ARMD Workshop on Materials and Methods for Rapid Manufacturing for Commercial and Urban Aviation

This report documents the goals, organization and outcomes of the NASA Aeronautics Research Mission Directorates (ARMD) Materials and Methods for Rapid Manufacturing for Commercial and Urban Aviation Workshop. The workshop began with a series of plenary presentations by leaders in the field of structures and materials, followed by concurrent symposia focused on forecasting the future of various technologies related to rapid manufacturing of metallic materials and polymeric matrix composites, referred to herein as composites. Shortly after the workshop, questionnaires were sent to key workshop participants from the aerospace industry with requests to rank the importance of a series of potential investment areas identified during the workshop. Outcomes from the workshop and subsequent questionnaires are being used as guidance for NASA investments in this important technology area

Improving the clinical value and utility of CGM systems: issues and recommendations : a joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group

The first systems for continuous glucose monitoring (CGM) became available over 15 years ago. Many then believed CGM would revolutionise the use of intensive insulin therapy in diabetes; however, progress towards that vision has been gradual. Although increasing, the proportion of individuals using CGM rather than conventional systems for self-monitoring of blood glucose on a daily basis is still low in most parts of the world. Barriers to uptake include cost, measurement reliability (particularly with earlier-generation systems), human factors issues, lack of a standardised format for displaying results and uncertainty on how best to use CGM data to make therapeutic decisions. This scientific statement makes recommendations for systemic improvements in clinical use and regulatory (pre- and postmarketing) handling of CGM devices. The aim is to improve safety and efficacy in order to support the advancement of the technology in achieving its potential to improve quality of life and health outcomes for more people with diabetes

Improving the clinical value and utility of CGM systems: issues and recommendations: a joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group

The first systems for continuous glucose monitoring (CGM) became available over 15 years ago. Many then believed CGM would revolutionize the use of intensive insulin therapy in diabetes; however, progress toward that vision has been gradual. Although increasing, the proportion of individuals using CGM rather than conventional systems for self-monitoring of blood glucose on a daily basis is still low in most parts of the world. Barriers to uptake include cost, measurement reliability (particularly with earlier-generation systems), human factors issues, lack of a standardized format for displaying results, and uncertainty on how best to use CGM data to make therapeutic decisions. This Scientific Statement makes recommendations for systemic improvements in clinical use and regulatory (pre- and postmarketing) handling of CGM devices. The aim is to improve safety and efficacy in order to support the advancement of the technology in achieving its potential to improve quality of life and health outcomes for more people with diabetes

Status of NASA In-Space Propulsion Technologies and Their Infusion Potential

Since 2001, the In-Space Propulsion Technology (ISPT) program has been developing in-space propulsion technologies that will enable or enhance NASA robotic science missions. These in-space propulsion technologies have broad applicability to future competed Discovery and New Frontiers mission solicitations, and are potentially enabling for future NASA flagship and sample return missions currently being considered. This paper provides status of the technology development of several in-space propulsion technologies that are ready for infusion into future missions. The technologies that are ready for flight infusion are: 1) the high-temperature Advanced Material Bipropellant Rocket (AMBR) engine providing higher performance; 2) NASA s Evolutionary Xenon Thruster (NEXT) ion propulsion system, a 0.6-7 kW throttle-able gridded ion system; and 3) Aerocapture technology development with investments in a family of thermal protection system (TPS) materials and structures; guidance, navigation, and control (GN&C) models of blunt-body rigid aeroshells; and aerothermal effect models. Two component technologies that will be ready for flight infusion in FY12/13 are 1) Advanced Xenon Flow Control System, and 2) ultra-lightweight propellant tank technology advancements and their infusion potential will be also discussed. The paper will also describe the ISPT project s future focus on propulsion for sample return missions: 1) Mars Ascent Vehicles (MAV); 2) multi-mission technologies for Earth Entry Vehicles (MMEEV) needed for sample return missions from many different destinations; and 3) electric propulsion for sample return and low cost missions. These technologies are more vehicle-focused, and present a different set of technology infusion challenges. Systems/Mission Analysis focused on developing tools and assessing the application of propulsion technologies to a wide variety of mission concepts

