Test, Control and Monitor System (TCMS) operations plan

The purpose is to provide a clear understanding of the Test, Control and Monitor System (TCMS) operating environment and to describe the method of operations for TCMS. TCMS is a complex and sophisticated checkout system focused on support of the Space Station Freedom Program (SSFP) and related activities. An understanding of the TCMS operating environment is provided and operational responsibilities are defined. NASA and the Payload Ground Operations Contractor (PGOC) will use it as a guide to manage the operation of the TCMS computer systems and associated networks and workstations. All TCMS operational functions are examined. Other plans and detailed operating procedures relating to an individual operational function are referenced within this plan. This plan augments existing Technical Support Management Directives (TSMD's), Standard Practices, and other management documentation which will be followed where applicable

Mental Health And The Role Of The States

Researchers from the State Health Care Spending Project -- a collaboration between The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation -- sought to better understand the country's mental health challenges and, in particular, the states' role in addressing them. The project found that:In 2013, approximately 44 million adults -- 18.5 percent of the population 18 and older -- were classified as having a mental illness. Of these, 10 million had a serious mental illness. The rate of serious mental illness varied from state to state.In 2009, the most recent year for which national mental health data are available, $147 billion was spent on mental health treatment in the United States. A majority of the spending, 60 percent, came from public sources such as Medicaid, state and local governments, Medicare, and federal grants. Private sources, including health insurance and individual out-of-pocket spending, made up the difference.Funding from states and localities totaled$22 billion (15 percent) in 2009. This total does not include state and local Medicaid expenditures. Counting those contributions brings total state and local spending up to $35.5 billion (24 percent).This report is intended to help federal, state, and local policymakers working to address the country's mental health challenges to better understand their prevalence, treatment, and funding trends

Chopped Sugar Beets for Growing and Finishing Cattle

Crossbred steers (n=270; 645 lb, ± 3 lb) were used in a 2 × 3 factorial treatment design in a growing (54 d) and finishing study (130 d). Th e factors were 0 or 44% sugar beets (dry matter basis) in place of dry rolled corn, during the growing phase and 0, 15, or 30% sugar beets during the finishing phase. Daily gain was not different for the growing treatments but the calves on the 44% sugar beet treatment had less dry matter intake than those on the 0% sugar beet treatment, making them 5.5% more efficient. However, during the finishing phase, the steers on the 0% sugar beet treatment had greater daily gain than those on the 44% sugar beet treatment. Related to the beet inclusion during finishing, the 0% sugar beet treatment and the 15% had similar gain and feed efficiency, which was greater than the 30% sugar beet treatment. Hot carcass weight, back fat, and yield grade were greatest for the 0%, followed by 15%, and with 30% sugar beets having the least. Including sugar beets in a growing ration could increase feed efficiency by decreasing dry matter intake with similar gain. Including sugar beets in a finishing diet will likely not result in similar performance or carcass characteristics to a dry- rolled corn based diet

Normative Data for Email Writing by Native Speakers of British English

This dataset includes emails from forty two control participants ranging from 16 to 88 years of age (mean = 46) and 9 to 24 years of education (mean = 13). Three emails were produced by each participant (between 2011 and 2014), each within a time limit of three minutes. It is expected that this normative data will be useful for clinicians and researchers working with adults with acquired language disorders in assessing email writing

Developing content for a process-of-care checklist for use in intensive care units: a dual-method approach to establishing construct validity

Background: In the intensive care unit (ICU), checklists can be used to support the delivery of quality and consistent clinical care. While studies have reported important benefits for clinical checklists in this context, lack of formal validity testing in the literature prompted the study aim; to develop relevant `process-of-care? checklist statements, using rigorously applied and reported methods that were clear, concise and reflective of the current evidence base. These statements will be sufficiently instructive for use by physicians during ICU clinical rounds. Methods: A dual-method approach was utilized; semi-structured interviews with local clinicians; and rounds of surveys to an expert Delphi panel. The interviews helped determine checklist item inclusion/exclusion prior to the first round Delphi survey. The panel for the modified-Delphi technique consisted of local intensivists and a state- wide ICU quality committee. Minimum standards for consensus agreement were set prior to the distribution of questionnaires, and rounds of surveys continued until consensus was achieved. Results: A number of important issues such as overlap with other initiatives were identified in interviews with clinicians and integrated into the Delphi questionnaire, but no additional checklist items were suggested, demonstrating adequate checklist coverage sourced from the literature. These items were verified by local clinicians as being relevant to ICU and important elements of care that required checking during ward rounds. Two rounds of Delphi surveys were required to reach consensus on nine checklist statements: nutrition, pain management, sedation, deep vein thrombosis and stress ulcer prevention, head-of-bed elevation, blood glucose levels, readiness to extubate, and medications. Conclusions: Statements were developed as the most clear, concise, evidence-informed and instructive statements for use during clinical rounds in an ICU. Initial evidence in support of the checklist?s construct validity was established prior to further prospective evaluation in the same ICU

