Sample records for achieving continuous improvement

  1. Continuous Personal Improvement.

    Emiliani, M. L.


    Suggests that continuous improvement tools used in the workplace can be applied to self-improvement. Explains the use of such techniques as one-piece flow, kanban, visual controls, and total productive maintenance. Points out misapplications of these tools and describes the use of fishbone diagrams to diagnose problems. (SK)

  2. Achieving continuity: a story of stellar magnitude

    Evans, Michael S.


    Scientists tell a story of 2,000 years of stellar magnitude research that traces back to Hipparchus. This story of continuity in practices serves an important role in scientific education and outreach. STS scholars point out many ways that stories of continuity, like many narratives about science, are disconnected from practices. Yet the story of continuity in stellar magnitude is a powerful scientific achievement precisely because of its connection to practice. The historical development of star catalogues shows how specific recording practices connected past and present in a useful way. The narrative of continuity in stellar magnitude, however else it might be subject to STS critique of narrative, maintains its power because of its connection to practice. I suggest that more attention be paid to connections between practice and narrative in STS, and in particular to the ways that historical practices sustain narratives by connecting past and present.

  3. 氯碱厂持续改进项目及成果%Continuous improvement projects and achievements in chlor-alkali plant

    李鸿俊; 董雷


    Continuous improvement projects and energy saving of primary brine, electrolysis, chlorine treatment process was introduced. Improvements to enhance operations, significant economic and environmental benefits were acquired.%介绍了一次盐水、电解、氯气处理、氢气处理工序的持续改进项目及节能降耗情况。通过改进,取得了显著的经济效益和环境效益。


    Yenque D., Julio; Universidad Nacional Mayor de San Marcos; García P., Manuel; Universidad Nacional Mayor de San Marcos; Raez G., Luis; Universidad Nacional Mayor de San Marcos


    Many times we ask the question why Japanese companies are competitive?, Surely many of the answers to this mystery have support in the Kaizen. And the Kaizen is not a simple concept, it is a whole way of life that involves both managers and workers in the pursuit of progressive improvement of enterprises. In his book Kaizen, The Key to Japanese Competitive Advantage, Masaaki Imai explains in simple terms what is the essence of this philosophy: Kaizen means improvement means further progressiv...

  5. Continuous improvement of software quality

    Sivertsen, Terje


    The present report is the first Halden Work Report delivered from the OECD Halden Reactor Project's research activity on formal methods and software quality. Of particular concern in this activity is to reach a consensus between regulators, licensees and the nuclear industry on questions related to the effective, industrial use of formal methods. The report gives considerable attention to the importance of continuous improvement as a characteristic of a living software quality system, and to the need of providing a basis for software process/product quality integration. In particular, the report discusses these aspects from the perspectives of defect prevention, formal methods, Total Quality Management (TQM), and Bayesian Belief Nets. Another concern is to promote controlled experiments on the use of new methods, techniques, and tools. This is achieved partly by reviewing suggestions on the collection and experimental use of data, and by surveying a number of metrics believed to have some potential for comparison studies (author) (ml)

  6. An improved characterization method for international accountancy measurements of fresh and irradiated mixed oxide (MOX) fuel: helping achieve continual monitoring and safeguards through the fuel cycle

    Evans, Louise G [Los Alamos National Laboratory; Croft, Stephen [Los Alamos National Laboratory; Swinhoe, Martyn T [Los Alamos National Laboratory; Tobin, S. J. [Los Alamos National Laboratory; Boyer, B. D. [Los Alamos National Laboratory; Menlove, H. O. [Los Alamos National Laboratory; Schear, M. A. [Los Alamos National Laboratory; Worrall, Andrew [U.K., NNL


    Nuclear fuel accountancy measurements are conducted at several points through the nuclear fuel cycle to ensure continuity of knowledge (CofK) of special nuclear material (SNM). Non-destructive assay (NDA) measurements are performed on fresh fuel (prior to irradiation in a reactor) and spent nuclear fuel (SNF) post-irradiation. We have developed a fuel assembly characterization system, based on the novel concept of 'neutron fingerprinting' with multiplicity signatures to ensure detailed CofK of nuclear fuel through the entire fuel cycle. The neutron fingerprint in this case is determined by the measurement of the various correlated neutron signatures, specific to fuel isotopic composition, and therefore offers greater sensitivity to variations in fissile content among fuel assemblies than other techniques such as gross neutron counting. This neutron fingerprint could be measured at the point of fuel dispatch (e.g. from a fuel fabrication plant prior to irradiation, or from a reactor site post-irradiation), monitored during transportation of the fuel assembly, and measured at a subsequent receiving site (e.g. at the reactor site prior to irradiation, or reprocessing facility post-irradiation); this would confirm that no unexpected changes to the fuel composition or amount have taken place during transportation and/or reactor operations. Changes may indicate an attempt to divert material for example. Here, we present the current state of the practice of fuel measurements for both fresh mixed oxide (MOX) fuel and SNF (both MOX and uranium dioxide). This is presented in the framework of international safeguards perspectives from the US and UK. We also postulate as to how the neutron fingerprinting concept could lead to improved fuel characterization (both fresh MOX and SNF) resulting in: (a) assured CofK of fuel across the nuclear fuel cycle, (b) improved detection of SNM diversion, and (c) greater confidence in safeguards of SNF transportation.

  7. An improved characterization method for international accountancy measurements of fresh and irradiated mixed oxide (MOX) fuel: helping achieve continual monitoring and safeguards through the fuel cycle

    Evans, Louise G [Los Alamos National Laboratory; Croft, Stephen [Los Alamos National Laboratory; Swinhoe, Martyn T [Los Alamos National Laboratory; Tobin, S. J. [Los Alamos National Laboratory; Menlove, H. O. [Los Alamos National Laboratory; Schear, M. A. [Los Alamos National Laboratory; Worrall, Andrew [U.K. NNL


    Nuclear fuel accountancy measurements are conducted at several points through the nuclear fuel cycle to ensure continuity of knowledge (CofK) of special nuclear material (SNM). Non-destructive assay (NDA) measurements are performed on fresh fuel (prior to irradiation in a reactor) and spent nuclear fuel (SNF) post-irradiation. We have developed a fuel assembly characterization system, based on the novel concept of 'neutron fingerprinting' with multiplicity signatures to ensure detailed CofK of nuclear fuel through the entire fuel cycle. The neutron fingerprint in this case is determined by the measurement of the various correlated neutron signatures, specific to fuel isotopic composition, and therefore offers greater sensitivity to variations in fissile content among fuel assemblies than other techniques such as gross neutron counting. This neutron fingerprint could be measured at the point of fuel dispatch (e.g. from a fuel fabrication plant prior to irradiation, or from a reactor site post-irradiation), monitored during transportation of the fuel assembly, and measured at a subsequent receiving site (e.g. at the reactor site prior to irradiation, or reprocessing facility post-irradiation); this would confirm that no unexpected changes to the fuel composition or amount have taken place during transportation and/ or reactor operations. Changes may indicate an attempt to divert material for example. Here, we present the current state of the practice of fuel measurements for both fresh mixed oxide (MOX) fuel and SNF (both MOX and uranium dioxide). This is presented in the framework of international safeguards perspectives from the US and UK. We also postulate as to how the neutron fingerprinting concept could lead to improved fuel characterization (both fresh MOX and SNF) resulting in: (a) assured CofK of fuel across the nuclear fuel cycle, (b) improved detection of SNM diversion, and (c) greater confidence in safeguards of SNF transportation.

  8. Spectroelectrochemical sensing based on multimode selectivity simultaneously achievable in a single device. 17. Improvement in detection limits using ultrathin perfluorosulfonated ionomer films in conjunction with continuous sample flow.

    Andria, Sara E; Richardson, John N; Kaval, Necati; Zudans, Imants; Seliskar, Carl J; Heineman, William R


    We report herein an attenuated total reflectance (ATR) absorbance-based spectroelectrochemical sensor for tris(2,2'-bipyridyl)ruthenium(II) ion [Ru(bpy)(3)(2+)] that employs ultrathin (24-50 nm) Nafion films as the charge-selective layer. This film serves to sequester and preconcentrate the analyte at the optically transparent electrode surface such that it can be efficiently detected optically via electrochemical modulation. Our studies indicate that use of ultrathin films in tandem with continuous flow of sample solution through the cell compartment leads to a 100-500-fold enhancement in detection limit (10 nM) compared to earlier absorbance-based spectroelectrochemical sensors ( approximately 1-5 microM); markedly shorter analysis times also result. We report the dependence of the measured absorbance on sample flow rate and Nafion film thickness, and also provide calibration curves that illustrate the linear range and detection limits of the sensor using a 24 nm film at a constant sample flow rate of 0.07 mL/min.

  9. Achieve inventory reduction and improve customer service?

    Moody, M C


    Is it really possible to achieve significant reductions in your manufacturing inventories while improving customer service? If you really want to achieve significant inventory reductions, focus on the root causes, and develop countermeasures and a work plan, to execute your countermeasures. Include measurements for recording your progress, and deploy your countermeasures until they are no longer required, or until new ones are needed.

  10. Quick and continuous improvement through kaizen blitz.

    McNichols, T; Hassinger, R; Bapst, G W


    It is our objective to provide you with a step-by-step approach to conducting a kaizen blitz within two days and describe how to achieve dramatic performance improvement with employee buy-in through this process. Kaizen blitz has been used dozens of times by the authors, and in some instances the same area has been blitzed as many as four times, with significant improvements each and every time. Employees have even taken it on themselves to conduct informal blitzes as a continuing improvement effort after a formal blitz has been conducted in their area. Blitzes can succeed in a variety of environments. The morning after the employees of one company attended this presentation, they self initiated a mini-blitz and discovered opportunities for improvement that they enthusiastically presented to management.


    Hector Ricardo Formento


    Full Text Available The goal of this work was to examine the content of continuous improvement strategies, taking into account the important role they play in building competitiveness. This paper argues that several specific issues must be taken into account in order to reach successful outcomes. This work starts with a literature review on the matter. On this basis, we designed a survey administered to a group of 30 large companies, each of which is renowned leader in Argentina. Finally, we compared the development of continuous improvement process in companies with very effective results and with scarce results. Differences that emerged from this comparison enabled us to identify critical factors for achieving a successful improvement process. As there are no recent researches on continuous improvement programs in Argentina, this paper contributes to recognizing and systematizing what has been done, comparing it with theoretical framework and uncovering research gaps for future studies. However, further research must confirm these findings and move forward on the analysis of intangible factors, like: internal communications, climate, culture, self reflexion, consensus, etc.

  12. Exemplar pediatric collaborative improvement networks: achieving results.

    Billett, Amy L; Colletti, Richard B; Mandel, Keith E; Miller, Marlene; Muething, Stephen E; Sharek, Paul J; Lannon, Carole M


    A number of pediatric collaborative improvement networks have demonstrated improved care and outcomes for children. Regionally, Cincinnati Children's Hospital Medical Center Physician Hospital Organization has sustained key asthma processes, substantially increased the percentage of their asthma population receiving "perfect care," and implemented an innovative pay-for-performance program with a large commercial payor based on asthma performance measures. The California Perinatal Quality Care Collaborative uses its outcomes database to improve care for infants in California NICUs. It has achieved reductions in central line-associated blood stream infections (CLABSI), increased breast-milk feeding rates at hospital discharge, and is now working to improve delivery room management. Solutions for Patient Safety (SPS) has achieved significant improvements in adverse drug events and surgical site infections across all 8 Ohio children's hospitals, with 7700 fewer children harmed and >$11.8 million in avoided costs. SPS is now expanding nationally, aiming to eliminate all events of serious harm at children's hospitals. National collaborative networks include ImproveCareNow, which aims to improve care and outcomes for children with inflammatory bowel disease. Reliable adherence to Model Care Guidelines has produced improved remission rates without using new medications and a significant increase in the proportion of Crohn disease patients not taking prednisone. Data-driven collaboratives of the Children's Hospital Association Quality Transformation Network initially focused on CLABSI in PICUs. By September 2011, they had prevented an estimated 2964 CLABSI, saving 355 lives and $103,722,423. Subsequent improvement efforts include CLABSI reductions in additional settings and populations.

  13. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    Middel, Rick; Boer, Harry; Fisscher, Olaf


    A substantial body of theoretical and practical knowledge has been developed on continuous improvement. However, there is still a considerable lack of impirically grounded contributions and theories on collaborative improvement, that is, continuous improvement in an interorganizational setting....... The CO-IMPROVE project investigated whether and how the concept of continuous improvement can be extended and transferred to such settings. The objective of this article is ti evaluate the CO-IMPROVE research findings in view of existing theories on continuous innovation. The article investigates...

  14. Improving Student Achievement in Math and Science

    Sullivan, Nancy G.; Hamsa, Irene Schulz; Heath, Panagiota; Perry, Robert; White, Stacy J.


    As the new millennium approaches, a long anticipated reckoning for the education system of the United States is forthcoming, Years of school reform initiatives have not yielded the anticipated results. A particularly perplexing problem involves the lack of significant improvement of student achievement in math and science. Three "Partnership" projects represent collaborative efforts between Xavier University (XU) of Louisiana, Southern University of New Orleans (SUNO), Mississippi Valley State University (MVSU), and the National Aeronautics and Space Administration (NASA), Stennis Space Center (SSC), to enhance student achievement in math and science. These "Partnerships" are focused on students and teachers in federally designated rural and urban empowerment zones and enterprise communities. The major goals of the "Partnerships" include: (1) The identification and dissemination of key indices of success that account for high performance in math and science; (2) The education of pre-service and in-service secondary teachers in knowledge, skills, and competencies that enhance the instruction of high school math and science; (3) The development of faculty to enhance the quality of math and science courses in institutions of higher education; and (4) The incorporation of technology-based instruction in institutions of higher education. These goals will be achieved by the accomplishment of the following objectives: (1) Delineate significant ?best practices? that are responsible for enhancing student outcomes in math and science; (2) Recruit and retain pre-service teachers with undergraduate degrees in Biology, Math, Chemistry, or Physics in a graduate program, culminating with a Master of Arts in Curriculum and Instruction; (3) Provide faculty workshops and opportunities for travel to professional meetings for dissemination of NASA resources information; (4) Implement methodologies and assessment procedures utilizing performance-based applications of higher order

  15. Continuous Improvement and Collaborative Improvement: Similarities and Differences

    Middel, Rick; Boer, Harry; Fisscher, Olaf


    A substantial body of theoretical and practical knowledge has been developed on continuous improvement. However, there is still a considerable lack of empirically grounded contributions and theories on collaborative improvement, that is, continuous improvement in an inter-organizational setting. The

  16. Fibromyalgia syndrome: Can improvement be achieved?

    Natalia Vladimirovna Chichasova


    Full Text Available Research Institute of Rheumatology, Russian Academy of Medical Sciences, Moscow The paper gives data on the prevalence, pathogenesis, clinical manifestations, and treatment of fibromyalgia (FM syndrome. It is stated that the ratio of all clinical symptoms of FM syndrome should be borne in mind when treating patients with this disease. Various specialists should be attracted to the treatment of these patients. Psychotropic medications that are prescribed by a psychiatrist are indicated where there is a preponderance of psychological disorders; the duration of this therapy is variable, but not more than 2—3 months. Most patients need proper analgesia, improved sleep quality and duration, and diminished fatigability that frequently leads to lower (none working capacity. Pregabalin (lyrica promptly suppresses the major manifestations of FM; the onset of its action is seen just after one week of treatment; the use of the drug may be continued as long as it is effective and safe.

  17. Human Resource Management for Continuous Improvement

    Jørgensen, Frances; Laugen, Bjørge; Boer, Harry


    The objective of this paper is to investigate the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, organizational performance. The paper i...

  18. Human Resource Management for Continuous Improvement

    Jørgensen, Frances; Laugen, Bjørge Timenes; Boer, Harry


    This paper investigates the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, company performance. The paper begins with a brief review of ...

  19. Continue Service Improvement at CERN Computing Centre

    Barroso Lopez, M.; Everaerts, L.; Meinhard, H.; Baehler, P.; Haimyr, N.; Guijarro, J. M.


    Using the framework of ITIL best practises, the service managers within CERN-IT have engaged into a continuous improvement process, mainly focusing on service operation. This implies an explicit effort to understand and improve all service management aspects in order to increase efficiency and effectiveness. We will present the requirements, how they were addressed and share our experiences. We will describe how we measure, report and use the data to continually improve both the processes and the services being provided. The focus is not the tool or the process, but the results of the continuous improvement effort from a large team of IT experts providing services to thousands of users, supported by the tool and its local team. This is not an initiative to address user concerns in the way the services are managed but rather an on-going working habit of continually reviewing, analysing and improving the service management processes and the services themselves, having in mind the currently agreed service levels and whose results also improve the experience of the users about the current services.



    The relationship between major quality tools such as quality function development (QFD),failure mode and effects analysis (FMEA), design of experiments (DOE) and statistical process control (SPC) is analyzed through an extensive review of the literature and the concurrent quality engineering philosophy, and a basic structure for the integration of quality tools is presented. An integrated quality management system (IQMS) is developed using C++ Builder, nmning in the Windows 2000 Server environment with the basic internet connections, and SQL Server 2000 as the platform for developing the database. An illustrative example applying IQMS to the continuous quality improvement for a crane equipment manufacturing is reported. The result shows that the application of IQMS can optimize the process of design and manufacturing, shorten the cycle time of product, reduce the cost, and realize quality improvement continuously. The proposed integrated framework with IQMS is believed to be applicable to continuous quality improvement in many manufacturing companies.


    Daniel Indarto Prajogo


    Full Text Available This paper discusses the concept of continuous improvement (CI by looking beyond what traditionally highlighted in literature concerning continuous improvement or Total Quality Management (TQM. The primary argument put forwarded in the discussion is that despite the undeniable positive results from CI practices, the way these activities are implemented, however, will lead to most programs becoming self-limiting. It needs to be asserted here that this paper is not intended to despise CI, rather, its purpose is limited only to provide a balance on the prevailing positive views toward CI.

  2. Software Maintenance Management Evaluation and Continuous Improvement

    April, Alain


    This book explores the domain of software maintenance management and provides road maps for improving software maintenance organizations. It describes full maintenance maturity models organized by levels 1, 2, and 3, which allow for benchmarking and continuous improvement paths. Goals for each key practice area are also provided, and the model presented is fully aligned with the architecture and framework of software development maturity models of CMMI and ISO 15504. It is complete with case studies, figures, tables, and graphs.

  3. Improving mental health outcomes: achieving equity through quality improvement

    Poots, Alan J.; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek


    Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s) Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s) (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), compared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low, medium and high deprivation areas attained similar changes in depression score (ΔPHQ9: M = −6.60, SD = 6.41). Similar proportions of patients achieved the key performance indicator across initiative phase and deprivation categories. Conclusions QI methods improved access to mental health services; this paper finds no evidence for differences in clinical outcomes in patients, regardless of level of deprivation, interpreted as no evidence of inequity in the service with respect to this outcome. PMID:24521701

  4. Human Resource Development's Contribution to Continuous Improvement

    Jørgensen, Frances; Hyland, Paul

    Continuous Improvement (CI) is an approach to organizational change that requires active involvement of skilled and motivated employees, which implies an important role for HRD practitioners. The findings from a literature review and a survey of 168 Danish manufacturing companies indicate however...

  5. Human Resource Development's Contribution to Continuous Improvement

    Jørgensen, Frances; Hyland, Paul


    Continuous Improvement (CI) is an approach to organizational change that requires active involvement of skilled and motivated employees, which implies an important role for HRD practitioners. The findings from a literature review and a survey of 168 Danish manufacturing companies indicate however...

  6. Improving Achievement through Problem-Based Learning

    Sungur, Semra; Tekkaya, Ceren; Geban, Omer


    In this study, the effect of problem-based learning on students' academic achievement and performance skills in a unit on the human excretory system was investigated. Sixty-one 10th grade students, from two full classes instructed by the same biology teacher, were involved in the study. Classes were randomly assigned as either the experimental or…

  7. A Typology of Continuous Improvement Implementation Processes

    Rijnders, Sander; Boer, Harry


    This article presents a typology of continuous improvement (CI) implementation processes. The typology is based on an empirical study of 26 companies engaged in the implementation of CI. The data underpinning the typology was collected through retrospective interviews guided by a semi-structured ......This article presents a typology of continuous improvement (CI) implementation processes. The typology is based on an empirical study of 26 companies engaged in the implementation of CI. The data underpinning the typology was collected through retrospective interviews guided by a semi......-structured questionnaire. Four different approaches to implementing CI are identified, described and analysed. The resulting typology contributes to the development of CI implementation theory - an underdeveloped area of theory - and is useful for companies considering to engage in, or step up, their CI activities....

  8. Improving Learner Achievement through Evaluation by Objectives.

    Sullivan, Howard J.

    Evaluation techniques were designed to improve learner performance through use of pre-specified popular instructional objectives. Current curriculum planning and evaluation practices are examined. Two common evaluation malpractices are: (1) the tendency to treat the content of the program as the most important criterion for evaluation, (2) the…

  9. Improving Outcome Measures Other Than Achievement

    Kristin Anderson Moore


    Full Text Available Research indicates that educational, economic, and life success reflect children’s nonacademic as well as academic competencies. Therefore, longitudinal surveys that assess educational progress and success need to incorporate nonacademic measures to avoid omitted variable bias, inform development of new intervention strategies, and support mediating and moderating analyses. Based on a life course model and a whole child perspective, this article suggests constructs in the domains of child health, emotional/psychological development, educational achievement/attainment, social behavior, and social relationships. Four critical constructs are highlighted: self-regulation, agency/motivation, persistence/diligence, and executive functioning. Other constructs that are currently measured need to be retained, including social skills, positive relationships, activities, positive behaviors, academic self-efficacy, educational engagement, and internalizing/emotional well-being. Examples of measures that are substantively and psychometrically robust are provided.

  10. 2.2 Continuous quality improvement.

    Rohlin, Madeleine; Schaub, Rob M H; Holbrook, Peter; Leibur, Edvitar; Lévy, Gérard; Roubalikova, Lenka; Nilner, Maria; Roger-Leroi, Valerie; Danner, Gunter; Iseri, Haluk; Feldman, Cecile


    Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of public accountability, maintaining European standards and the improvement of dental education. Many examples are known where recommendations from both external and internal evaluation are used for the improvement of dental education. Unfortunately, the implementation of the recommendations is inconsistent, rarely systematic and usually not transparent. This section agreed that it is essential to apply CQI in a structured, systematic and transparent way if we are to improve and maintain the quality of dental education. A model is proposed which includes three aspects: a) the process of CQI; b) the subjects to which CQI should be applied; and c) the management tools to govern CQI. It is stressed, that CQI is a process that can be applied in any dental school irrespective of curriculum or educational approach within the relevant context of the country or the region. The approach needs to recognize the complexity and the need to balance a quality improvement with accountability. A CQI system is also constrained in any organization by the attitudes and values of the staff. Inevitably there has to be a wide range in the application of CQI. Nevertheless, an agreed model on CQI might enhance convergence towards higher standards of dental education. The process of CQI can be supported by developments in information and communication technology (ICT): collection of data, identifying the steps in CQI, formats of reports, etc. The section was set, as one of its tasks, to advise on the development of a network based on a number of case studies on the application of CQI in dental education.

  11. Continuous quality improvement: improving hemodialysis catheter patency using urokinase.

    Northsea, C


    Opportunities for improvements in patient outcomes through applied continuous quality improvement (CQI) programs are endless and exciting. Improving vascular access outcomes has been a long-standing clinical problem for hemodialysis patients and the nephrology team. During the past few years there has been a dramatic increase in the use of dialysis catheters as permanent accesses for hemodialysis patients. All hemodialysis with dialysis catheters are at risk for catheter occlusion. An innovative, 2-year CQI program was developed, implemented, and designed to improve dialysis catheter patency rates with the use of urokinase. The CQI program resulted in a number of clinical outcomes that were beneficial to the patients and dialysis staff, and were cost-effective to the program.

  12. Continuous improvement based on learning capacity of petroleum industry

    Filho, C.A.; Silva, E.N.C.; Rodriguez, M.V.R.; Quelhas, O.L.G. [Univ. Federal Fluminense, Rio de Janeiro (Brazil)


    Knowledge management is one of the newest strategies for organizations to improve their productivity. Oil companies seeking business sustainability are faced with the challenge of continuously improving their operations. This paper emphasized that in order to improve, companies must gain valuable experience through planning, perseverance, commitment and processes that accumulate results. It presented a visual methodology, based on symbolisms and key words, which is intended to facilitate the assimilation of the continuous improvement program structure from knowledge management. The concepts of Garvin, Nonaka and Takeuchi were presented as means for improving the capacity of an organization seeking a learning atmosphere through the prioritization of actions to facilitate team activities and accumulate knowledge in the individual. It was shown that Japanese companies in the production sector have used 4 processes of knowledge conversion: socialization, exteriorization, internalization and their combinations. The Garvin concept has proposed that continuous improvement of an organization would be more positive if the companies learnt a basic lesson. This paper articulated resulting observations from Garvin and from Nonaka and Takeuchi theories and proposed recommendations based on symbolism for identifying action strategies and achievement objectives. Issues regarding working conditions and the influence on learning were discussed along with different ways to transfer knowledge in terms of competencies and skills. 14 refs., 7 figs.

  13. Continual Improvement In Small Soaps Company

    Borget Alfred Anoye


    Full Text Available Abstract In this paper using quality management tools we track root causes and principal causes of the rising manufacturing cost of the bar soaps and propose solution to solve the problem. First we identify and analyze the roots causes of problem with the Fishbone Diagram. We use multivoting approach to reduce roots causes to main causes from which we identify classify and analyze principal causes using the Pareto Diagram. We then perform a deep analysis of these principal causes using the 5 whys analysis technique. Three principal causes were found amp61480high level of overtime poor machine performance and poor employees performanceamp61481 and were weighing 55 of the problem. For that reason working on these areas was necessary to address the problem of the rising manufacturing cost of the bar soaps. With the result we then use the PDCA 7 steps of TQM method to solve the problem of the rising manufacturing cost by testing whether expanding production capacity leads to performance improvements of these areas. We decide to expand production capacity by adding two more machine groups. Six months after implementation of the proposed solution the result shows an enhanced workload and schedule an increased production capacity an elimination of the overtime issue an increased machines performance and an improved workers performance. Two main savings were achieved as wage costs and maintenance costs. As a result while competitors bar soaps prices increased the company bar soaps price decreased by 50 making the company bar soaps more attractive on market as this performance permitted the company to apply price reduction at the retailer level.

  14. Self-assessment/continuous improvement: Opportunity or burden?

    Ryder, D.E.


    Quality assurance is defined in US Department of Energy (DOE) Order 5700.6C as ``actions that provide confidence that quality is achieved.`` Confidence is the key word in this definition. Because of a lackof confidence, Congress has mandated improved performance by DOE and its contractors. DOE Headquarters has responded, in part, by requiring increased oversight of all affected organizations. Self-assessment/continuous improvement (SA/CI) is presented in this paper as a ten-step process to help restore confidence. The SA/CI process begins when you identify your customers. SA/CI then leads to determining customer requirements and establishing performance objectives and criteria against which current processes and performance are evaluated. SA/CI should be performed by managers and supervisors at all levels and should includedirect observation of work in progress in addition to analysis of performance data. Traditional independent assessment processes such as audits and surveillances can be used to provide valuable information for performing the evaluation. SA/CI is an aggressive ``no-fault`` self-assessment process coupled with a continuous improvement process that yields truly cost-effective corrective action and a high level of confidence that process and product quality objectives have been met. This approach should provide customers the evidence needed to increase their confidence in the organization`s activities. The end result should bean improvement in the quality of work life for the organization`s employees and a significant reduction in external oversight (i.e., audits).

  15. An integrated model for continuous quality improvement and productivity improvement in health services organizations.

    Rakich, J S; Darr, K; Longest, B B


    The health services paradigm with respect to quality has shifted to that of conformance to requirements (the absence of defects) and fitness for use (meeting customer expectations and needs). This article presents an integrated model of continuous quality improvement (CQI) (often referred to as total quality management) and productivity improvement for health services organizations. It incorporates input-output theory and focuses on the CQI challenge--"How can we be certain that we do the right things right the first time, every time?" The twin pillars of CQI are presented. Achievement of both will result in productivity improvement and enhancement of the health services organization's competitive position.

  16. Metacognitive Training in Professional Development Can Improve and Sustain Student Achievement

    Phillips, Jeffrey A; Clemmer, Katharine W


    Secondary school students in the United States continue to underachieve in mathematics and science. Improving teacher quality is a core component of improving student achievement. Here we report on a professional development program, the MAST System, that develops the knowledge and skills for teaching mathematics, including metacognitive knowledge and regulation. In this cognitive apprenticeship program, teachers learn to plan, evaluate and adjust to improve student engagement and achievement. Central is the metacognitive practice of defense of instruction. By practicing this reflective approach, teachers become adaptive experts, able to innovate in the classroom. During the two-year intervention, the MAST System resulted in large increases in the California Standards Test mathematics scores, compared to both the district and the state. In addition, improvement continued for several years after the intervention was completed. This continued improvement in student scores indicated that the teachers and schools...

  17. Heterogeneity Improves Cooperation in Continuous Snowdrift Game

    ZHONG Li-Xin; QIU Tian; XU Jiang-Rong


    We study the networking effects on the population divergence and the increased level of cooperation in the continuous snowdrift game (CSG). In the regular world, limited interaction inhibits the occurrence of evolutionary branching. The formation of clusters defends the intermediate-investors from intruding by high- or low-investors. In a rewired network, the collective behaviour is related to the rewiring rules. A linear relationship I = ασ + b between the average investment and the standard deviation of the degree distribution is found.

  18. Construct Validity of the Computerized Continuous Performance Test with Measures of Intelligence, Achievement, and Behavior.

    Campbell, Janice Whitten; And Others


    Administered Continuous Performance Test (CPT), Wechsler Intelligence Scale for Children-Revised, Wide Range Achievement Test-Revised, Bender Visual-Motor Gestalt Test, and reading comprehension subtest of Peabody Individual Achievement Test to 54 school-aged children and adolescents referred for evaluation of learning disabilities. Parents…

  19. Human Physiology: Improving Students' Achievements through Intelligent Studyware.

    Dori, Yehudit J.; Yochim, Jerome M.


    A studyware comprising a set of interconnected modules on human physiology has been developed and used to improve undergraduate students' achievements. Study results show the scores of students who used the optional computer laboratory sessions were enhanced over those who did not use the studyware. Presents examples from the modules. (LZ)

  20. New Directions in Social Psychological Interventions to Improve Academic Achievement

    Wilson, Timothy D.; Buttrick, Nicholas R.


    Attempts to improve student achievement typically focus on changing the educational environment (e.g., better schools, better teachers) or on personal characteristics of students (e.g., intelligence, self-control). The 6 articles in this special issue showcase an additional approach, emanating from social psychology, which focuses on students'…

  1. Metric Development for Continuous Process Improvement


    improve the bottom line of an organization. The first step of this process is to solicit the key performance indicators ( KPIs ) that best reflect the...organization’s mission. The second step is to use and/or develop metrics based on those KPIs to measure the organization’s mission performance today...The third step is to capture the trends of those KPIs over time to see if the organization is getting better or worse. The final step is to

  2. Continuing education for performance improvement: a creative approach.

    Collins, Patti-Ann; Hardesty, Ilana; White, Julie L; Zisblatt, Lara


    In an effort to improve patient safety and health care outcomes, continuing medical education has begun to focus on performance improvement initiatives for physician practices. Boston University School of Medicine's (BUSM) Continuing Nursing Education Accredited Provider Unit has begun a creative project to award nursing contact hours for nurses' participation in performance improvement activities. This column highlights its initial efforts.

  3. Self-assessment/continuous improvement: Opportunity or burden

    Ryder, D.E.


    Quality assurance is defined in US Department of Energy (DOE) Order 5700.6C as actions that provide confidence that quality is achieved.'' Confidence is the key word in this definition. Because of a lackof confidence, Congress has mandated improved performance by DOE and its contractors. DOE Headquarters has responded, in part, by requiring increased oversight of all affected organizations. Self-assessment/continuous improvement (SA/CI) is presented in this paper as a ten-step process to help restore confidence. The SA/CI process begins when you identify your customers. SA/CI then leads to determining customer requirements and establishing performance objectives and criteria against which current processes and performance are evaluated. SA/CI should be performed by managers and supervisors at all levels and should includedirect observation of work in progress in addition to analysis of performance data. Traditional independent assessment processes such as audits and surveillances can be used to provide valuable information for performing the evaluation. SA/CI is an aggressive no-fault'' self-assessment process coupled with a continuous improvement process that yields truly cost-effective corrective action and a high level of confidence that process and product quality objectives have been met. This approach should provide customers the evidence needed to increase their confidence in the organization's activities. The end result should bean improvement in the quality of work life for the organization's employees and a significant reduction in external oversight (i.e., audits).

  4. Continuous quality improvement of colorectal cancer screening

    Mariusz; Madalinski


    Quality assurance is a key issue in colorectal cancer screening, because effective screening is able to improve primary prevention of the cancer. The quality measure may be described in terms:how well the screening test tells who truly has a disease (sensitivity) and who truly does not have a disease (specificity). This paper raises concerns about identification of the optimal screening test for colorectal cancer. Colonoscopy vs flexible sigmoidoscopy in colorectal cancer screening has been a source of ongoing debate. A multicentre randomised controlled trial comparing flexible sigmoidoscopy with usual care showed that flexible sigmoidoscopy screening is able to diminish the incidence of distal and proximal colorectal cancer, and also mortality related to the distal colorectal cancer. However, colonoscopy provides a more complete examination and remains the more sensitive exam than flexible sigmoidoscopy. Moreover, colonoscopy with polypectomy significantly reduces colorectal cancer incidence and colorectal cancer-related mortality in the general population. The article considers the relative merits of both methods and stresses an ethical aspect of patient’s involvement in decision-making. Patients should be informed not only about tests tolerability and risk of endoscopy complications, but also that different screening tests for bowel cancer have different strength to exclude colonic cancer and polyps. The authorities calculate effectiveness and costs of the screening tests, but patients may not be interested in statistics regarding flexible sigmoidoscopy screening and from an ethical point of view, they have the right to chose colonoscopy, which is able to exclude a cancer and precancerous lesions in the whole large bowel.


    Dorota Stadnicka


    Full Text Available Continuous improvement is indispensable for ensuring the company's development and its survival on the constantly changing global market. Continuous improvement is particularly important in the quality and production management systems. A company should deliver a product compliant with a client's requirements in a specified time and at an appropriate price. That is why, continuous improvement refers to different areas of an organization's functioning and it is an integral part of Lean Manufacturing. This article presents the results of the study conducted in production enterprises on a limited area. The aim of the study was the assessment of the implementation of continuous improvement in Lean Manufacturing, and, in particular, employees' involvement in the problem identification and in reporting improvements as well as the way of motivating employees to involve themselves. The authors also tried to identify the factors influencing the elements of a continuous improvement system.

  6. Implementing Continuous Improvement Management (CIM) in the Public Schools.

    Borgers, William E.; Thompson, Tommy A.

    This book traces the restructuring of a Texas school district that moved from management by coercion to continuous improvement for quality. In 1990, the Dickinson Independent School District (Texas) began implementation of Continuous Improvement Management (CIM), based on the teachings of W. Edwards Deming, William Glasser, and J. M. Juran.…

  7. [Continuous nursing education to improve the quality of health care].

    Fumić, Nera; Marinović, Marin; Brajan, Dolores


    Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and

  8. Microalloying Boron Carbide with Silicon to Achieve Dramatically Improved Ductility.

    An, Qi; Goddard, William A


    Boron carbide (B4C) is a hard material whose value for extended engineering applications such as body armor; is limited by its brittleness under impact. To improve the ductility while retaining hardness, we used density functional theory to examine modifying B4C ductility through microalloying. We found that replacing the CBC chain in B4C with Si-Si, denoted as (B11Cp)-Si2, dramatically improves the ductility, allowing a continuous shear to a large strain of 0.802 (about twice of B4C failure strain) without brittle failure. Moreover, (B11C)-Si2 retains low density and high hardness. This ductility improvement arises because the Si-Si linkages enable the icosahedra accommodate additional shear by rotating instead of breaking bonds.

  9. Behaviour and school achievement in patients with early and continuously treated phenylketonuria

    Stemerdink, BA; Kalverboer, AF; van der Meere, JJ; de Jong, LWA; Slijper, FME; Verkerk, PH; van Spronsen, FJ


    Thirty patients with early and continuously treated phenylketonuria (PKU) between 8 and 20 years of age were compared with 30 controls, matched individually for age, sex, and educational level of both parents, on behaviour rating scales for parents and teachers as well as a school achievement scale.

  10. Improvements to the CONTINUE feature in transient analysis

    Pamidi, P. R.


    The CONTINUE feature in transient analysis as implemented in the standard release of COSMIC/NASTRAN has inherent errors associated with it. As a consequence, the results obtained by a CONTINUEd restart run do not, in general, match the results that would be obtained in a single run without the CONTINUE feature. These inherent errors were eliminated by improvements to the restart logic that were developed by RPK Corporation and that are available on all RPK-supported versions of COSMIC/NASTRAN. These improvements ensure that the results of a CONTINUEd transient analysis run are the same as those of a non-CONTINUEd run. In addition, the CONTINUE feature was extended to transient analysis involving uncoupled modal equations. The improvements and enhancement were illustrated by examples.

  11. Teacher Tweets Improve Achievement for Eighth Grade Science Students

    Carol Van Vooren


    Full Text Available In the Digital Age teachers have fallen far behind the technical skills of their "digital native" students. The implementation of technology as a tool for classroom communication is foreign for most teachers, but highly preferred by students. While teenagers are using Facebook, Twitter, and other social networks to communicate, teachers continue to respond through face-to-face conversations, telephone calls, and email messaging. Twitter, a platform for short message service text, is an online social network site that allows users to send and receive messages using 140 characters or less called Tweets. To analyze the relationship of the teacher's use of Twitter with student academic achievement, a correlation study conducted by Bess collected data from two matched samples of eighth grade science students: one utilizing Twitter and one not utilizing Twitter to reinforce classroom instruction. Two tests matching the science standards were given to both samples of students. The results of the tests were used as primary data. The findings suggested a positive correlation between the use of Twitter and student performance on the standardized tests. Implications for this study indicate that young teenagers may prefer Twitter as a mode of communication with their teacher, resulting in higher academic achievement in a middle school science class.

  12. Secondary School Reading: Using the Quality Principle of Continuous Improvement To Build an Exemplary Program.

    Weller, L. David; Weller, Sylvia J.


    POWER (Providing Opportunities with Everyday Reading), stressing reading in the content areas, is a program for high schoolers driven by continuous improvement and teamwork. Improved test scores and enhanced attitudes toward reading result from high teacher commitment and sustained interest achieved through this teacher-led program's design. (MLH)

  13. A model for continuous improvement at a South African minerals benefication plant

    Ras, Eugene Ras


    Full Text Available South Africa has a variety of mineral resources, and several minerals beneficiation plants are currently in operation. These plants must be operated effectively to ensure that the end-users of its products remain internationally competitive. To achieve this objective, plants need a sustainable continuous improvement programme. Several frameworks for continuous improvement are used, with variable success rates, in beneficiation plants around the world. However, none of these models specifically addresses continuous improvement from a minerals-processing point of view. The objective of this research study was to determine which factors are important for a continuous improvement model at a minerals beneficiation plant, and to propose a new model using lean manufacturing, six sigma, and the theory of constraints. A survey indicated that managers in the industry prefer a model that combines various continuous improvement models.

  14. Improved apparatus for continuous culture of hydrogen-fixing bacteria

    Foster, J. F.; Litchfield, J. H.


    Improved apparatus permits the continuous culture of Hydrogenomonas eutropha. System incorporates three essential subsystems - /1/ environmentally isolated culture vessel, /2/ analytical system with appropriate sensors and readout devices, /3/ control system with feedback responses to each analytical measurement.

  15. Modelling the Role of Human Resource Management in Continuous Improvement

    Jørgensen, Frances; Hyland, Paul; Kofoed, Lise B.


    Although it is widely acknowledged that both Human Resource Management (HRM) and Continuous Improvement have the potential to positively influencing organizational performance, very little attention has been given to how certain HRM practices may support CI, and consequently, a company...

  16. Continuous Improvement in Nursing Education through Total Quality Management (TQM

    Tang Wai Mun


    Full Text Available Total Quality Management (TQM has generally been validated as a crucial revolution in the management field. Many academicians believe that the concept of TQM is applicable to academics and provides guiding principles towards improving education. Therefore, an increasing number of educational institutions such as schools, colleges and universities have started to embrace TQM philosophies to their curricula.Within the context of TQM, this paper would explore the concept of continuous improvement by using the Deming philosophy. Subsequently, this paper would elaborate on the application of TQM to bring about continuous improvement in the current education system.

  17. Agile kaizen managing continuous improvement far beyond retrospectives

    Medinilla, Ángel


    Agile teams have been struggling with the concept of continuous improvement since the first Agile frameworks were developed, and still very little has been written about the practice of continuous improvement in Agile environments. Although team retrospectives have been prescribed and some practices have been introduced in order to implement and facilitate them, the truth is that most Agile teams are conducting dull retrospectives that end with a list of things that have been done wrong, just to repeat the same list two weeks later at the next meeting.Instead of listing hundreds of Japanese-la

  18. Eurodish-Continuous Operation, System Improvement and Reference Units

    Keck, T.; Schiel, W.; Heller, P.; Reinalter, W.; Gineste, J. M.; Ferriere, A.; Flamant, G.


    The 10 kWel Dish/Stirling system EuroDish was enhanced. Newly developed and improved components like the ceramic cavity insulation and the control system are described as well as a novel assembly method for the concentrator and a number of improvements and new features of the control software. Country Reference Units were built in Spain, France and Germany and are continuously operated. Operation experiences and performance data are presented. (Author)

  19. Lean management systems: creating a culture of continuous quality improvement.

    Clark, David M; Silvester, Kate; Knowles, Simon


    This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.

  20. Promoting Continuous Quality Improvement in Online Teaching: The META Model

    Dittmar, Eileen; McCracken, Holly


    Experienced e-learning faculty members share strategies for implementing a comprehensive postsecondary faculty development program essential to continuous improvement of instructional skills. The high-impact META Model (centered around Mentoring, Engagement, Technology, and Assessment) promotes information sharing and content creation, and fosters…

  1. Jump starting of continuous improvement through self-assessment

    Jørgensen, Frances; Boer, Harry; Gertsen, Frank


    The innumerable accounts of successful implementation of kaizen in Japan during more than 40 years has led to the expectation that continuous improvement (CI) might offer companies a means to gain and maintain a competitive advantage in the turbulent 1980s and 1990s. However, the majority of CI i...

  2. IMHEX fuel cell repeat component manufacturing continuous improvement accomplishments

    Jakaitis, L.A.; Petraglia, V.J.; Bryson, E.S. [M-C Power Corp., Burr Ridge, IL (United States)] [and others


    M-C Power is taking a power generation technology that has been proven in the laboratory and is making it a commercially competitive product. There are many areas in which this technology required scale up and refinement to reach the market entry goals for the IMHEX{reg_sign} molten carbonate fuel cell power plant. One of the primary areas that needed to be addressed was the manufacturing of the fuel cell stack. Up to this point, the fuel cell stack and associated components were virtually hand made for each system to be tested. M-C Power has now continuously manufactured the repeat components for three 250 kW stacks. M-C Power`s manufacturing strategy integrated both evolutionary and revolutionary improvements into its comprehensive commercialization effort. M-C Power`s objectives were to analyze and continuously improve stack component manufacturing and assembly techniques consistent with established specifications and commercial scale production requirements. Evolutionary improvements are those which naturally occur as the production rates are increased and experience is gained. Examples of evolutionary (learning curve) improvements included reducing scrap rates and decreasing raw material costs by buying in large quantities. Revolutionary improvements result in significant design and process changes to meet cost and performance requirements of the market entry system. Revolutionary changes often involve identifying new methods and developing designs to accommodate the new process. Based upon our accomplishments, M-C Power was able to reduce the cost of continuously manufactured fuel cell repeat components from the first to third 250 kW stack by 63%. This paper documents the continuous improvement accomplishments realized by M-C Power during IMHEX{reg_sign} fuel cell repeat component manufacturing.

  3. Community-University Partnerships: Achieving continuity in the face of change

    Linda Silka


    Full Text Available A challenge that community-university partnerships everywhere will face is how to maintain continuity in the face of change. The problems besetting communities continually shift and the goals of the university partners often fluctuate. This article describes a decade-long strategy one university has successfully used to address this problem. Over the past ten years, a community-university partnership at the University of Massachusetts Lowell has used summer content funding to respond creativity to shifting priorities. Each summer a research-action project is developed that targets a different content issue that has emerged with unexpected urgency. Teams of graduate students and high school students are charged with investigating this issue under the auspices of the partnership. These highly varied topics have included immigrant businesses, youth asset mapping, women owned businesses, the housing crisis, social program cutbacks, sustainability, and economic development and the arts. Despite their obvious differences, these topics share underlying features that further partnership commitment and continuity. Each has an urgency: the information is needed quickly, often because some immediate policy change is under consideration. Each topic has the advantage of drawing on multiple domains: the topics are inherently interdisciplinary and because they do not “belong” to any single field, they lend themselves to disciplines pooling their efforts to achieve greater understanding. Each also has high visibility: their salience has meant that people were often willing to devote scarce resources to the issues and also that media attention could easily be gained to highlight the advantages of students, partners, and the university working together. And the topics themselves are generative: they have the potential to contribute in many different ways to teaching, research, and outreach. This paper ends with a broader consideration of how partnerships can

  4. How to Sustain Change and Support Continuous Quality Improvement.

    Silver, Samuel A; McQuillan, Rory; Harel, Ziv; Weizman, Adam V; Thomas, Alison; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T; Chertow, Glenn M


    To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are

  5. Reservoir continuous process improvement six sigma methodology implementation

    Wannamaker, A.L.


    The six sigma methodology adopted by AlliedSignal Inc. for implementing continuous improvement activity was applied to a new manufacturing assignment for Federal Manufacturing & Technologies (FM&T). The responsibility for reservoir development/production was transferred from Rocky Flats to FM&T. Pressure vessel fabrication was new to this facility. No fabrication history for this type of product existed in-house. Statistical tools such as process mapping, failure mode and effects analysis, and design of experiments were used to define and fully characterize the machine processes to be used in reservoir production. Continuous improvement with regard to operating efficiencies and product quality is an ongoing activity at FM&T.

  6. Ergonomics oriented to processes becomes a tool for continuous improvement.

    Getty, R L; Getty, J M


    A holistic view is essential for quality initiatives such as Total Quality Management (TQM), Standard No. ISO 9001:1994 (International Organization for Standardization [ISO], 1994), Concurrent Engineering, Business Reengineering, and Business Process Improvement. The challenge is knowing how to transition from this theoretical concept to implementation. The relationship between quality interest and an ergonomics program will be the focus of this discussion. An ergonomics oriented improvement program includes (a) ergonomics or fitting the job to the person; (b) integration of operations management, safety engineering, medical management, and employees as co-owners of the process; (c) the emphasis of ergonomic precepts in the engineering of new processes and improvement of current processes; and (d) the emphasis of employees taking responsibility for their own well being and the improvement of their work environment. The parallel between the continuous improvement process delineated by the quality-system requirements in Standard No. ISO 9001:1994 (ISO, 1994) and the improvement contributions of ergonomics are very revealing (Getty, Abbott, & Getty, 1995). It is the contention of this approach that if the precepts of ergonomics were applied to the work environment, it would support the objective of world class quality and productivity, resulting in improved global competitiveness of businesses.

  7. Paths to continuous improvement of a CRM strategy

    Lluís G. Renart


    Full Text Available The concept of relationship marketing has led to a paradigm change in marketing. Over the last few decades, numerous studies have analyzed the impact of customer relationship management (CRM programs on customer satisfaction and loyalty. Quite a few CRM programs have been found to have little or no impact. Having already published several articles and cases on the subject, in this paper we set out to answer the following question: assuming a company already has a reasonably successful CRM strategy in place, how can it continuously adapt and improve that strategy? Our recommendation is that such companies implement a continuous improvement process at four different but complementary levels: first, review and reinforce the company’s mission, culture and values; second, reconsider and, if necessary, redesign the CRM strategy; third, manage the various relationship-building activities more effectively; and lastly, review and, if necessary, improve the quality of material and human resources, program execution and process governance. A systematic review of these four levels or “paths” of improvement should help generate and maintain high quality relationships over time.

  8. Improving Our Odds: Success through Continuous Risk Management

    Greenhalgh, Phillip O.


    Launching a rocket, running a business, driving to work and even day-to-day living all involve some degree of risk. Risk is ever present yet not always recognized, adequately assessed and appropriately mitigated. Identification, assessment and mitigation of risk are elements of the risk management component of the "continuous improvement" way of life that has become a hallmark of successful and progressive enterprises. While the application of risk management techniques to provide continuous improvement may be detailed and extensive, the philosophy, ideals and tools can be beneficially applied to all situations. Experiences with the use of risk identification, assessment and mitigation techniques for complex systems and processes are described. System safety efforts and tools used to examine potential risks of the Ares I First Stage of NASA s new Constellation Crew Launch Vehicle (CLV) presently being designed are noted as examples. Recommendations from lessons learned are provided for the application of risk management during the development of new systems as well as for the improvement of existing systems. Lessons learned and suggestions given are also examined for applicability to simple systems, uncomplicated processes and routine personal daily tasks. This paper informs the reader of varied uses of risk management efforts and techniques to identify, assess and mitigate risk for improvement of products, success of business, protection of people and enhancement of personal life.

  9. Improving Student Achievement: Can Ninth Grade Academies Make A Difference?

    Ronald Anthony Styron


    Full Text Available This study focused on student achievement in ninth grade schools or academies compared to ninth grade students enrolled in traditional high schools. Student achievement was measured by standardized test scores. Other variables tested were gender and ethnicity. All students used in this study were enrolled in the ninth grade during the 2005-2006 school year at one of six schools selected for this research. Participants were enrolled in Algebra I and/or Biology I course(s and therefore took the standardized Subject Area Test in these disciplines. Data indicated students enrolled in ninth grade academies scored significantly higher then ninth graders enrolled in traditional high schools on both the Algebra I and Biology test. Further analysis of data revealed significant differences based on ethnicity in achievement of Biology I students in the ninth grade academies when compared to the Biology I students in the traditional high schools. The African American students in the ninth grade academies had a higher mean score on the Biology I SAPT than Caucasian and African American students enrolled in the traditional high schools. Additionally, the Caucasian students in the ninth grade academies scored only .03 higher than the mean score of African American students in the ninth grade academies.




    Full Text Available Quality has been one of the most important factors in judging any product. Quality means “a degree or grade of excellence or worth”. Quality is a term that is usually described using adjectives. Quality has several attributes to it, some of which can be quantified using metrics. These attributes such as usability, portability, security, performance, reliability etc have different importance in different projects. Different software quality assurance methods & practices have been used in different software projects to attain the true value. Quality is an attribute which is a distinct feature and it differs with people’s perception. Achieving high software quality involves measurement of software metrics and optimization based on estimated values. As the software systems grow larger, complexity ofdesign and implementation increases, and this in turn is more prone to defects and hence directly affect the quality of the systems. However, in any software project, high quality is always desirable, and many projects have specific quality requirements. Achieving high software quality involves measurement of software metrics and optimization based on estimated values. Developing high quality software is governed by factors such as people, process, technology and cost. This paper attempts to present a novel approach towards achieving high software quality in various kinds of projects under given constraints.

  11. The Divisional Approach to Achieving Hospital Improvement Goals

    Cortazzo, Arnold D.; Allen, Robert M.


    The divisional or horizontal approach, rather than the traditional or vertical model, was employed in improving the major organizations and programatic and service structure of a residential facility for retardates, Sunland Training Center (Miami, Florida). (KW)

  12. Deploying continuous improvement across the drug discovery value chain.

    Walker, Stephen M; Davies, Barry J


    In addressing the challenges facing pharmaceutical R&D one question is frequently asked: how can continuous improvement (CI), delivered through a Lean Sigma approach, be applied in a research environment to deliver overall benefit? We show that taking a value chain approach to improvement projects in a discovery research organization, initially focusing on the drug discovery project delivery level (i.e. middle layer of the value chain), provides the foundation for an effective CI programme. The adaptation of Lean Sigma principles and methodology, combined with the tenacity and creativity of scientists, enabled the delivery of significant improvements in challenging areas, including target selection, project decision making and the compound design-make-test-analyse (DMTA) cycle.

  13. Applying PPM to ERP Maintenance and Continuous Improvement Initiatives

    El-Tal, Nada Maria; Fonnesbæk, Majbrit; Kræmmergaard, Pernille


    Enterprise Resource Planning Systems (ERP) has been implemented in many companies during the last decade and has gained an increasing significance. For many companies it means that the focus is no longer on how to implement the ERP system, but rather on how to maintain and improve the system...... to gain business benefits from the systems. However the ERP literature on how to do this is limited. The purpose of this article is to explore how Project Portfolio Management (PPM) from the Research and Development (R&D) literature can be applied to an ERP second wave context, when companies...... are to prioritize and select maintenance and continuous improvement initiatives. This is done by reviewing the existing literature in the fields of PPM from R&D literature and then by reviewing the existing literature about maintenance and improvement initiatives in the ERP literature, after which the two...

  14. Organizational management practices for achieving software process improvement

    Kandt, Ronald Kirk


    The crisis in developing software has been known for over thirty years. Problems that existed in developing software in the early days of computing still exist today. These problems include the delivery of low-quality products, actual development costs that exceed expected development costs, and actual development time that exceeds expected development time. Several solutions have been offered to overcome out inability to deliver high-quality software, on-time and within budget. One of these solutions involves software process improvement. However, such efforts often fail because of organizational management issues. This paper discusses business practices that organizations should follow to improve their chances of initiating and sustaining successful software process improvement efforts.

  15. Lifetime Impact Identification for Continuous Improvement of Wind Farm Performance

    Petersen, Kristian R.; Ruitenburg, Richard J.; Madsen, Erik Skov;


    To become profitable, the cost of offshore windfarms must be reduced. Optimization of the Operations & Maintenance process offers a great potential for cost reductions, especially for existing windfarm. As Continuous Improvement may deliver these cost reductions, this paper aims at fostering CI...... in the offshore wind industry. In order to identify where to focus CI efforts, we turn to the theory of Asset Life Cycle Management which shows that a shared multidisciplinary understanding of the complete lifetime of a windfarm is critical. Based on a case study at a leading offshore wind farm company...

  16. Continual improvement: A bibliography with indexes, 1992-1993


    This bibliography lists 606 references to reports and journal articles entered into the NASA Scientific and Technical Information Database during 1992 to 1993. Topics cover the philosophy and history of Continual Improvement (CI), basic approaches and strategies for implementation, and lessons learned from public and private sector models. Entries are arranged according to the following categories: Leadership for Quality, Information and Analysis, Strategic Planning for CI, Human Resources Utilization, Management of Process Quality, Supplier Quality, Assessing Results, Customer Focus and Satisfaction, TQM Tools and Philosophies, and Applications. Indexes include subject, personal author, corporate source, contract number, report number, and accession number.

