    Malek Tabbara

    2012-01-01

    Full Text Available Development of new personal mobile and wireless devices for healthcare has become essential due to our aging population characterized by constant rise in chronic diseases that consequently require a complex treatment and close monitoring. Personal telehealth devices allow patients to adequately receive their appropriate treatment, followup with their doctors, and report any emergency without the need of the presence of any caregivers with them thus increasing their quality of life in a cost-effective fashion. This paper includes a brief overview of personal telehealth systems, a survey of 100 consecutive ED patients aged >65 years, and introduces “Limmex” a new GSM based technology packaged in a wristwatch. Limmex can by a push of a button initiate multiple emergency call and establish mobile communication between the patient and a preselected person, institution, or a search and rescue service. To the best of our knowledge, Limmex is the first of its kind worldwide.

  12. Design and Implementation of an Interactive Website for Pediatric Voice Therapy-The Concept of In-Between Care: A Telehealth Model.

    Science.gov (United States)

    Doarn, Charles R; Zacharias, Stephanie; Keck, Casey Stewart; Tabangin, Meredith; DeAlarcon, Alessandro; Kelchner, Lisa

    2018-06-05

    This article describes the design and implementation of a web-based portal developed to provide supported home practice between weekly voice therapy sessions delivered through telehealth to children with voice disorders. This in-between care consisted of supported home practice that was remotely monitored by speech-language pathologists (SLPs). A web-based voice therapy portal (VTP) was developed as a platform so participants could complete voice therapy home practice by an interdisciplinary team of SLPs (specialized in pediatric voice therapy), telehealth specialists, biomedical informaticians, and interface designers. The VTP was subsequently field tested in a group of children with voice disorders, participating in a larger telehealth study. Building the VTP for supported home practice for pediatric voice therapy was challenging, but successful. Key interactive features of the final site included 11 vocal hygiene questions, traditional voice therapy exercises grouped into levels, audio/visual voice therapy demonstrations, a store-and-retrieval system for voice samples, message/chat function, written guidelines for weekly therapy exercises, and questionnaires for parents to complete after each therapy session. Ten participants (9-14 years of age) diagnosed with a voice disorder were enrolled for eight weekly telehealth voice therapy sessions with follow-up in-between care provided using the VTP. The development and implementation of the VTP as a novel platform for the delivery of voice therapy home practice sessions were effective. We found that a versatile individual, who can work with all project staff (speak the language of both SLPs and information technologists), is essential to the development process. Once the website was established, participants and SLPs effectively utilized the web-based VTP. They found it feasible and useful for needed in-between care and reinforcement of therapeutic exercises.

  13. A Pilot Study to Improve Access to Eye Care Services for Patients in Rural India by Implementing Community Ophthalmology through Innovative Telehealth Technology.

    Science.gov (United States)

    John, Sheila; Premila, M; Javed, Mohd; Vikas, G; Wagholikar, Amol

    2015-01-01

    To inform about a very unique and first of its kind telehealth pilot study in India that has provided virtual telehealth consultation to eye care patients in low resource at remote villages. Provision of Access to eye care services in remote population is always challenging due to pragmatic reasons. Advances in Telehealth technologies have provided an opportunity to improve access to remote population. However, current Telehealth technologies are limited to face-to-face video consultation only. We inform about a pilot study that illustrates real-time imaging access to ophthalmologists. Our innovative software led technology solution allowed screening of patients with varying ocular conditions. Eye camps were conducted in 2 districts in South India over a 12-month period in 2014. Total of 196 eye camps were conducted. Total of 19,634 patients attended the eye camps. Innovative software was used to conduct consultation with the ophthalmologist located in the city hospital. The software enabled virtual visit and allowed instant sharing of fundus camera images for assessment and diagnosis. About 71% of the patients were found to have Refractive Error problems, 15% of them were found to have cataract, 7% of the patients were diagnosed to have Retina problems and 7% of the patients were found to have other ocular diseases. The patients requiring cataract surgery were immediately transferred to city hospital for treatment. Software led assessment of fundus camera images assisted in identifying retinal eye diseases. Our real-time virtual visit software assisted in specialist care provision and illustrated a novel tele health solution for low resource population.

  14. Atrial Fibrillation Screening in Nonmetropolitan Areas Using a Telehealth Surveillance System With an Embedded Cloud-Computing Algorithm: Prospective Pilot Study.

    Science.gov (United States)

    Chen, Ying-Hsien; Hung, Chi-Sheng; Huang, Ching-Chang; Hung, Yu-Chien; Hwang, Juey-Jen; Ho, Yi-Lwun

    2017-09-26

    Atrial fibrillation (AF) is a common form of arrhythmia that is associated with increased risk of stroke and mortality. Detecting AF before the first complication occurs is a recognized priority. No previous studies have examined the feasibility of undertaking AF screening using a telehealth surveillance system with an embedded cloud-computing algorithm; we address this issue in this study. The objective of this study was to evaluate the feasibility of AF screening in nonmetropolitan areas using a telehealth surveillance system with an embedded cloud-computing algorithm. We conducted a prospective AF screening study in a nonmetropolitan area using a single-lead electrocardiogram (ECG) recorder. All ECG measurements were reviewed on the telehealth surveillance system and interpreted by the cloud-computing algorithm and a cardiologist. The process of AF screening was evaluated with a satisfaction questionnaire. Between March 11, 2016 and August 31, 2016, 967 ECGs were recorded from 922 residents in nonmetropolitan areas. A total of 22 (2.4%, 22/922) residents with AF were identified by the physician's ECG interpretation, and only 0.2% (2/967) of ECGs contained significant artifacts. The novel cloud-computing algorithm for AF detection had a sensitivity of 95.5% (95% CI 77.2%-99.9%) and specificity of 97.7% (95% CI 96.5%-98.5%). The overall satisfaction score for the process of AF screening was 92.1%. AF screening in nonmetropolitan areas using a telehealth surveillance system with an embedded cloud-computing algorithm is feasible. ©Ying-Hsien Chen, Chi-Sheng Hung, Ching-Chang Huang, Yu-Chien Hung, Juey-Jen Hwang, Yi-Lwun Ho. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 26.09.2017.

  15. Atrial Fibrillation Screening in Nonmetropolitan Areas Using a Telehealth Surveillance System With an Embedded Cloud-Computing Algorithm: Prospective Pilot Study

    Science.gov (United States)

    Chen, Ying-Hsien; Hung, Chi-Sheng; Huang, Ching-Chang; Hung, Yu-Chien

    2017-01-01

    Background Atrial fibrillation (AF) is a common form of arrhythmia that is associated with increased risk of stroke and mortality. Detecting AF before the first complication occurs is a recognized priority. No previous studies have examined the feasibility of undertaking AF screening using a telehealth surveillance system with an embedded cloud-computing algorithm; we address this issue in this study. Objective The objective of this study was to evaluate the feasibility of AF screening in nonmetropolitan areas using a telehealth surveillance system with an embedded cloud-computing algorithm. Methods We conducted a prospective AF screening study in a nonmetropolitan area using a single-lead electrocardiogram (ECG) recorder. All ECG measurements were reviewed on the telehealth surveillance system and interpreted by the cloud-computing algorithm and a cardiologist. The process of AF screening was evaluated with a satisfaction questionnaire. Results Between March 11, 2016 and August 31, 2016, 967 ECGs were recorded from 922 residents in nonmetropolitan areas. A total of 22 (2.4%, 22/922) residents with AF were identified by the physician’s ECG interpretation, and only 0.2% (2/967) of ECGs contained significant artifacts. The novel cloud-computing algorithm for AF detection had a sensitivity of 95.5% (95% CI 77.2%-99.9%) and specificity of 97.7% (95% CI 96.5%-98.5%). The overall satisfaction score for the process of AF screening was 92.1%. Conclusions AF screening in nonmetropolitan areas using a telehealth surveillance system with an embedded cloud-computing algorithm is feasible. PMID:28951384

  16. Effectiveness of a telehealth service delivery model for treating attention-deficit/hyperactivity disorder: a community-based randomized controlled trial.

    Science.gov (United States)

    Myers, Kathleen; Vander Stoep, Ann; Zhou, Chuan; McCarty, Carolyn A; Katon, Wayne

    2015-04-01

    To test the effectiveness of a telehealth service delivery model for the treatment of children with attention-deficit/hyperactivity disorder (ADHD) that provided pharmacological treatment and caregiver behavior training. The Children's ADHD Telemental Health Treatment Study (CATTS) was a randomized controlled trial with 223 children referred by 88 primary care providers (PCPs) in 7 communities. Children randomized to the experimental telehealth service model received 6 sessions over 22 weeks of combined pharmacotherapy, delivered by child psychiatrists through videoconferencing, and caregiver behavior training, provided in person by community therapists who were supervised remotely. Children randomized to the control service delivery model received treatment with their PCPs augmented with a telepsychiatry consultation. Outcomes were diagnostic criteria for ADHD and oppositional defiant disorder (ODD) and role performance on the Vanderbilt ADHD Rating Scale (VADRS) completed by caregivers (VADRS-Caregivers) and teachers (VADRS-Teachers) and impairment on the Columbia Impairment Scale-Parent Version (CIS-P). Measures were completed at 5 assessments over 25 weeks. Children in both service models improved. Children assigned to the telehealth service model improved significantly more than children in the augmented primary care arm for VADRS-Caregiver criteria for inattention (χ(2)[4] = 19.47, p ADHD (χ(2)[4] = 14.90, p = .005), ODD (χ(2)[4] = 10.05, p = .04), and VADRS-Caregiver role performance (χ(2) [4] = 12.40, p = .01) and CIS-P impairment (χ(2)[4] = 20.52, p ADHD (χ(2)[4] = 9.72, p = .045). The CATTS trial demonstrated the effectiveness of a telehealth service model to treat ADHD in communities with limited access to specialty mental health services. Clinical trial registration information-Children's Attention Deficit Disorder With Hyperactivity (ADHD) Telemental Health Treatment Study; http://clinicaltrials.gov; NCT00830700. Copyright © 2015 American

  17. U.S. advanced launch vehicle technology programs : Quarterly Launch Report : special report

    Science.gov (United States)

    1996-01-01

    U.S. firms and U.S. government agencies are jointly investing in advanced launch vehicle technology. This Special Report summarizes U.S. launch vehicle technology programs and highlights the changing : roles of government and industry players in pick...

  18. Soyuz Spacecraft Transported to Launch Pad

    Science.gov (United States)

    2003-01-01

    The Soyuz TMA-3 spacecraft and its booster rocket (rear view) is shown on a rail car for transport to the launch pad where it was raised to a vertical launch position at the Baikonur Cosmodrome, Kazakhstan on October 16, 2003. Liftoff occurred on October 18th, transporting a three man crew to the International Space Station (ISS). Aboard were Michael Foale, Expedition-8 Commander and NASA science officer; Alexander Kaleri, Soyuz Commander and flight engineer, both members of the Expedition-8 crew; and European Space agency (ESA) Astronaut Pedro Duque of Spain. Photo Credit: 'NASA/Bill Ingalls'

  19. Space Launch System (SLS) Mission Planner's Guide

    Science.gov (United States)

    Smith, David Alan

    2017-01-01

    The purpose of this Space Launch System (SLS) Mission Planner's Guide (MPG) is to provide future payload developers/users with sufficient insight to support preliminary SLS mission planning. Consequently, this SLS MPG is not intended to be a payload requirements document; rather, it organizes and details SLS interfaces/accommodations in a manner similar to that of current Expendable Launch Vehicle (ELV) user guides to support early feasibility assessment. Like ELV Programs, once approved to fly on SLS, specific payload requirements will be defined in unique documentation.