Having burned the straw man of Christian spiritual leadership, what can we learn from Jesus about leading ethically?

In considering what it means to lead organizations effectively and ethically the literature comprising spirituality at work (SAW) and spiritual leadership theory (SLT) has become highly influential, especially in the USA. It has also attracted significant criticism. While, in this paper we endorse this critique, we argue that that the strand of literature which purportedly takes a Christian standpoint within the wider SAW school of thought, largely misconstrues and misapplies the teaching of its founder, Jesus. As a result, in dismissing the claims and application of SAW and SLT, there is a real risk that we lose the vital contribution of Christian thought, not least some of the timeless counter-cultural wisdom of Jesus which, we contend, offers a vital foundation to the practice of ethical leadership and business ethics in organisations. In proposing a way forward, two thorny issues which face all leaders are addressed: dealing with ego and closing the gap between what we say and what we do. The more we understand about the dynamics of human nature, the more we learn about the profundity of Jesus’ teachings. We then propose a number of ways in which Jesus-centred ethical leadership can be practised. Each is radical and each implies risk: both the personal risk of inner renewal arising from repentance as a doorway to personal integrity, as well as the risk of opposing unethical practices and promoting the excellence of core practices in the workplace

Swimming in nature:A scoping review of the mental health and wellbeing benefits of open water swimming

Purpose: Open water swimming (also known as outdoor or wild swimming) is a popular blue activity which has become of recent interest in the mental health sphere. Moreover, it is an accessible and low-cost activity, requiring little to no specialist equipment other than access to an appropriate blue space. Subsequently, it could be an effective and accessible intervention that supports mental health and wellbeing worldwide. This scoping review aims to summarise the open water swimming literature. Principal methods and results: A comprehensive search, extraction and charting of relevant literature was undertaken, identifying 14 studies exploring the mental health and wellbeing benefits of open water swimming. The findings were synthesised and summarised for both quantitative and qualitative literature, addressing all scoping review aims, whilst also assessing the quality of the literature. Major conclusions: Open water swimming may lead to improvements in mood and wellbeing, reductions in mental distress symptomatology, and was experienced as a positive, enriching process for many. Blue spaces involve embodiment, mindful presence, community and much more, offering for some a therapeutic accretion which sustains mental health and wellbeing across a lifetime. More robust evidence is needed before open water swimming may become a viable mental health resource.</p

Multi-morbidity and its association with common cancer diagnoses: a UK Biobank prospective study

Background Whilst multi-morbidity is known to be a concern in people with cancer, very little is known about the risk of cancer in multi-morbid patients. This study aims to investigate the risk of being diagnosed with lung, colorectal, breast and prostate cancer associated with multi-morbidity. Methods We investigated the association between multi-morbidity and subsequent risk of cancer diagnosis in UK Biobank. Cox models were used to estimate the relative risks of each cancer of interest in multi-morbid participants, using the Cambridge Multimorbidity Score. The extent to which reverse causation, residual confounding and ascertainment bias may have impacted on the findings was robustly investigated. Results Of the 436,990 participants included in the study who were cancer-free at baseline, 21.6% (99,965) were multi-morbid (≥ 2 diseases). Over a median follow-up time of 10.9 [IQR 10.0–11.7] years, 9,019 prostate, 7,994 breast, 5,241 colorectal, and 3,591 lung cancers were diagnosed. After exclusion of the first year of follow-up, there was no clear association between multi-morbidity and risk of colorectal, prostate or breast cancer diagnosis. Those with ≥ 4 diseases at recruitment had double the risk of a subsequent lung cancer diagnosis compared to those with no diseases (HR 2.00 [95% CI 1.70–2.35] p for trend  Conclusions Individuals with multi-morbidity are at an increased risk of lung cancer diagnosis. While this association did not appear to be due to common sources of bias in observational studies, further research is needed to understand what underlies this association