  17. Achieving Success via Multi-Model Process Improvement


    Mellon University page 19 Lean Tactics: Kaizen Events Kaizen - Make people’s jobs easier by taking them apart, studying them, and making improvements...KAI” - take apart and make anew • “ZEN” - think, make good the actions of others, do good deeds and help others Kaizen tips (VAL, M&A, QPM, - Requires firm understanding of the “before” state - “Just do it” Projects - Kaizen event with rollout plan • required use of Six Sigma

  18. Framework for continuous performance improvement in small drinking water systems.

    Bereskie, Ty; Haider, Husnain; Rodriguez, Manuel J; Sadiq, Rehan


    Continuous performance improvement (CPI) can be a useful approach to overcome water quality problems impacting small communities. Small drinking water systems (SDWSs) struggle to meet regulatory requirements and often lack the economic and human resource flexibility for immediate improvement. A CPI framework is developed to provide SDWS managers and operators an approach to gauge their current performance against similar systems and to track performance improvement from the implementation of the new technologies or innovations into the future. The proposed CPI framework incorporates the use of a water quality index (WQI) and functional performance benchmarking to evaluate and compare drinking water quality performance of an individual water utility against that of a representative benchmark. The results are then used to identify and prioritize the most vulnerable water quality indicators and subsequently identify and prioritize performance improvement strategies. The proposed CPI framework has been demonstrated using data collected from SDWSs in the province of Newfoundland and Labrador (NL), Canada and using the Canadian Council of Ministers of the Environment (CCME) WQI.

  19. Continued Development and Improvement of Pneumatic Heavy Vehicles

    Robert J. Englar


    The objective of this applied research effort led by Georgia Tech Research Institute is the application of pneumatic aerodynamic technology previously developed and patented by us to the design of an appropriate Heavy Vehicle (HV) tractor-trailer configuration, and experimental confirmation of this pneumatic configuration's improved aerodynamic characteristics. In Phases I to IV of our previous DOE program (Reference 1), GTRI has developed, patented, wind-tunnel tested and road-tested blown aerodynamic devices for Pneumatic Heavy Vehicles (PHVs) and Pneumatic Sports Utility Vehicles (PSUVs). To further advance these pneumatic technologies towards HV and SUV applications, additional Phase V tasks were included in the first year of a continuing DOE program (Reference 2). Based on the results of the Phase IV full-scale test programs, these Phase V tasks extended the application of pneumatic aerodynamics to include: further economy and performance improvements; increased aerodynamic stability and control; and safety of operation of Pneumatic HVs. Continued development of a Pneumatic SUV was also conducted during the Phase V program. Phase V was completed in July, 2003; its positive results towards development and confirmation of this pneumatic technology are reported in References 3 and 4. The current Phase VI of this program was incrementally funded by DOE in order to continue this technology development towards a second fuel economy test on the Pneumatic Heavy Vehicle. The objectives of this current Phase VI research and development effort (Ref. 5) fall into two categories: (1) develop improved pneumatic aerodynamic technology and configurations on smaller-scale models of the advanced Pneumatic Heavy Vehicle (PHV); and based on these findings, (2) redesign, modify, and re-test the modified full-scale PHV test vehicle. This second objective includes conduct of an on-road preliminary road test of this configuration to prepare it for a second series of SAE Type

  20. Improvement of Continuous Hydrologic Models and HMS SMA Parameters Reduction

    Rezaeian Zadeh, Mehdi; Zia Hosseinipour, E.; Abghari, Hirad; Nikian, Ashkan; Shaeri Karimi, Sara; Moradzadeh Azar, Foad


    Hydrological models can help us to predict stream flows and associated runoff volumes of rainfall events within a watershed. There are many different reasons why we need to model the rainfall-runoff processes of for a watershed. However, the main reason is the limitation of hydrological measurement techniques and the costs of data collection at a fine scale. Generally, we are not able to measure all that we would like to know about a given hydrological systems. This is very particularly the case for ungauged catchments. Since the ultimate aim of prediction using models is to improve decision-making about a hydrological problem, therefore, having a robust and efficient modeling tool becomes an important factor. Among several hydrologic modeling approaches, continuous simulation has the best predictions because it can model dry and wet conditions during a long-term period. Continuous hydrologic models, unlike event based models, account for a watershed's soil moisture balance over a long-term period and are suitable for simulating daily, monthly, and seasonal streamflows. In this paper, we describe a soil moisture accounting (SMA) algorithm added to the hydrologic modeling system (HEC-HMS) computer program. As is well known in the hydrologic modeling community one of the ways for improving a model utility is the reduction of input parameters. The enhanced model developed in this study is applied to Khosrow Shirin Watershed, located in the north-west part of Fars Province in Iran, a data limited watershed. The HMS SMA algorithm divides the potential path of rainfall onto a watershed into five zones. The results showed that the output of HMS SMA is insensitive with the variation of many parameters such as soil storage and soil percolation rate. The study's objective is to remove insensitive parameters from the model input using Multi-objective sensitivity analysis. Keywords: Continuous Hydrologic Modeling, HMS SMA, Multi-objective sensitivity analysis, SMA Parameters

  1. Change and Continuity in Student Achievement from Grades 3 to 5: A Policy Dilemma

    Mary McCaslin


    Full Text Available In this article, we examine student performance on mandated tests in grades 3, 4, and 5 in one state. We focus on this interval, which we term "the fourth grade window," based on our hypothesis that students in grade four are particularly vulnerable to decrements in achievement. The national focus on the third grade as the critical benchmark in student performance has distracted researchers and policy makers from recognition that the fourth grade transition is essential to our understanding of how to promote complex thinking and reasoning that are built upon a foundation of basic skills that may be necessary, but are not sufficient, for the more nuanced learning expected in subsequent grades. We hypothesized that the basic skills that define a successful third grade performance do not predict successful performance in subsequent years. We examined student performance over time using two measures of student success: the Arizona Instrument to Measure Standards (AIMS, a standards based test; and the Stanford 9 (SAT9, a norm-referenced test. Three groups of schools were included in these analyses. Schools were individually matched to the original sample of interest, which were schools serving students of poverty that received state funding to implement Comprehensive School Reform (CSR models that emphasize continuity across grade levels. The first comparison sample includes schools that also serve students of poverty but did not receive CSR funding, "nonCSR" schools. The second comparison sample includes schools individually matched on all variables except economic status. These schools, which we term "ow poverty" schools, are the wealthiest public schools in the state, with less than 10% of attending students receiving free or reduced lunch. Student test scores in math, reading, and writing (AIMS or language (SAT9 were analyzed for the years 2000-2003. These intervals allowed the analysis of two cohorts of the fourth grade window. Our results

  2. Innovative Outcome Assessment in Graduate Business Education and Continuous Improvement

    Chattopadhyay Satya P.


    Full Text Available The changed environment of global economy with painful austerity and restructuring measures causing severe economic dislocations in many diverse parts of the world have brought into focus the usefulness and value of management education in general and graduate management education in particular. The various accrediting bodies in America, Europe and Asia in recent years have shifted their emphasis to ensuring that learning outcomes of students in the program are tied to the goals and missions of the academic institution and meet the needs of the external partners of the academic enterprise that the students go on to serve. This has resulted in rapid advances in the field of innovative outcome assessment, and measurement of competency in performing higher order tasks as well as demonstration of traits related to successful transition into the business world and contribution to the success of the enterprise where the students are employed. The mere assessment/measurement of traits is not the end, but rather the first step in the cycle of continuous improvement in the tradition of the Plan-Do-Study-Act tradition of TQM. The goal is to identify shortcomings or opportunities for improvement via the assessment process and then to “close the loop” by introducing planned changes to improve system performance.

  3. Organizational culture, continuous quality improvement, and medication administration error reporting.

    Wakefield, B J; Blegen, M A; Uden-Holman, T; Vaughn, T; Chrischilles, E; Wakefield, D S


    This study explores the relationships among measures of nurses' perceptions of organizational culture, continuous quality improvement (CQI) implementation, and medication administration error (MAE) reporting. Hospital-based nurses were surveyed using measures of organizational culture and CQI implementation. These data were combined with previously collected data on perceptions of MAE reporting. A group-oriented culture had a significant positive correlation with CQI implementation, whereas hierarchical and rational culture types were negatively correlated with CQI implementation. Higher barriers to reporting MAE were associated with lower perceived reporting rates. A group-oriented culture and a greater extent of CQI implementation were positively (but not significantly) associated with the estimated overall percentage of MAEs reported. We conclude that health care organizations have implemented CQI programs, yet barriers remain relative to MAE reporting. There is a need to assess the reliability, validity, and completeness of key quality assessment and risk management data.

  4. Measuring Teacher Quality: Continuing the Search for Policy-Relevant Predictors of Student Achievement

    Knoeppel, Robert C.; Logan, Joyce P.; Keiser, Clare M.


    The purpose of this study was to investigate the potential viability of the variable certification by the National Board for Professional Teaching Standards (NBPTS) as a policy-relevant predictor of student achievement. Because research has identified the teacher as the most important school-related predictor of student achievement, more research…

  5. Initiatives for the improvement of continuous management training

    Jon Landeta


    Full Text Available Purpose. This work aims to present, from the company viewpoint, a structured account of management proposals and practices directed toward improving the intensity and effectiveness of continuous management training (CMT. Design/methodology/approach. The article takes as its main theoretical referents the Theory of Human Capital, the Resource-Based Vision and the contributions made via the new institutional economy with regard to the problems of information asymmetry between companies, employees and training providers and completes the proposals that derive from this theoretical approach. To do this, experience-based contributions are collected from a selection of company training and HR managers from twelve Basque companies characterised by their strong investment in management training. The methodology used was qualitative and obtained by different qualitative techniques: Focus Groups, Nominal Groups and the Delphi Method, which make up the so-called Hybrid Delphi. Findings and implications. The proposals are aimed at the main agents in training activity: training providers, associations and public agents engaged in management training and, particularly, companies themselves. The initiatives seek above all to increase training market transparency, to improve mutual commitments between companies and managers, and to link training and development with culture and strategic management, so that firms make optimal investment in management training. Originality/value. The methodology used is original, and the contributions are consistent with the theory, have a proven practical utility, and are presented in a hierarchy, which facilitates decision making.

  6. Improved Continuous-Time Higher Harmonic Control Using Hinfinity Methods

    Fan, Frank H.

    The helicopter is a versatile aircraft that can take-off and land vertically, hover efficiently, and maneuver in confined space. This versatility is enabled by the main rotor, which also causes undesired harmonic vibration during operation. This unwanted vibration has a negative impact on the practicality of the helicopter and also increases its operational cost. Passive control techniques have been applied to helicopter vibration suppression, but these methods are generally heavy and are not robust to changes in operating conditions. Feedback control offers the advantages of robustness and potentially higher performance over passive control techniques, and amongst the various feedback schemes, Shaw's higher harmonic control algorithm has been shown to be an effective method for attenuating harmonic disturbance in helicopters. In this thesis, the higher harmonic disturbance algorithm is further developed to achieve improved performance. One goal in this thesis is to determine the importance of periodicity in the helicopter rotor dynamics for control synthesis. Based on the analysis of wind tunnel data and simulation results, we conclude the helicopter rotor can be modeled reasonably well as linear and time-invariant for control design purposes. Modeling the helicopter rotor as linear time-invariant allows us to apply linear control theory concepts to the higher harmonic control problem. Another goal in this thesis is to find the limits of performance in harmonic disturbance rejection. To achieve this goal, we first define the metrics to measure the performance of the controller in terms of response speed and robustness to changes in the plant dynamics. The performance metrics are incorporated into an Hinfinity control problem. For a given plant, the resulting Hinfinity controller achieves the maximum performance, thus allowing us to identify the performance limitation in harmonic disturbance rejection. However, the Hinfinity controllers are of high order, and may

  7. Effects of Improvements in Interval Timing on the Mathematics Achievement of Elementary School Students

    Taub, Gordon E.; McGrew, Kevin S.; Keith, Timothy Z.


    This article examines the effect of improvements in timing/rhythmicity on mathematics achievement. A total of 86 participants attending 1st through 4th grades completed pre- and posttest measures of mathematics achievement from the Woodcock-Johnson III Tests of Achievement. Students in the experimental group participated in a 4-week intervention…

  8. Achieving quality improvement in the nursing home: influence of nursing leadership on communication and teamwork.

    Vogelsmeier, Amy; Scott-Cawiezell, Jill


    Leadership, communication, and teamwork are essential elements of organizational capacity and are linked to organizational performance. How those organizations actually achieve improved performance, however, is not clearly understood. In this comparative case study, nursing leadership who facilitated open communication and teamwork achieved improvement while nursing leadership who impeded open communication and teamwork did not.

  9. Benchmarking: a method for continuous quality improvement in health.

    Ettorchi-Tardy, Amina; Levif, Marie; Michel, Philippe


    Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach's emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector. Benchmarking is often thought to consist simply of comparing indicators and is not perceived in its entirety, that is, as a tool based on voluntary and active collaboration among several organizations to create a spirit of competition and to apply best practices. The key feature of benchmarking is its integration within a comprehensive and participatory policy of continuous quality improvement (CQI). Conditions for successful benchmarking focus essentially on careful preparation of the process, monitoring of the relevant indicators, staff involvement and inter-organizational visits. Compared to methods previously implemented in France (CQI and collaborative projects), benchmarking has specific features that set it apart as a healthcare innovation. This is especially true for healthcare or medical-social organizations, as the principle of inter-organizational visiting is not part of their culture. Thus, this approach will need to be assessed for feasibility and acceptability before it is more widely promoted.

  10. What drives continuous improvement project success in healthcare?

    Stelson, Paul; Hille, Joshua; Eseonu, Chinweike; Doolen, Toni


    Purpose The purpose of this paper is to present findings from a study of factors that affect continuous improvement (CI) project success in hospitals. Design/methodology/approach Quantitative regression analysis was performed on Likert scale survey responses. Qualitative thematic analysis was performed on open-ended survey responses and written reports on CI projects. Findings The paper identifies managerial and employee factors that affect project success. These factors include managerial support, communication, and affective commitment. Affective commitment is the extent to which employees perceive the change as being needed or necessary. Practical implications The results highlight how managerial decisions, approaches to communication - including communication before, during and after CI projects affect project success. The results also show that success depends on the way employees perceive proposed changes. This suggests the need for a more individualized approach to CI, lean, and broader change initiatives. Originality/value This research is the first to fuse project success and sustainability theory to CI projects, beyond Kaizen events, in healthcare environments. The research is particularly important at a time when healthcare organizations are required to make rapid changes with limited resources as they work toward outcome-based assessment and reimbursement rules.

  11. Achieving Continuity of Care: Facilitators and Barriers in Community Mental Health Teams

    Jones Ian Rees


    Full Text Available Abstract Background The integration of mental health and social services for people diagnosed with severe mental illness (SMI has been a key aspect of attempts to reform mental health services in the UK and aims to minimise user and carer distress and confusion arising from service discontinuities. Community mental health teams (CMHTs are a key component of UK policy for integrated service delivery, but implementing this policy has raised considerable organisational challenges. The aim of this study was to identify and explore facilitators and barriers perceived to influence continuity of care by health and social care professionals working in and closely associated with CMHTs. Methods This study employed a survey design utilising in-depth, semi-structured interviews with a proportionate, random sample of 113 health and social care professionals and representatives of voluntary organisations. Participants worked in two NHS Mental Health Trusts in greater London within eight adult CMHTs and their associated acute in-patient wards, six local general practices, and two voluntary organisations. Results Team leadership, decision making, and experiences of teamwork support were facilitators for cross boundary and team continuity; face-to-face communication between teams, managers, general practitioners, and the voluntary sector were facilitators for information continuity. Relational, personal, and longitudinal continuity were facilitated in some local areas by workforce stability. Barriers for cross boundary and team continuity were specific leadership styles and models of decision making, blurred professional role boundaries, generic working, and lack of training for role development. Barriers for relational, personal, and longitudinal continuity were created by inadequate staffing levels, high caseloads, and administrative duties that could limit time spent with users. Incompatibility of information technology systems hindered information

  12. Continued SOFC cell and stack technology and improved production methods

    Wandel, M.; Brodersen, K.; Phair, J. (and others)


    Within this project significant results are obtained on a number of very diverse areas ranging from development of cell production, metallic creep in interconnect to assembling and test of stacks with foot print larger than 500 cm2. Out of 38 milestones 28 have been fulfilled and 10 have been partly fulfilled. This project has focused on three main areas: 1) The continued cell development and optimization of manufacturing processes aiming at production of large foot-print cells, improving cell performance and development environmentally more benign production methods. 2) Stack technology - especially stacks with large foot print and improving the stack design with respect to flow geometry and gas leakages. 3) Development of stack components with emphasis on sealing (for 2G as well as 3G), interconnect (coat, architecture and creep) and test development. Production of cells with a foot print larger than 500 cm2 is very difficult due to the brittleness of the cells and great effort has been put into this topic. Eight cells were successfully produced making it possible to assemble and test a real stack thereby giving valuable results on the prospects of stacks with large foot print. However, the yield rate is very low and a significant development to increase this yield lies ahead. Several lessons were learned on the stack level regarding 'large foot print' stacks. Modelling studies showed that the width of the cell primarily is limited by production and handling of the cell whereas the length (in the flow direction) is limited by e.g. pressure drop and necessary manifolding. The optimal cell size in the flow direction was calculated to be between approx20 cm and < 30 cm. From an economical point of view the production yield is crucial and stacks with large foot print cell area are only feasible if the cell production yield is significantly enhanced. Co-casting has been pursued as a production technique due to the possibilities in large scale production

  13. Improving Low-Achieving Schools: Building State Capacity to Support School Improvement through Race to the Top

    Childs, Joshua; Russell, Jennifer Lin


    Improving low-achieving schools is a critical challenge facing urban education. Recent national policy shifts have pressed states to take an expanded role in school improvement efforts. In 2009, a federal grant competition called Race to the Top (RttT) compelled states to improve their capacity to implement ambitious education reform agendas.…

  14. Leveraging Improvements in Precipitation Measuring from GPM Mission to Achieve Prediction Improvements in Climate, Weather and Hydrometeorology

    Smith, Eric A.


    the way for what ultimately is expected to become an internationally-organized operational global precipitation observing system. Notably, the broad societal applications of GPM are reflected in the United Nation s identification of this mission as a foremost candidate for its Peaceful Uses of Space Program. In this presentation, an overview of the GPM mission design will be presented, followed by an explanation of its scientific agenda as an outgrowth of making improvements in rain retrieval accuracy, microphysics dexterity, sampling frequency, and global coverage. All of these improvements offer new means to observe variability in precipitation and water cycle fluxes and to achieve improved predictability of weather, climate, and hydrometeorology. Specifically, the scientific agenda of GPM has been designed to leverage the measurement improvements to improve prognostic model performance, particularly quantitative precipitation forecasting and its linked phenomena at short, intermediate, and extended time scales. The talk will address how GPM measurements will enable better detection of accelerations and decelerations in regional and global water cycle processes and their relationship to climate variability, better impacts of precipitation data assimilation on numerical weather prediction and global climate reanalysis, and better performance from basin scale hydrometeorological models for short and long term flood-drought forecasting and seasonal fresh water resource assessment. Improved hydrometeorological forecasting will be possible by using continuous global precipitation observations to obtain better closure in water budgets and to generate more realistic forcing of the models themselves to achieve more accurate estimates of interception, infiltration, evaporation/transpiration fluxes, storage, and runoff.

  15. Success beyond success : The ‘Golden Triangle’ of continuous performance improvement


    The main subject of the article is continuous performance improvement (CPI). More specifically, the author seeks to understand the most important management challenges under that heading. An extensive empirical study determines companies' most important continuous performance improvement roots.

  16. What Districts Can Do To Improve Instruction and Achievement in All Schools.

    Togneri, Wendy


    A study of five high-poverty districts making strides in improving student achievement revealed that these districts focused on systemwide strategies including new approaches to professional development; making decisions based on data, not instinct; and redefining leadership roles. (MLF)

  17. Teachers' Perception of Their Principal's Leadership Style and the Effects on Student Achievement in Improving and Non-Improving Schools

    Hardman, Brenda Kay


    Teachers' perceptions of their school leaders influence student achievement in their schools. The extent of this influence is examined in this study. This quantitative study examined teachers' perceptions of the leadership style of their principals as transformational, transactional or passive-avoidant in improving and non-improving schools in…

  18. Improving the Relationship between Continuing Education Leadership and Marketing Directors

    Fong, Jim


    In this economy, college and university continuing education units will not automatically reap the benefits of returning adult learners as in past recessions: this economy caused a drastic reduction of resources available to the workforce and for personal revenue. As a result of decreased personal income and workforce training funding, competition…

  19. Modular Approach for Continuous Cell-Level Balancing to Improve Performance of Large Battery Packs: Preprint

    Muneed ur Rehman, M.; Evzelman, M.; Hathaway, K.; Zane, R.; Plett, G. L.; Smith, K.; Wood, E.; Maksimovic, D.


    Energy storage systems require battery cell balancing circuits to avoid divergence of cell state of charge (SOC). A modular approach based on distributed continuous cell-level control is presented that extends the balancing function to higher level pack performance objectives such as improving power capability and increasing pack lifetime. This is achieved by adding DC-DC converters in parallel with cells and using state estimation and control to autonomously bias individual cell SOC and SOC range, forcing healthier cells to be cycled deeper than weaker cells. The result is a pack with improved degradation characteristics and extended lifetime. The modular architecture and control concepts are developed and hardware results are demonstrated for a 91.2-Wh battery pack consisting of four series Li-ion battery cells and four dual active bridge (DAB) bypass DC-DC converters.

  20. Continuous quality improvement in acute health care: creating a holistic and integrated approach.

    Sewell, N


    Reviews the range of quality activity in a National Health Service hospital trust, using a staff questionnaire survey, self-assessment against the Baldrige Quality Award criteria, and the application of the SERVQUAL approach to service quality assessment. Reviews the acute health care quality programme literature. Finds that there are needs for greater integration of quality effort, to engage with patients in a more meaningful manner, and to achieve greater commitment and involvement from clinicians and managers. Identifies lack of time and resources as a major barrier to greater application of quality programmes. Explores ways of developing a more holistic and integrated programme of quality improvement. Describes the creation and implementation of a model for continuous improvement in health care quality.

  1. Automated monitoring: a potential solution for achieving sustainable improvement in hand hygiene practices.

    Levchenko, Alexander I; Boscart, Veronique M; Fernie, Geoff R


    Adequate hand hygiene is often considered as the most effective method of reducing the rates of hospital-acquired infections, which are one of the major causes of increased cost, morbidity, and mortality in healthcare. Electronic monitoring technologies provide a promising direction for achieving sustainable hand hygiene improvement by introducing the elements of automated feedback and creating the possibility to automatically collect individual hand hygiene performance data. The results of the multiphase testing of an automated hand hygiene reminding and monitoring system installed in a complex continuing care setting are presented. The study included a baseline Phase 1, with the system performing automated data collection only, a preintervention Phase 2 with hand hygiene status indicator enabled, two intervention Phases 3 and 4 with the system generating hand hygiene reminding signals and periodic performance feedback sessions provided, and a postintervention Phase 5 with only hand hygiene status indicator enabled and no feedback sessions provided. A significant increase in hand hygiene performance observed during the first intervention Phase 3 was sustained over the second intervention Phase 4, with the postintervention phase also indicating higher hand hygiene activity rates compared with the preintervention and baseline phases. The overall trends observed during the multiphase testing, the factors affecting acceptability of the automated hand hygiene monitoring system, and various strategies of technology deployment are discussed.

  2. How to achieve and prove performance improvement - 15 years of experience in German wastewater benchmarking.

    Bertzbach, F; Franz, T; Möller, K


    This paper shows the results of performance improvement, which have been achieved in benchmarking projects in the wastewater industry in Germany over the last 15 years. A huge number of changes in operational practice and also in achieved annual savings can be shown, induced in particular by benchmarking at process level. Investigation of this question produces some general findings for the inclusion of performance improvement in a benchmarking project and for the communication of its results. Thus, we elaborate on the concept of benchmarking at both utility and process level, which is still a necessary distinction for the integration of performance improvement into our benchmarking approach. To achieve performance improvement via benchmarking it should be made quite clear that this outcome depends, on one hand, on a well conducted benchmarking programme and, on the other, on the individual situation within each participating utility.


    Ling CHEN; Jie SHEN; Ling QIN; Hongjian CHEN


    A modified ant colony algorithm for solving optimization problem with continuous parameters is presented. In the method, groups of candidate values of the components are constructed, and each value in the group has its trail information. In each iteration of the ant colony algorithm, the method first chooses initial values of the components using the trail information. Then GA operations of crossover and mutation can determine the values of the components in the solution. Our experimental results on the problem of nonlinear programming show that our method has a much higher convergence speed and stability than those of simulated annealing (SA) and GA.

  4. Continuous Process Improvement at Tinker Air Logistics Complex


    essential to improving business practices (Deming, 1982; Garvin , 1993). Lander and Liker define this construct as “a no blame environment where... defined variables to test our hypotheses based on the 14 principles of the TPS described in The Toyota Way and other quality management principles...become leaner by reducing Work In Progress (WIP) inventory, reducing flow times, and increasing product quality to meet aircraft and engine demand

  5. Improved SOFC performance with continuously graded anode functional layer

    Wang, Zhenhua; Xu, Ping [Department of Chemistry, Harbin Institute of Technology, Harbin 150001 (China); Zhang, Naiqing; Sun, Kening [Academy of Fundamental and Interdisciplinary Sciences, Harbin Institute of Technology, Harbin, Heilongjiang 150001 (China); Qiao, Jinshuo [Academy of Fundamental and Interdisciplinary Sciences, Harbin Institute of Technology, Harbin, Heilongjiang 150001 (China); Post-doctoral Research Center of Civil Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001 (China)


    Continuously graded anode functional layers (CG-AFLs) were fabricated on the Ni-YSZ anode substrates by electrophoretic co-deposition (EPD) technique. The microstructure and composition of the CG-AFLs were investigated. The result showed that uniform and graded structure in AFL was obtained. The single cells were constructed on the basis of CG-AFLs, with a maximum output power density greater than 1.10 W cm{sup -2} obtained at 800 C for the cell with 9.8 {mu}m-thick CG-AFL. Electrochemical impedance spectroscopy (EIS) indicated that the excellent cell performance was contributed to the enlargement of triple phase boundary (TPB) by adding the CG-AFL. (author)

  6. Professional learning communities: Teachers working collaboratively for continuous improvement

    Griffith, Louise Ann

    Current research indicates that a professional learning community (PLC) is an effective means for helping teachers to bridge the gap between research and practice. A PLC is a team of educators systematically working together to improve teaching practice and student learning. This study evaluated the PLC formed by teachers at a public elementary school. A 2-part formative assessment was conducted: an implementation evaluation to determine if PLC practices were in place and an evaluation to determine the PLC's progress towards meeting its goals. The PLC consisted of 6 4th grade and 5th grade teachers working to increase their science content and pedagogical knowledge. The foundation of this PLC was based in 4 areas of educational research and theory: constructivism, social learning, multiple intelligences, and differentiated instruction. Data were collected by means of interviews, participant observation, and analysis of artifacts. Data were then analyzed using an iterative set of phases: data reduction, data display, conclusion drawing and verification. The implementation evaluation showed that the PLC was in the developing stage. The progress evaluation showed that the PLC was making significant progress towards its goals of increased collaboration and pedagogical knowledge, but there was insufficient evidence to determine if participants' science content knowledge improved. An executive summary of the results and recommendations was presented to the stakeholders. The positive social change implications include knowledge useful for educators who are searching for direction in improving the quality of professional development offered to elementary teachers.

  7. Continuous improvement processes using Lean Management tools. A case study

    Pârv Luminița


    Full Text Available The paper describes how Lean Management may be applied in the university setting to improve the management processes. The correlation of didactic, educational and research activities with the stakeholders needs is one of the main objectives of the university. In this respect, an indicator used to analyse a university, for the purposes of fulfilling its mission, respectively for the purposes of streamlining its didactic and scientific activity, is related to the number of graduates on the labour market, acting in their area of specialization. This work presents a best practice of Lean Management at Transilvania University of Brasov, Romania.

  8. Positioning Continuing Education: Boundaries and Intersections between the Domains Continuing Education, Knowledge Translation, Patient Safety and Quality Improvement

    Kitto, Simon; Bell, Mary; Peller, Jennifer; Sargeant, Joan; Etchells, Edward; Reeves, Scott; Silver, Ivan


    Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the…

  9. Organizational climate survey: management model tool on continuous improvement promotion in Finantial Institutional Environment

    Alex Amancio da Silva


    Full Text Available The organizational climate survey has been an important tool in the corporate world, the way in which the institutions can assess and ascertain through the results, the degree of satisfaction of its employees and look through plan of action, achieve better results in both performance and production. Through an empirical research, exploratory qualitative research, with collection of secondary data, it was found that the implementation of the organizational climate survey, "Speak Frankly" from Itaú Unibanco, it could analyze data and make a plan of effective action aiming at continuous improvement in the organizational environment, serving as personnel management model. The results were favorable in the period from year 2012 to 2014 with an increase of the degree of satisfaction in four 4% and maintained excellent adherence to answer questions reaching 90% the number of employees.

  10. Improving the Syllable-Synchronous Network Search Algorithm for Word Decoding in Continuous Chinese Speech Recognition

    郑方; 武健; 宋战江


    The previously proposed syllable-synchronous network search (SSNS) algorithm plays a very important role in the word decoding of the continuous Chinese speech recognition and achieves satisfying performance. Several related key factors that may affect the overall word decoding effect are carefully studied in this paper, including the perfecting of the vocabulary, the big-discount Turing re-estimating of the N-Gram probabilities, and the managing of the searching path buffers. Based on these discussions, corresponding approaches to improving the SSNS algorithm are proposed. Compared with the previous version of SSNS algorithm, the new version decreases the Chinese character error rate (CCER) in the word decoding by 42.1% across a database consisting of a large number of testing sentences (syllable strings).

  11. Ergonomics, quality and continuous improvement--conceptual and empirical relationships in an industrial context.

    Eklund, J


    This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.

  12. Extraordinary improvement of the graphitic structure of continuous carbon nanofibers templated with double wall carbon nanotubes.

    Papkov, Dimitry; Beese, Allison M; Goponenko, Alexander; Zou, Yan; Naraghi, Mohammad; Espinosa, Horacio D; Saha, Biswajit; Schatz, George C; Moravsky, Alexander; Loutfy, Raouf; Nguyen, Sonbinh T; Dzenis, Yuris


    Carbon nanotubes are being widely studied as a reinforcing element in high-performance composites and fibers at high volume fractions. However, problems with nanotube processing, alignment, and non-optimal stress transfer between the nanotubes and surrounding matrix have so far prevented full utilization of their superb mechanical properties in composites. Here, we present an alternative use of carbon nanotubes, at a very small concentration, as a templating agent for the formation of graphitic structure in fibers. Continuous carbon nanofibers (CNF) were manufactured by electrospinning from polyacrylonitrile (PAN) with 1.2% of double wall nanotubes (DWNT). Nanofibers were oxidized and carbonized at temperatures from 600 °C to 1850 °C. Structural analyses revealed significant improvements in graphitic structure and crystal orientation in the templated CNFs, with the largest improvements observed at lower carbonization temperatures. In situ pull-out experiments showed good interfacial bonding between the DWNT bundles and the surrounding templated carbon matrix. Molecular Dynamics (MD) simulations of templated carbonization confirmed oriented graphitic growth and provided insight into mechanisms of carbonization initiation. The obtained results indicate that global templating of the graphitic structure in fine CNFs can be achieved at very small concentrations of well-dispersed DWNTs. The outcomes reveal a simple and inexpensive route to manufacture continuous CNFs with improved structure and properties for a variety of mechanical and functional applications. The demonstrated improvement of graphitic order at low carbonization temperatures in the absence of stretch shows potential as a promising new manufacturing technology for next generation carbon fibers.

  13. Staff Development Designed To Improve the Achievement of Students with Disabilities.

    Byrnes, MaryAnn; Majors, Martha

    This paper describes how the University of Massachusetts (Boston) developed partnership programs to improve achievement of students with significant disabilities just beginning to participate in a standards-based general curriculum. Fundamental to the effort was development of a 12-credit graduate certificate program focused on adapting the…

  14. Investing in Educator Data Literacy Improves Student Achievement. Evidence of Impact: The Oregon Data Project

    Data Quality Campaign, 2012


    Since 2007 the Oregon DATA Project has been investing resources to provide educators on-the-job training around effective data use to improve student achievement. New evidence shows that their efforts are paying off. A 2011 Oregon DATA Project report detailed the impact of their investment in the state's educators, finding the following: (1)…

  15. Evolution of curriculum systems to improve learning outcomes and reduce disparities in school achievement

    H.K. Altinyelken


    Based on an extensive review of scholarly literature, this paper seeks to overview curriculum reforms aimed at improving learning outcomes and reduce disparities in school achievement in low and middle income countries in the past 15 years. The paper focuses on four major curriculum areas, including

  16. Geometry-Related Children's Literature Improves the Geometry Achievement and Attitudes of Second-Grade Students

    McAndrew, Erica M.; Morris, Wendy L.; Fennell, Francis


    Use of mathematics-related literature can engage students' interest and increase their understanding of mathematical concepts. A quasi-experimental study of two second-grade classrooms assessed whether daily inclusion of geometry-related literature in the classroom improved attitudes toward geometry and achievement in geometry. Consistent with the…

  17. Improving Students' Creative Thinking and Achievement through the Implementation of Multiple Intelligence Approach with Mind Mapping

    Widiana, I. Wayan; Jampel, I. Nyoman


    This classroom action research aimed to improve the students' creative thinking and achievement in learning science. It conducted through the implementation of multiple intelligences with mind mapping approach and describing the students' responses. The subjects of this research were the fifth grade students of SD 8 Tianyar Barat, Kubu, and…

  18. Adhesion improvement of fibres by continuous plasma treatment at atmospheric pressure

    Kusano, Yukihiro; Løgstrup Andersen, Tom; Sørensen, Bent F.


    Carbon fibres and ultra-high-molecular-weight polyethylene (UHMWPE) fibres were continuously treated by a dielectric barrier discharge plasma at atmospheric pressure for adhesion improvement with epoxy resins. The plasma treatment improved wettability, increased the oxygen containing polar...

  19. Achieving continuous improvement in reductions in foodborne listeriosis: A risk-based approach

    Gram, Lone


    likely due to consumption of contaminated soft cheeses such as queso fresco and queso blanco. The International Life Sciences Institute Risk Science Institute Expert Panel concluded that certain foods pose a high risk for causing listeriosis. High-risk foods have all of the following properties: (1) have...... the potential for contamination with L. monocytogenes; (2) support the growth of L. monocytogenes to high numbers; (3) are ready to eat; (4) require refrigeration; and (5) are stored for an extended period of time. Control strategies are needed in the food chain from preharvest through consumption to minimize...... of listeriosis, through the normal healthy population younger than 65 years of age, who appear to have a minimal risk for listeriosis. In addition, unique subpopulations may exist; for example, pregnant Latina women appear to have a higher risk of listeriosis than pregnant women of other ethnic groups, most...

  20. Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

    Mohammed Hamed Ahmed


    Full Text Available Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor using some lean techniques and tools. What was not clear is that this required from Toyota a long process of leadership development, and a high commitment to training and coaching their employee. A Failure to achieve and sustain the improvement is a problem of both management and leadership as well as the improper understanding of the human behavior, and the required culture to success.

  1. Continuous Improvement in the Industrial and Management Systems Engineering Programme at Kuwait University

    Aldowaisan, Tariq; Allahverdi, Ali


    This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…

  2. Improved methodologies for continuous-flow analysis of stable water isotopes in ice cores

    Jones, Tyler R.; White, James W. C.; Steig, Eric J.; Vaughn, Bruce H.; Morris, Valerie; Gkinis, Vasileios; Markle, Bradley R.; Schoenemann, Spruce W.


    Water isotopes in ice cores are used as a climate proxy for local temperature and regional atmospheric circulation as well as evaporative conditions in moisture source regions. Traditional measurements of water isotopes have been achieved using magnetic sector isotope ratio mass spectrometry (IRMS). However, a number of recent studies have shown that laser absorption spectrometry (LAS) performs as well or better than IRMS. The new LAS technology has been combined with continuous-flow analysis (CFA) to improve data density and sample throughput in numerous prior ice coring projects. Here, we present a comparable semi-automated LAS-CFA system for measuring high-resolution water isotopes of ice cores. We outline new methods for partitioning both system precision and mixing length into liquid and vapor components - useful measures for defining and improving the overall performance of the system. Critically, these methods take into account the uncertainty of depth registration that is not present in IRMS nor fully accounted for in other CFA studies. These analyses are achieved using samples from a South Pole firn core, a Greenland ice core, and the West Antarctic Ice Sheet (WAIS) Divide ice core. The measurement system utilizes a 16-position carousel contained in a freezer to consecutively deliver ˜ 1 m × 1.3 cm2 ice sticks to a temperature-controlled melt head, where the ice is converted to a continuous liquid stream and eventually vaporized using a concentric nebulizer for isotopic analysis. An integrated delivery system for water isotope standards is used for calibration to the Vienna Standard Mean Ocean Water (VSMOW) scale, and depth registration is achieved using a precise overhead laser distance device with an uncertainty of ±0.2 mm. As an added check on the system, we perform inter-lab LAS comparisons using WAIS Divide ice samples, a corroboratory step not taken in prior CFA studies. The overall results are important for substantiating data obtained from LAS

  3. Software Process Improvement Framework Based on CMMI Continuous Model Using QFD

    Yonghui Cao


    Full Text Available In the rapid technological innovation and changes era, the key to the survival company is the continuous improvement of its process. In this paper, we introduce Software Process Improvement (SPI and Quality Function Deployment (QFD; and for combining also the staged model and the continuous model in CMMI, the Software Process Improvement framework with CMMI has two parts: 1 Software Process Improvement framework with CMMI staged model based on QFD and 2 SPI framework for C MI Mbased on QFD continuous model. Finally, we also draw conclusions.

  4. Improved swimming pool achieves higher reproducibility and sensitivity to effect of food components as ergogenic AIDS.

    Ishihara, Kengo; Yamada, Ayumi; Mita, Yukiko; Goto, Ayako; Ishimi, Tomoe; Mabuchi, Haruko; Inoue, Kazuo; Fushiki, Tohru; Yasumoto, Kyoden


    A previously developed current swimming pool for mice has been used to evaluate many food components that enhance endurance exercise performance. In this article, to improve reproducibility, reliability and sensitivity of this assay system, we improved the spout part to generate a uniform current and divided the pool into six lanes to avoid physical interference between swimming mice. The stability of the current flow was assessed by measuring the surface current speed and water volume from the spout part. Maximum swimming times of ddY and BALB/c mice were measured to assess the reproducibility of the maximum swimming time. The improvement in sensitivity compared to the original equipment was estimated under three physiological conditions: low carbohydrate diet feeding, low blood hemoglobin level, and carbohydrate supplementation during exercise. The new spout part improved uniformity and quick adjustment of surface current, yielding an increase of workload in a stepwise manner during swimming. Exercise workload was increased in proportion to surface current speed, as evidenced by cadence of kicks and serum lactic acid levels. The improved swimming pool showed higher reproducibility of swimming time until fatigue (pswimming time was improved in the swimming pool. The improved swimming pool yielded higher sensitivity for low carbohydrate diet feeding (pswimming pool. The improvement of the swimming pool achieved higher sensitivity and reproducibility in assessing various diet and food components compared to the original swimming pool.

  5. The efficacy of a continuous quality improvement (CQI) method in a radiological department: comparison with non-CQI control material

    Laurila, J. [Oulu Univ. Central Hospital (Finland). Dept. of Radiology; Standertskjoeld-Nordenstam, C.G. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Suramo, I. [Oulu Univ. Central Hospital (Finland). Dept. of Radiology; Tolppanen, E.M. [Helsinki Univ. (Finland). Dept. of Public Health; Tervonen, O. [Oulu Univ. Central Hospital (Finland). Dept. of Radiology; Korhola, O. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Brommels, M. [Helsinki Univ. (Finland). Dept. of Public Health


    To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00 - 22:00 and a radiographer was moved from the morning shift to 15:00 - 22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

  6. Continuous improvement in the Industrial and Management Systems Engineering programme at Kuwait University

    Aldowaisan, Tariq; Allahverdi, Ali


    This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been applied to the results of four assessment tools and other data sources to improve performance. Important improvements include the need to reconsider two student outcomes as they were difficult to implement in courses. In addition, through benchmarking and the engagement of Alumni and Employers, key decisions were made to improve the curriculum and enhance employability.

  7. Integrating Essential Components of Quality Improvement into a New Paradigm for Continuing Education

    Van Hoof, Thomas J.; Meehan, Thomas P.


    Continuing education (CE) that strives to improve patient care in a complex health care system requires a different paradigm than CE that seeks to improve clinician knowledge and competence in an educational setting. A new paradigm for CE is necessary in order to change clinician behavior and to improve patient outcomes in an increasingly…

  8. An action research study; cultural differences impact how manufacturing organizations receive continuous improvement

    Kattman, Braden R.

    National culture and organizational culture impact how continuous improvement methods are received, implemented and deployed by suppliers. Previous research emphasized the dominance of national culture over organizational culture. The countries studied included Poland, Mexico, China, Taiwan, South Korea, Estonia, India, Canada, the United States, the United Kingdom, and Japan. The research found that Canada was most receptive to continuous improvement, with China being the least receptive. The study found that organizational culture was more influential than national culture. Isomorphism and benchmarking is driving continuous-improvement language and methods to be more universally known within business. Business and management practices are taking precedence in driving change within organizations.

  9. Political and cultural factors in achieving continuity with a primary health care provider at an Indian Health Service hospital.

    Dietrich, A J; Olson, A L


    A primary care system was established at Zuni-Ramah Indian Health Service Hospital and clinic in New Mexico. Continuity and coordination of care were added to a health care system that was already accountable, accessible, and comprehensive. The new system offered each patient a personal health care provider who worked as a member of a multidisciplinary team. In changing the health care system, special attention was given to its cultural and political setting, the village of Zuni. After thorough discussion with community and staff, community members' concerns about patients' privacy and free choice were better understood, and special efforts were made to safeguard them. Ongoing evaluation is essential to maintain continuity. Eight months after the primary care system was begun, 64 percent of patients who came for care had established a personal relationship with a health care provider. For 59 percent of the visits during the 1-month evaluation period, patients saw their regular provider and, for 82 percent, patients saw their provider or one of his or her team colleagues. These percentages include night and walk-in visits. The system required no extra funding or staff. The political process of planning and consultation helped anticipate and alleviate the community's concerns, but resistance from physician's assistants and some physicians was unexpected. A flexible approach has led to a gradual acceptance of this voluntary system. This experience with the people of Zuni village shows that a primary care system can be started in a rural Indian Health Service facility with minimal outside help. Apparent improvements in quality of care make the continuity of primary care worthy of further consideration in the IHS and similar health services systems.

  10. Pediatric Oncology Clinic Care Model: Achieving Better Continuity of Care for Patients in a Medium-sized Program.

    Johnston, Donna L; Halton, Jacqueline; Bassal, Mylène; Klaassen, Robert J; Mandel, Karen; Ramphal, Raveena; Simpson, Ewurabena; Peckan, Li


    Providing the best care in both the inpatient and outpatient settings to pediatric oncology patients is all programs goal. Using continuous improvement methodologies, we changed from a solely team-based physician care model to a hybrid model. All patients were assigned a dedicated oncologist. There would then be 2 types of weeks of outpatient clinical service. A "Doc of the Day" week where each oncologist would have a specific day in clinic when their assigned patients would be scheduled, and then a "Doc of the Week" week where one physician would cover clinic for the week. Patient satisfaction surveys done before and 14 months after changing the model of care showed that patients were very satisfied with the care they received in both models. A questionnaire to staff 14 months after changing showed that the biggest effect was increased continuity of care, followed by more efficient clinic workflow and increased consistency of care. Staff felt it provided better planning and delivery of care. A hybrid model of care with a primary physician for each patient and assigned clinic days, alternating with weeks of single physician coverage is a feasible model of care for a medium-sized pediatric oncology program.

  11. Achievements and prospects of grass pea (Lathyrus sativus L.) improvement for sustainable food production

    Girish Prasad Dixit; Ashok Kumar Parihar; Abhishek Bohra; Narendra Pratap Singh


    Grass pea offers an attractive choice for sustainable food production, owing to its intrinsic properties including limited water requirement and drought tolerance. However, low productivity and the presence of a neurotoxin (ODAP) have posed major obstacles to its genetic improvement. Also, biotechnological investments remain limited and the genome is complex and not well understood. Strategies that allow identification of genotypes with reduced ODAP content, coupling of low ODAP content with enhanced yield, and effective seed detoxification methods merit immediate attention. Breeder-friendly genomic tools are being increasingly made available to improve the efficiency of breeding protocols. To this end, the application of next-generation sequencing has provided a means of leveraging the repertoire of genomic resources for this somewhat neglected crop. In this review, we describe progress achieved in Lathyrus genetic improvement. We also explore potential opportunities in Lathyrus research and identify urgent research needs.

  12. 78 FR 21879 - Improving 9-1-1 Reliability; Reliability and Continuity of Communications Networks, Including...


    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Chapter I Improving 9-1-1 Reliability; Reliability and Continuity of Communications Networks, Including Broadband Technologies AGENCY: Federal Communications Commission. ACTION: Notice...


    Dassisti, Michele


    Abstract An hybrid methodology based on the joint recourse of Business Process An hybrid methodology for Continuous Performance Improvement (CPI) is presented, basically funded on the joint recourse of Business Process Reengineering (BPR) and Continuous Quality Improvement (CQI) principles and tools. The methodology (called HY-CHANGE) is conceived as a logical and technical support to the decision maker. It results in a number of recursive phases, where the rational and synchronous...


    Jose Marcelo Almeida Prado Cestari


    Full Text Available This paper presents the approach adopted by a software development unit in order to achieve the maturity level 3 of CMMI-DEV and therefore obtaining better performance. Through historical research and secondary data analysis of the organization, the paper intends to answer the following research question: "Could the adoption of maturity/best practices models bring better performance results to small and medium organizations?" Data and analysis conducted show that, besides the creation of indicator’s based management, there are some quantitative performance improvements in indicators such as: Schedule Deviation Rate, Effort Deviation Rate, Percent Late Delivery, Productivity Deviation and Internal Rework Rate

  15. The continuous improvement of the Internal Audits Process assurance the effective compliance of ISO 17025:2005 requirements

    Carina Di Candia


    Full Text Available Continuous Improvement Process started in LATU in 1996. The Impact was so important that covered all the organization. Nowadays LATU has almost all its processes certificated and most than 200 tests accredited. The Internal Audits process began in 1996 with an annual planning for all the laboratory's areas. For the UKAS accreditation in 1998, LATU improves the internal audits planning auditing not only the system but also the tests. In 1999 LATU was certified by SQS and accredited the calibrations by DKD. Since 2004 internal audits was managed as a process; in order to that was defined objectives, indicators, achievements and the necessary resources of the internal audit programme and process. The internal audit programme has a pre defined tri annual planning that includes all the laboratory areas. The results of the measures obtained till now demonstrate the improvement in the internal audit and all the laboratory processes. Auditors final staff increase their technical competence. As a consequence of managing the internal audits as a process, the internal communication has an important relevance to feedback the continuous improvement of the laboratory. This was evidence in a decrease of the documentaries non conformities, improvement of the calibrations and maintenance programme, optimization trainings and qualifications of the staff, common internal trainings, creation of a quality assurance team to improvement the tests control, improvement in the relationship with the support areas. Most of this requirements are included in ISO 17025:2005; that assurance the effective compliance of this standard.

  16. Achieving continuous manufacturing for final dosage formation: challenges and how to meet them. May 20-21, 2014 Continuous Manufacturing Symposium.

    Byrn, Stephen; Futran, Maricio; Thomas, Hayden; Jayjock, Eric; Maron, Nicola; Meyer, Robert F; Myerson, Allan S; Thien, Michael P; Trout, Bernhardt L


    We describe the key issues and possibilities for continuous final dosage formation, otherwise known as downstream processing or drug product manufacturing. A distinction is made between heterogeneous processing and homogeneous processing, the latter of which is expected to add more value to continuous manufacturing. We also give the key motivations for moving to continuous manufacturing, some of the exciting new technologies, and the barriers to implementation of continuous manufacturing. Continuous processing of heterogeneous blends is the natural first step in converting existing batch processes to continuous. In heterogeneous processing, there are discrete particles that can segregate, versus in homogeneous processing, components are blended and homogenized such that they do not segregate. Heterogeneous processing can incorporate technologies that are closer to existing technologies, where homogeneous processing necessitates the development and incorporation of new technologies. Homogeneous processing has the greatest potential for reaping the full rewards of continuous manufacturing, but it takes long-term vision and a more significant change in process development than heterogeneous processing. Heterogeneous processing has the detriment that, as the technologies are adopted rather than developed, there is a strong tendency to incorporate correction steps, what we call below "The Rube Goldberg Problem." Thus, although heterogeneous processing will likely play a major role in the near-term transformation of heterogeneous to continuous processing, it is expected that homogeneous processing is the next step that will follow. Specific action items for industry leaders are: Form precompetitive partnerships, including industry (pharmaceutical companies and equipment manufacturers), government, and universities. These precompetitive partnerships would develop case studies of continuous manufacturing and ideally perform joint-technology development, including

  17. Creating Sustainable Education Projects in Roatán, Honduras through Continuous Process Improvement

    Raven, Arjan; Randolph, Adriane B.; Heil, Shelli


    The investigators worked together with permanent residents of Roatán, Honduras on sustainable initiatives to help improve the island's troubled educational programs. Our initiatives focused on increasing the number of students eligible and likely to attend a university. Using a methodology based in continuous process improvement, we developed…

  18. Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes

    Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita


    Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students’ attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students’ performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students’ performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills. PMID:28289305

  19. From Guide to Practice: Improving Your After School Science Program to Increase Student Academic Achievement

    Taylor, J.


    Numerous science organizations, such as NASA, offer educational outreach activities geared towards after school. For some programs, the primary goal is to grow students' love of science. For others, the programs are also intended to increase academic achievement. For those programs looking to support student learning in out-of-school time environments, aligning the program with learning during the classroom day can be a challenge. The Institute for Education Sciences, What Works Clearinghouse, put together a 'Practice Guide' for maximizing learning time beyond the regular school day. These practice guides provide concrete recommendations for educators supported by research. While this guide is not specific to any content or subject-area, the recommendations provided align very well with science education. After school science is often viewed as a fun, dynamic environment for students. Indeed, one of the recommendations to ensure time is structured according to students' needs is to provide relevant and interesting experiences. Given that our after school programs provide such creative environments for students, what other components are needed to promote increased academic achievement? The recommendations provided to academic achievement, include: 1. Align Instruction, 2. Maximize Attendance and Participation, 3. Adapt Instruction, 4. Provide Engaging Experiences, and 5. Evaluate Program. In this session we will examine these five recommendations presented in the Practice Guide, discuss how these strategies align with science programs, and examine what questions each program should address in order to provide experiences that lend themselves to maximizing instruction. Roadblocks and solutions for overcoming challenges in each of the five areas will be presented. Jessica Taylor will present this research based on her role as an author on the Practice Guide, 'Improving Academic Achievement in Out-of-School Time' and her experience working in various informal science

  20. Achieving continuous manufacturing: technologies and approaches for synthesis, workup, and isolation of drug substance. May 20-21, 2014 Continuous Manufacturing Symposium.

    Baxendale, Ian R; Braatz, Richard D; Hodnett, Benjamin K; Jensen, Klavs F; Johnson, Martin D; Sharratt, Paul; Sherlock, Jon-Paul; Florence, Alastair J


    This whitepaper highlights current challenges and opportunities associated with continuous synthesis, workup, and crystallization of active pharmaceutical ingredients (drug substances). We describe the technologies and requirements at each stage and emphasize the different considerations for developing continuous processes compared with batch. In addition to the specific sequence of operations required to deliver the necessary chemical and physical transformations for continuous drug substance manufacture, consideration is also given to how adoption of continuous technologies may impact different manufacturing stages in development from discovery, process development, through scale-up and into full scale production. The impact of continuous manufacture on drug substance quality and the associated challenges for control and for process safety are also emphasized. In addition to the technology and operational considerations necessary for the adoption of continuous manufacturing (CM), this whitepaper also addresses the cultural, as well as skills and training, challenges that will need to be met by support from organizations in order to accommodate the new work flows. Specific action items for industry leaders are: Develop flow chemistry toolboxes, exploiting the advantages of flow processing and including highly selective chemistries that allow use of simple and effective continuous workup technologies. Availability of modular or plug and play type equipment especially for workup to assist in straightforward deployment in the laboratory. As with learning from other industries, standardization is highly desirable and will require cooperation across industry and academia to develop and implement. Implement and exploit process analytical technologies (PAT) for real-time dynamic control of continuous processes. Develop modeling and simulation techniques to support continuous process development and control. Progress is required in multiphase systems such as

  1. How to improve patient satisfaction when patients are already satisfied: a continuous process-improvement approach.

    Friesner, Dan; Neufelder, Donna; Raisor, Janet; Bozman, Carl S


    The authors present a methodology that measures improvement in customer satisfaction scores when those scores are already high and the production process is slow and thus does not generate a large amount of useful data in any given time period. The authors used these techniques with data from a midsized rehabilitation institute affiliated with a regional, nonprofit medical center. Thus, this article functions as a case study, the findings of which may be applicable to a large number of other healthcare providers that share both the mission and challenges faced by this facility. The methodology focused on 2 factors: use of the unique characteristics of panel data to overcome the paucity of observations and a dynamic benchmarking approach to track process variability over time. By focusing on these factors, the authors identify some additional areas for process improvement despite the institute's past operational success.

  2. Continuous rotary motor electro-hydraulic servo system based on the improved repetitive controller

    WANG Xiao-jing; JIANG ji-hai; LI Shang-yi


    In order to suppress the periodic interference of the continuous rotary electro-hydraulic servo motor,this paper makes the motor tracking the periodic signals with high accuracy,and improves the influence of friction interference to the performance of continuous rotary electro-hydraulic servo motor.The mathematic model of the electro-hydraulic position servo system of the continuous rotary motor was established,and the compound control method was adopted based on the repetitive control,feed forward and PID to suppress the friction interference.Through the simulation,the result confirms that the compound control method decreases the tracking error of the system,increases the robust performance of the system and improves the performance of the continuous rotary electro-hydraulic servo motor.