  20. Control of the launch of attosecond pulses

    International Nuclear Information System (INIS)

    Cao Wei; Lu Peixiang; Lan Pengfei; Wang Xinlin; Li Yuhua

    2007-01-01

    We propose an approach to steer the launch of attosecond (as) pulses with a high precision. We numerically demonstrate that by adding a weak second-harmonic (SH) field to the fundamental beam the ionization and recollision process of the electron will be perturbed, which can induce a variation of the emission time of high harmonics. Through modifying the relative intensity of the SH and fundamental fields, the launch of as pulses can be manipulated with a resolution less than 40 as. This will show significant potential for ultrafast optics

  1. The Standard Deviation of Launch Vehicle Environments

    Science.gov (United States)

    Yunis, Isam

    2005-01-01

    Statistical analysis is used in the development of the launch vehicle environments of acoustics, vibrations, and shock. The standard deviation of these environments is critical to accurate statistical extrema. However, often very little data exists to define the standard deviation and it is better to use a typical standard deviation than one derived from a few measurements. This paper uses Space Shuttle and expendable launch vehicle flight data to define a typical standard deviation for acoustics and vibrations. The results suggest that 3dB is a conservative and reasonable standard deviation for the source environment and the payload environment.

  2. Autonomous system for launch vehicle range safety

    Science.gov (United States)

    Ferrell, Bob; Haley, Sam

    2001-02-01

    The Autonomous Flight Safety System (AFSS) is a launch vehicle subsystem whose ultimate goal is an autonomous capability to assure range safety (people and valuable resources), flight personnel safety, flight assets safety (recovery of valuable vehicles and cargo), and global coverage with a dramatic simplification of range infrastructure. The AFSS is capable of determining current vehicle position and predicting the impact point with respect to flight restriction zones. Additionally, it is able to discern whether or not the launch vehicle is an immediate threat to public safety, and initiate the appropriate range safety response. These features provide for a dramatic cost reduction in range operations and improved reliability of mission success. .

  3. Launch Pad Escape System Design (Human Spaceflight)

    Science.gov (United States)

    Maloney, Kelli

    2011-01-01

    A launch pad escape system for human spaceflight is one of those things that everyone hopes they will never need but is critical for every manned space program. Since men were first put into space in the early 1960s, the need for such an Emergency Escape System (EES) has become apparent. The National Aeronautics and Space Administration (NASA) has made use of various types of these EESs over the past 50 years. Early programs, like Mercury and Gemini, did not have an official launch pad escape system. Rather, they relied on a Launch Escape System (LES) of a separate solid rocket motor attached to the manned capsule that could pull the astronauts to safety in the event of an emergency. This could only occur after hatch closure at the launch pad or during the first stage of flight. A version of a LES, now called a Launch Abort System (LAS) is still used today for all manned capsule type launch vehicles. However, this system is very limited in that it can only be used after hatch closure and it is for flight crew only. In addition, the forces necessary for the LES/LAS to get the capsule away from a rocket during the first stage of flight are quite high and can cause injury to the crew. These shortcomings led to the development of a ground based EES for the flight crew and ground support personnel as well. This way, a much less dangerous mode of egress is available for any flight or ground personnel up to a few seconds before launch. The early EESs were fairly simple, gravity-powered systems to use when thing's go bad. And things can go bad very quickly and catastrophically when dealing with a flight vehicle fueled with millions of pounds of hazardous propellant. With this in mind, early EES designers saw such a passive/unpowered system as a must for last minute escapes. This and other design requirements had to be derived for an EES, and this section will take a look at the safety design requirements had to be derived for an EES, and this section will take a look at

  4. NASA rocket launches student project into space

    OpenAIRE

    Crumbley, Liz

    2005-01-01

    A project that began in 2002 will culminate at sunrise on Tuesday, March 15, when a team of Virginia Tech engineering students watch a payload section they designed lift off aboard a sounding rocket from a launch pad at NASA's Wallops Island Flight Facility and travel 59 miles into space.

  5. Ares Launch Vehicles Lean Practices Case Study

    Science.gov (United States)

    Doreswamy, Rajiv; Self, Timothy A.

    2007-01-01

    The Ares launch vehicles team, managed by the Ares Projects Office (APO) at NASA Marshall Space Flight Center, has completed the Ares I Crew Launch Vehicle System Requirements Review and System Definition Review and early design work for the Ares V Cargo Launch Vehicle. This paper provides examples of how Lean Manufacturing, Kaizen events, and Six Sigma practices are helping APO deliver a new space transportation capability on time and within budget, while still meeting stringent technical requirements. For example, Lean philosophies have been applied to numerous process definition efforts and existing process improvement activities, including the Ares I-X test flight Certificate of Flight Readiness (CoFR) process, risk management process, and review board organization and processes. Ares executives learned Lean practices firsthand, making the team "smart buyers" during proposal reviews and instilling the team with a sense of what is meant by "value-added" activities. Since the goal of the APO is to field launch vehicles at a reasonable cost and on an ambitious schedule, adopting Lean philosophies and practices will be crucial to the Ares Project's long-term SUCCESS.

  6. Commercial launch systems: A risky investment?

    Science.gov (United States)

    Dupnick, Edwin; Skratt, John

    1996-03-01

    A myriad of evolutionary paths connect the current state of government-dominated space launch operations to true commercial access to space. Every potential path requires the investment of private capital sufficient to fund the commercial venture with a perceived risk/return ratio acceptable to the investors. What is the private sector willing to invest? Does government participation reduce financial risk? How viable is a commercial launch system without government participation and support? We examine the interplay between various forms of government participation in commercial launch system development, alternative launch system designs, life cycle cost estimates, and typical industry risk aversion levels. The boundaries of this n-dimensional envelope are examined with an ECON-developed business financial model which provides for the parametric assessment and interaction of SSTO design variables (including various operational scenarios with financial variables including debt/equity assumptions, and commercial enterprise burden rates on various functions. We overlay this structure with observations from previous ECON research which characterize financial risk aversion levels for selected industrial sectors in terms of acceptable initial lump-sum investments, cumulative investments, probability of failure, payback periods, and ROI. The financial model allows the construction of parametric tradeoffs based on ranges of variables which can be said to actually encompass the ``true'' cost of operations and determine what level of ``true'' costs can be tolerated by private capitalization.

  7. SMAP Post-launch Field Campaign Planning

    Science.gov (United States)

    The SMAP post-launch Cal/Val activities are intended both to assess the quality of the mission products and to support analyses that lead to their improvement. A suite of complementary methodologies will be employed that will result in a robust global assessment. Much of the work will occur in the C...

  8. Landsat Data Continuity Mission - Launch Fever

    Science.gov (United States)

    Irons, James R.; Loveland, Thomas R.; Markham, Brian L.; Masek, Jeffrey G.; Cook, Bruce; Dwyer, John L.

    2012-01-01

    The year 2013 will be an exciting period for those that study the Earth land surface from space, particularly those that observe and characterize land cover, land use, and the change of cover and use over time. Two new satellite observatories will be launched next year that will enhance capabilities for observing the global land surface. The United States plans to launch the Landsat Data Continuity Mission (LDCM) in January. That event will be followed later in the year by the European Space Agency (ESA) launch of the first Sentinel 2 satellite. Considered together, the two satellites will increase the frequency of opportunities for viewing the land surface at a scale where human impact and influence can be differentiated from natural change. Data from the two satellites will provide images for similar spectral bands and for comparable spatial resolutions with rigorous attention to calibration that will facilitate cross comparisons. This presentation will provide an overview of the LDCM satellite system and report its readiness for the January launch.

  9. Lunar landing and launch facilities and operations

    Science.gov (United States)

    1988-01-01

    A preliminary design of a lunar landing and launch facility for a Phase 3 lunar base is formulated. A single multipurpose vehicle for the lunar module is assumed. Three traffic levels are envisioned: 6, 12, and 24 landings/launches per year. The facility is broken down into nine major design items. A conceptual description of each of these items is included. Preliminary sizes, capacities, and/or other relevant design data for some of these items are obtained. A quonset hut tent-like structure constructed of aluminum rods and aluminized mylar panels is proposed. This structure is used to provide a constant thermal environment for the lunar modules. A structural design and thermal analysis is presented. Two independent designs for a bridge crane to unload/load heavy cargo from the lunar module are included. Preliminary investigations into cryogenic propellant storage and handling, landing/launch guidance and control, and lunar module maintenance requirements are performed. Also, an initial study into advanced concepts for application to Phase 4 or 5 lunar bases has been completed in a report on capturing, condensing, and recycling the exhaust plume from a lunar launch.

  10. Launch and Recovery System Literature Review

    Science.gov (United States)

    2010-12-01

    water. Goldie [21] suggests a sled or cart recovery system for use with UAV’s on the Littoral Combatant Ship (LCS) and other small deck navy ships...21. Goldie , J., “A Recovery System for Unmanned Aerial Vehicles (UAVs) Aboard LCS and other Small-Deck Navy Ships,” ASNE Launch and Recovery of

  11. Air loads on solar panels during launch

    NARCIS (Netherlands)

    Beltman, W.M.; van der Hoogt, Peter; Spiering, R.M.E.J.; Tijdeman, H.

    1996-01-01

    The dynamical behaviour of solar panels during launch is significantly affected by the thin layers of air trapped between the panels. For narrow gaps the air manifests itself not only as a considerable added mass, but its viscosity can result in a substantial amount of damping. A model has been

  12. The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: a quasi-experimental study.

    Science.gov (United States)

    Chiang, Li-Chi; Chen, Wan-Chou; Dai, Yu-Tzu; Ho, Yi-Lwun

    2012-10-01

    Telehealth care was developed to provide home-based monitoring and support for patients with chronic disease. The positive effects on physical outcome have been reported; however, more evidence is required concerning the effects on family caregivers and family function for heart failure patients transitioning from the hospital to home. To evaluate the effectiveness of nursing-led transitional care combining discharge plans and telehealth care on family caregiver burden, stress mastery and family function in family caregivers of heart failure patients compared to those receiving traditional discharge planning only. This is a quasi-experimental study design. Sixty-three patients with heart failure were assessed for eligibility and invited to participate in either telehealth care or standard care in a medical centre from May to October 2010. Three families refused to participate in data collection. Thirty families who chose telehealth care after discharge from the hospital to home comprised the experimental group; the others families receiving discharge planning only comprised the comparison group. Telenursing specialist provided the necessary family nursing interventions by 24-h remote monitoring of patients' health condition and counselling by telephone, helping the family caregivers successfully transition from hospital to home. Data on caregiver burden, stress mastery and family function were collected before discharge from the hospital and one month later at home. Effects of group, time, and group×time interaction were analysed using Mixed Model in SPSS (17.0). Family caregivers in both groups had significantly lower burden, higher stress mastery, and better family function at one-month follow-up compared to before discharge. The total score of caregiver burden, stress mastery and family function was significantly improved for the family caregivers in the experimental group compared to the comparison group at posttest. Two subscales of family function

  13. The Launch Systems Operations Cost Model

    Science.gov (United States)

    Prince, Frank A.; Hamaker, Joseph W. (Technical Monitor)

    2001-01-01

    One of NASA's primary missions is to reduce the cost of access to space while simultaneously increasing safety. A key component, and one of the least understood, is the recurring operations and support cost for reusable launch systems. In order to predict these costs, NASA, under the leadership of the Independent Program Assessment Office (IPAO), has commissioned the development of a Launch Systems Operations Cost Model (LSOCM). LSOCM is a tool to predict the operations & support (O&S) cost of new and modified reusable (and partially reusable) launch systems. The requirements are to predict the non-recurring cost for the ground infrastructure and the recurring cost of maintaining that infrastructure, performing vehicle logistics, and performing the O&S actions to return the vehicle to flight. In addition, the model must estimate the time required to cycle the vehicle through all of the ground processing activities. The current version of LSOCM is an amalgamation of existing tools, leveraging our understanding of shuttle operations cost with a means of predicting how the maintenance burden will change as the vehicle becomes more aircraft like. The use of the Conceptual Operations Manpower Estimating Tool/Operations Cost Model (COMET/OCM) provides a solid point of departure based on shuttle and expendable launch vehicle (ELV) experience. The incorporation of the Reliability and Maintainability Analysis Tool (RMAT) as expressed by a set of response surface model equations gives a method for estimating how changing launch system characteristics affects cost and cycle time as compared to today's shuttle system. Plans are being made to improve the model. The development team will be spending the next few months devising a structured methodology that will enable verified and validated algorithms to give accurate cost estimates. To assist in this endeavor the LSOCM team is part of an Agency wide effort to combine resources with other cost and operations professionals to

