Nuclear powered Mars cargo transport mission utilizing advanced ion propulsion

Nuclear-powered ion propulsion technology was combined with detailed trajectory analysis to determine propulsion system and trajectory options for an unmanned cargo mission to Mars in support of manned Mars missions. A total of 96 mission scenarios were identified by combining two power levels, two propellants, four values of specific impulse per propellant, three starting altitudes, and two starting velocities. Sixty of these scenarios were selected for a detailed trajectory analysis; a complete propulsion system study was then conducted for 20 of these trajectories. Trip times ranged from 344 days for a xenon propulsion system operating at 300 kW total power and starting from lunar orbit with escape velocity, to 770 days for an argon propulsion system operating at 300 kW total power and starting from nuclear start orbit with circular velocity. Trip times for the 3 MW cases studied ranged from 356 to 413 days. Payload masses ranged from 5700 to 12,300 kg for the 300 kW power level, and from 72,200 to 81,500 kg for the 3 MW power level

Evaluation of a New Technical Technical Support Process for Patients and Providers in the Virtual Setting

A growing body of evidence suggests that care delivered by the virtual platform can be safe and effective. However, digital health solutions need to be integrated into the patient pathway for optimal support as well as improving the patients experience. The findings provided the evaluator an opportunity to learn what is working well for outcome effectiveness and what areas need improvement to achieve better outcomes, particularly with patient and provider satisfaction, access to care, and the overall usage of virtual follow-up among diverse patient populations. The usefulness of the program evaluation can facilitate the critical integration of the nursing leadership role to advancing and delivering goal-concordant care in the virtual setting. In regard to nursing implications, the utility of oncology providers are very instrumental and capable in providing collaborative leadership strategies. In addition, nursing leaders are well-poised to incorporate the role of technology in inter-professional practice. Future program evaluation should allow for dissemination with a robust use of program evaluation tools to other areas within the organization for process improvement initiatives.https://openworks.mdanderson.org/acif23/1007/thumbnail.jp

Evaluation of a New Technical Support Process for Patients and Providers in the Virtual Setting

Clover Patterson pictured.https://openworks.mdanderson.org/aprn-week-22/1016/thumbnail.jp

Efficacy of treatment in an opioid –dependent population group using the Maudsley Addiction Profile (MAP) tool

A pilot study was performed to assess the effectiveness of treatment in an opioid dependent population using the Maudsley Addiction Profile (MAP) tool1

Healthy and Safe Neighborhoods

Final project for URSP688L: Planning Technologies (Fall 2015). University of Maryland, College Park.For this project the Healthy and Safe Neighborhoods group worked with Baltimore’s Southwest Partnership (SWP) to create mapping resources for their seven partnering neighborhoods. The primary focus was to investigate the health and safety of Southwest Baltimore’s current neighborhood using the most recent ACS (American Community Survey) and Census Data as well as open source data provided by the City and the SWP, to determine if certain conditions influence one another. Like much of Baltimore, the Partnership’s neighborhoods have been isolated and neglected due to white flight, racially restrictive zoning, redlining, and “decades of disinvestment.”1 By using GIS mapping to visualize the neighborhood conditions and GIS analysis to pinpoint areas of opportunity and concern, we hope to help SWP focus their resources to attract new residents and investment, particularly from its neighboring partners and anchor institutions. Recently planners have used GIS to map areas of opportunity and spatial mismatch where, for example, employment needs do not match resident skills. Using crime data provided by the SWP and the City, this report compares street conditions and demographics in Southwest Baltimore with contributing factors or variables that would affect the neighborhoods’ health and safety. The following variables were mapped: racial demographics, median household income, vacant houses, crime density by type and time of day, urban tree canopy, street conditions, street lights, and illegal dumping sites. Analysis showed that the neighborhood trends reflected issues facing Baltimore City as a whole, so the study area was expanded to provide context and draw comparisons between the City and the SWP area. Both Baltimore City and the SWP area have overlapping clusters of aging infrastructure, low income, crime, and vacancies abutting areas of wealth and security. In the end, the limiting factors on the analysis were due to incomplete data sets, which SWP recognizes and continues to build.The Southwest Partnership (SWP), Baltimor

