WorldWideScience

Sample records for evaluating improvement strategies

  1. Evaluation of two communication strategies to improve udder health management

    NARCIS (Netherlands)

    Jansen, J.; Renes, R.J.; Lam, T.J.G.M.

    2010-01-01

    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers’ udder health management, tools such as

  2. Evaluation of two communication strategies to improve udder health management.

    Science.gov (United States)

    Jansen, J; Renes, R J; Lam, T J G M

    2010-02-01

    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

  3. Performance in Physiology Evaluation: Possible Improvement by Active Learning Strategies

    Science.gov (United States)

    Montrezor, Luís H.

    2016-01-01

    The evaluation process is complex and extremely important in the teaching/learning process. Evaluations are constantly employed in the classroom to assist students in the learning process and to help teachers improve the teaching process. The use of active methodologies encourages students to participate in the learning process, encourages…

  4. Performance in physiology evaluation: possible improvement by active learning strategies.

    Science.gov (United States)

    Montrezor, Luís H

    2016-12-01

    The evaluation process is complex and extremely important in the teaching/learning process. Evaluations are constantly employed in the classroom to assist students in the learning process and to help teachers improve the teaching process. The use of active methodologies encourages students to participate in the learning process, encourages interaction with their peers, and stimulates thinking about physiological mechanisms. This study examined the performance of medical students on physiology over four semesters with and without active engagement methodologies. Four activities were used: a puzzle, a board game, a debate, and a video. The results show that engaging in activities with active methodologies before a physiology cognitive monitoring test significantly improved student performance compared with not performing the activities. We integrate the use of these methodologies with classic lectures, and this integration appears to improve the teaching/learning process in the discipline of physiology and improves the integration of physiology with cardiology and neurology. In addition, students enjoy the activities and perform better on their evaluations when they use them. Copyright © 2016 The American Physiological Society.

  5. Evaluating Fidelity to a Modified NIATx Process Improvement Strategy for Improving HIV Services in Correctional Facilities.

    Science.gov (United States)

    Pankow, Jennifer; Willett, Jennifer; Yang, Yang; Swan, Holly; Dembo, Richard; Burdon, William M; Patterson, Yvonne; Pearson, Frank S; Belenko, Steven; Frisman, Linda K

    2018-04-01

    In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.

  6. IMPROVING STUDENT PERFORMANCE AND FACULTY EVALUATION: A TRANSACTIONAL RELATIONSHIP STRATEGY

    OpenAIRE

    Wade, Mark A.

    2000-01-01

    As in any relationship between buyer and seller, the educational transaction between learner and teacher requires that a level of receptivity be created so that features, advantages and benefits of the transaction can be examined. Student responses to instructor efforts to create a vested covenant in the classroom were evaluated. Teaching methods were altered in two of four course sessions taught by the instructor. When efforts were made to gain student ownership of the class, both student gr...

  7. Evaluation Strategy

    DEFF Research Database (Denmark)

    Coto Chotto, Mayela; Wentzer, Helle; Dirckinck-Holmfeld, Lone

    2009-01-01

    The paper presents an evaluation strategy based on deliberate ideals and principles of dialogue design. The evaluation strategy is based on experiential phenomenology taking the point of departure for design and evaluation processes in the experienced practitioners themselves. The article present...... the evaluation strategy and methodology of a research project Making Online Path to Enter new Markets, MOPEM. It is an EU-research project with partners from different Educational Institutions of Technology and Business in five European Countries.......The paper presents an evaluation strategy based on deliberate ideals and principles of dialogue design. The evaluation strategy is based on experiential phenomenology taking the point of departure for design and evaluation processes in the experienced practitioners themselves. The article presents...

  8. Subscriber Number Forecasting Tool Based on Subscriber Attribute Distribution for Evaluating Improvement Strategies

    OpenAIRE

    Hiramatsu, Ayako; Shono, Yuji; Oiso, Hiroaki; Komoda, Norihisa

    2005-01-01

    In this paper, a subscriber number forecasting tool that evaluates quiz game mobile content improvement strategies is developed. Unsubscription rates depend on such subscriber attributes such as consecutive months, stages, rankings, and so on. In addition, content providers can anticipate change in unsubscription rates for each content improvement strategy. However, subscriber attributes change dynamically. Therefore, a method that deals with dynamic subscriber attribute changes is proposed. ...

  9. A Holistic Quality Evaluation, Selection and Improvement Approach driven by Multilevel Goals and Strategies

    Directory of Open Access Journals (Sweden)

    Belen Rivera

    2016-12-01

    Full Text Available Organizations should establish business goals and check for their achievement in a systematic and disciplined way. In order to know if a business goal is achieved, it should be necessary to consider information need goals that also can require satisfying measurement and evaluation goals at operational level. Furthermore, if measurement and evaluation goals are not aligned with top-level business goals such as tactical or strategic level goals, the organization could waste its effort and resources. Usually, the different goals established in an organization are operationalized through projects. For a given project, strategies should be used in order to help in the goal achievement. A strategy defines a set of activities and methods to be followed for a specific goal purpose. Ultimately, to engineering all these issues in a systematic way, organizations should adopt a holistic evaluation approach supported by a set of integrated strategies. By means of a systematic literature review as research method, we have observed that very few approaches support integrated strategies and multilevel goals. To bridge this gap, we have developed a holistic quality multilevel and multipurpose evaluation approach that ties together multilevel goals, projects and integrated strategies. As contributions, this paper discusses an enhanced conceptual base (specified by ontologies for linking business and information need goal concepts with project, strategy and nonfunctional requirements concepts. Then, it defines the step by step of our holistic quality evaluation approach, by listing the necessary activities to establish goals and projects at different organizational levels. Lastly, it specifies and illustrates evaluation scenarios for business/information need goal purposes such as understanding, improving, monitoring and controlling, comparing and selecting entities, which are supported by strategies and strategy patterns.

  10. Evaluating research recruitment strategies to improve response rates amongst South African nurses

    Directory of Open Access Journals (Sweden)

    Natasha Khamisa

    2014-03-01

    Research purpose: The aim of this study was to evaluate three research recruitment methods for their impact on recruitment and participation rates amongst South African nurses. Motivation for the study: A limited number of studies exist that formally evaluates different recruitment strategies to improve participation in research amongst nurses within developing contexts, especially South Africa. Research approach, design and method: Participants were recruited using three different methods. Of the 250 nurses randomly selected and invited to participate in a cross-sectional survey, 201 agreed and 162 (81% returned the questionnaires. Main findings: Nursing management participation in the recruitment and data collection process produces more favourable response rates. Reminders and the use of shorter questionnaires also aid higher response rates. Practical/managerial implications: Reminders as well as face-to-face recruitment strategies (especially by a familiar person successfully improved participation rates amongst South African nurses in this study. Contribution/value-add: This study identifies some strategies that could be used more widely to increase the recruitment and participation of South African nurses in research whilst potentially improving their work situation.

  11. Evaluating the enhancement and improvement of China's technology and financial services platform innovation strategy.

    Science.gov (United States)

    Wu, Ching-Sung; Hu, Kuang-Hua; Chen, Fu-Hsiang

    2016-01-01

    The development of high-tech industry has been prosperous around the world in past decades, while technology and finance have already become the most significant issues in the information era. While high-tech firms are a major force behind a country's economic development, it requires a lot of money for the development process, as well as the financing difficulties for its potential problems, thus, how to evaluate and establish appropriate technology and financial services platforms innovation strategy has become one of the most critical and difficult issues. Moreover, how the chosen intertwined financial environment can be optimized in order that high-tech firms financing problems can be decided has seldom been addressed. Thus, this research aims to establish a technology and financial services platform innovation strategy improvement model, as based on the hybrid MADM model, which addresses the main causal factors and amended priorities in order to strengthen ongoing planning. A DEMATEL technique, as based on Analytic Network Process, as well as modified VIKOR, will be proposed for selecting and re-configuring the aspired technology and financial services platform. An empirical study, as based on China's technology and financial services platform innovation strategy, will be provided for verifying the effectiveness of this proposed methodology. Based on expert interviews, technology and financial services platforms innovation strategy improvement should be made in the following order: credit guarantee platform ( C )_credit rating platform ( B )_investment and finance platform ( A ).

  12. Evaluation of Strategies to Improve the Thermal Performance of Steel Frames in Curtain Wall Systems

    Directory of Open Access Journals (Sweden)

    Ji Hyun Oh

    2016-12-01

    Full Text Available Recently, metal curtain wall systems have been widely used in high-rise buildings due to many advantages, including being lightweight, rapid construction, and aesthetic features. Since the metal frame may lead to lower energy performance, thermal discomfort, and condensation risk due to the high thermal conductivity, its thermal performance can be important for the improvement of the overall thermal performance of the curtain wall system, as well as the energy efficiency of the building envelope. This study aims to evaluate variety of design strategies to improve the thermal performance of steel curtain wall frames. Five base cases and three further steps were selected for two different head profile shapes based on a state-of-the art technology review, and their thermal transmittances were calculated through simulations according to the ISO 12631 standard which is an international standard for calculating thermal transmittance of curtain wall system. Measured results that were obtained from hot-box tests were compared with the calculated results to validate the simulation method of this study. The shape of the head profile did not strongly influence the overall thermal transmittance, and the choice of strategies for the rabbet space was more important. More effective strategies could be decided according to the steps for variation development. This result can serve as a guideline for the design of high-performance curtain wall frames.

  13. Evaluability Assessment of an immunization improvement strategy in rural Burkina Faso: intervention theory versus reality, information need and evaluations.

    Science.gov (United States)

    Sanou, Aboubakary; Kouyaté, Bocar; Bibeau, Gilles; Nguyen, Vinh-Kim

    2011-08-01

    An innovative immunization improvement strategy was proposed by the CRSN (Centre de Recherche en Santé de Nouna) to improve the low coverage rate for children aged 0-11 months in the health district of Nouna in Burkina Faso. This article reports on the Evaluability Assessment (EA) study that aimed to orient decisions for its evaluation in close relationship with the information needs of the stakeholders. Various methods were used, including document reviews, individual interviews, focus group discussions, meetings, literature reviews and site visits. A description of the intervention theory and philosophy is provided with its logic models and its reality documented. Lessons on the procedure include the importance of the position of the evaluability assessor, the value of replicating some steps of the assessment and the relationships between EA and process evaluation. The evaluability study concludes that the intervention had some evaluable components. To satisfy the stakeholders' needs, the initially planned community randomized controlled trial can be maintained and complemented with a process evaluation. There is a need to provide sufficient information on the cost of the intervention. This will inform decision makers on the possibility of replicating the intervention in other contexts. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Long Island Transportation Plan to Manage Congestion: Framework for Developing and Evaluating Improvement Strategies

    Science.gov (United States)

    2002-04-20

    The Long Island Transportation Plan to Manage Congestion (LITP 2000) will establish an integrated, multi-modal transportation program of cost-effective strategies to manage congestion and improve the movement of people and goods in Nassau and Suffolk...

  15. Evaluation of Patient and Family Engagement Strategies to Improve Medication Safety.

    Science.gov (United States)

    Kim, Julia M; Suarez-Cuervo, Catalina; Berger, Zackary; Lee, Joy; Gayleard, Jessica; Rosenberg, Carol; Nagy, Natalia; Weeks, Kristina; Dy, Sydney

    2018-04-01

    Patient and family engagement (PFE) is critical for patient safety. We systematically reviewed types of PFE strategies implemented and their impact on medication safety. We searched MEDLINE, EMBASE, reference lists and websites to August 2016. Two investigators independently reviewed all abstracts and articles, and articles were additionally reviewed by two senior investigators for selection. One investigator abstracted data and two investigators reviewed the data for accuracy. Study quality was determined by consensus. Investigators developed a framework for defining the level of patient engagement: informing patients about medications (Level 1), informing about engagement with health care providers (Level 2), empowering patients with communication tools and skills (Level 3), partnering with patients in their care (Level 4), and integrating patients as full care team members (Level 5). We included 19 studies that mostly targeted older adults taking multiple medications. The median level of engagement was 2, ranging from 2-4. We identified no level 5 studies. Key themes for patient engagement strategies impacting medication safety were patient education and medication reconciliation, with a subtheme of patient portals. Most studies (84%) reported implementation outcomes. The most commonly reported medication safety outcomes were medication errors, including near misses and discrepancies (47%), and medication safety knowledge (37%). Most studies (63%) were of medium to low quality, and risk of bias was generally moderate. Among the 11 studies with control groups, 55% (n = 6) reported statistically significant improvement on at least one medication safety outcome. Further synthesis of medication safety measures was limited due to intervention and outcome heterogeneity. Key strategies for engaging patients in medication safety are education and medication reconciliation. Patient engagement levels were generally low, as defined by a novel framework for determining

  16. Management strategy evaluation of pheromone-baited trapping techniques to improve management of invasive sea lamprey

    Science.gov (United States)

    Dawson, Heather; Jones, Michael L.; Irwin, Brian J.; Johnson, Nicholas; Wagner, Michael C.; Szymanski, Melissa

    2016-01-01

    We applied a management strategy evaluation (MSE) model to examine the potential cost-effectiveness of using pheromone-baited trapping along with conventional lampricide treatment to manage invasive sea lamprey. Four pheromone-baited trapping strategies were modeled: (1) stream activation wherein pheromone was applied to existing traps to achieve 10−12 mol/L in-stream concentration, (2) stream activation plus two additional traps downstream with pheromone applied at 2.5 mg/hr (reverse-intercept approach), (3) trap activation wherein pheromone was applied at 10 mg/hr to existing traps, and (4) trap activation and reverse-intercept approach. Each new strategy was applied, with remaining funds applied to conventional lampricide control. Simulating deployment of these hybrid strategies on fourteen Lake Michigan streams resulted in increases of 17 and 11% (strategies 1 and 2) and decreases of 4 and 7% (strategies 3 and 4) of the lakewide mean abundance of adult sea lamprey relative to status quo. MSE revealed performance targets for trap efficacy to guide additional research because results indicate that combining lampricides and high efficacy trapping technologies can reduce sea lamprey abundance on average without increasing control costs.