  14. Launching a world-class joint venture.

    Science.gov (United States)

    Bamford, James; Ernst, David; Fubini, David G

    2004-02-01

    More than 5,000 joint ventures, and many more contractual alliances, have been launched worldwide in the past five years. Companies are realizing that JVs and alliances can be lucrative vehicles for developing new products, moving into new markets, and increasing revenues. The problem is, the success rate for JVs and alliances is on a par with that for mergers and acquisitions--which is to say not very good. The authors, all McKinsey consultants, argue that JV success remains elusive for most companies because they don't pay enough attention to launch planning and execution. Most companies are highly disciplined about integrating the companies they target through M&A, but they rarely commit sufficient resources to launching similarly sized joint ventures or alliances. As a result, the parent companies experience strategic conflicts, governance gridlock, and missed operational synergies. Often, they walk away from the deal. The launch phase begins with the parent companies' signing of a memorandum of understanding and continues through the first 100 days of the JV or alliance's operation. During this period, it's critical for the parents to convene a team dedicated to exposing inherent tensions early. Specifically, the launch team must tackle four basic challenges. First, build and maintain strategic alignment across the separate corporate entities, each of which has its own goals, market pressures, and shareholders. Second, create a shared governance system for the two parent companies. Third, manage the economic interdependencies between the corporate parents and the JV. And fourth, build a cohesive, high-performing organization (the JV or alliance)--not a simple task, since most managers come from, will want to return to, and may even hold simultaneous positions in the parent companies. Using real-world examples, the authors offer their suggestions for meeting these challenges.

  15. Throttleable GOX/ABS launch assist hybrid rocket motor for small scale air launch platform

    Science.gov (United States)

    Spurrier, Zachary S.

    Aircraft-based space-launch platforms allow operational flexibility and offer the potential for significant propellant savings for small-to-medium orbital payloads. The NASA Armstrong Flight Research Center's Towed Glider Air-Launch System (TGALS) is a small-scale flight research project investigating the feasibility for a remotely-piloted, towed, glider system to act as a versatile air launch platform for nano-scale satellites. Removing the crew from the launch vehicle means that the system does not have to be human rated, and offers a potential for considerable cost savings. Utah State University is developing a small throttled launch-assist system for the TGALS platform. This "stage zero" design allows the TGALS platform to achieve the required flight path angle for the launch point, a condition that the TGALS cannot achieve without external propulsion. Throttling is required in order to achieve and sustain the proper launch attitude without structurally overloading the airframe. The hybrid rocket system employs gaseous-oxygen and acrylonitrile butadiene styrene (ABS) as propellants. This thesis summarizes the development and testing campaign, and presents results from the clean-sheet design through ground-based static fire testing. Development of the closed-loop throttle control system is presented.

  16. A Low-Cost Launch Assistance System for Orbital Launch Vehicles

    Directory of Open Access Journals (Sweden)

    Oleg Nizhnik

    2012-01-01

    Full Text Available The author reviews the state of art of nonrocket launch assistance systems (LASs for spaceflight focusing on air launch options. The author proposes an alternative technologically feasible LAS based on a combination of approaches: air launch, high-altitude balloon, and tethered LAS. Proposed LAS can be implemented with the existing off-the-shelf hardware delivering 7 kg to low-earth orbit for the 5200 USD per kg. Proposed design can deliver larger reduction in price and larger orbital payloads with the future advances in the aerostats, ropes, electrical motors, and terrestrial power networks.

  17. Management Challenges of Launching Multiple Payloads for Multiple Customers

    OpenAIRE

    Callen, Dave

    1999-01-01

    Orbital has provided launch services for multiple satellites as a means to provide greater economy for access to space. These include satellites from NASA, 000, commercial companies, universities, and foreign governments. While satellite customers view shared launches as a means to achieve reduced launch costs, this approach adds many complexities that a traditional launch service provider does not have to address for a dedicated launch. This paper will discuss some of the challenges associat...

  18. Hail Disrometer Array for Launch Systems Support

    Science.gov (United States)

    Lane, John E.; Sharp, David W.; Kasparis, Takis C.; Doesken, Nolan J.

    2008-01-01

    Prior to launch, the space shuttle might be described as a very large thermos bottle containing substantial quantities of cryogenic fuels. Because thermal insulation is a critical design requirement, the external wall of the launch vehicle fuel tank is covered with an insulating foam layer. This foam is fragile and can be damaged by very minor impacts, such as that from small- to medium-size hail, which may go unnoticed. In May 1999, hail damage to the top of the External Tank (ET) of STS-96 required a rollback from the launch pad to the Vehicle Assembly Building (VAB) for repair of the insulating foam. Because of the potential for hail damage to the ET while exposed to the weather, a vigilant hail sentry system using impact transducers was developed as a hail damage warning system and to record and quantify hail events. The Kennedy Space Center (KSC) Hail Monitor System, a joint effort of the NASA and University Affiliated Spaceport Technology Development Contract (USTDC) Physics Labs, was first deployed for operational testing in the fall of 2006. Volunteers from the Community Collaborative Rain. Hail, and Snow Network (CoCoRaHS) in conjunction with Colorado State University were and continue to be active in testing duplicate hail monitor systems at sites in the hail prone high plains of Colorado. The KSC Hail Monitor System (HMS), consisting of three stations positioned approximately 500 ft from the launch pad and forming an approximate equilateral triangle (see Figure 1), was deployed to Pad 39B for support of STS-115. Two months later, the HMS was deployed to Pad 39A for support of STS-116. During support of STS-117 in late February 2007, an unusual hail event occurred in the immediate vicinity of the exposed space shuttle and launch pad. Hail data of this event was collected by the HMS and analyzed. Support of STS-118 revealed another important application of the hail monitor system. Ground Instrumentation personnel check the hail monitors daily when a

  19. Reusable launch vehicle facts and fantasies

    Science.gov (United States)

    Kaplan, Marshall H.

    2002-01-01

    Many people refuse to address many of the realities of reusable launch vehicle systems, technologies, operations and economics. Basic principles of physics, space flight operations, and business limitations are applied to the creation of a practical vision of future expectations. While reusable launcher concepts have been proposed for several decades, serious review of potential designs began in the mid-1990s, when NASA decided that a Space Shuttle replacement had to be pursued. A great deal of excitement and interest was quickly generated by the prospect of ``orders-of-magnitude'' reduction in launch costs. The potential for a vastly expanded space program motivated the entire space community. By the late-1990s, and after over one billion dollars were spent on the technology development and privately-funded concepts, it had become clear that there would be no new, near-term operational reusable vehicle. Many factors contributed to a very expensive and disappointing effort to create a new generation of launch vehicles. It began with overly optimistic projections of technology advancements and the belief that a greatly increased demand for satellite launches would be realized early in the 21st century. Contractors contributed to the perception of quickly reachable technology and business goals, thus, accelerating the enthusiasm and helping to create a ``gold rush'' euphoria. Cost, schedule and performance margins were all highly optimistic. Several entrepreneurs launched start up companies to take advantage of the excitement and the availability of investor capital. Millions were raised from private investors and venture capitalists, based on little more than flashy presentations and animations. Well over $500 million were raised by little-known start up groups to create reusable systems, which might complete for the coming market in launch services. By 1999, it was clear that market projections, made just two years earlier, were not going to be realized. Investors

  20. NASA's Space Launch System Development Status

    Science.gov (United States)

    Lyles, Garry

    2014-01-01

    Development of the National Aeronautics and Space Administration's (NASA's) Space Launch System (SLS) heavy lift rocket is shifting from the formulation phase into the implementation phase in 2014, a little more than 3 years after formal program establishment. Current development is focused on delivering a vehicle capable of launching 70 metric tons (t) into low Earth orbit. This "Block 1" configuration will launch the Orion Multi-Purpose Crew Vehicle (MPCV) on its first autonomous flight beyond the Moon and back in December 2017, followed by its first crewed flight in 2021. SLS can evolve to a130t lift capability and serve as a baseline for numerous robotic and human missions ranging from a Mars sample return to delivering the first astronauts to explore another planet. Benefits associated with its unprecedented mass and volume include reduced trip times and simplified payload design. Every SLS element achieved significant, tangible progress over the past year. Among the Program's many accomplishments are: manufacture of core stage test barrels and domes; testing of Solid Rocket Booster development hardware including thrust vector controls and avionics; planning for RS- 25 core stage engine testing; and more than 4,000 wind tunnel runs to refine vehicle configuration, trajectory, and guidance. The Program shipped its first flight hardware - the Multi-Purpose Crew Vehicle Stage Adapter (MSA) - to the United Launch Alliance for integration with the Delta IV heavy rocket that will launch an Orion test article in 2014 from NASA's Kennedy Space Center. The Program successfully completed Preliminary Design Review in 2013 and will complete Key Decision Point C in 2014. NASA has authorized the Program to move forward to Critical Design Review, scheduled for 2015 and a December 2017 first launch. The Program's success to date is due to prudent use of proven technology, infrastructure, and workforce from the Saturn and Space Shuttle programs, a streamlined management

  1. Carbon Dioxide, Hydrographic, and Chemical Data Obtained During the R/V Thomas G. Thompson Cruise in the Pacific Ocean; TOPICAL

    International Nuclear Information System (INIS)

    Sabine, C.L.; Key, R.M.; Hall, M.; Kozyr, A.

    1999-01-01

    This data documentation discusses the procedures and methods used to measure total carbon dioxide (TCO2), total alkalinity (TALK), and radiocarbon (delta 14C), at hydrographic stations, as well as the underway partial pressure of CO2 (pCO2) during the R/V Thomas G. Thompson oceanographic cruise in the Pacific Ocean (Section P10). Conducted as part of the World Ocean Circulation Experiment (WOCE), the cruise began in Suva, Fiji, on October 5, 1993, and ended in Yokohama, Japan, on November 10, 1993. Measurements made along WOCE Section P10 included pressure, temperature, salinity[measured by conductivity temperature, and depth sensor (CTD)], bottle salinity, bottle oxygen, phosphate, nitrate, silicate, chlorofluorocarbons (CFC-11, CFC-12), TCO2, TALK, delta 14C, and underway pCO2

  2. Cloud amount/frequency, NITRATE and other data from THOMAS G. THOMPSON in the TOGA Area - Pacific from 1985-03-30 to 1985-06-03 (NODC Accession 9100164)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The data Trans-Pacific Section 24 Bottle data in this accession was collected in th TOGA Area - Pacific (30 N to 30 S) in 1984 using ship THOMAS G. THOMPSON. The...

  3. The worldwide growth of launch vehicle technology and services : Quarterly Launch Report : special report

    Science.gov (United States)

    1997-01-01

    This report will discuss primarily those vehicles being introduced by the newly emerging space nations. India, Israel, and Brazil are all trying to turn launch vehicle assets into profitable businesses. In this effort, they have found the technologic...

  4. NASA's Launch Propulsion Systems Technology Roadmap

    Science.gov (United States)

    McConnaughey, Paul K.; Femminineo, Mark G.; Koelfgen, Syri J.; Lepsch, Roger A; Ryan, Richard M.; Taylor, Steven A.