  3. Improving Students’ Skills in Translation through Students-Teams Achievement Division (STAD Technique

    Syarwan Ahmad


    Full Text Available This classroom action rresearch was aimed at improving students’ skills in translating at the English Department of the State Islamic University (UIN Ar-Rarniry Banda Aceh by using the Student-Teams Achievement Division (STAD Technique. Throughout the entire cycles, students worked in groups of 4-5 persons to plan and write their translations. The study showed that the average score of pre- test (66 increased dramatically to reach 86, and moved up a little higher (87 after the second cycle. It is recommended that STAD Cooperative Technique be implemented in teaching translation courses.  Key words: Teaching translation; STAD; UIN Aceh.Copyright © 2015 by Al-Ta'lim All right reserved

  4. Optimization of Oxidation Temperature for Commercially Pure Titanium to Achieve Improved Corrosion Resistance

    Bansal, Rajesh; Singh, J. K.; Singh, Vakil; Singh, D. D. N.; Das, Parimal


    Thermal oxidation of commercially pure titanium (cp-Ti) was carried out at different temperatures, ranging from 200 to 900 °C to achieve optimum corrosion resistance of the thermally treated surface in simulated body fluid. Scanning electron microscopy, x-ray diffraction, Raman spectroscopy and electrochemical impedance spectroscopy techniques were used to characterize the oxides and assess their protective properties exposed in the test electrolyte. Maximum resistance toward corrosion was observed for samples oxidized at 500 °C. This was attributed to the formation of a composite layer of oxides at this temperature comprising Ti2O3 (titanium sesquioxide), anatase and rutile phases of TiO2 on the surface of cp-Ti. Formation of an intact and pore-free oxide-substrate interface also improved its corrosion resistance.

  5. Improved achievable secrecy rate of visible light communication with cooperative jamming

    Zaid, Hajar


    In this paper we study the problem of securing a visible light communication (VLC) link against passive eavesdropping, with the help of a (friendly) jammer. Differently from radio frequency (RF) communications, VLC imposes a peak amplitude constraint on the input distribution which renders Gaussian inputs not admissible. We provide an achievable secrecy rate that improves upon a recently established one in a concurrent work by Mostafa and Lampe. Our scheme follows from both the secrecy capacity result by Wyner and the artificial noise scheme by Goel and Negi, but using truncated Gaussian input distributions instead of uniform ones. Via numerical results, we show that our secrecy rate outperforms the concurrent rate in different settings. © 2015 IEEE.

  6. Digitalization of inspection data:a means for enhancing learning and continuous improvements?

    Lundkvist, Robert; Meiling, John; Vennström, Anders


    According to Total Quality Management (TQM), Lean Production and Six Sigma literature, companies should develop organisational arrangements that foster learning from experience and base decisions on facts, since continuous improvements require continuous experience feedback in some form. In Sweden every construction project is checked in several inspections, and data about defects are collected in paper-based "punch lists", but what happens to these data after the defects have been corrected ...

  7. Problem Lah! Learning to Tell the Story of Continuous Assessment and Improvement

    Hanken, Tamera


    To succeed organizations rely on the purposeful application of the management functions, planning, organizing, leading and controlling, i.e., assessment. Assessment involves the collection and analysis of service and performance data to inform planning, organizing and leading-- opening the door to a culture of assessment and continuous improvement. Like other organizations responding to ever challenging economies and ever changing customer expectations, libraries are examining continuous impr...

  8. Comprehensive approach to improving maternal health and achieving MDG 5: report from the mountains of Lesotho.

    Hind Satti

    Full Text Available BACKGROUND: Although it is now widely recognized that reductions in maternal mortality and improvements in women's health cannot be achieved through simple, vertical strategies, few programs have provided successful models for how to integrate services into a comprehensive program for maternal health. We report our experience in rural Lesotho, where Partners In Health (PIH in partnership with the Ministry of Health and Social Welfare implemented a program that provides comprehensive care of pregnant women from the community to the clinic level. METHODS: Between May and July 2009, PIH trained 100 women, many of whom were former traditional birth attendants, to serve as clinic-affiliated maternal health workers. They received performance-based incentives for accompanying pregnant women during antenatal care (ANC visits and facility-based delivery. A nurse-midwife provided ANC and delivery care and supervised the maternal health workers. To overcome geographic barriers to delivering at the clinic, women who lived far from the clinic stayed at a maternal lying-in house prior to their expected delivery dates. We analyzed data routinely collected from delivery and ANC registers to compare service utilization before and after implementation of the program. RESULTS: After the establishment of the program, the average number first ANC visits increased from 20 to 31 per month. The clinic recorded 178 deliveries in the first year of the program and 216 in the second year, compared to 46 in the year preceding the program. During the first two years of the program, 49 women with complications were successfully transported to the district hospital, and no maternal deaths occurred among the women served by the program. CONCLUSIONS: Our results demonstrate that it is possible to achieve dramatic improvements in the utilization of maternal health services and facility-based delivery by strengthening human resource capacity, implementing active follow-up in the

  9. Paediatric ED BiPAP continuous quality improvement programme with patient analysis: 2005–2013

    Abramo, Thomas; Williams, Abby; Mushtaq, Samaiya; Meredith, Mark; Sepaule, Rawle; Crossman, Kristen; Burney Jones, Cheryl; Godbold, Suzanne; Hu, Zhuopei; Nick, Todd


    Objective In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment. BiPAP works by unloading fatigued inspiratory muscles, a direct bronchodilation effect, offsetting intrinsic PEEP and recruiting collapsed alveoli that reduces the patient's work of breathing and achieves their total lung capacity quicker. Unfortunately, paediatric emergency department (PED) BiPAP is underused and quality analysis is non-existent. A PED BiPAP Continuous Quality Improvement Program (CQIP) from 2005 to 2013 was evaluated using descriptive analytics for the primary outcomes of usage, safety, BiPAP settings, therapeutics and patient disposition. Interventions PED BiPAP CQIP descriptive analytics. Setting Academic PED. Participants 1157 patients. Interventions A PED BiPAP CQIP from 2005 to 2013 for the usage, safety, BiPAP settings, therapeutic response parameters and patient disposition was evaluated using descriptive analytics. Primary and secondary outcomes Safety, usage, compliance, therapeutic response parameters, BiPAP settings and patient disposition. Results 1157 patients had excellent compliance without complications. Only 6 (0.5%) BiPAP patients were intubated. BiPAP median settings: IPAP 18 (16,20) cm H2O range 12–28; EPAP 8 cmH2O (8,8) range 6–10; inspiratory-to-expiratory time (I:E) ratio 1.75 (1.5,1.75). Pediatric Asthma Severity score and RR decreased (pcare units (PICU), 832 wards, with 52 of these PED ward patients were discharged home with only 2 hours of PED BiPAP with no returning to the PED within 72

  10. How PEPFAR's public-private partnerships achieved ambitious goals, from improving labs to strengthening supply chains.

    Sturchio, Jeffrey L; Cohen, Gary M


    The President's Emergency Plan for AIDS Relief (PEPFAR), established in 2003, is widely recognized as one of the most ambitious and successful bilateral programs ever implemented to address a single disease. Part of the program's success is attributable to the participation of the private sector, working in partnership with the US and local governments and implementing organizations to maximize the reach and effectiveness of every dollar spent. We examined key public-private partnerships that grew out of PEPFAR to identify features that have made them effective. For example, PEPFAR's Supply Chain Management System took advantage of private industry's best practices in logistics, and a partnership with the medical technology company BD (Becton, Dickinson and Company) improved laboratory systems throughout sub-Saharan Africa. We found that setting ambitious goals, enlisting both global and local partners, cultivating a culture of collaboration, careful planning, continuous monitoring and evaluation, and measuring outcomes systematically led to the most effective programs. The Office of the US Global AIDS Coordinator and PEPFAR should continue to strengthen their capacity for private-sector partnerships, learning from a decade of experience and identifying new ways to make smart investments that will make the most efficient use of taxpayer resources, expand proven interventions more rapidly, and help ensure the sustainability of key programs.

  11. Longer term improvement in neurocognitive functioning and affective distress among methamphetamine users who achieve stable abstinence.

    Iudicello, Jennifer E; Woods, Steven P; Vigil, Ofilio; Scott, J Cobb; Cherner, Mariana; Heaton, Robert K; Atkinson, J Hampton; Grant, Igor


    Chronic use of methamphetamine (MA) is associated with neuropsychological dysfunction and affective distress. Some normalization of function has been reported after abstinence, but little in the way of data is available on the possible added benefits of long-term sobriety. To address this, we performed detailed neuropsychological and affective evaluations in 83 MA-dependent individuals at a baseline visit and following an average one-year interval period. Among the 83 MA-dependent participants, 25 remained abstinent, and 58 used MA at least once during the interval period. A total of 38 non-MA-addicted, demographically matched healthy comparison (i.e., HC) participants were also examined. At baseline, both MA-dependent participants who were able to maintain abstinence and those who were not performed significantly worse than the healthy comparison subjects on global neuropsychological functioning and were significantly more distressed. At the one-year follow-up, both the long-term abstainers and healthy comparison groups showed comparable global neuropsychological performance and affective distress levels, whereas the MA-dependent group who continued to use MA were worse than the comparison participants in terms of global neuropsychological functioning and affective distress. An interaction was observed between neuropsychological impairment at baseline, MA abstinence, and cognitive improvement, with abstinent MA-dependent participants who were neuropsychologically impaired at baseline demonstrating significantly and disproportionately greater improvement in processing speed and slightly greater improvement in motor abilities than the other participants. These results suggest partial recovery of neuropsychological functioning and improvement in affective distress upon sustained abstinence from MA that may extend beyond a year or more.

  12. Sustainability of continuous improvement systems in industry: Survey of BAC and Navarre

    Carmen Jaca García


    Full Text Available This article will examine the level of sustainability for companies in Continuous Improvement Management and the factors which are supporting sustainability during time, through a survey to 350 companies of Basque Autonomous Community and Navarra in June of 2009. The study presents some data about the development of the improvement systems. Then, factors that companies have related to the abandonment of improvement systems are analysed. Since improvement systems are based on workers’ participation, this study characterizes this participation. Finally, the elements which have been used in the improvement systems by the companies are analyzed, and how objectives and indicators are used in their management system. To conclude, the following key issues are emphasized: a higher involvement of workforce in improvement systems, the integration of improvement system in the management system and the establishment of associated indicators to the system.

  13. Methodology for the collaboration in supply chains with a focus on continuous improvement

    José Anselmo Mayer


    Full Text Available A collaborative relationship between companies in a supply chain makes it possible to improve both the performance and the results of the companies and of the supply chain. Several studies have analyzed supply chains, but few studies have proposed the application of tools for continuous improvement in a collaborative manner within the supply chain. The objective of this work is to present a methodology for the collaboration in a supply chain with a focus on continuous improvement. Three case studies were conducted with Brazilian multinational focal companies that manufacture technology-based products. It was seen that relationships, trust, the exchange of information, and the sharing of gains and risks sustains collaborative practices focused on continuous improvement. The proposed methodology considers the need for supplier development, for the monitoring of the supplies, and for the development of a partnership for problem solving through the application of tools for continuous improvement.

  14. Achievement for All: improving psychosocial outcomes for students with special educational needs and disabilities.

    Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry


    Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA) programme that was designed to improve outcomes for students with SEND through: (1) academic assessment, tracking and intervention, (2) structured conversations with parents, and (3) developing provision to improve wider outcomes (e.g. positive relationships). Using a quasi-experimental, pre-test-post-test control group design, we assessed the impact of AfA on teacher ratings of the behaviour problems, positive relationships and bullying of students with SEND over an 18-month period. Participants were 4758 students with SEND drawn from 323 schools across England. Our main impact analysis demonstrated that AfA had a significant impact on all three response variables when compared to usual practice. Hierarchical linear modelling of data from the intervention group highlighted a range of school-level contextual factors and implementation activities and student-level individual differences that moderated the impact of AfA on our study outcomes. The implications of our findings are discussed, and study strengths and limitations are noted.

  15. Assessment of Beee and Bepe Program as Part of Continual Quality Improvement

    Farah Hani Nordin,; Ungku Anisa Ungku Amirulddin; Fazrena Azlee Hamid; Azrul Mohd Ariffin; Chau Chien Fat


    Continual Quality Improvement (CQI) involves analyzing the Program Educational Objectives (PEO) and Program Outcomes (PO) which helps an academic institution to reflect on the quality of the programs offered where recommendations for improvements can be made. As part of the CQI process, this paper presents the attainments and feedbacks on the PEO and PO for the Bachelor of Electrical and Electronics Engineering (BEEE) and Bachelor of Electrical Power Engineering (BEPE) which are obtained thro...

  16. (Mis)Perceptions of Continuing Education: Insights from Knowledge Translation, Quality Improvement, and Patient Safety Leaders

    Kitto, Simon C.; Bell, Mary; Goldman, Joanne; Peller, Jennifer; Silver, Ivan; Sargeant, Joan; Reeves, Scott


    Introduction: Minimal attention has been given to the intersection and potential collaboration among the domains of continuing education (CE), knowledge translation (KT), quality improvement (QI), and patient safety (PS), despite their overlapping objectives. A study was undertaken to examine leaders' perspectives of these 4 domains and their…

  17. Motivational Interviewing (MINT) Improves Continuous Positive Airway Pressure (CPAP) Acceptance and Adherence: A Randomized Controlled Trial

    Olsen, Sara; Smith, Simon S.; Oei, Tian P. S.; Douglas, James


    Objective: Adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) is poor. We assessed the effectiveness of a motivational interviewing intervention (motivational interview nurse therapy [MINT]) in addition to best practice standard care to improve acceptance and adherence to CPAP therapy in people with…

  18. Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

    Pietz, Victoria Lynn


    Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

  19. Continuous Quality Improvement as an Innovation: Which Nursing Facilities Adopt It?

    Lucas, Judith A.; Avi-Itzhak, Tamara; Robinson, Joanne P.; Morris, Catherine G.; Koren, Mary Jane; Reinhard, Susan C.


    Purpose: We identify environmental and organizational predictors that best discriminate between formal continuous quality improvement (CQI) adopters and nonadopters in nursing homes (NHs) and create a diagnostic profile for facility administrators and policy makers to promote CQI. Design and Methods: We performed a cross-sectional survey of…

  20. Towards a new approach of continuous process improvement based on CMMI and PMBOK

    Rdiouat Yassine


    Full Text Available A process-centric approach helps an organization to improve the way it works with. It allows scalability and provides a way to capitalize knowledge on best practices. It also makes better use of resources and helps to understand trends. PMBOK is a project management methodology, while CMMI is a model for process improvement. In this paper, we conduct a study on PMBOK and CMMI frameworks to show that they can be converged and complementary. We expect this paper research will be useful for organizations to deploy a new approach of continuous process improvement based on pooling CMMI and PMBOK.

  1. Continuous improvement in manufacturing and inspection of fuel; Mejora continua en fabricacion e inspeccion de combustible

    Domingon, A.; Ruiz, R.


    The manufacturing and inspection process of fuel assemblies in ENUSA is characterized by its robustness acquired over the last thirty years of experience in manufacturing. The reliability of these processes is based on a qualified processes and continuous improvement in the design and upgrading of equipment and optimization of software and manufacturing processes. Additionally, management and quality control systems have been improved in both software and measuring business objectives. this article emphasizes the improvements made over the past five years in management, production and inspection of fuel assemblies. (Author)

  2. Longitudinal Analysis of the Role of Perceived Self-Efficacy for Self-Regulated Learning in Academic Continuance and Achievement

    Caprara, Gian Vittorio; Fida, Roberta; Vecchione, Michele; Del Bove, Giannetta; Vecchio, Giovanni Maria; Barbaranelli, Claudio; Bandura, Albert


    The present study examined the developmental course of perceived efficacy for self-regulated learning and its contribution to academic achievement and likelihood of remaining in school in a sample of 412 Italian students (48% males and 52% females ranging in age from 12 to 22 years). Latent growth curve analysis revealed a progressive decline in…

  3. Improving Science Achievement and Attitudes of Students With and Without Learning Disabilities

    Sanders-White, Pamela

    The primary purpose of this study was to investigate the effect of structured note-taking compared to traditional note-taking on the acquisition of scientific knowledge for students with and without learning disabilities (LD) and students with reading difficulties (RD). An additional purpose was to examine whether the two note-taking methods affected students' attitudes toward science. The sample population consisted of 203 fifth grade students across four public schools in the southern area of the United States. A standardized instrument aligned to Florida's science standards was used to measure the acquisition of scientific knowledge and the Test of Science-Related Attitudes (TOSRA) was used to measure seven distinct science-related attitudes. For meaningful analyses, students with LD and students with RD were collapsed to form a single group due to the small numbers of participants in each of the subgroups; the collapsed group was referred to as "low achievers." A three-way repeated measures ANOVA was conducted to determine the effects of the pretest-posttest Science Interim assessment by group, type of student, and gender. The pretest-posttest Science Interim assessment scores were the within-group factor, while group, type of student, and gender were the between-groups factors. Results revealed that there was a significant interaction between the pretest-posttest Science Interim assessment and group, F(1, 191) = 9.320, p = .003, indicating that scientific knowledge scores increased for the experimental group, but decreased for the control group. Results also indicated that there was a significant three-way interaction between the pretest-posttest Science Interim assessment, group, and gender, F(1, 191) = 5.197, p = .024, showing that all participants in the experimental group improved their scores; while in the control group, female scores decreased and male scores increased. Participants in the experimental and control groups did not show improved attitudes

  4. Utilizing Collaborative Analysis of Student Learning in Educator Preparation Programs for Continuous Improvement

    Susan Colby


    Full Text Available In this results-oriented era of accountability, educator preparation programs are called upon to provide comprehensive data related to student and program outcomes while also providing evidence of continuous improvement. Collaborative Analysis of Student Learning (CASL is one approach for fostering critical inquiry about student learning. Graduate educator preparation programs in our university used collaborative analysis as the basis for continuous improvement during an accreditation cycle. As authors of this study, we sought to better understand how graduate program directors and faculty used collaborative analysis to inform practice and improve programs. Our findings suggested that CASL has the potential to foster collective responsibility for student learning, but only with a strong commitment from administrators and faculty, purposefully designed protocols and processes, fidelity to the CASL method, and a focus on professional development. Through CASL, programs have the ability to produce meaningful data related to student and program outcomes and meet the requirements for accreditation.

  5. Continuous improvement and TQM in health care: an emerging operational paradigm becomes a strategic imperative.

    Swinehart, K; Green, R F


    Argues that US health care is in a state of crisis. Escalating costs account for 13 per cent of GNP, making health care the third largest industry in the USA, and spending is expected to increase. Claims health-care providers need to control rising costs, improve productivity and flexibility, adopt appropriate technologies, and maintain competitive levels of quality and value. States that TQM may provide an environment that will focus on quality of patient care and continuous quality improvement at all levels of the organization including the governing body, the administrative, managerial, and clinical areas. Any new national or state health-care plan will force providers to be more efficient while maintaining quality standards. Concludes that it will be strategically imperative that health-care providers ranging from family physicians to major medical centres and suppliers ranging from laboratories to pharmaceutical firms establish methods for making rapid continuous improvement and total quality management the cornerstone of the strategic planning process.

  6. Programme Learning Outcomes Assessment and Continuous Quality Improvement in Faculty of Mechanical and Manufacturing, UTHM

    Taib, H.; Salleh, S. M.; Zain, B. A. Md; Azlan, M. A.; Mahzan, S.; Hafeez, Z. A.; Ong, P.; Ahmad, S.; N. A Rahman, M.; Nasir, N. F.; Azham Azmi, M.; Rahman, H. A.; Ngali, Z.


    This paper describes the assessment and continuous quality improvement of Programme Learning Outcomes (PLOs) in the Faculty of Mechanical Engineering and Manufacturing. PLO is known as an elementary requirement in Outcome Based Education (OBE) system. All PLOs have been mapped with graduate attributes by EAC Manual 2012. Conceptual process for establishing and reviewing PLOs has been explained in the Plan-Check-Do-Act cycle. PLO assessment has been shown in different types which classified as direct and indirect methods. Continuous Quality Improvement has been extracted from a variety of assessment and has been discussed. Seven (7) CQIs are identified using different assessment methods of PLO during years 2013 to 2016 and subsequent improvement actions have been taken by the faculty within three years.

  7. How Visual Management for Continuous Improvement Might Guide and Affect Hospital Staff: A Case Study.

    Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Westerlund, Hugo; Sandahl, Christer; Thor, Johan


    Visual management (VM) tools such as whiteboards, often employed in Lean thinking applications, are intended to be helpful in improving work processes in different industries including health care. It remains unclear, however, how VM is actually applied in health care Lean interventions and how it might influence the clinical staff. We therefore examined how Lean-inspired VM using whiteboards for continuous improvement efforts related to the hospital staff's work and collaboration. Within a case study design, we combined semistructured interviews, nonparticipant observations, and photography on 2 cardiology wards. The fate of VM differed between the 2 wards; in one, it was well received by the staff and enhanced continuous improvement efforts, whereas in the other ward, it was not perceived to fit in the work flow or to make enough sense in order to be sustained. Visual management may enable the staff and managers to allow communication across time and facilitate teamwork by enabling the inclusion of team members who are not present simultaneously; however, its adoption and value seem contingent on finding a good fit with the local context. A combination of continuous improvement and VM may be helpful in keeping the staff engaged in the change process in the long run.

  8. What Makes High-Achiever Students Hard to Improve Their Speaking Skill?

    Irmawati, Dini Kurnia


    Speaking problems do not only happen to low achiever students. High-achiever students with high average score (above 90) also still have speaking problems. This makes the researcher find it important to investigate what factors that make them still get difficulties in speaking. This research is a descriptive study. The subjects include 9 high-achiever students majoring in English Department that have been selected from University of Brawijaya, State University of Malang, and Kanjuruhan Univer...

  9. Harnessing the genetics of the modern dairy cow to continue improvements in feed efficiency.

    VandeHaar, M J; Armentano, L E; Weigel, K; Spurlock, D M; Tempelman, R J; Veerkamp, R


    Feed efficiency, as defined by the fraction of feed energy or dry matter captured in products, has more than doubled for the US dairy industry in the past 100 yr. This increased feed efficiency was the result of increased milk production per cow achieved through genetic selection, nutrition, and management with the desired goal being greater profitability. With increased milk production per cow, more feed is consumed per cow, but a greater portion of the feed is partitioned toward milk instead of maintenance and body growth. This dilution of maintenance has been the overwhelming driver of enhanced feed efficiency in the past, but its effect diminishes with each successive increment in production relative to body size and therefore will be less important in the future. Instead, we must also focus on new ways to enhance digestive and metabolic efficiency. One way to examine variation in efficiency among animals is residual feed intake (RFI), a measure of efficiency that is independent of the dilution of maintenance. Cows that convert feed gross energy to net energy more efficiently or have lower maintenance requirements than expected based on body weight use less feed than expected and thus have negative RFI. Cows with low RFI likely digest and metabolize nutrients more efficiently and should have overall greater efficiency and profitability if they are also healthy, fertile, and produce at a high multiple of maintenance. Genomic technologies will help to identify these animals for selection programs. Nutrition and management also will continue to play a major role in farm-level feed efficiency. Management practices such as grouping and total mixed ration feeding have improved rumen function and therefore efficiency, but they have also decreased our attention on individual cow needs. Nutritional grouping is key to helping each cow reach its genetic potential. Perhaps new computer-driven technologies, combined with genomics, will enable us to optimize management for

  10. An Experimental Investigation to Facilitate an Improvement in the Design of an Electromagnetic Continuous Casting Mould

    Lintao Zhang


    Full Text Available An electromagnetic continuous casting mould designed is proposed with a non-uniform slit distribution structure. This design has aimed to reduce the number of slits so that the mould’s strength is enhanced, whilst maintaining a similar metallurgy effect. In this paper, the metallurgy effect for the designed mould is investigated through the magnetic field distribution along the casting direction, the uniformity feature in the vicinity of the meniscus region, the temperature variation of the molten alloy pool and the mould wall. The results show that the designed mould achieved a similar effect as compared to the original mould; however, the configuration is simplified. This research highlights the topic of mould structure optimization, which would enable the Electromagnetic continuous casting (EMCC technique to be utilized with greater ease by industry.

  11. 41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?


    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What type of records management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive...

  12. An improved continuous flow analysis system for high-resolution field measurements on ice cores.

    Kaufmann, Patrik R; Federer, Urs; Hutterli, Manuel A; Bigler, Matthias; Schüpbach, Simon; Ruth, Urs; Schmitt, Jochen; Stocker, Thomas F


    Continuous flow analysis (CFA) is a well-established method to obtain information about impurity contents in ice cores as indicators of past changes in the climate system. A section of an ice core is continuously melted on a melter head supplying a sample water flow which is analyzed online. This provides high depth and time resolution of the ice core records and very efficient sample decontamination as only the inner part of the ice sample is analyzed. Here we present an improved CFA system which has been totally redesigned in view of a significantly enhanced overall efficiency and flexibility, signal quality, compactness, and ease of use. These are critical requirements especially for operations of CFA during field campaigns, e.g., in Antarctica or Greenland. Furthermore, a novel deviceto measure the total air content in the ice was developed. Subsequently, the air bubbles are now extracted continuously from the sample water flow for subsequent gas measurements.

  13. Organisational learning and continuous improvement of health and safety in certified manufacturers

    Granerud, Lise; Rocha, Robson Sø


    and raise goals within health and safety on a continuous basis. The article examines how certified occupational and health management systems influence this process to evaluate how far they hinder or support learning. It presents a model with which it is possible to identify and analyse improvement...... that certified health and safety management does not obstruct learning, and can support advanced learning. Improvement practices with regard to health and safety are mainly dependent upon the firm’s overall organisational processes and do not automatically arise from the standard alone....

  14. Development of a team-based framework for conducting self-assessment of Continuous Improvement

    Jørgensen, Frances; Gertsen, Frank; Boer, Harry


    The study presented in this article is based on two basic premises. First, successful continuous improvement (CI) is dependent on shop floor level involvement and participation in improvement efforts. Second, the term "self-assessment" clearly implies that those whose performance is being measure......, the study shows how these principles relate to the teams' own work processes, and a deeper understanding of their organization's strategy and objectives......., and who are involved in conducting the assessment process. Excerpts from longitudinal case studies in a single Danish manufacturing organization demonstrate how teams involved in the process of conducting self-assessment of CI developed a better understanding of the basic principles of CI. Furthermore...

  15. Continuous Plasma Treatment of Ultra-High-Molecular-Weight Polyethylene (UHMWPE) Fibres for Adhesion Improvement

    Teodoru, Steluta; Kusano, Yukihiro; Rozlosnik, Noemi


    A dielectric barrier discharge in Ar, He, He/O2, N2 or O2 at atmospheric pressure was used for the continuous plasma treatment of UHMWPE fibres. The influence of the input power of the discharge and the gas flow rate on surface modification is studied with the aim of adhesion improvement. Surface...... characterization using X-ray photoelectron spectroscopy and atomic force microscopy shows a significant increase in polar functional groups and roughness at the surfaces after plasma treatment, indicating that adhesive properties can be improved....

  16. Principal Readiness and Professional Development to Conduct Effective Teacher Evaluations That Lead to Improved Student Achievement

    Hunziker, Shawn


    Education reform is the focus of many of the political agendas today. The research is clear that the best way to increase student achievement is by having highly effective teachers in the classroom. As a result of prior research, both the state and federal governments have created mandates and legislation aimed at achieving that goal. One of the…

  17. Using Student Teams-Achievement Divisions (STAD Strategy to Improve the Students’ Speaking Skill at Vocational School

    Rumiarsih Rumiarsih


    Full Text Available The present study was conducted in order to describe how Student Teams-Achievement Divisions (STAD Strategy can improve the students’ speaking skill. The researcher used Classroom Action Research (CAR and applied it in the teaching of speaking of XII TKR 2 of SMK Negeri 1 Madiun. The finding of this research indicated that the STAD Strategy was successful in improving the students’ speaking skill. The STAD Strategy employed in this study consisted five steps, namely: (1 forming teams; (2 class presentation; (3 quiz; (4 individual improvement score; and (5 team recognition. The activities in those five steps which were don chronologically improved both in the students’ speaking achievements and the students’ participation during the teaching and learning of speaking. Key Words: speaking skill, student teams-achievement divisions (STAD strategy

  18. Continuous improvement process and waste reduction through a QFD tool: the case of a metallurgic plant

    Leoni Pentiado Godoy


    Full Text Available This paper proposes the use of QFD for the continuous improvement of production processes and waste reduction actions. To collect the information we used the simple observation and questionnaire with closed questions applied to employees, representing 88.75% of the population that works in the production processes of an industry of metal-mechanic sector, located inRio Grandedo Sul. QFD is an effective method of quality planning, because it provides a diagnosis that underpins the definition of improvement actions aimed at combating waste. Actions were set providing improved communication between the sectors, enabling the delivery of products with specifications that meet customer requirements, on time and the right amounts, at a minimum cost and satisfaction of those involved with the company. The implementation of these actions reduces waste, minimizes the extra work, maximizes effective labor and increases profitability.

  19. Kaizen - continuous improvement of high voltage products; Kaizen - kontinuierliche Verbesserung bei Hochspannungsprodukten

    Schwarz, M. [ABB Calor Emag Schaltanlagen AG, Hanau-Grossauheim (Germany); Goessmann, T. [ABB Calor Emag Schaltanlagen AG, Mannheim (Germany)


    In the actual global competition only the company can survive who cares for the continuous improvement of all business activities. The ABB Calor Emag Schaltanlagen AG at his production site in Hanau-Grossauheim has installed a specific improvement programm called KVP what is based on the ideas of Kaizen. Aim is the improvement of processes, mainly in production, concerning quality, dates, costs and environment by activating all colleagues. (orig.) [Deutsch] Im heutigen globalen Wettbewerb kann sich nur der behaupten, der sich kontinuierlich in allen Unternehmensbereichen weiterentwickelt. Die ABB Calor Emag Schaltanlagen AG hat in ihrem Werk Hanau-Grossauheim nach den Ideen des Kaizen ein werkspezifisches Programm zur kontinuierlichen Verbesserung der Prozesse in der Fertigung eingefuehrt. Ziel ist die stetige Verbesserung von Fertigungsparametern, wie Qualitaet, Termine, Kosten und Umwelt unter Einbeziehung aller Mitarbeiter. (orig.)

  20. Adhesion improvement of fibres by continuous plasma treatment at atmospheric pressure

    Kusano, Y.; Andersen, Tom L.; Soerensen, B.F.; Toftegaard, H.L.; Teodoru, S. [Technical Univ. of Denmark. DTU Wind Energy, Risoe Campus, Roskilde (Denmark); Hansen, Charles M. [Hoersholm (Denmark)


    Carbon fibres and ultra-high-molecular-weight polyethylene (UHMWPE) fibres were continuously treated by a dielectric barrier discharge plasma at atmospheric pressure for adhesion improvement with epoxy resins. The plasma treatment improved wettability, increased the oxygen containing polar functional groups at the surface, and subsequently improved adhesion to the epoxy and fracture resistance of epoxy composites. Hansen solubility parameters (HSP), quantitatively describing physical interactions among molecules, were measured for the UHMWPE fibre surfaces. The result identifies two distinct types of surfaces in both the plasma treated and the untreated fibres. One type is typical of polyethylene polymers while the other is characteristic of the oxygenated surface at much higher values of HSP. (Author)

  1. Continuous improvement of environmental aspect in Juzbado factory; Mejora continua del comportamiento ambiental de la fabrica de Juzbado



    ENUSA's Fuel Assembly Factory in Juzbado (Salamanca), conscious of its responsibilities with the environment where its activities are carried out, has an Environmental Management System (EMS) certified by AENOR (N. CGM-99/31) according to the requirements of Standard UNE{sub E}N-ISO 14001 and afterwards, as a result of compromise with continuous improvement of its environmental performance, joined the European Regulation 761/2001(EMAS), which has allowed the EMS to achieve levels of excellence in environmental management, doing it in a much more transparent and participative way and letting the public and other interested parts to have access to the information referring its environmental activities, as demanded by society, by the elaboration and verification of an Environmental Statement (VDM-03/010) on a yearly basis. (Author)

  2. Improvement production of bacterial cellulose by semi-continuous process in molasses medium.

    Cakar, Fatih; Ozer, Işılay; Aytekin, A Özhan; Sahin, Fikrettin


    Bacterial cellulose (BC) has unique properties such as structural, functional, physical and chemical. The mass production of BC for industrial application has recently become attractive to produce more economical and high productive cellulose. In this study, to improve the productivity of bacterial cellulose (BC), BC production by Gluconacetobacter xylinus FC01 was investigated in molasses medium with static semi-continuous operation mode. Cell dry weight, polysaccharide, sugar and cellulose concentrations were monitored and cellulose was characterized by Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM). The highest cellulose yield (1.637 g/L) was obtained in SCP50-7d, which molasses of 1/2 ratio for 7 days by static semi-continuous operation mode. The results show that BC can be highly produced by G. xylinus in molasses with static semi-continuous process than batch process. We claimed that low-cost medium with semi-continuous operation mode in static culture is a good candidate for industrial scale BC productions.

  3. A quality control method enhancement concept-Continual improvement of regulatory approved QC methods.

    Åsberg, Dennis; Nilsson, Mikael; Olsson, Susanne; Samuelsson, Jörgen; Svensson, Olof; Klick, Silke; Ennis, Julie; Butterworth, Paul; Watt, Denise; Iliadou, Stavroula; Karlsson, Angelica; Walker, Joanne T; Arnot, Kate; Ealer, Norb; Hernqvist, Kerstin; Svensson, Karin; Grinell, Ali; Quist, Per-Ola; Karlsson, Anders; Fornstedt, Torgny


    Quality Control methods (QC-methods) play an important role in the overall control strategy for drug manufacturing. However, efficient life-cycle management and continual improvement are hindered due to a variety of post-approval variation legislations across territories and a lack of harmonization of the requirements. As a result, many QC-methods fall behind the technical development. Developing the QC-method in accordance with the Quality by Design guidelines gives the possibility to do continual improvements inside the original Method Operable Design Region (MODR). However, often it is necessary to do changes outside the MODR, e.g. to incorporate new technology that was not available at the time the original method was development. Here, we present a method enhancement concept which allows minor adjustments, within the same measuring principle, outside the original MODR without interaction with regulatory agencies. The feasibility of the concept is illustrated by a case study of a QC-method based on HPLC, assumed to be developed before the introduction of UHPLC, where the switch from HPLC to UHPLC is necessary as a continual improvement strategy. The concept relies on the assumption that the System Suitability Test (SST) and failure modes are relevant for other conditions outside the MODR as well when the same measuring principle is used. It follows that it should be possible to move outside the MODR as long as the SST has passed. All minor modifications of the original, approved QC-method must be re-validated according to a template given in the original submission and a statistical equivalence should be shown between the original and modified QC-methods. To summarize, revalidation is handled within the pharmaceutical quality control system according to internal change control procedures, but without interaction with regulating agencies.

  4. A Mobile Gamification Learning System for Improving the Learning Motivation and Achievements

    Su, C-H.; Cheng, C-H.


    This paper aims to investigate how a gamified learning approach influences science learning, achievement and motivation, through a context-aware mobile learning environment, and explains the effects on motivation and student learning. A series of gamified learning activities, based on MGLS (Mobile Gamification Learning System), was developed and…

  5. Physically Active Math and Language Lessons Improve Academic Achievement : A Cluster Randomized Controlled Trial

    Mullender-Wijnsma, Marijke J.; Hartman, Esther; de Greeff, Johannes W.; Doolaard, Simone; Bosker, Roel J.; Visscher, Chris


    OBJECTIVES: Using physical activity in the teaching of academic lessons is a new way of learning. The aim of this study was to investigate the effects of an innovative physically active academic intervention ("Fit & Vaardig op School" [F&V]) on academic achievement of children. METHODS: Using physic

  6. 3D Game-Based Learning System for Improving Learning Achievement in Software Engineering Curriculum

    Su,Chung-Ho; Cheng, Ching-Hsue


    The advancement of game-based learning has encouraged many related studies, such that students could better learn curriculum by 3-dimension virtual reality. To enhance software engineering learning, this paper develops a 3D game-based learning system to assist teaching and assess the students' motivation, satisfaction and learning achievement. A…

  7. Improving Secondary School Students' Achievement and Retention in Biology through Video-Based Multimedia Instruction

    Gambari, Amosa Isiaka; Yaki, Akawo Angwal; Gana, Eli S.; Ughovwa, Queen Eguono


    The study examined the effects of video-based multimedia instruction on secondary school students' achievement and retention in biology. In Nigeria, 120 students (60 boys and 60 girls) were randomly selected from four secondary schools assigned either into one of three experimental groups: Animation + Narration; Animation + On-screen Text;…

  8. Improving grade 7 students’ achievement in initial algebra through a technology-based intervention.

    Jupri, A.; Drijvers, P.H.M.|info:eu-repo/dai/nl/074302922; Van den Heuvel-Panhuizen, M.|info:eu-repo/dai/nl/069266255


    Digital technology plays an increasingly important role in daily life, mathematics education and algebra education in particular. To investigate the effect of a technology-rich intervention related to initial algebra on the achievement of 12–13 year old Indonesian students, we set up an experiment.

  9. Effectiveness of a Metacognitive Reading Strategies Program for Improving Low Achieving EFL Readers

    Ismail, Nasrah Mahmoud; Tawalbeh, Tha'er Issa


    As the training of language learners was a main concern of EFL teachers, this study aimed to assess the effectiveness of metacognitive reading strategies instruction (MRSI) on Taif University EFL students who achieved low results in reading. The final sample of this study was (21) female university students. The sample was divided into two groups;…

  10. Improving Low Achievers' Academic Performance at University by Changing the Social Value of Mastery Goals

    Dompnier, Benoît; Darnon, Céline; Meier, Emanuele; Brandner, Catherine; Smeding, Annique; Butera, Fabrizio


    Recent research has shown that, in a university context, mastery goals are highly valued and that students may endorse these goals either because they believe in their utility (i.e., social utility), in which case mastery goals are positively linked to achievement, or to create a positive image of themselves (i.e., social desirability), in which…

  11. Improving Student Achievement in Language Arts through Implementation of Multiple Intelligences Strategies.

    Geimer, Mandy; Getz, Jennifer; Pochert, Terry; Pullam, Karen

    Student achievement has been low in language arts in Suburban Chicago, Illinois school districts. This action research project was designed to determine the effect of incorporating multiple intelligence strategies into the language arts curriculum. The targeted students were in the second, third, and fifth grades, in a western suburb of Chicago,…

  12. Using Culturally Competent Responsive Services to Improve Student Achievement and Behavior

    Schellenberg, Rita; Grothaus, Tim


    This article illustrates standards blending, the integration of core academic and school counseling standards, as a culturally alert responsive services strategy to assist in closing the achievement gap while also enhancing employability skills and culturally salient career competencies. The responsive services intervention described in this…

  13. Making Employee Recognition a Tool for Achieving Improved Performance: Implication for Ghanaian Universities

    Amoatemaa, Abena Serwaa; Kyeremeh, Dorcas Darkoah


    Many organisations are increasingly making use of employee recognition to motivate employees to achieve high performance and productivity. Research has shown that effective recognition occurs in organisations that have strong supportive culture, understand the psychology of praising employees for their good work, and apply the principles of…

  14. Improving Astronomy Achievement and Attitude through Astronomy Summer Project: A Design, Implementation and Assessment

    Türk, Cumhur; Kalkan, Hüseyin; Iskeleli', Nazan Ocak; Kiroglu, Kasim


    The purpose of this study is to examine the effects of an astronomy summer project implemented in different learning activities on elementary school students, pre-service elementary teachers and in-service teachers' astronomy achievement and their attitudes to astronomy field. This study is the result of a five-day, three-stage, science school,…

  15. Improving Attainment through Action Research: An Introduction to Hillingdon's Raising Achievement Project.

    Irshad, Khalid; Imrie, Jean


    Describes the Raising Achievement Project designed to address the need for more information on the performance of ethnic minorities for whom English is an additional language, and the need for support for children who have passed the initial stages of learning English. It also describes the action research model used to answer questions about…

  16. Using Weblog in Cooperative Learning to Improve the Achievement of History Learning

    Leng, Lim Hooi; Leng, Chin Hai; Abedalaziz, Nabeel


    This research investigates the use of Weblog in Cooperative Learning to enhance students' learning of History. The main issues of this study were the lack of interest and low achievement scores in History learning. The objectives of this study are to explore the incorporation of Weblog in Cooperative Learning within the teaching and learning…


    Yan-ping Chen; Yun-qing Huang


    Improved L2-error estimates are computed for mixed finite element methods for second order nonlinear hyperbolic equations. Results are given for the continuous-time case. The convergence of the values for both the scalar function and the flux is demonstrated. The technique used here covers the lowest-order Raviart-Thomas spaces, as well as the higherorder spaces. A second paper will present the analysis of a fully discrete scheme (Numer.Math. J. Chinese Univ. vol.9, no.2, 2000, 181-192).

  18. Method of Improving the Navigation Accuracy of SINS by Continuous Rotation

    YANG Yong; MIAO Ling-juan; SHEN Jun


    A method of improving the navigation accuracy of strapdown inertial navigation system (SINS) is studied. The particular technique discussed involves the continuous rotation of gyros and accelerometers cluster about the vertical axis of the vehicle. Then the errors of these sensors will have periodic variation corresponding to components along the body frame. Under this condition, the modulated sensor errors produce reduced system errors. Theoretical analysis based on a new coordinate system defined as sensing frame and test results are presented, and they indicate the method attenuates the navigation errors brought by the gyros' random constant drift and the accelerometer's bias and their white noise compared to the conventional method.

  19. On improving the convergence rate of linear continuous-time systems subject to asymmetrically constrained control

    A. Baddou


    Full Text Available This paper solves the problem of controlling linear continuous-time systems subject to control signals constrained in magnitude (maybe asymmetrically. A controller design methodology is proposed, based on using an asymmetric Lyapunov function, that avoids the discontinuities in the control vector components resulting from the application of a piecewise linear control law previously proposed. The proposed method gives improved speed of convergence without discontinuities of the control vector components, respecting always the imposed asymmetric constraints. An example illustrates the approach.

  20. Improving the fidelity of continuous-variable quantum teleportation by tuning displacement gain

    Jinming Liu(刘金明); Jian Li(李剑); Guangcan Guo(郭光灿)


    The fidelity of teleportation of continuous quantum variables can be improved by tuning the local displace-ment gain. We investigate the optimization of the fidelity for the teleportation of Schrodinger cat states,and of coherent states. It is found that the gain corresponding to the maximum fidelity is not equal to onefor the two input states in the case of the small squeezing degree of the entanglement resource, while unitydisplacement gain is the best choice for teleporting arbitrary quantum states in the case of large squeezing.

  1. Coconut (Cocos nucifera L. genetic improvement in Vanuatu: overview of research achievements from 1962 to 2002

    Labouisse Jean-Pierre


    Compared to higher-yielding hybrids, the improved VTT populations offer the advantage of being totally tolerant of coconut foliar decay and of being reproducible by farmers themselves. The merits of setting up decentralized seed gardens in the Vanuatu archipelago from improved populations at the research station, or from locally surveyed material, are discussed.

  2. Improving Service Quality: Achieving High Performance in the Public and Private Sectors.

    Milakovich, Michael E.

    Quality-improvement principles are a sound means to respond to customer needs. However, when various quality and productivity theories and methods are applied, it is very difficult to consistently deliver quality results, especially in quasi-monopolistic, non-competitive, and regulated environments. This book focuses on quality-improvement methods…

  3. Does Spending More on Education Improve Academic Achievement? Backgrounder. No. 2179

    Lips, Dan; Watkins, Shanea J.; Fleming, John


    Debates about how to improve public education in America often focus on whether government should spend more on education. Federal and state policymakers proposing new education programs often base their arguments on the need to provide more resources to schools to improve opportunities for students. Many Americans seem to share this view. While…

  4. Waste Minimization Improvements Achieved Through Six Sigma Analysis Result In Significant Cost Savings

    Mousseau, Jeffrey, D.; Jansen, John, R.; Janke, David, H.; Plowman, Catherine, M.


    Improved waste minimization practices at the Department of Energy's (DOE) Idaho National Engineering and Environmental Laboratory (INEEL) are leading to a 15% reduction in the generation of hazardous and radioactive waste. Bechtel, BWXT Idaho, LLC (BBWI), the prime management and operations contractor at the INEEL, applied the Six Sigma improvement process to the INEEL Waste Minimization Program to review existing processes and define opportunities for improvement. Our Six Sigma analysis team: composed of an executive champion, process owner, a black belt and yellow belt, and technical and business team members used this statistical based process approach to analyze work processes and produced ten recommendations for improvement. Recommendations ranged from waste generator financial accountability for newly generated waste to enhanced employee recognition programs for waste minimization efforts. These improvements have now been implemented to reduce waste generation rates and are producing positive results.

  5. Improved ultrasonic TV images achieved by use of Lamb-wave orientation technique

    Berger, H.


    Lamb-wave sample orientation technique minimizes the interference from standing waves in continuous wave ultrasonic television imaging techniques used with thin metallic samples. The sample under investigation is oriented such that the wave incident upon it is not normal, but slightly angled.

  6. Worm-improved estimators in continuous-time quantum Monte Carlo

    Gunacker, P.; Wallerberger, M.; Ribic, T.; Hausoel, A.; Sangiovanni, G.; Held, K.


    We derive the improved estimators for general interactions and employ these for the continuous-time quantum Monte Carlo method. Using a worm algorithm we show how measuring higher-ordered correlators leads to an improved high-frequency behavior in irreducible quantities such as the one-particle self-energy or the irreducible two-particle vertex for non-density-density interactions. A good knowledge of the asymptotics of the two-particle vertex is essential for calculating nonlocal electronic correlations using diagrammatic extensions to the dynamical mean field theory as well as for calculating susceptibilities. We test our algorithm against analytic results for the multiorbital atomic limit and the Falicov-Kimball model.

  7. The Effectiveness of Computerized Instructional Packages on Concept Acquisition and Improving Academic Achievement among Female Deaf Students in KSA

    Bagabas, Hanan Ali


    The current study aimed to investigate the effectiveness of computerized instructional packages on concept acquisition and improving academic achievement among deaf students in Saudi Arabia. The sample consisted of (16) third-grade female deaf students in prep stage for the first semester of the academic year 2013/2014, randomly selected from…

  8. A University Engagement Model for Achieving Technology Adoption and Performance Improvement Impacts in Healthcare, Manufacturing, and Government

    McKinnis, David R.; Sloan, Mary Anne; Snow, L. David; Garimella, Suresh V.


    The Purdue Technical Assistance Program (TAP) offers a model of university engagement and service that is achieving technology adoption and performance improvement impacts in healthcare, manufacturing, government, and other sectors. The TAP model focuses on understanding and meeting the changing and challenging needs of those served, always…

  9. Improving Learning Achievements, Motivations and Problem-Solving Skills through a Peer Assessment-Based Game Development Approach

    Hwang, Gwo-Jen; Hung, Chun-Ming; Chen, Nian-Shing


    In this study, a peer assessment-based game development approach is proposed for improving students' learning achievements, motivations and problem-solving skills. An experiment has been conducted to evaluate the effectiveness of the proposed approach in a science course at an elementary school. A total of 167 sixth graders participated in…

  10. Experimental Evaluations of Two Strategies to Improve Reading Achievement in Kenya: Enhanced Literacy Instruction and Treatment of Malaria

    Jukes, Matthew; Dubeck, Margaret; Brooker, Simon; Wolf, Sharon


    There is less quality evidence on how malaria may affect cognitive abilities and educational achievement or on how schools can tackle the problem of malaria among school children. A randomised trial among Sri Lankan children showed that weekly malaria chemoprophylaxis with chloroquine can improve school examination scores. The Health and Literacy…

  11. Improving Science, Technology and Mathematics Students' Achievement: Imperatives for Teacher Preparation in the Caribbean Colleges and Universities

    Ogunkola, Babalola J.


    The concerns of this article are the unacceptable status of Science, Technology and Mathematics (STM) Education in the Caribbean and how to improve the students' achievement in the subjects involved through the instrumentality of better preparation of teachers by the Colleges and University faculties training teachers in the region. The index for…

  12. Lifestyle intervention for improving school achievement in overweight or obese children and adolescents

    Martin, Anne; Saunders, David H; Shenkin, Susan D.; Sproule, John


    The prevalence of overweight and obesity in childhood and adolescence is high. Excessive body fat at a young age is likely to persist into adulthood and is associated with physical and psychosocial co-morbidities, as well as lower cognitive, school and later life achievement. Lifestyle changes, including reduced caloric intake, decreased sedentary behaviour and increased physical activity, are recommended for prevention and treatment of child and adolescent obesity. Evidence suggests that lif...

  13. Dressed for Success: Do School Uniforms Improve Student Behavior, Attendance, and Achievement?

    Scott Imberman; Elisabetta Gentile


    Concerns about safety in urban schools has led many school districts to require uniforms for their students. However, we know very little about what impact school uniforms have had on the educational environment. In this paper we use a unique dataset to assess how uniform adoption affects student achievement and behavior in a large urban school district in the southwest. Since each school in the district could decide independently about whether or not to adopt uniforms, we are able to use var...

  14. A physical education trial improves adolescents' cognitive performance and academic achievement: the EDUFIT study.

    Ardoy, D N; Fernández-Rodríguez, J M; Jiménez-Pavón, D; Castillo, R; Ruiz, J R; Ortega, F B


    To analyze the effects of an intervention focused on increasing the time and intensity of Physical Education (PE), on adolescents' cognitive performance and academic achievement. A 4-month group-randomized controlled trial was conducted in 67 adolescents from South-East Spain, 2007. Three classes were randomly allocated into control group (CG), experimental group 1 (EG1) and experimental group 2 (EG2). CG received usual PE (two sessions/week), EG1 received four PE sessions/week and EG2 received four PE sessions/week of high intensity. Cognitive performance (non-verbal and verbal ability, abstract reasoning, spatial ability, verbal reasoning and numerical ability) was assessed by the Spanish Overall and Factorial Intelligence Test, and academic achievement by school grades. All the cognitive performance variables, except verbal reasoning, increased more in EG2 than in CG (all P performance and academic achievement. This study contributes to the current knowledge by suggesting that the intensity of PE sessions might play a role in the positive effect of physical activity on cognition and academic success. Future studies involving larger sample sizes should confirm or contrast these preliminary findings.

  15. Enabling Continuous Quality Improvement in Practice: The Role and Contribution of Facilitation

    Harvey, Gillian; Lynch, Elizabeth


    Facilitating the implementation of continuous quality improvement (CQI) is a complex undertaking. Numerous contextual factors at a local, organizational, and health system level can influence the trajectory and ultimate success of an improvement program. Some of these contextual factors are amenable to modification, others less so. As part of planning and implementing healthcare improvement, it is important to assess and build an understanding of contextual factors that might present barriers to or enablers of implementation. On the basis of this initial diagnosis, it should then be possible to design and implement the improvement intervention in a way that is responsive to contextual barriers and enablers, often described as “tailoring” the implementation approach. Having individuals in the active role of facilitators is proposed as an effective way of delivering a context-sensitive, tailored approach to implementing CQI. This paper presents an overview of the facilitator role in implementing CQI. Drawing on empirical evidence from the use of facilitator roles in healthcare, the type of skills and knowledge required will be considered, along with the type of facilitation strategies that can be employed in the implementation process. Evidence from both case studies and systematic reviews of facilitation will be reviewed and key lessons for developing and studying the role in the future identified. PMID:28275594

  16. Strategic planning as a focus for continuous improvement. A case study

    Oneill, John W.; Gordon-Winkler, Lyn

    What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

  17. Integrated insulin pump therapy with continuous glucose monitoring for improved adherence: technology update

    Tumminia A


    Full Text Available Andrea Tumminia,1 Laura Sciacca,1 Lucia Frittitta,1 Sebastiano Squatrito,1 Riccardo Vigneri,2 Rosario Le Moli,1 Letizia Tomaselli2 1Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Hospital, Catania, Italy; 2Endocrinology, Garibaldi-Nesima Hospital, Catania, Italy Abstract: Insulin pump therapy combined with real-time continuous glucose monitoring, known as sensor-augmented pump (SAP therapy, has been shown to improve metabolic control and to reduce the rate of hypoglycemia in adults with type 1 diabetes compared to multiple daily injections or standard continuous subcutaneous insulin infusion. Glycemic variability is also reduced in patients on SAP therapy. This approach allows patients to monitor their glucose levels being informed of glycemic concentration and trend. Trained diabetic patients, therefore, can appropriately modify insulin infusion and/or carbohydrate intake in order to prevent hypo- or hyperglycemia. For these reasons, SAP therapy is now considered the gold standard for type 1 diabetes treatment. To be clinically effective, however, devices and techniques using advanced technology should not only have the potential to theoretically ameliorate metabolic control, but also be well accepted by patients in terms of satisfaction and health-related quality of life, because these factors will improve treatment adherence and consequently overall outcome. SAP therapy is generally well tolerated by patients; however, many clinical trials have identified significant noncompliance in the use of this device, most notably in the pediatric and adolescent populations. In this review we aim to analyze the main reasons for good or poor adherence to SAP therapy and to provide useful tips in order to fully benefit from this kind of novel therapeutic approach. Keywords: sensor-augmented insulin pump therapy, type 1 diabetes, quality of life, patient adherence, continuous subcutaneous insulin

  18. Continuous flushing of the bladder in rodents reduces artifacts and improves quantification in molecular imaging.

    Deleye, Steven; Heylen, Marthe; Deiteren, Annemie; De Man, Joris; Stroobants, Sigrid; De Winter, Benedicte; Staelens, Steven


    In this study, we evaluated the partial volume effect (PVE) of 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) tracer accumulation in the bladder on the positron emission tomographic (PET) image quantification in mice and rats suffering from inflammatory bowel disease. To improve the accuracy, we implemented continuous bladder flushing procedures. Female mice and rats were scanned using microPET/computed tomography (CT) at baseline and after induction of acute colitis by injecting 2,4,6-trinitrobenzene sulfonic acid (TNBS) intrarectally. During the scans, the bladder was continuously flushed in one group, whereas in the other group, no bladder flushing was performed. As a means of in vivo and ex vivo validation of the inflammation, animals also underwent colonoscopy and were sacrificed for gamma counting (subpopulation) and to score the colonic damage both micro- and macroscopically as well as biochemically. At baseline, the microPET signal in the colon of both mice and rats was significantly higher in the nonflushed group compared to the flushed group, caused by the PVE of tracer activity in the bladder. Hence, the colonoscopy and postmortem analyses showed no significant differences at baseline between the flushed and nonflushed animals. TNBS induced significant colonic inflammation, as revealed by colonoscopic and postmortem scores, which was not detected by microPET in the mice without bladder flushing, again because of spillover of bladder activity in the colonic area. MicroPET in bladder-flushed animals did reveal a significant increase in 18F-FDG uptake. Correlations between microPET and colonoscopy, macroscopy, microscopy, and myeloperoxidase yielded higher Spearman rho values in mice with continuously flushed bladders during imaging. Comparable, although somewhat less pronounced, results were shown in the rat. Continuous bladder flushing reduced image artifacts and is mandatory for accurate image quantification in the pelvic region for both mice and rats. We

  19. Continuous Flushing of the Bladder in Rodents Reduces Artifacts and Improves Quantification in Molecular Imaging

    Steven Deleye


    Full Text Available In this study, we evaluated the partial volume effect (PVE of 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG tracer accumulation in the bladder on the positron emission tomographic (PET image quantification in mice and rats suffering from inflammatory bowel disease. To improve the accuracy, we implemented continuous bladder flushing procedures. Female mice and rats were scanned using microPET/computed tomography (CT at baseline and after induction of acute colitis by injecting 2,4,6-trinitrobenzene sulfonic acid (TNBS intrarectally. During the scans, the bladder was continuously flushed in one group, whereas in the other group, no bladder flushing was performed. As a means of in vivo and ex vivo validation of the inflammation, animals also underwent colonoscopy and were sacrificed for gamma counting (subpopulation and to score the colonic damage both micro- and macroscopically as well as biochemically. At baseline, the microPET signal in the colon of both mice and rats was significantly higher in the nonflushed group compared to the flushed group, caused by the PVE of tracer activity in the bladder. Hence, the colonoscopy and postmortem analyses showed no significant differences at baseline between the flushed and nonflushed animals. TNBS induced significant colonic inflammation, as revealed by colonoscopic and postmortem scores, which was not detected by microPET in the mice without bladder flushing, again because of spillover of bladder activity in the colonic area. MicroPET in bladder-flushed animals did reveal a significant increase in 18F-FDG uptake. Correlations between microPET and colonoscopy, macroscopy, microscopy, and myeloperoxidase yielded higher Spearman rho values in mice with continuously flushed bladders during imaging. Comparable, although somewhat less pronounced, results were shown in the rat. Continuous bladder flushing reduced image artifacts and is mandatory for accurate image quantification in the pelvic region for both mice

  20. Researching achievement and inclusion to improve the educational experiences and outcomes of all learners

    Lani FLORIAN


    Full Text Available This paper considers some of the key issues that must be taken into account when conducting research on inclusive education in an era of standards based reform. It challenges the widely held assumption that high levels of educational inclusion are incompatible with high levels of academic achievement in schools and presents the Framework for Participation, a research tool developed by the authors, which supports practitioners (and other researchers who wish to examine the development of inclusive practice in their own schools.