  17. Strategies and policies for improving energy efficiency programs: Closing the loop between evaluation and implementation

    International Nuclear Information System (INIS)

    Vine, Edward

    2008-01-01

    Program implementers often use evaluation results to improve the performance of their programs, but, as described in this paper, this is not always the case. Based on a review of the literature, participation in workshops, and interviews with over 50 program implementers, evaluators, and regulators in the United States and Canada, the utilization of evaluation results is investigated by asking the following questions: (1) How are program evaluation results used by program implementers and other stakeholders? (2) How are program evaluation results communicated to program implementers and other stakeholders? (3) Are the needs of program implementers being met by program evaluation? (4) What is the role of the utility regulator in facilitating the use of program evaluation results? (5) What other mechanisms can facilitate the use of program evaluation results? While there is some consensus on the answers to these questions, the type of interest in and use of evaluation varies by functional role (e.g., evaluator versus implementer), maturity of the energy efficiency market, institutional context (e.g., evaluation and implementation conducted inside the same organization, or evaluation and implementation conducted by separate entities), and by regulatory demands and evaluation interests

  18. Development, implementation, and evaluation of a mental rehearsal strategy to improve clinical performance and reduce stress: A mixed methods study.

    Science.gov (United States)

    Ignacio, Jeanette; Dolmans, Diana; Scherpbier, Albert; Rethans, Jan-Joost; Lopez, Violeta; Liaw, Sok Ying

    2016-02-01

    Mental rehearsal is a form of mental training that has been used by physicians and nurses to improve performance of clinical skills, and as a vital component of stress management training. To help novice nurses deal with often stressful clinical events that require the processing of information essential to patient management, a mental rehearsal strategy was developed and implemented in a Year 3 nursing simulation program. Inherent to mental rehearsal is imagery, which facilitates cognitive and affective modification, and reduction of extraneous cognitive load. As such, it was expected that the mental rehearsal strategy would improve students' performance and reduce stress in managing deteriorating patients. The study used a mixed methods design. Eighteen Year 3 nursing students participated in the pre- and post-design study, which consisted of the development and implementation of a mental rehearsal strategy. The Rescuing A Patient In Deteriorating Situations (RAPIDS) tool was used to assess performance. Heart rates and systolic blood pressures were used to measure stress. The State-Trait Anxiety Inventory (STAI) was used as a psychological measure of stress/anxiety. Five participants were involved in a focus group discussion that evaluated the usefulness of the mental rehearsal strategy. There was a significant improvement in performance (Pstrategy. The mental rehearsal strategy for deteriorating patient management can be valuable based on the findings on performance and based on the participants' feedback. Its role in reducing stress, however, needs further evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Evaluation of use of reading comprehension strategies to improve reading comprehension of adult college students with acquired brain injury.

    Science.gov (United States)

    Griffiths, Gina G; Sohlberg, McKay Moore; Kirk, Cecilia; Fickas, Stephen; Biancarosa, Gina

    2016-01-01

    Adults with mild to moderate acquired brain injury (ABI) often pursue post-secondary or professional education after their injuries in order to enter or re-enter the job market. An increasing number of these adults report problems with reading-to-learn. The problem is particularly concerning given the growing population of adult survivors of ABI. Despite the rising need, empirical evaluation of reading comprehension interventions for adults with ABI is scarce. This study used a within-subject design to evaluate whether adult college students with ABI with no more than moderate cognitive impairments benefited from using reading comprehension strategies to improve comprehension of expository text. Integrating empirical support from the cognitive rehabilitation and special education literature, the researchers designed a multi-component reading comprehension strategy package. Participants read chapters from an introductory-level college anthropology textbook in two different conditions: strategy and no-strategy. The results indicated that reading comprehension strategy use was associated with recall of more correct information units in immediate and delayed free recall tasks; more efficient recall in the delayed free recall task; and increased accuracy recognising statements from a sentence verification task designed to reflect the local and global coherence of the text. The findings support further research into using reading comprehension strategies as an intervention approach for the adult ABI population. Future research needs include identifying how to match particular reading comprehension strategies to individuals, examining whether reading comprehension performance improves further through the incorporation of systematic training, and evaluating texts from a range of disciplines and genres.

  20. Unlocking the “black box” of practice improvement strategies to implement surgical safety checklists: a process evaluation

    Directory of Open Access Journals (Sweden)

    Gillespie BM

    2017-04-01

    Full Text Available Brigid M Gillespie,1–3 Kyra Hamilton,4 Dianne Ball,5 Joanne Lavin,6 Therese Gardiner,6 Teresa K Withers,7 Andrea P Marshall1–3 1School of Nursing & Midwifery, Griffith University, Gold Coast, 2Gold Coast University Hospital and Health Service, Southport, 3Nursing & Midwifery Education & Research Unit (NMERU, National Centre of Research Excellence in Nursing, Menzies Health Institute of Queensland, Griffith University, Gold Coast, 4School of Applied Psychology, Griffith University, Mt Gravatt, 5Communio Pty Ltd, Sydney, 6Nursing & Midwifery Education & Research Unit, 7Surgical and Procedural Services, Gold Coast University Hospital and Health Service, Southport, Australia Background: Compliance with surgical safety checklists (SSCs has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve.Objectives: The objective of this study was to undertake a process evaluation of four knowledge translation (KT strategies used to implement the Pass the Baton (PTB intervention which was designed to improve utilization of the SSC. Methods: As part of the process evaluation, a logic model was generated to explain which KT strategies worked well (or less well in the operating rooms of a tertiary referral hospital in Queensland, Australia. The KT strategies implemented included change champions/opinion leaders, education, audit and feedback, and reminders. In evaluating the implementation of these strategies, this study considered context, intervention and underpinning assumptions, implementation, and mechanism of impact. Observational and interview data were collected to assess implementation of the KT strategies relative to fidelity, feasibility, and acceptability. Results: Findings from 35 structured observations and 15 interviews with 96 intervention participants suggest that all of the KT strategies were consistently

  1. [Educative strategy evaluation to improve critical reading skills on clinical research texts in second year gyneco-obstetrics residents].

    Science.gov (United States)

    Carranza Lira, Sebastián; Arce Herrera, Rosa María; González González, Patricia

    2007-11-01

    The educative models and strategies to achieve a significant learning have a wide variety. The development of clinical aptitude for clinical research papers lecture has an important place to maintain the physician actualized and for resident formation. To evaluate the degree of development of the aptitude for the reading of clinical research articles in 2nd grade residents of the gynecology and obstetrics speciality alter an educative strategy. In 16 2nd year gynecology and obstetrics residents, a previously validated instrument was applied for the evaluation of critical lecture of clinical research articles in general medicine previous and after and educative strategy. Statistical analysis was with Kruskal-Wallis analysis of variance. Also Wilcoxon test was used to assess the differences between baseline and final results. The median of age was 27 (24-31) years, gender 56.3% women and 43.8% men. A statistically significant increase in global score was observed after the educative strategy. After it only there was a significant increase in the indicator to interpret. After evaluating the domain degrees according to the indicator to interpret, in baseline evaluation it predominated the very low level and at the final evaluation the very low and low levels. In the indicator to judge at baseline the majority were in the very low level, and at the end in very low and low levels. According to the indicator to propose at baseline all were in the level expected by hazard, and at the end a minimal proportion was at very low level. These results traduce a discrete improvement in critical lecture process, which makes to consider the educative strategy that was used, since the objective to improve critical lecture capacity was not achieved.

  2. Non-oblivious Strategy Improvement

    OpenAIRE

    Fearnley, John

    2010-01-01

    We study strategy improvement algorithms for mean-payoff and parity games. We describe a structural property of these games, and we show that these structures can affect the behaviour of strategy improvement. We show how awareness of these structures can be used to accelerate strategy improvement algorithms. We call our algorithms non-oblivious because they remember properties of the game that they have discovered in previous iterations. We show that non-oblivious strategy improvement algorit...

  3. Evaluating the Effectiveness of Two Teaching Strategies to Improve Nursing Students' Knowledge, Skills, and Attitudes About Quality Improvement and Patient Safety.

    Science.gov (United States)

    Maxwell, Karen L; Wright, Vivian H

    The purpose of this study was to evaluate two teaching strategies with regard to quality and safety education for nurses content on quality improvement and safety. Two groups (total of 64 students) participated in online learning or online learning in conjunction with a flipped classroom. A pretest/posttest control group design was used. The use of online modules in conjunction with the flipped classroom had a greater effect on increasing nursing students' knowledge of quality improvement than the use of online modules only. There was no statistically significant difference between the groups for safety.

  4. Evaluation and Improvement of Marketing Strategy of Lexiderm at PT Biofarma

    OpenAIRE

    Putra, Ronaldo Bagus; Wandebori, Harimukti

    2013-01-01

    The decrease of sales in export sector, triggered with the development of private hospitals make PT. Biofarma starts focusing on private sector by cooperating with PT. Compose Element to distribute Hydrogel modern wound care dressing named Lexiderm. The obstacles such as poor socialization, lack of coordination between distributor and marketing division, lack of education and promotion make the marketing strategy becomes less effective and less efficient. However, VMI (Vendor Managed Inventor...

  5. Evaluation of Rehabilitation Strategies and Management Schemes for the Improvement of Mangrove Management Programs in Lingayen Gulf

    Directory of Open Access Journals (Sweden)

    Severino Salmo III

    2007-06-01

    Full Text Available We evaluated the mangrove rehabilitation strategies and management schemes in five municipalities in Lingayen Gulf (Bolinao, Anda, Bani, Alaminos and San Fernando. Mangrove planting appears to be the first and only option used in the area, ignoring other recommended management strategies, e.g. conservation, landscaping, and sustainable production. All planting sites were located in coastal fringes and are mostly monospeficic stands of the species Rhizophora mucronata. The planted mangroves were constrained by low seedling survival and stunted growth as probably caused by poor species-substrate matching, mono-species planting and pest infestations. Three management schemes were noted: community-managed (Bolinao and Anda, local government unit (LGU-managed (Alaminos and San Fernando, and co-managed between the LGU and the community (Bani. The community-managed mangrove areas have the benefits of voluntary efforts from community-based organizations in conducting daily management activities but were constrained with budgetary and logistical concerns. In contrast, both LGU-managed and co-managed areas received institutional and logistical supports from their respective municipal governments, but lacking community participation made mangrove management difficult. Almost two decades of mangrove management indeed helped improved the mangrove forest condition, at least in terms of forest structure. These projects demonstrated some level of success but also encountered several setbacks. Several lessons can be derived from these areas that can help improve the mangrove rehabilitation and management approaches in Lingayen Gulf. Among the recommendations are: (1 provide ordinance enacting the remaining natural secondary growth mangroves as marine protected areas, (2 promote planting in former mangrove areas by reverting abandoned, idled and unproductive aquaculture ponds to mangroves; (3 improve management schemes by formulating resource management plan

  6. Non-oblivious Strategy Improvement

    Science.gov (United States)

    Fearnley, John

    We study strategy improvement algorithms for mean-payoff and parity games. We describe a structural property of these games, and we show that these structures can affect the behaviour of strategy improvement. We show how awareness of these structures can be used to accelerate strategy improvement algorithms. We call our algorithms non-oblivious because they remember properties of the game that they have discovered in previous iterations. We show that non-oblivious strategy improvement algorithms perform well on examples that are known to be hard for oblivious strategy improvement. Hence, we argue that previous strategy improvement algorithms fail because they ignore the structural properties of the game that they are solving.