Facilitators and barriers to post-discharge pain assessment and triage: a qualitative study of nurses\u27 and patients\u27 perspectives

BACKGROUND: After hospital discharge, patients can experience symptoms prompting them to seek acute medical attention. Early evaluation of patients\u27 post-discharge symptoms by healthcare providers may improve appropriate healthcare utilization and patient safety. Post-discharge follow-up phone calls, which are used for routine transitional care in U.S. hospitals, serve as an important channel for provider-patient communication about symptoms. This study aimed to assess the facilitators and barriers to evaluating and triaging pain symptoms in cardiovascular patients through follow-up phone calls after their discharge from a large healthcare system in Central Massachusetts. We also discuss strategies that may help address the identified barriers. METHODS: Guided by the Practical, Robust, Implementation and Sustainability Model (PRISM), we completed semi-structured interviews with 7 nurses and 16 patients in 2020. Selected nurses conducted (or supervised) post-discharge follow-up calls on behalf of 5 clinical teams (2 primary care; 3 cardiology). We used thematic analysis to identify themes from interviews and mapped them to the domains of the PRISM model. RESULTS: Participants described common facilitators and barriers related to the four domains of PRISM: Intervention (I), Recipients (R), Implementation and Sustainability Infrastructure (ISI), and External Environment (EE). Facilitators include: (1) patients being willing to receive provider follow-up (R); (2) nurses experienced in symptom assessment (R); (3) good care coordination within individual clinical teams (R); (4) electronic health record system and call templates to support follow-up calls (ISI); and (5) national and institutional policies to support post-discharge follow-up (EE). Barriers include: (1) limitations of conducting symptom assessment by provider-initiated follow-up calls (I); (2) difficulty connecting patients and providers in a timely manner (R); (3) suboptimal coordination for transitional care among primary care and cardiology providers (R); and (4) lack of emphasis on post-discharge follow-up call reimbursement among cardiology clinics (EE). Specific barriers for pain assessment include: (1) concerns with pain medication misuse (R); and (2) no standardized pain assessment and triage protocol (ISI). CONCLUSIONS: Strategies to empower patients, facilitate timely patient-provider communication, and support care coordination regarding pain evaluation and treatment may reduce the barriers and improve processes and outcomes of pain assessment and triage

Measles Virus Infection in a Transgenic Model Virus-Induced Immunosuppression and Central Nervous System Disease

AbstractMeasles virus (MV) infects 40 million persons and kills one million per year primarily by suppressing the immune system and afflicting the central nervous system (CNS). The lack of a suitable small animal model has impeded progress of understanding how MV causes disease and the development of novel therapies and improved vaccines. We tested a transgenic mouse line in which expression of the MV receptor CD46 closely mimicked the location and amount of CD46 found in humans. Virus replicated in and was recovered from these animals' immune systems and was associated with suppression of humoral and cellular immune responses. Infectious virus was recovered from the CNS, replicated primarily in neurons, and spread to distal sites presumably by fast axonal transport. Thus, a small animal model is available for analysis of MV pathogenesis