  1. The Sustainable Development Goals cannot be achieved without improving maternal and child nutrition.

    Baye, Kaleab


    Poor nutrition is a global pandemic with social, economic, and environmental causes and consequences. Of the 17 Sustainable Development Goals (SDGs), only SDG2 explicitly mentions nutrition. Turning the aspirations of the SDGs into reality will require recognition that good nutrition ensured through sustainable agriculture, is simultaneously an absolutely fundamental input and output. Because all of the other SDGs are directly or indirectly linked to improving nutrition, funding to improve nutrition is essential to success for many SDGs. Greater focus on cooperation across disciplines to advance the science of program delivery and to understand the full contribution of nutrition to many desirable outcomes as part of development are surely the ways forward. Missing today's opportunities to advance thinking and program implementation for more effectively improving nutrition for all, especially for women and children, will lead to a wider failure to meet the SDGs.

  2. The Sustainable Development Goals cannot be achieved without improving maternal and child nutrition.

    Baye, Kaleab


    Poor nutrition is a global pandemic with social, economic, and environmental causes and consequences. Of the 17 Sustainable Development Goals (SDGs), only SDG2 explicitly mentions nutrition. Turning the aspirations of the SDGs into reality will require recognition that good nutrition ensured through sustainable agriculture, is simultaneously an absolutely fundamental input and output. Because all of the other SDGs are directly or indirectly linked to improving nutrition, funding to improve nutrition is essential to success for many SDGs. Greater focus on cooperation across disciplines to advance the science of program delivery and to understand the full contribution of nutrition to many desirable outcomes as part of development are surely the ways forward. Missing today's opportunities to advance thinking and program implementation for more effectively improving nutrition for all, especially for women and children, will lead to a wider failure to meet the SDGs.

  3. The role of the continuous improvement tools of procesess in building relationships in supply chain

    Maciej Urbaniak


    Full Text Available Background: The aim of this paper is to determine the importance of the quality management and environmental management systems as well as operational improvement tools (such as TPS, Six Sigma, and Lean Management in building partnerships in supply chain. Methods: This paper contains the results of survey in companies operating in Poland and an analysis of the requirements for suppliers in the implementation of the quality and environmental management systems elements as well as recommendation for them to implement process improvement tools (such as elements of the TPS, the concept of Lean Management and Six Sigma methodologies. Results: The results of the survey and the analysis of the examples show that companies that are buyers in the B2B market often define the very individualized to suppliers needs through detailed specifications defining the requirements for quality assurance, performance increases, (for example, shortening implementation cycles, efficiency (cost reduction, safety, reducing the negative impact on the environment. Conclusions: The effectiveness of the action on improving the quality of processes and products by building relationships with suppliers depends largely on the support provided to them. To achieve these objectives many companies introduce special development programs for suppliers.

  4. Improving Secondary School Students' Achievement and Retention in Biology Through Video-based Multimedia Instruction

    Amosa Isiaka Gambari, PhD


    Full Text Available The study examined the effects of video-based multimedia instruction on secondary school students' achievement and retention in biology. In Nigeria, 120 students (60 boys and 60 girls were randomly selected from four secondary schools assigned either into one of three experimental groups: Animation + Narration; Animation + On-screen Text; Animation + Narration + On-screen Text or a control group. The pretest, posttest experimental, and control group design was adopted. A 50-item multiple-choice objective test termed Biology Achievement Test (BAT was used for collecting data. The validated BAT was tested for reliability using Kuder Richardson (KR20, which yielded 0.89. T-test, analysis of covariance (ANCOVA, and Scheffe’s post-hoc analysis were used in determining the significant differences among the four groups. The results showed that there was no statistically significant difference among the experimental groups. Generally, students under multimedia instruction performed better than their colleagues in the conventional teaching method. However, students in conventional teaching method had better retention than other groups.

  5. Techniques for mass resolution improvement achieved by typical plasma mass analyzers: Modeling and simulations

    Nicolaou, Georgios; Yamauchi, Masatoshi; Wieser, Martin; Barabash, Stas; Fedorov, Andrei


    Mass separation and particularly distinction between atomic ions and molecular ions are essential in understanding a wide range of plasma environments, with each consisted of different species with various properties. In this study we present the optimization results of light-weight (about 2 kg) magnetic mass analyzers with high g-factor for Rosetta (Ion Composition Analyser: ICA) and for Mars Express and Venus Express (Ion Mass Analyser: IMA). For the instrument's optimization we use SIMION, a 3D ion tracing software in which we can trace particle beams of several energies and directions, passing through the instrument's units. We first reproduced ICA and IMA results, which turned out to be different from simple models for low energy (< 100 eV). We then change the mechanical structure of several units of the instrument and we quantify the new mass resolution achieved with each change. Our goal is to find the optimal instrument's structure, which will allow us to achieve a proper mass resolution to distinguish atomic nitrogen from atomic oxygen for the purposes of a future magnetospheric mission.

  6. Combined Fluency and Cognitive Strategies Instruction Improves Mathematics Achievement in Early Elementary School

    Carr, Martha; Taasoobshirazi, Gita; Stroud, Rena; Royer, James M.


    One hundred and seventy-eight second grade students from two states (Georgia and Massachusetts) participated in an experiment in which they were randomly assigned to either (1) a computer program designed to increase fluency in addition and subtraction, (2) a program designed to improve cognitive strategy use for addition and subtraction, (3) a…

  7. Increasing Student Achievement and Improving Self-Esteem through a Community Building Intervention

    Lupo, Concetta M.


    This study focused on improving students' self-esteem through community building at an elementary school in a low socioeconomic community where over 55% of the students live below the poverty line. Orefield and Yun state in their 1999 article, "Resegregation of America's schools," "school level poverty is related to many…

  8. Creating Birds of Similar Feathers: Leveraging Similarity to Improve Teacher-Student Relationships and Academic Achievement

    Gehlbach, Hunter; Brinkworth, Maureen E.; King, Aaron M.; Hsu, Laura M.; McIntyre, Joseph; Rogers, Todd


    When people perceive themselves as similar to others, greater liking and closer relationships typically result. In the first randomized field experiment that leverages actual similarities to improve real-world relationships, we examined the affiliations between 315 9th grade students and their 25 teachers. Students in the treatment condition…

  9. A combined continuous and interval aerobic training improves metabolic syndrome risk factors in men

    Sari-Sarraf V


    Full Text Available Vahid Sari-Sarraf,1 Akbar Aliasgarzadeh,2 Mohammad-Mahdi Naderali,3 Hamid Esmaeili,1 Ebrahim K Naderali4 1Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, 2Bone Research Centre, Endocrine Unit, Department of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 3The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, 4Faculty of Science, Liverpool Hope University, Liverpool, UK Abstract: Individuals with metabolic syndrome have significantly higher risk of cardiovascular disease and type 2 diabetes leading to premature death mortality. Metabolic syndrome has a complex etiology; thus, it may require a combined and multi-targeted aerobic exercise regimen to improve risk factors associated with it. Therefore, the aim of this study was to evaluate the effect of combined continuous and interval aerobic training on patients with metabolic syndrome. Thirty adult male with metabolic syndrome (54±8 years were randomly divided into two groups: test training group (TTG; n=15 and control group (CG; n=15. Subjects in TTG performed combined continuous and interval aerobic training using a motorized treadmill three times per week for 16 weeks. Subjects in CG were advised to continue with their normal activities of life. Twenty-two men completed the study (eleven men in each group. At the end of the study, in TTG, there were significant (for all, P<0.05 reductions in total body weight (-3.2%, waist circumference (-3.43 cm, blood pressure (up to -12.7 mmHg, and plasma insulin, glucose, and triacylglyceride levels. Moreover, there were significant (for all, P<0.05 increases VO2max (-15.3% and isometric strength of thigh muscle (28.1% and high-density lipoprotein in TTG. None of the above indices were changed in CG at the end of 16-week study period. Our study suggests that adoption of a 16-week combined continuous and interval aerobic training regimen in men

  10. Fuzzy approach for improved recognition of citric acid induced piglet coughing from continuous registration

    Van Hirtum, A.; Berckmans, D.


    A natural acoustic indicator of animal welfare is the appearance (or absence) of coughing in the animal habitat. A sound-database of 5319 individual sounds including 2034 coughs was collected on six healthy piglets containing both animal vocalizations and background noises. Each of the test animals was repeatedly placed in a laboratory installation where coughing was induced by nebulization of citric acid. A two-class classification into 'cough' or 'other' was performed by the application of a distance function to a fast Fourier spectral sound analysis. This resulted in a positive cough recognition of 92%. For the whole sound-database however there was a misclassification of 21%. As spectral information up to 10000 Hz is available, an improved overall classification on the same database is obtained by applying the distance function to nine frequency ranges and combining the achieved distance-values in fuzzy rules. For each frequency range clustering threshold is determined by fuzzy c-means clustering.

  11. A Gaussian-like immersed-boundary kernel with three continuous derivatives and improved translational invariance

    Bao, Yuanxun; Kaye, Jason; Peskin, Charles S.


    The immersed boundary (IB) method is a general mathematical framework for studying problems involving fluid-structure interactions in which an elastic structure is immersed in a viscous incompressible fluid. In the IB formulation, the fluid described by Eulerian variables is coupled with the immersed structure described by Lagrangian variables via the use of the Dirac delta function. From a numerical standpoint, the Lagrangian force spreading and the Eulerian velocity interpolation are carried out by a regularized, compactly supported discrete delta function, which is assumed to be a tensor product of a single-variable immersed-boundary kernel. IB kernels are derived from a set of postulates designed to achieve approximate grid translational invariance, interpolation accuracy and computational efficiency. In this note, we present a new 6-point immersed-boundary kernel that is C3 and yields a substantially improved translational invariance compared to other common IB kernels.

  12. Achieving the Health Care Financing Administration limits by quality improvement and quality control. A real-world example.

    Engebretson, M J; Cembrowski, G S


    With the enactment of the Clinical Laboratory Improvement Amendments of 1988 (CLIA 88), the federal government is now using proficiency testing as the primary indicator of laboratory quality. Laboratories with proficiency test failures are now at risk of a variety of harsh penalties including large monetary fines and suspension of operations. To minimize the risk of failed proficiency testing, we initiated a continuous quality improvement program in our general chemistry laboratory in conjunction with the use of a new survey-validated quality control product. This article describes the quality improvement program and our success in reducing the long-term random error in general chemistry. Despite our improvement program, significant analytical errors (greater than 30% of the CLIA limits) still exist in analytes measured by our chemistry analyzer. These errors are present in nearly the same analytes measured by other common chemistry analyzers indicating the need for improvement in their design and manufacture.

  13. In praise of conscious awareness: a new framework for the investigation of 'continuous improvement' in expert athletes

    John eToner


    Full Text Available A key postulate of traditional theories of motor skill learning (e.g., Fitts and Posner, 1967; Shiffrin and Schneider, 1977 is that expert performance is largely automatic in nature and tends to deteriorate when the performer ‘reinvests’ in, or attempts to exert conscious control over, proceduralized movements (Masters and Maxwell, 2008. This postulate is challenged, however, by recent empirical evidence (e.g., Nyberg, in press; Geeves et al., in press which shows that conscious cognitive activity plays a key role in facilitating further improvement amongst expert sports performers and musicians – people who have already achieved elite status (Toner and Moran, in press. This evidence suggests that expert performers in motor domains (e.g., sport, music can strategically deploy conscious attention to alternate between different modes of bodily awareness (reflective and pre-reflective during performance. Extrapolating from this phenomenon, the current paper considers how a novel theoretical approach (adapted from Sutton, McIlwain, Christensen, and Geeves, 2011 could help researchers to elucidate some of the cognitive mechanisms mediating continuous improvement amongst expert performers.

  14. The continuous improvement system of nuclear power plant of Laguna Verde; El sistema de mejora continua de la central nucleoelectrica Laguna Verde

    Rivera C, A. [Comision Federal de Electricidad, Central Nucleoelectrica Laguna Verde, Km. 42.5 Cardel-Nautla, Veracruz (Mexico)], e-mail:


    This paper describes the continuous improvement system of nuclear power plant of Laguna Verde and the achievements in implementing the same and additionally two study cases are presents. In February 2009 is noteworthy because the World Association of Nuclear Operators we identified as a learning organization, qualification which shows that the continuous improvement system has matured, and this system will expose as I get to learn to capitalize on our own experiences and external experiences diffused by the nuclear industry. In 2007 the management of nuclear power plants integrates its improvement systems and calls it continuous improvement system and is presented in the same extensive report that won the National Quality Award. This system is made up of 5 subsystems operating individually and are also related 1) human performance; 2) referential comparison or benchmarking; 3) self-assessment; 4) corrective action and 5) external operating experience. Five subsystems that plan, generate, capture, manage, communicate and protect the knowledge generated during the processes execution of nuclear power plant of Laguna Verde, as well as from external sources. The target set in 2007 was to increase the intellectual capital to always give response to meeting the security requirements, but creating a higher value to quality, customer, environment protection and society. In brief each of them, highlighting the objective, expectations management, implementation and some benefits. At the end they will describe two study cases selected to illustrate these cases as the organization learns by their continuous improvement system. (Author)

  15. Improving University Ranking to Achieve University Competitiveness by Management Information System

    Dachyar, M.; Dewi, F.


    One way to increase university competitiveness is through information system management. A literature review was done to find information system factors that affect university performance in Quacquarelli Symonds (QS) University Ranking: Asia evaluation. Information system factors were then eliminated using Delphi method through consensus of 7 experts. Result from Delphi method was used as measured variables in PLS-SEM. Estimation with PLS-SEM method through 72 respondents shows that the latent variable academic reputation and citation per paper have significant correlation to university competitiveness. In University of Indonesia (UI) the priority to increase university competitiveness as follow: (i) network building in international conference, (ii) availability of research data to public, (iii) international conference information, (iv) information on achievements and accreditations of each major, (v) ease of employment for alumni.

  16. Identification of Energy Efficiency Opportunities through Building Data Analysis and Achieving Energy Savings through Improved Controls

    Katipamula, Srinivas; Taasevigen, Danny J.; Koran, Bill


    This chapter will highlight analysis techniques to identify energy efficiency opportunities to improve operations and controls. A free tool, Energy Charting and Metrics (ECAM), will be used to assist in the analysis of whole-building, sub-metered, and/or data from the building automation system (BAS). Appendix A describes the features of ECAM in more depth, and also provide instructions for downloading ECAM and all resources pertaining to using ECAM.

  17. Live births achieved via IVF are increased by improvements in air quality and laboratory environment

    Heitmann, Ryan J; Hill, Micah J; James, Aidita N; Schimmel, Tim; Segars, James H; Csokmay, John M; Cohen, Jacques; Payson, Mark D


    Infertility is a common disease, which causes many couples to seek treatment with assisted reproduction techniques. Many factors contribute to successful assisted reproduction technique outcomes. One important factor is laboratory environment and air quality. Our facility had the unique opportunity to compare consecutively used, but separate assisted reproduction technique laboratories, as a result of a required move. Environmental conditions were improved by strategic engineering designs. All other aspects of the IVF laboratory, including equipment, physicians, embryologists, nursing staff and protocols, were kept constant between facilities. Air quality testing showed improved air quality at the new IVF site. Embryo implantation (32.4% versus 24.3%; P < 0.01) and live birth (39.3% versus 31.8%, P < 0.05) were significantly increased in the new facility compared with the old facility. More patients met clinical criteria and underwent mandatory single embryo transfer on day 5 leading to both a reduction in multiple gestation pregnancies and increased numbers of vitrified embryos per patient with supernumerary embryos available. Improvements in IVF laboratory conditions and air quality had profound positive effects on laboratory measures and patient outcomes. This study further strengthens the importance of the laboratory environment and air quality in the success of an IVF programme. PMID:26194882

  18. Integrating the development of continuous improvement andinnovation capabilities into engineering education

    Jørgensen, Frances; Kofoed, Lise B.


    In this paper, a study is presented in which engineering students at a Danish university developed Continuous Improvement (CI) and innovation capabilities through action research and experientiallearning methods. The paper begins with a brief overview of the literature on CI and innovation......, followed by an account of how the students designed and implemented solutions to self-identified problems within their educational program using the principles of CI, and how these learning activities facilitated the development of basic innovation capabilities. The paper concludes with insights regarding...... how such an innovative design of teaching methods based on learning-by-doing may not only support the development of CI and innovation in engineering students, which is increasingly demanded by industry, but also represent a way in which to enhance sustainability and innovation of the education itself....

  19. A Marketing approach on how continuous processes improvement can contribute to hotel business Organic Growth

    Ioana-Simona IVASCIUC


    Full Text Available Generating sustainable growth and profits is like finding a unicorn for most managers. Organic growth should be considered as an alternative for long-term growth in the hotel business. Designing the service process to deliver what customers expect from the hotel offer is a crucial component of encounter marketing. Hotels need to embrace the changes and ensure that their internal processes are aligned not just to current trends, but also to the expected future changes. Keeping up with global changes and trends of any kind, evaluating their impact on your business, continuous improving of the services using PDCA cycle, Six Sigma or Lean principles, are the keys to long-term organic growth.


    Aiguo WU; Huafeng DONG; Guangren DUAN


    The design of full-order robust estimators is investigated for continuous-time polytopic uncertain systems. The main purpose is to obtain a stable linear estimator such that the estimation error system remains robustly stable with a prescribed H∞ attenuation level. Firstly, a simple alterna- tive proof is given for an improved LMI representation of H∞ performance proposed recently. Based on the performance criterion which keeps the Lyapunov matrix out of the product of the system dynamic matrices, a sufficient condition for the existence of the robust estimator is provided in terms oflinear matrix inequalities. It is shown that the proposed design strategy allows the use of parameter-dependent Lyapunov functions and hence it is less conservative than the earlier results. A numericalexample is employed to illustrate the feasibility and advantage of the proposed design.

  1. Improved dichotomous search frequency offset estimator for burst-mode continuous phase modulation

    翟文超; 李赞; 司江勃; 柏均


    A data-aided technique for carrier frequency offset estimation with continuous phase modulation (CPM) in burst-mode transmission is presented. The proposed technique first exploits a special pilot sequence, or training sequence, to form a sinusoidal waveform. Then, an improved dichotomous search frequency offset estimator is introduced to determine the frequency offset using the sinusoid. Theoretical analysis and simulation results indicate that our estimator is noteworthy in the following aspects. First, the estimator can operate independently of timing recovery. Second, it has relatively low outlier, i.e., the minimum signal-to-noise ratio (SNR) required to guarantee estimation accuracy. Finally, the most important property is that our estimator is complexity-reduced compared to the existing dichotomous search methods: it eliminates the need for fast Fourier transform (FFT) and modulation removal, and exhibits faster convergence rate without accuracy degradation.


    Janaina Siegler


    Full Text Available The importance of interaction between Operations Management (OM and Human Behavior has been recently re-addressed. This paper introduced the Reasoned Action Theory suggested by Froehle and Roth (2004 to analyze Operational Capabilities exploring the suitability of this model in the context of OM. It also seeks to discuss the behavioral aspects of operational capabilities from the perspective of organizational routines. This theory was operationalized using Fishbein and Ajzen (F/A behavioral model and a multi-case strategy was employed to analyze the Continuous Improvement (CI capability. The results posit that the model explains partially the CI behavior in an operational context and some contingency variables might influence the general relationsamong the variables involved in the F/A model. Thus intention might not be the determinant variable of behavior in this context.

  3. A Knowledge Tree Model and Its Application for Continuous Management Improvement

    Lu, Yun; Bao, Zhen-Qiang; Zhao, Yu-Qin; Wang, Yan; Wang, Gui-Jun

    This chapter analyzes the relationship of organizational knowledge and brings forward that organizational knowledge consists of three layers: core knowledge, structural knowledge, and implicit knowledge. According to the principle of knowledge maps, a dynamic management model of organizational knowledge based on knowledge tree is introduced and the definition of the value of knowledge node is given so that the quantitative management on knowledge is realized, which lays a foundation for performance evaluation of knowledge management. We also carefully study the application of knowledge tree in service quality management of hospital organizations and management innovation process and give the example of cooperation in endoscopic surgery to establish a knowledge tree about operational cooperation degree, which states the principle of organizational knowledge management and the knowledge innovation process of continuous management improvement.

  4. The new health-care quality: value, outcomes, and continuous improvement.

    O'Connor, S J; Lanning, J A


    No longer convinced that their viewpoint on quality is the only one, different stakeholders in the health-care arena are sharing perspectives to piece together the quality picture. Although still preoccupied with the cost of health care, purchasers are concerned about value--efficiency, appropriateness, and effectiveness--as well as price. Faced with evidence of medically unnecessary procedures and unexamined medical theory, practitioners are searching for appropriateness guidelines, useful outcome measures, and methods to elicit informed patient preferences about elective surgeries. Underlying this search for reliable indicators of quality--now expanded to include patient satisfaction--is a new interest in the Japanese notion of "Kaizen" or continuous quality improvement. The end product of this ferment may determine whether good medicine drives out the bad--or vice versa.

  5. Continuous quality improvement: a shared governance model that maximizes agent-specific knowledge.

    Burkoski, Vanessa; Yoon, Jennifer


    Motivate, Innovate, Celebrate: an innovative shared governance model through the establishment of continuous quality improvement (CQI) councils was implemented across the London Health Sciences Centre (LHSC). The model leverages agent-specific knowledge at the point of care and provides a structure aimed at building human resources capacity and sustaining enhancements to quality and safe care delivery. Interprofessional and cross-functional teams work through the CQI councils to identify, formulate, execute and evaluate CQI initiatives. In addition to a structure that facilitates collaboration, accountability and ownership, a corporate CQI Steering Committee provides the forum for scaling up and spreading this model. Point-of-care staff, clinical management and educators were trained in LEAN methodology and patient experience-based design to ensure sufficient knowledge and resources to support the implementation.

  6. Continuing medical education, quality improvement, and organizational change: implications of recent theories for twenty-first-century CME.

    Price, David


    Healthcare providers and systems are being asked to measure and improve the quality of care delivered to their patients. Additionally, the American Board of Medical Specialties now requires physicians to participate in systems-based practice and practice-based learning and improvement activities as part of maintenance of specialty board certification. These changing paradigms provide opportunities for continuing medical education to become more aligned with health system goals and help prepare clinicians to practice in this new environment. Organizational change and quality improvement principles have much in common with continuing medical education planning processes. Medical education can play a role in helping organizations improve. Continuing medical education must move beyond delivering content to individual clinicians towards becoming a facilitator of organizational improvement. Research is needed to determine the effect of integrating continuing medical education with organizational change approaches on professional competence, organizational processes and patient outcomes.

  7. Coconut (Cocos nucifera L. genetic improvement in Vanuatu: Overview of research achievements from 1962 to 2002.

    Labouisse Jean-Pierre


    Full Text Available From 1962 to 2002, at the Saraoutou research station on the island of Santo in Vanuatu, a hybrid creation programme was implemented to improve the productive potential of coconut cultivars. The first stage was to create a collection by introducing around thirty exotic varieties. All those varieties and most of the 60 hybrids created proved to be susceptible to coconut foliar decay, a viral disease transmitted by Myndus taffini and endemic in Vanuatu. Only the Vanuatu Tall populations and two hybrids (Vanuatu Red Dwarf × Vanuatu Tall and Vanuatu Tall × Rennell Island Tall displayed tolerance enabling their distribution to farmers. The author indicates the origin of the parents and the production characteristics of these two hybrids. The Vanuatu Red Dwarf × Vanuatu Tall hybrid expresses good hybrid vigour with a production potential ranging from 2.5 to 3.4 tons per hectare per year. However, it does have several defects: slow germination and a highly irregular final germinated nut rate, susceptibility to cyclones when young, premature nut fall sometimes seen on young palms, and a mediocre copra content (between 135 and 160 g. The Vanuatu Tall × Rennell Island Tall hybrid stands out through its early start to bearing (4 years, its vigour and its good adaptation to cyclones. The copra content of its nuts (between 210 and 245 g is better than that of the Vanuatu Tall, making copra preparation easier. Its production ranges from 2.5 to 3 tons per hectare per year, which is around 30% better than the improved Vanuatu Tall (Elite Vanuatu Tall. However, dissemination of this hybrid, which can only be produced in centralized seed gardens, is limited by the cost of production and of transport throughout the archipelago. Only large-scale Elite Vanuatu Tall production in decentralized seed gardens would enable a significant improvement in coconut productivity in Vanuatu.

  8. Anti-idiotypic antibodies as cancer vaccines: achievements and future improvements

    Maha Zohra eLadjemi


    Full Text Available Since the discovery of tumor-associated antigens (TAA, researchers have tried to develop immune-based anti-cancer therapies. Thanks to their specificity, monoclonal antibodies (mAbs offer the major advantage to induce fewer side effects than those caused by non-specific conventional treatments (eg. chemotherapy, radiotherapy. Passive immunotherapy by means of mAbs or cytokines has proved efficacy in oncology and validated the use of immune-based agents as part of anti-cancer treatment options. The next step was to try to induce an active immune protection aiming to boost own’s host immune defense against TAAs. Cancer vaccines are thus developed to specifically induce active immune protection targeting only tumor cells while preserving normal tissues from a non-specific toxicity. But, as most of TAAs are self antigens, an immune tolerance against them exists representing a barrier to effective vaccination against these oncoproteins. One promising approach to break this immune tolerance consists in the use of anti-idiotypic mAbs, so called Ab2, as antigen surrogates. This vaccination strategy allows also immunization against non-proteic antigens (such as carbohydrates. In some clinical studies, anti-idiotypic (anti-Id cancer vaccines indeed induced efficient humoral and/or cellular immune responses associated with clinical benefit.This review article will focus on recent achievements of anti-Id mAbs use as cancer vaccines in solid tumors.

  9. Optimization of continuous hydrothermal treatment for improving the dehulling of black gram (Vigna mungo L).

    Jerish Joyner, J; Yadav, B K


    Black gram kernels with three initial moisture contents (10, 14 & 18 % w.b.) were steam treated in a continuous steaming unit at three inlet steam pressures (2, 3 & 4 kg/cm(2)) for three grain residence times (2, 4 & 6 min) in order to determine best treatment condition for maximizing the dhal yield while limiting the colour change in acceptable range. The dhal yield, dehulling loss and the colour difference (Delta E*) of the dehulled dhal were found to vary respectively, from 56.4 to 78.8 %, 30.8 to 8.6 % and 2.1 to 9.5 with increased severity of treatment. Optimization was done in order to obtain higher dhal yield while limiting the colour difference (Delta E*) within acceptable range i.e. 2.0 to 3.5 using response surface methodology. The best condition was obtained with the samples having 13.1 % initial moisture treated with 4 kg/cm(2) for about 6 min to achieve a dhal yield of 71.2 % and dehulling loss of 15.5 %.


    Mohammed Yunus


    Full Text Available The present study is carried out to improve quality level by identifying the prime reasons of the quality related problems in the seat hardfacing process involving the deposition of cobalt based super alloy in I.C. Engine valves using TIG welding process. During the Process, defects like stellite deposition overflow, head melt, non-uniform stellite merging, etc., are observed and combining all these defects, the rejection level was in top position in Forge shop. We use widely referred QC tools of the manufacturing field to monitor the complete operation and continuous progressive process improvement to ensure ability and efficiency of quality management system of any firm. The work aims to identify the various causes for the rejection by the detailed study of the operation, equipment, materials and the various process parameters that are very important to get defects-free products. Also, to evolve suitable countermeasures for reducing the rejection percentage using seven QC tools. To further understand and validate the obtained results, we need to address other studies related to motivations, advantages, and disadvantages of applying quality control tools.

  11. Continued improvement of cardiovascular mortality in Hungary - impact of increased cardio-metabolic prescriptions

    Jozan Peter


    Full Text Available Abstract Background During the last 35 years the poor ranking of Hungary on the list of life expectancy at birth among European countries, has not changed. In 1970 our lag behind the leading European countries was the smallest. The gap was growing between 1970 and 1993 but from 1994 onwards the life expectancy at birth in Hungary has increased continuously and somewhat faster than in other European countries. The aim of this study was to analyze the association between decreasing cardiovascular mortality rates, as a main cause of death and the increase in cardio-metabolic prescriptions and possible changes in lifestyle behavior. Methods Analyses were conducted on national data concerning cardiovascular mortality and the number of cardio-metabolic drug prescription per capita. The association between yearly rates of cardiovascular events and changes in antihypertensive, antilipidemic and antidiabetic prescription rates was analyzed. The changes in other cardiovascular risk factors, like lifestyle were also considered. Results We observed a remarkable decline of mortality due to stroke and acute myocardial infarction (AMI. The fall was significantly associated with all prescription rates. The proportion of each treatment type responsible for suppression of specific mortality rates is different. All treatment types comparably improved stroke mortality, while antilipidemic therapy improved AMI outcome. Conclusions These results emphasize the importance of a comprehensive strategy that maximizes the population coverage of effective treatments. Hungary appears to be at the beginning of the fourth stage of epidemiologic transition, i.e. it has entered the stage of delayed chronic noninfectious diseases.

  12. Quality management science in clinical chemistry: a dynamic framework for continuous improvement of quality.

    Westgard, J O; Burnett, R W; Bowers, G N


    Current quality assurance approaches will not be adequate to satisfy the needs for quality in the next decade. Quality management science (QMS), as evolving in industry today, provides the dynamic framework necessary to provide continuous improvement of quality. QMS emphasizes the importance of defining quality goals based on the needs and expectations (implied needs) of customers. The laboratory can develop customer-friendly goals and measures of quality by recognizing that customers' experiences are represented by a totality of results. Quality goals and measures are best communicated as "total performance" by specifying a limit and percentile of the distribution, rather than a mean and standard deviation. Application of quality goals within the laboratory will usually require partitioning the total performance goal into components and translating those components into specifications to guide the operation and management of production processes. QMS also extends beyond technical processes to people processes and provides guidance for improving the quality of worklife and caring for the laboratory's most essential resource--our people.

  13. Achieving clean epitaxial graphene surfaces suitable for device applications by improved lithographic process

    Nath, A., E-mail:; Rao, M. V. [George Mason University, 4400 University Dr., Fairfax, Virginia 22030 (United States); Koehler, A. D.; Jernigan, G. G.; Wheeler, V. D.; Hite, J. K.; Hernández, S. C.; Robinson, Z. R.; Myers-Ward, R. L.; Eddy, C. R.; Gaskill, D. K. [U.S. Naval Research Laboratory, 4555 Overlook Ave. SW, Washington, D.C. 20375 (United States); Garces, N. Y. [Sotera Defense Solutions, 2200 Defense Hwy. Suite 405, Crofton, Maryland 21114 (United States)


    It is well-known that the performance of graphene electronic devices is often limited by extrinsic scattering related to resist residue from transfer, lithography, and other processes. Here, we report a polymer-assisted fabrication procedure that produces a clean graphene surface following device fabrication by a standard lithography process. The effectiveness of this improved lithography process is demonstrated by examining the temperature dependence of epitaxial graphene-metal contact resistance using the transfer length method for Ti/Au (10 nm/50 nm) metallization. The Landauer-Buttiker model was used to explain carrier transport at the graphene-metal interface as a function of temperature. At room temperature, a contact resistance of 140 Ω-μm was obtained after a thermal anneal at 523 K for 2 hr under vacuum, which is comparable to state-of-the-art values.

  14. Continuous Non-Invasive Arterial Pressure Technique Improves Patient Monitoring during Interventional Endoscopy

    Sylvia Siebig, Felix Rockmann, Karl Sabel, Ina Zuber-Jerger, Christine Dierkes, Tanja Brünnler, Christian E. Wrede


    Full Text Available Introduction: Close monitoring of arterial blood pressure (BP is a central part of cardiovascular surveillance of patients at risk for hypotension. Therefore, patients undergoing diagnostic and therapeutic procedures with the use of sedating agents are monitored by discontinuous non-invasive BP measurement (NIBP. Continuous non-invasive BP monitoring based on vascular unloading technique (CNAP®, CN Systems, Graz may improve patient safety in those settings. We investigated if this new technique improved monitoring of patients undergoing interventional endoscopy. Methods: 40 patients undergoing interventional endoscopy between April and December 2007 were prospectively studied with CNAP® in addition to standard monitoring (NIBP, ECG and oxygen saturation. All monitoring values were extracted from the surveillance network at one-second intervals, and clinical parameters were documented. The variance of CNAP® values were calculated for every interval between two NIBP measurements. Results: 2660 minutes of monitoring were recorded (mean 60.1±34.4 min/patient. All patients were analgosedated with midazolam and pethidine, and 24/40 had propofol infusion (mean 90.9±70.3 mg. The mean arterial pressure for CNAP® was 102.4±21.2 mmHg and 106.8±24.8 mmHg for NIBP. Based on the first NIBP value in an interval between two NIBP measurements, BP values determined by CNAP® showed a maximum increase of 30.8±21.7% and a maximum decrease of 22.4±28.3% (mean of all intervals. Discussion: Conventional intermittent blood pressure monitoring of patients receiving sedating agents failed to detect fast changes in BP. The new technique CNAP® improved the detection of rapid BP changes, and may contribute to a better patient safety for those undergoing interventional procedures.

  15. Ammonium Ion Adsorption and Settleability Improvement Achieved in a Synthetic Zeolite-Amended Activated Sludge

    Emilia Otal; Luís F. Vilches; Yolanda Luna; Rodrigo Poblete; Juan M. García-Maya; Constantino Fernández-Pereira


    Municipal wastewater treatment plants typically exhibit two classic problems:high ammonium concen-tration in water after conventional biological treatment and, in some cases, poor activated sludge sediment ability. Potential solutions to these problems were investigated by adding a synthetic zeolite obtained from coal fly ash to different steps of activated sludge treatment. The experimental results for ammonium removal fit well with the theo-retical adsorption isotherms of the Freundlich model with a maximum adsorption capacity of 13.72 mg·g−1. Utiliza-tion of this kind of zeolite to improve activated sludge sediment ability is studied for the first time in this work. It is found that the addition of the zeolite (1 g·L−1) to an activated sludge with settling problems significantly enhances its sediment ability and compact ability. This is confirmed by the sludge volume index (SVI), which was reduced from 163 ml·g−1 to 70 ml·g−1, the V60 value, which was reduced from 894 ml·L−1 to 427 ml·L−1, and the zeta poten-tial (ζ), which was reduced from−19.81 mV to−14.29 mV. The results indicate that the addition of this synthetic zeolite to activated sludge, as an additional waste management practice, has a positive impact on both ammonium removal and sludge settleability.

  16. Fully automated whole-head segmentation with improved smoothness and continuity, with theory reviewed.

    Huang, Yu; Parra, Lucas C


    Individualized current-flow models are needed for precise targeting of brain structures using transcranial electrical or magnetic stimulation (TES/TMS). The same is true for current-source reconstruction in electroencephalography and magnetoencephalography (EEG/MEG). The first step in generating such models is to obtain an accurate segmentation of individual head anatomy, including not only brain but also cerebrospinal fluid (CSF), skull and soft tissues, with a field of view (FOV) that covers the whole head. Currently available automated segmentation tools only provide results for brain tissues, have a limited FOV, and do not guarantee continuity and smoothness of tissues, which is crucially important for accurate current-flow estimates. Here we present a tool that addresses these needs. It is based on a rigorous Bayesian inference framework that combines image intensity model, anatomical prior (atlas) and morphological constraints using Markov random fields (MRF). The method is evaluated on 20 simulated and 8 real head volumes acquired with magnetic resonance imaging (MRI) at 1 mm3 resolution. We find improved surface smoothness and continuity as compared to the segmentation algorithms currently implemented in Statistical Parametric Mapping (SPM). With this tool, accurate and morphologically correct modeling of the whole-head anatomy for individual subjects may now be feasible on a routine basis. Code and data are fully integrated into SPM software tool and are made publicly available. In addition, a review on the MRI segmentation using atlas and the MRF over the last 20 years is also provided, with the general mathematical framework clearly derived.

  17. Fully automated whole-head segmentation with improved smoothness and continuity, with theory reviewed.

    Yu Huang

    Full Text Available Individualized current-flow models are needed for precise targeting of brain structures using transcranial electrical or magnetic stimulation (TES/TMS. The same is true for current-source reconstruction in electroencephalography and magnetoencephalography (EEG/MEG. The first step in generating such models is to obtain an accurate segmentation of individual head anatomy, including not only brain but also cerebrospinal fluid (CSF, skull and soft tissues, with a field of view (FOV that covers the whole head. Currently available automated segmentation tools only provide results for brain tissues, have a limited FOV, and do not guarantee continuity and smoothness of tissues, which is crucially important for accurate current-flow estimates. Here we present a tool that addresses these needs. It is based on a rigorous Bayesian inference framework that combines image intensity model, anatomical prior (atlas and morphological constraints using Markov random fields (MRF. The method is evaluated on 20 simulated and 8 real head volumes acquired with magnetic resonance imaging (MRI at 1 mm3 resolution. We find improved surface smoothness and continuity as compared to the segmentation algorithms currently implemented in Statistical Parametric Mapping (SPM. With this tool, accurate and morphologically correct modeling of the whole-head anatomy for individual subjects may now be feasible on a routine basis. Code and data are fully integrated into SPM software tool and are made publicly available. In addition, a review on the MRI segmentation using atlas and the MRF over the last 20 years is also provided, with the general mathematical framework clearly derived.

  18. The program of continuous improvements in factory in Juzbado; El programa de mejora continua en la Fabrica de Juzbado

    Prieto, M.


    This articles describes the historical development of the continuous improvement program at Juzbado Factory, since its beginning to nowadays. The evolution throughout the ideas of Total Quality, ISO, EFQM, Six Sigma, and so on, leading to the present situation in which all these tools and methodologies live together is shown. all this has led to a philosophy and business culture focused on safety, quality and continuous improvement. (Author)

  19. Relationship Between the maturity of continuous improvement and the certification of quality management system in automotive sector in Brazil

    Alexandra de Fatima Chiaradia Valadão


    Full Text Available The present paper aims to identify the relationship between the maturity of continuous improvement and the certification of the quality management system within a company in the Autoparts industry located in the South of Minas Gerais State. Continuous improvement has become the element of greatest importance for the development of all kinds of organizations, whether in production operations or when providing services, with the ends of reaching the objective of the present paper, where the following propositions shall be verified. The time necessary to implement the Quality Management System in certified companies brings forth implications with regards to the maturity of continuous improvement. The continuous improvement process is a gradual organization learning process. With the purpose of dealing with this issue, the explanatory qualitative Case Study method was chosen, through the use of the triangulation method where interviews with representatives were used, with direct observation and survey and analysis of historical facts. The approach taken is primarily descriptive/qualitative, where it was sought to analyze, classify, and interpret facts without research interference. As a result, it was observed that within the research unit the certification time did not show to be the principal factor for the advance in continuous improvement maturity levels. Organizational learning significantly contributes to the maturation of the continuous improvement system, especially when found deeply taking root in the company´s culture.

  20. Organisational learning: A tool for continuous improvement of the organization; Aprendizaje Organizativo: una herramienta para la mejora continua de la organizacion

    Santos, J. L.; Esteban, M. J.


    We are used to hear a success company in today's world is not possible unless a continuous improvement is developed. How can we be successful in the nuclear plant? We have to achieve safety for workers, people and environment in the first step, and for the second step availability and reliability for systems and components to avoid failure of components that could reduce availability. The aim is to search for new measures to reach this way. One of the improvements implemented in the plants to improve continuously was mainly Operating Experience activities, which was based in event analysis in the plants, causes identification, and to implement corrective actions. For External Operating Experience the aim was to learn from others to avoid occurrence of events in our plants. This was the lessons learned from Three Mile Island event. This was the learning process implemented so far, to get a continuous improvement. So far, the developed capabilities for process improvement follow the Operating Experience process that could be considered classical and will be revitalized nowadays. (Author)

  1. Continuous quality improvement in daily clinical practice: a proof of concept study.

    Jonathan A Lorch

    Full Text Available Continuous Quality Improvement (CQI is an iterative process of: planning to improve a product or process, plan implementation, analyzing and comparing results against those expected, and corrective action on differences between actual and expected results. It is little used in clinical medicine. Anemia, a complex problem in End Stage Renal Disease patients, served to test the ability of an unique electronic medical record (EMR optimized for daily care to empower CQI in practice. We used data collected during daily care, stored in the EMR, and organized to display temporal relationships between clinical, laboratory, and therapeutic events. Our aims were optimal hemoglobin with minimum epoetin, and maintaining stable hemoglobin and epoetin. The study was done on 250 patients treated by maintenance hemodialysis (HD, receiving epoetin prior to February 1, 2010 and followed to July 31, 2011. Repleting iron, ensuring iron sufficiency, slow epoetin reduction, and decision support tools enabling data display over long periods in patient-centered reports were key elements. Epoetin dose, adjusted 6-8 weekly, was based on current clinical conditions and past responses. Hemoglobin increased by months 1-2; epoetin decreased from month 4. By months 16-18, epoetin had decreased 42% to 9,720 units/week while hemoglobin increased 8% to 123.6 g/L. Hemoglobin and epoetin were stable from month 7 onward. New epoetin orders decreased 83%. Transferrin saturation increased after the study start. Individual patient hemoglobin variation decreased by 23%, range by 27%. Mortality, 11.78 per 100 patient years, was 42% less than United States dialysis patient mortality. Allowable epoetin charges decreased by $15.33 per treatment and were $22.88 less than current Medicare allowance. The study validates the hypothesis that an EMR optimized for daily patient care can empower CQI in clinical medicine and serve to monitor medical care quality and cost.

  2. The Influence of a Continuing Medical Education Campaign on New Strategies to Improve Appropriate Use of Antibiotics

    Brenda A. Bucklin


    Full Text Available Introduction. Widespread use of antibiotics has led to drug-resistant bacteria and reports of drug-resistant infections. A continuing medical education (CME campaign was used to improve antibiotic use among primary care providers. Methods. The Office of CME and Professional Development at the University of Colorado School of Medicine produces a semiannual, week-long course for primary care providers. A 2-year multifaceted CME campaign consisted of course content on antibiotic use, a practice audit, and two surveys to measure perceptions of the problem of antibiotic overuse, potential barriers to achieving appropriate use, and strategies to overcome barriers. Results. The overall response rate in the 2nd part of the campaign was 68.4%. Sixty-six percent of respondents had implemented at least one strategy to reduce antibiotic overuse. The rate was significantly higher among those who had attended previous reviews (81.0% compared with those who had attended neither (54%, p=0.0002. However, there was no “dose effect” on the rate of implementing a new strategy. Conclusions. Overuse of antibiotic therapy has important public health implications. Results suggest that mixed interactive and didactic CME program was effective in increasing awareness of antibiotic overuse and strategies for reducing antibiotic administration.

  3. Regularised Model Identification Improves Accuracy of Multisensor Systems for Noninvasive Continuous Glucose Monitoring in Diabetes Management

    Mattia Zanon


    Full Text Available Continuous glucose monitoring (CGM by suitable portable sensors plays a central role in the treatment of diabetes, a disease currently affecting more than 350 million people worldwide. Noninvasive CGM (NI-CGM, in particular, is appealing for reasons related to patient comfort (no needles are used but challenging. NI-CGM prototypes exploiting multisensor approaches have been recently proposed to deal with physiological and environmental disturbances. In these prototypes, signals measured noninvasively (e.g., skin impedance, temperature, optical skin properties, etc. are combined through a static multivariate linear model for estimating glucose levels. In this work, by exploiting a dataset of 45 experimental sessions acquired in diabetic subjects, we show that regularisation-based techniques for the identification of the model, such as the least absolute shrinkage and selection operator (better known as LASSO, Ridge regression, and Elastic-Net regression, improve the accuracy of glucose estimates with respect to techniques, such as partial least squares regression, previously used in the literature. More specifically, the Elastic-Net model (i.e., the model identified using a combination of and norms has the best results, according to the metrics widely accepted in the diabetes community. This model represents an important incremental step toward the development of NI-CGM devices effectively usable by patients.

  4. Improving the TNM classification: findings from a 10-year continuous literature review.

    Webber, Colleen; Gospodarowicz, Mary; Sobin, Leslie H; Wittekind, Christian; Greene, Frederick L; Mason, Malcolm D; Compton, Carolyn; Brierley, James; Groome, Patti A


    The Union for International Cancer Control's (UICC) TNM classification is a globally accepted system to describe the anatomic extent of malignant tumors. Since its development seventy years ago, the TNM classification has undergone significant revisions to reflect the current understanding of extent of disease and its role in prognosis. To ensure that revisions are evidence-based, the UICC implemented a process for continuous improvement of the TNM classification that included a formalized system for submitting proposals for revisions directly to the UICC and an annual review of the scientific literature on staging that assessed, criticized or made suggestions for changes. The process involves review of the proposals and literature by a group of international, multidisciplinary Expert Panels. The process has been in place for 10 years and informed the development of the 7th edition of the TNM classification published in 2009. The purpose of this article is to provide a description of the annual literature review process, including the search strategy, article selection process and the roles and requirements of the Expert Panels in the review of the literature. Since 2002, 147 Expert Panel members in 11 cancer sites have reviewed over 770 articles. The results of the annual literature reviews, Expert Panel feedback and documentation and dissemination of results are described.


    Carlos Monge Perry


    Full Text Available Structural equation modeling (SEM has traditionally been deployed in areas of marketing, consumer satisfaction and preferences, human behavior, and recently in strategic planning. These areas are considered their niches; however, there is a remarkable tendency in empirical research studies that indicate a more diversified use of the technique.  This paper shows the application of structural equation modeling using partial least square (PLS-SEM, in areas of manufacturing, quality, continuous improvement, operational efficiency, and environmental responsibility in Mexico’s medium and large manufacturing plants, while using a small sample (n = 40.  The results obtained from the PLS-SEM model application mentioned, are highly positive, relevant, and statistically significant. Also shown in this paper, for purposes of validity, reliability, and statistical power confirmation of PLS-SEM, is a comparative analysis against multiple regression showing very similar results to those obtained by PLS-SEM.  This fact validates the use of PLS-SEM in areas of untraditional scientific research, and suggests and invites the use of the technique in diversified fields of the scientific research

  6. Evaluation and capacity building to improve precollege science and mathematics achievement in the US: 10 CFR, Part 605


    The National Center for Improving Science Education has undertaken activities to achieve evaluation goals for DOE's Precollege programs: develop means to determine program quality; develop means for determining the contribution of DOE precollege programs to both teacher enhancement and student achievement; provide evaluation designs and instruments and reports of program quality and impact; and strengthen both DOE's and the Labs' capacity to do both short- and long-term planning as well as deliver effective programs and evaluation. Appendices include evaluation/technical assistance report, profiling teacher research participation and teacher development programs, teacher surveys, impact assessment design, and teacher research participation programs anecdotes for 8 labs.

  7. One Small Step at a Time: Implementing Continuous Quality Improvement in Child and Youth Mental Health Services

    Chovil, Nicole


    Continuous quality improvement (CQI) is increasingly being adopted by health care, including child and youth mental health services. As part of the commitment to ongoing quality improvement, child and youth mental health teams in the Fraser region in British Columbia undertook CQI projects over a one year period (2007-2008). The projects covered a…

  8. Survey of sustainability of continuous improvement systems: a comparison of two manufacturing communities in Spain and Mexico

    Carmen Jaca


    Full Text Available Purpose: During the last 50 years industrial companies have adopted continuous improvement systems to improve their competitiveness. However, the maintenance of improvement systems is not an easy matter. Some companies, after an initial period of one to two years, abandon the system for various reasons. This article aims to examine the level of application of Continuous Improvement Systems and the factors which support sustainability over time in two different regions.Design/methodology/approach: In order to obtain a comparative result between two different regions, a survey was conducted in two industrial zones—one in the north of Spain and another in Mexico—that are important industrial clusters these countries. The study was conducted through the analysis of survey data. Specifically, the survey was directed at large industrial enterprises who had participated in activities supported by local foundations for the promotion of quality and improvement.Findings and Originality/value: We suggest the following three keys for sustainable improvement: greater involvement of task forces in the improvement program, a PDCA improvement cycle for improvement and a clear purpose for continuous improvement, integration of the continuous improvement system in the organization, and the establishment of indicators associated with the system.Research limitations/implications: The comparative study focused on only two industrial zones in Spain and Mexico. In that sense, the findings of the research are limited to the Basque zone and geographical zone of Toluca-Lerma.Practical implications: Some of the companies have started to apply some continuous improvement techniques in a sustainability way. Therefore, these findings could be very useful for general and operation managers that are involved in continuous improvement systems in industrial companies in Spain and Mexico.Social implications: As a consequence, slow and small transformations in certain

  9. Closing the social-class achievement gap: a difference-education intervention improves first-generation students' academic performance and all students' college transition.

    Stephens, Nicole M; Hamedani, MarYam G; Destin, Mesmin


    College students who do not have parents with 4-year degrees (first-generation students) earn lower grades and encounter more obstacles to success than do students who have at least one parent with a 4-year degree (continuing-generation students). In the study reported here, we tested a novel intervention designed to reduce this social-class achievement gap with a randomized controlled trial (N = 168). Using senior college students' real-life stories, we conducted a difference-education intervention with incoming students about how their diverse backgrounds can shape what they experience in college. Compared with a standard intervention that provided similar stories of college adjustment without highlighting students' different backgrounds, the difference-education intervention eliminated the social-class achievement gap by increasing first-generation students' tendency to seek out college resources (e.g., meeting with professors) and, in turn, improving their end-of-year grade point averages. The difference-education intervention also improved the college transition for all students on numerous psychosocial outcomes (e.g., mental health and engagement).

  10. Fortifier and Cream Improve Fat Delivery in Continuous Enteral Infant Feeding of Breast Milk

    Mika Tabata


    Full Text Available Premature and high-risk infants require accurate delivery of nutrients to promote appropriate growth. Continuous enteral feeding methods may result in significant fat and micronutrient loss. This study evaluated fat loss in enteral nutrition using current strategies for providing high-risk infants fortified human milk (HM. The fat content of HM was measured by IR analyzer in a simulated feeding system using the Kangaroo epumpTM and the MedFusionTM 2010 pump. Comparisons in fat loss were made between HM, HM supplemented with donor HM-derived fortifier Prolacta + H2MFTM (H2MF, and HM supplemented with H2MF and donor HM-derived cream ProlactCRTM (cream. When using the Kangaroo epumpTM, the addition of H2MF and cream to HM increased fat delivery efficiency from 75.0% ± 1.2% to 83.7% ± 1.0% (p < 0.0001. When using the MedFusionTM 2010 pump, the addition of H2MF to HM increased fat delivery efficiency from 83.2% ± 2.8% to 88.8% ± 0.8% (p < 0.05, and the addition of H2MF and cream increased fat delivery efficiency to 92.0% ± 0.3% (p < 0.01. The addition of H2MF and cream to HM provides both the benefits of bioactive elements from mother’s milk and increased fat delivery, making the addition of H2MF and cream an appropriate method to improve infant weight gain.

  11. Improving the performance of a continuous process for the production of ethanol from starch.

    Trovati, Joubert; Giordano, Roberto C; Giordano, Raquel L C


    In a previous work, a continuous simultaneous saccharification and fermentation process to produce ethanol from cassava starch was studied, using a set of fixed-bed reactors. The biocatalyst consisted of glucoamylase immobilized in silica particles and co-immobilized with S. cerevisiae in pectin gel. Using 3.8 U mL(-1) (reactor) and 0.05 g(wet yeast) mL(-1) (reactor) at start-up, starch hydrolysis was the rate-limiting step. Maximum ethanol productivity was 5.8 g(ethanol) L(-1) h(-1), with 94.0% conversion of total reducing sugars (TRS) and 83.0% of the ethanol theoretical yield. In this work, the molar mass of the substrate and the biocatalyst particle size were reduced in an attempt to improve the bioreactor performance. The diameters of silica and pectin gel particles were reduced from 100 mum and 3-4 mm, respectively, to 60 mum and 1-1.5 mm, and the degree of substrate prehydrolysis by alpha-amylase was increased. The bioreactor performance was assessed for different loads of immobilized glucoamylase (2.1, 2.8, and 3.8 U mL(-1) (reactor)), for the same initial cell concentration (0.05 g(wet yeast.)mL(-1) (reactor)). Feeding with 154.0 g L(-1) of TRS and using 3.8 U mL(-1) (reactor), fermentation became the rate-limiting step. Productivity reached 11.7 g L(-1) h(-1), with 97.0% of TRS conversion and 92.0% of the ethanol theoretical yield. The reactor was operated during 275 h without any indication of destabilization.

  12. The Pediatrix BabySteps Data Warehouse and the Pediatrix QualitySteps improvement project system--tools for "meaningful use" in continuous quality improvement.

    Spitzer, Alan R; Ellsbury, Dan L; Handler, Darren; Clark, Reese H


    The Pediatrix BabySteps Clinical Data Warehouse (CDW) is a rich and novel tool allowing unbiased extraction of information from an entire neonatal population care by physicians and advanced practice nurses in Pediatrix Medical Group. Because it represents the practice of newborn medicine ranging from small community intensive care units to some of the largest neonatal intensive care units in the United States, it is highly representative of scope of practice in this country. Its value in defining outcome measures, quality improvement projects, and research continues to grow annually. Now coupled with the BabySteps QualitySteps program for defined clinical quality improvement projects, it represents a robust methodology for meaningful use of an electronic health care record, as designated during this era of health care reform. Continued growth of the CDW should result in continued important observations and improvements in neonatal care.