  7. An improved strategy for evaluating the extent of chronic arterial baroreceptor denervation in conscious rats

    Directory of Open Access Journals (Sweden)

    M. Rodríguez-Martínez

    2010-11-01

    Full Text Available There is no index or criterion of aortic barodenervation, nor can we differentiate among rats that have suffered chronic sham, aortic or sino-aortic denervation. The objective of this study was to develop a procedure to generate at least one quantitative, reproducible and validated index that precisely evaluates the extent of chronic arterial barodenervation performed in conscious rats. Data from 79 conscious male Wistar rats of about 65-70 days of age with diverse extents of chronic arterial barodenervation and used in previous experiments were reanalyzed. The mean arterial pressure (MAP and the heart rate (HR of all rats were measured systematically before (over 1 h and after three consecutive iv bolus injections of phenylephrine (PHE and sodium nitroprusside (SNP. Four expressions of the effectiveness of barodenervation (MAP lability, PHE ratio, SNP ratio, and SNP-PHE slope were assessed with linear fixed models, three-level average variance, average separation among levels, outlier box plot analysis, and overlapping graphic analysis. The analysis indicated that a neither MAP lability nor SNP-PHE slope was affected by the level of chronic sodium intake; b even though the Box-Cox transformations of both MAP lability [transformed lability index (TLI] and SNP-PHE slope [transformed general sensitivity index (TGSI, {((3-(ΔHRSNP-ΔHRPHE/ΔMAPSNP-ΔMAPPHE-0.4-1/-0.04597}] could be two promising indexes, TGSI proved to be the best index; c TLI and TGSI were not freely interchangeable indexes for this purpose. TGSI ranges that permit differentiation between sham (10.09 to 11.46, aortic (8.40 to 9.94 and sino-aortic (7.68 to 8.24 barodenervated conscious rats were defined.

  8. Improved nurse-parent communication in neonatal intensive care unit: evaluation and adjustment of an implementation strategy.

    Science.gov (United States)

    Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

    2014-12-01

    To evaluate and adjust systematic implementation of guided family-centred care in a neonatal intensive care unit. Family-centred care is valued in neonatal intensive care units internationally, but innovative strategies are needed to realise the principles. Guided family-centred care was developed to facilitate person-centred communication by bridging the gap between theory and practice in family-centred care. Main mechanisms of guided family-centred care are structured dialogue, reflection and person-centred communication. Qualitative and quantitative data were used to monitor participatory implementation of a systematic approach to training and certification of nurses delivering guided family-centred care. Systematic implementation of guided family-centred care included workshops, supervised delivery and certification. Evaluation and adjustment of nurse adherence to guided family-centred care was conducted by monitoring (1) knowledge, (2) delivery, (3) practice uptake and (4) certification. Implementation was improved by the development of a strategic framework and by adjusting the framework according to the real-life context of a busy neonatal care unit. Promoting practice uptake was initially underestimated, but nurse guided family-centred care training was improved by increasing the visibility of the study in the unit, demonstrating intervention progress to the nurses and assuring a sense of ownership among nurse leaders and nonguided-family-centred-care-trained nurses. An adjusted framework for guided family-centred care implementation was successful in overcoming barriers and promoting facilitators. Insights gained from our pioneering work might help nurses in a similar context to reach their goals of improving family-centred care. © 2014 John Wiley & Sons Ltd.

  9. Evaluation of Rehabilitation Strategies and Management Schemes for the Improvement of Mangrove Management Programs in Lingayen Gulf

    OpenAIRE

    Severino Salmo III; Dante Torio; Janalezza Morvenna Esteban

    2007-01-01

    We evaluated the mangrove rehabilitation strategies and management schemes in five municipalities in Lingayen Gulf (Bolinao, Anda, Bani, Alaminos and San Fernando). Mangrove planting appears to be the first and only option used in the area, ignoring other recommended management strategies, e.g. conservation, landscaping, and sustainable production. All planting sites were located in coastal fringes and are mostly monospeficic stands of the species Rhizophora mucronata. The planted mangroves w...

  10. Evaluation of the Multimodal Strategy for Improvement of Hand Hygiene as Proposed by the World Health Organization.

    Science.gov (United States)

    Pereira, Eliana B S; Jorge, Miguel T; Oliveira, Elias J; Júnior, Alberto Lopes Ribeiro; Santos, Lauro R L; Mendes-Rodrigues, Clesnan

    Hand hygiene has the biggest impact and is the least expensive way to prevent and control health care-associated infections. In this study, we assessed the effectiveness of the multimodal strategy of the World Health Organization to improve health care-associated infection rates, hand hygiene compliance, and the related knowledge of health care professionals in a Brazilian university hospital. We observed the necessity for an alternative approach in hospitals with high staff turnover and low attendance of educational sessions.

  11. A strategy for company improvement.

    Science.gov (United States)

    Howley, L

    2000-03-01

    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.

  12. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique.

    Science.gov (United States)

    Basheti, Iman A; Armour, Carol L; Bosnic-Anticevich, Sinthia Z; Reddel, Helen K

    2008-07-01

    To evaluate the feasibility, acceptability and effectiveness of a brief intervention about inhaler technique, delivered by community pharmacists to asthma patients. Thirty-one pharmacists received brief workshop education (Active: n=16, CONTROL: n=15). Active Group pharmacists were trained to assess and teach dry powder inhaler technique, using patient-centered educational tools including novel Inhaler Technique Labels. Interventions were delivered to patients at four visits over 6 months. At baseline, patients (Active: 53, CONTROL: 44) demonstrated poor inhaler technique (mean+/-S.D. score out of 9, 5.7+/-1.6). At 6 months, improvement in inhaler technique score was significantly greater in Active cf. CONTROL patients (2.8+/-1.6 cf. 0.9+/-1.4, p<0.001), and asthma severity was significantly improved (p=0.015). Qualitative responses from patients and pharmacists indicated a high level of satisfaction with the intervention and educational tools, both for their effectiveness and for their impact on the patient-pharmacist relationship. A simple feasible intervention in community pharmacies, incorporating daily reminders via Inhaler Technique Labels on inhalers, can lead to improvement in inhaler technique and asthma outcomes. Brief training modules and simple educational tools, such as Inhaler Technique Labels, can provide a low-cost and sustainable way of changing patient behavior in asthma, using community pharmacists as educators.

  13. Strategies for improving employee retention.

    Science.gov (United States)

    Verlander, Edward G; Evans, Martin R

    2007-03-28

    This article proposes a solution to the perennial problem of talent retention in the clinical laboratory. It includes the presentation of 12 strategies that may be used to significantly improve institutional identity formation and establishment of the psychological contract that employees form with laboratory management. Identity formation and psychological contracting are deemed as essential in helping reduce employee turnover and increase retention. The 12 conversational strategies may be used as a set of best practices for all employees, but most importantly for new employees, and should be implemented at the critical moment when employees first join the laboratory. This time is referred to as "retention on-boarding"--the period of induction and laboratory orientation. Retention on-boarding involves a dialogue between employees and management that is focused on the psychological, practical, cultural, and political dimensions of the laboratory. It is placed in the context of the modern clinical laboratory, which is faced with employing and managing Generation X knowledge workers. Specific topics and broad content areas of those conversations are outlined.

  14. Can a "good death" be made better?: A preliminary evaluation of a patient-centred quality improvement strategy for severely ill in-patients

    Directory of Open Access Journals (Sweden)

    Powis Jeff

    2004-05-01

    Full Text Available Abstract Background Prior studies attempting to improve end-of-life care have focused on specific outcomes deemed important to healthcare providers, with disappointing results. Improvement may be best achieved by identifying concerns important to individual patients, communicating the patients' concerns to the treating medical team, and repeating the process frequently until all concerns are addressed. Our objective was to conduct a preliminary evaluation of this innovative patient-centred quality improvement strategy. Methods Initial interviews elicited participants' ideas for improvement, which were then fed back to health care providers by the study investigator. A rapid-cycle change model ensured frequent reassessment and continued feedback. The study involved 36 seriously ill, hospitalized patients on teaching general medical inpatient units of a tertiary care hospital. The main outcome measure was participants' ratings of satisfaction within different domains of care on follow-up interviews. Results The proportion of participants who rated various aspects of their care as "excellent" or "very good" on initial interview was 72% for overall care, 64% for symptom control, 66% for level of support, and 75% for discussions about life sustaining treatments. Patients and families identified many actionable steps for improvement such as; better control of pain and shortness of breath, better access to physicians and medical information, more help with activities of daily living, improving the patient's environment, and shorter waits for nursing care, diagnosis, and treatment. Following feedback to the clinical team, participants reported improvement in overall care (32%, symptom control (44%, and support (40%. Only a minority had further discussions about life sustaining treatments. Conclusion A patient-centred approach using rapid-cycle change was feasible and shows promise for improving the quality of end-of-life care. It should be evaluated on

  15. ITERATIVE EVALUATION IN A MOBILE COUNSELING AND TESTING PROGRAM TO REACH PEOPLE OF COLOR AT RISK FOR HIV—NEW STRATEGIES IMPROVE PROGRAM ACCEPTABILITY, EFFECTIVENESS, AND EVALUATION CAPABILITIES

    Science.gov (United States)

    Spielberg, Freya; Kurth, Ann; Reidy, William; McKnight, Teka; Dikobe, Wame; Wilson, Charles

    2016-01-01

    This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program’s results show that an increased focus on mobile outreach using rapid testing, incentives and health information technology tools may improve program acceptability, quality, productivity and timeliness of reports. This article describes program design decisions based on continuous quality assessment efforts. It also examines the impact of the Computer Assessment and Risk Reduction Education computer tool on HIV testing rates, staff perception of counseling quality, program productivity, and on the timeliness of evaluation reports. The article concludes with a discussion of implications for programmatic responses to the Centers for Disease Control and Prevention’s HIV testing recommendations. PMID:21689041

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

    Science.gov (United States)

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

    2012-01-01

    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…

  17. Strategies to improve quality of childbirth care

    Directory of Open Access Journals (Sweden)

    farahnaz Changaee

    2015-01-01

    Full Text Available Background: Access to affordable and quality health care is one of the most important ways for reducing maternal and child mortality. The purpose of this study was to provide strategies to promote the quality of care during childbirth in Lorestan province in 2011. Materials and Methods: This research was a mixed method (quantitative, qualitative, study in which quality of 200 care during childbirth in hospitals of Lorestan Province were evaluated. Data gathered through self-made tools (Checklists prepared according to the guidelines of the ministry of health. Descriptive statistics and SPSS software were used to data analysis.In the second part of the study which was qualitative, interview with service providers, hospital officials and high-ranking officials of Lorestan university of medical sciences (decision makers was used to discuss strategies to improve the quality of care. Results: The results showed that the care of the first stage delivery in %54.5, second stage %57 and third stage 66% were in accordance with the desired status and care in this three stages was of moderate quality. Based on the interviews, the officials who are in charge of Lorestan university of medical sciences, proposed strategies such as financial incentives and in-service training of midwives as suitable strategies to improve quality of services. Conclusion: According to the results, strategies such as financial incentives, increased use of private sector services to reduce the workload of the public sector and increase of quality and use of more in-service training, to improve the quality of services, are recommended.

  18. Model Evaluation and Uncertainty in Agricultural Impacts Assessments: Results and Strategies from the Agricultural Model Intercomparison and Improvement Project (AgMIP)

    Science.gov (United States)

    Rosenzweig, C.; Hatfield, J.; Jones, J. W.; Ruane, A. C.

    2012-12-01

    The Agricultural Model Intercomparison and Improvement Project (AgMIP) is an international effort to assess the state of global agricultural modeling and to understand climate impacts on the agricultural sector. AgMIP connects the climate science, crop modeling, and agricultural economic modeling communities to generate probabilistic projections of current and future climate impacts. The goals of AgMIP are to improve substantially the characterization of risk of hunger and world food security due to climate change and to enhance adaptation capacity in both developing and developed countries. This presentation will describe the general approach of AgMIP, highlight AgMIP efforts to evaluate climate, crop, and economic models, and discuss AgMIP uncertainty assessments. Model evaluation efforts will be outlined using examples from various facets of AgMIP, including climate scenario generation, the wheat crop model intercomparison, and the global agricultural economics model intercomparison being led in collaboration with the Inter-Sectoral Impact Model Intercomparison Project (ISI-MIP). Strategies developed to quantify uncertainty in each component of AgMIP, as well as the propagation of uncertainty through the climate-crop-economic modeling framework, will be detailed and preliminary uncertainty assessments that highlight crucial areas requiring improved models and data collection will be introduced.