Planetary Science Technology Infusion Study: Findings and Recommendations Status

The Planetary Science Division (PSD) within the National Aeronautics and Space Administrations (NASA) Science Mission Directorate (SMD) at NASA Headquarters sought to understand how to better realize a scientific return on spacecraft system technology investments currently being funded. In order to achieve this objective, a team at NASA Glenn Research Center was tasked with surveying the science and mission communities to collect their insight on technology infusion and additionally sought inputs from industry, universities, and other organizations involved with proposing for future PSD missions. This survey was undertaken by issuing a Request for Information (RFI) activity that requested input from the proposing community on present technology infusion efforts. The Technology Infusion Study was initiated in March 2013 with the release of the RFI request. The evaluation team compiled and assessed this input in order to provide PSD with recommendations on how to effectively infuse new spacecraft systems technologies that it develops into future competed missions enabling increased scientific discoveries, lower mission cost, or both. This team is comprised of personnel from the Radioisotope Power Systems (RPS) Program and the In-Space Propulsion Technology (ISPT) Program staff.The RFI survey covered two aspects of technology infusion: 1) General Insight, including: their assessment of barriers to technology infusion as related to infusion approach; technology readiness; information and documentation products; communication; integration considerations; interaction with technology development areas; cost-capped mission areas; risk considerations; system level impacts and implementation; and mission pull. 2) Specific technologies from the most recent PSD Announcements of Opportunities (AOs): The Advanced Stirling Radioisotope Generator (ASRG), aerocapture and aeroshell hardware technologies, the NASA Evolutionary Xenon Thruster (NEXT) ion propulsion system, and the Advanced Materials Bi-propellant Rocket (AMBR) engine.This report will present the teams Findings from the RFI inputs and the recommendations that arose from these findings. Methodologies on the findings and recommendations development are discussed

A safer place for patients: learning to improve patient safety

1 Every day over one million people are treated successfully by National Health Service (NHS) acute, ambulance and mental health trusts. However, healthcare relies on a range of complex interactions of people, skills, technologies and drugs, and sometimes things do go wrong. For most countries, patient safety is now the key issue in healthcare quality and risk management. The Department of Health (the Department) estimates that one in ten patients admitted to NHS hospitals will be unintentionally harmed, a rate similar to other developed countries. Around 50 per cent of these patient safety incidentsa could have been avoided, if only lessons from previous incidents had been learned. 2 There are numerous stakeholders with a role in keeping patients safe in the NHS, many of whom require trusts to report details of patient safety incidents and near misses to them (Figure 2). However, a number of previous National Audit Office reports have highlighted concerns that the NHS has limited information on the extent and impact of clinical and non-clinical incidents and trusts need to learn from these incidents and share good practice across the NHS more effectively (Appendix 1). 3 In 2000, the Chief Medical Officer’s report An organisation with a memory 1 , identified that the key barriers to reducing the number of patient safety incidents were an organisational culture that inhibited reporting and the lack of a cohesive national system for identifying and sharing lessons learnt. 4 In response, the Department published Building a safer NHS for patients3 detailing plans and a timetable for promoting patient safety. The goal was to encourage improvements in reporting and learning through the development of a new mandatory national reporting scheme for patient safety incidents and near misses. Central to the plan was establishing the National Patient Safety Agency to improve patient safety by reducing the risk of harm through error. The National Patient Safety Agency was expected to: collect and analyse information; assimilate other safety-related information from a variety of existing reporting systems; learn lessons and produce solutions. 5 We therefore examined whether the NHS has been successful in improving the patient safety culture, encouraging reporting and learning from patient safety incidents. Key parts of our approach were a census of 267 NHS acute, ambulance and mental health trusts in Autumn 2004, followed by a re-survey in August 2005 and an omnibus survey of patients (Appendix 2). We also reviewed practices in other industries (Appendix 3) and international healthcare systems (Appendix 4), and the National Patient Safety Agency’s progress in developing its National Reporting and Learning System (Appendix 5) and other related activities (Appendix 6). 6 An organisation with a memory1 was an important milestone in the NHS’s patient safety agenda and marked the drive to improve reporting and learning. At the local level the vast majority of trusts have developed a predominantly open and fair reporting culture but with pockets of blame and scope to improve their strategies for sharing good practice. Indeed in our re-survey we found that local performance had continued to improve with more trusts reporting having an open and fair reporting culture, more trusts with open reporting systems and improvements in perceptions of the levels of under-reporting. At the national level, progress on developing the national reporting system for learning has been slower than set out in the Department’s strategy of 2001 3 and there is a need to improve evaluation and sharing of lessons and solutions by all organisations with a stake in patient safety. There is also no clear system for monitoring that lessons are learned at the local level. Specifically: a The safety culture within trusts is improving, driven largely by the Department’s clinical governance initiative 4 and the development of more effective risk management systems in response to incentives under initiatives such as the NHS Litigation Authority’s Clinical Negligence Scheme for Trusts (Appendix 7). However, trusts are still predominantly reactive in their response to patient safety issues and parts of some organisations still operate a blame culture. b All trusts have established effective reporting systems at the local level, although under-reporting remains a problem within some groups of staff, types of incidents and near misses. The National Patient Safety Agency did not develop and roll out the National Reporting and Learning System by December 2002 as originally envisaged. All trusts were linked to the system by 31 December 2004. By August 2005, at least 35 trusts still had not submitted any data to the National Reporting and Learning System. c Most trusts pointed to specific improvements derived from lessons learnt from their local incident reporting systems, but these are still not widely promulgated, either within or between trusts. The National Patient Safety Agency has provided only limited feedback to trusts of evidence-based solutions or actions derived from the national reporting system. It published its first feedback report from the Patient Safety Observatory in July 2005