    2012-01-01

    Safe, reliable, and affordable access to low-Earth (LEO) orbit is necessary for all of the United States (US) space endeavors. In 2010, NASA s Office of the Chief Technologist commissioned 14 teams to develop technology roadmaps that could be used to guide the Agency s and US technology investment decisions for the next few decades. The Launch Propulsion Systems Technology Area (LPSTA) team was tasked to address the propulsion technology challenges for access to LEO. The developed LPSTA roadmap addresses technologies that enhance existing solid or liquid propulsion technologies and their related ancillary systems or significantly advance the technology readiness level (TRL) of less mature systems like airbreathing, unconventional, and other launch technologies. In developing this roadmap, the LPSTA team consulted previous NASA, military, and industry studies as well as subject matter experts to develop their assessment of this field, which has fundamental technological and strategic impacts for US space capabilities.

  5. A perfect launch viewed across Banana Creek

    Science.gov (United States)

    2000-01-01

    Billows of smoke and steam surround Space Shuttle Discovery as it lifts off from Launch Pad 39A on mission STS-92 to the International Space Station. The perfect on-time liftoff occurred at 7:17 p.m. EDT, sending a crew of seven on the 100th launch in the history of the Shuttle program. Discovery carries a payload that includes the Integrated Truss Structure Z-1, first of 10 trusses that will form the backbone of the Space Station, and the third Pressurized Mating Adapter that will provide a Shuttle docking port for solar array installation on the sixth Station flight and Lab installation on the seventh Station flight. Discovery's landing is expected Oct. 22 at 2:10 p.m. EDT.

  6. Performance Efficient Launch Vehicle Recovery and Reuse

    Science.gov (United States)

    Reed, John G.; Ragab, Mohamed M.; Cheatwood, F. McNeil; Hughes, Stephen J.; Dinonno, J.; Bodkin, R.; Lowry, Allen; Brierly, Gregory T.; Kelly, John W.

    2016-01-01

    For decades, economic reuse of launch vehicles has been an elusive goal. Recent attempts at demonstrating elements of launch vehicle recovery for reuse have invigorated a debate over the merits of different approaches. The parameter most often used to assess the cost of access to space is dollars-per-kilogram to orbit. When comparing reusable vs. expendable launch vehicles, that ratio has been shown to be most sensitive to the performance lost as a result of enabling the reusability. This paper will briefly review the historical background and results of recent attempts to recover launch vehicle assets for reuse. The business case for reuse will be reviewed, with emphasis on the performance expended to recover those assets, and the practicality of the most ambitious reuse concept, namely propulsive return to the launch site. In 2015, United Launch Alliance (ULA) announced its Sensible, Modular, Autonomous Return Technology (SMART) reuse plan for recovery of the booster module for its new Vulcan launch vehicle. That plan employs a non-propulsive approach where atmospheric entry, descent and landing (EDL) technologies are utilized. Elements of such a system have a wide variety of applications, from recovery of launch vehicle elements in suborbital trajectories all the way to human space exploration. This paper will include an update on ULA's booster module recovery approach, which relies on Hypersonic Inflatable Aerodynamic Decelerator (HIAD) and Mid-Air Retrieval (MAR) technologies, including its concept of operations (ConOps). The HIAD design, as well as parafoil staging and MAR concepts, will be discussed. Recent HIAD development activities and near term plans including scalability, next generation materials for the inflatable structure and heat shield, and gas generator inflation systems will be provided. MAR topics will include the ConOps for recovery, helicopter selection and staging, and the state of the art of parachute recovery systems using large parafoils

  7. Resonant mode controllers for launch vehicle applications

    Science.gov (United States)

    Schreiner, Ken E.; Roth, Mary Ellen

    1992-01-01

    Electro-mechanical actuator (EMA) systems are currently being investigated for the National Launch System (NLS) as a replacement for hydraulic actuators due to the large amount of manpower and support hardware required to maintain the hydraulic systems. EMA systems in weight sensitive applications, such as launch vehicles, have been limited to around 5 hp due to system size, controller efficiency, thermal management, and battery size. Presented here are design and test data for an EMA system that competes favorably in weight and is superior in maintainability to the hydraulic system. An EMA system uses dc power provided by a high energy density bipolar lithium thionyl chloride battery, with power conversion performed by low loss resonant topologies, and a high efficiency induction motor controlled with a high performance field oriented controller to drive a linear actuator.

  8. Evolution of the Florida Launch Site Architecture: Embracing Multiple Customers, Enhancing Launch Opportunities

    Science.gov (United States)

    Colloredo, Scott; Gray, James A.

    2011-01-01

    The impending conclusion of the Space Shuttle Program and the Constellation Program cancellation unveiled in the FY2011 President's budget created a large void for human spaceflight capability and specifically launch activity from the Florida launch Site (FlS). This void created an opportunity to re-architect the launch site to be more accommodating to the future NASA heavy lift and commercial space industry. The goal is to evolve the heritage capabilities into a more affordable and flexible launch complex. This case study will discuss the FlS architecture evolution from the trade studies to select primary launch site locations for future customers, to improving infrastructure; promoting environmental remediation/compliance; improving offline processing, manufacturing, & recovery; developing range interface and control services with the US Air Force, and developing modernization efforts for the launch Pad, Vehicle Assembly Building, Mobile launcher, and supporting infrastructure. The architecture studies will steer how to best invest limited modernization funding from initiatives like the 21 st elSe and other potential funding.

  9. The reusable launch vehicle technology program

    Science.gov (United States)

    Cook, S.

    1995-01-01

    Today's launch systems have major shortcomings that will increase in significance in the future, and thus are principal drivers for seeking major improvements in space transportation. They are too costly; insufficiently reliable, safe, and operable; and increasingly losing market share to international competition. For the United States to continue its leadership in the human exploration and wide ranging utilization of space, the first order of business must be to achieve low cost, reliable transportatin to Earth orbit. NASA's Access to Space Study, in 1993, recommended the development of a fully reusable single-stage-to-orbit (SSTO) rocket vehicle as an Agency goal. The goal of the Reusable Launch Vehicle (RLV) technology program is to mature the technologies essential for a next-generation reusable launch system capable of reliably serving National space transportation needs at substantially reduced costs. The primary objectives of the RLV technology program are to (1) mature the technologies required for the next-generation system, (2) demonstrate the capability to achieve low development and operational cost, and rapid launch turnaround times and (3) reduce business and technical risks to encourage significant private investment in the commercial development and operation of the next-generation system. Developing and demonstrating the technologies required for a Single Stage to Orbit (SSTO) rocket is a focus of the program becuase past studies indicate that it has the best potential for achieving the lowest space access cost while acting as an RLV technology driver (since it also encompasses the technology requirements of reusable rocket vehicles in general).

  10. National Security Space Launch at a Crossroads

    Science.gov (United States)

    2016-05-13

    appropriations measure expire (i.e., at the start of FY2017). Rocket Engines: Goods or Services37 In the Commercial Space Act of 1998 (CSA),38...procured from commercial sources or whether the government may independently develop and manufacture rocket engines. The resolution to this question may...Space Act of 1998 ...) the DoD procures commercial launch services rather than rockets or engines used in those services.”43 Notably, the view

  11. The reusable launch vehicle technology program

    Science.gov (United States)

    Cook, S.

    Today's launch systems have major shortcomings that will increase in significance in the future, and thus are principal drivers for seeking major improvements in space transportation. They are too costly; insufficiently reliable, safe, and operable; and increasingly losing market share to international competition. For the United States to continue its leadership in the human exploration and wide ranging utilization of space, the first order of business must be to achieve low cost, reliable transportatin to Earth orbit. NASA's Access to Space Study, in 1993, recommended the development of a fully reusable single-stage-to-orbit (SSTO) rocket vehicle as an Agency goal. The goal of the Reusable Launch Vehicle (RLV) technology program is to mature the technologies essential for a next-generation reusable launch system capable of reliably serving National space transportation needs at substantially reduced costs. The primary objectives of the RLV technology program are to (1) mature the technologies required for the next-generation system, (2) demonstrate the capability to achieve low development and operational cost, and rapid launch turnaround times and (3) reduce business and technical risks to encourage significant private investment in the commercial development and operation of the next-generation system. Developing and demonstrating the technologies required for a Single Stage to Orbit (SSTO) rocket is a focus of the program becuase past studies indicate that it has the best potential for achieving the lowest space access cost while acting as an RLV technology driver (since it also encompasses the technology requirements of reusable rocket vehicles in general).

  12. Ares Launch Vehicles Lean Practices Case Study

    Science.gov (United States)

    Doreswamy, Rajiv, N.; Self, Timothy A.

    2008-01-01

    This viewgraph presentation describes test strategies and lean philisophies and practices that are applied to Ares Launch Vehicles. The topics include: 1) Testing strategy; 2) Lean Practices in Ares I-X; 3) Lean Practices Applied to Ares I-X Schedule; 4) Lean Event Results; 5) Lean, Six Sigma, and Kaizen Practices in the Ares Projects Office; 6) Lean and Kaizen Success Stories; and 7) Ares Six Sigma Practices.

  13. Textile materials trading center formally launched online

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Textile materials trading center was formally launched online in Wuxi City,Jiangsu Province. This is the first third-party electronic trading platform for spot trading in China textile materials professional market. The project will strive to build the most influential textile materials trading center of East China,the whole country and even the whole world China textile materials trading center will be

  14. Nuclear safety review requirements for launch approval

    International Nuclear Information System (INIS)

    Sholtis, J.A. Jr.; Winchester, R.O.

    1992-01-01

    Use of nuclear power systems in space requires approval which is preceded by extensive safety analysis and review. This careful study allows an informed risk-benefit decision at the highest level of our government. This paper describes the process as it has historically been applied to U.S. isotopic power systems. The Ulysses mission, launched in October 1990, is used to illustrate the process. Expected variations to deal with reactor-power systems are explained

  15. NASA's Space Launch System Takes Shape

    Science.gov (United States)

    Askins, Bruce; Robinson, Kimberly F.

    2017-01-01

    Major hardware and software for NASA's Space Launch System (SLS) began rolling off assembly lines in 2016, setting the stage for critical testing in 2017 and the launch of a major new capability for deep space human exploration. SLS continues to pursue a 2018 first launch of Exploration Mission 1 (EM-1). At NASA's Michoud Assembly Facility near New Orleans, LA, Boeing completed welding of structural test and flight liquid hydrogen tanks, and engine sections. Test stands for core stage structural tests at NASA's Marshall Space Flight Center, Huntsville, AL. neared completion. The B2 test stand at NASA's Stennis Space Center, MS, completed major structural renovation to support core stage green run testing in 2018. Orbital ATK successfully test fired its second qualification solid rocket motor in the Utah desert and began casting the motor segments for EM-1. Aerojet Rocketdyne completed its series of test firings to adapt the heritage RS-25 engine to SLS performance requirements. Production is under way on the first five new engine controllers. NASA also signed a contract with Aerojet Rocketdyne for propulsion of the RL10 engines for the Exploration Upper Stage. United Launch Alliance delivered the structural test article for the Interim Cryogenic Propulsion Stage to MSFC for tests and construction was under way on the flight stage. Flight software testing at MSFC, including power quality and command and data handling, was completed. Substantial progress is planned for 2017. Liquid oxygen tank production will be completed at Michoud. Structural testing at Marshall will get under way. RS-25 hotfire testing will verify the new engine controllers. Core stage horizontal integration will begin. The core stage pathfinder mockup will arrive at the B2 test stand for fit checks and tests. EUS will complete preliminary design review. This paper will discuss the technical and programmatic successes and challenges of 2016 and look ahead to plans for 2017.

  16. Launching platforms for user-generated content

    OpenAIRE

    Batista, Guilherme Luís Caroço

    2015-01-01

    Field lab: Entrepreneurial and innovative ventures This paper intends to discuss and absorb the Best Practices employed by successful User- Generated Content (UGC)1 platforms and constitute a guide on how to launch a platform without having a cyclical lack of content and users. Research shows that companies have resorted to integration with mature UGC platforms, and providing content by themselves, in an initial state. I conclude that integration possibilities should be explore...