  19. Methods of Evaluating Performances for Marketing Strategies

    OpenAIRE

    Ioan Cucu

    2005-01-01

    There are specific methods for assessing and improving the effectiveness of a marketing strategy. A marketer should state in the marketing plan what a marketing strategy is supposed to accomplish. These statements should set forth performance standards, which usually are stated in terms of profits, sales, or costs. Actual performance must be measured in similar terms so that comparisons are possible. This paper describes sales analysis and cost analysis, two general ways of evaluating the act...

  20. Improving Water Resources Management on Global and Region Scales - Evaluating Strategies for Water Futures with the IIASA's Community Water Model

    Science.gov (United States)

    Burek, P.; Kahil, T.; Satoh, Y.; Greve, P.; Byers, E.; Langan, S.; Wada, Y.

    2017-12-01

    Half of the planet's population is severely impacted by severe water issues including absent or unreliable water supply, sanitation, poor water quality, unmitigated floods and droughts, and degraded water environments. In recent years, global water security has been highlighted not only by the science community but also by business leaders as one of the greatest threats to sustainable human development for different generations. How can we ensure the well-being of people and ecosystems with limited water, technology and financial resources? To evaluate this, IIASA's Water Futures and Solutions Initiative (WFaS) is identifying a portfolios of robust and cost-effective options across different economic sectors including agriculture, energy, manufacturing, households, and environment and ecosystems. Options to increase water supply and accessibility are evaluated together with water demand management and water governance options. To test these solution-portfolios in order to obtain a clear picture of the opportunities but also of the risks and the trade-offs we have developed the Community Water Model (CWATM) which joins IIASA's integrated assessment modeling framework, coupling hydrology with hydro-economics (ECHO model), energy (MESSAGE model) and land use (GLOBIOM model). CWATM has been developed to work flexibly with varying spatial resolutions from global to regional levels. The model is open source and community-driven to promote our work amongst the wider water and other science community worldwide, with flexibility to link to other models and integrate newly developed modules such as water quality. In order to identify the solution portfolios, we present a global hotspots assessment of water-related risks with the ability to zoom in at regional scale using the example of the Lake Victoria basin in E. Africa. We show how socio-economic and climate change will alter spatial patterns of the hydrological cycle and have regional impacts on water availability. At

  1. Evaluating strategies to improve glucosinolate concentration and root yield of field-grown horseradish in a Mediterranean environment: preliminary results

    Directory of Open Access Journals (Sweden)

    Anna Rita Rivelli

    2016-03-01

    Full Text Available Horseradish is grown for its enlarged taproot that is widely used as a dish condiment and as a source of horseradish peroxidase. Nowadays, the species is gaining great interest due to the richness in bioactive compounds that besides providing a high nutritional value are tested for innovative applications in different fields. Nevertheless, the effect of crop management on root yield and glucosinolates (GLS biosynthesis is poorly documented. Aim of this study was to evaluate the root yield and GLS concentration of two field-grown horseradish accessions (Cor and Mon grown with nitrogen (N alone and both N and sulphur (S (-N-S, +N-S and +N+S treatments and harvested at different times [late autumn (LA, 2011 and 2012, early spring (ES, 2012]. Yield increased throughout the harvests up to 48% on average of the fertilised treatments and 25% in the unfertilised control. Conversely, root GLS concentration significantly declined in the unfertilised control throughout the harvests [from 7.6 in LA_2011 to 1.43 μmol/g dry matter (DM in LA_2012] while it highly increased in plants grown with N alone and with both N and S by 46 and 98%, respectively, from LA_2011 to ES_2012 (up to 11.9 and 21.1 μmol/g DM, respectively; then it drastically decreased by 80% on average, in the next harvest. Among individual GLS, the concentration of sinigrin and nasturtin similarly varied as effect of the analysed factors, showing the highest values in Cor accession. The data show that although the level of GLS is highly dependent on genotype, fertilisation and harvesting date may play a primary role in determining the yield and GLS concentration in horseradish root.

  2. Implementation and Evaluation of Two Educational Strategies to Improve Screening for Eating Disorders in Pediatric Primary Care.

    Science.gov (United States)

    Gooding, Holly C; Cheever, Elizabeth; Forman, Sara F; Hatoun, Jonathan; Jooma, Farah; Touloumtzis, Currie; Vernacchio, Louis

    2017-05-01

    Routine screening for disordered eating or body image concerns is recommended by the American Academy of Pediatrics. We evaluated the ability of two educational interventions to increase screening for eating disorders in pediatric primary care practice, predicting that the "active-learning" group would have an increase in documented screening after intervention. We studied 303 practitioners in a large independent practice association located in the northeastern United States. We used a quasi-experimental design to test the effect of printed educational materials ("print-learning" group, n = 280 participants) compared with in-person shared learning followed by on-line spaced education ("active-learning" group, n = 23 participants) on documented screening of adolescents for eating disorder symptoms during preventive care visits. A subset of 88 participants completed additional surveys regarding knowledge of eating disorders, comfort screening for, diagnosing, and treating eating disorders, and satisfaction with their training regarding eating disorders. During the preintervention period, 4.5% of patients seen by practitioners in both the print-learning and active-learning groups had chart documentation of screening for eating disorder symptoms or body image concerns. This increased to 22% in the active-learning group and 5.7% in the print-learning group in the postintervention period, a statistically significant result. Compared with print-learning participants, active-learning group participants had greater eating disorder knowledge scores, increases in comfort diagnosing eating disorders, and satisfaction with their training in this area. In-person shared learning followed by on-line spaced education is more effective than print educational materials for increasing provider documentation of screening for eating disorders in primary care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series.

    Science.gov (United States)

    Goetz, Matthew B; Bowman, Candice; Hoang, Tuyen; Anaya, Henry; Osborn, Teresa; Gifford, Allen L; Asch, Steven M

    2008-03-19

    We describe how we used the framework of the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) to develop a program to improve rates of diagnostic testing for the Human Immunodeficiency Virus (HIV). This venture was prompted by the observation by the CDC that 25% of HIV-infected patients do not know their diagnosis - a point of substantial importance to the VA, which is the largest provider of HIV care in the United States. Following the QUERI steps (or process), we evaluated: 1) whether undiagnosed HIV infection is a high-risk, high-volume clinical issue within the VA, 2) whether there are evidence-based recommendations for HIV testing, 3) whether there are gaps in the performance of VA HIV testing, and 4) the barriers and facilitators to improving current practice in the VA.Based on our findings, we developed and initiated a QUERI step 4/phase 1 pilot project using the precepts of the Chronic Care Model. Our improvement strategy relies upon electronic clinical reminders to provide decision support; audit/feedback as a clinical information system, and appropriate changes in delivery system design. These activities are complemented by academic detailing and social marketing interventions to achieve provider activation. Our preliminary formative evaluation indicates the need to ensure leadership and team buy-in, address facility-specific barriers, refine the reminder, and address factors that contribute to inter-clinic variances in HIV testing rates. Preliminary unadjusted data from the first seven months of our program show 3-5 fold increases in the proportion of at-risk patients who are offered HIV testing at the VA sites (stations) where the pilot project has been undertaken; no change was seen at control stations. This project demonstrates the early success of the application of the QUERI process to the development of a program to improve HIV testing rates. Preliminary unadjusted results show that the coordinated use of

  4. Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series

    Directory of Open Access Journals (Sweden)

    Osborn Teresa

    2008-03-01

    Full Text Available Abstract Background We describe how we used the framework of the U.S. Department of Veterans Affairs (VA Quality Enhancement Research Initiative (QUERI to develop a program to improve rates of diagnostic testing for the Human Immunodeficiency Virus (HIV. This venture was prompted by the observation by the CDC that 25% of HIV-infected patients do not know their diagnosis – a point of substantial importance to the VA, which is the largest provider of HIV care in the United States. Methods Following the QUERI steps (or process, we evaluated: 1 whether undiagnosed HIV infection is a high-risk, high-volume clinical issue within the VA, 2 whether there are evidence-based recommendations for HIV testing, 3 whether there are gaps in the performance of VA HIV testing, and 4 the barriers and facilitators to improving current practice in the VA. Based on our findings, we developed and initiated a QUERI step 4/phase 1 pilot project using the precepts of the Chronic Care Model. Our improvement strategy relies upon electronic clinical reminders to provide decision support; audit/feedback as a clinical information system, and appropriate changes in delivery system design. These activities are complemented by academic detailing and social marketing interventions to achieve provider activation. Results Our preliminary formative evaluation indicates the need to ensure leadership and team buy-in, address facility-specific barriers, refine the reminder, and address factors that contribute to inter-clinic variances in HIV testing rates. Preliminary unadjusted data from the first seven months of our program show 3–5 fold increases in the proportion of at-risk patients who are offered HIV testing at the VA sites (stations where the pilot project has been undertaken; no change was seen at control stations. Discussion This project demonstrates the early success of the application of the QUERI process to the development of a program to improve HIV testing rates

  5. Strategies to improve recruitment to randomised trials.

    Science.gov (United States)

    Treweek, Shaun; Pitkethly, Marie; Cook, Jonathan; Fraser, Cynthia; Mitchell, Elizabeth; Sullivan, Frank; Jackson, Catherine; Taskila, Tyna K; Gardner, Heidi

    2018-02-22

    Recruiting participants to trials can be extremely difficult. Identifying strategies that improve trial recruitment would benefit both trialists and health research. To quantify the effects of strategies for improving recruitment of participants to randomised trials. A secondary objective is to assess the evidence for the effect of the research setting (e.g. primary care versus secondary care) on recruitment. We searched the Cochrane Methodology Review Group Specialised Register (CMR) in the Cochrane Library (July 2012, searched 11 February 2015); MEDLINE and MEDLINE In Process (OVID) (1946 to 10 February 2015); Embase (OVID) (1996 to 2015 Week 06); Science Citation Index & Social Science Citation Index (ISI) (2009 to 11 February 2015) and ERIC (EBSCO) (2009 to 11 February 2015). Randomised and quasi-randomised trials of methods to increase recruitment to randomised trials. This includes non-healthcare studies and studies recruiting to hypothetical trials. We excluded studies aiming to increase response rates to questionnaires or trial retention and those evaluating incentives and disincentives for clinicians to recruit participants. We extracted data on: the method evaluated; country in which the study was carried out; nature of the population; nature of the study setting; nature of the study to be recruited into; randomisation or quasi-randomisation method; and numbers and proportions in each intervention group. We used a risk difference to estimate the absolute improvement and the 95% confidence interval (CI) to describe the effect in individual trials. We assessed heterogeneity between trial results. We used GRADE to judge the certainty we had in the evidence coming from each comparison. We identified 68 eligible trials (24 new to this update) with more than 74,000 participants. There were 63 studies involving interventions aimed directly at trial participants, while five evaluated interventions aimed at people recruiting participants. All studies were in

  6. An Implementation Strategy to Improve the Guideline Adherence of Insurance Physicians: A Process Evaluation Alongside an Experiment in a Controlled Setting

    Science.gov (United States)

    Zwerver, Feico; Bonefaas-Groenewoud, Karin; Schellart, Antonius J. M.; Anema, Johannes R.; van der Beek, Allard J.

    2013-01-01

    Background: We developed an implementation strategy for the insurance medicine guidelines for depression, which we implemented via a post-graduate course for insurance physicians (IPs). In this study we evaluate the physicians' experiences of the implementation strategy by measuring the following aspects: recruitment and reach, dose delivered and…

  7. Teaching Strategies to Improve Algebra Learning

    Science.gov (United States)

    Zbiek, Rose Mary; Larson, Matthew R.