Measuring Neighborhood Stability

Final project for URSP601: Research Methods (Spring 2016). University of Maryland, College Park.In their work, students made two types of conclusions—about the effectiveness of the measured characteristics in revealing neighborhood stability and about the stability of particular census tracts in the County. Measured Characteristics: Given that housing sales prices and household incomes are higher than average in Howard County, the typical measures of neighborhood stability are not well-suited to the County. In some measures, for example, between the initial Neighborhood Stability Index and the housing price analysis, the majority of the data did not align. Census tracts identified by the Index as stable were identified as unstable in the housing price analysis. Neighborhood Stability in Howard County: The County’s southwestern section, including Columbia, had the greatest concentration of extreme results: both high and low performing tracts. Its north and west sections were more uniform in their distribution, containing both stable and declining housing prices. Between 2000 and 2010, approximately 80% of Howard County experienced increases in average housing sales prices, with 25 census tracts experiencing increases of more than $100,000. Three census tracts, two located in the north of the County and one south of Columbia, showed increases in average housing sales prices of more than$300,000. Only two census tracts showed a decrease in average housing sales prices, with one of those census tracts experiencing an almost $350,000 decrease in average sales price of homes. The census tracts showing high increases in predicted home sales prices are clustered in the southern part of the County and around Columbia. Two are in the southern part of Columbia in the Owen Brown and Greenleaf areas (census tracts 606707 and 606704). Other census tracts with high increases in prices are west of the Patuxent Parkway and east of Columbia toward Waterloo Park. Roughly half of the County, those census tracts north and west of Columbia, exhibit low to moderate changes in sales prices. Only one census tract (601203), located southeast of Columbia, showed a decrease in sales price. Neighborhoods or census tracts directly within and around Columbia show the least stability, especially those census tracts south of Columbia and along the County’s southern border. Given that this pattern has repeatedly resulted in our analyses, we recommend that the County further assess conditions in these census tracts to verify our findings. Although Columbia is often among the top 10 "Best Places to Live," the highest concentration of tracts at risk of decline are within the boundaries of Columbia. Census tract 6067.04 is the bottom-performing tract, is located in Columbia’s Owen Brown Village area a community with some of the most dated housing stock in Columbia that also has crime issues. There are also several tracts at risk of decline in Columbia’s Long Reach Village area where there are plans to revamp the center, which was declared a blight zone by the Howard County Council. Other tracts at risk of decline are in Clarksville, Laurel and Elkridge. However, with the exception of Clarksville, these areas also consist of stable tracts and those experiencing improvement or upgrade.Howard Count

Healthy Annapolis

Final project for Urban Studies and Planning Studio (Summer 2017). University of Maryland, College Park.Annapolis, Maryland, located in Anne Arundel County, is home to the United States Naval Academy and Saint John’s College. The small waterfront capital city is also a popular tourist destination for sailors and history buffs drawn to the nationally recognized historic district. While continuing to focus on preserving the City’s historic and natural resources and strong local economy, Annapolis is taking steps to become a healthier city by participating in the Let’s Move! Cities Towns, and Counties (LMCTC) initiative, a national campaign to end childhood obesity by providing guidance to elected officials, parents, schools, community leaders, and other stakeholders in order to make healthy living accessible for everyone. Annapolis has successfully met the five initial program goals for LMCTC, and has achieved All-Star status. This report will help the City pursue three of the four All-Star strategies it is now eligible to pursue after achieving All-Star status. This report highlights disadvantaged communities, as they are more likely to suffer from poor health. In addition to an increased likelihood of health issues, these communities are also less likely to have resources such as education and community support to improve certain aspects of their health. This University of Maryland PALS summer studio project is meant to help guide the City of Annapolis in creating a healthier city for all residents, and in reaching their LMCTC All-Star strategies. Four chapters were written by groups that focused on health-related aspects of the city that relate directly to areas of focus for achieving All-Star status: 1) updates to incorporate health into the Comprehensive Plan, 2) parks and open space, 3) bicycle infrastructure, and 4) urban agriculture and community gardens. We hope that by providing recommendations for integrating health into the planning process and city design, and by suggesting strategies to make the most effective use of existing tools, Annapolis will be better situated to achieve its LMCTC All-Star strategies.The City of Annapoli

Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health

The article of record as published may be found at http://dx.doi.org/10.1093/sleep/zsab161Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: 1) a recognition of the factors contributing to fatigue and fatigue-related risks; 2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and 3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.Academy of Sleep Medicine (AASM)Sleep Research Societ