Simple computations for near-optimum ascent and abort maneuver targets and deorbit ignition time

Closed-form solutions are presented for a two-burn orbit insertion, AOA, and ATO maneuver targets, and for time of ignition of a one-burn deorbit. Based on the assumption that the orbits involved deviate only to the first order about a reference circular orbit, these solutions are nearly fuel-minimum. They are expressed in terms of linear terminal velocity constraint shuttle guidance targets and, thus, are readily applicable to both ground and onboard software use. In addition to potential application to real-time targeting, the equations may be used as a mission design aid in preliminary definition of target loads and definition of abort mode boundaries

Interprofessional Opportunities in Sleep Practice

Interprofessional education has the potential to prepare health career students to be practice-ready and enter the workforce with a collaborative mindset. Respiratory care educators must adequately prepare students to work in this capacity. This emphasis on a team approach to patient-centered care has the ability to impact and improve health outcomes. Throughout the last decade, sleep medicine has experienced fluctuations. Sustainability of sleep labs who only perform diagnostic testing may prove challenging. The role of interprofessional practice in sleep medicine would be to overcome traditional roles (silos) so that multiple skilled practitioners could help identify and treat complex patient conditions. A review of the literature demonstrated how various providers can serve as active members of interprofessional health care teams. The opportunity to expand services and partner with other providers to detect, educate, and treat sleep disordered breathing could help laboratories endure and even thrive in the current health care system

Advances in Cystic Fibrosis

The purpose of this review was to identify the history of and advances in cystic fibrosis (CF). New treatment plans, medication developments, and a historical perspective of airway clearance therapy (ACT) will be presented. The importance of treatment compliance and time management in the care of cystic fibrosis patients will also be discussed. Furthermore, the development of cystic fibrosis clinics and the pivotal role they play in the treatment of the disease will be addressed. Lastly, a brief discussion concerning the need for and process of lung transplantation will be reported

Sagittal Subtalar and Talocrural Joint Assessment With Weight-Bearing Fluoroscopy During Barefoot Ambulation

Background: Identifying talar position during ambulation has proved difficult as the talus lacks palpable landmarks for skin marker placement and more invasive methodologies such as bone pins are not practical for most clinical subjects. A fluoroscopic motion system was used to track the talus and calcaneus, allowing kinematic analysis of the talocrural and subtalar joints. Methods: Thirteen male subjects (mean age 22.9 ± 3.0 years) previously screened for normal gait were tested. A fluoroscopy unit was used to collect images at 120 fps during stance. Sagittal motion of the talocrural and subtalar joints were analyzed. Results: The intersubject mean and standard deviation values for all 58 trials of 13 subjects are reported. Maximum talocrural joint plantarflexion of 11.2 degrees (4.3 degrees of standard deviation) occurred at 11% stance and maximum dorsiflexion of −6.9 degrees (5.6 degrees of standard deviation) occurred at 85%. Maximum subtalar joint plantarflexion of 4.8 degrees (1.0 degrees of standard deviation) occurred at 96% stance and maximum dorsiflexion of −3.6 degrees (2.3 degrees of standard deviation) occurred at 30%. Talocrural and subtalar range of motion values during stance were 18.1 and 8.4 degrees, respectively. Conclusion: Existing fluoroscopic technology was capable of defining sagittal plane talocrural and subtalar motion during gait. These kinematic results compare favorably with more invasive techniques. This type of assessment could support more routine analysis of in vivo bony motion during gait. Clinical Relevance: Fluoroscopic technology offers improved sagittal plane motion evaluation during weight-bearing with potential application in patients with end-stage ankle arthritis, postoperative ankle replacements and fusions, and orthotics and braces

Key Elements of a State Master Plan in Higher Education

A master plan in higher education is developed to address the academic and workforce needs of a particular state. The master plan helps serve as the roadmap for implementation of proposed strategies to reach state goals in education and degree attainment. In Tennessee, Drive to 55 is a state-wide effort to increase the number of Tennesseans with a higher education credential to 55% by the year 2025. In an attempt to gain a deeper understanding of the key elements within state master plans, an independent review of ten state plans was conducted. The states involved in the analysis were Tennessee, Virginia, West Virginia, New York, Colorado, Arkansas, Nevada, Louisiana, Connecticut, and Massachusetts. The informal review revealed four key elements of state master plans in higher education: accessibility, affordability, accountability, and success. A consensus to reach underserved, underrepresented, or nontraditional students could be found among all ten states. Increasing accessibility to higher education can help abridge achievement gaps and eliminate disparities. Through responsible planning, management of resources, and assistance of those with demonstrated financial need, a quality higher education degree or credential that is affordable could be obtained. Accountability is measured in various ways by the ten states; however, clear expectations for performance are needed to ensure student success and positive institutional outcomes are experienced. A key element of success was noted to be college readiness and characteristics of students including determination and grit. Nine out of the ten states reviewed had some form of performance-based funding measures in place; providing incentives for institutions to help students successfully complete degree program

Respiratory Therapists as Physician Extenders: Perceptions of Practitioners and Educators

Introduction: The purpose of this study was to determine the perceptions of practicing respiratory therapists (RT) and respiratory care educators regarding the role of RTs serving as physician extenders. Methods: The survey instrument was an electronic questionnaire that consisted of 17 questions. Participation was voluntary and participants were selected through random and convenience sampling techniques. Results: Of 506 respondents, 234 were respiratory care educators. Overwhelmingly, the respondents held the Registered Respiratory Therapist credential (92.7%). Respondents were about equally split among three education levels: 31.7% associate degree, 31.7% bachelor’s degree, and 27.3% master’s degree. Of the respondents 62.45% had considered pursing a degree in physician assistant (PA). Respondents expressed a preference for an Advanced Practice Respiratory Therapy (APRT) program (77.9%) rather than a PA program. Nearly two-thirds of the respondents reported they felt that a master’s degree should be the minimum level of education for an APRT. Conclusions: This study suggests that practitioners and educators alike are strongly supportive of advanced practice in the profession of respiratory therapy