    2015-01-01

    Improving student learning is the primary goal of every teacher of algebra. Teachers seek strategies to help all students learn important algebra content and develop mathematical practices. The new Institute of Education Sciences[IES] practice guide, "Teaching Strategies for Improving Algebra Knowledge in Middle and High School Students"…

  8. Strategies to improve retention in randomised trials

    Science.gov (United States)

    Brueton, Valerie C; Tierney, Jayne; Stenning, Sally; Harding, Seeromanie; Meredith, Sarah; Nazareth, Irwin; Rait, Greta

    2013-01-01

    Background Loss to follow-up from randomised trials can introduce bias and reduce study power, affecting the generalisability, validity and reliability of results. Many strategies are used to reduce loss to follow-up and improve retention but few have been formally evaluated. Objectives To quantify the effect of strategies to improve retention on the proportion of participants retained in randomised trials and to investigate if the effect varied by trial strategy and trial setting. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PreMEDLINE, EMBASE, PsycINFO, DARE, CINAHL, Campbell Collaboration's Social, Psychological, Educational and Criminological Trials Register, and ERIC. We handsearched conference proceedings and publication reference lists for eligible retention trials. We also surveyed all UK Clinical Trials Units to identify further studies. Selection criteria We included eligible retention trials of randomised or quasi-randomised evaluations of strategies to increase retention that were embedded in 'host' randomised trials from all disease areas and healthcare settings. We excluded studies aiming to increase treatment compliance. Data collection and analysis We contacted authors to supplement or confirm data that we had extracted. For retention trials, we recorded data on the method of randomisation, type of strategy evaluated, comparator, primary outcome, planned sample size, numbers randomised and numbers retained. We used risk ratios (RR) to evaluate the effectiveness of the addition of strategies to improve retention. We assessed heterogeneity between trials using the Chi2 and I2 statistics. For main trials that hosted retention trials, we extracted data on disease area, intervention, population, healthcare setting, sequence generation and allocation concealment. Main results We identified 38 eligible retention trials. Included trials evaluated six broad types of strategies to improve retention. These

  9. Local Strategy Improvement for Parity Game Solving

    Directory of Open Access Journals (Sweden)

    Oliver Friedmann

    2010-06-01

    Full Text Available The problem of solving a parity game is at the core of many problems in model checking, satisfiability checking and program synthesis. Some of the best algorithms for solving parity game are strategy improvement algorithms. These are global in nature since they require the entire parity game to be present at the beginning. This is a distinct disadvantage because in many applications one only needs to know which winning region a particular node belongs to, and a witnessing winning strategy may cover only a fractional part of the entire game graph. We present a local strategy improvement algorithm which explores the game graph on-the-fly whilst performing the improvement steps. We also compare it empirically with existing global strategy improvement algorithms and the currently only other local algorithm for solving parity games. It turns out that local strategy improvement can outperform these others by several orders of magnitude.

  10. Iterative Evaluation in a Mobile Counseling and Testing Program to Reach People of Color at Risk for HIV--New Strategies Improve Program Acceptability, Effectiveness, and Evaluation Capabilities

    Science.gov (United States)

    Spielberg, Freya; Kurth, Ann; Reidy, William; McKnight, Teka; Dikobe, Wame; Wilson, Charles

    2011-01-01

    This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program's…

  11. Evaluation of different operational strategies for lithium ion battery systems connected to a wind turbine for primary frequency regulation and wind power forecast accuracy improvement

    Energy Technology Data Exchange (ETDEWEB)

    Swierczynski, Maciej; Stroe, Daniel Ioan; Stan, Ana Irina; Teodorescu, Remus; Andreasen, Soeren Juhl [Aalborg Univ. (Denmark). Dept. of Energy Technology

    2012-07-01

    High penetration levels of variable wind energy sources can cause problems with their grid integration. Energy storage systems connected to wind turbine/wind power plants can improve predictability of the wind power production and provide ancillary services to the grid. This paper investigates economics of different operational strategies for Li-ion systems connected to wind turbines for wind power forecast accuracy improvement and primary frequency regulation. (orig.)

  12. Evaluation strategies for monadic computations

    Directory of Open Access Journals (Sweden)

    Tomas Petricek

    2012-02-01

    Full Text Available Monads have become a powerful tool for structuring effectful computations in functional programming, because they make the order of effects explicit. When translating pure code to a monadic version, we need to specify evaluation order explicitly. Two standard translations give call-by-value and call-by-name semantics. The resulting programs have different structure and types, which makes revisiting the choice difficult. In this paper, we translate pure code to monadic using an additional operation malias that abstracts out the evaluation strategy. The malias operation is based on computational comonads; we use a categorical framework to specify the laws that are required to hold about the operation. For any monad, we show implementations of malias that give call-by-value and call-by-name semantics. Although we do not give call-by-need semantics for all monads, we show how to turn certain monads into an extended monad with call-by-need semantics, which partly answers an open question. Moreover, using our unified translation, it is possible to change the evaluation strategy of functional code translated to the monadic form without changing its structure or types.

  13. Evaluating the Use of Instructional Coaching as a Tool to Improve Teacher Instructional Strategies at a Title 1 Middle School: An Action Research Study

    Science.gov (United States)

    Learmond, Karen W.

    2017-01-01

    This action research study focused on the use of an instructional coaching model to support teachers in the use of Marzano's nine research-based instructional strategies at a low performing Title 1 middle school. The intervention was carried out over five and a half -month period and was aimed at improving teachers' classroom instruction. The…

  14. Local Strategy Improvement for Parity Game Solving

    OpenAIRE

    Friedmann, Oliver; Lange, Martin

    2010-01-01

    The problem of solving a parity game is at the core of many problems in model checking, satisfiability checking and program synthesis. Some of the best algorithms for solving parity game are strategy improvement algorithms. These are global in nature since they require the entire parity game to be present at the beginning. This is a distinct disadvantage because in many applications one only needs to know which winning region a particular node belongs to, and a witnessing winning strategy may...

  15. Evaluation of a tailored implementation strategy to improve the management of patients with chronic obstructive pulmonary disease in primary care: a study protocol of a cluster randomized trial.

    Science.gov (United States)

    Godycki-Cwirko, Maciek; Zakowska, Izabela; Kosiek, Katarzyna; Wensing, Michel; Krawczyk, Jaroslaw; Kowalczyk, Anna

    2014-04-04

    Chronic obstructive pulmonary disease (COPD) remains a major health problem, strongly related to smoking. Despite the publication of practice guidelines on prevention and treatment, not all patients with the disease receive the recommended healthcare, particularly with regard to smoking cessation advice where applicable. We have developed a tailored implementation strategy for enhancing general practitioners' adherence to the disease management guidelines. The primary aim of the study is to evaluate the effects of this tailored implementation intervention on general practitioners' adherence to guidelines. A pragmatic two-arm cluster randomized trial has been planned to compare care following the implementation of tailored interventions of four recommendations in COPD patients against usual care. The study will involve 18 general practices (9 in the intervention group and 9 in the control group) in Poland, each with at least 80 identified (at the baseline) patients with diagnosed COPD. The nine control practices will provide usual care without any interventions. Tailored interventions to implement four recommendations will be delivered in the remaining nine practices. At follow-up after nine months, data will be collected for all 18 general practices. The primary outcome measure is physicians' adherence to all four recommendations: brief anti-smoking advice, dyspnea assessment, care checklist utilization and demonstration to patients of correct inhaler use. This measurement will be based on data extracted from identified patients' records. Additionally, we will survey and interview patients with chronic obstructive pulmonary disease about the process of care. The results of this trial will be directly applicable to primary care in Poland and add to the growing body of evidence on interventions to improve chronic illness care. This trial has been registered with Clinical Trials Protocol Registration System. NCT01893476.

  16. Using Appropriate Strategies to Improve Students' Comprehension ...

    African Journals Online (AJOL)

    Using Appropriate Strategies to Improve Students' Comprehension of Chemistry Texts: A Guide for Chemistry Teachers. ... African Research Review ... Unfortunately, contemporary research insight into science reading is lacking and science educators tend to focus on methods of teaching specific subject matter and ...

  17. Parking management : strategies, evaluation and planning

    International Nuclear Information System (INIS)

    Litman, T.A.

    2006-01-01

    Parking facilities are a major cost to society. Current planning practices are based on the assumption that parking should be abundant and provided free, with costs borne indirectly. This report examined parking management strategies related to integrated parking plans. Problems with current parking planning practices were reviewed. The costs of parking facilities were examined, as well as the savings that can accrue from improved management techniques. Strategies included shared parking; remote parking and shuttle services; walking and cycling improvements; improved enforcement and control; and increasing the capacity of existing parking facilities. Parking pricing methods, financial incentives and parking tax reforms were reviewed. Issues concerning user information and marketing were examined. Overflow parking plans were evaluated. Three illustrative examples of parking management programs were outlined, along with details of implementation, planning and evaluation procedures. It was concluded that cost-effective parking management programs can often reduce parking requirements by 20 to 40 per cent compared with conventional planning requirements, in addition to providing economic, social and environmental benefits. 32 refs., 7 tabs., 3 figs

  18. Didactic Strategies to Improve Reading and Writing

    Directory of Open Access Journals (Sweden)

    Elide del Rosario Castellanos Santiago

    2017-11-01

    Full Text Available The importance of the present article is that it tries to reflect on generating theoretical orientations on didactic strategies to improve the literacy in the students of the school Mercedes Diaz of the parish Sabana de Mendoza, municipality Sucre, Trujillo state. Methodologically, the research was documentary, descriptive, supported by the postulates of Lev Vygotsky (1993, Piaget (1978 and Emilia Ferreiro (2000, Ortiz, (2008 Flower and Hayes (2009. The obtained results evidenced the effective participation by the teachers and the commitment acquired through the management and application of didactic strategies of reading and writing that can favor the learning of the subject that learns.

  19. Using Relational Reasoning Strategies to Help Improve Clinical Reasoning Practice.

    Science.gov (United States)

    Dumas, Denis; Torre, Dario M; Durning, Steven J

    2018-05-01

    Clinical reasoning-the steps up to and including establishing a diagnosis and/or therapy-is a fundamentally important mental process for physicians. Unfortunately, mounting evidence suggests that errors in clinical reasoning lead to substantial problems for medical professionals and patients alike, including suboptimal care, malpractice claims, and rising health care costs. For this reason, cognitive strategies by which clinical reasoning may be improved-and that many expert clinicians are already using-are highly relevant for all medical professionals, educators, and learners.In this Perspective, the authors introduce one group of cognitive strategies-termed relational reasoning strategies-that have been empirically shown, through limited educational and psychological research, to improve the accuracy of learners' reasoning both within and outside of the medical disciplines. The authors contend that relational reasoning strategies may help clinicians to be metacognitive about their own clinical reasoning; such strategies may also be particularly well suited for explicitly organizing clinical reasoning instruction for learners. Because the particular curricular efforts that may improve the relational reasoning of medical students are not known at this point, the authors describe the nature of previous research on relational reasoning strategies to encourage the future design, implementation, and evaluation of instructional interventions for relational reasoning within the medical education literature. The authors also call for continued research on using relational reasoning strategies and their role in clinical practice and medical education, with the long-term goal of improving diagnostic accuracy.

  20. Does reading strategy instruction improve students’ comprehension?

    Directory of Open Access Journals (Sweden)

    Oyetunji, Christianah Oluwatoyin

    2013-12-01

    Full Text Available This paper describes the effect of reading strategy instruction on Second Language (L2 students’ reading comprehension in a Botswana College of Education. The intervention programme was implemented based on the observation that some trainee teachers failed to improve on their L2 proficiency after spending a year in the L2 classroom. Prior to the intervention, difficulty in reading and comprehending had been identified as one of the contributing factors to their failure to improve on their proficiency level. A reading comprehension test was used to collect data from participants who were trainee teachers at a College of Education in Botswana before and after the intervention. The six-week intervention programme focused on seven reading strategies, namely the use of background knowledge, self-questioning, inferencing, rereading, drawing conclusions, identifying main ideas and summarising. The findings suggest that strategy training can increase L2 students’ reading comprehension. Based on the findings, it is recommended that strategy training be introduced into the L2 syllabus of the primary school teacher trainees in all Botswana Colleges of Education.

  1. Efficient Parallel Strategy Improvement for Parity Games

    OpenAIRE

    Fearnley, John

    2017-01-01

    We study strategy improvement algorithms for solving parity games. While these algorithms are known to solve parity games using a very small number of iterations, experimental studies have found that a high step complexity causes them to perform poorly in practice. In this paper we seek to address this situation. Every iteration of the algorithm must compute a best response, and while the standard way of doing this uses the Bellman-Ford algorithm, we give experimental results that show that o...

  2. Communication strategies to improve HIV treatment adherence.

    Science.gov (United States)

    Rochon, Donna; Ross, Michael W; Looney, Carol; Nepal, Vishnu P; Price, Andrea J; Giordano, Thomas P

    2011-01-01

    Although antiretroviral therapy has increased the survival of HIV-positive patients, traditional approaches to improving medication adherence have failed consistently. Acknowledging the role of communication in health behavior, we conducted a qualitative study to learn about patients' HIV treatment adherence experiences and to identify which communication strategies might influence adherence. Findings indicate that five constructs--cultural beliefs/language, stigma, cues to action, self-efficacy, and mood state--are potentially modifiable by improved communication. Results will be used to create a direct marketing campaign targeted to HIV-infected patients. Copyright © Taylor & Francis Group, LLC

  3. Improving health equity through theory-informed evaluations: a look at housing first strategies, cross-sectoral health programs, and prostitution policy.

