Framework for Evaluating Traffic Management Services in Higher Airspace

Flying faster, farther, longer and higher has always captured the public’s imagination. Yet there is a vast realm of airspace that remains unexplored, save for a handful of scientific and national security missions. It is a realm rife with extremes, where flights can reach multi-Mach speeds or stay aloft for months as they slowly circumnavigate the globe. It is a realm that lies high above the clouds, at the edge of space. Recent breakthroughs in technology, fueled by a globalized economy and society’s appetite for information, have set the stage for routine commercial operations in this new realm. Companies, old and new, consider it an unexploited frontier, and are investing in ways to harness its potential. Until recently, few have contemplated how this assortment of operations will coexist where the air is thin and manned operations are the exception, not the rule. Today’s air traffic management system was largely designed for manned fixed-wing aircraft performance and capabilities, not unmanned and lighter-than-air operations. As a result, existing flight rules (visual and instrument) which govern aircraft behavior, are likely to be ill-suited to these non-traditional operations. Therefore, attempting to retrofit current air traffic management practices and policies to safely accommodate increased new entrant activity may not lead to an optimal solution, given the anticipated increase in highly automated constellations of operations. This paper will evaluate a range of options for providing air traffic management reflecting user expectations as set forth by the International Civil Aviation Organization Global Air Traffic Management Document

Airlines Entry and Exit and the Impact on Air Traffic Management: An Analytical Framework for Zero-Sum and Positive-Sum Outcomes

Passenger airline service can have a significant impact on a metropolitan region's economy in terms of direct spending and employment, as well as on indirect spending related to industries such as tourism and the service sector. In the past decade passenger service levels have changed considerably in many markets because of a wide variety of events including increased competition, terrorism, and a downturn in the economy. Airlines have responded to these challenges in a variety of ways. Some of the traditional network carriers have been forced into bankruptcy in an attempt to reduce costs and compete more effectively with low cost carriers. In contrast, the low cost carriers have expanded service and entered new markets at a rapid pace.This paper examines the economic evolutionary process whereby a dominant carrier competes intensely in one market against a similar airline and retreats in another where new, lower-cost entrant expands service. Literature is examined for evidence pertaining to the market's response to a network carrier's financial distress, its impact on airport service levels, and implications for local economies. A zero sum case is explained using a recent example. A positive sum case is explored, where the positive contributions of the entering carrier exceed those left behind by the resident carrier. In the process, depending on the types of gains and nature of the evolving airlines' network, the patterns of air traffic may also change. Using these experiences, an analytical framework is proposed that attempts to explain the emergent behavior of low cost carriers when they enter new markets. In addition, the impact of these changes on the air traffic management system is also examined

Utilization of microbial source-tracking markers to inform targeted remediation and predict potential pathogens in high priority surface waters

Although Escherichia coli and enterococci will be recommended for use as recreational water quality standards (RWQS) for all surface waters by the U.S. EPA, measuring their levels contributes little to our knowledge of the source of contamination in nonpoint source (NPS) impacted waters. Yet understanding the sources of fecal pollution is critical for developing management plans to protect recreational waters and for assessing the associated health risks. Testing for these fecal indicator bacteria (FIB) augmented with microbial source-tracking (MST) assays may improve our ability to identify and prioritize sources that have a high likelihood of contributing human pathogens to surface waters. Yet more research is required to understand how MST methods relate to measurements of FIB in inland waters, which are predominantly impacted by NPS containing both human and animal source fecal contamination. To understand whether MST assays can aid in better targeting of remediation efforts, novel, promising MST markers were evaluated for (1) their relationship to land use, (2) their ability to predict microorganisms of public health concern, and (3) their association with FIB within two areas of the Cape Fear watershed. The results of this research suggest that MST markers are necessary for identifying and prioritizing areas with a high likelihood of contributing human pathogens to surface waters, but that they cannot be easily utilized in a tiered approach with FIB.Doctor of Philosoph

Clinical Utility of the Adapted Biopsychosocial Model: An Initial Validation Through Peer Review

Background: The World Health Organization has called on health care providers to adopt a biopsychosocial approach to improve health and well-being and reduce disability. While a variety of holistic models exist in occupational therapy, none are explicitly biopsychosocial and use language consistent with both the World Health Organization’s International Classification of Functioning, Disability and Health and the Occupational Therapy Practice Framework. Following the recent introduction of the Adapted Biopsychosocial Model (A-BPSM), this study served as an initial step toward validation of this model for use in occupational therapy. Method: A qualitative descriptive design was implemented with a maximum variation purposive sample of 30 participants, including occupational therapy students, clinicians, and educators. The participants were interviewed regarding their perceptions of the utility of the A-BPSM. A thematic analysis approach was used. Results: The participant data supported three major themes relating to the participants’ perceptions of the A-BPSM: clarity, utility, and anticipated competence for application. Conclusion: The findings support an initial step toward validation of the model and serve to offer occupational therapists an adapted biopsychosocial model of care. Recommendations include further evaluation of this model in comparison with existing models, as well as the application of the model to other disciplines