  17. Globe hosts launch of new processor

    CERN Multimedia

    2006-01-01

    Launch of the quadecore processor chip at the Globe. On 14 November, in a series of major media events around the world, the chip-maker Intel launched its new 'quadcore' processor. For the regions of Europe, the Middle East and Africa, the day-long launch event took place in CERN's Globe of Science and Innovation, with over 30 journalists in attendance, coming from as far away as Johannesburg and Dubai. CERN was a significant choice for the event: the first tests of this new generation of processor in Europe had been made at CERN over the preceding months, as part of CERN openlab, a research partnership with leading IT companies such as Intel, HP and Oracle. The event also provided the opportunity for the journalists to visit ATLAS and the CERN Computer Centre. The strategy of putting multiple processor cores on the same chip, which has been pursued by Intel and other chip-makers in the last few years, represents an important departure from the more traditional improvements in the sheer speed of such chips. ...

  18. Benefits of Government Incentives for Reusable Launch Vehicle Development

    Science.gov (United States)

    Shaw, Eric J.; Hamaker, Joseph W.; Prince, Frank A.

    1998-01-01

    Many exciting new opportunities in space, both government missions and business ventures, could be realized by a reduction in launch prices. Reusable launch vehicle (RLV) designs have the potential to lower launch costs dramatically from those of today's expendable and partially-expendable vehicles. Unfortunately, governments must budget to support existing launch capability, and so lack the resources necessary to completely fund development of new reusable systems. In addition, the new commercial space markets are too immature and uncertain to motivate the launch industry to undertake a project of this magnitude and risk. Low-cost launch vehicles will not be developed without a mature market to service; however, launch prices must be reduced in order for a commercial launch market to mature. This paper estimates and discusses the various benefits that may be reaped from government incentives for a commercial reusable launch vehicle program.

  19. CryoSat: ready to launch (again)

    Science.gov (United States)

    Francis, R.; Wingham, D.; Cullen, R.

    2009-12-01

    Over the last ten years the relationship between climate change and the cryosphere has become increasingly important. Evidence of change in the polar regions is widespread, and the subject of public discussion. During this same ten years ESA has been preparing its CryoSat mission, specifically designed to provide measurements to determine the overall change in the mass balance of all of the ice caps and of change in the volume of sea-ice (rather than simply its extent). In fact the mission was ready for launch in October 2005, but a failure in the launch vehicle led to a loss of the satellite some 6 minutes after launch. The determination to rebuild the satellite and complete the mission was widespread in the relevant scientific, industrial and political entities, and the decision to redirect financial resources to the rebuild was sealed with a scientific report confirming that the mission was even more important in 2005 than at its original selection in 1999. The evolution of the cryosphere since then has emphasised that conclusion. In order to make a meaningful measurement of the secular change of the surface legation of ice caps and the thickness of sea-ice, the accuracy required has been specified as about half of the variation expected due to natural variability, over reasonable scales for the surfaces concerned. The selected technique is radar altimetry. Previous altimeter missions have pioneered the method: the CryoSat instrument has been modified to provide the enhanced capabilities needed to significantly extend the spatial coverage of these earlier missions. Thus the radar includes a synthetic aperture mode which enables the along-track resolution to be improved to about 250 m. This will will allow detection of leads in sea-ice which are narrower than those detected hitherto, so that operation deeper into pack-ice can be achieved with a consequent reduction in errors due to omission. Altimetry over the steep edges of ice caps is hampered by the irregular

  20. Launch Pad Coatings for Smart Corrosion Control

    Science.gov (United States)

    Calle, Luz M.; Hintze, Paul E.; Bucherl, Cori N.; Li, Wenyan; Buhrow, Jerry W.; Curran, Jerome P.; Whitten, Mary C.

    2010-01-01

    Corrosion is the degradation of a material as a result of its interaction with the environment. The environment at the KSC launch pads has been documented by ASM International (formerly American Society for Metals) as the most corrosive in the US. The 70 tons of highly corrosive hydrochloric acid that are generated by the solid rocket boosters during a launch exacerbate the corrosiveness of the environment at the pads. Numerous failures at the pads are caused by the pitting of stainless steels, rebar corrosion, and the degradation of concrete. Corrosion control of launch pad structures relies on the use of coatings selected from the qualified products list (QPL) of the NASA Standard 5008A for Protective Coating of Carbon Steel, Stainless Steel, and Aluminum on Launch Structures, Facilities, and Ground Support Equipment. This standard was developed to establish uniform engineering practices and methods and to ensure the inclusion of essential criteria in the coating of ground support equipment (GSE) and facilities used by or for NASA. This standard is applicable to GSE and facilities that support space vehicle or payload programs or projects and to critical facilities at all NASA locations worldwide. Environmental regulation changes have dramatically reduced the production, handling, use, and availability of conventional protective coatings for application to KSC launch structures and ground support equipment. Current attrition rate of qualified KSC coatings will drastically limit the number of commercial off the shelf (COTS) products available for the Constellation Program (CxP) ground operations (GO). CxP GO identified corrosion detection and control technologies as a critical, initial capability technology need for ground processing of Ares I and Ares V to meet Constellation Architecture Requirements Document (CARD) CxP 70000 operability requirements for reduced ground processing complexity, streamlined integrated testing, and operations phase affordability

  1. Ares Launch Vehicles Overview: Space Access Society

    Science.gov (United States)

    Cook, Steve

    2007-01-01

    America is returning to the Moon in preparation for the first human footprint on Mars, guided by the U.S. Vision for Space Exploration. This presentation will discuss NASA's mission, the reasons for returning to the Moon and going to Mars, and how NASA will accomplish that mission in ways that promote leadership in space and economic expansion on the new frontier. The primary goals of the Vision for Space Exploration are to finish the International Space Station, retire the Space Shuttle, and build the new spacecraft needed to return people to the Moon and go to Mars. The Vision commits NASA and the nation to an agenda of exploration that also includes robotic exploration and technology development, while building on lessons learned over 50 years of hard-won experience. NASA is building on common hardware, shared knowledge, and unique experience derived from the Apollo Saturn, Space Shuttle, and contemporary commercial launch vehicle programs. The journeys to the Moon and Mars will require a variety of vehicles, including the Ares I Crew Launch Vehicle, which transports the Orion Crew Exploration Vehicle, and the Ares V Cargo Launch Vehicle, which transports the Lunar Surface Access Module. The architecture for the lunar missions will use one launch to ferry the crew into orbit, where it will rendezvous with the Lunar Module in the Earth Departure Stage, which will then propel the combination into lunar orbit. The imperative to explore space with the combination of astronauts and robots will be the impetus for inventions such as solar power and water and waste recycling. This next chapter in NASA's history promises to write the next chapter in American history, as well. It will require this nation to provide the talent to develop tools, machines, materials, processes, technologies, and capabilities that can benefit nearly all aspects of life on Earth. Roles and responsibilities are shared between a nationwide Government and industry team. The Exploration Launch

  2. Launching to the Moon, Mars, and Beyond

    Science.gov (United States)

    Sumrall, John P.

    2007-01-01

    America is returning to the Moon in preparation for the first human footprint on Mars, guided by the U.S. Vision for Space Exploration. This presentation will discuss NASA's mission today, the reasons for returning to the Moon and going to Mars, and how NASA will accomplish that mission. The primary goals of the Vision for Space Exploration are to finish the International Space Station, retire the Space Shuttle, and build the new spacecraft needed to return people to the Moon and go to Mars. Unlike the Apollo program of the 1960s, this phase of exploration will be a journey, not a race. In 1966, the NASA's budget was 4 percent of federal spending. Today, with 6/10 of 1 percent of the budget, NASA must incrementally develop the vehicles, infrastructure, technology, and organization to accomplish this goal. Fortunately, our knowledge and experience are greater than they were 40 years ago. NASA's goal is a return to the Moon by 2020. The Moon is the first step to America's exploration of Mars. Many questions about the Moon's history and how its history is linked to that of Earth remain even after the brief Apollo explorations of the 1960s and 1970s. This new venture will carry more explorers to more diverse landing sites with more capable tools and equipment. The Moon also will serve as a training ground in several respects before embarking on the longer, more perilous trip to Mars. The journeys to the Moon and Mars will require a variety of vehicles, including the Ares I Crew Launch Vehicle, the Ares V Cargo Launch Vehicle, the Orion Crew Exploration Vehicle, and the Lunar Surface Access Module. The architecture for the lunar missions will use one launch to ferry the crew into orbit on the Ares I and a second launch to orbit the lunar lander and the Earth Departure Stage to send the lander and crew vehicle to the Moon. In order to reach the Moon and Mars within a lifetime and within budget, NASA is building on proven hardware and decades of experience derived from

  3. Structural Weight Estimation for Launch Vehicles

    Science.gov (United States)

    Cerro, Jeff; Martinovic, Zoran; Su, Philip; Eldred, Lloyd

    2002-01-01

    This paper describes some of the work in progress to develop automated structural weight estimation procedures within the Vehicle Analysis Branch (VAB) of the NASA Langley Research Center. One task of the VAB is to perform system studies at the conceptual and early preliminary design stages on launch vehicles and in-space transportation systems. Some examples of these studies for Earth to Orbit (ETO) systems are the Future Space Transportation System [1], Orbit On Demand Vehicle [2], Venture Star [3], and the Personnel Rescue Vehicle[4]. Structural weight calculation for launch vehicle studies can exist on several levels of fidelity. Typically historically based weight equations are used in a vehicle sizing program. Many of the studies in the vehicle analysis branch have been enhanced in terms of structural weight fraction prediction by utilizing some level of off-line structural analysis to incorporate material property, load intensity, and configuration effects which may not be captured by the historical weight equations. Modification of Mass Estimating Relationships (MER's) to assess design and technology impacts on vehicle performance are necessary to prioritize design and technology development decisions. Modern CAD/CAE software, ever increasing computational power and platform independent computer programming languages such as JAVA provide new means to create greater depth of analysis tools which can be included into the conceptual design phase of launch vehicle development. Commercial framework computing environments provide easy to program techniques which coordinate and implement the flow of data in a distributed heterogeneous computing environment. It is the intent of this paper to present a process in development at NASA LaRC for enhanced structural weight estimation using this state of the art computational power.

  4. Mary Tyler Moore Helps Launch NIH MedlinePlus Magazine

    Science.gov (United States)

    ... Issues Mary Tyler Moore Helps Launch NIH MedlinePlus Magazine Past Issues / Winter 2007 Table of Contents For ... Javascript on. Among those attending the NIH MedlinePlus magazine launch on Capitol Hill were (l-r) NIH ...

  5. Cost Comparison Of Expendable, Hybrid and Reusable Launch Vehicles

    National Research Council Canada - National Science Library

    Gstattenbauer, Greg J

    2006-01-01

    .... This comparison was accomplished using top level mass and cost estimating relations (MERs, CERs). Mass estimating relationships were correlated to existing launch system data and ongoing launch system studies...