    Science.gov (United States)

    Dunn, James R; van der Meulen, Emily; O'Campo, Patricia; Muntaner, Carles

    2013-02-01

    The emergent realist perspective on evaluation is instructive in the quest to use theory-informed evaluations to reduce health inequities. This perspective suggests that in addition to knowing whether a program works, it is imperative to know 'what works for whom in what circumstances and in what respects, and how?' (Pawson & Tilley, 1997). This addresses the important issue of heterogeneity of effect, in other words, that programs have different effects for different people, potentially even exacerbating inequities and worsening the situation of marginalized groups. But in addition, the realist perspective implies that a program may not only have a greater or lesser effect, but even for the same effect, it may work by way of a different mechanism, about which we must theorize, for different groups. For this reason, theory, and theory-based evaluations are critical to health equity. We present here three examples of evaluations with a focus on program theories and their links to inequalities. All three examples illustrate the importance of theory-based evaluations in reducing health inequities. We offer these examples from a wide variety of settings to illustrate that the problem of which we write is not an exception to usual practice. The 'Housing First' model of supportive housing for people with severe mental illness is based on a theory of the role of housing in living with mental illness that has a number of elements that directly contradict the theory underlying the dominant model. Multisectoral action theories form the basis for the second example on Venezuela's revolutionary national Barrio Adentro health improvement program. Finally, decriminalization of prostitution and related health and safety policies in New Zealand illustrate how evaluations can play an important role in both refining the theory and contributing to improved policy interventions to address inequalities. The theoretically driven and transformative nature of these interventions create

  4. Evaluation strategies in CT scanning

    DEFF Research Database (Denmark)

    In this talk, dimensional measurement results using different measuring strategies applied in different inspection software packages for volume and surface data analysis are presented. The influence of the strategy on the dimensional measurement is determined by calculating the measurement...... uncertainty. This investigation includes measurements of two industrial items, an aluminum pipe connector and a plastic toggle, a hearing aid component. These are measured using a commercial CT scanner. Traceability is transferred using tactile and optical coordinate measuring machines, which are used...

  5. Biotechnological interventions in sugarcane improvement: strategies, methods and progress

    International Nuclear Information System (INIS)

    Suprasanna, P.

    2010-01-01

    Work has been conducted towards employing in vitro culture system combined with radiation induced mutagenesis in the improvement of sugarcane. Several radiation induced mutants with agronomically desirable traits were isolated and evaluated under field conditions, besides studying abiotic stress responses using biochemical, physiological and molecular tools. This article describes the developments in the in vitro culture systems and related biotechnologies that are evolving as novel strategies in the recent years for use in sugarcane improvement

  6. Evaluating the US Counter-ISIL Strategy

    Science.gov (United States)

    2017-05-25

    strategy is actually addressing those critical capabilities and vulnerabilities. Finally, it explores alternative, whole-of-government strategies that...Counterterrorism Strategies as an Illustration. Santa Monica, CA: RAND Corporation , 2009. Enduring Leadership in a Dynamic World. Quadrennial Diplomacy...Evaluating the US Counter-ISIL Strategy A Monograph by LTC Jason A. Curl U.S. Army School of Advanced Military Studies United States Army

  7. Risk evaluation of accident management strategies

    International Nuclear Information System (INIS)

    Dingman, S.; Camp, A.

    1992-01-01

    The use of Probabilistic Risk Assessment (PRA) methods to evaluate accident management strategies in nuclear power plants discussed in this paper. The PRA framework allows an integrated evaluation to be performed to give the full implications of a particular strategy. The methodology is demonstrated for a particular accident management strategy, intentional depressurization of the reactor coolant system to avoid containment pressurization during the ejection of molten debris at vessel breach

  8. TPM- A KEY STRATEGY FOR PRODUCTIVITY IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    J.S. DUREJA

    2011-02-01

    Full Text Available During high growth era companies are making technical progress in automation and centralization of the plants, which needs large amount of manual work to maintain the automation systems. The strategy of maintaining the equipment of a plant is crucial for the effectiveness of manufacturing. Total productive maintenance (TPM is a maintenance program, which involves concepts for maintaining plant and equipments effectively. In this paper detailed implementation of TPM in the cold rolling plant is discussed. Results achieved are quite encouraging in terms of motivated employees, improvement in overall equipment effectiveness (OEE and reduction in no. of accidents on shop floor.

  9. Improving Health Care Accessibility: Strategies and Recommendations.

    Science.gov (United States)

    Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Access time refers to the interval between requesting and actual outpatient appointment. It reflects healthcare accessibility and has a great influence on patient treatment and satisfaction. King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia studied the accessibility to outpatient services in order to develop useful strategies and recommendations for improvement. Utilized, unutilized and no-show appointments were analyzed. It is crucial to manage no-shows and short notice appointment cancellations by preparing a waiting list for those patients who can be called in to an appointment on the same day using an open access policy. An overlapping appointment scheduling model can be useful to minimize patient waiting time and doctor idle time in addition to the sensible use of appointment overbooking that can significantly improve productivity.

  10. DESIGNING STRATEGIES FOR IMPROVING TOTAL QUALITY MANAGEMENT IN MANUFACTURING INDUSTRIES

    Directory of Open Access Journals (Sweden)

    Alfian Nur Ubay

    2017-05-01

    Full Text Available This research was aimed at designing strategies for improving total quality management at CV XYZ and PT HIJ. The research locations were selected intentionally with the consideration that the company is a middle class company that started to apply a study in line with the research topic. The experts were chosen using an approach method. This research used a descriptive approach and quantitative analysis through questionnaires using purposive sampling. The stages began with data processing, i.e. testing the questionnaire quality through validity and reliability tests, making a causality diagram, evaluating the implementation levels of each company by giving evaluation scales based on the existing condition, making House of Quality (HOQ using QFD methods, and then analyzing the problem solutions produced from the QFD methods with 5W + IH analysis, and finally determining the improvement priorities using Fuzzy AHP methods. The results were the strategies for improving total quality management /TQM of CV XYZ, namely the factor that plays the most important role was improving the quality management performance. The actor that has the competence to carry out the TQM improvement is the director. The prioritized goal to be achieved is a commitment to improve the quality of goods and services.  The prioritized strategy used in improving TQM is carrying out SOP consistently.Keywords: strategies, improvement, TQM, manufacturing company, fuzzy AHPABSTRAKPenelitian ini bertujuan merancang strategi peningkatan manajemen mutu terpadu pada CV XYZ dan PT HIJ. Pemilihan lokasi penelitian dilakukan secara sengaja dengan pertimbangan bahwa perusahaan tersebut merupakan perusahaan kelas menengah yang mulai menerapkan kajian sesuai dengan topik penelitian. Penentuan pakar dilakukan dengan metode pendekatan secara sengaja. Adapun penelitian ini menggunakan pendekatan deskriptif dan analisa kuantitatif dengan menyebarkan kuesioner secara sengaja (purposive sampling

  11. Conceptual maps as evaluation strategy

    Directory of Open Access Journals (Sweden)

    Dionísio Borsato

    2007-03-01

    Full Text Available The following work shows the conceptual map as an evaluation tool. In this study, an opening text was used as a previous organizer, with a theme related to the students’ daily lives. The developed activity consisted in elaborating conceptual maps before and after the experimental works. The evaluation was applied to 21 students of the 1st grade and 22 of the 3rd grade of High School. The elaborated maps were scored according to hierarchy, propositions, linking words, cross linking and examples. The classification of the maps elaborated before and after the experimental activity, was obtained having as a parameter, a referential conceptual map. In this classification many differences were observed between the first and second maps of both grades and among the groups. The elaboration of conceptual maps showed great potential as evaluation resources.

  12. Using Strategy Improvement to Stay Alive

    Directory of Open Access Journals (Sweden)

    Luboš Brim

    2010-06-01

    Full Text Available We design a novel algorithm for solving Mean-Payoff Games (MPGs. Besides solving an MPG in the usual sense, our algorithm computes more information about the game, information that is important with respect to applications. The weights of the edges of an MPG can be thought of as a gained/consumed energy -- depending on the sign. For each vertex, our algorithm computes the minimum amount of initial energy that is sufficient for player Max to ensure that in a play starting from the vertex, the energy level never goes below zero. Our algorithm is not the first algorithm that computes the minimum sufficient initial energies, but according to our experimental study it is the fastest algorithm that computes them. The reason is that it utilizes the strategy improvement technique which is very efficient in practice.

  13. Opioid adjuvant strategy: improving opioid effectiveness.

    Science.gov (United States)

    Bihel, Frédéric

    2016-01-01

    Opioid analgesics continue to be the mainstay of pharmacologic treatment of moderate to severe pain. Many patients, particularly those suffering from chronic pain, require chronic high-dose analgesic therapy. Achieving clinical efficacy and tolerability of such treatment regimens is hampered by the appearance of opioid-induced side effects such as tolerance, hyperalgesia and withdrawal syndrome. Among the therapeutic options to improve the opioid effectiveness, this current review focuses on strategies combining opioids to other drugs that can modulate opioid-mediated effects. We will discuss about experimental evidences reported for several potential opioid adjuvants, including N-methyl-D-aspartate receptor antagonists, 5-HT7 agonists, sigma-1 antagonists, I2-R ligands, cholecystokinin antagonists, neuropeptide FF-R antagonists and toll-like receptor 4 antagonists.

  14. Approved Risk Evaluation and Mitigation Strategies

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Food and Drug Administration Amendments Act of 2007 gave FDA the authority to require a Risk Evaluation and Mitigation Strategy (REMS) from manufacturers to...

  15. Decision Strategy: Radiological Evaluations: Air

    Energy Technology Data Exchange (ETDEWEB)

    Sohier, A

    2000-07-01

    The objectives of SCK-CEN's R and D programme on off-site emergency management are (1) to improve methods to assess in real time the radiological impact to the population and the environment during a nuclear emergency; (2) to support and advise the Belgian authorities on specific problems concerning existing and potential hazards from exposure to ionising radiation in normal and accidental conditions; (3) to organise training courses on off-site emergency response to nuclear accidents. Main achievements in 1999 are reported on.

  16. Decision Strategy: Radiological Evaluations: Air

    International Nuclear Information System (INIS)

    Sohier, A.

    2000-01-01

    The objectives of SCK-CEN's R and D programme on off-site emergency management are (1) to improve methods to assess in real time the radiological impact to the population and the environment during a nuclear emergency; (2) to support and advise the Belgian authorities on specific problems concerning existing and potential hazards from exposure to ionising radiation in normal and accidental conditions; (3) to organise training courses on off-site emergency response to nuclear accidents. Main achievements in 1999 are reported on

  17. Evaluating risk management strategies in resource planning

    International Nuclear Information System (INIS)

    Andrews, C.J.

    1995-01-01

    This paper discusses the evaluation of risk management strategies as a part of integrated resource planning. Value- and scope-related uncertainties can be addressed during the process of planning, but uncertainties in the operating environment require technical analysis within planning models. Flexibility and robustness are two key classes of strategies for managing the risk posed by these uncertainties. This paper reviews standard capacity expansion planning models and shows that they are poorly equipped to compare risk management strategies. Those that acknowledge uncertainty are better at evaluating robustness than flexibility, which implies a bias against flexible options. Techniques are available to overcome this bias

  18. A strategy for evaluating pathway analysis methods.

    Science.gov (United States)

    Yu, Chenggang; Woo, Hyung Jun; Yu, Xueping; Oyama, Tatsuya; Wallqvist, Anders; Reifman, Jaques

    2017-10-13

    Researchers have previously developed a multitude of methods designed to identify biological pathways associated with specific clinical or experimental conditions of interest, with the aim of facilitating biological interpretation of high-throughput data. Before practically applying such pathway analysis (PA) methods, we must first evaluate their performance and reliability, using datasets where the pathways perturbed by the conditions of interest have been well characterized in advance. However, such 'ground truths' (or gold standards) are often unavailable. Furthermore, previous evaluation strategies that have focused on defining 'true answers' are unable to systematically and objectively assess PA methods under a wide range of conditions. In this work, we propose a novel strategy for evaluating PA methods independently of any gold standard, either established or assumed. The strategy involves the use of two mutually complementary metrics, recall and discrimination. Recall measures the consistency of the perturbed pathways identified by applying a particular analysis method to an original large dataset and those identified by the same method to a sub-dataset of the original dataset. In contrast, discrimination measures specificity-the degree to which the perturbed pathways identified by a particular method to a dataset from one experiment differ from those identifying by the same method to a dataset from a different experiment. We used these metrics and 24 datasets to evaluate six widely used PA methods. The results highlighted the common challenge in reliably identifying significant pathways from small datasets. Importantly, we confirmed the effectiveness of our proposed dual-metric strategy by showing that previous comparative studies corroborate the performance evaluations of the six methods obtained by our strategy. Unlike any previously proposed strategy for evaluating the performance of PA methods, our dual-metric strategy does not rely on any ground truth

  19. A critical evaluation of the strategy project

    International Nuclear Information System (INIS)

    Howard, B. J.; Liland, A.; Beresford, N. A.; Andersson, K. G.; Cox, G.; Gil, J. M.; Hunt, J.; Nisbet, A.; Oughton, D. H.; Voigt, G.