From Barriers to Opportunities: Renewable Energy Issues in Law and Policy

A Report on the Work of the Renewable Energy and International Law (REIL) Project, 2006-200

Breaking the transactional mindset: A new path for healthcare leadership built on a commitment to human experience

Numerous health care publications have focused on the compelling need to improve patient experience and the associated improvements necessary to address workforce well-being. The COVID-19 pandemic exacerbated and illuminated long-standing problems in health care including workforce shortages, inequity in health care delivery outcomes, care provider burnout, and overall societal structural racism.1,2 The Beryl Institute’s Nursing Executive Council (NEC) manuscript Rebuilding a Foundation of Trust: A Call to Action in Creating a Safe Environment for Everyone3 focused on actions and behaviours to heal relationships and build trust between care providers and leaders with commitments to safety, empathy, shared decision making, transparency, growth and development. Research studies abound offering new frameworks and interventions intending to strengthen systems of care that respect whole person needs. The nursing profession has always been anchored in holistic person-centered care yet continues to be challenged in work environments laden with fragmentation and barriers to human caring. The purpose of this paper is to review the dominance of transactional business mindsets and practices today that may foster those challenging environments and assert that the use of Service-Dominant Logic (SDL) demonstrates the importance of human relations in developing effective and sustainable organizational performance. Ultimately it can help us lead differently at all levels as we work to transform the human experience in healthcare. Experience Framework This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

From Debate to Design: Issues in Clean Energy and Climate Change Law and Policy

A report on the work of the REIL Network 2007-200

Highly accurate detection of ovarian cancer using CA125 but limited improvement with serum matrix-assisted laser desorption/ionization time-of-flight mass spectrometry profiling

Objectives: Our objective was to test the performance of CA125 in classifying serum samples from a cohort of malignant and benign ovarian cancers and age-matched healthy controls and to assess whether combining information from matrix-assisted laser desorption/ionization (MALDI) time-of-flight profiling could improve diagnostic performance. Materials and Methods: Serum samples from women with ovarian neoplasms and healthy volunteers were subjected to CA125 assay and MALDI time-of-flight mass spectrometry (MS) profiling. Models were built from training data sets using discriminatory MALDI MS peaks in combination with CA125 values and tested their ability to classify blinded test samples. These were compared with models using CA125 threshold levels from 193 patients with ovarian cancer, 290 with benign neoplasm, and 2236 postmenopausal healthy controls. Results: Using a CA125 cutoff of 30 U/mL, an overall sensitivity of 94.8% (96.6% specificity) was obtained when comparing malignancies versus healthy postmenopausal controls, whereas a cutoff of 65 U/mL provided a sensitivity of 83.9% (99.6% specificity). High classification accuracies were obtained for early-stage cancers (93.5% sensitivity). Reasons for high accuracies include recruitment bias, restriction to postmenopausal women, and inclusion of only primary invasive epithelial ovarian cancer cases. The combination of MS profiling information with CA125 did not significantly improve the specificity/accuracy compared with classifications on the basis of CA125 alone. Conclusions: We report unexpectedly good performance of serum CA125 using threshold classification in discriminating healthy controls and women with benign masses from those with invasive ovarian cancer. This highlights the dependence of diagnostic tests on the characteristics of the study population and the crucial need for authors to provide sufficient relevant details to allow comparison. Our study also shows that MS profiling information adds little to diagnostic accuracy. This finding is in contrast with other reports and shows the limitations of serum MS profiling for biomarker discovery and as a diagnostic too

Hepatitis E virus and coliphages in waters proximal to swine concentrated animal feeding operations

North Carolina is the second leading state in pork production in the United States, with over 10 million swine. Swine manure in NC is typically collected and stored in open-pit lagoons before the liquid waste is sprayed onto agricultural fields for disposal. Components of this waste may be able to impact surface water quality with the potential for human exposure. This study examined viruses of public health concern in creeks adjacent to swine concentrated animal feeding operation (CAFO) spray fields. Surface water samples (n = 154) were collected from public access waters in proximity to swine CAFO spray fields for six months and were tested for hepatitis E virus (HEV) and coliphages. HEV was detected in one sample. Somatic coliphages were detected in 98% of samples (geometric mean 24 ± 4.1 PFU per 100 ml), and F + coliphages were detected in 85% of samples (geometric mean 6.8 ± 5.0 PFU per 100 ml). Only 3% (21) of the F + coliphage isolates were RNA phage, and all of the F + RNA coliphages belonged to genogroup I. Although the pervasiveness of swine CAFOs in this area prevented a comparison with samples from un-impacted sites, the near ubiquity of coliphages, as well as the presence of HEV, suggests that current waste management practices may be associated with the dissemination of viruses of public health concern in waters proximal to CAFO spray fields