  13. Predicting core losses and efficiency of SRM in continuous current mode of operation using improved analytical technique

    Parsapour, Amir, E-mail: [Department of Electrical Engineering, University of Isfahan, Isfahan (Iran, Islamic Republic of); Dehkordi, Behzad Mirzaeian, E-mail: [Department of Electrical Engineering, University of Isfahan, Isfahan (Iran, Islamic Republic of); Moallem, Mehdi, E-mail: [Department of Electrical Engineering, Isfahan University of Technology, Isfahan (Iran, Islamic Republic of)


    In applications in which the high torque per ampere at low speed and rated power at high speed are required, the continuous current method is the best solution. However, there is no report on calculating the core loss of SRM in continuous current mode of operation. Efficiency and iron loss calculation which are complex tasks in case of conventional mode of operation is even more involved in continuous current mode of operation. In this paper, the Switched Reluctance Motor (SRM) is modeled using finite element method and core loss and copper loss of SRM in discontinuous and continuous current modes of operation are calculated using improved analytical techniques to include the minor loop losses in continuous current mode of operation. Motor efficiency versus speed in both operation modes is obtained and compared. - Highlights: • Continuous current method for Switched Reluctance Motor (SRM) is explained. • An improved analytical technique is presented for SRM core loss calculation. • SRM losses in discontinuous and continuous current operation modes are presented. • Effect of mutual inductances on SRM performance is investigated.

  14. Continuous improvement programs as processes for organizational learning: A case study of a company in the food products industry.

    André Luiz Fischer


    Full Text Available This article intends to show the relationships between quality practices and the process of organizational learning. When we look at the literature about programs of continuous improvement we see that theoreticians consider that the process of organizational learning is a superior stage in the quality culture adopted by companies. To investigate this possibility, we put together a series of indicators taken from classic authors who have written about organizational learning. Adopting a multiple methodology, we applied these indicators to two plants belonging to the Nestlé food product company which have introduced continuous improvement programs over the last two years

  15. Life Improvement of Pot Hardware in Continuous Hot Dipping Processes Final Report

    Xingbo Liu


    The process of continuous galvanizing of rolled sheet steel includes immersion into a bath of molten zinc/aluminum alloy. The steel strip is dipped in the molten bath through a series of driving motors and rollers which control the speed and tension of the strip, with the ability to modify both the amount of coating applied to the steel as well as the thickness and width of the sheet being galvanized. There are three rolls used to guide the steel strip through the molten metal bath. The rolls that operate in the molten Zn/Al are subject to a severely corrosive environment and require frequent changing. The performance of this equipment, the metallic hardware submerged in the molten Zn/Al bath, is the focus of this research. The primary objective of this research is to extend the performance life of the metallic hardware components of molten Zn/Al pot hardware by an order of magnitude. Typical galvanizing operations experience downtimes on the order of every two weeks to change the metallic hardware submerged in the molten metal bath. This is an expensive process for industry which takes upwards of 3 days for a complete turn around to resume normal operation. Each roll bridle consists of a sink, stabilizer, and corrector roll with accompanying bearing components. The cost of the bridle rig with all components is as much as $25,000 dollars just for materials. These inefficiencies are of concern to the steel coating companies and serve as a potential market for many materials suppliers. This research effort served as a bridge between the market potential and industry need to provide an objective analytical and mechanistic approach to the problem of wear and corrosion of molten metal bath hardware in a continuous sheet galvanizing line. The approach of the investigators was to provide a means of testing and analysis that was both expeditious and cost effective. The consortium of researchers from West Virginia University and Oak Ridge National Laboratory developed

  16. La motivación de logro mejora el rendimiento académico (Achievement Motivation Improves Academic Performance

    Jose Miguel Garcia-Ramirez


    Full Text Available A través de los proyectos de innovación docente las universidades mejoran y consolidan la calidad de la educación que ofrecen, tomando la creatividad y visibilidad como claves de la motivación por competencias y logro. Método: La investigación se realiza durante el curso académico 2013-14, a través del proyecto de innovación docente “ReiDoCrea” de la Universidad de Granada. Los participantes (N=62, M=22.7, SD=6.6, estudiantes de la Facultad de Ciencias del Trabajo, se adscribieron voluntariamente al Grupo Experimental (n=30 o al Grupo Control (n=32. El grupo experimental participó en el proyecto, mientras que el grupo control no participó; los instrumentos utilizados fueron dos pruebas objetivas (pre y post del programa de evaluación académica. Resultados: El análisis estadístico muestra que existen diferencias significativas entre los resultados obtenidos por el Grupo Experimental (M=83.6, SE=1.259, t(60=3.748, p<.05, d=.95 r=.43 y el Grupo Control (M=77.25, SE=1.14. Conclusiones: En la innovación docente, la motivación por competencias y de logro es clave para desarrollar el pensamiento creativo y mejorar el rendimiento académico. Abstract: Through teaching innovation projects universities improve and consolidate the quality of education they offer, taking creativity and visibility as the key to competence and achievement motivation. Method: The research study was conducted during the academic year 2013-14, through the teaching innovation project "ReiDoCrea" of the University of Granada. The participants (N=62, M=22.7, SD=6.6, students of the Faculty of Labour, voluntarily joined the Experimental Group (n=30 or the Control Group (n=32. The experimental group participated in the project, while the Control Group did not participate; the instruments used were two objective tests (pre and post, part of the academic program evaluation. Results: The statistical analysis shows that there are significant differences between the

  17. La motivación de logro mejora el rendimiento académico (Achievement Motivation Improves Academic Performance

    Jose Miguel Garcia-Ramirez


    Full Text Available A través de los proyectos de innovación docente las universidades mejoran y consolidan la calidad de la educación que ofrecen, tomando la creatividad y visibilidad como claves de la motivación por competencias y logro. Método: La investigación se realiza durante el curso académico 2013-14, a través del proyecto de innovación docente “ReiDoCrea” de la Universidad de Granada. Los participantes (N=62, M=22.7, SD=6.6, estudiantes de la Facultad de Ciencias del Trabajo, se adscribieron voluntariamente al Grupo Experimental (n=30 o al Grupo Control (n=32. El grupo experimental participó en el proyecto, mientras que el grupo control no participó; los instrumentos utilizados fueron dos pruebas objetivas (pre y post del programa de evaluación académica. Resultados: El análisis estadístico muestra que existen diferencias significativas entre los resultados obtenidos por el Grupo Experimental (M=83.6, SE=1.259, t(60=3.748, p<.05, d=.95, r=.43 y el Grupo Control (M=77.25, SE=1.14. Conclusiones: En la innovación docente, la motivación por competencias y de logro es clave para desarrollar el pensamiento creativo y mejorar el rendimiento académico. Abstract: Through teaching innovation projects universities improve and consolidate the quality of education they offer, taking creativity and visibility as the key to competence and achievement motivation. Method: The research study was conducted during the academic year 2013-14, through the teaching innovation project "ReiDoCrea" of the University of Granada. The participants (N=62, M=22.7, SD=6.6, students of the Faculty of Labour, voluntarily joined the Experimental Group (n=30 or the Control Group (n=32. The experimental group participated in the project, while the Control Group did not participate; the instruments used were two objective tests (pre and post, part of the academic program evaluation. Results: The statistical analysis shows that there are significant differences between the

  18. Improving Electrical Engineering Education at the American University of Sharjah through Continuous Assessment

    Al-Nashash, Hasan; Khaliq, Abdul; Qaddoumi, Nasser; Al-Assaf, Yousef; Assaleh, Khaled; Dhaouadi, Rached; El-Tarhuni, Mohamed


    The electrical engineering (ELE) program at the American University of Sharjah (AUS) is designed to fulfill the ABET criteria. Several assessment tools are used to qualitatively and quantitatively measure the level of achievement of the program's educational objectives and outcomes. These tools include alumni, employer, and graduate advisor…

  19. A Model of Continuous Improvement in High Schools: A Process for Research, Innovation Design, Implementation, and Scale

    Cohen-Vogel, Lora; Cannata, Marisa; Rutledge, Stacey A.; Socol, Allison Rose


    This chapter describes a model for continuous improvement that guides the work of the National Center on Scaling Up Effective Schools, or NCSU. NCSU is a research and development center funded by the Institute for Education Sciences, the research arm of the United States Department of Education. At the core of the Center's work is an innovative…

  20. Public Relations in Catholic Secondary Schools: Nearly 40 Years of Continuous Improvement

    James, John T.


    This article traces the phenomenal improvement in public relations efforts over the past 40 years made by Catholic secondary schools. The improvements were brought about by crises, a theological paradigm shift, professional lay involvement, a growing awareness and appreciation of public relations, competition, and increasing financial need. The…

  1. Continuous quality improvement based on Lean Six Sigma in manufacturing small and medium sized enterprises

    Timans, Werner


    Kleine en middelgrote bedrijven uit de maakindustrie ervaren toenemende eisen met betrekking tot de kwaliteit van producten en processen. Om in competitie te blijven is voortdurend verbeteren van cruciaal belang, en de Lean Six Sigma benadering biedt veelbelovende mogelijkheden om continu verbeteren

  2. Direct Measurement and Evaluation for Mechanical Engineering Programme Outcomes: Impact on Continuous Improvement

    Tahir, Mohd Faizal Mat; Khamis, Nor Kamaliana; Wahid, Zaliha; Ihsan, Ahmad Kamal Ariffin Mohd; Ghani, Jaharah Ab; Sabri, Mohd Anas Mohd; Sajuri, Zainuddin; Abdullah, Shahrum; Sulong, Abu Bakar


    Universiti Kebangsaan Malaysia (UKM) is a research university that continuously undergoes an audit and accreditation process for the management of its courses. The Faculty of Engineering and the Built Environment (FKAB) is subjected to such processes, one of them is the auditing conducted by the Engineering Accreditation Council (EAC), which gives…

  3. The ‘devils triangle’ of MSC certification: Balancing credibility, accessibility and continuous improvement

    Bush, S.R.; Toonen, H.M.; Oosterveer, P.J.M.; Mol, A.P.J.


    The Marine Stewardship Council (MSC) has continued to strengthen its position in the market based on its credibility as a transparent, accountable and science-based third party certification scheme. However, the consolidation of MSC's credibility risks being undermined by the poor representation of

  4. Improve Downlink Burst Allocation to Achieve High Frame Utilization of Mobile WiMAX (802.16e

    Zaid Ghanim Ali


    Full Text Available The burst allocation algorithm is responsible about calculating the appropriate dimensions and location of each users data to construct the bursts in the downlink subframe in term of the number of slots for each user. Burst allocation is one of the performance parameter which influences the mobile WiMAX systems, due to resource wastage in the form of unused and unallocated slots per frame which affects the Base station performance. In this paper, a Sequential Burst Allocation (SBA algorithm is proposed to overcome frame wastage. The SBA algorithm is based on the idea of sequential allocation of user slots. SBA limits the excessive unused slots, and burst fragmentation when necessary is forced to be used to eliminate unallocated slots between data bursts. Continuous allocation from one frame to the next has a significant impact on reducing resource wastage. It has been observed from the results that the percentage difference of the frame utilization between SBA and ST algorithms is 32.84 %, which achieve significant reduction of resource wastage per frame, leading to more exploit of the WiMAX frame.

  5. Lean management: innovative tools for engaging teams in continuous quality improvement.

    Perreault, Lucille; Vaillancourt, Lise; Filion, Catherine; Hadj, Camélia


    Lean management has proven to be a sustainable method to ensure a high level of patient care through innovation and teamwork. It involves a set of six tools that allow for visual management shared among team members. The team focuses their efforts on the improvement of organizational indicators in a standardized and engaging way, resulting in the sustainability of improvements. This article outlines the program's rollout at Montfort Hospital (l'Hôpital Montfort). In only a few months, two pilot units accomplished close to 50 improvements each. In addition, the organizational employee satisfaction questionnaire showed very positive results.

  6. Slovenska »mala« inovativnost: nenehno izboljševanje ali trajna stagnacija? = Slovenian Employee Suggestion Systems: A Continuous Improvement Or a Continuous Stagnation?

    Peter Fatur


    Full Text Available The operations management theory emphasizes the management ofincremental innovations as one of the cornerstones for continuous improvementof a firm’s operational efficiency. Also in Slovenia, the companiesfollow the foreign practices in this field as well as developingtheir own solutions. Unfortunately, the introduction of employee suggestionsystems very often turns out to be a failure. The paper aimsto analyze the incremental innovation management systems, in particularthe employee suggestion systems, on a sample of Sloveniancompanies from the automotive and fabricated metal products industry.Based on the key output indices, two groups of companies are definedwith a different ability to introduce innovations. The main differencesin the organization of the employee suggestions managementbetween the two groups are presented. As such, the research resultsmay contribute to an improvement and further growth of these systemsin Slovenian companies.

  7. Improved multi-level capability in Si3N4-based resistive switching memory using continuous gradual reset switching

    Kim, Sungjun; Park, Byung-Gook


    In this letter, we compare three different types of reset switching behavior in a bipolar resistive random-access memory (RRAM) system that is housed in a Ni/Si3N4/Si structure. The abrupt, step-like gradual and continuous gradual reset transitions are largely determined by the low-resistance state (LRS). For abrupt reset switching, the large conducting path shows ohmic behavior or has a weak nonlinear current-voltage (I-V) characteristics in the LRS. For gradual switching, including both the step-like and continuous reset types, trap-assisted direct tunneling is dominant in the low-voltage regime, while trap-assisted Fowler-Nordheim tunneling is dominant in the high-voltage regime, thus causing nonlinear I-V characteristics. More importantly, we evaluate the multi-level capabilities of the two different gradual switching types, including both step-like and continuous reset behavior, using identical and incremental voltage conditions. Finer control of the conductance level with good uniformity is achieved in continuous gradual reset switching when compared to that in step-like gradual reset switching. For continuous reset switching, a single conducting path, which initially has a tunneling gap, gradually responds to pulses with even and identical amplitudes, while for step-like reset switching, the multiple conducting paths only respond to incremental pulses to obtain effective multi-level states.

  8. Continuous Energy Improvement in Motor Driven Systems - A Guidebook for Industry

    Gilbert A. McCoy and John G. Douglass


    This guidebook provides a step-by-step approach to developing a motor system energy-improvement action plan. An action plan includes which motors should be repaired or replaced with higher efficiency models, recommendations on maintaining a spares inventory, and discussion of improvements in maintenance practices. The guidebook is the successor to DOE’s 1997 Energy Management for Motor Driven Systems. It builds on its predecessor publication by including topics such as power transmission systems and matching driven equipment to process requirements in addition to motors.

  9. Continuous Exercise but Not High Intensity Interval Training Improves Fat Distribution in Overweight Adults

    Shelley E. Keating


    Full Text Available Objective. The purpose of this study was to assess the effect of high intensity interval training (HIIT versus continuous aerobic exercise training (CONT or placebo (PLA on body composition by randomized controlled design. Methods. Work capacity and body composition (dual-energy X-ray absorptiometry were measured before and after 12 weeks of intervention in 38 previously inactive overweight adults. Results. There was a significant group × time interaction for change in work capacity (P<0.001, which increased significantly in CONT (23.8±3.0% and HIIT (22.3±3.5% but not PLA (3.1±5.0%. There was a near-significant main effect for percentage trunk fat, with trunk fat reducing in CONT by 3.1±1.6% and in PLA by 1.1±0.4%, but not in HIIT (increase of 0.7±1.0% (P=0.07. There was a significant reduction in android fat percentage in CONT (2.7±1.3% and PLA (1.4±0.8% but not HIIT (increase of 0.8±0.7% (P=0.04. Conclusion. These data suggest that HIIT may be advocated as a time-efficient strategy for eliciting comparable fitness benefits to traditional continuous exercise in inactive, overweight adults. However, in this population HIIT does not confer the same benefit to body fat levels as continuous exercise training.

  10. Effectiveness of Music Education for the Improvement of Reading Skills and Academic Achievement in Young Poor Readers: A Pragmatic Cluster-Randomized, Controlled Clinical Trial

    Cogo-Moreira, H; de Avila, CRB; Ploubidis, GB; Mari, JD


    INTRODUCTION: Difficulties in word-level reading skills are prevalent in Brazilian schools and may deter children from gaining the knowledge obtained through reading and academic achievement. Music education has emerged as a potential method to improve reading skills because due to a common neurobiological substratum. OBJECTIVE: To evaluate the effectiveness of music education for the improvement of reading skills and academic achievement among children (eight to 10 years of age) with reading...

  11. Modern trends in improvement of steel heating technology in continuous furnaces

    Timoshpolskiy, V. I.; Temlyantsev, M. V.; Trusova, I. A.


    The principles and approaches in the development and improvement of steel heating technology in the furnaces of rolling manufacture of various structural design, based on the systematic study of thermal physical and technological processes, including mathematical modeling, industrial experiments, development of rational temperature-thermal modes.

  12. Continuous Quality Improvement in Student Affairs: A Survey of Staff Opinions on the Work Environment.

    Malaney, Gary D.; Osit, Carla J.


    Analyzes the results of a survey which queried student affairs staff members about their opinions on the importance of and their satisfaction with 37 aspects of their work environments. Discusses results of the survey and addresses efforts to improve the work climate. (Contains 18 references.) (Author/GCP)

  13. Implementing TQM at Oregon State University: Moving Continuous Quality Improvement Practices into Higher Education.

    Rudolph, Jacquelyn T.; Howard, Nancy Lee


    The evolution of an award-winning Total Quality Management (TQM) program for administrative and academic staff development at Oregon State University is chronicled. Special attention is given to application of TQM for faculty and corporate interaction, instructional improvement, and curriculum development. Special challenges for implementation of…

  14. Improving Genetics Education in Graduate and Continuing Health Professional Education: Workshop Summary

    Berger, Adam C.; Johnson, Samuel G.; Beachy, Sarah H.; Olson, Steve


    Many health care providers do not have either the knowledge or the tools they need in order to apply genetic information in their day-to-day practices. This lack of support is contributing to a substantial delay in the translation of genetic research findings, when appropriate, into improvement in patient outcomes within the health care system.…

  15. Dot Hill reports third quarter 2001 results operating results continue to improve


    Dot Hill Systems Corp., a leading supplier of carrier-class data storage and storage area network solutions announced slighly improved financial results for the period ending Sept. 30, 2001. Of their products, SANnet Axis and the SANnet 7100 Fibre Channel storage system were selected as the essential storage components for the GRID demonstration at the High Performance Networking Forum Conference at CERN.

  16. Healthy Students 2000: An Agenda for Continuous Improvement in America's Schools.

    Allensworth, Diane DeMuth; Symons, Cynthia Wolford; Olds, R. Scott

    This publication is a project replication kit for practitioners who want to improve their school health programs. The project used a multidisciplinary model of comprehensive school health education in three secondary schools within the Cleveland School District, Ohio. Based on the Healthy People 2000 initiative, this publication focuses on six…

  17. 78 FR 12221 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...


    ... require all local educational agencies (LEAs) that participate in the NSLP and/or School Breakfast Program... able to adapt to improved data sources. It is important to point out that there is already some built... attend NSLP schools. Also, it is important to remember that the benchmarks are not set at 100%; and...

  18. Transformational Approach To School Leadership: Contribution To Continued Improvement Of Education

    Anca Nedelcu


    Full Text Available Over the last decades, an impressive number of conceptual models in the field of educational leadership have emerged; contingency or trait theories, situational, instructional, shared or distributed school leadership approaches, all tried to demonstrate their specific impact on school development and students achievement. The present paper is focused on exploring one of the foremost models, subject of systematic inquiry and controversial debates developed in relation with school or in nonschool organizations: transformational school leadership. The approach is considered a relevant support for school change process. Its contribution is analyzed in comparison with the benefits of other competing models, the aim of the paper being not to establish hierarchies but to gather significant solutions for better schooling. As a reconciliation solution, the integrative leadership model is also advocated.

  19. Improvements to the User Interface for LHCb's Software continuous integration system.

    Clemencic, M.; Couturier, B.; Kyriazi, S.


    The purpose of this paper is to identify a set of steps leading to an improved interface for LHCb's Nightly Builds Dashboard. The goal is to have an efficient application that meets the needs of both the project developers, by providing them with a user friendly interface, as well as those of the computing team supporting the system, by providing them with a dashboard allowing for better monitoring of the build job themselves. In line with what is already used by LHCb, the web interface has been implemented with the Flask Python framework for future maintainability and code clarity. The Database chosen to host the data is the schema-less CouchDB[7], serving the purpose of flexibility in document form changes. To improve the user experience, we use JavaScript libraries such as JQuery[11].

  20. Continuous curriculum review in a bachelor of nursing program: preventing curriculum drift and improving quality.

    van de Mortel, Thea F; Bird, Jennifer L


    Higher education institutions have rigorous internal accreditation processes for new courses and typically require thorough course reviews every 5 years. Courses such as nursing must also be accredited by professional registration boards. However, in the years between initial accreditation and formal reaccreditation cycles, the risk of a widening gap between the accredited curriculum and the taught curriculum is real when there is no process to monitor the changes that individual unit assessors make to their subjects as they teach them. This curriculum drift may interfere with the intended development of graduate attributes and the taxonomic structure of assessment tasks across the course. This article describes the implementation of a formative continuous curriculum review process that prevents curriculum drift and enhances the quality of a bachelor of nursing curriculum.

  1. Conversion to No-Till Improves Maize Nitrogen Use Efficiency in a Continuous Cover Cropping System

    Habbib, Hazzar; Verzeaux, Julien; Nivelle, Elodie; Roger, David; Lacoux, Jérôme; Catterou, Manuella; Hirel, Bertrand; Dubois, Frédéric; Tétu, Thierry


    A two-year experiment was conducted in the field to measure the combined impact of tilling and N fertilization on various agronomic traits related to nitrogen (N) use efficiency and to grain yield in maize cultivated in the presence of a cover crop. Four years after conversion to no-till, a significant increase in N use efficiency N harvest index, N remobilization and N remobilization efficiency was observed both under no and high N fertilization conditions. Moreover, we observed that grain yield and grain N content were higher under no-till conditions only when N fertilizers were applied. Thus, agronomic practices based on continuous no-till appear to be a promising for increasing N use efficiency in maize. PMID:27711154

  2. Operational Improvements of Continuous Process with Tools of Lean Production - A Case Study in a Brazilian Petrochemical

    Francisco Uchoa Passos


    Full Text Available This study seeks to evaluate operational improvements in Brazilian petrochemical company Braskem, which has been using lean production management tools to monitor its processes. There was some improvement in plant efficiency, measured from the beginning of implementation of management tools Six Sigma and TPM. Thus, we investigated three efficiency indicators considered by the company of great importance for the competitiveness of the business: the physical loss of products, plant’s energy efficiency, and the utilization rate of assets. The differences observed in these indicators, before and after the use of the tools, were tested for its statistical significance, which revealed that the physical losses of ethylene and plant’s energy efficiency improved, almost reaching the performance considered as class world. As for the utilization rate of assets, although it has evolved positively, still is at a considerable distance from that performance standard. By registering operational improvements in a continuous process plant, with lean production tools, this study indicates that these instruments, even if they have no causal relation with the improvements, are suitable for continuous processes and could have a much broader use, oriented, first of all, by the general approach of process optimization and, somehow, regardless of the nature of productive activity.

  3. Improving the 5th Formers’ Continuous Writing Skills through the Creative Writing Module

    Mohana Ram Murugiah


    Full Text Available Writing is a complex task. The development of students’ writing skill depends on the teacher’s teaching strategy and also the materials used in the writing lesson. In the present study, the effectiveness of a creative writing module was examined that was designed to improve the writing skill of a group of excellent students. It was added with explicit teaching strategies. The selected group of students were students who were in the excellent group but lacked creativity and vocabulary in their writing. The creative writing module was designed to help these students. Students’ improvement was observed through observation in the classrooms during the lessons and through writing task as well as interviews. Two observations were made. One was before the creative writing project was started and another after the completion of the entire task of the module. The interview was carried out to learn about the students’ perception of the module and how do they find the module has helped them.  The result of the research showed that students have shown a great level of improvement in their writing skills. The outcome of this present study could be useful to assist language instructors in helping proficient learners to undergo a more effective second language learning experience.

  4. Application of continuous quality improvement in central sterilization supply department%持续质量改进在消毒供应中心的应用



    OBJECTIVE To apply continuous quality management mode combining the characteristics of the center of sterilization supply, to continuously improve the quality.METHODS Process management mode was adopted,efficient continuous quality control work team was established, quality evaluation system was perfected.RESULTS Various disinfection segregation indexes complied with the ministry of health "disinfect technical specification of line marking requirements".The qualified rate of monitoring asepsis items reached to 100.0%.Monitoring of the center of sterilization supply infection control work was more standardized, standard and scientific.CONCLUSION Continuous quality improvement in the center of sterilization supply has been achieved remarkable effects, and also promoted the level of nursing management.%目的 应用持续质量管理模式,结合消毒供应中心的特点,对其进行持续质量改进.方法 采用过程管理模式,建立高效持续质量控制工作团队,健全质量评价体系.结果 各项消毒隔离指标符合卫生部的行标要求,无菌物品监测合格率达100.O%,消毒供应中心的感染控制工作更规范化、标准化、科学化.结论 持续质量改进在消毒供应中心取得显著成效,提升了护理管理水平.

  5. Using activity-based costing and theory of constraints to guide continuous improvement in managed care.

    Roybal, H; Baxendale, S J; Gupta, M


    Activity-based costing and the theory of constraints have been applied successfully in many manufacturing organizations. Recently, those concepts have been applied in service organizations. This article describes the application of activity-based costing and the theory of constraints in a managed care mental health and substance abuse organization. One of the unique aspects of this particular application was the integration of activity-based costing and the theory of constraints to guide process improvement efforts. This article describes the activity-based costing model and the application of the theory of constraint's focusing steps with an emphasis on unused capacities of activities in the organization.

  6. Continuous biohydrogen production using cheese whey: Improving the hydrogen production rate

    Davila-Vazquez, Gustavo; Cota-Navarro, Ciria Berenice; Razo-Flores, Elias [Division de Ciencias Ambientales, Instituto Potosino de Investigacion Cientifica y Tecnologica, Camino a la Presa San Jose 2055, Lomas 4a seccion, C.P. 78216, San Luis Potosi, S.L.P (Mexico); Rosales-Colunga, Luis Manuel; de Leon-Rodriguez, Antonio [Division de Biologia Molecular, Instituto Potosino de Investigacion Cientifica y Tecnologica, Camino a la Presa San Jose 2055, Lomas 4a seccion, C.P. 78216, San Luis Potosi, S.L.P (Mexico)


    Due to the renewed interest in finding sustainable fuels or energy carriers, biohydrogen (Bio-H{sub 2}) from biomass is a promising alternative. Fermentative Bio-H{sub 2} production was studied in a continuous stirred tank reactor (CSTR) operated during 65.6 d with cheese whey (CW) as substrate. Three hydraulic retention times (HRTs) were tested (10, 6 and 4 h) and the highest volumetric hydrogen production rate (VHPR) was attained with HRT of 6 h. Therefore, four organic loading rates (OLRs) at a fixed HRT of 6 h were tested thereafter, being: 92.4, 115.5, 138.6 and 184.4 g lactose/L/d. The highest VHPR (46.61 mmol H{sub 2}/L/h) and hydrogen molar yield (HMY) of 2.8 mol H{sub 2}/mol lactose were found at an OLR of 138.6 g lactose/L/d; a sharp fall in VHPR occurred at an OLR of 184.4 g lactose/L/d. Butyric, propionic and acetic acids were the main soluble metabolites found, with butyric-to-acetic ratios ranging from 1.0 to 2.4. Bacterial community was identified by partial sequence analysis of the 16S rRNA and polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE). The results showed that at HRT of 10 h and 6 h were dominated by the Clostridium genus. The VHPR attained in this study is the highest reported value for a CSTR system using CW as substrate with anaerobic sludge as inoculum and represents a 33-fold increase compared to a previous study. Thus, it was demonstrated that continuous fermentative Bio-H{sub 2} production from CW can be significantly enhanced by an appropriate selection of parameters such as HRT and OLR. Enhancements in VHPR are significant because it is a critical parameter to determine the full-scale practical application of fermentation technologies that will be used for sustainable and clean energy generation. (author)

  7. Improved nutrient removal using in situ continuous on-line sensors with short response time.

    Ingildsen, P; Wendelboe, H


    Nutrient sensors that can be located directly in the activated sludge processes are gaining in number at wastewater treatment plants. The in situ location of the sensors means that they can be located close to the processes that they aim to control and hence are perfectly suited for automatic process control. Compared to the location of automatic analysers in the effluent from the sedimentation reactors the in situ location means a large reduction in the response time. The settlers typically work as a first-order delay on the signal with a retention time in the range of 4-12 hours depending on the size of the settlers. Automatic process control of the nitrogen and phosphorus removal processes means that considerable improvements in the performance of aeration, internal recirculation, carbon dosage and phosphate precipitation dosage can be reached by using a simple control structure as well as simple PID controllers. The performance improvements can be seen in decreased energy and chemicals consumption and less variation in effluent concentrations of ammonium, total nitrogen and phosphate. Simple control schemes are demonstrated for the pre-denitrification and the post precipitation system by means of full-scale plant experiments and model simulations.

  8. Continuous Improvement of Hospital Medical Waste Management%医疗废物管理及其持续改进

    王米兰; 蒋景华


    目的 通过系列整改,持续提高医院医疗废物管理质量.方法 查找问题,制定整改措施,组织培训,检查考核,反馈改进.结果 整改后病区医疗废物处置合格率均有显著提高(P<0.01).结论 通过加大对医疗废物管理工作的投入,建立完善的管理制度和标准化的管理流程,运用科学方法可以持续改进医疗废物管理质量.%Objective To improve the quality of hospital medical waste management continuously through a series of rectification.Methods Identification of problems, development of rectification measures, the organization of training, inspections and examinations, and feedback-based improvements were adopted.Results The qualified rate of medical waste disposal in ward is improved significantly after the rectification (P<0.01). Conclusion By increasing investment, establishing a sound management system and standardized management process, and applying scientific methods, the quality of medical waste management can be continuously improved.


    G. Swathi


    Full Text Available Background: COPD is characterized by chronic airflow limitation and a range of pathological changes in the lung. Chronic inflammation causes structural changes and narrowing of the small airways and destruction of lung parenchyma, leads to the loss of alveolar attachments to the small airways and decreases lung elastic recoil; in turn these changes diminish the expiration and the work of breathing is increased. Scarcity of evidence on continuous and interval exercises is forcing researchers conduct studies on effectiveness of interval exercise with continuous exercise on exercise tolerance in subjects with COPD. Methods: 60 subjects were selected by lottery method. All the subjects were explained about the condition and mode of assessment and written informed consent were obtained from them and divided into 2 groups interval training group and continuous exercise training group and subjects were scheduled to attend exercise session 5 days a week for 4 weeks with exercise duration 20 min’s with cycle ergometer. Outcome measure: six minute walk test and heart rate. Results: On observing the means of post test parameters of experimental group A and experimental group B Independent t-test was done and the P- value is >0.05 .It shows a no significant difference between the two groups. Conclusion: The results had shown that both interval exercise group and continuous exercise group who received four weeks of therapy has improved significantly on pre and post test values within the groups but when compared between these groups there is no statistical significance noted. So this study concluded that there is no significant difference between interval exercise group and continuous exercise group in improving exercise tolerance among COPD subjects.

  10. A New Approach to Educator Preparation Evaluation: Evidence for Continuous Improvement?

    Corinne Baron Donovan


    Full Text Available The landscape for educator preparation has shifted to accountability models emphasizing performance assessment of teaching, employer feedback reports, newly approved accreditation standards showing impact on K-12 student learning, and expectations of public access to all of this information. This article provides a perspective on the extent to which this change offers promise for improving educator preparation programs and consequently excellence in teaching in K-12 schools. Two accountability reports are used as the empirical evidence for review; one is a pilot institutional feedback report from the Teacher Quality Research Center (Boyd, Lankford, & Wyckoff, 2009 and the second is a new Teacher Preparation Program report prepared by New York City’s department of education (NYCDOE, 2013. Ultimately, a systems perspective is recommended, in which candidates, IHEs, and K-12 schools are involved in the process of how educator preparation is evaluated and how that connects to other aspects of the education profession.

  11. Development of Pathways to Achieve the SE4ALL Energy Efficiency Objective: Global and Regional Potential for Energy Efficiency Improvements

    Gregg, Jay Sterling; Balyk, Olexandr; Pérez, Cristian Hernán Cabrera

    efficiency. When the SE4ALL renewable energy objective is achieved, the economically optimal solution produced by ETSAP-TIAM also includes a reduction in energy intensity: globally, the compound annual reduction in energy intensity of GDP is 1.8% when the renewable energy objective is achieved. Likewise...

  12. A review of strategies for improving the degradation properties of laminated continuous-fiber/epoxy composites with carbon-based nanoreinforcements

    Lubineau, Gilles


    Continuous-fiber/epoxy-matrix laminated composites are a key structural material for aeronautical and aerospace applications. Introducing nanoscale reinforcements to these materials is a possible way to achieve improved mechanical properties. To date, much work has been done on nano-reinforced polymers. However, few systematic studies concerning the effect of the nanoreinforcements on the mechanical properties on laminated composites were conducted. This paper presents a systematic review of the mechanisms of degradation in laminated structures and considers various nanoreinforcement strategies in the light of well-known mechanisms of degradation and phenomenologies in classical laminated composites. We also discuss various nanoreinforcement strategies in terms of their potential to reduce degradation on every scale. In addition, we review studies conducted on the role that nanoreinforcements play in mechanical properties involved in structural simulation and design. The degradation mechanisms are systematically considered to provide a full picture of each reinforcement strategy. © 2012 Elsevier Ltd. All rights reserved.

  13. Proposals for improving the performance of the continuation power flow; Propostas para a melhoria do desempenho do fluxo de carga continuado

    Bonini Neto, A.; Magalhaes, E.M.; Alves, D.A. [Universidade Estadual Paulista (FEIS/UNESP), Ilha Solteira, SP (Brazil). Fac. de Engenharia. Dept. Engenharia Eletrica], Emails:,,


    This paper aims to present a proposal for improving the performance of continuation power flow. For this propose the addition of an equation of one straight line in the plane formed by the load factor variables and bus voltage magnitude. It becomes possible with this, more precise determination of the maximum loading point without calculating a large number of points P-V curve. The work also shows that it is possible to obtain a reduction in computing time required for obtain P-V curve. The reduction is achieved by upgrading Jacobian matrix only when the system suffer some significant change (changing the type of PV bar to PQ or vice versa), instead of updating it at each iteration.

  14. Continuous practice quality improvement initiative for communication of critical findings in neuroradiology.

    Babiarz, Lukasz S; Lewin, Jonathan S; Yousem, David M


    The authors examined faculty's compliance with a hospital-approved neuroradiology critical findings (CFs) policy, which requires urgent verbal communication with the clinical team when 17 specific critical pathologies are identified. During June 2011 to July 2013, 50 random neuroradiology reports were sampled monthly for the presence of CFs and appropriate action. Faculty were provided ongoing feedback, and at the end of 2 years, the medical records for cases with noncommunicated CFs were reviewed to identify potential adverse outcomes. Of the 1200 reviewed reports, 195 (16.3%) had and 1005 (83.8%) did not have a CF. A total of 176 of 195 (90.3%) cases with CFs were communicated, and compliance increased from 77.4% to 85.6% (P = .027) since the monthly sampling was instituted; 1 of 19 (5.3%) noncommunicated CFs resulted in a potential adverse event. The ongoing monthly feedback resulted in improved faculty compliance with the CF policy. However, a small number of cases with CFs are still not being communicated.

  15. Real-time tracking data drive process improvements, even while ED volumes continue to climb.


    Christiana Hospital in Newark, DE, has been able to dramatically reduce length-of-stay in the ED by making use of data derived from a real-time location system (RTLS) that tracks the movements of patients, providers, and staff. Administrators say that while some efficiencies are gained from the system alone, most of the positive impact is derived from using the RTLS data to focus on specific processes and make refinements. Within one year of implementing the RTLS technology, LOS in the ED was reduced by 40 minutes for admitted patients and 18 to 20 minutes for the treated-and-released population. A work group focused on process improvements in the ED's fast track section reduced the average LOS from 2.5 hours to 60 minutes or less. Similarly, a work group focused on the ESI 3 population reduced the average treatment time for this population from 5 or 6 hours to 3.4 hours. Administrators say key steps toward a successful RTLS implementation are careful planning for how you want to use the technology, and alleviating staff concerns about why their movements are being tracked.

  16. Improvement of denitrification rates in confined zones of fractured subsoils under continuous wastewater injection.

    Carrieri, Carmelo; Masciopinto, Costantino


    An attempt to improve the natural biodegradation rate in a fractured aquifer (Nardò (Le), Southern Italy) subject since '91 to the injection of 12,000 m3/d of treated municipal wastewater, has been carried out through tests on pilot plants. The lab experiments showed that a complete nitrogen removal can be realized after 10 d of infiltration in fractures by adding whey in the influent waste. The lab results have been used in a mathematical model in order to simulate ground water quality changes caused by the addition of whey in the injecting water. The analytical parameters of ground water sampled in monitoring wells located at different distances from the injection site, have been compared with mathematical model results. Moreover for preserving such resource from pollution, the mathematical model allowed two areas, around the injection site to be drawn. These areas, where withdrawals would be prohibited, are required to avoid infections by pathogens and bacteria in ground water due to incomplete biodegradation processes. The experimental results can be useful to identify standardized methodology for artificial ground water recharge which could be required for aquifer clean up (Water Frame Directive 2000/60).

  17. An improved fiber tracking algorithm based on fiber assignment using the continuous tracking algorithm and two-tensor model

    Liuhong Zhu; Gang Guo


    This study tested an improved fiber tracking algorithm, which was based on fiber assignment using a continuous tracking algorithm and a two-tensor model. Different models and tracking decisions were used by judging the type of estimation of each voxel. This method should solve the cross-track problem. This study included eight healthy subjects, two axonal injury patients and seven demyelinating disease patients. This new algorithm clearly exhibited a difference in nerve fiber direction between axonal injury and demyelinating disease patients and healthy control subjects. Compared with fiber assignment with a continuous tracking algorithm, our novel method can track more and longer nerve fibers, and also can solve the fiber crossing problem.


    C.C. Van Waveren


    Full Text Available

    ENGLISH ABSTRACT: It is generally agreed that one way for organisations to be competitive in the new global economy is by embracing the principles of Peter Senge’s “The Fifth Discipline” and becoming “learning organisations”. The literature on the nature of learning organisations is extensive, but few of the discussions break through the philosophical barrier and actually address practical ways in which organisations can move away from traditional organisation thinking models and become learning organisations. This paper discusses a 9-S framework and an accompanying measurement model that can be used by organisations to determine whether they are learning organisations, and if not, where and how they need to improve. The framework is based on the Hitt 8-S framework, and the measurement model takes the form of a series of weighted questions and results that graphically represent how successful an organisation has been in its quest to become a learning organisation. A practical implementation of the measurement model that focuses on the planning aspect of organisational management is included in the paper.

    AFRIKAANSE OPSOMMING: Vir ’n organisasie om kompeterend in ’n wereldekonomie te wees, word daar algemeen aanvaar dat die organisasie sekere leergerigtheidseienskappe moet bemeester soos beskryf in Peter Senge se boek “The Fifth Discipline”. Omvattende literatuur oor die leergerigtheidseienskappe van organisasies bestaan, maar daar is egter min inligting oor praktiese maniere om ’n tradisionele organisasie na 'n leergerigtheidsorganisasie oor te skakel. Hierdie artikel bespreek ’n 9-S raamwerk asook ’n gepaardgaande evalueringsmodel wat gebruik kan word om ’n organisasie te meet aan sekere leergerigtheidseienskappe. Die raamwerk is gebaseer op die Hitt 8-S raamwerk en die evalueringsmodel maak gebruik van geweegde vrae waarvan die resultate grafies vertoon word om die sukses van leergerigtheid in die organisasie

  19. Sustainable MSD prevention: management for continuous improvement between prevention and production. Ergonomic intervention in two assembly line companies.

    Caroly, S; Coutarel, F; Landry, A; Mary-Cheray, I


    To increase output and meet customers' needs, companies have turned to the development of production management systems: Kaizen, one piece flow, Kanban, etc. The aim of such systems is to accelerate decisions, react to environmental issues and manage various productions. In the main, this type of management system has led to the continuous improvement of production performance. Consequently, such production management systems can have unexpected negative effects on operators' health and safety. Conversely, regulation and control systems focusing on work-related risks have obliged firms to implement health and safety management systems such as OHSAS 18001. The purpose of this type of system, also based on continuous improvement, is to reduce risks, facilitate work-related activities and identify solutions in terms of equipment and tools. However, the prevention actions introduced through health and safety systems often result in other unexpected and unwanted effects on production. This paper shows how companies can improve the way they are run by taking into account both types of management system.

  20. IEEE Validation of the Continuing Education Achievement of Engineers Registry System. Procedures for Use with a CPT 8000 Word Processor and Communications Package.

    Institute of Electrical and Electronics Engineers, Inc., New York, NY.

    The Institute of Electrical and Electronics Engineers (IEEE) validation program is designed to motivate persons practicing in electrical and electronics engineering to pursue quality technical continuing education courses offered by any responsible sponsor. The rapid acceptance of the validation program necessitated the additional development of a…

  1. Biotherapic T. cruzi 17DH when continuously used clinically improves mice infected with T. cruzi.

    Silvana Marques de Araujo


    treatment ways using biotherapic T. cruzi 17DH showed differences in the clinical evolution. The treatment using biotherapic diluted in water initially shows hypothermia, with subsequent recovery of normal temperature (p=0.05 (Fig1. The weight curve shows a better evolution in mice treated with water compared to control groups (p=0.055 and the groups treated by gavage (p=0.0064. Feed and water intake did not differ among the groups. While the mice that were treated with biotherapic diluted in water showed a slight level of ruffled fur, the mice in control groups and the ones treated by gavage showed a more intense level of ruffled fur (p=0.00001. The difference in the evolution of mortality among the groups was significant (p=0.034, while in the group treated with biotherapic diluted with water, the mortality rate started later, reaching the maximum of 90%. This group showed a better clinical result, expressed by the smaller extent of ruffled fur, a better evolution of the temperature curve and higher gain of weight. This is an important result because the Y strain of T. cruzi has a mortality rate of 100% in mice, showing once again the good performance of biotherapic in this model of infection. Conclusion: The use of biotherapic T. cruzi 17DH for a long period causes clinical improvement of the infected mice with Trypanosoma cruzi. The clinical use of these results in human beings should consider the allometric medicine dosage which takes into account the metabolic rate of each organism.

  2. [A New Method for Eliminating Background Signal Drift to Improve the Detection Precision in Continuous Harmonic Detection].

    Zhao, Ying; Zhao, Xue-hong; Wang, Zhe; Zhang, Rui; Wang, Yan


    To overcome the second harmonic background signal drift in gas continuous detection based on tunable diode laser absorption spectroscopy(TDLAS), a new method of background elimination was proposed by changing center current of the laser. This method can eliminated the effects of background signal drifting on concentration inversion. Based on the wavelength modulation theory, the theoretical expression of the second harmonic of the background signal is derived. In addition, the second harmonic background signal components and the factors that affect it are described. In different working temperatures, the relationship curve between thelaser current and output light intensity. In the process of continuous detection, we analyzes the feasibility ofchangingthe laser center current extraction of background signal. Combined with the principle of the background signal searching, the LabView flow chart was designed to search background center current. Ammonia (NH₃) was detected by the TDLAS experimental system, which demonstrated the feasibility of the new method. The range of experiment parameters and the range of background center current searches were determined, in the situation that there was only one absorption line in the full laser workspace. The experimental results showed that this method realizes background signal extraction, reduces the error of concentration inversion and the effects of concentration inversion bybackground signal. Thus it improved the detection accuracy of the concentration. In the continuous detection experiment, the standarddeviation of inversion concentration reduced from 2.688 3 to 1.856 1, which demonstrated. that the degree of dispersion of detected concentration is reduced, even eliminate the effects of background signal drifting on concentration inversion and the accuracy of detection is improved. This method provides an effective background drifting elimination approach for improving the detection accuracy of the concentration.

  3. Improvement of thoracic aortic vasoreactivity by continuous and intermittent exercise in high-fat diet-induced obese rats.

    Liu, Hongpeng; Yang, Zhen; Hu, Jian; Luo, Yan; Zhu, Lingqin; Yang, Huifang; Li, Guanghua


    The aim of the present study was to explore the effects of continuous and intermittent exercise on the thoracic aortic vasoreactivity and free radical metabolism in rats fed with a high-fat diet (HD). Sprague-Dawley (SD) rats were randomly divided into four groups (n=8, each group): Conventional diet (CD), HD, HD with continuous exercise (HCE) and HD with intermittent exercise (HIE). HCE rats swam once/day for 90 min; HIE rats performed swimming exercises 3 times/day, 30 min each time with an interval of 4 h. In these two groups, the exercise was conducted 5 days a week for 8 weeks. Rats in the CD and HD groups were fed without swimming training. At the end of the exercise, all the rats were sacrificed and the blood, thoracic aorta and myocardium were collected immediately. The thoracic aortic vasoreactivity, the plasma total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), superoxide dismutase (SOD), malondialdehyde (MDA) and vascular endothelial nitric oxide synthase (eNOS) gene expression were measured. Compared to the control group, in the HD group the enhanced contractile response of the thoracic aortic rings to noradrenaline (NA) was observed (Pintermittent exercise is better than the continuous exercise in improving the thoracic aorta vasoreactivity.

  4. Preventive effect of continuous quality improvement on the malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly peritoneal dialysis patients



    Objective To investigate the preventive effect of continuous quality improvement (CQI) on malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly patients undergoing peritoneal dialysis.Methods A single-center prospective self-controlled study was performed.32 stable elderly patients to undergo continuous ambulatory peritoneal dialysis (CAPD) were included.The continuous quality improvement program was conducted by using the 4-step problem-solving

  5. In Their Own Words: Erasing Deficits and Exploring What Works to Improve K-12 and Postsecondary Black Male School Achievement

    Warren, Chezare A.; Douglas, Ty-Ron M. O.; Howard, Tyrone C.


    This article outlines the imperative for strengths-based research to counter deficit perceptions and perspectives of Black males in contemporary discussions of their school achievement in the United States. The importance of young men of color in shaping research agendas, practice, and public policy is argued followed by a brief overview of the…

  6. Neurofeedback as an Intervention to Improve Reading Achievement in Students with Attention- Deficit/Hyperactivity Disorder, Inattentive Subtype

    La Marca, Jeffry P.; O'Connor, Rollanda E.


    Research consistently demonstrates that attention deficits have a deleterious effect on academic achievement. Impairments in attention, and not hyperactivity/impulsivity, are associated with learning difficulties and academic problems in students with attention-deficit/hyperactivity disorder (ADHD). To date, most studies have focused on symptoms…

  7. An Augmented Reality-Based Mobile Learning System to Improve Students' Learning Achievements and Motivations in Natural Science Inquiry Activities

    Chiang, Tosti H. C.; Yang, Stephen J. H.; Hwang, Gwo-Jen


    In this study, an augmented reality-based mobile learning system is proposed for conducting inquiry-based learning activities. An experiment has been conducted to examine the effectiveness of the proposed approach in terms of learning achievements and motivations. The subjects were 57 fourth graders from two classes taught by the same teacher in…

  8. The power of the National Surgical Quality Improvement Program--achieving a zero pneumonia rate in general surgery patients.

    Fuchshuber, Pascal R; Greif, William; Tidwell, Chantal R; Klemm, Michael S; Frydel, Cheryl; Wali, Abdul; Rosas, Efren; Clopp, Molly P


    The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year. This article summarizes briefly the history of NSQIP and how its report on surgical outcomes can be used for performance improvement within a hospital system. In particular, it describes how to drive performance improvement with NSQIP data using the example of postoperative respiratory complications--a major factor of postoperative mortality. In addition, this article explains the benefit of a collaborative of several participating NSQIP hospitals and describes how to develop a "playbook" on the basis of an outcome improvement project.

  9. Using International Study Series and Meta-Analytic Research Syntheses to Scope Pedagogical Development Aimed at Improving Student Attitude and Achievement in School Mathematics and Science

    Ruthven, Kenneth


    Taking lower-secondary schooling within the English educational system as an example, this paper illustrates the contribution of two bodies of international scholarship to the scoping of research-based pedagogical development aimed at improving student attitude and achievement in science and mathematics. After sketching the English context of…

  10. Improving Reading Achievement of Chapter 1 Pull-Out Students through Self-Esteem Building Classes Involving Buddy Group and Teacher Participation.

    Hershfield, Marlene

    A practicum attempted to improve the low reading achievement of Chapter 1 students in a low socioeconomic fifth-grade class by implementing a self-esteem building program. Activities were designed in a workbook format to complement class instruction in self-esteem building exercises. An emphasis on critical thinking skills was incorporated into…

  11. Improving Dairy Organizational Communication from the Veterinarian's Perspective: Results of a Continuing Veterinary Medical Education Pilot Program.

    Moore, Dale A; Sischo, William M; Kurtz, Suzanne; Siler, Julie D; Pereira, Richard V; Warnick, Lorin D; Davis, Margaret A


    The increasing size and complexity of US dairy farms could make it more difficult for a veterinary practitioner to effectively communicate protocol recommendations for prevention or treatment on the farm. A continuing education workshop was set up based on the results of research on dairy organizational communication on dairy farms, which resulted in a tool to assess dairy communication structure and flow. The workshop specifically focused on communication structure and whom to talk to when implementing health care changes in calf rearing. In addition, modern methods of veterinary-client communication knowledge and skills were provided. Primary outcomes of the workshops were to obtain feedback from participants about research findings and the communication model, to improve awareness about the complexity of communication structures on dairy farms, and to change participants' knowledge and skills associated with on-farm communication by providing communication theory and skills and an approach to evaluate and improve dairy organizational communication. Of the 37 participants completing the pre-program assessment, most recognized a need for themselves or their practice to improve communication with clients and farm employees. After the program, most participants were confident in their new communication skills and would consider using them. They highlighted specific new ideas they could apply in practice, such as conducting a "communication audit." The results from the assessment of this communication workshop, focused on dairy veterinarians, highlighted the need for communication training in this sector of the profession and practitioners' desire to engage in this type of training.

  12. Accreditation council for graduate medical education (ACGME annual anesthesiology residency and fellowship program review: a "report card" model for continuous improvement

    Long Timothy R


    Full Text Available Abstract Background The Accreditation Council for Graduate Medical Education (ACGME requires an annual evaluation of all ACGME-accredited residency and fellowship programs to assess program quality. The results of this evaluation must be used to improve the program. This manuscript describes a metric to be used in conducting ACGME-mandated annual program review of ACGME-accredited anesthesiology residencies and fellowships. Methods A variety of metrics to assess anesthesiology residency and fellowship programs are identified by the authors through literature review and considered for use in constructing a program "report card." Results Metrics used to assess program quality include success in achieving American Board of Anesthesiology (ABA certification, performance on the annual ABA/American Society of Anesthesiology In-Training Examination, performance on mock oral ABA certification examinations, trainee scholarly activities (publications and presentations, accreditation site visit and internal review results, ACGME and alumni survey results, National Resident Matching Program (NRMP results, exit interview feedback, diversity data and extensive program/rotation/faculty/curriculum evaluations by trainees and faculty. The results are used to construct a "report card" that provides a high-level review of program performance and can be used in a continuous quality improvement process. Conclusions An annual program review is required to assess all ACGME-accredited residency and fellowship programs to monitor and improve program quality. We describe an annual review process based on metrics that can be used to focus attention on areas for improvement and track program performance year-to-year. A "report card" format is described as a high-level tool to track educational outcomes.

  13. Virtual reality continuous-miner training simulator (VR-CMTS) for improving Sasol Coal's continuous-miner operations

    Trivett, G. [Sasol Coal, Secunda (South Africa)


    Virtual reality is designed to produce the illusion of being in a real place where there is motion and a changing view of a three-dimensional world with which one can interact, from the book 'From Talking Drums to the Internet: An encyclopedia of Communications Technology', written by Robert Gardner and Dennis Shortelle (ABC-Clio, 1997). Sasol Coal and Fifth Dimension Technologies have developed a cost-effective training simulator utilizing interactive Virtual Reality technology. Continuous-miner operations have been synthesized into a virtual environment. This technology is incorporated into two networked personal computer (PCs) and software. Through the software, a virtual image of an underground production section is projected in two forms: into a head-mounted display (HMD) helmet worn by the trainee; and onto a wall-mounted screen for general viewing. The operator stands adjacent to the instructor and dons the HDM helmet to view and hear computer-generated mining events in simulated three-dimensional form. The instructor can program any series of possible mining events based on the typical use of a continuous-miner into a scenario. With a hand-held control panel linked to the PC, the operator can control the virtual continuous-miner and perform virtual mining, complete with virtual sound, dust generation and other signs of movement. The virtual reality continuous-miner training simulator (VR-CMTS) utilizes a volumetric pixel (Voxel) technique to generate images of mining: cutting from the face: transferring coal to a shuttle car; and advancing into the newly mined void to repeat the cycle. A trainee typically starts with presimulation, through which the basic terminology and controls of the continuous-miner are work through a user specific mining scenario. Through a proficiency database, the operator and instructor can monitor operator performance and implement corrective measures. 2 refs., 1 fig.

  14. Semicoherent searches for continuous gravitational waves: improving robustness versus transient disturbances and increasing sensitivity to transient signals

    Keitel, David


    The vulnerability of standard detection methods for long-duration quasi-monochromatic gravitational waves from non-axisymmetric rotating neutron stars ('continuous waves', CWs) to single-detector instrumental artifacts was addressed in past work [Keitel, Prix, Papa, Leaci and Siddiqi, Phys. Rev. D 89, 064023 (2014)] by a Bayesian approach. An explicit model of persistent single-detector disturbances led to a generalized detection statistic with improved robustness against such artifacts. Since many strong outliers in semicoherent searches of LIGO data are caused by transient disturbances that last only a few hours, we extend this approach to cover transient disturbances, and demonstrate increased robustness in realistic simulated data. Besides long-duration CWs, neutron stars could also emit transient signals which, for a limited time, also follow the CW signal model (tCWs). As a pragmatic alternative to specialized transient searches, we demonstrate how to make standard semicoherent CW searches more sensitiv...

  15. Contrast improvement of continuous wave diffuse optical tomography reconstruction by hybrid approach using least square and genetic algorithm.

    Patra, Rusha; Dutta, Pranab K


    Reconstruction of the absorption coefficient of tissue with good contrast is of key importance in functional diffuse optical imaging. A hybrid approach using model-based iterative image reconstruction and a genetic algorithm is proposed to enhance the contrast of the reconstructed image. The proposed method yields an observed contrast of 98.4%, mean square error of 0.638×10⁻³, and object centroid error of (0.001 to 0.22) mm. Experimental validation of the proposed method has also been provided with tissue-like phantoms which shows a significant improvement in image quality and thus establishes the potential of the method for functional diffuse optical tomography reconstruction with continuous wave setup. A case study of finger joint imaging is illustrated as well to show the prospect of the proposed method in clinical diagnosis. The method can also be applied to the concentration measurement of a region of interest in a turbid medium.

