Operationally Responsive Space (ORS): An Architecture and Enterprise Model for Adaptive Integration, Test and Logistics

The capability to rapidly deploy tactical satellites to meet a Joint Force Commander\u27s immediate battlespace requirements is a well-documented joint capability need. Key U.S. strategic documentation cites the need for the capability to maintain persistent surveillance or an unblinking eye over battlespace and to rapidly reconstitute critical space capabilities to preserve situational awareness. The warfighter requires a tactical space-based deployment capability which employs a request to launch and operational deployment window of 90 to 120 days. This master\u27s thesis executed two (2) major areas of work: apply, and reinforce the Operationally Responsive Space (ORS) mission tasks using the Joint Capabilities Integration Development System (JCIDS) process; then based on capability gap data generated from the process, analyze and define the capability gap of an ORS Adaptive Integration, Test and Logistics (IT&L) process for payload to bus deployment to meet the identified time scales. This document recommends engineering solutions and processes for the ORS IT&L to-be state for this warfighter capability. The ORS adaptive IT&L CONOPS developed as part of this work focuses on the Tactical Satellite Rapid Deployment System (TSRDS), which is an adaptive integration, test and logistics capability that enables rapid and effective payload to bus integration to meet a 90- to 120-day warfighter window

Fact Sheet #1: How Family-Centered is MaineCare?

Parent reports on family experiences of care can provide health plans, systems and providers with crucial information on their performance in the domain of family-centeredness. The Maine Department of Health and Human Services (DHHS) conducts an annual survey to gather this kind of information for MaineCare, the state of Maine’s Medicaid and Child Health Insurance (CHIP) program

Fact Sheet #2: How Do MaineCare Providers Perform on Childhood Screening and Prevention?

The annual Survey of Children Served by MaineCare, which collects a wealth of data on the experiences of MaineCare families, examines the extent to which MaineCare providers follow Bright Futures guidelines during well-child visits. This fact sheet presents findings on Bright Futures adherence from the 2013 survey

Cardiopulmonary phenotype associated with human PHD2 mutation.

Oxygen-dependent regulation of the erythropoietin gene is mediated by the hypoxia-inducible factor (HIF) family of transcription factors. When oxygen is plentiful, HIF undergoes hydroxylation by a family of oxygen-dependent prolyl hydroxylase domain (PHD) proteins, promoting its association with the von Hippel-Lindau (VHL) ubiquitin E3 ligase and subsequent proteosomal degradation. When oxygen is scarce, the PHD enzymes are inactivated, leading to HIF accumulation and upregulation not only of erythropoietin expression, but also the expression of hundreds of other genes, including those coordinating cardiovascular and ventilatory adaptation to hypoxia. Nevertheless, despite the identification of over 50 mutations in the PHD-HIF-VHL pathway in patients with previously unexplained congenital erythrocytosis, there are very few reports of associated cardiopulmonary abnormalities. We now report exaggerated pulmonary vascular and ventilatory responses to acute hypoxia in a 35-year-old man with erythrocytosis secondary to heterozygous mutation in PHD2, the most abundant of the PHD isoforms. We compare this phenotype with that reported in patients with the archetypal disorder of cellular oxygen sensing, Chuvash polycythemia, and discuss the possible clinical implications of our findings, particularly in the light of the emerging role for small molecule PHD inhibitors in clinical practice

Mapping evaporative water loss in desert passerines reveals an expanding threat of lethal dehydration

Extreme high environmental temperatures produce a variety of consequences for wildlife, including mass die-offs. Heat waves are increasing in frequency, intensity, and extent, and are projected to increase further under climate change. However, the spatial and temporal dynamics of die-off risk are poorly understood. Here, we examine the effects of heat waves on evaporative water loss (EWL) and survival in five desert passerine birds across the southwestern United States using a combination of physiological data, mechanistically informed models, and hourly geospatial temperature data. We ask how rates of EWL vary with temperature across species; how frequently, over what areas, and how rapidly lethal dehydration occurs; how EWL and die-off risk vary with body mass; and how die-off risk is affected by climate warming. We find that smaller-bodied passerines are subject to higher rates of mass-specific EWL than larger-bodied counterparts and thus encounter potentially lethal conditions much more frequently, over shorter daily intervals, and over larger geographic areas. Warming by 4 °C greatly expands the extent, frequency, and intensity of dehydration risk, and introduces new threats for larger passerine birds, particularly those with limited geographic ranges. Our models reveal that increasing air temperatures and heat wave occurrence will potentially have important impacts on the water balance, daily activity, and geographic distribution of arid-zone birds. Impacts may be exacerbated by chronic effects and interactions with other environmental changes. This work underscores the importance of acute risks of high temperatures, particularly for small-bodied species, and suggests conservation of thermal refugia and water sources

Left-handedness and risk of breast cancer

Left-handedness may be an indicator of intrauterine exposure to oestrogens, which may increase the risk of breast cancer. Women (n=1786) from a 1981 health survey in Busselton were followed up using death and cancer registries. Left-handers had higher risk of breast cancer than right-handers and the effect was greater for post-menopausal breast cancer (hazard ratio=2.59, 95% confidence interval 1.11–6.03)

UK survey of occupational therapist’s and physiotherapist’s experiences and attitudes towards hip replacement precautions and equipment

Background: Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). Historically, people following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. The purpose of this study was to determine current practices in the provision of these interventions in the UK for people following primary THR. Methods: A 27-question, self-administered online survey was developed and distributed to UK physiotherapists and occupational therapists involved in the management of people following primary THR (target respondents). The survey included questions regarding the current practices in the provision of equipment and hip precautions for THR patients, and physiotherapist’s and occupational therapist’s attitudes towards these practices. The survey was disseminated through print and web-based/social media channels. Results: 170 health professionals (87 physiotherapists and 83 occupational therapists), responded to the survey. Commonly prescribed equipment in respondent’s health trusts were raised toilet seats (95%), toilet frames and rails (88%), furniture raises (79%), helping hands/grabbers (77%), perching stools (75%) and long-handled shoe horns (75%). Hip precautions were routinely prescribed by 97% of respondents. Hip precautions were most frequently taught in a pre-operative group (52% of respondents). Similarly equipment was most frequently provided pre-operatively (61% respondents), and most commonly by occupational therapists (74% respondents). There was variability in the advice provided on the duration of hip precautions and equipment from up to six weeks post-operatively to life-time usage. Conclusions: Current practice on hip precautions and provision of equipment is not full representative of clinician’s perceptions of best care after THR. Future research is warranted to determine whether and to whom hip precautions and equipment should be prescribed post-THR as opposed to the current ‘blanket’ provision of equipment and movement restriction provided in UK practice