  6. Status of NASA's Space Launch System

    Science.gov (United States)

    Honeycutt, John; Lyles, Garry

    2016-01-01

    NASA's Space Launch System (SLS) continued to make significant progress in 2015 and 2016, completing hardware and testing that brings NASA closer to a new era of deep space exploration. Programmatically, SLS completed Critical Design Review (CDR) in 2015. A team of independent reviewers concluded that the vehicle design is technically and programmatically ready to move to Design Certification Review (DCR) and launch readiness in 2018. Just five years after program start, every major element has amassed development and flight hardware and completed key tests that will lead to an accelerated pace of manufacturing and testing in 2016 and 2017. Key to SLS' rapid progress has been the use of existing technologies adapted to the new launch vehicle. The existing fleet of RS-25 engines is undergoing adaptation tests to prove it can meet SLS requirements and environments with minimal change. The four-segment shuttle-era booster has been modified and updated with a fifth propellant segment, new insulation, and new avionics. The Interim Cryogenic Upper Stage is a modified version of an existing upper stage. The first Block I SLS configuration will launch a minimum of 70 metric tons (t) of payload to low Earth orbit (LEO). The vehicle architecture has a clear evolutionary path to more than 100t and, ultimately, to 130t. Among the program's major 2015-2016 accomplishments were two booster qualification hotfire tests, a series of RS-25 adaptation hotfire tests, manufacturing of most of the major components for both core stage test articles and first flight tank, delivery of the Pegasus core stage barge, and the upper stage simulator. Renovations to the B-2 test stand for stage green run testing was completed at NASA Stennis Space Center. This year will see the completion of welding for all qualification and flight EM-1 core stage components and testing of flight avionics, completion of core stage structural test stands, casting of the EM-1 solid rocket motors, additional testing

  7. NASA Space Launch System Operations Outlook

    Science.gov (United States)

    Hefner, William Keith; Matisak, Brian P.; McElyea, Mark; Kunz, Jennifer; Weber, Philip; Cummings, Nicholas; Parsons, Jeremy

    2014-01-01

    The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center (MSFC), is working with the Ground Systems Development and Operations (GSDO) Program, based at the Kennedy Space Center (KSC), to deliver a new safe, affordable, and sustainable capability for human and scientific exploration beyond Earth's orbit (BEO). Larger than the Saturn V Moon rocket, SLS will provide 10 percent more thrust at liftoff in its initial 70 metric ton (t) configuration and 20 percent more in its evolved 130-t configuration. The primary mission of the SLS rocket will be to launch astronauts to deep space destinations in the Orion Multi- Purpose Crew Vehicle (MPCV), also in development and managed by the Johnson Space Center. Several high-priority science missions also may benefit from the increased payload volume and reduced trip times offered by this powerful, versatile rocket. Reducing the lifecycle costs for NASA's space transportation flagship will maximize the exploration and scientific discovery returned from the taxpayer's investment. To that end, decisions made during development of SLS and associated systems will impact the nation's space exploration capabilities for decades. This paper will provide an update to the operations strategy presented at SpaceOps 2012. It will focus on: 1) Preparations to streamline the processing flow and infrastructure needed to produce and launch the world's largest rocket (i.e., through incorporation and modification of proven, heritage systems into the vehicle and ground systems); 2) Implementation of a lean approach to reach-back support of hardware manufacturing, green-run testing, and launch site processing and activities; and 3) Partnering between the vehicle design and operations communities on state-of-the-art predictive operations analysis techniques. An example of innovation is testing the integrated vehicle at the processing facility in parallel, rather than

  8. Launching fast waves in large devices

    International Nuclear Information System (INIS)

    Jacquinot, J.; Bhatnagar, V.P.; Kaye, A.; Brown, T.

    1994-01-01

    Design features of JET A2-antennae including that of remote location of ceramic are outlined. These antennae are being installed in preparation for the new divertor phase of JET that will commence in 1994. The experience of antenna design gained at JET is carried forward to present an outline in blanket/shield design of an antenna for launching fast waves in ITER for heating and current drive. Further, a new wide band antenna the so called 'violin antenna' is presented that features high plasma coupling resistance in selected bands in the 20-85 MHz frequency range. (author)

  9. Combline antennas for launching traveling fast waves

    International Nuclear Information System (INIS)

    Moeller, C.P.; Gould, R.W.; Phelps, D.A.; Pinsker, R.I.

    1994-01-01

    The combline structure shows promise for launching traveling fast magnetosonic waves with adjustable n parallel (3 ≤ n parallel ≤ 6) for current drive. In this paper, the dispersion and damping properties of the combline antenna with and without a Faraday shield are given. The addition of a Faraday shield which eliminates the electrostatic coupling between current straps as well as between the straps and plasma offers the advantage of eliminating the need for the lumped capacitors which are otherwise required with this structure. The results of vacuum dispersion and damping measurements on a low power model antenna are also given. (author)

  10. NASA to launch second business communications satellite

    Science.gov (United States)

    1981-01-01

    The two stage Delta 3910 launch vehicle was chosen to place the second small business satellite (SBS-B) into a transfer orbit with an apogee of 36,619 kilometers and a perigee of 167 km, at an inclination of 27.7 degrees to Earth's equator. The firing and separation sequence and the inertial guidance system are described as well as the payload assist module. Facilities and services for tracking and control by NASA, COMSAT, Intelsat, and SBS are outlined and prelaunch operations are summarized.

  11. White certificate: how to launch the system?

    International Nuclear Information System (INIS)

    2005-01-01

    White certificates are a supple and suitable economical system for the quest of diffuse energy saving. It relies on the energy distribution networks and is complementary to other existing system (fiscality, regulation, etc). It is an open system, based on a market logics in order to make energy savings where they are the less costly. This document gathers the synthesis of the conference about white certificates, held in Paris in October 2005, the presentations (transparencies) given by J. Percebois (Creden) about the French system of energy savings and by P. Guyonnet (ATEE) about the way to launch the system of white certificates. The debate with the audience is also reported. (J.S.)

  12. Launching a Two-sided Platform

    OpenAIRE

    Solheim, Magnus Tovsen; Tovsen, Ole Kristoffer Solheim

    2017-01-01

    Two-sided platforms, such as Airbnb, Uber and eBay, have all revolutionized their industries. Despite having colossal potential, they are very difficult to launch. This is due to what s referred to as network effects, which imply that the value of the platform becomes larger as more people use it. Network effects lead to a chicken-or-egg-problem , where it is difficult to convince sellers to join if there are no buyers and vice versa, in addition to the need to reach a critical mass of users...

  13. Space Shuttle Orbiter Endeavour STS-47 Launch

    Science.gov (United States)

    1992-01-01

    A smooth countdown culminated in a picture-perfect launch as the Space Shuttle Orbiter Endeavour (STS-47) climbed skyward atop a ladder of billowing smoke on September 12, 1992. The primary payload for the plarned seven-day flight was the Spacelab-J science laboratory. The second flight of Endeavour marks a number of historic firsts: the first space flight of an African-American woman, the first Japanese citizen to fly on a Space Shuttle, and the first married couple to fly in space.

  14. Effect of Contract Compliance Rate to a Fourth-Generation Telehealth Program on the Risk of Hospitalization in Patients With Chronic Kidney Disease: Retrospective Cohort Study.

    Science.gov (United States)

    Hung, Chi-Sheng; Lee, Jenkuang; Chen, Ying-Hsien; Huang, Ching-Chang; Wu, Vin-Cent; Wu, Hui-Wen; Chuang, Pao-Yu; Ho, Yi-Lwun

    2018-01-24

    Chronic kidney disease (CKD) is prevalent in Taiwan and it is associated with high all-cause mortality. We have shown in a previous paper that a fourth-generation telehealth program is associated with lower all-cause mortality compared to usual care with a hazard ratio of 0.866 (95% CI 0.837-0.896). This study aimed to evaluate the effect of renal function status on hospitalization among patients receiving this program and to evaluate the relationship between contract compliance rate to the program and risk of hospitalization in patients with CKD. We retrospectively analyzed 715 patients receiving the telehealth care program. Contract compliance rate was defined as the percentage of days covered by the telehealth service before hospitalization. Patients were stratified into three groups according to renal function status: (1) normal renal function, (2) CKD, or (3) end-stage renal disease (ESRD) and on maintenance dialysis. The outcome measurements were first cardiovascular and all-cause hospitalizations. The association between contract compliance rate, renal function status, and hospitalization risk was analyzed with a Cox proportional hazards model with time-dependent covariates. The median follow-up duration was 694 days (IQR 338-1163). Contract compliance rate had a triphasic relationship with cardiovascular and all-cause hospitalizations. Patients with low or very high contract compliance rates were associated with a higher risk of hospitalization. Patients with CKD or ESRD were also associated with a higher risk of hospitalization. Moreover, we observed a significant interaction between the effects of renal function status and contract compliance rate on the risk of hospitalization: patients with ESRD, who were on dialysis, had an increased risk of hospitalization at a lower contract compliance rate, compared with patients with normal renal function or CKD. Our study showed that there was a triphasic relationship between contract compliance rate to the

  15. Popular NREL-Developed Transportation Mobile App Launches on Android

    Science.gov (United States)

    Platform | News | NREL Popular NREL-Developed Transportation Mobile App Launches on Android Platform Popular NREL-Developed Transportation Mobile App Launches on Android Platform May 23, 2017 More since the new Android version of the Alternative Fueling Station Locator App launched last week. The U.S

  16. The launch of new-look Chishango.

    Science.gov (United States)

    Chavasse, D

    2002-09-01

    PSI/Malawi is a local affiliate of the non-profit NGO, Population Services International, which operates in over 50 countries worldwide. PSI/Malawi's mission is to "improve and sustain the health of all Malawians through cost-effective social marketing of needed and affordable health products". In this context, social marketing involves using a range of media channels to create demand for branded health products which are sold at subsidised prices through a wide range of distribution outlets (e.g. wholesalers/retailers, institutions, NGOs, the workplace, etc.). Chishango is PSI/Malawi's condom brand which was launched in 1994 to provide sexually active Malawians with an affordable means of protecting themselves and their partners from HIV transmission. In 2001, research indicated that the brand needed a 'face lift' to improve its relevance to modern Malawians and therefore lead to an increase in consistent condom use resulting in a further reduction in HIV transmission. The newly packaged and positioned Chishango was launched on the 13th May 2002. The speech below was given by the Resident Director of PSI/Malawi, Dr Desmond Chavasse at the relaunch of Chishango.

  17. Next Generation Launch Technology Program Lessons Learned

    Science.gov (United States)

    Cook, Stephen; Tyson, Richard

    2005-01-01

    In November 2002, NASA revised its Integrated Space Transportation Plan (ISTP) to evolve the Space Launch Initiative (SLI) to serve as a theme for two emerging programs. The first of these, the Orbital Space Plane (OSP), was intended to provide crew-escape and crew-transfer functions for the ISS. The second, the NGLT Program, developed technologies needed for safe, routine space access for scientific exploration, commerce, and national defense. The NGLT Program was comprised of 12 projects, ranging from fundamental high-temperature materials research to full-scale engine system developments (turbine and rocket) to scramjet flight test. The Program included technology advancement activities with a broad range of objectives, ultimate applications/timeframes, and technology maturity levels. An over-arching Systems Engineering and Analysis (SE&A) approach was employed to focus technology advancements according to a common set of requirements. Investments were categorized into three segments of technology maturation: propulsion technologies, launch systems technologies, and SE&A.

  18. Reaction Control Engine for Space Launch Initiative

    Science.gov (United States)

    2002-01-01

    Engineers at the Marshall Space Flight Center (MSFC) have begun a series of engine tests on a new breed of space propulsion: a Reaction Control Engine developed for the Space Launch Initiative (SLI). The engine, developed by TRW Space and Electronics of Redondo Beach, California, is an auxiliary propulsion engine designed to maneuver vehicles in orbit. It is used for docking, reentry, attitude control, and fine-pointing while the vehicle is in orbit. The engine uses nontoxic chemicals as propellants, a feature that creates a safer environment for ground operators, lowers cost, and increases efficiency with less maintenance and quicker turnaround time between missions. Testing includes 30 hot-firings. This photograph shows the first engine test performed at MSFC that includes SLI technology. Another unique feature of the Reaction Control Engine is that it operates at dual thrust modes, combining two engine functions into one engine. The engine operates at both 25 and 1,000 pounds of force, reducing overall propulsion weight and allowing vehicles to easily maneuver in space. The low-level thrust of 25 pounds of force allows the vehicle to fine-point maneuver and dock while the high-level thrust of 1,000 pounds of force is used for reentry, orbit transfer, and coarse positioning. SLI is a NASA-wide research and development program, managed by the MSFC, designed to improve safety, reliability, and cost effectiveness of space travel for second generation reusable launch vehicles.