  16. Improvement of Castability and Surface Quality of Continuously Cast TWIP Slabs by Molten Mold Flux Feeding Technology

    Cho, Jung-Wook; Yoo, Shin; Park, Min-Seok; Park, Joong-Kil; Moon, Ki-Hyeon


    An innovative continuous casting process named POCAST (POSCO's advanced CASting Technology) was developed based on molten mold flux feeding technology to improve both the productivity and the surface quality of cast slabs. In this process, molten mold flux is fed into the casting mold to enhance the thermal insulation of the meniscus and, hence, the lubrication between the solidifying steel shell and the copper mold. Enhancement of both the castability and the surface quality of high-aluminum advanced high-strength steel (AHSS) slabs is one of the most important advantages when the new process has been applied into the commercial continuous casting process. A trial cast of TWIP steel has been carried out using a 10-ton scale pilot caster and 100-ton scale and 250-ton scale commercial casters. The amount of mold flux consumption was more than 0.2 kg/m2 in the new process, which is much larger than that in the conventional powder casting. Trial TWIP castings at both the pilot and the plant caster showed stable mold performances such as mold heat transfer. Also, cast slabs showed periodic/sound oscillation marks and little defects. The successful casting of TWIP steel has been attributed to the following characteristics of POCAST: dilution of the reactant by increasing the slag pool depth, enlargement of channel for slag film infiltration at meniscus by elimination of the slag bear, and decrease of apparent viscosity of the mold slag at meniscus by increasing the slag temperature.

  17. Improvement of Castability and Surface Quality of Continuously Cast TWIP Slabs by Molten Mold Flux Feeding Technology

    Cho, Jung-Wook; Yoo, Shin; Park, Min-Seok; Park, Joong-Kil; Moon, Ki-Hyeon


    An innovative continuous casting process named POCAST (POSCO's advanced CASting Technology) was developed based on molten mold flux feeding technology to improve both the productivity and the surface quality of cast slabs. In this process, molten mold flux is fed into the casting mold to enhance the thermal insulation of the meniscus and, hence, the lubrication between the solidifying steel shell and the copper mold. Enhancement of both the castability and the surface quality of high-aluminum advanced high-strength steel (AHSS) slabs is one of the most important advantages when the new process has been applied into the commercial continuous casting process. A trial cast of TWIP steel has been carried out using a 10-ton scale pilot caster and 100-ton scale and 250-ton scale commercial casters. The amount of mold flux consumption was more than 0.2 kg/m2 in the new process, which is much larger than that in the conventional powder casting. Trial TWIP castings at both the pilot and the plant caster showed stable mold performances such as mold heat transfer. Also, cast slabs showed periodic/sound oscillation marks and little defects. The successful casting of TWIP steel has been attributed to the following characteristics of POCAST: dilution of the reactant by increasing the slag pool depth, enlargement of channel for slag film infiltration at meniscus by elimination of the slag bear, and decrease of apparent viscosity of the mold slag at meniscus by increasing the slag temperature.

  18. Using M and S to Improve Human Decision Making and Achieve Effective Problem Solving in an International Environment

    Christie, Vanessa L.; Landess, David J.


    In the international arena, decision makers are often swayed away from fact-based analysis by their own individual cultural and political bias. Modeling and Simulation-based training can raise awareness of individual predisposition and improve the quality of decision making by focusing solely on fact vice perception. This improved decision making methodology will support the multinational collaborative efforts of military and civilian leaders to solve challenges more effectively. The intent of this experimental research is to create a framework that allows decision makers to "come to the table" with the latest and most significant facts necessary to determine an appropriate solution for any given contingency.

  19. Achieving Superior Tropical Cyclone Intensity Forecasts by Improving the Assimilation of High-Resolution Satellite Data into Mesoscale Prediction Models


    Hurricane Sandy with 6-hourly assimilation of retrieved soundings (blue) and radiances (red). UCAR --PI Liu This past year, NCAR’s work was... UCAR is related to a NASA GNSS proposal: “Improving Tropical Prediction and Analysis using COSMIC Radio Occultation Observations and an Ensemble Data

  20. Evaluation and capacity building to improve precollege science and mathematics achievement in the US: 10 CFR, Part 605. Technical progress report, June--December 1992


    The National Center for Improving Science Education has undertaken activities to achieve evaluation goals for DOE`s Precollege programs: develop means to determine program quality; develop means for determining the contribution of DOE precollege programs to both teacher enhancement and student achievement; provide evaluation designs and instruments and reports of program quality and impact; and strengthen both DOE`s and the Labs` capacity to do both short- and long-term planning as well as deliver effective programs and evaluation. Appendices include evaluation/technical assistance report, profiling teacher research participation and teacher development programs, teacher surveys, impact assessment design, and teacher research participation programs anecdotes for 8 labs.

  1. Monitoring Hip and Elbow Dysplasia achieved modest genetic improvement of 74 dog breeds over 40 years in USA.

    Yali Hou

    Full Text Available Hip (HD and Elbow Dysplasia (ED are two common complex developmental disorders of dogs. In order to decrease their prevalence and severity, the Orthopedic Foundation for Animals (OFA has a voluntary registry of canine hip and elbow conformation certified by boarded radiologists. However, the voluntarily reports have been severely biased against exposing dogs with problems, especially at beginning period. Fluctuated by additional influential factors such as age, the published raw scores barely showed trends of improvement. In this study, we used multiple-trait mixed model to simultaneously adjust these factors and incorporate pedigree to derive Estimated Breeding Values (EBV. A total of 1,264,422 dogs from 74 breeds were evaluated for EBVs from 760,455 hip scores and 135,409 elbow scores. These EBVs have substantially recovered the reporting bias and the other influences. Clear and steady trends of genetic improvement were observed over the 40 years since 1970. The total genetic improvements were 16.4% and 1.1% of the phenotypic standard deviation for HD and ED, respectively. The incidences of dysplasia were 0.83% and 2.08%, and the heritabilities were estimated as 0.22 and 0.17 for hip and elbow scores, respectively. The genetic correlation between them was 0.12. We conclude that EBV is more effective than reporting raw phenotype. The weak genetic correlation suggested that selection based on hip scores would also slightly improve elbow scores but it is necessary to allocate effort toward improvement of elbow scores alone.


    Carlos Monge


    Full Text Available A random and statistically significant sample of 40 medium (12 and large (28 manufacturing plants of Apodaca, Mexico were surveyed using a structured and validated questionnaire to investigate the level of implementation of lean manufacturing, sustainable manufacturing, continuous improvement and operational efficiency and environmental responsibility in them, it is important to mention it was found that performance in the mentioned philosophies, on the two categories of plants is low, however large plants show a better performance than medium plants. In both cases, it is worrying that in the highly industrialized municipality of Apodaca,  Mexico are not decisively adopting the philosophies mentioned, as this compromises in a global world, in the medium and long term the viability of the plants, particularly the medium size plants. Finally this article shows the results of the answers to the items of questionnaire for the plants managers, and this can be useful to the management of the plants to identify and to define specific improvement actions towards priority areas.

  3. Performance improvement of continuous-variable quantum key distribution with an entangled source in the middle via photon subtraction

    Guo, Ying; Liao, Qin; Wang, Yijun; Huang, Duan; Huang, Peng; Zeng, Guihua


    A suitable photon-subtraction operation can be exploited to improve the maximal transmission of continuous-variable quantum key distribution (CVQKD) in point-to-point quantum communication. Unfortunately, the photon-subtraction operation faces solving the improvement transmission problem of practical quantum networks, where the entangled source is located in the third part, which may be controlled by a malicious eavesdropper, instead of in one of the trusted parts, controlled by Alice or Bob. In this paper, we show that a solution can come from using a non-Gaussian operation, in particular, the photon-subtraction operation, which provides a method to enhance the performance of entanglement-based (EB) CVQKD. Photon subtraction not only can lengthen the maximal transmission distance by increasing the signal-to-noise rate but also can be easily implemented with existing technologies. Security analysis shows that CVQKD with an entangled source in the middle (ESIM) from applying photon subtraction can well increase the secure transmission distance in both direct and reverse reconciliations of the EB-CVQKD scheme, even if the entangled source originates from an untrusted part. Moreover, it can defend against the inner-source attack, which is a specific attack by an untrusted entangled source in the framework of ESIM.

  4. An improved anti-leukemic effect achieved with donor progenitor cell infusion for relapse patients after allogeneic bone marrow transplantation

    黄晓军; 郭乃榄; 任汉云; 张耀臣; 高志勇; 陆道培


    Objective To observe the antileukemic effect in relapse patients by infusion of donor immunocompetent cells with or without granulocyte colony-stimulating factor (G-CSF) mobilization.Methods Twenty patients with leukemia in relapse after allogeneic bone marrow transplantation (allo-BMT) were treated with chemotherapy followed by donor-derived lymphocytes (DDL) without G-CSF mobilization (Group A, n=11), or donor peripheral blood progenitor cells (PBPCs) with G-CSF mobilization (Group B, n=9).Results Five patients in Group A were in hematologic relapse. After DDL infusion, 3 of 5 patients had a temporary complete remission (CR) and relapsed after 3, 7 and 10 months, respectively. One achieved partial remission and died of interstitial pneumonia; and the other one showed no response. Another 6 patients in Group A were in cytogenetic relapse or central nerve system (CNS) leukemia, and all achieved CR and remained in disease free survival (DFS) for 10 to 98 months after DDL infusion. All 9 patients in group B were in hematologic relapse. Three patients with chronic myeloid leukemia (CML) had cytogenetic and molecular remission for 16, 35 and 51 months, respectively after PBPC infusion; and 5 patients with acute lymphoid leukemia (ALL) had CR and were still in CR for 10 to 18 months except 1 patient relapsed soon. And the other one with AML showed no response to the therapy.Conclusion Donor immunocompetent cells infusion is an effective therapy for relapsed leukemia after allo-BMT, especially for the patients with early (molecular and cytogenetic) or CNS relapse. Infusion of donor PBPC mobilized by G-CSF seems to have more potentiated graft-versus-leukemia (GVL) effect than DDL infusion.

  5. 口腔护理专业质量管理的持续改进分析%Analysis on Continuous Improvement of Quality Management in Oral Nursing



    口腔门诊的患者流量大、复诊患者多,且科室内手术仪器设备、所用材料及药品的种类繁多,技术操作具有一定的复杂性,为此,建立一套完善的护理质量管理体系显得尤为重要,以防止医患纠纷和护理差错等现象的出现。持续质量改进是美国卫生保健组织鉴定联合委员会提出的管理模式,其更注重过程管理、环节质量控制,属于一种新的管理理论。主要通过收集资料、明确问题、提出更合理有效措施,达到有效护理的目的,目前已应用到临床护理实践中。因此,我院口腔门诊病分析了口腔科室管理中出现的问题,提出相应对策,改进其管理模式,应用持续质量改进模式,提高了护理质量。%In oral outpatient service, the number of patients is great, the number of visitspatients is also large,and dental surgical instruments and equipment, with many different kinds of materials and drugs, and technical operation has certain complexity. Therefore, the establishment of perfect system of nursing quality management is very important to prevent disputes between doctors and patients and the nursing error. Continuous quality improvement isproposed by Committee of the United States Health Care Organization, the management model is more emphasis on process management, link quality control, is a new management theory. Mainly through the collection of information, put forward more reasonable and effective measures, and has achieved the purpose of nursing, but has been applied to clinical nursing practice. So we entrance diagnose analysis the oral management, improve the management mode, puts forward the corresponding countermeasure and the model of continuous quality improvement, improve the quality of nursing.

  6. Improving educational achievement and anaemia of school children: design of a cluster randomised trial of school-based malaria prevention and enhanced literacy instruction in Kenya

    Halliday Katherine E


    Full Text Available Abstract Background Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement. However, there is limited experimental evidence on the benefits of school-based malaria prevention or how health interventions interact with other efforts to improve education quality. This study aims to evaluate the impact of school-based malaria prevention and enhanced literacy instruction on the health and educational achievement of school children in Kenya. Design A factorial, cluster randomised trial is being implemented in 101 government primary schools on the coast of Kenya. The interventions are (i intermittent screening and treatment of malaria in schools by public health workers and (ii training workshops and support for teachers to promote explicit and systematic literacy instruction. Schools are randomised to one of four groups: receiving either (i the malaria intervention alone; (ii the literacy intervention alone; (iii both interventions combined; or (iv control group where neither intervention is implemented. Children from classes 1 and 5 are randomly selected and followed up for 24 months. The primary outcomes are educational achievement and anaemia, the hypothesised mediating variables through which education is affected. Secondary outcomes include malaria parasitaemia, school attendance and school performance. A nested process evaluation, using semi-structured interviews, focus group discussion and a stakeholder analysis will investigate the community acceptability, feasibility and cost-effectiveness of the interventions. Discussion Across Africa, governments are committed to improve health and education of school-aged children, but seek clear policy and technical guidance as to the optimal approach to address malaria and improved literacy. This evaluation will be one of the first to simultaneously evaluate the impact of health and education interventions in the improvement of

  7. Mandatory and voluntary disclosures of Serbian listed companies: Achieved level and some recommendation for improving their relevance

    Denčić-Mihajlov, Ksenija; Spasić, Dejan


    Purpose - This paper investigates mandatory and voluntary disclosure practices of non-financial listed companies on the Belgrade Stock Exchange. The results help in determining the level of transparency of Serbian s listed companies and in formulating recommendations for improving the quality and relevance of disclosed information. Design/methodology/approach - We focus on modeling both mandatory and voluntary disclosure indices for financial and non-financial information in order to evaluate...

  8. Effectiveness of 3-Day Continuous Glucose Monitoring for Improving Glucose Control in Type 2 Diabetic Patients in Clinical Practice

    Soo Kyoung Kim


    Full Text Available BackgroundThe aim of this study was to investigate whether adjusting diabetic treatment regimens according to the information obtained from a continuous glucose monitoring system (CGMS might lead to improved glycemic control in patients with type 2 diabetes.MethodsWe reviewed the medical charts of 172 patients who used the CGMS for 1 year starting in December 2008 and the records of 1,500 patients who visited their regular outpatient clinics during December 2008. Of these patients, a total of 65 CGMS patients and 301 regular outpatients (control group were enrolled in the study after propensity score matching. There were no differences in baseline glycated hemoglobin (HbA1c, age, and duration of diabetes between the CGMS and the control groups after propensity score matching. The changes in the HbA1c levels from baseline to 6 months were calculated.ResultsThe CGMS group showed a significant improvement in the HbA1c level compared to the control group at 3 months (7.9%±1.6% vs. 7.4%±1.2%, P=0.001 and at 6 months (7.4%±1.2% vs. 7.9%±1.6%, P=0.010. There were significant differences in the treatment modality changes between the CGMS group and the control group.ConclusionUsing a 3-day CGMS was advantageous for improving glucose control in patients with type 2 diabetes and may help these patients to optimize glycemic control in clinical practice.

  9. Sensitivity improvement of an electrical sensor achieved by control of biomolecules based on the negative dielectrophoretic force.

    Kim, Hye Jin; Kim, Jinsik; Yoo, Yong Kyoung; Lee, Jeong Hoon; Park, Jung Ho; Hwang, Kyo Seon


    Effective control of nano-scale biomolecules can enhance the sensitivity and limit of detection of an interdigitated microelectrode (IME) sensor. Manipulation of the biomolecules by dielectrophoresis (DEP), especially the negative DEP (nDEP) force, so that they are trapped between electrodes (sensing regions) was predicted to increase the binding efficiency of the antibody and target molecules, leading to a more effective reaction. To prove this concept, amyloid beta 42 (Aβ42) and prostate specific antigen (PSA) protein were respectively trapped between the sensing region owing to the nDEP force under 5V and 0.05V, which was verified with COMSOL simulation. Using the simulation value, the resistance change (ΔR/Rb) of the IME sensor from the specific antibody-antigen reaction of the two biomolecules and the change in fluorescence intensity were compared in the reference (pDEP) and nDEP conditions. The ΔR/Rb value improved by about 2-fold and 1.66-fold with nDEP compared to the reference condition with various protein concentrations, and these increases were confirmed with fluorescence imaging. Overall, nDEP enhanced the detection sensitivity for Aβ42 and PSA by 128% and 258%, respectively, and the limit of detection improved by up to 2-orders of magnitude. These results prove that DEP can improve the biosensor's performance.

  10. 论临床路径实施中的持续质量改进%Continuous Quality Improvement by Using Clinical Pathways in Hospitals

    江芹; 张振忠; 赵颖旭; 于丽华; 郎婧婧; 张智国; 常欢欢


    The implementation of clinical pathway in some places has made a lot of good experiences, i. e. : integration of medical resources, medical institutions and medical staff to improve work efficiency ; reduce medical costs; improving the quality of medical care, increased patient satisfaction and etc. But currently domestic hospital management and technical level of the in China vary remarkably, in the process of implementation of the clinical pathway also encountered many difficulties, such as the design of clinical pathways and the lack of evidence - based standards development process support, inadequate preparation with limited resource mobilization , lack of effective implementation of the results of scientific evaluation and improvement of coping mechanisms. Need to improve the clinical pathway system design to achieve good clinical pathways to improve the basic conditions , to grasp the critical aspects of clinical pathways and other multi - angle control for continuous improvement.%临床路径的实施在一些地方取得了不错的经验,如整合医疗资源、提高医疗机构和医务人员的工作效率、降低医疗成本;通过提高病种的医疗护理质量,提高了病人满意度.但国内医院目前的管理和技术水平良莠不齐,在推行临床路径的过程中也遇到了不少困难,比如在临床路径设计和流程标准制定上缺乏循证支持,准备不足,医疗机构内部的资源动员有限,缺乏科学有效的实施效果评价和完善机制等等.需要从完善临床路径制度的设计、改善临床路径的基础条件、把握临床路径关键环节的控制等多角度进行持续改进.

  11. Improving the Image Quality of Synthetic Transmit Aperture Ultrasound Images - Achieving Real-Time In-Vivo Imaging

    Gammelmark, Kim


    to increase the SNR, which employs multi-element subapertures and linearly frequency modulated (FM) signals at each emission. The subaperture is applied to emulate a high power spherical wave transmitted by a virtual point source positioned behind the subaperture, and the linear FM signal replaces...... in-vivo experiments, showed, that TMS imaging can increase the SNR by as much as 17 dB compared to the traditional imaging techniques, which improves the in-vivo image quality to a highly competitive level. An in-vivo evaluation of convex array TMS imaging for abdominal imaging applications...

  12. The Use of Silent Reading in Improving Students’ Reading Comprehension and Their Achievement in TOEFL Score at a Private English Course

    Hapid Ali


    Full Text Available The purpose of the study is to analyze the use of silent reading in improving students’ reading comprehension and their achievement in TOEFL Score at a Private English Course. The methodology used in the study is quantitative model of analysis base by using inferential statistics analysis; the measurement of correlation coefficient and t-test. The respondents used are students of Private English Course, and the sampling technique used is random stratified sampling with 55 people as the respondents. The result of the research shows that the use of silent reading has a significant and positive influence toward improving students’ reading comprehension and their achievement in TOEFL Score on the study object.

  13. The Use of Silent Reading in Improving Students’ Reading Comprehension and Their Achievement in TOEFL Score at a Private English Course

    Hapid Ali


    The purpose of the study is to analyze the use of silent reading in improving students’ reading comprehension and their achievement in TOEFL Score at a Private English Course. The methodology used in the study is quantitative model of analysis base by using inferential statistics analysis; the measurement of correlation coefficient and t-test. The respondents used are students of Private English Course, and the sampling technique used is random stratified sampling with 55 people as the respo...

  14. Improved silencing suppression and enhanced heterologous protein expression are achieved using an engineered viral helper component proteinase.

    Haikonen, T; Rajamäki, M-L; Valkonen, J P T


    RNA silencing limits transient expression of heterologous proteins in plants. Co-expression of viral silencing suppressor proteins can increase and prolong protein expression, but highly efficient silencing suppressors may stress plant tissue and be detrimental to protein yields. Little is known whether silencing suppression could be improved without harm to plant tissues. This study reports development of enhanced silencing suppressors by engineering the helper component proteinase (HCpro) of Potato virus A (PVA). Mutations were introduced to a short region of HCpro (positions 330-335 in PVA HCpro), which is hypervariable among potyviruses. Three out of the four HCpro mutants suppressed RNA silencing more efficiently and sustained expression of co-expressed jellyfish green fluorescent protein for a longer time than wild-type HCpro in agroinfiltrated leaves of Nicotiana benthamiana. Leaf tissues remained healthy-looking without any visible signs of stress.

  15. General chemistry courses that can affect achievement: An action research study in developing a plan to improve undergraduate chemistry courses

    Shweikeh, Eman

    Over the past 50 years, considerable research has been dedicated to chemistry education. In evaluating principal chemistry courses in higher education, educators have noted the learning process for first-year general chemistry courses may be challenging. The current study investigated perceptions of faculty, students and administrators on chemistry education at three institutions in Southern California. Via action research, the study sought to develop a plan to improve student engagement in general chemistry courses. A mixed method was utilized to analyze different perceptions on key factors determining the level of commitment and engagement in general chemistry education. The approach to chemistry learning from both a faculty and student perspective was examined including good practices, experiences and extent of active participation. The research study considered well-known measures of effective education with an emphasis on two key components: educational practices and student behavior. Institutional culture was inclusively assessed where cognitive expectations of chemistry teaching and learning were communicated. First, the extent in which faculty members are utilizing the "Seven Principles for Good Practice in Undergraduate Education" in their instruction was explored. Second, student attitudes and approaches toward chemistry learning were examined. The focus was on investigating student understanding of the learning process and the structure of chemistry knowledge. The seven categories used to measure students' expectations for learning chemistry were: effort, concepts, math link, reality link, outcome, laboratory, and visualization. This analysis represents the views of 16 faculty and 140 students. The results validated the assertion that students need some competencies and skills to tackle the challenges of the chemistry learning process to deeply engage in learning. A mismatch exists between the expectations of students and those of the faculty

  16. Revenue enhancement through total quality management/continuous quality improvement (TQM/CQI) in outpatient coding and billing.

    Dwore, R B; Murray, B P; Parsons, R J; Smith, P M; Vorderer, L H


    To survive and thrive, rural hospitals are seeking enhanced revenues. This study focuses on outpatient laboratory and radiology coding and billing accuracy in a nonrandom sample of seven rural hospitals in a Western state. Information was gathered on (1) procedures incorrectly coded, (2) potential revenue increases from correct coding and billing, (3) barriers to implementing changes, and (4) perceived audit value. The identified major source of potential revenue enhancement was increased fees from private payers. Correct coding and billing to Medicare and Medicaid offered the potential of additional revenue. Participating administrators appreciated the validation of coding and billing practices and identification of potential enhanced revenues. Five of seven hospitals (71.4%) selectively implemented recommended changes. Complete compliance with recommended changes was limited by barriers of tradition, competition, and reimbursement, which must be overcome to realize successful implementation. Joint Commission on Accreditation of Healthcare Organization's (JCAHO) new Total Quality Management/Continuous Quality Improvement (TQM/CQI) emphasis provides an opportunity for revenue enhancement through coding/billing assessments and interdepartmental focus and coordination.

  17. Beyond Effectiveness: A Pragmatic Evaluation Framework for Learning and Continuous Quality Improvement of e-Learning Interventions in Healthcare.

    Dafalla, Tarig Dafalla Mohamed; Kushniruk, Andre W; Borycki, Elizabeth M


    A pragmatic evaluation framework for evaluating the usability and usefulness of an e-learning intervention for a patient clinical information scheduling system is presented in this paper. The framework was conceptualized based on two different but related concepts (usability and usefulness) and selection of appropriate and valid methods of data collection and analysis that included: (1) Low-Cost Rapid Usability Engineering (LCRUE), (2) Cognitive Task Analysis (CTA), (3) Heuristic Evaluation (HE) criteria for web-based learning, and (4) Software Usability Measurement Inventory (SUMI). The results of the analysis showed some areas where usability that were related to General Interface Usability (GIU), instructional design and content was problematic; some of which might account for the poorly rated aspects of usability when subjectively measured. This paper shows that using a pragmatic framework can be a useful way, not only for measuring the usability and usefulness, but also for providing a practical objective evidences for learning and continuous quality improvement of e-learning systems. The findings should be of interest to educators, developers, designers, researchers, and usability practitioners involved in the development of e-learning systems in healthcare. This framework could be an appropriate method for assessing the usability, usefulness and safety of health information systems both in the laboratory and in the clinical context.

  18. Using optimal combination of teaching-learning methods (open book assignment and group tutorials) as revision exercises to improve learning outcome in low achievers in biochemistry.

    Rajappa, Medha; Bobby, Zachariah; Nandeesha, H; Suryapriya, R; Ragul, Anithasri; Yuvaraj, B; Revathy, G; Priyadarssini, M


    Graduate medical students of India are taught Biochemistry by didactic lectures and they hardly get any opportunity to clarify their doubts and reinforce the concepts which they learn in these lectures. We used a combination of teaching-learning (T-L) methods (open book assignment followed by group tutorials) to study their efficacy in improving the learning outcome. About 143 graduate medical students were classified into low (75%: group 3, n = 46) achievers, based on their internal assessment marks. After the regular teaching module on the topics "Vitamins and Enzymology", all the students attempted an open book assignment without peer consultation. Then all the students participated in group tutorials. The effects on the groups were evaluated by pre and posttests at the end of each phase, with the same set of MCQs. Gain from group tutorials and overall gain was significantly higher in the low achievers, compared to other groups. High and medium achievers obtained more gain from open book assignment, than group tutorials. The overall gain was significantly higher than the gain obtained from open book assignment or group tutorials, in all three groups. All the three groups retained the gain even after 1 week of the exercise. Hence, optimal use of novel T-L methods (open book assignment followed by group tutorials) as revision exercises help in strengthening concepts in Biochemistry in this oft neglected group of low achievers in graduate medical education. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(4):321-325, 2016.

  19. Endothelial function does not improve with high-intensity continuous exercise training in SHR: implications of eNOS uncoupling.

    Battault, Sylvain; Singh, François; Gayrard, Sandrine; Zoll, Joffrey; Reboul, Cyril; Meyer, Grégory


    Exercise training is a well-recognized way to improve vascular endothelial function by increasing nitric oxide (NO) bioavailability. However, in hypertensive subjects, unlike low- and moderate-intensity exercise training, the beneficial effects of continuous high-intensity exercise on endothelial function are not clear, and the underlying mechanisms remain unknown. The aim of this study was to investigate the impact of high-intensity exercise on vascular function, especially on the NO pathway, in spontaneous hypertensive rats (SHR). These effects were studied on WKY, sedentary SHR and SHR that exercised at moderate (SHR-MOD) and high intensity (SHR-HI) on a treadmill (1 h per day; 5 days per week for 6 weeks at 55% and 80% of their maximal aerobic velocity, respectively). Endothelial function and specific NO contributions to acetylcholine-mediated relaxation were evaluated by measuring the aortic ring isometric forces. Endothelial nitric oxide synthase (eNOS) expression and phosphorylation (ser1177) were evaluated by western blotting. The total aortic and eNOS-dependent reactive oxygen species (ROS) production was assessed using electron paramagnetic resonance in aortic tissue. Although the aortas of SHR-HI had increased eNOS levels without alteration of eNOS phosphorylation, high-intensity exercise had no beneficial effect on endothelium-dependent vasorelaxation, unlike moderate exercise. This result was associated with increased eNOS-dependent ROS production in the aortas of SHR-HI. Notably, the use of the recoupling agent BH4 or a thiol-reducing agent blunted eNOS-dependent ROS production in the aortas of SHR-HI. In conclusion, the lack of a positive effect of high-intensity exercise on endothelial function in SHR was mainly explained by redox-dependent eNOS uncoupling, resulting in a switch from NO to O2(-) generation.

  20. Effectiveness of music education for the improvement of reading skills and academic achievement in young poor readers: a pragmatic cluster-randomized, controlled clinical trial.

    Hugo Cogo-Moreira

    Full Text Available INTRODUCTION: Difficulties in word-level reading skills are prevalent in Brazilian schools and may deter children from gaining the knowledge obtained through reading and academic achievement. Music education has emerged as a potential method to improve reading skills because due to a common neurobiological substratum. OBJECTIVE: To evaluate the effectiveness of music education for the improvement of reading skills and academic achievement among children (eight to 10 years of age with reading difficulties. METHOD: 235 children with reading difficulties in 10 schools participated in a five-month, randomized clinical trial in cluster (RCT in an impoverished zone within the city of São Paulo to test the effects of music education intervention while assessing reading skills and academic achievement during the school year. Five schools were chosen randomly to incorporate music classes (n = 114, and five served as controls (n = 121. Two different methods of analysis were used to evaluate the effectiveness of the intervention: The standard method was intention-to-treat (ITT, and the other was the Complier Average Causal Effect (CACE estimation method, which took compliance status into account. RESULTS: The ITT analyses were not very promising; only one marginal effect existed for the rate of correct real words read per minute. Indeed, considering ITT, improvements were observed in the secondary outcomes (slope of Portuguese = 0.21 [p<0.001] and slope of math = 0.25 [p<0.001]. As for CACE estimation (i.e., complier children versus non-complier children, more promising effects were observed in terms of the rate of correct words read per minute [β = 13.98, p<0.001] and phonological awareness [β = 19.72, p<0.001] as well as secondary outcomes (academic achievement in Portuguese [β = 0.77, p<0.0001] and math [β = 0.49, p<0.001] throughout the school year. CONCLUSION: The results may be seen as promising, but they are not

  1. The Power to drive change: Working together for excellence. Creating a continuously improving consumer engagement framework for excellence in patient-centered care.

    Ryan, Catherine


    The World Health Organization has acknowledged Patient Safety while receiving hospital care as a serious global public health issue, with patient empowerment and community engagement key to continuously improving safety and quality of care for the best possible clinical and patient outcomes. In Australia, the introduction of ten mandatory National Safety and Quality Health Service Standards in 2011 provided the catalyst for all Australian health facilities to review their systems. Standard 2: Partnering with Consumers required health facilities across Australia to assess commitment to, and capacity for consumer and community engagement and participation. At this time, the Royal Brisbane and Women's Hospital did not have a strategic perspective and understanding, or an organizational structure for engaging with consumers (patients, families, care givers and community members). The concept required a new model to replace the clinician-led model of healthcare historically featured in Australia, with a change in culture and core business. processes to partner with consumers at all levels of the system, from individual patient care through to participating in policy development, health service planning and delivery, and evaluation and measurement processes. The challenge for the hospital was to build a sustainable framework of engagement for a genuine patient-centered model of care informed by best practice, and provide leadership and commitment to developing as an area of excellence in patient engagement and experience. A successful and sustainable framework for consumer and community engagement has been embedded in the hospital, with resultant culture change, achieving accreditation across all core and developmental criteria for the partnering with consumer standards including several Met with Merit ratings.

  2. Knowledge management in R&D centres, in the field of biomedicine, using contemporary information and communication technology and the methodology of continuous improvement

    Ryszard Depta


    Full Text Available Some sophisticated medical applications, including advanced therapeutics with monoclonal antibodies, stem cells, and gene therapies are currently available in clinical trials. More revolutionary technologies are coming soon and will be marketed by the best technically advanced companies in the world. R&D companies with a much smaller indicator of technological progress and organizational efficiency, but with a great desire to become a major player in this industry, will also compete for a share of this market. However, in order to become a fixture in the changes initiated, both must constantly learn and be more innovative. In the current market situation, a hypercompetitive economy with the entrepreneurs’ focus on the prosumer, creativity is becoming extremely important in achieving final success. Creativity, which is the result of proper knowledge management, especially in science. The market value of R&D companies and their further future depends to a large extent on the prosperity of knowledge transfer. The most important role in the process of knowledge transfer is played by information and communication technologies (ICT and tools for continuous improvement. If companies implement these efficiently and safely, they can develop and benefit from competitive advantages for a very long period of time. Such an approach would give them the possibility of reducing the cost and time to deliver new products to market, and create a new platform to generate innovative products. This is a new perspective for R&D businesses, and a great opportunity for institutions in the biomedical arena to become part of the upcoming bio-revolution.

  3. Feasibility of Continuous Frying System to Improve the Quality Indices of Palm Olein for the Production of Extruded Product.

    Ahmad Tarmizi, Azmil Haizam; Ahmad, Karimah


    Comparative frying studies on the processing of extruded product were conducted under intermittent and continuous frying conditions using two separate frying systems, i.e batch and pilot scale continuous fryers, respectively. Thermal resistance of palm olein were assessed for a total of 5 days of frying operation at 155°C - the unconventional frying temperature gave the product moisture content of 3% after intermittent and continuous frying for 2.5 min and 2 min, respectively. The formation of free fatty acid in palm olein in the case of intermittent frying was more than 2-fold higher compared to its counterpart (0.66%). Smoke point inversely evolved with oil acidity: the value dropped progressively from 215 to 177°C and from 219 to 188°C when extruded product was intermittently and continuously fried, respectively. In the light of induction period, repeated frying exhibited a gradual decrease in the value after 5 days of frying (12.2 h). Interestingly, continuous frying gave somewhat similar induction period, as demonstrated by fresh palm olein, across frying time. Frying at lower temperature, to some extent, provides opportunity for palm olein to retain 74% of its initial vitamin E during continuous frying. This benefit, however, is somehow denied when extruded product was processed under intermittent frying conditions--only 27% of vitamin E was remained at the end of frying session. Regardless of frying protocols, transient in polar compounds was minimal and hence comparable. The colour in the case of continuous frying appeared to be darker due to higher degree of oil utilisation for frying. The data obtained will provide useful information for food processors on how palm olein behaves when frying is undertaken under different frying protocols.

  4. Impacts of continual and periodic disturbances on a Central Amazonian forest: lessons from a gap model for future model improvement

    Holm, J. A.; Chambers, J. Q.; Collins, W.


    Uncertainties surrounding vegetation and carbon responses to increased disturbance rates associated with climate change remains a major global change issue for Amazon forests. To help quantify the impacts of increased disturbances on climate and the earth system, the fidelity of tree mortality and disturbance algorithms in global land surface models (here the Community Land Model, CLM) warrant critical evaluation. In order to address this issue, we parameterized and calibrated ZELIG-TROP, a dynamic vegetation gap model, to simulate a complex Central Amazon forest toward improving disturbance-recovery processes in CLM. To evaluate the long-term consequences of increased disturbance rates in ZELIG-TROP and CLM for a Central Amazon rainforest, we 1) doubled background tree mortality rates (i.e., high disturbance treatment), and 2) applied a periodic disturbance treatment of removing 20% of stems every 50 years (i.e., periodic treatment) and compared model results. For the high disturbance treatment, ZELIG-TROP predicted that AGB and ANPP decreased by an average of 110 Mg ha-1 and 0.48 Mg C ha-1 yr-1 respectively (41.9% and 7.7%). The net carbon loss due to the periodic treatment, with four large-scale disturbances, was not as extreme as the loss from the high disturbance treatment, due to recovery dynamics. AGB only decreased by 15.9% (vs. 41.9%), however ANPP decreased by 19% (vs. 7.7%). For the high disturbance treatment in ZELIG-TROP, there were a higher proportion of smaller stems and a decrease in larger stems. This resulted in a decrease in coarse litter (trunks and large branches >10 cm in diameter) production rates (Mg C ha-1 yr-1) by 11.5%. For the periodic disturbance the average coarse litter production rates increased by 11.2% due to the four large-scale disturbance events. A comparison of the biomass response of ZELIG-TROP and CLM from simulated disturbance and recovery events displayed the same pattern between the two models, and for both disturbance

  5. Continuous parallel coordinates.

    Heinrich, Julian; Weiskopf, Daniel


    Typical scientific data is represented on a grid with appropriate interpolation or approximation schemes,defined on a continuous domain. The visualization of such data in parallel coordinates may reveal patterns latently contained in the data and thus can improve the understanding of multidimensional relations. In this paper, we adopt the concept of continuous scatterplots for the visualization of spatially continuous input data to derive a density model for parallel coordinates. Based on the point-line duality between scatterplots and parallel coordinates, we propose a mathematical model that maps density from a continuous scatterplot to parallel coordinates and present different algorithms for both numerical and analytical computation of the resulting density field. In addition, we show how the 2-D model can be used to successively construct continuous parallel coordinates with an arbitrary number of dimensions. Since continuous parallel coordinates interpolate data values within grid cells, a scalable and dense visualization is achieved, which will be demonstrated for typical multi-variate scientific data.

  6. Research on improved design of airfoil profiles based on the continuity of airfoil surface curvature of wind turbines

    Chen, Jin; Cheng, Jiangtao; Shen, Wenzhong


    Aerodynamic of airfoil performance is closely related to the continuity of its surface curvature, and airfoil profiles with a better aerodynamic performance plays an important role in the design of wind turbine. The surface curvature distribution along the chord direction and pressure distributio...

  7. Observations of human factors as a continuous improvement tool; Las obervaciones de factores humanos como herramienta de mejora continua

    Almeida, P.


    Principles for Excellence in Human Performance should promote behaviors throughout an organization that support safety and reliable operation of the plant. Such behaviors must be clearly defined, communicated and reinforced by managers, on a continuous basis. To identify if workers behaviors are in compliance with those expected is paramount to have an observations program in place, which in one hand identifies deviations from expectations to correct them, and on the other promotes the desired behaviors through positive reinforcement. (Author)

  8. Army Corps of Engineers. Recent Changes Have Reduced the Use of Continuing Contracts, but Management Processes Need to Be Improved


    that were awarded during the 2-year time frame but were missing from the Corps’ quarterly reports by querying the Corps’ Primavera database.3 We did...not assess the reliability of the Primavera database, but we verified information from that... Primavera has an optional field to track continuing contracts that was added to the database in early 2007. Page 17 GAO-09-552 Army Corps of Engineers

  9. Improving the teaching and learning of science in a suburban junior high school on Long Island: Achieving parity through cogenerative dialogues

    Baker, Eileen Perman

    The research in this dissertation focuses on ways to improve the teaching and learning of science in a suburban junior high school on Long Island, New York. The study is my attempt to find ways to achieve parity in my classroom in terms of success in science. I was specifically looking for ways to encourage Black female students in my classroom and in other classrooms to continue their science education into the upper grades. The participants were the 27 students in the class, a friend of one of the students, and I, as the teacher-researcher. In order to examine the ways in which structure mediates the social and historical contexts of experiences in relation to teacher and student practices in the classroom, I used collaborative research; autobiographical reflection; the sociology of emotions; immigration, racialization, and ethnicity, and cogenerative dialogues (cogens) as tools. Cogenerative dialogues are a way for students and teachers to accept shared responsibility for teaching and learning. This study is of importance because of my school's very diverse student body. The school has a large minority population and therefore shares many of the characteristics of urban schools. In my study I look at why there are so few Black female students in the advanced science courses offered by our district and how this problem can be addressed. I used a variety of qualitative approaches including critical ethnography and micro analysis to study the teaching and learning of science. In addition to the usual observational, methodological, and theoretical field notes, I videotaped and audiotaped lessons and had discussions with students and teachers, one-on-one and in groups. In the first year the cogenerative group consisted of two Black female students. In the second year of the study there were four Black and one White-Hispanic female students in the cogen group. In my research I studied the interactions of the students between lessons and during laboratory activities as

  10. Comparative Analysis of Improved Cuckoo Search(ICS Algorithm and Artificial Bee Colony (ABC Algorithm on Continuous Optimization Problems

    Shariba Islam Tusiy


    Full Text Available This work is related on two well-known algorithm, Improved Cuckoo Search and Artificial Bee Colony Algorithm which are inspired from nature. Improved Cuckoo Search (ICS algorithm is based on Lévy flight and behavior of some birds and fruit flies and they have some assumptions and each assumption is highly observed to maintain their characteristics. Besides Artificial Bee Colony (ABC algorithm is based on swarm intelligence, which is based on bee colony with the way the bees maintain their life in that colony. Bees’ characteristics are the main part of this algorithm. This is a theoretical result of this topic and a quantitative research paper.

  11. Provision of Continuity in Power Supply of Wind Power Stations by Improvement of Methods for Control of Oil Transformer Serviceability

    Y. A. Rolik


    Full Text Available The paper considers problems pertaining to reduction of time for restoration of a wind power station (WPS by development of a method and control means according to informative parameter. A high-voltage oil transformer has been selected as a control WPS object.  The paper shows that the most informative parameter determining continuity in WPS power supply is an over-heating temperature of oil transformer elements. A method and means for control of WPS oil transformer serviceability are proposed in the paper.

  12. Program improvements in the CEA service continuity: report and impact of the ice storm on CEA data

    Billinton, R. [Saskatchewan Univ., Saskatoon, SK (Canada)


    The Canadian Electrical Association has been collecting statistical data on various aspects of electric power generation, transmission and distribution since 1979, when the Equipment Reliability Information System (ERIS) database has been implemented. Currently, the CEA publishes annual reports and statistics on generation and transmission component outages. Data gathering and reporting is monitored and guided by the Consultative Committee on Outage Statistics (CCOS). The Electric Power System Reliability Assessment (EPSRA) protocols represent the second stage of reliability data development. This system is designed to collect and report on data relating to the overall electricity supply system and the overall performance of the bulk electricity system. (ERIS reporting is concerned with equipment outages). This paper describes the Service Continuity Reporting System segment of the EPSRA protocols. Details of performance in service continuity for 1998 are provided with and without the 1998 ice storms effects. The complete data and indices on each participating utility, together with the overall Canada and total participating utility data, provides a convenient base for general utility comparisons. Comparisons of the various indices of reliability with like statistics from electric utility companies of Australia, New Zealand and the United States are also provided. 2 tabs., 1 fig.

  13. 'No delays achiever'.


    The latest version of the NHS Institute for Innovation and Improvement's 'no delays achiever', a web based tool created to help NHS organisations achieve the 18-week target for GP referrals to first treatment, is available at

  14. Empowerment and continuous improvement in the United States, Mexico, Poland, and India: predicting fit on the basis of the dimensions of power distance and individualism.

    Robert, C; Probst, T M; Martocchio, J J; Drasgow, F; Lawler, J J


    Although variations in national cultures predominate as explanation for the belief that universal approaches to management do not exist, there have been few reports of systematic studies. Data from employees of a single firm with operations in the United States, Mexico, Poland, and India were used to test the fit of empowerment and continuous improvement practices with national culture. Using the theoretical constructs of individualism-collectivism and power distance, the authors predicted that the practices would be more congruent in some cultures than in others and that value congruence would result in job satisfaction. Using structural equations modeling, the authors found that empowerment was negatively associated with satisfaction in India but positively associated in the other 3 samples. Continuous improvement was positively associated with satisfaction in all samples. Substantive, theoretical, and methodological implications are discussed.

  15. Selection of indicators for continuous monitoring of patient safety: recommendations of the project 'safety improvement for patients in Europe'

    Kristensen, Solvejg; Mainz, Jan; Bartels, Paul


    BACKGROUND: Initiatives to improve patient safety have high priority among health professionals and politicians in most developed countries. Currently, however, assessment of patient safety problems relies mainly on case-based methodologies. The evidence for their efficiency and reproducibility......, proving that safety of care has improved with their usage, is questionable. The exact incidence and prevalence of patient safety quality problems are unknown. Therefore, there is a need for firm, evidence-based methods to survey and develop patient safety and derived activities. OBJECTIVE: The objective...... of this paper is to describe a method to select patient safety indicators and present the indicators derived through this process. METHODS: The patient safety indicators were derived and recommended for use in a formalized consensus process based on literature review, targeted information gathering, expert...

  16. Signal Processing Algorithms Implementing the “Smart Sensor” Concept to Improve Continuous Glucose Monitoring in Diabetes

    Facchinetti, Andrea; Sparacino, Giovanni; Cobelli, Claudio


    Glucose readings provided by current continuous glucose monitoring (CGM) devices still suffer from accuracy and precision issues. In April 2013, we proposed a new conceptual architecture to deal with these problems and render CGM sensors algorithmically smarter, which consists of three modules for denoising, enhancement, and prediction placed in cascade to a commercial CGM sensor. The architecture was assessed on a data set consisting of 24 type 1 diabetes patients collected in four clinical centers of the AP@home Consortium (a European project of 7th Framework Programme funded by the European Committee). This article, as a companion to our prior publication, illustrates the technical details of the algorithms and of the implementation issues. PMID:24124959

  17. Improving the action requirements of technical specifications: A risk-comparison of continued operation and plant shutdown

    Kim, I.S.; Samanta, P.K. [Brookhaven National Lab., Upton, NY (United States); Mankamo, T.


    When the systems needed to remove decay heat are inoperable or degraded, the risk of shutting down the plant may be comparable to, or even higher than, that of continuing power operation with the equipment inoperable while giving priority to repairs. This concern arises because the plant may not have sufficient capability for removing decay heat during the shutdown. However, Technical Specifications (TSs) often require {open_quotes}immediate{close_quotes} shutdown of the plant. In this paper, we present risk-based analyses of the various operational policy alternatives available in such situations, with an example application to the standby service water (SSW) system of a BWR. These analyses can be used to define risk-effective requirements for those standby safety systems under discussion.

  18. Super High Dosing with a Novel Buttiauxella Phytase Continuously Improves Growth Performance, Nutrient Digestibility, and Mineral Status of Weaned Pigs.

    Zeng, Zhikai; Li, Qingyun; Tian, Qiyu; Zhao, Panfeng; Xu, Xiao; Yu, Shukun; Piao, Xiangshu


    This study was conducted to evaluate the efficacy of a novel Buttiauxella phytase to pigs fed P-deficient, corn-soybean meal diets. One hundred and twenty crossbred piglets (9.53 ± 0.84 kg) were allocated to one of five treatments which consisted of four low P diets (0.61 % Ca and 0.46 % total P) supplemented with 0, 500, 1,000, or 20,000 FTU/kg phytase as well as a positive control diet (0.77 % Ca and 0.62 % total P). Each treatment had six replicated pens with four pigs per pen. Pigs were fed the experimental diets for 28 days. Phytase supplementation linearly improved (P phytase (20,000 FTU/kg) further increased (P phytase inclusion group, as well as ATTD of Ca and P. Metacarpal bone characteristics and several trace mineral concentration in bone, plasma, or organ tissues were linearly (P phytase. Super high dosing with phytase (20,000 FTU/kg) supplementation improved (P phytase supplementation (500 or 1,000 FTU/kg). In conclusion, supplementation of 500 FTU of Buttiauxella phytase/kg and above effectively hydrolyzed phytate in a low-P corn-soybean diet for pigs. In addition, a super high dosing with phytase (20,000 FTU/kg) improved macro- or micro mineral availability and growth performance.


    Sabahudin Jasarevic


    Full Text Available There are number of obstacles on a challenging road to the effectiveness and business and organizational excellence. One of the most difficult ones is human (not understanding of the constant flux of change. Such is the case when it comes to development of quality management system. Will the quality be either a problem or resource of some organization depends above all on the basic standpoint towards quality that exists in the organization. Many authors underline that implementation of quality management system and obtaining ISO 9000 certificate is not an easy task, but also emphasize that its maintenance and improvement is much more difficult task. The greatest number of problems that occur during the realization of project of quality management system as well as its improvement are the result of misunderstanding of the essence of standard, that is its principles. On of these principles is Leadership too, that is the role of Top Management. Managers at the highest levels are certainly the most responsible for establishing the vision and guiding organization in all business aspects, including Quality Management and Quality Management System. This work presents results of research conducted on the top management in 204 organizations with introduced quality system. Results show views of top management about the effects of introduced quality system as well as about future steps in terms of improving the same.

  20. 浅谈实验室质量体系的持续改进%Discussion on the Laboratory Quality System of Continuous Improvement



    通过实验室资质认定和国家实验室认可后几年来本所质量管理体系的有效运行,笔者结合实际,从不断完善质量管理体系文件、加强人员培训、加强质量管理体系内审和管理评审、开展有效的质量监督工作,以及积极参加能力验证活动几方面对持续改进实验室质量管理体系做了全面的阐述,为实验室持续改进其管理体系提供了参考性意见。%Through the effective operation of our quality management system for several years after the laboratory qualification and national laboratory accreditation,by combining the actual situation,the author comprehensively describes the continual improvement of the quality management system of the laboratory from the aspects of improving quality management system documents continuously,strengthening personnel training,strengthening internal audit and management review of the quality management system,carrying out effective quality supervision and actively participating in proficiency testing,thus provides reference opinions for the laboratory to improve its management system continuously.

  1. Achieving Standardization

    Henningsson, Stefan


    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...

  2. Achieving Standardization

    Henningsson, Stefan


    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...


    Maruya, Hiroaki

    For most Japanese companies and organizations, the enormous damage of the Great East Japan Earthquake was more than expected. In addition to great tsunami and earthquake motion, the lack of electricity and fuel disturbed to business activities seriously, and they should be considered important constraint factors in future earthquakes. Furthermore, disruption of supply chains also led considerable decline of production in many industries across Japan and foreign countries. Therefore it becomes urgent need for Japanese government and industries to utilize the lessons of the Great Earthquake and execute effective countermeasures, considering great earthquakes such as Tonankai & Nankai earthquakes and Tokyo Inland Earthquakes. Obviously most basic step is improving earthquake-resistant ability of buildings and facilities. In addition the spread of BCP and BCM to enterprises and organizations is indispensable. Based on the lessons, the BCM should include the point of view of the supply chain management more clearly, and emphasize "substitute strategy" more explicitly because a company should survive even if it completely loses its present production base. The central and local governments are requested, in addition to develop their own BCP, to improve related systematic conditions for BCM of the private sectors.

  4. On the Use of Evolutionary Algorithms to Improve the Robustness of Continuous Speech Recognition Systems in Adverse Conditions

    Selouani, Sid-Ahmed; O'Shaughnessy, Douglas


    Limiting the decrease in performance due to acoustic environment changes remains a major challenge for continuous speech recognition (CSR) systems. We propose a novel approach which combines the Karhunen-Loève transform (KLT) in the mel-frequency domain with a genetic algorithm (GA) to enhance the data representing corrupted speech. The idea consists of projecting noisy speech parameters onto the space generated by the genetically optimized principal axis issued from the KLT. The enhanced parameters increase the recognition rate for highly interfering noise environments. The proposed hybrid technique, when included in the front-end of an HTK-based CSR system, outperforms that of the conventional recognition process in severe interfering car noise environments for a wide range of signal-to-noise ratios (SNRs) varying from 16 dB to[InlineEquation not available: see fulltext.] dB. We also showed the effectiveness of the KLT-GA method in recognizing speech subject to telephone channel degradations.

  5. Continuous twin screw melt granulation of glyceryl behenate: Development of controlled release tramadol hydrochloride tablets for improved safety.

    Keen, Justin M; Foley, Connor J; Hughey, Justin R; Bennett, Ryan C; Jannin, Vincent; Rosiaux, Yvonne; Marchaud, Delphine; McGinity, James W


    Interest in granulation processes using twin screw extrusion machines is rapidly growing. The primary objectives of this study were to develop a continuous granulation process for direct production of granules using this technique with glyceryl behenate as a binder, evaluate the properties of the resulting granules and develop controlled release tablets containing tramadol HCl. In addition, the granulation mechanism was probed and the polymorphic form of the lipid and drug release rate were evaluated on stability. Granules were prepared using a Leistritz NANO16 twin screw extruder operated without a constricting die. The solid state of the granules were characterized by differential scanning calorimetry and X-ray diffraction. Formulated tablets were studied in 0.1N HCl containing 0-40% ethanol to investigate propensity for alcohol induced dose dumping. The extrusion barrel temperature profile and feed rate were determined to be the primary factors influencing the particle size distribution. Granules were formed by a combination immersion/distribution mechanism, did not require subsequent milling, and were observed to contain desirable polymorphic forms of glyceryl behenate. Drug release from tablets was complete and controlled over 16 h and the tablets were determined to be resistant to alcohol induced dose dumping. The drug release rate from the tablets was found to be stable at 40°C and 75% relative humidity for the duration of a 3 month study.

  6. On the Use of Evolutionary Algorithms to Improve the Robustness of Continuous Speech Recognition Systems in Adverse Conditions

    Sid-Ahmed Selouani


    Full Text Available Limiting the decrease in performance due to acoustic environment changes remains a major challenge for continuous speech recognition (CSR systems. We propose a novel approach which combines the Karhunen-Loève transform (KLT in the mel-frequency domain with a genetic algorithm (GA to enhance the data representing corrupted speech. The idea consists of projecting noisy speech parameters onto the space generated by the genetically optimized principal axis issued from the KLT. The enhanced parameters increase the recognition rate for highly interfering noise environments. The proposed hybrid technique, when included in the front-end of an HTK-based CSR system, outperforms that of the conventional recognition process in severe interfering car noise environments for a wide range of signal-to-noise ratios (SNRs varying from 16 dB to −4 dB. We also showed the effectiveness of the KLT-GA method in recognizing speech subject to telephone channel degradations.

  7. 手卫生持续改进方案提高护工手卫生依从性的研究分析%Analysis of Hand Hygiene Continuous Improvement Program in Improving Nurse Hand Hygiene Compliance

    古晓莉; 黄开霞


    目的 探讨手卫生持续改进方案提高护工手卫生依从性的效果.方法 手卫生持续改进方案实施前护工37例为对照组,手卫生持续改进方案实施后护工37例为观察组,采用现场观察和问卷调查的方式记录护工手卫生依从性.结果 观察组快速手消毒剂、洗手液使用率、相关知识考核优秀率、六步洗手法演示正确率均高于对照组(P<0.05).结论 手卫生持续改进方案可提高护工手卫生依从性.%Objective To investigate effect of hand hygiene continuous improvement program in improving nurse hand hygiene compliance.Methods 37 nurse without hand hygiene continuous improvement program as control group. 37 nurse with hand hygiene continuous improvement program as observation group. Nurse hand hygiene compliance recorded by field observation and questionnaire survey.Results Fast hand disinfectant and hand washing liquid using rate,related knowledge assessment excelence rate,six step washing technique demonstration correct rate in observation group were significantly higher than control group(P<0.05).Conclusion Hand hygiene continuous improvement program can significantly improve nurse hand hygiene compliance.