INDIVIDUAL INFUSION OF M-HEALTH TECHNOLOGIES: DETERMINANTS AND OUTCOMES

Despite substantial research on IT implementation in the IS field, the healthcare industry has historically been considered a technological laggard and lacks direction for how to successfully infuse new technological innovations within individuals work practices. Theoretically, mobile-health (m-health) technologies, if infused in work practices can potentially enhance the quality of healthcare delivery. The question remains as to whether practitioners\u27 performance significantly improves and individual knowledge is enhanced through the infusion of these technologies. While a significant amount of extant literature focuses on initial technology adoption and acceptance, there remains a dearth of literature in the IS field focusing on the long term utilisation and associated benefits. This paper addresses this gap in extant literature through the development and testing of a conceptual model, exploring determinants of individual infusion of m-health technologies and their subsequent outcomes. This study reveals (a) key enablers of successful mobile infusion in a healthcare context and that successful infusion is determined by the characteristics of the: 1. technology 2. user and 3. task, (b) Infusion of mobile technologies leads to improvements in preventative care, greater decision making and reduced medical errors and, (c) Individuals perceive that knowledge is presented rather than created through mobile technologies

Patient safety in Europe: medication errors and hospital-acquired infections

The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required

Training Faculty to Adopt the Ignatian Pedagogical Paradigm, IPP and its Influence on Teaching and Learning: Process and Outcomes

This is the second of two articles describing the action research undertaken by the three trainees and their trainer (author of this article). After formal training, the training team integrated the Ignatian Pedagogical Paradigm (IPP) into their undergraduate courses from fall of 2010 through May 2013 in the College of Professional Studies (CPS) at Marquette University in Milwaukee, Wisconsin. The first article was published in this journal in fall 2012 and provided a narrative describing the faculty development process, predicated on the five constructs of the IPP: Context, Experience, Reflection, Action and Evaluation. This article includes a full description of the training protocol, data collection process, and the qualitative data analysis methods. This training team used an Action Research model put forth by Reil over two years and nine months to determine the influence of the IPP on their teaching. This study seeks to provide others who teach at Jesuit Colleges and Universities a rationale for using the IPP both as pedagogy, a curriculum guide along with specific instructional practices, and learning activities. In addition, a replicable IPP training protocol is provided that is based on best practices derived from analogous research in the fields of contemporary learning, cognitive, and educational research. The study also provides the outcomes related to the impact the infusion of the IPP had on the instructors’ curricula, pedagogies, instructional strategies, learning activities, and assessment practices, as well as the student-teacher learning relationship