    2004-01-01

    The STRATEGY project (sustainable restoration and long-term management of contaminated rural, urban and industrial ecosystems; www.strategy-ec.org.uk) addressed the need for a holistic decision framework for the selection of optimal remediation strategies for long-term sustainable management of contaminated areas in Western Europe. The project considered both technical and social aspects of implementing restoration strategies for urban and rural environments. The importance of considering socially relevant objectives in addition to the dose reduction was emphasised. A critical evaluation was carried out on 101 selected countermeasures, (including rural waste disposal options), a model was developed to aid optimising countermeasure strategies and a method of carrying out participatory decision-making suggested. The outputs of the project are described and critically evaluated. (authors)

  20. A critical evaluation of the STRATEGY project

    DEFF Research Database (Denmark)

    Howard, B.J.; Liland, A.; Beresford, N.A.

    2004-01-01

    The STRATEGY project (sustainable restoration and long-term management of contaminated rural, urban and industrial ecosystems; www.strategy-ec.org.uk) addressed the need for a holistic decision framework for the selection of optimal remediation strategies for long-term sustainable management...... of contaminated areas in Western Europe. The project considered both technical and social aspects of implementing restoration strategies for urban and rural environments. The importance of considering socially relevant objectives in addition to the dose reduction was emphasised. A critical evaluation was carried...... out on 101 selected countermeasures, (including rural waste disposal options), a model was developed to aid optimising countermeasure strategies and a method of carrying out participatory decision-making suggested. The outputs of the project are described and critically evaluated....

  1. "Healthy Eating - Healthy Action": evaluating New Zealand's obesity prevention strategy

    Directory of Open Access Journals (Sweden)

    Tanuvasa Ausaga

    2009-12-01

    Full Text Available Abstract Background New Zealand rates of obesity and overweight have increased since the 1980s, particularly among indigenous Māori people, Pacific people and those living in areas of high deprivation. New Zealand's response to the obesity epidemic has been The Healthy Eating-Healthy Action: Oranga Kai - Oranga Pumau (HEHA Strategy ('the Strategy', launched in 2003. Because the HEHA Strategy explicitly recognises the importance of evaluation and the need to create an evidence base to support future initiatives, the Ministry of Health has commissioned a Consortium of researchers to evaluate the Strategy as a whole. Methods This paper discusses the Consortium's approach to evaluating the HEHA Strategy. It includes an outline of the conceptual framework underpinning the evaluation, and describes the critical components of the evaluation which are: judging to what extent stakeholders were engaged in the process of the strategy implementation and to what extent their feedback was incorporated in to future iterations of the Strategy (continuous improvement, to what extent the programmes, policies, and initiatives implemented span the target populations and priority areas, whether there have been any population changes in nutrition and/or physical activity outcomes or behaviours relating to those outcomes, and to what extent HEHA Strategy and spending can be considered value for money. Discussion This paper outlines our approach to evaluating a complex national health promotion strategy. Not only does the Evaluation have the potential to identify interventions that could be adopted internationally, but also the development of the Evaluation design can inform other complex evaluations.

  2. [Factors influencing research activity of Andalusian nurses and improvement strategies].

    Science.gov (United States)

    López Alonso, Sergio R; Gálvez González, María; Amezcua, Manuel

    2013-04-01

    To identify factors influencing research activity of Andalusian nurses and to find improvement strategies. Qualitative research using SWOT analysis (weaknesses, threats, strengths, opportunities). Nurses were selected deliberately in eight groups according to predetermined criteria. Analysis included categorization and relationship of factors and strategies. 81 participants were included in groups of 7-12 range. 45 categories were identified with 212 factors: 12 weaknesses (50 factors), 10 strengths (44 factors), 12 threats (68 factors) and 11 opportunities (50 factors). In addition, 32 categories were identified with 53 strategies: 14 categories of W-T strategies (42 strategies), 3 categories of S-T strategies (11 strategies), 5 categories of W-O strategies (13 strategies) and 10 categories of S-O strategies (41 strategies). Nurses identified numerous factors, mainly threats. The strategies are focused on W-T but they also suggest many but weak 5-0 strategies due to the low potential of the opportunities and strengths perceived.

  3. FAB (Functionally Alert Behavior Strategies) to Improve Self-Control

    Science.gov (United States)

    Pagano, John

    2015-01-01

    This paper describes the FAB (Functionally Alert Behavior) Strategies approach to improve behavior in children and adolescents with complex behavioral challenges. FAB Strategies include evidence-based environmental adaptations, sensory modulation, positive behavioral support, and physical self-regulation strategies. FAB Strategies can be used by…

  4. Combined strategies for the improvement of heterologous ...

    African Journals Online (AJOL)

    use

    2011-12-14

    Dec 14, 2011 ... Full Length Research Paper. Combined ... Three different cultivation strategies had been compared for the production of .... biorector using combined fermentation strategies, and the ... shaking flask was chosen as a host for the transformation of SalI- linearized ... sterile filtered after bioreactor sterilization.

  5. Evaluation of different operational strategies for lithium ion battery systems connected to a wind turbine for primary frequency regulation and wind power forecast accuracy improvement

    DEFF Research Database (Denmark)

    Swierczynski, Maciej Jozef; Stroe, Daniel Ioan; Stan, Ana-Irina

    2012-01-01

    High penetration levels of variable wind energy sources can cause problems with their grid integration. Energy storage systems connected to wind turbine/wind power plants can improve predictability of the wind power production and provide ancillary services to the grid. This paper investigates ec...

  6. 214 Using Appropriate Strategies to Improve Students ...

    African Journals Online (AJOL)

    User

    2011-07-21

    Jul 21, 2011 ... As a result, learners lack the skills and strategies involved in reading and hence having .... Readers must intentionally and purposefully work to ... anticipating what is going to happen or come ..... Life long Learning: The Adult.

  7. Evaluation of Deep Discount Fare Strategies

    Science.gov (United States)

    1995-08-01

    This report evaluates the success of a fare pricing strategy known as deep discounting, that entails the bulk sale of transit tickets or tokens to customers at a significant discount compared to the full fare single ticket price. This market-driven s...

  8. Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series

    OpenAIRE

    Goetz, MB; Bowman, C; Hoang, T; Anaya, H; Osborn, T; Gifford, AL; Asch, SM

    2008-01-01

    Abstract Background We describe how we used the framework of the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) to develop a program to improve rates of diagnostic testing for the Human Immunodeficiency Virus (HIV). This venture was prompted by the observation by the CDC that 25% of HIV-infected patients do not know their diagnosis – a point of substantial importance to the VA, which is the largest provider of HIV care in the United States. Methods Fo...

  9. Practical strategies for nursing education program evaluation.

    Science.gov (United States)

    Lewallen, Lynne Porter

    2015-01-01

    Self-evaluation is required for institutions of higher learning and the nursing programs within them. The literature provides information on evaluation models and instruments, and descriptions of how specific nursing education programs are evaluated. However, there are few discussions in the nursing education literature of the practical aspects of nursing education program evaluation: how to get started, how to keep track of data, who to involve in data collection, and how to manage challenging criteria. This article discusses the importance of program evaluation in the academic setting and provides information on practical ways to organize the evaluation process and aggregate data, and strategies for gathering data from students, graduates, alumni, and employers of graduates. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Strategies for improving quality and methods for innovation services

    Directory of Open Access Journals (Sweden)

    Bajić Milan

    2009-01-01

    Full Text Available Contemporary concepts of business of service organisations, focus their researches on measuring quality of the services and identification of mistakes. The aim of strategies is the improvement of quality. Marketing concepts shows that the constant creation of new products and the modification of characteristics on the old products, makes possible market strategy that stimulates development of activities. This paper is focusing on the improving of service using the strategies that can innovate and improve the services. Paper seeks to demonstrate one of possible observations and importance of performance, combined with blueprinting of services and benchmarking as a useful strategies for improving and innovation of services.

  11. KNOWLEDGE MANAGEMENT STRATEGY TO IMPROVE BUSINESS SECTOR

    Directory of Open Access Journals (Sweden)

    Haradhan Kumar Mohajan

    2017-09-01

    Full Text Available Every organization needs the proper knowledge management (KM strategy for the development of the organization. In the last decades the business environment has changed and recently it becomes more dynamic and more complex. At present KM is valuable not only for individuals, and organizations, but also, for global humanity. So, the directors of the organizations must emphasize on the existing knowledge and try to develop them to achieve the competitive advantage. The purpose of the study is to explore the recent KM practice in the organizations and to show the ways to develop the new KM strategy in future. An attempt has been taken here to apply KM strategy in business performance, business intelligence, and e-business.

  12. Improved targeted immunization strategies based on two rounds of selection

    Science.gov (United States)

    Xia, Ling-Ling; Song, Yu-Rong; Li, Chan-Chan; Jiang, Guo-Ping

    2018-04-01

    In the case of high degree targeted immunization where the number of vaccine is limited, when more than one node associated with the same degree meets the requirement of high degree centrality, how can we choose a certain number of nodes from those nodes, so that the number of immunized nodes will not exceed the limit? In this paper, we introduce a new idea derived from the selection process of second-round exam to solve this problem and then propose three improved targeted immunization strategies. In these proposed strategies, the immunized nodes are selected through two rounds of selection, where we increase the quotas of first-round selection according the evaluation criterion of degree centrality and then consider another characteristic parameter of node, such as node's clustering coefficient, betweenness and closeness, to help choose targeted nodes in the second-round selection. To validate the effectiveness of the proposed strategies, we compare them with the degree immunizations including the high degree targeted and the high degree adaptive immunizations using two metrics: the size of the largest connected component of immunized network and the number of infected nodes. Simulation results demonstrate that the proposed strategies based on two rounds of sorting are effective for heterogeneous networks and their immunization effects are better than that of the degree immunizations.

  13. 7 Strategies for Improving Drug Utilization.

    Science.gov (United States)

    Schlosser, Michael; Chamberlain, Ronald; Dortch, Marcus

    2017-06-01

    When new pharmaceutical products enter the market, the lack of real-world experience with these drugs creates quandaries for payers and providers alike. Often, all there is to go on is the minimum required for FDA approval-non-inferiority to a comparator product in terms of efficacy and safety. Here are a few promising strategies to end this ambiguity.

  14. Development and face validation of strategies for improving consultation skills

    OpenAIRE

    Lefroy, J; Thomas, A; Harrison, C; Williams, S; O'Mahony, F; Gay, S; Kinston, R; McKinley, RK

    2014-01-01

    While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skil...

  15. Strategy for improved [11C]DAA1106 radiosynthesis and in vivo peripheral benzodiazepine receptor imaging using microPET, evaluation of [11C]DAA1106

    International Nuclear Information System (INIS)

    Probst, Katrin C.; Izquierdo, David; Bird, Joseph L.E.; Brichard, Laurent; Franck, Dominic; Davies, John R.; Fryer, Tim D.; Richards, Hugh K.; Clark, John C.; Davenport, Anthony P.; Weissberg, Peter L.; Warburton, Elizabeth A.