  19. Launching to the Moon, Mars, and Beyond

    Science.gov (United States)

    Dumbacher, Daniel L.

    2006-01-01

    The U.S. Vision for Space Exploration, announced in 2004, calls on NASA to finish constructing the International Space Station, retire the Space Shuttle, and build the new spacecraft needed to return to the Moon and go on the Mars. By exploring space, America continues the tradition of great nations who mastered the Earth, air, and sea, and who then enjoyed the benefits of increased commerce and technological advances. The progress being made today is part of the next chapter in America's history of leadership in space. In order to reach the Moon and Mars within the planned timeline and also within the allowable budget, NASA is building upon the best of proven space transportation systems. Journeys to the Moon and Mars will require a variety of vehicles, including the Ares I Crew Launch Vehicle, the Ares V Cargo Launch Vehicle, the Orion Crew Exploration Vehicle, and the Lunar Surface Access Module. What America learns in reaching for the Moon will teach astronauts how to prepare for the first human footprints on Mars. While robotic science may reveal information about the nature of hydrogen on the Moon, it will most likely tale a human being with a rock hammer to find the real truth about the presence of water, a precious natural resource that opens many possibilities for explorers. In this way, the combination of astronauts using a variety of tools and machines provides a special synergy that will vastly improve our understanding of Earth's cosmic neighborhood.

  20. Launched electrons in plasma opening switches

    International Nuclear Information System (INIS)

    Mendel, C.W. Jr.; Rochau, G.E.; Sweeney, M.A.; McDaniel, D.H.; Quintenz, J.P.; Savage, M.E.; Lindman, E.L.; Kindel, J.M.

    1989-01-01

    Plasma opening switches have provided a means to improve the characteristics of super-power pulse generators. Recent advances involving plasma control with fast and slow magnetic fields have made these switches more versatile, allowing for improved switch uniformity, triggering, and opening current levels that are set by the level of auxiliary fields. Such switches necessarily involve breaks in the translational symmetry of the transmission line geometry and therefore affect the electron flow characteristics of the line. These symmetry breaks are the result of high electric field regions caused by plasma conductors remaining in the transmission line, ion beams crossing the line, or auxilliary magnetic field regions. Symmetry breaks cause the canonical momentum of the electrons to change, thereby moving them away from the cathode. Additional electrons are pulled from the cathode into the magnetically insulated flow, resulting in an excess of electron flow over that expected for the voltage and line current downstream of the switch. We call these electrons ''launched electrons''. Unless they are recaptured at the cathode or else are fed into the load and used beneficially, they cause a large power loss downstream. This paper will show examples of SuperMite and PBFA II data showing these losses, explain the tools we are using to study them, and discuss the mechanisms we will employ to mitigate the problem. The losses will be reduced primarily by reducing the amount of launched electron flow. 7 refs., 9 figs

  1. Motivation for Air-Launch: Past, Present, and Future

    Science.gov (United States)

    Kelly, John W.; Rogers, Charles E.; Brierly, Gregory T.; Martin, J Campbell; Murphy, Marshall G.

    2017-01-01

    Air-launch is defined as two or more air-vehicles joined and working together, that eventually separate in flight, and that have a combined performance greater than the sum of the individual parts. The use of the air-launch concept has taken many forms across civil, commercial, and military contexts throughout the history of aviation. Air-launch techniques have been applied for entertainment, movement of materiel and personnel, efficient execution of aeronautical research, increasing aircraft range, and enabling flexible and efficient launch of space vehicles. For each air-launch application identified in the paper, the motivation for that application is discussed.

  2. 76 FR 33139 - Launch Safety: Lightning Criteria for Expendable Launch Vehicles

    Science.gov (United States)

    2011-06-08

    ... or near an electrified environment in or near a cloud. These changes will increase launch... sending the comment (or signing the comment for an association, business, labor union, etc.). You may... Confidential Business Information Do not file in the docket information that you consider to be proprietary or...

  3. A quality assurance study on the accuracy of measuring physical function under current conditions for use of clinical video telehealth.

    Science.gov (United States)

    Hoenig, Helen; Tate, Latoya; Dumbleton, Sarina; Montgomery, Christy; Morgan, Michelle; Landerman, Lawrence R; Caves, Kevin

    2013-05-01

    To determine whether conditions for use of clinical video telehealth technology might affect the accuracy of measures of physical function. Repeated measures. Veterans Administration Medical Center. Three healthy adult volunteers for a sample size of n=30 independent trials for each of 3 physical function tasks. None. Three tasks capturing differing aspects of physical function: fine-motor coordination (number of finger taps in 30s), gross-motor coordination (number of gait deviations in 10ft [3.05m]), and clinical spatial relations (identifying the proper height for a cane randomly preset ±0-2in [5.1cm] from optimal), with performance simultaneously assessed in person and video recorded. Interrater reliability and criterion validity were determined for the measurement of these 3 tasks scored according to 5 methods: (1) in person (community standard), (2) slow motion review of the video recording (criterion standard), and (3-5) full speed review at 3 Internet bandwidths (64kps, 384kps, and 768kps). Fine-motor coordination-Interrater reliability was variable (r=.43-.81) and criterion validity was poor at 64kps and 384kps, but both were acceptable at 768kps (reliability r=.74, validity β=.81). Gross-motor coordination-Interreliability was variable (range r=.53-.75) and criterion validity was poor at all bandwidths (β=.28-.47). Motionless spatial relations-Excellent reliability (r=.92-.97) and good criterion validity (β=.84-.89) at all the tested bandwidths. Internet bandwidth had differing effects on measurement validity and reliability for the fine-motor task, the gross-motor task, and spatial relations, with results for some tasks at some transmission speeds well below acceptable quality standards and community standards. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. [The Technology Acceptance Model and Its Application in a Telehealth Program for the Elderly With Chronic Illnesses].

    Science.gov (United States)

    Chang, Chi-Ping

    2015-06-01

    Many technology developments hold the potential to improve the quality of life of people and make life easier and more comfortable. New technologies have been well accepted by most people. Information sharing in particular is a major catalyst of change in our current technology-based society. Technology has widely innovated life and drastically changed lifestyles. The Technology Acceptance Model (TAM), a model developed to address the rapid advances in computer technology, is used to explain and predict user acceptance of new information technology. In the past, businesses have used the TAM as an assessment tool to predict user acceptance when introducing new technology products. They have also used external factors in the model to influence user perceptions and beliefs and to ensure the successful spread of new technologies. Informatization plays a critical role in healthcare services. Due to the rapid aging of populations and upward trends in the incidence of chronic illness, requirements for long-term care have increased in both quality and quantity. Therefore, there has been an increased emphasis on integrating healthcare and information technology. However, most elderly are significantly less adept at technology use than the general population. Therefore, we reexamined the effect that the essential concepts in a TAM exerted on technology acceptance. In the present study, the technology acceptance experience with regard to telehealth of the elderly was used as an example to explain how the revised technology acceptance model (TAM 2) may be effectively applied to enhance the understanding of technology care among nurses. The results may serve as a reference for future research on healthcare-technology use in long-term care or in elderly populations.

  5. The use of telehealth (text messaging and video communications) in patients with cystic fibrosis: A pilot study.

    Science.gov (United States)

    Gur, Michal; Nir, Vered; Teleshov, Anna; Bar-Yoseph, Ronen; Manor, Eynav; Diab, Gizelle; Bentur, Lea

    2017-05-01

    Background Poor communications between cystic fibrosis (CF) patients and health-care providers may result in gaps in knowledge and misconceptions about medication usage, and can lead to poor adherence. We aimed to assess the feasibility of using WhatsApp and Skype to improve communications. Methods This single-centre pilot study included CF patients who were older than eight years of age assigned to two groups: one without intervention (control group), and one with intervention. Each patient from the intervention group received Skype-based online video chats and WhatsApp messages from members of the multidisciplinary CF team. CF questionnaires, revised (CFQ-R) scores, knowledge and adherence based on CF My Way and patients satisfaction were evaluated before and after three months. Feasibility was assessed by session attendance, acceptability and satisfaction survey. Descriptive analysis and paired and non-paired t-tests were used as applicable. Results Eighteen patients were recruited to this feasibility study (nine in each group). Each intervention group participant had between four and six Skype video chats and received 22-45 WhatsApp messages. In this small study, CFQ-R scores, knowledge, adherence and patient satisfaction were similar in both groups before and after the three-month intervention. Conclusions A telehealth-based approach, using Skype video chats and WhatsApp messages, was feasible and acceptable in this pilot study. A larger and longer multi-centre study is warranted to examine the efficacy of these interventions to improve knowledge, adherence and communication.

  6. Telehealth in Schools Using a Systematic Educational Model Based on Fiction Screenplays, Interactive Documentaries, and Three-Dimensional Computer Graphics.

    Science.gov (United States)

    Miranda, Diogo Julien; Chao, Lung Wen

    2018-03-01

    Preliminary studies suggest the need of a global vision in academic reform, leading to education re-invention. This would include problem-based education using transversal topics, developing of thinking skills, social interaction, and information-processing skills. We aimed to develop a new educational model in health with modular components to be broadcast and applied as a tele-education course. We developed a systematic model based on a "Skills and Goals Matrix" to adapt scientific contents on fictional screenplays, three-dimensional (3D) computer graphics of the human body, and interactive documentaries. We selected 13 topics based on youth vulnerabilities in Brazil to be disseminated through a television show with 15 episodes. We developed scientific content for each theme, naturally inserting it into screenplays, together with 3D sequences and interactive documentaries. The modular structure was then adapted to a distance-learning course. The television show was broadcast on national television for two consecutive years to an estimated audience of 30 million homes, and ever since on an Internet Protocol Television (IPTV) channel. It was also reorganized as a tele-education course for 2 years, reaching 1,180 subscriptions from all 27 Brazilian states, resulting in 240 graduates. Positive results indicate the feasibility, acceptability, and effectiveness of a model of modular entertainment audio-visual productions using health and education integrated concepts. This structure also allowed the model to be interconnected with other sources and applied as tele-education course, educating, informing, and stimulating the behavior change. Future works should reinforce this joint structure of telehealth, communication, and education.

  7. NASA's Space Launch System: Affordability for Sustainability

    Science.gov (United States)

    May, Todd A.; Creech, Stephen D.

    2012-01-01

    The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is charged with delivering a new capability for human exploration beyond Earth orbit in an austere economic climate. But the SLS value is clear and codified in United States (U.S.) budget law. The SLS Program knows that affordability is the key to sustainability and will provide an overview of initiatives designed to fit within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017 within the projected budget. It also has a long-range plan to keep the budget flat, yet evolve the 70-tonne (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through the competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface some 40 years ago. Astronauts train for long-duration voyages on platforms such as the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. To arrive at the launch vehicle concept, the SLS Program conducted internal engineering and business studies that have been externally validated by industry and reviewed by independent assessment panels. In parallel with SLS concept studies, NASA is now refining its mission manifest, guided by U.S. space policy and the Global Exploration Roadmap, which reflects the mutual goals of a dozen member nations. This mission planning will converge with a flexible heavy-lift rocket that can carry international crews and the air, water, food, and equipment they need for extended trips to asteroids and Mars. In addition, the SLS capability will accommodate very large science instruments and other payloads, using a series of modular fairings and

  8. Business Intelligence Modeling in Launch Operations

    Science.gov (United States)

    Bardina, Jorge E.; Thirumalainambi, Rajkumar; Davis, Rodney D.