  8. Continuous Monitoring and Intrafraction Target Position Correction During Treatment Improves Target Coverage for Patients Undergoing SBRT Prostate Therapy

    Lovelock, D. Michael, E-mail: [Memorial Sloan Kettering Cancer Center, New York, New York (United States); Messineo, Alessandra P. [Memorial Sloan Kettering Cancer Center, New York, New York (United States); Cox, Brett W. [North Shore-Long Island Jewish Health System, New Hyde Park, New York (United States); Kollmeier, Marisa A.; Zelefsky, Michael J. [Memorial Sloan Kettering Cancer Center, New York, New York (United States)


    Purpose: To compare the potential benefits of continuous monitoring of prostate position and intervention (CMI) using 2-mm displacement thresholds during stereotactic body radiation therapy (SBRT) treatment to those of a conventional image-guided procedure involving single localization prior to treatment. Methods and Materials: Eighty-nine patients accrued to a prostate SBRT dose escalation protocol were implanted with radiofrequency transponder beacons. The planning target volume (PTV) margin was 5 mm in all directions, except for 3 mm in the posterior direction. The prostate was kept within 2 mm of its planned position by the therapists halting dose delivery and, if necessary, correcting the couch position. We computed the number, type, and time required for interventions and where the prostate would have been during dose delivery had there been, instead, a single image-guided setup procedure prior to each treatment. Distributions of prostate displacements were computed as a function of time. Results: After the initial setup, 1.7 interventions per fraction were required, with a concomitant increase in time for dose delivery of approximately 65 seconds. Small systematic drifts in prostate position in the posterior and inferior directions were observed in the study patients. Without CMI, intrafractional motion would have resulted in approximately 10% of patients having a delivered dose that did not meet our clinical coverage requirement, that is, a PTV D95 of >90%. The posterior PTV margin required for 95% of the dose to be delivered with the target positioned within the PTV was computed as a function of time. The margin necessary was found to increase by 2 mm every 5 minutes, starting from the time of the imaging procedure. Conclusions: CMI using a tight 2-mm displacement threshold was not only feasible but was found to deliver superior PTV coverage compared with the conventional image-guided procedure in the SBRT setting.

  9. The Impact of Coteaching on Regular Education Eighth Grade Student Achievement on a Basic Skills Algebra Assessment

    Rigdon, Misty B.


    Coteaching strategies have been implemented in many of the inclusion math classrooms in an attempt to improve the achievement of students. Math achievement continues to be a concern as reported by the National Mathematics Advisory Council in 2007. Educators and previous research reported that coteaching does not improve student achievement. The…

  10. Indicators of the management for the continuous improvement of the radiological safety in a radioactive facility; Indicadores de gestion para la mejora continua de la seguridad radiologica en una instalacion radiactiva

    Amador B, Z. H. [Centro de Isotopos, Ave. Monumental y Carretera La Rada, Km 3, Guanabacoa, Apartado 3415, Ciudad de La Habana (Cuba)]. e-mail:


    The use of safety indicators is common in the nuclear industry. In this work the implementation of indicators for the efficiency analysis of the radiological safety management system of a radioactive installation is presented. Through the same ones the occupational exposure, the training Y authorization of the personnel, the control of practices Y radioactive inventory, the results of the radiological surveillance, the occurrence of radiological events, the aptitude of the monitoring equipment, the management of the radioactive waste, the public exposure, the audits Y the costs of safety are evaluated. Its study is included in the periodic training of the workers. Without this interrelation it is not possible to maintain the optimization of the safety neither to achieve a continuous improvement. (Author)

  11. Application of PDCA Cycle in Hospital Prescription Continuous Quality Improvement%PDCA循环在医院处方持续质量改进中的应用

    郑造乾; 黄萍; 袁雍; 杨秀丽; 辛传伟


    nonstandard prescriptions dropped by 32.98%, from 0.23% to 0.16%(P<0.01), the proportion of unsuitable drug use prescriptions dropped by 31.75%, from 0.17% to 0.12%(P<0.01), the proportion of paranormal prescriptions dropped by 17.42%, from 0.04% to 0.03%(P<0.05).②Clinical Pharmacists group: The proportion of irrational prescriptions dropped by 36.38%, from 4.96% to 3.16%(P<0.01).Among them, the proportion of nonstandard prescriptions dropped by 38.23%%, from 2.63% to 1.61%(P<0.01), the proportion of unsuitable drug use prescriptions dropped by 37.66%, from 1.94% to 1.19%(P<0.01), the proportion of paranormal prescriptions dropped by 23.40%, from 2.63% to 1.61%(P<0.01). The number and proportion of incomplete clinical diagnosises, prescriptions with discordant units and dosage decreased significantly (P<0.01). The use of traditional Chinese medicine injection and antibacterial drugs tended to be rational. The expected objective of continuous improvement of the quality of the prescriptions is achieved. CONCLUSION The application of PDCA cycle obviously improved the hospital prescription quality. It can be widely used in hospital prescription quality management.

  12. Comprehensive automation and monitoring of MV grids as the key element of improvement of energy supply reliability and continuity

    Stanisław Kubacki


    Full Text Available The paper presents the issue of comprehensive automation and monitoring of medium voltage (MV grids as a key element of the Smart Grid concept. The existing condition of MV grid control and monitoring is discussed, and the concept of a solution which will provide the possibility of remote automatic grid reconfiguration and ensure full grid observability from the dispatching system level is introduced. Automation of MV grid switching is discussed in detail to isolate a faulty line section and supply electricity at the time of the failure to the largest possible number of recipients. An example of such automation controls’ operation is also presented. The paper’s second part presents the key role of the quick fault location function and the possibility of the MV grid’s remote reconfiguration for improving power supply reliability (SAIDI and SAIFI indices. It is also shown how an increase in the number of points fitted with faulted circuit indicators with the option of remote control of switches from the dispatch system in MV grids may affect reduction of SAIDI and SAIFI indices across ENERGA-OPERATOR SA divisions.

  13. Inhibition of tumor necrosis factor improves sleep continuity in patients with treatment resistant depression and high inflammation.

    Weinberger, Jeremy F; Raison, Charles L; Rye, David B; Montague, Amy R; Woolwine, Bobbi J; Felger, Jennifer C; Haroon, Ebrahim; Miller, Andrew H


    Blockade of the inflammatory cytokine tumor necrosis factor (TNF) in depressed patients with increased inflammation has been associated with decreased depressive symptoms. Nevertheless, the impact of TNF blockade on sleep in depressed patients has not been examined. Accordingly, sleep parameters were measured using polysomnography in 36 patients with treatment resistant major depression at baseline and 2weeks after 3 infusions (week 8) of either the TNF antagonist infliximab (n=19) or placebo (n=17). Markers of inflammation including c-reactive protein (CRP) and TNF and its soluble receptors were also assessed along with depression measured by the 17-item Hamilton Depression Rating Scale. No differences in sleep parameters were found as a function of infliximab treatment over time. Nevertheless, wake after sleep onset (WASO), the spontaneous arousal index and sleep period time significantly decreased, and sleep efficiency significantly increased, from baseline to week 8 in infliximab-treated patients with high (CRP>5mg/L) (n=9) versus low inflammation (CRP⩽5mg/L) (n=10), controlling for changes in scores of depression. Stage 2 sleep also significantly decreased in infliximab-treated patients with high versus low inflammation. Decreases in soluble TNF receptor 1 (sTNFR1) significantly correlated with decreases in WASO and increases in sleep efficiency in infliximab-treated subjects with high inflammation. Placebo-treated subjects exhibited no sleep changes as a function of inflammation, and no correlations between inflammatory markers and sleep parameters in placebo-treated patients were found. These data suggest that inhibition of inflammation may be a viable strategy to improve sleep alterations in patients with depression and other disorders associated with increased inflammation.

  14. Continuous mutual improvement of macromolecular structure models in the PDB and of X-ray crystallographic software: the dual role of deposited experimental data

    Terwilliger, Thomas C., E-mail: [Los Alamos National Laboratory, Mail Stop M888, Los Alamos, NM 87507 (United States); Bricogne, Gerard, E-mail: [Global Phasing Ltd, Sheraton House, Castle Park, Cambridge CB3 0AX (United Kingdom); Los Alamos National Laboratory, Mail Stop M888, Los Alamos, NM 87507 (United States)


    Macromolecular structures deposited in the PDB can and should be continually reinterpreted and improved on the basis of their accompanying experimental X-ray data, exploiting the steady progress in methods and software that the deposition of such data into the PDB on a massive scale has made possible. Accurate crystal structures of macromolecules are of high importance in the biological and biomedical fields. Models of crystal structures in the Protein Data Bank (PDB) are in general of very high quality as deposited. However, methods for obtaining the best model of a macromolecular structure from a given set of experimental X-ray data continue to progress at a rapid pace, making it possible to improve most PDB entries after their deposition by re-analyzing the original deposited data with more recent software. This possibility represents a very significant departure from the situation that prevailed when the PDB was created, when it was envisioned as a cumulative repository of static contents. A radical paradigm shift for the PDB is therefore proposed, away from the static archive model towards a much more dynamic body of continuously improving results in symbiosis with continuously improving methods and software. These simultaneous improvements in methods and final results are made possible by the current deposition of processed crystallographic data (structure-factor amplitudes) and will be supported further by the deposition of raw data (diffraction images). It is argued that it is both desirable and feasible to carry out small-scale and large-scale efforts to make this paradigm shift a reality. Small-scale efforts would focus on optimizing structures that are of interest to specific investigators. Large-scale efforts would undertake a systematic re-optimization of all of the structures in the PDB, or alternatively the redetermination of groups of structures that are either related to or focused on specific questions. All of the resulting structures should be

  15. Manage costs and revenues by achieving continuous measurement certainty with the Auto-Adjust Turbo Meter; Gerez les couts et les recettes en acquerant une certitude continuelle de mesure grace au Auto-Adjust Turbo Meter

    Anderson, D. [Invensys Energy Metering, Pennsylvania (United States)


    Uncertainty in flow measurement and its consequent ramifications are accepted as normal costs of transporting and distributing natural gas. However, a notable advancement in turbine meter technology, pioneered by Invensys Energy Metering, uses two rotors in a tandem configuration to offer unique capabilities beyond those of the tried-and-proven, single-rotor turbine. A flow meter, which monitors its own performance and adjusts its measurement, on a real-time basis, for any deviations from its initial calibration, could largely eliminate many of the costs and lost revenue associated with flow metering and measurement uncertainty. The dual-rotor turbine, trade named the Auto-Adjust Turbo Meter (AAT), is such a flow meter; it provides Continuous Measurement Certainty, with the accompanying potential for enhanced management of costs and revenues. Proprietary algorithms in the AAT's secondary electronics correlate the velocities of the main rotor and the downstream sensing rotor, over the full range of the meter's rated capacity and pressure, such that a real-time adjustment to the indicated volume corrects it to the actual volume. Improved gas accountability results, and substantial savings related to meter site visits, meter testing and repair, preventive maintenance programs, and measurement disputes can be realized. Test data and case histories from a broad range of end users are related to demonstrate areas of potential savings and revenue recovery. (author)

  16. Key Factors for a High-Quality Peritoneal Dialysis Program — The Role of the PD Team and Continuous Quality Improvement

    Fang, Wei; Ni, Zhaohui; Qian, Jiaqi


    The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. PMID:24962961

  17. Key factors for a high-quality peritoneal dialysis program--the role of the PD team and continuous quality improvement.

    Fang, Wei; Ni, Zhaohui; Qian, Jiaqi


    The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program.

  18. Public Open Space Development for Elderly People by Using the DANP-V Model to Establish Continuous Improvement Strategies towards a Sustainable and Healthy Aging Society

    Bo-Wei Zhu


    Full Text Available With the global trend of population aging, how to integrate the health needs of elderly people into public open space (POS development while taking into account public interest is a major challenge in the 21st century. Although the issues of elderly people’s health and their POS needs are receiving increasing attention, research on continuous improvement strategies for POS for healthy aging societies is still limited. Hence, this study explored continuous improvement strategies thoroughly and systematically by using the DANP-V model. The findings revealed cognitive differences between expert and elderly groups. Moreover, water features, waste management, and co-maintenance spaces were the three criteria with the largest gap value. POS improvement has previously been implemented based on a priority order ranked from the criterion with largest gap value to the criterion with the smallest one. However, an alternative approach based on the cause–effect relationship is proposed in this paper. The study findings have both theoretical and practical implications for POS planners and designers.

  19. 'There's only one enabler; come up, help us': staff perspectives of barriers and enablers to continuous quality improvement in Aboriginal primary health-care settings in South Australia.

    Newham, Jo; Schierhout, Gill; Bailie, Ross; Ward, Paul R


    This paper presents the findings from a qualitative study, which sought to investigate the barriers and enablers to implementation of a continuous quality improvement (CQI) program by health-care professionals in Aboriginal primary health-care services in South Australia. Eighteen semi-structured interviews across 11 participating services were conducted alongside CQI implementation activities. Multiple barriers exist, from staff perspectives, which can be categorised according to different levels of the primary health-care system. At the macro level, barriers related to resource constraints (workforce issues) and access to project support (CQI coordinator). At the meso level, barriers related to senior level management and leadership for quality improvement and the level of organisational readiness. At the micro level, knowledge and attitudes of staff (such as resistance to change; lack of awareness of CQI) and lack of team tenure were cited as the main barriers to implementation. Staff identified that successful and sustained implementation of CQI requires both organisational systems and individual behaviour change. Improvements through continuing regional level collaborations and using a systems approach to develop an integrated regional level CQI framework, which includes building organisational and clinic team CQI capacity at the health centre level, are recommended. Ideally, this should be supported at the broader national level with dedicated funding.

  20. The Effect of Formative Program Evaluation on Continuous Program Improvement: A Case Study of a Clinical Training Program in Lao PDR.

    Yoon, Hyun Bae; Shin, Jwa-Seop; Lee, Seung-Hee; Kim, Do-Hwan; Hwang, Jinyoung; Kim, Eun Jung; Bouphavanh, Ketsomsouk


    This study aimed to evaluate the effect of the formative program evaluation on the continuous improvement of a clinical training program for Lao health professionals. The training program was conducted 4 times consecutively for total 48 health professionals, and the formative program evaluation was carried out during the whole process. To evaluate the satisfaction and the transfer of the trainees, the questionnaire survey, the focus group interview, and the trainees' medical records were used. After the end of each batch of the program, the evaluation data were analyzed, and its results were shared with the training management committee and the trainers, who, based on the results, reached a consensus on how to improve the program. The evaluation results and the comparison of them among the four batches of the program showed that there was a continuous increase of the satisfaction and the transfer of the trainees, especially in the early period of the program. The formative program evaluation which was conducted during the whole process of the clinical training program had a positive effect on the improvement of the program, especially in the early phase, by increasing the satisfaction and transfer of the trainees.

  1. Continuous improvement concepts as a link between quality assurance and implementation of cleaner production: Case study in the generic pharmaceutical industry

    Boltić Zorana


    Full Text Available The subject and the research objective presented in this article is establishing of the relationship between quality assurance and implementation of cleaner production in the generic pharmaceutical industry through the comprehensive concept of continuous improvement. This is mostly related to application of Lean and Six Sigma tools and techniques for process improvement and their link to other known concepts used in the industrial environment, especially manufacturing of generic pharmaceutical products from which two representative case studies were selected for comparative analysis, also considering relevant regulatory requirements in the field of quality management, as well as appropriate quality standards. Although the methodology discussed in this conceptual and practice oriented article is strongly related to chemical engineering, the focus is mainly on process industry, i.e. production systems, rather than any specific technological process itself. The scope of this research is an engineering approach to evaluation of the production systems in terms of continuous improvement concepts application, considering both quality aspects and efficiency of such systems. [Projekat Ministarstva nauke Republike Srbije, br. TR 34009

  2. The effects of continuous quality improvement on renal biopsy nursing%持续质量改进在肾活检护理中的应用



    Objective To investigate the effects of continuous quality improvement (CQI)on renal biopsy nursing. Methods Eighty - five patients were divided into control group(45 patients) and observed group(40 patients). Control group patients were given ordinary nursing, observed group were given CQI mode nursing. Nursing problems were evaluated in the process of renal biopsy, and the reasons of these problems were analysed, improvement target was enacted. Steps were taken according to the target. Specific measures were laid out, the effect was appraised. Result The nursing effect of the control group is much better than the observed group. Conclusions Continuous quality improvement application on renal biopsy nursing reduced complications, ensured the patients' safety, improved nursing service quality, and reflected people- first service philosophy.%目的 探讨肾活检护理中持续质量改进(CQI)的应用效果.方法 将85例患者分为对照组45例和观察组40例,对照组按常规护理,观察组采用CQI模式进行护理,评估肾活检过程中存在的护理问题并进行分析,制定改进目标,并根据目标采取措施.制定具体实施步骤,并评价措施产生的效果.结果 观察组的护理效果显著优于对照组.结论肾活检护理中采用持续质量改进,减少了肾活检术后并发症,保证患者安全,提高了护理服务质量,体现了以人为本的护理理念.

  3. Melhoria contínua e aprendizagem organizacional: múltiplos casos em empresas do setor automobilístico Continuous improvement and organizational learning: multiple cases in automotive industry companies

    Rodrigo Valio Dominguez Gonzalez


    Full Text Available A acirrada competição, ressaltada pela disputa globalizada, exige que as organizações estabeleçam inovações cada vez mais frequentes e rápidas a fim de atender às mudanças tecnológicas, econômicas e políticas que a sociedade atravessa. Neste contexto, a melhoria contínua dos produtos e processos produtivos é necessária para manter a empresa competitiva, entretanto, muitas destas iniciativas fracassam dentro das organizações. Com o objetivo de analisar como os mecanismos de aprendizagem sustentam as atividades de melhoria, é realizada uma pesquisa de campo, baseada no estudo de caso em três empresas do setor automobilístico. O artigo conclui que, além de implantar programas e ferramentas para resolução de problemas, as organizações precisam desenvolver ambientes que estimulem a aprendizagem e a cooperação entre seus indivíduos, trabalhando no desenvolvimento dos recursos humanos para que as iniciativas de melhoria sejam, de fato, contínuas.Fierce competition, highlighted by global competition has increasingly required organizations to adopt frequent and quick innovations to meet the current technological, economic, and political changes in society. Accordingly , the continuous improvement of products and production processes is necessary to keep the company competitive. However, many of these initiatives fail in organizations. In order to analyze how the mechanisms of learning support improvement activities, a field research based on case study of three companies in the automotive sector was carried out. The article concludes that in addition to programs and tools for solving problems, organizations need to develop environments that encourage learning and cooperation among its individuals working in human resources development to achieve continuous improvement.

  4. Elimination of acetate production to improve ethanol yield during continuous synthesis gas fermentation by engineered biocatalyst Clostridium sp. MTEtOH550.

    Berzin, Vel; Kiriukhin, Michael; Tyurin, Michael


    Acetogen strain Clostridum sp. MT653 produced acetate 273 mM (p Clostridum sp. MT653 was metabolically engineered to the biocatalyst strain Clostridium sp. MTEtOH550. The biocatalyst increased ethanol yield to 590 mM with no acetate production during single-stage continuous syngas fermentation due to expression of synthetic adh cloned in a multi-copy number expression vector. The acetate production was eliminated by inactivation of the pta gene in Clostridium sp. MTEtOH550. Gene introduction and gene elimination were achieved only using Syngas Biofuels Energy, Inc. electroporation generator. The electrotransformation efficiencies were 8.0 ± 0.2 × 10(6) per microgram of transforming DNA of the expression vector at cell viability ~15%. The frequency of suicidal vector integration to inactivate pta was ~10(-5) per the number of recipient cells. This is the first report on elimination of acetate production and overexpression of synthetic adh gene to engineer acetogen biocatalyst for selective biofuel ethanol production during continuous syngas fermentation.

  5. Diretrizes para desenvolvimento coletivo de melhoria contínua em arranjos produtivos locais Guidelines for collective development of continuous improvement in local productive arrangements

    Ariana Martins Vieira


    Full Text Available Em um cenário dinâmico e competitivo como o atual, a melhoria contínua passou a ser um requisito básico da gestão que visa potencializar o desempenho de empresas e dos possíveis Arranjos Produtivos Locais em que estejam inseridas, sobretudo no caso daquelas de menor porte. O objetivo deste trabalho é apresentar diretrizes para desenvolvimento coletivo de melhoria contínua em Micro, Pequenas e Médias Empresas industriais que atuem neste tipo de arranjo. A proposta foi desenvolvida a partir do referencial teórico e validada por um estudo de caso. As diretrizes estão estruturadas em seis etapas principais: Preparação, Diagnóstico do Arranjo, Diagnóstico das empresas, Implantação, Auditoria e Avaliação.In the current dynamic and competitive environment, continuous improvement has become a basic management requirement aiming to increase performance of firms and local productive arrangements. The objective of this study is to present guidelines for collective development of continuous improvement in Micro, Small, and Medium Enterprises that operate in this type of arrangement. The proposal was formulated based on the theoretical concept and validated by a case study. The guidelines are composed of six main stages: Preparation, Array Diagnosis, Company Diagnostics, Implementation, Audit, and Evaluation.

  6. Sustaining motivation for continuous improvement

    Jørgensen, Frances; Kofoed, Lise Busk


    activities is an important issue for managers. The paper begins with a short description of CI, with an emphasis on barriers to successful implementation cited in the literature. Thereafter, a number of widely-acknowledged-albeit perhaps somewhat dated-theories of motivation are explored in relation...... to the elements of CI in practice. Based on their own experiences with CI implementation in numerous action-research based studies, the authors propose a scenario for motivating CI participation through emphasis on factors common to the presented motivational theories. The paper ends with insights into future...... for managers to motivate participation in CI. Further the paper contributes to development of CI theory by suggesting how elements of motivation theory may address the most common types of barriers to successful CI....

  7. Developing a Continuous Improvement System


    classroom training, distance learning, computer-based training, on-the-job-training, job shadowing, seminars, and developmental assignments. Although...excuses. There was no substance, little buy-in, and filling out an IDP was really just extra work. The managers at CAAA use the IDP system within the...Army’s Career Acquisition Personnel and Position Management In- formation System. This system allows the employee to plan, coordinate, and manage their

  8. Continuous Process Improvement Transformation Guidebook


    except full-scale im- plementation. Error Proofing ( Poka Yoke ) Finding and correcting defects caused by errors costs more and more as a system or...proofing. Shigeo Shingo introduced the concept of Poka - Yoke at Toyota Motor Corporation. Poka Yoke (pronounced “poh-kah yoh-kay”) translates to “avoid

  9. Control-value theory: using achievement emotions to improve understanding of motivation, learning, and performance in medical education: AMEE Guide No. 64.

    Artino, Anthony R; Holmboe, Eric S; Durning, Steven J


    In this AMEE Guide, we consider the emergent theoretical and empirical work on human emotion and how this work can inform the theory, research, and practice of medical education. In the Guide, we define emotion, in general, and achievement emotions, more specifically. We describe one of the leading contemporary theories of achievement emotions, control-value theory (Pekrun 2006), and we distinguish between different types of achievement emotions, their proximal antecedents, and their consequences for motivation, learning, and performance. Next, we review the empirical support for control-value theory from non-medical fields and suggest several important implications for educational practice. In this section, we highlight the importance of designing learning environments that foster a high degree of control and value for students. Finally, we end with a discussion of the need for more research on achievement emotions in medical education, and we propose several key research questions we believe will facilitate our understanding of achievement emotions and their impact on important educational outcomes.

  10. Nurse-led intensive interventions improve adherence to continuous positive airway pressure therapy and quality of life in obstructive sleep apnea patients

    Chen XF


    Full Text Available Xiaofen Chen,1 Weiting Chen,1 Weijie Hu,2 Kui Huang,3 Jing Huang,4 Yu Zhou5 1Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 2People Hospital of Tiantai, Taizhou, 3Department of Orthodontics, Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 4The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 5Department of Orthodontics, Hospital of Stomatology, Wenzhou Medical University, Wenzhou, People’s Republic of China Background: Continuous positive airway pressure (CPAP is widely recommended for the treatment of sleep apnea/hypopnea syndrome (SAHS, but its usage by patients is very low. The aim of this study was to assess intensive educational programs and nursing support for the improvement of CPAP use and outcomes in SAHS patients.Methods: Eighty new SAHS patients were randomized to receive nurse-led intensive interventions or usual support at hospital and home. The main outcome measure was CPAP use; changes in sleeping, symptoms, mood, and quality of life were also assessed after 12 months of treatment.Results: All outcome measures were improved after treatment in both groups. However, patients receiving intensive support with significantly higher CPAP use (higher daily CPAP usage by 2.2 hours/day had greater improvements in SAHS symptoms and mood (P<0.05. The intervention group further showed an improvement in the Short Form-36 domains of mental and physical health (P<0.05.Conclusion: The CPAP usage and quality of life can be significantly improved by nurse-led intensive program in obstructive sleep apnea patients. Keywords: CPAP, quality of life, SAHS, compliance

  11. Cinacalcet HCl and Concurrent Low-dose Vitamin D Improves Treatment of Secondary Hyperparathyroidism in Dialysis Patients Compared with Vitamin D Alone: The ACHIEVE Study Results

    Fishbane, Steven; Shapiro, Warren B.; Corry, Dalila B.; Vicks, Steven L.; Roppolo, Michael; Rappaport, Kenneth; Ling, Xiang; Goodman, William G.; Turner, Stewart; Charytan, Chaim


    Background and objectives: Patients with chronic kidney disease (CKD) receiving dialysis often develop secondary hyperparathyroidism with disturbed calcium and phosphorus metabolism. The National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (KDOQI) was established to guide treatment practices for these disorders. The ACHIEVE study was designed to test two treatment strategies for achieving KDOQI goals. Design, setting, participants, measurements: Individuals on hemodialysis treated with vitamin D sterols were enrolled in this 33-week study. Subjects were randomly assigned to treatment with either cinacalcet and low-dose vitamin D (Cinacalcet-D) or flexible vitamin D alone (Flex-D) to achieve KDOQI-recommended bone mineral targets. ACHIEVE included a 6-week screening phase, including vitamin D washout, a 16-week dose-titration phase, and an 11-week assessment phase. Results: Of 173 subjects enrolled, 83% of Cinacalcet-D and 67% of Flex-D subjects completed the study. A greater proportion of Cinacalcet-D versus Flex-D subjects had a ≥30% reduction in parathyroid hormone (PTH) (68% versus 36%, P < 0.001) as well as PTH ≤300 pg/ml (44% versus 23%, P = 0.006). The proportion of subjects simultaneously achieving targets for intact PTH (150–300 pg/ml) and calcium-phosphorus product (Ca×P) (<55 mg2/dl2) was also greater (21% versus 14%), but this was not statistically significant. This was attributable to 19% of Cinacalcet-D subjects with a PTH value below the KDOQI target range. Conclusions: Achievement of KDOQI targets was difficult, especially with Flex-D. Maintaining calcium and phosphorus target values precluded the use of vitamin D doses necessary to lower PTH to within the narrow target range and highlighted limitations inherent to the KDOQI treatment algorithm. PMID:18945995

  12. Method for reducing excess heat supply experienced in typical Chinese district heating systems by achieving hydraulic balance and improving indoor air temperature control at the building level

    Zhang, Lipeng; Gudmundsson, Oddgeir; Thorsen, Jan Eric;


    that once the hydraulic balance is achieved and indoor temperatures are controlled with this integrated approach, 17% heat savings and 42.8% pump electricity savings can be achieved. The energy savings will also have a positive environmental effect with seasonal reductions of 11 kg CO2, 0.1 kg SO2, and 0...... with the actual heat demand. This results in 15-30% of the total supplied heat being lost. This paper proposes an integrated approach that aims to reduce the excess heat loss by introducing pre-set thermostatic radiator valves combined with automatic balancing valves. Those devices establish hydraulic balance...

  13. Improvement on the productivity of continuous tequila fermentation by Saccharomyces cerevisiae of Agave tequilana juice with supplementation of yeast extract and aeration.

    Hernández-Cortés, Guillermo; Valle-Rodríguez, Juan Octavio; Herrera-López, Enrique J; Díaz-Montaño, Dulce María; González-García, Yolanda; Escalona-Buendía, Héctor B; Córdova, Jesús


    Agave (Agave tequilana Weber var. azul) fermentations are traditionally carried out employing batch systems in the process of tequila manufacturing; nevertheless, continuous cultures could be an attractive technological alternative to increase productivity and efficiency of sugar to ethanol conversion. However, agave juice (used as a culture medium) has nutritional deficiencies that limit the implementation of yeast continuous fermentations, resulting in high residual sugars and low fermentative rates. In this work, fermentations of agave juice using Saccharomyces cerevisiae were put into operation to prove the necessity of supplementing yeast extract, in order to alleviate nutritional deficiencies of agave juice. Furthermore, continuous fermentations were performed at two different aeration flow rates, and feeding sterilized and non-sterilized media. The obtained fermented musts were subsequently distilled to obtain tequila and the preference level was compared against two commercial tequilas, according to a sensorial analysis. The supplementation of agave juice with air and yeast extract augmented the fermentative capacity of S. cerevisiae S1 and the ethanol productivities, compared to those continuous fermentations non supplemented. In fact, aeration improved ethanol production from 37 to 40 g L(-1), reducing sugars consumption from 73 to 88 g L(-1) and ethanol productivity from 3.0 to 3.2 g (Lh)(-1), for non-aerated and aerated (at 0.02 vvm) cultures, respectively. Supplementation of yeast extract allowed an increase in specific growth rate and dilution rates (0.12 h(-1), compared to 0.08 h(-1) of non-supplemented cultures), ethanol production (47 g L(-1)), reducing sugars consumption (93 g L(-1)) and ethanol productivity [5.6 g (Lh)(-1)] were reached. Additionally, the effect of feeding sterilized or non-sterilized medium to the continuous cultures was compared, finding no significant differences between both types of cultures. The overall effect

  14. An Augmented Reality-Based Mobile Learning System to Improve Students' Learning Achievements and Motivations in Natural Science Inquiry Activities

    Chiang, Tosti H. C.; Yang, Stephen J. H.; Hwang, Gwo-Jen


    In this study, an augmented reality-based mobile learning system is proposed for conducting inquiry-based learning activities. An experiment has been conducted to examine the effectiveness of the proposed approach in terms of learning achievements and motivations. The subjects were 57 fourth graders from two classes taught by the same teacher in…

  15. A Class Size Reduction (CSR) Implementation Plan Based on an Evaluative Study of CSRs for the Improvement of Third Grade Reading Achievement

    Vandyke, Barbara Adrienne


    For too long, educators have been left to their own devices when implementing educational policies, initiatives, strategies, and interventions, and they have longed to see the full benefits of these programs, especially in reading achievement. However, instead of determining whether a policy/initiative is working, educators have been asked to…

  16. Preliminary Discussion on Improving Tensile Strength of Polyester Bulked Continuous Filament%提高涤纶膨体变形长丝断裂强度初探



    Polyester (PET) bulked continuous filament (BCF) is made on the imported special spinning machine with conventional PET chips.The PET BCF with tensile strength higher than 2.5 cN/dtex is obtained by selecting suitable PET chips,optimum pre-crystallization and drying process,proper spinning temperature,improving drawing unit and process.%采用常规聚酯(PET)切片为原料,在进口专用纺丝机上生产PET膨体变形长丝(BCF).选择合适的聚酯切片,优选预结晶和干燥工艺,合理设计纺丝温度,改进牵伸装置,优化牵伸工艺,生产出断裂强度大于2.5 cN/dtex的PET BCF.

  17. 持续质量改进在医疗质量管理中的应用%The Application of Continuous Quality Improvement in Medial Quality Management

    陈莉萍; 陈明秀; 刘纯莉


    医院持续质量改进(Continuous quality improvement,CQI)的方法是:运用全面质量管理(Total quality management,TQM)的原理,建立全员参与的三级质量控制网络,不断修订完善质量标准和考评体系,狠抓质量教育,改进质量控制的手段和方法等.经过4年的实践,取得高医疗质量、高病人满意率和高经济效益的良好成果.文章对实践过程做了论述.

  18. The impact of the `Getting Practical: Improving Practical Work in Science' continuing professional development programme on teachers' ideas and practice in science practical work

    Abrahams, Ian; Reiss, Michael J.; Sharpe, Rachael


    Background:Despite the widespread use of practical work in school it has been recognised that more needs to be done to improve its effectiveness in developing conceptual understanding. The 'Getting Practical' CPD (Continuing Professional Development) programme was designed to contribute towards an improvement in the effectiveness of practical work through initiating changes in teachers' predominantly 'hands-on' approach to practical work to one which manifests a more equitable balance between 'hands-on' and 'minds-on'. Purpose:To evaluate the impact of the Getting Practical: Improving Practical Work in Science CPD programme on teachers' ideas and practice in science practical work in primary and secondary schools in England. Programme description:The CPD programme was designed to improve the effectiveness of science practical work in developing conceptual understanding in primary and secondary schools in England. Sample:Ten teachers of primary science and 20 secondary science teachers. Design and methods:The study employed a condensed fieldwork strategy with data collected using interviews, observational field notes and pre- and post-CPD training observations in practical lessons within 30 schools. Results:Whilst the CPD programme was effective in getting teachers to reflect on the ideas associated with the Getting Practical programme, it was much less effective in bringing about changes in actual teaching practice. Conclusion:The findings suggest that if change, rather than only an enhanced awareness of the issues, is to be brought about in established teaching practice then there is a need for ongoing support over an extended period of time. Furthermore, the impact of such CPD is more likely to be effective if it is undertaken by a senior member of a department or school with the full support of the SMT.

  19. Closing the Achievement Gap by Improving Reading Instruction. Hearing before the Committee on Education and the Workforce. House of Representatives, One Hundred Seventh Congress, First Session (Orlando, Florida, November 13, 2001).

    Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

    A field hearing of the United States House of Representatives' Committee on Education and the Workforce, entitled "Closing the Achievement Gap by Improving Reading Instruction," was held at Lancaster Elementary School in Orlando, Florida, on November 13, 2001. The hearing begins with welcoming statements by the committee chairman and one…

  20. Kazakhstan can achieve ambitious HIV targets despite expected donor withdrawal by combining improved ART procurement mechanisms with allocative and implementation efficiencies

    Benedikt, Clemens; Bokazhanova, Aliya; Đurić, Predrag; Petrenko, Irina; Ganina, Lolita; Kelly, Sherrie L.; Stuart, Robyn M.; Kerr, Cliff C.; Vinichenko, Tatiana; Zhang, Shufang; Hamelmann, Christoph; Manova, Manoela; Masaki, Emiko; Wilson, David P.; Gray, Richard T.


    Background Despite a non-decreasing HIV epidemic, international donors are soon expected to withdraw funding from Kazakhstan. Here we analyze how allocative, implementation, and technical efficiencies could strengthen the national HIV response under assumptions of future budget levels. Methodology We used the Optima model to project future scenarios of the HIV epidemic in Kazakhstan that varied in future antiretroviral treatment unit costs and management expenditure—two areas identified for potential cost-reductions. We determined optimal allocations across HIV programs to satisfy either national targets or ambitious targets. For each scenario, we considered two cases of future HIV financing: the 2014 national budget maintained into the future and the 2014 budget without current international investment. Findings Kazakhstan can achieve its national HIV targets with the current budget by (1) optimally re-allocating resources across programs and (2) either securing a 35% [30%–39%] reduction in antiretroviral treatment drug costs or reducing management costs by 44% [36%–58%] of 2014 levels. Alternatively, a combination of antiretroviral treatment and management cost-reductions could be sufficient. Furthermore, Kazakhstan can achieve ambitious targets of halving new infections and AIDS-related deaths by 2020 compared to 2014 levels by attaining a 67% reduction in antiretroviral treatment costs, a 19% [14%–27%] reduction in management costs, and allocating resources optimally. Significance With Kazakhstan facing impending donor withdrawal, it is important for the HIV response to achieve more with available resources. This analysis can help to guide HIV response planners in directing available funding to achieve the greatest yield from investments. The key changes recommended were considered realistic by Kazakhstan country representatives. PMID:28207809

  1. Might real-time pharmacokinetic/pharmacodynamic optimisation of high-dose continuous-infusion meropenem improve clinical cure in infections caused by KPC-producing Klebsiella pneumoniae?

    Pea, Federico; Della Siega, Paola; Cojutti, Piergiorgio; Sartor, Assunta; Crapis, Massimo; Scarparo, Claudio; Bassetti, Matteo


    The effect of real-time pharmacokinetic/pharmacodynamic (PK/PD) optimisation of high-dose continuous-infusion meropenem on the clinical outcome of patients receiving combination antimicrobial therapy for treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp) infections was retrospectively assessed. Data for all patients with KPC-Kp-related infections who received antimicrobial combination therapy containing high-dose continuous-infusion meropenem optimised by means of therapeutic drug monitoring (TDM) were retrieved. Optimal PK/PD exposure was considered a steady-state concentration to minimum inhibitory concentration ratio (Css/MIC) of 1-4. Univariate binary logistic regression analysis was performed to identify independent predictors of clinical outcome. Among the 30 eligible patients, 53.3% had infections caused by meropenem-resistant KPC-Kp (MIC ≥ 16 mg/L). Tigecycline and colistin were the two antimicrobials most frequently combined with meropenem. Mean doses of continuous-infusion meropenem ranged from 1.7 to 13.2 g/daily. The Css/MIC ratio was ≥1 in 73.3% of cases and ≥4 in 50.0%. Clinical outcome was successful in 73.3% of cases after a median treatment length of 14.0 days. In univariate analysis, a significant correlation with successful clinical outcome was found for a Css/MIC ratio ≥1 (OR = 10.556, 95% CI 1.612-69.122; P = 0.014), a Css/MIC ratio ≥4 (OR = 12.250, 95% CI 1.268-118.361; P = 0.030) and a Charlson co-morbidity index of ≥4 (OR = 0.158, 95% CI 0.025-0.999; P = 0.05). High-dose continuous-infusion meropenem optimised by means of real-time TDM may represent a valuable tool in improving clinical outcome when dealing with the treatment of infections caused by KPC-Kp with a meropenem MIC ≤ 64 mg/L.

  2. Reflections on Continuous Improvement of the Quality of Medical Care%医疗质量持续改进的思索


    To build a quality comprehensive medical care center, improve the quality of medical care and ensure patients’safety is the core and permanent topic for hospital management. The qual-ity of medical care is the lifeblood of a hospital’s survive and de-velopment, so the hospital should implement the core system of medical care and continuously improve the quality of medical care.%  建设“服务好、质量好、医德好、群众满意”的大型综合医疗中心,提高医疗质量、保证患者安全是医院管理的核心内容和永恒的主题。医疗质量是医院生存与发展的命脉,落实医疗核心制度,持续改进医疗质量,不断提高诊疗水平,减少差错事故,保障患者安全。

  3. Improved efficiency thanks to modulated power - Exergy analyses show the way; Une meilleure efficacite grace au reglage continu de la puissance. Des analyses exergetiques montrent le chemin

    Wellstein, J.


    This article summarizes the results of two research projects conducted at the University of Applied Sciences in Lucerne, Switzerland and supported by the Swiss Federal Office of Energy. Following the rapid development of the heat pump market for space heating in the past decades in Switzerland, the improvement of the heat pump coefficient of performance COP becomes a highly relevant issue. The problem is especially acute for air/water heat pumps, due to the fact that the COP significantly decreases when the outdoor air temperature decreases. However, laboratory measurements show that the COP could be much higher at intermediate heat load if less irreversibility in the thermodynamic cycle would occur. The Lucerne researchers have identified the exergy loss origins. Continuous heat power modulation instead of ON/OFF control of the heat pump compressor is one way for COP improvement. Another need for optimization was found in the construction of the finned lamellar heat exchanger used as evaporator. This can significantly reduce fin icing and, consequently, the power consumption during deicing.

  4. Increasing the satisfaction of general practitioners with continuing medical education programs: A method for quality improvement through increasing teacher-learner interaction

    Fogelman Yacov


    Full Text Available Abstract Background Continuing medical education (CME for general practitioners relies on specialist-based teaching methods in many settings. Formal lectures by specialists may not meet the learning needs of practitioners and may cause dissatisfaction with traditional CME. Increasing learner involvement in teaching programs may improve learner satisfaction. Methods A quality improvement program for CME for 18 general practitioners in the Tel Aviv region was designed as a result of dissatisfaction with traditional CME activities. A two-step strategy for change was developed. The CME participants first selected the study topics relevant to them from a needs assessment and prepared background material on the topics. In the second step, specialist teachers were invited to answer questions arising from the preparation of selected topics. Satisfaction with the traditional lecture program and the new participatory program were assessed by a questionnaire. The quality criteria included the relevance, importance and applicability of the CME topic chosen to the participant's practice, the clarity of the presentation and the effective use of teaching aids by the lecturer and the potential of the lecturer to serve as a consultant to the participant. Results The participatory model of CME significantly increased satisfaction with relevance, applicability and interest in CME topics compared to the traditional lecture format. Conclusions Increased learner participation in the selection and preparation of CME topics, and increased interaction between CME teachers and learners results in increased satisfaction with teaching programs. Future study of the effect of this model on physician performance is required.

  5. Healthy Eating and Academic Achievement


    This podcast highlights the evidence that supports the link between healthy eating and improved academic achievement. It also identifies a few actions to support a healthy school nutrition environment to improve academic achievement.  Created: 12/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/9/2014.

  6. Physical Activity and Academic Achievement


    This podcast highlights the evidence that supports the link between physical activity and improved academic achievement. It also identifies a few actions to support a comprehensive school physical activity program to improve academic achievement.  Created: 12/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/9/2014.

  7. Continuous auditing & continuous monitoring : Continuous value?

    van Hillo, Rutger; Weigand, Hans; Espana, S; Ralyte, J; Souveyet, C


    Advancements in information technology, new laws and regulations and rapidly changing business conditions have led to a need for more timely and ongoing assurance with effectively working controls. Continuous Auditing (CA) and Continuous Monitoring (CM) technologies have made this possible by obtain

  8. Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system

    Yano Elizabeth M


    Full Text Available Abstract Background Implementing quality improvement programs that require behavior change on the part of health care professionals and patients has proven difficult in routine care. Significant randomized trial evidence supports creating fall prevention programs for community-dwelling older adults, but adoption in routine care has been limited. Nationally-collected data indicated that our local facility could improve its performance on fall prevention in community-dwelling older people. We sought to develop a sustainable local fall prevention program, using theory to guide program development. Methods We planned program development to include important stakeholders within our organization. The theory-derived plan consisted of 1 an initial leadership meeting to agree on whether creating a fall prevention program was a priority for the organization, 2 focus groups with patients and health care professionals to develop ideas for the program, 3 monthly workgroup meetings with representatives from key departments to develop a blueprint for the program, 4 a second leadership meeting to confirm that the blueprint developed by the workgroup was satisfactory, and also to solicit feedback on ideas for program refinement. Results The leadership and workgroup meetings occurred as planned and led to the development of a functional program. The focus groups did not occur as planned, mainly due to the complexity of obtaining research approval for focus groups. The fall prevention program uses an existing telephonic nurse advice line to 1 place outgoing calls to patients at high fall risk, 2 assess these patients' risk factors for falls, and 3 triage these patients to the appropriate services. The workgroup continues to meet monthly to monitor the progress of the program and improve it. Conclusion A theory-driven program development process has resulted in the successful initial implementation of a fall prevention program.

  9. Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

    McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R


    To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management

  10. Hypnotherapy and Test Anxiety: Two Cognitive-Behavioral Constructs. The Effects of Hypnosis in Reducing Test Anxiety and Improving Academic Achievement in College Students.

    Sapp, Marty

    A two-group randomized multivariate analysis of covariance (MANCOVA) was used to investigate the effects of cognitive-behavioral hypnosis in reducing test anxiety and improving academic performance in comparison to a Hawthorne control group. Subjects were enrolled in a rigorous introductory psychology course which covered an entire text in one…

  11. What Works Clearinghouse Quick Review of the Report "Exercise Improves Executive Function and Achievement and Alters Brain Activation in Overweight Children: A Randomized, Controlled Trial"

    What Works Clearinghouse, 2012


    The study examined whether exercise offered to sedentary, overweight children ages 7 to 11 improved executive function--defined as strategy execution when presented with a novel task--and academic performance in reading and math. The study authors analyzed data on about 170 students from Georgia who were recruited in five cohorts from 2003 to…

  12. Title III Accountability and District Improvement Efforts: A Closer Look. ESEA Evaluation Brief: The English Language Acquisition, Language Enhancement, and Academic Achievement Act

    Tanenbaum, Courtney; Anderson, Lindsay


    "Title III Accountability and District Improvement Efforts: A Closer Look" (2010) summarizes findings from interviews with six Title III Directors and nine Title III district-level directors in the spring of 2009. States and districts were selected in order to collect information from some entities with a long history of serving English…

  13. The Rice coding algorithm achieves high-performance lossless and progressive image compression based on the improving of integer lifting scheme Rice coding algorithm

    Jun, Xie Cheng; Su, Yan; Wei, Zhang


    In this paper, a modified algorithm was introduced to improve Rice coding algorithm and researches of image compression with the CDF (2,2) wavelet lifting scheme was made. Our experiments show that the property of the lossless image compression is much better than Huffman, Zip, lossless JPEG, RAR, and a little better than (or equal to) the famous SPIHT. The lossless compression rate is improved about 60.4%, 45%, 26.2%, 16.7%, 0.4% on average. The speed of the encoder is faster about 11.8 times than the SPIHT's and its efficiency in time can be improved by 162%. The speed of the decoder is faster about 12.3 times than that of the SPIHT's and its efficiency in time can be rasied about 148%. This algorithm, instead of largest levels wavelet transform, has high coding efficiency when the wavelet transform levels is larger than 3. For the source model of distributions similar to the Laplacian, it can improve the efficiency of coding and realize the progressive transmit coding and decoding.

  14. 努力实现培训教育内涵的再提升%Striving to Achieve Inner Improvement of Educational Training

    李恒强; 刘泰; 邓昊; 刘昉


    If we want to improve the connotation of educational training in the trade union , we must do the following aspects .We should focus on service for the trade union in our city with three kinds of character . We should focus on adapt to the reality actively .We should make the training comprehensive , persistent , and innovative .Our improvement should keep the same speed with the development of the trade union .%追求工会教育培训内涵的再提升,就是要做到:着力为本市工会工作的“三大特色”服务;在紧密联系实际上认真下功夫;注重实现培训的全面性、全程性与全新性;与工会事业发展保持同节奏。

  15. Greater years of maternal schooling and higher scores on academic achievement tests are independently associated with improved management of child diarrhea by rural Guatemalan mothers.

    Webb, Aimee L; Ramakrishnan, Usha; Stein, Aryeh D; Sellen, Daniel W; Merchant, Moeza; Martorell, Reynaldo


    Appropriate home management can alleviate many of the consequences of diarrhea including malnutrition, impaired development, growth faltering, and mortality. Maternal cognitive ability, years of schooling, and acquired academic skills are hypothesized to improve child health by improving maternal child care practices, such as illness management. Using information collected longitudinally in 1996-1999 from 466 rural Guatemalan women with children Raven's Progressive Matrices and an illness management index (IMI). Women scoring in the lowest and middle tertiles of academic skills scored lower on the IMI compared to women in the highest tertile (-0.24 [95% CI: -0.54, 0.07]; -0.30 [95% CI: -0.54, -0.06], respectively) independent of sociodemographic factors, schooling, and Raven's scores. Among mothers with less than 1 year of schooling, scoring in the lowest tertile on the Raven's Progressive Matrices compared to the highest was significantly associated with scoring one point lower on the IMI (-1.18 [95% CI: -2.20, -0.17]). Greater academic skills were independently associated with maternal care during episodes of infant diarrhea. Schooling of young girls and/or community based programs that provide women with academic skills such as literacy, numeracy and knowledge could potentially improve mothers' care giving practices.

  16. Improvement of anaerobic digestion performance by continuous nitrogen removal with a membrane contactor treating a substrate rich in ammonia and sulfide.

    Lauterböck, B; Nikolausz, M; Lv, Z; Baumgartner, M; Liebhard, G; Fuchs, W


    The effect of reduced ammonia levels on anaerobic digestion was investigated. Two reactors were fed with slaughterhouse waste, one with a hollow fiber membrane contractor for ammonia removal and one without. Different organic loading rates (OLR) and free ammonia and sulfide concentrations were investigated. In the reactor with the membrane contactor, the NH4-N concentration was reduced threefold. At a moderate OLR (3.1 kg chemical oxygen demand - COD/m(3)/d), this reactor performed significantly better than the reference reactor. At high OLR (4.2 kg COD/m(3)/d), the reference reactor almost stopped producing methane (0.01 Nl/gCOD). The membrane reactor also showed a stable process with a methane yield of 0.23 Nl/g COD was achieved. Both reactors had predominantly a hydrogenotrophic microbial consortium, however in the membrane reactor the genus Methanosaeta (acetoclastic) was also detected. In general, all relevant parameters and the methanogenic consortium indicated improved anaerobic digestion of the reactor with the membrane.

  17. Sodium‐glucose cotransporter 2 inhibitor luseogliflozin improves glycaemic control, assessed by continuous glucose monitoring, even on a low‐carbohydrate diet

    Nishimura, R.; Omiya, H.; Sugio, K.; Ubukata, M.; Sakai, S.


    This randomized, double‐blind, placebo‐controlled, crossover study was the first to determine the effects of luseogliflozin in combination with a low‐carbohydrate diet (LCD) on 24‐h glucose variability, assessed by continuous glucose monitoring (CGM). A total of 18 Japanese patients with type 2 diabetes were randomized into two groups, in which patients first received luseogliflozin 2.5 mg once daily then placebo for 8 days each, or vice versa. Patients took luseogliflozin or placebo with a normal‐carbohydrate diet (NCD) on day 7 and with the LCD on day 8. CGM was performed on both days. Luseogliflozin significantly reduced glucose exposure in terms of the area under the curve over the course of 24 h when administered with the NCD (difference vs placebo: −555.6 mg/dl·h [1 mg/dl = 0.0556 mmol/l]; p diet. Although glucose levels were lower with the LCD than with the NCD in the placebo treatment period, luseogliflozin with the LCD improved glycaemic control throughout the day to nearly the same extent as luseogliflozin with the NCD, without inducing hypoglycaemia. PMID:26639943

  18. Continuous Electrical Current and Zinc Sulphate Administered by Transdermal Iontophoresis Improves Skin Healing in Diabetic Rats Induced by Alloxan: Morphological and Ultrastructural Analysis

    Lucas Langoni Cassettari


    Full Text Available Purpose. Evaluated the effects of continuous electrical current (CEC or zinc administrated by transdermal iontophoresis (Zn+TDI. Methods. 120 male Wistar rats were submitted to an incision surgery at the anterior region of abdomen and distributed into 6 experimental groups with 40 animals: 3 diabetic groups and 3 normal groups, untreated and treated with CEC alone or with Zn + TDI. Each group was further divided into 4 subgroups with 10 rats each to be evaluated on the 4th, 7th, 14th, and 21st day after surgery. In each period, clinical and laboratory parameters from the animals were analyzed. Results. The analysis by optical and scanning electron microscopy showed a delay in the phases of wound healing in diabetic rats without treatment in all periods of the experiment; breaking strength (BS was significantly reduced in skin scars of untreated diabetic rats when compared to other groups. In contrast, BS in skin scars of nondiabetic groups and diabetic rats treated with Zn + TDI showed significant increase in those, besides not presenting delayed healing. Conclusion. Electrical stimulation of surgical wounds used alone or in association with zinc by TDI is able to consistently improve the morphological and ultrastructural changes observed in the healing of diabetic animals.

  19. Deferasirox for up to 3 years leads to continued improvement of myocardial T2* in patients with β-thalassemia major

    Pennell, Dudley J.; Porter, John B.; Cappellini, Maria Domenica; Chan, Lee Lee; El-Beshlawy, Amal; Aydinok, Yesim; Ibrahim, Hishamshah; Li, Chi-Kong; Viprakasit, Vip; Elalfy, Mohsen S.; Kattamis, Antonis; Smith, Gillian; Habr, Dany; Domokos, Gabor; Roubert, Bernard; Taher, Ali


    Background Prospective data on cardiac iron removal are limited beyond one year and longer-term studies are, therefore, important. Design and Methods Seventy-one patients in the EPIC cardiac substudy elected to continue into the 3rd year, allowing cardiac iron removal to be analyzed over three years. Results Mean deferasirox dose during year 3 was 33.6±9.8 mg/kg per day. Myocardial T2*, assessed by cardiovascular magnetic resonance, significantly increased from 12.0 ms ±39.1% at baseline to 17.1 ms ±62.0% at end of study (P5 to <10 ms improved to 10 to <20 ms. There was no significant variation in left ventricular ejection fraction over the three years. No deaths occurred and the most common investigator-assessed drug-related adverse event in year 3 was increased serum creatinine (n=9, 12.7%). Conclusions Three years of deferasirox treatment along with a clinically manageable safety profile significantly reduced cardiac iron overload versus baseline and normalized T2* in 68.1% (32 of 47) of patients with T2* 10 to <20 ms. PMID:22271905

  20. Improvement Measures of Continuous Pickling Quality of Stainless Steel Strip%不锈带钢连续酸洗质量的改进措施

    李缠民; 陈昌龙; 武文斌


    不锈钢冷带在冷轧加工过程中要经过坯料酸洗和多次中间退火后酸洗。酸洗的质量直接决定着冷带产品的表面质量。通过对连续酸洗过程中的酸液配方、酸液温度、带钢运行速度及酸洗设备等方面进行优化、改进,解决了不锈带钢酸洗过程中存在的质量问题,为冷轧生产的正常进行提供了基础条件。%Stainless steel cold strip will go through the blank pickling and repeatedly pickling after intermediate annealing in the cold rolling process. Pickling quality directly determines the surface quality of cold strip products. Through the optimization, improvement of acidizing fluid formula, acid temperature, strip operating speed and pickling equipment during the continuous pickling process, the quality problems existed in the pickling process of stainless steel strip were solved so as to provide fundamental condition for normal operation of cold rolling.

  1. High-Intensity Interval Training and Isocaloric Moderate-Intensity Continuous Training Result in Similar Improvements in Body Composition and Fitness in Obese Individuals.

    Martins, Catia; Kazakova, Irina; Ludviksen, Marit; Mehus, Ingar; Wisloff, Ulrik; Kulseng, Bard; Morgan, Linda; King, Neil


    This study aimed to determine the effects of 12 weeks of isocaloric programs of high-intensity intermittent training (HIIT) or moderate-intensity continuous training (MICT) or a short-duration HIIT (1/2HIIT) inducing only half the energy deficit on a cycle ergometer, on body weight and composition, cardiovascular fitness, resting metabolism rate (RMR), respiratory exchange ratio (RER), nonexercise physical activity (PA) levels and fasting and postprandial insulin response in sedentary obese individuals. Forty-six sedentary obese individuals (30 women), with a mean BMI of 33.3 ± 2.9 kg/m2 and a mean age of 34.4 ± 8.8 years were randomly assigned to one of the three training groups: HIIT (n = 16), MICT (n = 14) or 1/2HIIT (n = 16) and exercise was performed 3 times/week for 12 weeks. Overall, there was a significant reduction in body weight, waist (p training protocols of HIIT or MICT (or 1/2HIIT inducing only half the energy deficit) exert similar metabolic and cardiovascular improvements in sedentary obese individuals.

  2. Enzymatic biodiesel production kinetics using co-solvent and an anhydrous medium: a strategy to improve lipase performance in a semi-continuous reactor.