    2005-01-01

    This technology project is to advance an integrated Planning and Management Simulation Model for evaluation of risks, costs, and reliability of launch systems from Earth to Orbit for Space Exploration. The approach builds on research done in the NASA ARC/KSC developed Virtual Test Bed (VTB) to integrate architectural, operations process, and mission simulations for the purpose of evaluating enterprise level strategies to reduce cost, improve systems operability, and reduce mission risks. The objectives are to understand the interdependency of architecture and process on recurring launch cost of operations, provide management a tool for assessing systems safety and dependability versus cost, and leverage lessons learned and empirical models from Shuttle and International Space Station to validate models applied to Exploration. The systems-of-systems concept is built to balance the conflicting objectives of safety, reliability, and process strategy in order to achieve long term sustainability. A planning and analysis test bed is needed for evaluation of enterprise level options and strategies for transit and launch systems as well as surface and orbital systems. This environment can also support agency simulation .based acquisition process objectives. The technology development approach is based on the collaborative effort set forth in the VTB's integrating operations. process models, systems and environment models, and cost models as a comprehensive disciplined enterprise analysis environment. Significant emphasis is being placed on adapting root cause from existing Shuttle operations to exploration. Technical challenges include cost model validation, integration of parametric models with discrete event process and systems simulations. and large-scale simulation integration. The enterprise architecture is required for coherent integration of systems models. It will also require a plan for evolution over the life of the program. The proposed technology will produce

  9. Business intelligence modeling in launch operations

    Science.gov (United States)

    Bardina, Jorge E.; Thirumalainambi, Rajkumar; Davis, Rodney D.

    2005-05-01

    The future of business intelligence in space exploration will focus on the intelligent system-of-systems real-time enterprise. In present business intelligence, a number of technologies that are most relevant to space exploration are experiencing the greatest change. Emerging patterns of set of processes rather than organizational units leading to end-to-end automation is becoming a major objective of enterprise information technology. The cost element is a leading factor of future exploration systems. This technology project is to advance an integrated Planning and Management Simulation Model for evaluation of risks, costs, and reliability of launch systems from Earth to Orbit for Space Exploration. The approach builds on research done in the NASA ARC/KSC developed Virtual Test Bed (VTB) to integrate architectural, operations process, and mission simulations for the purpose of evaluating enterprise level strategies to reduce cost, improve systems operability, and reduce mission risks. The objectives are to understand the interdependency of architecture and process on recurring launch cost of operations, provide management a tool for assessing systems safety and dependability versus cost, and leverage lessons learned and empirical models from Shuttle and International Space Station to validate models applied to Exploration. The systems-of-systems concept is built to balance the conflicting objectives of safety, reliability, and process strategy in order to achieve long term sustainability. A planning and analysis test bed is needed for evaluation of enterprise level options and strategies for transit and launch systems as well as surface and orbital systems. This environment can also support agency simulation based acquisition process objectives. The technology development approach is based on the collaborative effort set forth in the VTB's integrating operations, process models, systems and environment models, and cost models as a comprehensive disciplined

  10. A Shuttle Derived Vehicle launch system

    Science.gov (United States)

    Tewell, J. R.; Buell, D. N.; Ewing, E. S.

    1982-01-01

    This paper describes a Shuttle Derived Vehicle (SDV) launch system presently being studied for the NASA by Martin Marietta Aerospace which capitalizes on existing Shuttle hardware elements to provide increased accommodations for payload weight, payload volume, or both. The SDV configuration utilizes the existing solid rocket boosters, external tank and the Space Shuttle main engines but replaces the manned orbiter with an unmanned, remotely controlled cargo carrier. This cargo carrier substitution more than doubles the performance capability of the orbiter system and is realistically achievable for minimal cost. The advantages of the SDV are presented in terms of performance and economics. Based on these considerations, it is concluded that an unmanned SDV offers a most attractive complement to the present Space Transportation System.

  11. The CERN & Society programme launches its newsletter

    CERN Multimedia

    Matteo Castoldi

    2016-01-01

    The newsletter will be issued quarterly. Sign up to remain informed about the latest initiatives of the CERN & Society programme!    The CERN & Society programme encompasses projects in the areas of education and outreach, innovation and knowledge exchange, and culture and creativity that spread the CERN spirit of scientific curiosity for the inspiration and benefit of society. The programme is funded primarily by the CERN & Society Foundation, a charitable foundation established by CERN and supported by individuals, trusts, organisations and commercial companies. The projects are inspired or enabled by CERN but lie outside of the Laboratory’s specific research mandate. We especially want to help young talent from around the world to flourish in the future. The programme is now launching its newsletter, which will be issued quarterly. Everybody who wants to be informed about CERN & Society’s activities, stay up-to-date with its latest in...

  12. Launch of technical training courses for programmers

    CERN Multimedia

    2015-01-01

    This autumn, two new technical training courses have been launched for scientists and engineers at CERN who undertake programming tasks, particularly in C and C++. Both courses are taught by Andrzej Nowak, an expert in next-generation and cutting-edge computing technology research.   The training courses are organised in cooperation with CERN openlab and are sponsored by the CERN IT department – there is only a nominal registration fee of 50 CHF. This is an opportunity not to be missed! Computer architecture and hardware-software interaction (2 days, 26-27 October) The architecture course offers a comprehensive overview of current topics in computer architecture and their consequences for the programmer, from the basic Von Neumann schema to its modern-day expansions. Understanding hardware-software interaction allows the programmer to make better use of all features of available computer hardware and compilers. Specific architectural ...

  13. Improving Conceptual Design for Launch Vehicles

    Science.gov (United States)

    Olds, John R.

    1998-01-01

    This report summarizes activities performed during the second year of a three year cooperative agreement between NASA - Langley Research Center and Georgia Tech. Year 1 of the project resulted in the creation of a new Cost and Business Assessment Model (CABAM) for estimating the economic performance of advanced reusable launch vehicles including non-recurring costs, recurring costs, and revenue. The current year (second year) activities were focused on the evaluation of automated, collaborative design frameworks (computation architectures or computational frameworks) for automating the design process in advanced space vehicle design. Consistent with NASA's new thrust area in developing and understanding Intelligent Synthesis Environments (ISE), the goals of this year's research efforts were to develop and apply computer integration techniques and near-term computational frameworks for conducting advanced space vehicle design. NASA - Langley (VAB) has taken a lead role in developing a web-based computing architectures within which the designer can interact with disciplinary analysis tools through a flexible web interface. The advantages of this approach are, 1) flexible access to the designer interface through a simple web browser (e.g. Netscape Navigator), 2) ability to include existing 'legacy' codes, and 3) ability to include distributed analysis tools running on remote computers. To date, VAB's internal emphasis has been on developing this test system for the planetary entry mission under the joint Integrated Design System (IDS) program with NASA - Ames and JPL. Georgia Tech's complementary goals this year were to: 1) Examine an alternate 'custom' computational architecture for the three-discipline IDS planetary entry problem to assess the advantages and disadvantages relative to the web-based approach.and 2) Develop and examine a web-based interface and framework for a typical launch vehicle design problem.

  14. A point-to-point simple telehealth application for cardiovascular prevention: the ESINO LARIO experience. Cardiovascular prevention at point of care.

    Science.gov (United States)

    Malacarne, Mara; Gobbi, Giorgio; Pizzinelli, Paolo; Lesma, Alessandro; Castelli, Alberto; Lucini, Daniela; Pagani, Massimo

    2009-01-01

    Recent epidemiological evidence indicates that chronic degenerative diseases, notably cardiovascular, represent the major toll in terms of death and of impaired quality of life. Recent estimates indicate that a small increase in financial resources in a number of clinical cases may be sufficient to minimize the consequences of elevated cardiovascular risk per individual. The observation that lifestyle choices, and in particular increased physical exercise, might strongly impact cardiovascular risk, suggests a redesign of preventive strategies, based on the combination of pharmacological and behavioral interventions. Following our recent experience with the INteractive teleConsultation network for worldwide healthcAre Services (INCAS) system, we designed a simpler point-to-point telehealth infrastructure, to be employed in cardiovascular risk reduction programs, predicting a high level of acceptance from the population, at the cost of very limited investment. This model was tested on 181 subjects (ages 18-80 years) in the Italian mountain village of Esino Lario. These subjects underwent a screening test to evaluate arrhythmia and cardiometabolic risks (arrhythmias were found in 14% of subjects, systolic arterial pressure was observed in 43% of subjects above 140 mm Hg, diastolic arterial pressure in 31% above 90 mm Hg). This study demonstrates the feasibility of a scaled-down telehealth application particularly suited to cardiovascular prevention in remote areas, such as in mountain villages.

  15. Model Development to Predict Phenological scale of Table Grapes (cvs. Thompson, Crimson and Superior Seedless and Red Globe using Growing Degree Days

    Directory of Open Access Journals (Sweden)

    Nicolas Verdugo-Vásquez

    2017-09-01

    Full Text Available Phenological models have been made mainly for winegrape cultivars, despite the economic importance of table grapes. The aim of this work was to develop and validate models for predicting phenological scales of table grapes (cvs. Thompson, Crimson and Superior Seedless and Red Globe grown under semi-arid conditions. Measurements of phenology were carried out weekly from budburst to harvest during four growing seasons (2009-2013. Phenology models were developed using the Mitscherlich monomolecular equation where the dependent and independent variables were the Eichhorn and Lorenz phenological (ELP scale modified by Coombe and the growing degree days (GDD, respectively. Results indicated that there were strong non-linear correlations between the ELP scale and GDD for the four cultivars with coefficient of determinations (R2 ranging between 0.97-0.99. Also, validation indicated that the models were able to predict ELP scale with a root mean square (RMSE and mean absolute error (MAE ranging between 2.1-2.4 and 1.35-1.69, respectively. The prediction variability (expressed in days was between 4.4-19.4 days, obtaining the best results for the flowering period. This study suggested that the phenological models based on GDD could be useful planning tools for farming, especially from budburst to veraison of table grape cultivars.

  16. Temperature, salinity and other variables collected from discrete sample and profile observations using CTD, bottle and other instruments from THOMAS G. THOMPSON in the North Pacific Ocean and Papahanaumokuakea Marine National Monument from 1985-03-30 to 1985-04-30 (NCEI Accession 0143395)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0143395 includes discrete sample and profile data collected from THOMAS G. THOMPSON in the North Pacific Ocean and Papahanaumokuakea Marine National...

  17. Physical, chemical, and other data from bottle casts from the Coastal Waters of Washington/Oregon from the THOMAS G. THOMPSON as part of the International Decade of Ocean Exploration / Coastal Upwelling Ecosystems Analysis (IDOE/CUEA) from 1973-07-11 to 1973-07-21 (NODC Accession 7601145)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Physical, chemical, and other data were collected from bottle casts in the Coastal Waters of Washington/Oregon from the THOMAS G. THOMPSON from 11 July 1973 to 21...

  18. Dissolved inorganic carbon, pH, alkalinity, temperature, salinity and other variables collected from discrete sample and profile observations using CTD, bottle and other instruments from the THOMAS G. THOMPSON in the South Pacific Ocean from 1994-01-25 to 1994-02-19 (NODC Accession 0115762)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NODC Accession 0115762 includes chemical, discrete sample, physical and profile data collected from THOMAS G. THOMPSON in the South Pacific Ocean from 1994-01-25 to...

  19. Partial pressure (or fugacity) of carbon dioxide, dissolved inorganic carbon, alkalinity, temperature, salinity and other variables collected from Surface underway, discrete sample and profile observations using CTD, Carbon dioxide (CO2) gas analyzer and other instruments from THOMAS G. THOMPSON in the Bismarck Sea, Coral Sea and others from 1993-10-05 to 1993-11-10 (NODC Accession 0115019)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0115019 includes Surface underway, chemical, discrete sample, meteorological, physical and profile data collected from THOMAS G. THOMPSON in the...

  20. Dissolved inorganic carbon, pH, alkalinity, temperature, salinity and other variables collected from discrete sample and profile observations using CTD, bottle and other instruments from THOMAS G. THOMPSON in the Bering Sea, North Pacific Ocean and South Pacific Ocean from 1993-07-05 to 1993-09-02 (NODC Accession 0115008)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0115008 includes chemical, discrete sample, physical and profile data collected from THOMAS G. THOMPSON in the Bering Sea, North Pacific Ocean and...