    Azócar, Laura; Navia, Rodrigo; Beroiz, Leticia; Jeison, David; Ciudad, Gustavo


    Enzymatic biodiesel production kinetics under previously optimized conditions were investigated. Waste frying oil (WFO) was used as the raw material, Novozym 435 as catalyst, methanol as acyl acceptor and tert-butanol as co-solvent. To investigate pure transesterification kinetics improving product properties, 3Å molecular sieves were incorporated into the reaction to provide an anhydrous medium avoiding the side reactions of hydrolysis and esterification. The effects of either WFO or methanol on the reaction rate were analyzed separately. The reaction was described by a Ping Pong mechanism and competitive inhibition by methanol. The results obtained in the kinetics study were applied in the operation of a semi-continuous reactor for biodiesel production. The operational conditions of each reaction cycle were: methanol-to-oil ratio 8/1 (mol/mol), 15% (wt) Novozym 435, 0.75% (v/v) of tert-butanol, 44.5°C, 200 rpm and 4h of reaction time. The enzymes were successively reused by remaining in the reactor during all the cycles. Under these conditions, biodiesel production yields higher than 80% over 7 reaction cycles were observed. Both the kinetics study and the reactor operation showed that Novozym 435 was not inhibited at high methanol concentrations and that the kinetics of the proposed enzymatic process could be comparable to the conventional chemical process.

  3. 2011 and 2012 Early Careers Achievement Awards: improving the production, environmental, and economic efficiency of the stocker cattle industry in the southeastern United States.

    Beck, P A; Anders, M; Watkins, B; Gunter, S A; Hubbell, D; Gadberry, M S


    Grazing forages on small-grain fields can be a profitable "second crop" for grain producers and an opportunity for cow-calf producers to retain ownership of weaned calves. The increasing costs of conventional tillage and movement of soil nutrients into surface water creates a need for more sustainable production practices to be incorporated by producers into wheat pasture production systems. Research at the Livestock and Forestry Research Station near Batesville, AR, and the Southwest Research and Extension Center near Hope, AR, has been conducted over a 9-yr span to characterize the impacts of pasture systems on forage production, animal performance, soil quality, water runoff, and the economics associated with the stocker cattle enterprises. Gains of growing cattle grazing nontoxic endophyte-infected tall fescue and small-grain forages can be increased by 80 and 150%, respectively, compared with grazing Bermuda grass or toxic endophyte-infected tall fescue. Producers grazing spring-calving cowherds can use these improved forages to accelerate stocker performance when retaining calves in the fall and improve net returns by 99% with winter annual or nontoxic tall fescue production systems compared with Bermuda grass or toxic tall fescue. Rainfall simulation of small grain pastures indicates that runoff volume and nutrient load does not differ between conventionally tilled fields and no-till fields in the spring before tillage when soil surface cover is similar. In the fall after tillage, however, conventionally tilled fields had 4 times greater runoff; hence, there was 1.9 times greater N runoff and 3.2 times greater P runoff in conventionally tilled fields compared with no-till. Total natural rainfall runoff from conventionally tilled wheat fields were 2 times greater than from no-till fields with 25 mm rainfall events yet were 4 times greater with 62-mm rainfall events. Soil analysis shows that soil aggregate content was greater in no-till compared with

  4. Improved water resistance of SrAl2O4: Eu2+, Dy3+ phosphor directly achieved in a water-containing medium

    Qi, Tonggang; Xia, Haofu; Zhang, Zhanhui; Kong, Shijin; Peng, Weikang; Zhao, Qi; Huang, Zhiliang


    In this paper, a heterogeneous precipitation method utilizing urea hydrolysis was adopted to coat a SiO2 layer on the surface of SrAl2O4:Eu2+, Dy3+ long persistence phosphors. To avoid phosphor hydrolysis in a water-containing coating medium, the hydrolysis and polymerization reactions of tetraethyl orthosilicate (TEOS) were concerned and carried out. The crystal phases, surface morphologies, hydrolysis stability and water resistance on afterglow properties of coated phosphors were investigated. Scanning electron microscopy, energy dispersive spectrum analysis, transmission electron microscope and Fourier transform infrared spectrum results confirmed that a continuous, uniform and compact SiO2 coating layer was successfully obtained on the phosphors surface. A theoretical coating amount of 5% or higher was found to be good for hydrolysis stability. Photoluminescence results revealed the coated phosphors showed much better water resistance on afterglow properties than the uncoated phosphor. We also discussed and proposed the hydrolysis restriction mechanism of SrAl2O4:Eu2+, Dy3+ in the water-containing coating medium.

  5. Receta para el Exito. Una Guia Actualizada para Padres sobre el Mejoramiento de las Escuelas de Colorado y Logros Estudiantiles (Recipe for Success: An Updated Parents' Guide to Improving Colorado Schools and Student Achievement).

    Taher, Bonnie; Durr, Pamela

    This Spanish language guide describes ways that parents can help improve student achievement and school quality. It answers such questions as: how to choose the right early-education opportunity for a preschooler; how to make sure a 5-year-old is ready for school; how to help a daughter do well in school; how to work with a daughter's or son's…

  6. improvement of the programs of formation of Asco in the period 2010-2015. achievements and actions in March; Mejora de los programas de Formacion de Asco en el periodo 2010-2015. Logros conseguidos y acciones en marcha

    Diaz Heredia, R.


    The improvement plan is one of the plans of action included in the Strategic Plan of ANAV and is focused on achieving and consolidating the commitment of managers with the training, being them the training program for their unit owners. also the gradual implementation of the methodology Systematic Approach to Training and consolidate the structure of committees of training as a tool of management of training programmes. (Author)

  7. Prescribing Data in General Practice Demonstration (PDGPD project - a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension

    Williamson Margaret


    Full Text Available Abstract Background Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1 hypertension (HT and 2 chronic heart failure (CHF. The objectives of this study were to improve general practitioner’s drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention. Methods A pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI intervention on prescribing practice among Australian general practitioners (GP in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion with each group undertaking the clinical topics (CHF and HT in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a “control” for the other two groups. De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs. Discussion This paper describes the study protocol for a

  8. Nanoscale Polysulfides Reactors Achieved by Chemical Au-S Interaction: Improving the Performance of Li-S Batteries on the Electrode Level.

    Fan, Chao-Ying; Xiao, Pin; Li, Huan-Huan; Wang, Hai-Feng; Zhang, Lin-Lin; Sun, Hai-Zhu; Wu, Xing-Long; Xie, Hai-Ming; Zhang, Jing-Ping


    In this work, the chemical interaction of cathode and lithium polysulfides (LiPSs), which is a more targeted approach for completely preventing the shuttle of LiPSs in lithium-sulfur (Li-S) batteries, has been established on the electrode level. Through simply posttreating the ordinary sulfur cathode in atmospheric environment just for several minutes, the Au nanoparticles (Au NPs) were well-decorated on/in the surface and pores of the electrode composed of commercial acetylene black (CB) and sulfur powder. The Au NPs can covalently stabilize the sulfur/LiPSs, which is advantageous for restricting the shuttle effect. Moreover, the LiPSs reservoirs of Au NPs with high conductivity can significantly control the deposition of the trapped LiPSs, contributing to the uniform distribution of sulfur species upon charging/discharging. The slight modification of the cathode with <3 wt % Au NPs has favorably prospered the cycle capacity and stability of Li-S batteries. Moreover, this cathode exhibited an excellent anti-self-discharge ability. The slight decoration for the ordinary electrode, which can be easily accessed in the industrial process, provides a facile strategy for improving the performance of commercial carbon-based Li-S batteries toward practical application.

  9. Improving antibiotic prescribing for adults with community acquired pneumonia: Does a computerised decision support system achieve more than academic detailing alone? – a time series analysis

    Black James F


    Full Text Available Abstract Background The ideal method to encourage uptake of clinical guidelines in hospitals is not known. Several strategies have been suggested. This study evaluates the impact of academic detailing and a computerised decision support system (CDSS on clinicians' prescribing behaviour for patients with community acquired pneumonia (CAP. Methods The management of all patients presenting to the emergency department over three successive time periods was evaluated; the baseline, academic detailing and CDSS periods. The rate of empiric antibiotic prescribing that was concordant with recommendations was studied over time comparing pre and post periods and using an interrupted time series analysis. Results The odds ratio for concordant therapy in the academic detailing period, after adjustment for age, illness severity and suspicion of aspiration, compared with the baseline period was OR = 2.79 [1.88, 4.14], p Conclusion Deployment of a computerised decision support system was associated with an early improvement in antibiotic prescribing practices which was greater than the changes seen with academic detailing. The sustainability of this intervention requires further evaluation.

  10. Moving Toward Universal Health Coverage (UHC to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience; Comment on “Improving the World’s Health Through the Post-2015 Development Agenda: Perspectives from Rwanda”

    Ye Xu


    Full Text Available Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1 Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2 Improved quality of delivered care ensures supply-side readiness and effective coverage; (3 Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies.

  11. Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience Comment on "Improving the World's Health Through the Post-2015 Development Agenda: Perspectives from Rwanda".

    Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán


    Binagwaho and colleagues' perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries' health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies.

  12. Achieving English Spoken Fluency



    Language is first and foremost oral,spoken language,speaking skill is the most important one of the four skills(L,S,R,W)and also it is the most difficult one of the four skills. To have an all-round command of a language one must be able to speak and to understand the spoken language, it is not enough for a language learner only to have a good reading and writing skills. As Englisn language teachers, we need to focus on improving learners' English speaking skill to meet the need of our society and our country and provide learner some useful techniques to achieving their English spoken fluency. This paper focuses on the spoken how to improving learners speaking skill.

  13. Continuous venovenous haemodialysis

    Bistrup, C; Pedersen, R S; Jensen, Dorte Møller


    . Standard solutions for peritoneal dialysis are administered in a single-pass manner countercurrent to the blood flow. To control the dialysate flow through the filter, two separate pumps designed for intravenous infusion are used. Anticoagulation is achieved by means of continuous heparin infusion...

  14. Improving reading achievements of struggling learners

    Houtveen, Thoni; van de Grift, Wim


    In The Netherlands, the percentage of struggling readers in the 1st year of formal reading instruction is about 25%. This problem inspired us to develop the Reading Acceleration Programme. To evaluate the effectiveness of this programme, a quasi-experiment is carried out. The teachers in the experim

  15. Achieving High Performance Perovskite Solar Cells

    Yang, Yang


    Recently, metal halide perovskite based solar cell with the characteristics of rather low raw materials cost, great potential for simple process and scalable production, and extreme high power conversion efficiency (PCE), have been highlighted as one of the most competitive technologies for next generation thin film photovoltaic (PV). In UCLA, we have realized an efficient pathway to achieve high performance pervoskite solar cells, where the findings are beneficial to this unique materials/devices system. Our recent progress lies in perovskite film formation, defect passivation, transport materials design, interface engineering with respect to high performance solar cell, as well as the exploration of its applications beyond photovoltaics. These achievements include: 1) development of vapor assisted solution process (VASP) and moisture assisted solution process, which produces perovskite film with improved conformity, high crystallinity, reduced recombination rate, and the resulting high performance; 2) examination of the defects property of perovskite materials, and demonstration of a self-induced passivation approach to reduce carrier recombination; 3) interface engineering based on design of the carrier transport materials and the electrodes, in combination with high quality perovskite film, which delivers 15 ~ 20% PCEs; 4) a novel integration of bulk heterojunction to perovskite solar cell to achieve better light harvest; 5) fabrication of inverted solar cell device with high efficiency and flexibility and 6) exploration the application of perovskite materials to photodetector. Further development in film, device architecture, and interfaces will lead to continuous improved perovskite solar cells and other organic-inorganic hybrid optoelectronics.

  16. Achieving form in autobiography

    Nicholas (Nick Meihuizen


    Full Text Available This article argues that, unlike biographies which tend to follow patterns based on conventional expectations, salient autobiographies achieve forms unique to themselves. The article draws on ideas from contemporary formalists such as Peter McDonald and Angela Leighton but also considers ideas on significant form stemming from earlier writers and critics such as P.N. Furbank and Willa Cather. In extracting from these writers the elements of what they consider comprise achieved form, the article does not seek to provide a rigid means of objectively testing the formal attributes of a piece of writing. It rather offers qualitative reminders of the need to be alert to the importance of form, even if the precise nature of this importance is not possible to define. Form is involved in meaning, and this continuously opens up possibilities regarding the reader’s relationship with the work in question. French genetic critic Debray Genette distinguishes between ‘semantic effect’ (the direct telling involved in writing and ‘semiological effect’ (the indirect signification involved. It is the latter, the article argues in summation, which gives a work its singular nature, producing a form that is not predictable but suggestive, imaginative.

  17. Continuity theory

    Nel, Louis


    This book presents a detailed, self-contained theory of continuous mappings. It is mainly addressed to students who have already studied these mappings in the setting of metric spaces, as well as multidimensional differential calculus. The needed background facts about sets, metric spaces and linear algebra are developed in detail, so as to provide a seamless transition between students' previous studies and new material. In view of its many novel features, this book will be of interest also to mature readers who have studied continuous mappings from the subject's classical texts and wish to become acquainted with a new approach. The theory of continuous mappings serves as infrastructure for more specialized mathematical theories like differential equations, integral equations, operator theory, dynamical systems, global analysis, topological groups, topological rings and many more. In light of the centrality of the topic, a book of this kind fits a variety of applications, especially those that contribute to ...

  18. Improvement in the bioreactor specific productivity by coupling continuous reactor with repeated fed-batch reactor for acetone-butanol-ethanol production.

    Setlhaku, Mpho; Brunberg, Sina; Villa, Eva Del Amor; Wichmann, Rolf


    In comparison to the different fermentation modes for the production of acetone, butanol and ethanol (ABE) researched to date, the continuous fermentation is the most economically favored. Continuous fermentation with two or more reactor cascade is reported to be the most efficient as it results in a more stable solvent production process. In this work, it is shown that a continuous (first-stage) reactor coupled to a repeated fed-batch (second stage) is superior to batch and fed-batch fermentations, including two-stage continuous fermentation. This is due to the efficient catalyst use, reported through the specific product rate and rapid glucose consumption rate. High solvents are produced at 19.4 g(ABE) l⁻¹, with volumetric productivities of 0.92 g(butanol) l⁻¹ h⁻¹ and 1.47 g(ABE) l ⁻¹ h⁻¹. The bioreactor specific productivities of 0.62 and 0.39 g g⁻¹(cdw) h⁻¹ obtained show a high catalyst activity. This new process mode has not been reported before in the development of ABE fermentation and it shows great potential and superiority to the existing fermentation methods.

  19. Analysis of the United States Marine Corps Continuous Process Improvement Program Applied to the Contracting Process at Marine Corps Regional Contracting Office - Southwest


    errors • Motion study and material handling • Systems for workplace organization (5S approach) • Just-in-time principles • Kaizen methods • Continuous...profitability. Quality Progress, May. Imai, M. (1997). Gemba Kaizen : A commonsense, low-cost approach to management. New York: McGraw-Hill. Lean

  20. Achieving dependable software through Continuous Delivery and Quality Monitoring

    CERN. Geneva


    The idea for the presentation is to present our implementation of the CI/CD paradigms and explain on real live examples advantages and drawbacks of the current solution. During the presentation we will try to cover all the required steps which should automatically triggered by a developer’s commit. The presentation should give users a good hands-on experience on basic CI/CD principles and allow them to design and i...

  1. Melhoria contínua no ambiente ISO 9001:2000: estudo de caso em duas empresas do setor automobilístico Continuous improvement in ISO 9001:2000 enviroment: case study in two companies of automotive sector

    Rodrigo Valio Dominguez Gonzalez


    Full Text Available Este artigo avalia como duas empresas certificadas pela norma ISO 9001:2000, fornecedoras do setor automobilístico, realizam atividades de melhoria contínua em seus sistemas produtivos. É evidente que diferentes empresas apresentam diferenças quanto à condução de programas de melhoria contínua, e ainda, a motivação para a certificação neste sistema da qualidade também influi na amplitude e constância da melhoria dos processos. Nesse sentido, o artigo analisa como as organizações pesquisadas desenvolvem e estruturam internamente a melhoria contínua, enfatizando a organização do setor produtivo, o modelo de gestão e os principais programas e ferramentas utilizados.This article evaluate how two companies certified by the norm ISO 9001:2000, supplier of the automotive sector, accomplish continuous improvement activities in its productive processes. It is obvious that the different industrials environments, presented by the companies in particular, shows differences in relation to the conduction of the continuous improvement programs, and also, the stimulus to get the certification in this quality system which also inspires in the amplitude and constancy of the processes improvement. At this way, the article analyses how the researched organizations develop and organize internally the continuous improvement, emphasizing the production organization, improvement management model and programs and techniques used to these activities.

  2. Increased productivity through continuous improvement in quality in the sub data processing unit in a company courier: the case Peru Courier

    Ramos Martel, Walter Antonio; Universidad Inca Garcilaso de la Vega. Lima, Perú.


    The problems in the present investigation were the reprocessing and claims for delay; causing low quality, which could be affecting the productivity. Therefore it was necessary to apply a methodology of process improvement, based on tools and statistical thinking, being the Six Sigma methodology and its phases (Define, measure, analyze, improve and Control) the best adapted to the case study. After applying the first three phases of this methodology and to be a non-experimental research is de...

  3. Continuation calculus

    Bram Geron


    Full Text Available Programs with control are usually modeled using lambda calculus extended with control operators. Instead of modifying lambda calculus, we consider a different model of computation. We introduce continuation calculus, or CC, a deterministic model of computation that is evaluated using only head reduction, and argue that it is suitable for modeling programs with control. It is demonstrated how to define programs, specify them, and prove them correct. This is shown in detail by presenting in CC a list multiplication program that prematurely returns when it encounters a zero. The correctness proof includes termination of the program. In continuation calculus we can model both call-by-name and call-by-value. In addition, call-by-name functions can be applied to call-by-value results, and conversely.

  4. A Tentative Study of Improving Teachers' Professional Wellbeing in Continuous Education%提升继续教育教师职业幸福感初探

    白婕; 王永刚


    Starting with the teachers' sense of belonging,sense of honor and occupation burnout in continuing education,the analysis is made on the great enhanced effect of professional well-being to college humanities environment in continuing education.By demonstrating a dominate and influencing role that teachers' occupation happiness plays in the humane environment and continuing education,the paper points out that the teachers' sensation of professional wellbeing acts as a direct and overall guidance to the teachers and students,which can't be ignored as the law of education.Combined with features of continuing education colleges,corresponding measures are proposed in the construction of teachers' professional wellbeing.%从继续教育教师队伍的归属感、荣誉感、职业倦怠入手,分析职业幸福感对继续教育院校人文环境建设的重大促进作用;通过论证教师职业幸福感对学校人文环境和继续教育的支配和影响作用,指出提升职业幸福感对教师、学生以及整个继续教育起到直接、整体的指导作用是不容忽视的教育规律。结合继续教育院校自身的特点,提出建设继续教育教师队伍职业幸福感的相应举措。

  5. [Case of continuous trans-arterial calcium gluconate infusion using a direct arterial sphygmomanometry line that exhibited dramatic improvement of chemical burns on the fingers caused by hydrofluoric acid].

    Miyamoto, Kazuyuki; Shimizu, Makiko; Tanaka, Kotaro; Minemura, Atsuko; Tamatsukuri, Tatsuro; Miyake, Yasufumi; Aruga, Tohru


    Hydrofluoric acid (HFA) is commonly used and many injuries occur on the upper extremities following exposure to HFA. The use of calcium gluconate (CG) -containing gel or local injections of CG are widely used for the initial treatment of HFA exposure. However, severe pain continues in some cases despite the treatment. There was a report that trans-arterial CG infusion could improve HFA burns, however, such treatment is not an established clinical procedure. A 30-year-old male presented at our hospital with severe pain in his left thumb. He had been cleaning tiles with an HFA-containing detergent. We diagnosed him with a chemical burn due to HFA exposure. Local CG injections were tried several times, but his terrible pain continued. Therefore, a direct arterial sphygmomanometry line was inserted from the left radial artery, and continuous transarterial CG injection was performed. His terrible pain dramatically improved. Direct arterial sphygmomanometry systems are widely used in the critical care field to monitor the hemodynamics and ICU staffs are used to dealing with it. Moreover, continuous saline infusion prevents the tube obstruction. Continuous CG infusion from a direct arterial sphygmomanometry line is simple and safe way to administer CG in HFA burns.

  6. Rare Earth Additions in Continuously Cast Steel

    Wilson, William G.; Heaslip, L. J.; Sommerville, I. D.


    Rare earth (lanthanide metals) addiiions to continuously cast steel are particularly advantageous because of their ability to refine as-cast structures, reduce segregation and increase hot ductility at temperatures just below that of solidification. The complete shape control of sulfides in steels containing Rare Earth Metals (REM), whether continuously cast or ingot cast, is primarily responsible for improvements in ductility related mechanical properties, weldability, fatigue resistance and resistance to hydrogen damage. Complete sulfide shape control can be obtained with REM additions at sulfur levels as high as.020%. The greatest improvements, however, are obtained with REM additions to low sulfur steels. However, to achieve full operational advantages afforded by REM, nozzle blockage problems must be circumvented. Water model studies indicate a possible solution.

  7. Continuous earlywood vessels chronologies in floodplain ring-porous species can improve dendrohydrological reconstructions of spring high flows and flood levels

    Kames, S.; Tardif, J. C.; Bergeron, Y.


    Plants respond to environmental stimuli through changes in growth and development. Characteristics of wood cells such as the cross-sectional area of vessel elements (hereafter referred to as vessels) may store information about environmental factors present at the time of vessel differentiation. The analysis of vessel characteristics therefore offers a different time resolution than annual ring width because vessels in tree rings differentiate within days to a few weeks. Little research has been conducted on the sensitivity of earlywood vessels in ring-porous species in response to flooding. The general objectives of this study were to determine the plasticity of earlywood vessel to high flows and spring flooding in floodplain black ash (Fraxinus nigra Marsh.) trees and to assess the utility of developing continuous earlywood vessel chronologies in dendrohydrological reconstruction. In contrast, most dendrohydrological studies until now have mainly used vessel anomalies (flood rings) as discrete variables to identify exceptional flood events. The study area is located in the boreal region of northwestern Québec. Vessel and ring-width chronologies were generated from F. nigra trees growing on the floodplain of Lake Duparquet. Spring discharge had among all hydro-climatic variables the strongest impact on vessel formation and this signal was coherent spatially and in the frequency domain. The mean vessel area chronology was significantly and negatively correlated to discharge and both the linearity and the strength of this association were unique. In floodplain F. nigra trees, spring flooding promoted the formation of more abundant but smaller earlywood vessels. Earlywood vessels chronologies were also significantly associated with other hydrological indicators like Lake Duparquet's ice break-up date and both ice-scar frequency and height chronologies. These significant relationships stress the utility of developing continuous vessels chronologies for hydrological

  8. Integrated automation for continuous high-throughput synthetic chromosome assembly and transformation to identify improved yeast strains for industrial production of biofuels and bio-based chemicals

    An exponential increase in our understanding of genomes, proteomes, and metabolomes provides greater impetus to address critical biotechnological issues such as sustainable production of biofuels and bio-based chemicals and, in particular, the development of improved microbial biocatalysts for use i...

  9. Experiments to Generate New Data about School Choice: Commentary on "Defining Continuous Improvement and Cost Minimization Possibilities through School Choice Experiments" and Merrifield's Reply

    Berg, Nathan; Merrifield, John


    Benefiting from new data provided by experimental economists, behavioral economics is now moving beyond empirical tests of standard behavioral assumptions to the problem of designing improved institutions that are tuned to fit real-world behavior. It is therefore worthwhile to consider the potential for new experiments to advance school choice…

  10. Continuous cultivation of lipid rich microalga Chlorella sp. FC2 IITG for improved biodiesel productivity via control variable optimization and substrate driven pH control.

    Palabhanvi, Basavaraj; Muthuraj, Muthusivaramapandian; Kumar, Vikram; Mukherjee, Mayurketan; Ahlawat, Saumya; Das, Debasish


    A novel two-stage continuous heterotrophic cultivation of Chlorella sp. FC2 IITG was demonstrated for enhanced lipid productivity. Initially, effect of control variable e.g. dilution rate and feed stream substrate concentrations on biomass productivity was evaluated. This showed significant variation in biomass productivity from 2.4gL(-1)day(-1) to 11.2gL(-1)day(-1). Further, these control variables were optimized by using multi-nutrient mechanistic model for maximizing the biomass productivity. Finally, continuous production of lipid rich algal biomass was demonstrated in two sequential bioreactors for enhanced lipid productivity. The biomass productivity of 92.7gL(-1)day(-1) was observed in the first reactor which was operated at model predicted optimal substrate concentrations of feed stream. The intracellular neutral lipid enrichment by acetate addition resulted in lipid productivity of 9.76gL(-1)day(-1) in the second reactor. Both the biomass and lipid productivities obtained from current study are significantly high amongst similarly reported literatures.

  11. An improved billet on billet extrusion process of continuous aluminium alloy shapes for cryogenic applications in the Compact Muon Solenoid experiment

    Tavares, S S


    The Compact Muon Solenoid (CMS) is one of the experiments being designed in the framework of the Large Hadron Collider accelerator at CERN. CMS will contain the largest and the most powerful superconducting solenoid magnet ever built in terms of stored energy. It will work at 4.2 K, will have a magnetic length of 12.5 m, with a free bore of 6m and will be manufactured as a layered and modular structure of NbTi cables embedded in a high purity (99.998%) Al- stabiliser. Each layer consists of a wound continuous length of 2.55 km. In order to withstand the high electromagnetic forces, two external aluminium alloy reinforcing sections are foreseen. These reinforcements, of 24 mm multiplied by 18 mm cross-section, will be continuously electron beam (EB) welded to the pure Al-stabiliser. The alloy EN AW-6082 has been selected for the reinforcements due to its excellent extrudability, high strength in the precipitation hardened state, high toughness and strength at cryogenic temperatures and ready EB weldability. Ea...

  12. Leader as achiever.

    Dienemann, Jacqueline


    This article examines one outcome of leadership: productive achievement. Without achievement one is judged to not truly be a leader. Thus, the ideal leader must be a visionary, a critical thinker, an expert, a communicator, a mentor, and an achiever of organizational goals. This article explores the organizational context that supports achievement, measures of quality nursing care, fiscal accountability, leadership development, rewards and punishments, and the educational content and teaching strategies to prepare graduates to be achievers.

  13. New continuous air pumping technique to improve clinical outcomes of descemet-stripping automated endothelial keratoplasty in asian patients with previous ahmed glaucoma valve implantation.

    Chang-Min Liang

    Full Text Available BACKGROUND: To evaluate the outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK with the use of continuous air pumping technique in Asian eyes with previous Ahmed glaucoma valve implantation. METHODS: The DSAEK procedure was modified in that complete air retention of the anterior chamber was maintained for 10 min using continuous air pumping at 30 mm Hg. The primary outcome measurement was graft survival, and postoperative clinical features including, rate of graft detachment, endothelial cell count, intraocular pressure (IOP, surgical time and cup/disc ratio were also recorded. RESULTS: A total of 13 eyes of 13 patients which underwent modified DSAEK and 6 eyes of 6 patients which underwent conventional DSAEK were included. There was a significant difference in graft survival curves between two groups (P = 0.029; the 1-year graft survival rates were estimated as 100% and 66.7% for patients with modified DSAEK and those with traditional DSAEK, respectively. The rate of graft detachment were 0% and 33.3% for the modified DSAEK and conventional DSAEK groups, respectively (P = 0.088. The significantly lowered surgical time for air tamponade was noted in the modified DSAEK group compared to that in the conventional DSAEK group [median (IQR: 10.0 (10.0, 10.0 min vs. 24.5 (22.0, 27.0 min; P<0.001] Postoperatively, patients in the modified DSAEK group had significantly lower IOP as compared to the conventional DSAEK group [12.0 (11.0, 15.0 mm Hg vs. 16.0 (15.0, 18.0 mm Hg; P = 0.047]. Modified DSAEK patients had higher endothelial cell counts as compared to conventional DSAEK patients [2148.0 (1964.0, 2218.0 vs. 1529.0 (713.0, 2014.0], but the difference did not reach statistical significance (P = 0.072. CONCLUSIONS: New continuous air pumping technique in DSAEK can be performed safely and effectively in patients with prior GDDs placement who have corneal failure.

  14. A strategy for company improvement.

    Howley, L


    Strategies based on the kaizen methodology are designed to continuously improve company performance without the need for large capital investments. This article looks at how one company used simple kaizen principles to its advantage, achieving 67% increase in productivity and 10% reduction in the standard cost of product.

  15. Design and installation of continuous flow and water qualitymonitoring stations to improve water quality forecasting in the lower SanJoaquin River

    Quinn, Nigel W.T.


    This project deliverable describes a number ofstate-of-the-art, telemetered, flow and water quality monitoring stationsthat were designed, instrumented and installed in cooperation with localirrigation water districts to improve water quality simulation models ofthe lower San Joaquin River, California. This work supports amulti-disciplinary, multi-agency research endeavor to develop ascience-based Total Maximum Daily Load for dissolved oxygen in the SanJoaquin River and Stockton Deep Water Ship Channel.

  16. Construct validity in Operations Management by using Rasch Measurement Theory. The case of the construct “motivation to implement continuous improvement"

    Lidia Sanchez-Ruiz


    Full Text Available Construct design and validation is a common practise in the Operations Management field. In this sense, the aim of this study is to present Rasch Measurement Theory (RMT as richful and useful methodology in order to validate constructs. In order to do so, the measurement controversy in the social science is presented; then, RMT is explained as a solution for this measurement issue; after that, the different applications of RMT are described and, finally, the different stages of the validation process are presented. Thus, this work aims to serve as a guide for those researchers interested in the methodology. Therefore, a specific case is included: the validation of the construct “motivation to implement continuous improvement”.

  17. DFI oxyfuel process for saving energy and improving the performance and quality of continuous strip lines; DFI-Oxyfuel-Verfahren zur Energieeinsparung, Leistungs- und Qualitaetssteigerung von Banddurchlaufanlagen

    Eichelkraut, H. [ThyssenKrupp Steel AG, Duisburg (Germany). Standort Bruckhausen; Heiler, H.J. [ThyssenKrupp Steel AG, Finnentrop (Germany); Domels, H.P.; Hoegner, W. [ThyssenKrupp Steel AG, Duisburg (Germany). Energie/Anlagenwirtschaft


    The development of the 'Direct Flame Impingement (DFI)-Oxyfuel' process - in which an oxyfuel (oxygen-fuel) flame impinges directly on the material to be heated - represents a further development of furnace technology for continuous strip lines. With assistance from the cooperation partner Linde, the process was used on a hot-dip galvanizing line for the first time at ThyssenKrupp Steel's Finnentrop plant. Right from the start it produced outstanding results in terms of increased throughput, product quality, plant quality and energy efficiency and thus also a reduction in direct CO{sub 2} emissions. In the meantime, this technology also is being used at an additional strip galvanizing and aluminizing facility in the Duisburg-Bruckhausen plant. (orig.)

  18. 车道线识别中的自适应Canny边缘检测及改进研究%Achievement and Improvement of Adaptive Canny Operator in Lane Identification

    陈阳舟; 闫豪杰; 辛乐


    针对Canny边缘检测阈值在车道线识别中不易选取的问题,提出了基于Otsu算法实现自适应Canny边缘检测的方法.实验验证表明,其对远视野道路图像可以获得良好的边缘检测效果,而对近视野道路图像效果较差.进一步提出了目标区域补偿策略改进上述算法.结合Hough变换算法,实现了车道线的识别.实验结果表明,改进的算法可以达到实时获取车道线的要求.%For the difficulty of selecting the segmentation threshold in the process of Canny operator-based lane I-dentification, a method of adaptive segmentation threshold in virtue of Otsu algorithm is proposed. Experiments to verify the effectiveness of the algorithm show that it can get good binarization results for far field images, but unavailability for close vision images. Therefore, further improvement is made by proposing a target area compensation strategy. Finally, combining with Hough transform, the lane recognition is ultimately achieved. The Experimental results show that the improved algorithm meet real-time performance of lane detection and identification.

  19. Point-of-care continuous 13C-methacetin breath test improves decision making in acute liver disease: Results of a pilot clinical trial

    Gadi Lalazar; Tomer Adar; Yaron Ilan


    AIM: To assess the role of the 13C-methacetin breath test (MBT) in patients with acute liver disease. METHODS: Fifteen patients with severe acute liver disease from diverse etiologies were followed-up with 13C-MBT during the acute phase of their illnesses (range 3-116 d after treatment). Patients fasted for 8 h and ingested 75 mg of methacetin prior to the MBT. We compared results from standard clinical assessment, serum liver enzymes, synthetic function, and breath test scores. RESULTS: Thirteen patients recovered and two patients died. In patients that recovered, MBT parameters improved in parallel with improvements in lab results. Evidence of consistent improvement began on day 3 for MBT parameters and between days 7 and 9 for blood tests. Later convergence to normality occurred at an average of 9 d for MBT parameters and from 13 to 28 d for blood tests. In both patients that died, MBT parameters remained low despite fluctuating laboratory values. CONCLUSION: The 13C-MBT provides a rapid, noninvasive assessment of liver function in acute severe liver disease of diverse etiologies. The results of this pilot clinical trial suggest that the MBT may offer greater sensitivity than standard clinical tests for managing patients with severe acute liver disease.

  20. Continuous degradation of maltose: improvement in stability and catalytic properties of maltase (α-glucosidase) through immobilization using agar-agar gel as a support.

    Nawaz, Muhammad Asif; Karim, Asad; Aman, Afsheen; Marchetti, Roberta; Qader, Shah Ali Ul; Molinaro, Antonio


    Maltose degrading enzyme was immobilized within agar-agar support via entrapment method due to its industrial utilization. The maximum immobilization efficiency (82.77%) was achieved using 4.0% agar-agar keeping the diameter of bead up to 3.0 mm. The matrix entrapment showed maximum catalytic activity at pH 7.0 and temperature 65 °C. Substrate saturation kinetics showed that the K m of immobilized enzyme increased from 1.717 to 2.117 mM ml(-1) where as Vmax decreased from 8,411 to 7,450 U ml(-1 )min(-1) as compared to free enzyme. The immobilization significantly increased the stability of maltase against various temperatures and immobilized maltase retain 100% of its original activity after 2 h at 50 °C, whereas the free maltase only showed 60% residual activity under same condition. The reusability of entrapped maltase showed activity up to 12 cycles and retained 50% of activity even after 5th cycle. Storage stability of agar entrapped maltase retain 73% of its initial activity even after 2 months when stored at 30 °C while free enzyme showed only 37% activity at same storage conditions.

  1. Implemention of Medical Care Quality Score Management to Continuing Improve medical qualitu%实施积分管理提高医疗质量

    邹升帆; 刘华坤; 林新华; 彭广福


    Recently, hospitals across the country have been searching for efficient management methods to improve hospital quality. Performance point management system of hospital quality and medical safety is a A management method that is set Accroding to the essence of several health laws and regulations. By establishing and improving this management method in my hospital, we supervise individual service behavior using Performance point management system. In this way, the service behavior of the medical workers is specified so that the function of medical care quality - benefit management is strengthened.%制定并完善《医疗质量和医疗安全积分管理办法(试行)》,加强对个人医疗服务行为的监管与考核.实行院科两级质量控制,以科室自查、质控办月查、职能部门联合检查等方法促进办法落实,每月将检查结果交质控办汇总,经积分管理考核小组讨论通过后全院通报.实践表明,办法的实施,有效提升了医疗质量持续提高.

  2. 主动承担社会责任持续改进医保管理%Taking on Social Responsibility and Continually Improving Medical Insurance Management

    郭莺; 孔南玲; 高鑫; 王玉琦


    Hospitals, as carrier of the medical insurance policy, should actively take on social responsibility. We transform passive management to initiative management, which ensures the steady running of the medical insurance system, and defends both patients' and hospital staff's benefits. The measures include changing management conception to improve service quality, strengthening cost control and supervision, adjusting operation structure, emphasizing examine of the medical insurance and focu-sing on management improvement.%医院作为贯彻落实医保政策的"载体",必须主动承担社会责任.我院从转变管理理念,提高医疗服务质量;加强费用监控和监督自查工作;调整业务结构,加大医保考核力度等方面入手,从管理上找突破点,变他律为自律,使医院从初期的被动式管理转变为主动管理,保证医保制度的平稳运行,做到既代表患者的利益也代表医院职工的利益.

  3. Application of Bone Trauma Patients Used the Concept of Continuous Quality Improvement in Pain Management%骨创伤患者疼痛管理中持续质量改进理念的运用



    目的:探究在对骨创伤患者进行治疗期间,对疼痛管理进行持续质量改进理念的应用及临床价值。方法回顾分析我院2014年3月~2014年7月收治的110例骨创伤患者的临床资料,针对患者出现疼痛的原因制定有效的疼痛管理模式,分析其经过质量改进后的疼痛控制情况。结果患者接受质量改进的疼痛管理后,其疼痛情况有了明显改善,护理的满意度也大大提升。结论对患者进行持续质量改进的疼痛管理,可以缓解患者的疼痛,提高护理满意度。%Objective To explore clinical value patients with bone trauma pain management application of the concept of continuous quality improvement during the period of treatment.Methods Selected 110 patients with bone trauma from 2014 March to 2014 July in our hospital and analysis of the clinical data retrospectively. Make effective pain management model for the cause of pain and analyze after the quality improvement of pain control. Resultspatient pain had significantly improved and the nursing satisfaction also improve greatly after accept the pain management in the quality improvement.Conclusion Patients with continuous quality improvement of pain management can reduce the pain of patients and improve nursing satisfaction.

  4. An improvement of surfactin production by B. subtilis BBG131 using design of experiments in microbioreactors and continuous process in bubbleless membrane bioreactor.

    Motta Dos Santos, Luiz Fernando; Coutte, François; Ravallec, Rozenn; Dhulster, Pascal; Tournier-Couturier, Lucie; Jacques, Philippe


    Culture medium elements were analysed by a screening DoE to identify their influence in surfactin specific production by a surfactin constitutive overproducing Bacillus subtilis strain. Statistics pointed the major enhancement caused by high glutamic acid concentrations, as well as a minor positive influence of tryptophan and glucose. Successively, a central composite design was performed in microplate bioreactors using a BioLector®, in which variations of these impressive parameters, glucose, glutamic acid and tryptophan concentrations were selected for optimization of product-biomass yield (YP/X). Results were exploited in combination with a RSM. In absolute terms, experiments attained an YP/X 3.28-fold higher than those obtained in Landy medium, a usual culture medium used for lipopeptide production by B. subtilis. Therefore, two medium compositions for enhancing biomass and surfactin specific production were proposed and tested in continuous regime in a bubbleless membrane bioreactor. An YP/X increase of 2.26-fold was observed in bioreactor scale.

  5. 基于改进BP神经网络的连铸漏钢预报%Breakout Prediction Based on Improved BP Neural Network in Continuous Casting Process

    张本国; 李强; 王葛; 张水仙


    LM algorithm was introduced to the training process of a BP neural network and a LM--BP neural network model was established aiming at the defects of slow convergence in the train- ing process of the traditional BP neural network. The LM--BP neural network model was applied to the breakout prediction in the continuous casting processes, and it was tested with the historical data collected from a steel mill. The feasibility and the validity of the model are verified by the results with the accuracy rate of 96.15% and the prediction rate of 100%%针对传统BP神经网络在训练过程中存在收敛速度慢的缺陷,将LM(levenberg marquardt)算法引入到BP神经网络的训练过程,建立了LM—BP神经网络模型,并将其应用于连铸过程中的漏钢预报系统。结合某钢厂连铸现场历史数据对系统进行了测试,测试结果以96.15%的预报率及100%的报出率,验证了基于LM算法的BP神经网络连铸漏钢预报方案的可行性和有效性。

  6. An improved analytical method for the determination of urea nitrogen isotopomers in biological samples utilizing continuous flow isotope ratio mass spectrometry.

    Marini, Juan C; Attene-Ramos, Matias Sebastian


    Over the past few years numerous dual inlet isotope ratio mass spectrometry (IRMS) applications have been adapted to continuous flow systems which allow the automation of sample admission and a higher throughput. The isotopomer analysis of urea nitrogen by IRMS requires the offline conversion of urea into nitrogen gas before analysis. The oxidation of urea with LiOBr results in the monomolecular degradation of urea, which preserves the identity of the parent urea molecule, and has to be conducted under vacuum to prevent contamination with atmospheric nitrogen. We have developed an offline system of urea degradation utilizing disposable Exetainers, in which atmospheric nitrogen is displaced by helium. Recovery of urea nitrogen was linear within the range of the standards tested (0 to 420 microg nitrogen) and standard curves for 15N15N-urea standards showed high coefficients of determination (R2 > 0.9998). A small portion of urea degrades in a non-monomolecular fashion and has been shown to depend on the concentration of urea in the sample. Long-term storage of prepared samples showed a decline in 15N15N enrichment, suggesting air contamination. However, samples were stable for 24 h, which allows for the analysis of large sample batches. Interest in urea metabolism, particularly in ruminant species, has increased recently due to the environmental implications of urea and nitrogen excretion by farm animals. This novel analytical method will allow for accurate measurements and the rapid throughput needed in order to support these field studies.

  7. IDegLira Improves Both Fasting and Postprandial Glucose Control as Demonstrated Using Continuous Glucose Monitoring and a Standardized Meal Test

    Holst, Jens J; Buse, John B; Rodbard, Helena W


    : In this substudy, 260 (15.6%) of the original 1663 patients with inadequate glycemic control participating in a 26-week, open-label trial (DUAL I) were randomized 2:1:1 to once-daily IDegLira, insulin degludec or liraglutide. Continuous glucose monitoring (CGM) for 72 hours and a meal test were performed. RESULTS......: At week 26, IDegLira produced a significantly greater decrease from baseline in mean PPG increment (normalized iAUC0-4h) than insulin degludec (estimated treatment difference [ETD] -12.79 mg/dl [95% CI: -21.08; -4.68], P = .0023) and a similar magnitude of decrease as liraglutide (ETD -1.62 mg/dl [95% CI......: -10.09; 6.67], P = .70). CGM indicated a greater reduction in change from baseline in PPG increment (iAUC0-4h) for IDegLira versus insulin degludec over all 3 main meals (ETD -6.13 mg/dl [95% CI: -10.27, -1.98], P = .0047) and similar reductions versus liraglutide (ETD -1.80 mg/dl [95% CI: -2.52, 5...

  8. Creating Minimum Harm Practice (MiHaP: a concept for continuous improvement [v1; ref status: indexed,

    Ranjit Singh


    Full Text Available The author asks for the attention of leaders and all other stakeholders to calls of the World Health Organization (WHO, the Institute of Medicine (IOM, and the UK National Health Service (NHS to promote continuous learning to reduce harm to patients. This paper presents a concept for structured bottom-up methodology that enables and empowers all stakeholders to identify, prioritize, and address safety challenges. This methodology takes advantage of the memory of the experiences of all persons involved in providing care. It respects and responds to the uniqueness of each setting by empowering and motivating all team members to commit to harm reduction. It is based on previously published work on “Best Practices Research (BPR” and on “Systematic Appraisal of Risk and Its Management for Error Reduction (SARAIMER”. The latter approach, has been shown by the author (with Agency for Healthcare Research and Quality (AHRQ support, to reduce adverse events and their severity through empowerment, ownership and work satisfaction. The author puts forward a strategy for leaders to implement, in response to national and international calls for Better health, Better care, and Better value (the 3B’s of healthcare in the US Patient Protection and Affordable Care Act.  This is designed to enable and implement “A promise to learn- a commitment to act”.  AHRQ has recently published “A Toolkit for Rapid-Cycle Patient Safety and Quality Improvement” that includes an adapted version of SARAIMER.

  9. Achieving Extreme Utilization of Excitons by an Efficient Sandwich-Type Emissive Layer Architecture for Reduced Efficiency Roll-Off and Improved Operational Stability in Organic Light-Emitting Diodes.

    Wu, Zhongbin; Sun, Ning; Zhu, Liping; Sun, Hengda; Wang, Jiaxiu; Yang, Dezhi; Qiao, Xianfeng; Chen, Jiangshan; Alshehri, Saad M; Ahamad, Tansir; Ma, Dongge


    It has been demonstrated that the efficiency roll-off is generally caused by the accumulation of excitons or charge carriers, which is intimately related to the emissive layer (EML) architecture in organic light-emitting diodes (OLEDs). In this article, an efficient sandwich-type EML structure with a mixed-host EML sandwiched between two single-host EMLs was designed to eliminate this accumulation, thus simultaneously achieving high efficiency, low efficiency roll-off and good operational stability in the resulting OLEDs. The devices show excellent electroluminescence performances, realizing a maximum external quantum efficiency (EQE) of 24.6% with a maximum power efficiency of 105.6 lm W(-1) and a maximum current efficiency of 93.5 cd A(-1). At the high brightness of 5,000 cd m(-2), they still remain as high as 23.3%, 71.1 lm W(-1), and 88.3 cd A(-1), respectively. And, the device lifetime is up to 2000 h at initial luminance of 1000 cd m(-2), which is significantly higher than that of compared devices with conventional EML structures. The improvement mechanism is systematically studied by the dependence of the exciton distribution in EML and the exciton quenching processes. It can be seen that the utilization of the efficient sandwich-type EML broadens the recombination zone width, thus greatly reducing the exciton quenching and increasing the probability of the exciton recombination. It is believed that the design concept provides a new avenue for us to achieve high-performance OLEDs.

  10. Practice and Experience of the Establishment of Long Term Mechanism of Continuous Quality Improvement%建立医疗质量持续改进长效机制的实践与体会

    谭天林; 欧兵玺; 廖世川; 罗力; 李雪


    探讨建立医疗质量持续改进长效机制,确保患者医疗安全,提高患者满意度.坚持将健全组织、完善制度、优化流程、全员培训、全面监控、加强沟通、整改到位等措施,贯穿于基础质量控制、环节质量控制和终末质量控3个环节,是建立医疗质量持续改进长效机制的有效方法.%The establishment of long-term mechanism for continuous improvement of health care quality is explored to ensure the safety of patients, and to improve patient satisfaction. Adhering to a sound organization, improving the system, streamlining business process, training all staff, and enhancing comprehensive monitoring and communication are needed in place corrective measures, such as quality control throughout the base, part of quality control and quality control of the three terminal links, and are effective ways of continuous quality improvement of establishing long-term mechanism.

  11. Use of the Filter-Sandwich carriers in continuous effectiveness monitoring of slurry treatment methods as an element improving biosafety in agriculture.

    Skowron, Krzysztof; Olszewska, Halina; Paluszak, Piotr; Skowron, Karolina Jadwiga; Bauza-Kaszewska, Justyna


    Slurry, due to high microbiological contamination, requires hygienization before spreading. The agricultural usage of treated slurry has to guarantee biosafety. Therefore, constant monitoring of the slurry treatment process should be conducted. The use of Filter-Sandwich carriers seems to be a prospective solution. The aim of the research was to test whether Filter-Sandwich carriers influence the survivability of microorganisms during the slurry hygienization process and hence, whether they are safe for the environment. Raw cattle and swine slurry with different dry matter content was the research material. Salmonella Senftenberg W775 rods were introduced directly into the slurry and into the carriers placed in the liquid excrements stored at 4 and 20ºC, and underwent anaerobic digestion at 35ºC. The number of tested bacteria obtained from the slurry and carriers was determined using the MPN method with proper microbiological media. The values of physicochemical parameters of the raw and treated slurry were determined, both for the carriers and for slurry only. Biosafety control was also conducted for the carriers in slurry containers. The differences in the theoretical survivability between Salmonella Senftenberg W775 re-isolated from the slurry and the carriers, and in the values of the selected physicochemical parameters obtained at the end of the process, were not statistically significant. The re-contamination of the sterile slurry caused by the bacteria in the carrier was not observed after placement of the carrier with inoculated material. The conducted research proves the usefulness of Filter-Sandwich carriers for continuous hygienization monitoring of the slurry treatment process. This refers not only to the semi-technical scale, but also to the full-scale process.

  12. Sense of Community, Perceived Learning, and Achievement Relationships in an Online Graduate Course

    Trespalacios, Jesus; Perkins, Ross


    The ubiquity of online programs in higher education requires continued focus on designing instructional environments that improve students' learning. We examine students' perceptions of sense of community and learning, as well as academic achievement, using grades obtained from a final project and participation in asynchronous discussion forums.…

  13. Vietnam: achievements and challenges.

    Tran Tien Duc


    The Vietnamese Government's successful development of the National Population and Family Planning Program has contributed in raising people's awareness on population issues and changing their attitudes and behavior regarding fostering small families. It has also been found to be very effective in substantially decreasing fertility level. In addition, economic levels of many households have been greatly improved since the adoption of a renovation policy. The advancement of welfare accompanied by the provision of better basic social services, including health services, has boost people's health. Several factors behind the achievements of the National Population and Family Planning Program include: 1) Strengthening of the political commitment of national and local leaders; 2) Nationwide mobilization of mass organizations and NGOs; 3) A strong advocacy and information, education and communication program; 4) Provision of various kinds of contraceptives; 5) Effective management of the program by priority; and 6) Support of the international community. Despite such successes, Vietnam is facing a number of new issues such as enlargement of the work force, shifting migration patterns and accelerating urbanization, aging of population, and change of household structure. Nevertheless, the Government of Vietnam is preparing a New Population Strategy aimed to address these issues.

  14. Improved confinem

    Ahmed M. El-Kholy


    Full Text Available Traditional steel ties reinforcement cannot provide superior confinement for reinforced concrete (RC columns due to the constraints on tie spacing and disturbance of concrete continuity. This paper presents a practical confinement configuration consisting of single Expanded Metal Mesh (EMM layer in additional to regular tie reinforcement. The EMM layer is warped above ties. The proposed transverse reinforcement, with various volumetric ratios of ties, was investigated in sixteen square short RC column specimens categorized in two groups according to their slenderness ratios. The specimens were cast in vertical position simulating the construction field and they were tested under concentric compression till failure. The results indicated that the columns, confined with proposed lateral reinforcement, revealed significant improvement in the strength and ductility. Also, high reduction in ties volumetric ratio with no loss in ultimate load could be achieved by installing the EMM layer.

  15. Health and Nutrition: Preconditions for Educational Achievement.

    Negussie, Birgit

    This paper discusses the importance of maternal and infant health for children's educational achievement. Education, health, and nutrition are so closely related that changes in one causes changes in the others. Improvement of maternal and preschooler health and nutrition is a precondition for improved educational achievement. Although parental…

  16. Proposals for an effective application of the continuous improvement at the ININ according to the IAEA 50-C/SG-Q new code; Propuestas para una aplicacion efectiva del proceso de mejora continua en el ININ, de acuerdo al nuevo codigo 50-C/SG-Q del OIEA

    Cardenas A, B.M.; Olivares O, L.A. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)


    This work contains the requirements of continuous improvement contained in the IAEA new code {sup Q}uality assurance for safety in nuclear power plants and other nuclear installations, code 50-C/SG-Q. Assuming that it was the base for to elaborate the review No. 5 of the Quality assurance plan at ININ, it was done an analysis to give proposals for the application of continuous improvement in effective way. The relevant points which must be taken in account at the continuous improvement process are: Direction responsibility, involucring of all personnel, process planning, education and training, elaboration of improvement projects, investigation of processes which can be improved, continuation of the improvement process and its evaluation. With the implantation of an effective continuous improvement system it will be obtained to get a better quality and a more efficient safety. (Author)

  17. 护理质量持续改进对患者满意度的影响%The influence of continuous improvement of the quality of nursing on patient satisfaction

    刘燕; 曾桂红; 杨铃


    目的:探讨护理质量持续改进对患者满意度的影响。方法:回顾性分析2012年1月-12月间住院患者的满意度调查结果,在此基础上针对存在的问题采取相应的护理质量持续改进措施,对比措施实施前后的患者满意度。结果:实施护理质量改进措施后,每月患者满意度高于实施前(P<0.05),差异有统计学意义。结论:针对患者满意度调查中存在的问题进行分析,并实施相应的护理措施,有利于提高患者满意度。%Objective: The influence of continuous improvement of the quality of nursing on patient satisfaction were explored. Methods: From January 2012 to December 2012, satisfaction survey of hospitalized patients was retrospective analyzed. On the basis, the appropriate continuous improvement of the quality of nursing were adopted, while comparing patient satisfaction before and after the implementation of measures. Results: After the implementation of continuous improvement of the quality of nursing, patient satisfaction months was higher (P<0.05), with statistically significant difference. Conclusion: According to problems in patient satisfaction survey, appropriate care measures were adopted, to improve patient satisfaction.

  18. 静脉穿刺失败原因及持续改进后效果分析%Analyzing the Effect of Venous Puncture Causes of Failure and Continuous Improvement

    高灼; 黄天利


    Objective Investigate the causes and Effects of continuous improvement of the vein puncture. failure. Method Respectively randomly extract 3450 patients of venous puncture of rehabilitation department from October to December in 2012. Investigate failure rates of venous puncture of October to December,and analyze the the continuously improved Effects. Results The success rates of puncture in October,November and December are 95.37%,96.15% and 98.72%,respectively. Conclusion Through the comparison of each month puncture, continuously discovering problems,resolving them,and improving nursing strategies, the success rates of puncture have been obviously improved.%目的:探讨静脉穿刺失败原因及持续改进后效果分析。方法分别随机抽取2012年10、11、12月在康复科静脉穿刺的患者3450例(男性1871例,女性1579例,年龄21~78岁)。对10、11、12月份静脉穿刺失败率调查分析,并进行持续改进后效果分析,并给出相应的护理应对措施。结果10、11、12月穿刺成功率分别为95.37%、96.15%、98.72%。结论通过每个月份的穿刺比较,持续不断的发现问题,解决问题,改进护理对策,穿刺成功率有明显的提高。

  19. Establishment of Quality Management Improvement Mechanism in Higher Vocational Colleges. Based on Continuous Improvement of ISO9000 Quality Management System%高职院校质量管理改进机制的建立——基于ISO9000质量管理体系的持续改进



    The paper analyzes the connotation and ways of continual improvement of the ISO9000 Quality Management System in Higher Vocational Colleges and puts up the improvement measures of the estab- lishment of quality management improvement mechanism in Higher Vocational Colleges based on continu- ous improvement ofISO9000 Quality Management System.%文章分析了高职院校ISO9000质量管理体系持续改进的内涵和途径,并基于ISO9000质量管理体系的持续改进,提出了建立高职院校质量管理改进机制的措施。

  20. Continuous Improvement of Medical Records Management Process Under the Network Environment%网络环境下病案管理流程的持续改进



    电子病历系统及缩微数字一体化技术的运用使病案实现数字化、网络化管理,病案信息资源实现共享。在网络环境下如何利用信息管理平台提升病案管理工作效率是当务之急需考虑的问题。通过对实施病案数字化管理前后的流程对比分析,从中查找问题,利用信息技术对病案管理中的回收、借阅、复印、质控等重要流程进行优化,不仅使病案人员摆脱繁重原始的手工操作模式,优化工作流程,提高工作效率,同时获得良好的社会效益。%Application ofelectronic medical recordsystem andmicroformdigital integrationtechnology make the medical record ofdigitizationand network management, the medical record informationresourcessharing is realized. Optimize digital medical recordmanagement process which is including Recycling, borrowing, copying, quality control. The mode make the medical record staff get off the original manual operation mode, optimize workflow, improve work efficiency, and obtain good social benefits.