    2007-01-01

    Introduction: The peripheral benzodiazepine receptor (PBR) has shown considerable potential as a clinical marker of neuroinflammation and tumour progression. [ 11 C]DAA1106 ([ 11 C]N-(2,5-dimethoxybenzyl)-N-(5-fluoro-2-phenoxyphenyl)-acetamide) is a promising positron emission tomography (PET) radioligand for imaging PBRs. Methods: A four-step synthetic route was devised to prepare DAA1123, the precursor for [ 11 C]DAA1106. Two robust, high yielding methods for radiosynthesis based on [ 11 C]-O-methylation of DAA1123 were developed and implemented on a nuclear interface methylation module, producing [ 11 C]DAA1106 with up to 25% radiochemical yields at end-of-synthesis based on [ 11 C]CH 3 I trapped. Evaluation of [ 11 C]DAA1106 for in vivo imaging was performed in a rabbit model with microPET, and the presence of PBR receptor in the target organ was further corroborated by immunohistochemistry. Results: The standard solution method produced 2.6-5.2 GBq (n=19) of [ 11 C]DAA1106, whilst the captive solvent method produced 1.6-6.3 GBq (n=10) of [ 11 C]DAA1106. Radiochemical purities obtained were 99% and specific radioactivity at end-of-synthesis was up to 200 GBq/μmol for both methods. Based on radiochemical product, shorter preparation times and simplicity of synthesis, the captive solvent method was chosen for routine productions of [ 11 C]DAA1106. In vivo microPET [ 11 C]DAA1106 scans of rabbit kidney demonstrated high levels of binding in the cortex. The subsequent introduction of nonradioactive DAA1106 (0.2 μmol) produced considerable displacement of the radioactive signal in this region. The presence of PBR in kidney cortex was further corroborated by immunohistochemistry. Conclusions: A robust, high yielding captive solvent method of [ 11 C]DAA1106 production was developed which enabled efficacious in vivo imaging of PBR expressing tissues in an animal model

  16. NURE data collection and evaluation strategies

    International Nuclear Information System (INIS)

    Horton, R.C.

    1977-01-01

    Collection and evaluation strategies used in the National Uranium Resource Evaluation program are described. Hydrogeochemical, airborne radiometric and magnetic, and field geology data are collected in every quadrangle. Topical studies, modeling, and classification and recognition criteria are required for assessment--the final estimate of tons of uranium. The evaluation of quadrangles has been divided into three phases: Phase I, prefield work; Phase II, field work; Phase III, report and map preparation. All evaluators--the U.S. Geological Survey, state surveys, private subcontractors and Bendix--will follow identical procedures. This is not to say that all quadrangles are identical, or that identical techniques will be applied to, or identical data recovered from, each quadrangle

  17. Evaluation of alternative MGDS development strategies

    International Nuclear Information System (INIS)

    Roberds, W.; Miller, I.; Caldwell, D.

    1991-01-01

    A methodology has been developed to explicitly and quantitatively evaluate acceptable alternative repository development strategies, in terms of the degree to which they are likely to satisfy a specified set of system objectives (e.g., minimizing overall costs through closure, time to initial waste receipt and long-term health effects). An open-quotes acceptableclose quotes strategy is one which has a high likelihood of satisfying specified system functions and requirements. Simple but comprehensive system models have been developed to estimate the relevant consequences of any strategy, explicitly considering system uncertainties and contingencies, including the possibility of finding the site to be unsuitable and having to develop a repository elsewhere. Such open-quotes technical assessments,close quotes which are appropriately developed by technical experts, can then be combined with separate open-quotes value judgementsclose quotes regarding preferences and tradeoffs among the consequences, which are appropriately determined by the decision makers/stake holders (rather than by the technical experts) in order to explicitly determine preferences among the acceptable strategies. Implementation of the methodology has been demonstrated by example

  18. Workforce strategies to improve children's oral health.

    Science.gov (United States)

    Goodwin, Kristine

    2014-12-01

    (1) Tooth decay is the most common chronic disease for children. (2) As millions receive dental coverage under the Affordable Care Act, the demand for dental services is expected to strain the current workforce's ability to meet their needs. (3) States have adopted various workforce approaches to improve access to dental care for underserved populations.

  19. Current strategies for improving food bacteria

    NARCIS (Netherlands)

    Kuipers, O P; Buist, Girbe; Kok, Jan

    2000-01-01

    Novel concepts and methodologies are emerging that hold great promise for the directed improvement of food-related bacteria, specifically lactic acid bacteria. Also, the battle against food spoilage and pathogenic bacteria can now be fought more effectively. Here we describe recent advances in

  20. Cost-effectiveness of a team and leaders-directed strategy to improve nurses' adherence to hand hygiene guidelines: A cluster randomised trial

    NARCIS (Netherlands)

    Brink-Huis, A.M.; Hulscher, M.E.J.L.; Adang, E.M.; Grol, R.P.; Achterberg, T. van; Schoonhoven, L.

    2013-01-01

    BACKGROUND: Many strategies have been designed and evaluated to address poor hand hygiene compliance. Unfortunately, well-designed economic evaluations of hand hygiene improvement strategies are lacking. OBJECTIVE: To compare the cost-effectiveness of two successful implementation strategies for

  1. A Strategy for Improved System Assurance

    Science.gov (United States)

    2007-06-20

    Quality (Measurements Life Cycle Safety, Security & Others) ISO /IEC 12207 * Software Life Cycle Processes ISO 9001 Quality Management System...14598 Software Product Evaluation Related ISO /IEC 90003 Guidelines for the Application of ISO 9001:2000 to Computer Software IEEE 12207 Industry...Implementation of International Standard ISO /IEC 12207 IEEE 1220 Standard for Application and Management of the System Engineering Process Use in

  2. Development and Evaluation of an Implementation Strategy for Collecting Data in a National Registry and the Use of Patient-Reported Outcome Measures in Physical Therapist Practices: Quality Improvement Study.

    Science.gov (United States)

    Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J

    2017-08-01

    In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017

  3. Therapeutic strategies to improve control of hypertension.

    Science.gov (United States)

    Armario, Pedro; Waeber, Bernard

    2013-03-01

    Blood pressure is poorly controlled in most European countries and the control rate is even lower in high-risk patients such as patients with chronic kidney disease, diabetic patients or previous coronary heart disease. Several factors have been associated with poor control, some of which involve the characteristic of the patients themselves, such as socioeconomic factors, or unsuitable life-styles, other factors related to hypertension or to associated comorbidity, but there are also factors directly associated with antihypertensive therapy, mainly involving adherence problems, therapeutic inertia and therapeutic strategies unsuited to difficult-to-control hypertensive patients. It is common knowledge that only 30% of hypertensive patients can be controlled using monotherapy; all the rest require a combination of two or more antihypertensive drugs, and this can be a barrier to good adherence and log-term persistence in patients who also often need to use other drugs, such as antidiabetic agents, statins or antiplatelet agents. The fixed combinations of three antihypertensive agents currently available can facilitate long-term control of these patients in clinical practice. If well tolerated, a long-term therapeutic regimen that includes a diuretic, an ACE inhibitor or an angiotensin receptor blocker, and a calcium channel blocker is the recommended optimal triple therapy.

  4. Evaluation of teaching and learning strategies

    Directory of Open Access Journals (Sweden)

    SK Lechner

    2001-08-01

    Full Text Available With the growing awareness of the importance of teaching and learning in universities and the need to move towards evidence-based teaching, it behooves the professions to re-examine their educational research methodology. While the what, how and why of student learning have become more explicit, the professions still struggle to find valid methods of evaluating the explosion of new innovation in teaching/learning strategies. This paper discusses the problems inherent in applying traditional experimental design techniques to advances in educational practice.

  5. Segmenting hospitals for improved management strategy.

    Science.gov (United States)

    Malhotra, N K

    1989-09-01

    The author presents a conceptual framework for the a priori and clustering-based approaches to segmentation and evaluates them in the context of segmenting institutional health care markets. An empirical study is reported in which the hospital market is segmented on three state-of-being variables. The segmentation approach also takes into account important organizational decision-making variables. The sophisticated Thurstone Case V procedure is employed. Several marketing implications for hospitals, other health care organizations, hospital suppliers, and donor publics are identified.

  6. Novel strategies to improve the patency of vascular prostheses

    NARCIS (Netherlands)

    Heyligers, J.M.M.

    2006-01-01

    Two novel strategies to improve the patency of vascular prostheses are described in this thesis. To improve the outcome of synthetic vascular bypass surgery, cell seeding is a promising concept that has extensively been investigated and is still evolving. To improve the short term effects due to

  7. An improved AVC strategy applied in distributed wind power system

    Science.gov (United States)

    Zhao, Y. N.; Liu, Q. H.; Song, S. Y.; Mao, W.

    2016-08-01

    Traditional AVC strategy is mainly used in wind farm and only concerns about grid connection point, which is not suitable for distributed wind power system. Therefore, this paper comes up with an improved AVC strategy applied in distributed wind power system. The strategy takes all nodes of distribution network into consideration and chooses the node having the most serious voltage deviation as control point to calculate the reactive power reference. In addition, distribution principles can be divided into two conditions: when wind generators access to network on single node, the reactive power reference is distributed according to reactive power capacity; when wind generators access to network on multi-node, the reference is distributed according to sensitivity. Simulation results show the correctness and reliability of the strategy. Compared with traditional control strategy, the strategy described in this paper can make full use of generators reactive power output ability according to the distribution network voltage condition and improve the distribution network voltage level effectively.

  8. Strategies to improve learning of all students in a class

    Science.gov (United States)

    Suraishkumar, G. K.

    2018-05-01

    The statistical distribution of the student learning abilities in a typical undergraduate engineering class poses a significant challenge to simultaneously improve the learning of all the students in the class. With traditional instruction styles, the students with significantly high learning abilities are not satisfied due to a feeling of unfulfilled potential, and the students with significantly low learning abilities feel lost. To address the challenge in an undergraduate core/required course on 'transport phenomena in biological systems', a combination of learning strategies such as active learning including co-operative group learning, challenge exercises, and others were employed in a pro-advising context. The short-term and long-term impacts were evaluated through student course performances and input, respectively. The results show that it is possible to effectively address the challenge posed by the distribution of student learning abilities in a class.

  9. Multimodal strategies to improve surgical outcome

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Wilmore, Douglas W

    2002-01-01

    OBJECTIVE: To evaluate the effect of modifying perioperative care in noncardiac surgical patients on morbidity, mortality, and other outcome measures. BACKGROUND: New approaches in pain control, introduction of techniques that reduce the perioperative stress response, and the more frequent use...... anesthesia in elective operations, and pilot studies of fast track surgical procedures using the multimodality approach. RESULTS: The introduction of newer approaches to perioperative care has reduced both morbidity and mortality in surgical patients. In the future, most elective operations will become day...... surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...

  10. Evaluating the Legitimacy of Contemporary Legal Strategies for Obesity.

    Science.gov (United States)

    Morain, Stephanie

    2015-12-01

    Contemporary legal strategies for obesity raise troubling questions regarding individual liberty and the legitimate scope of public health authority. This article argues that the predominant approach to assessing public health legitimacy--John Stuart Mill's "harm principle"--may be unsuitable for evaluating the legitimacy of legal strategies for obesity. The article proposes an alternative test for assessing the legitimate scope of public health authority: John Rawls's liberal principle of legitimacy. It outlines how Rawls's principle would evaluate obesity policies, and contrasts this evaluation to that of Mill. The alternative test avoids some of the limitations of the Millian approach, and may offer an improved mechanism for assessing the liberty effects of policies for obesity and other public health activities.

  11. A critical evaluation of the strategy project

    International Nuclear Information System (INIS)

    Howard, B.J.; Liland, A.

    2003-01-01

    Full text: Experience after the Chernobyl accident has shown that remediation strategies need to consider a wide range of different issues to ensure the long-term sustainability of radioactively contaminated areas. The STRATEGY project (Sustainable Restoration And Long-Term Management Of Contaminated Rural, Urban And Industrial Ecosystems (www.strategy-ec.org.uk) had the overall objective of establishing a holistic decision framework for the selection of optimal remediation strategies for long-term sustainable management of contaminated areas in Western Europe. The project carried out a critical evaluation of a series of countermeasures and waste disposal options including a consideration of their technical feasibility and practicality and whether they (i) incur considerable direct or side-effect costs; (ii) have significant environmental side effects; and (iii) are acceptable to society. A main output was a comprehensive, documented evaluation of more than 100 countermeasures (in the form of standardized templates) that would be relevant for off-site nuclear emergency management in the mid to long term. Stakeholder participation is an important mechanism to explore these additional benefits or disadvantages to the use of countermeasures, and is an essential step in developing a decision framework which avoids problems previously experienced in emergency management. Close liaison with the FARMING stakeholder network facilitated evaluation of countermeasure templates for rural ecosystems. Stakeholder opinion suggested that some countermeasures were as likely to be rejected an socio-ethical grounds as technical and economic grounds. Rejection of specific countermeasures would be expected to show site, context and national differences. Suitable approaches for successfully communicating with a wide range of stakeholders were explored. The way in which countermeasure evaluation and selection is carried out is particularly relevant for ethical evaluation of remediation

  12. Teaching Written Communication Strategies: A Training to Improve Writing

    Directory of Open Access Journals (Sweden)

    Hanane Benali Taouis

    2018-03-01

    Full Text Available This research can be described as an experimental quantitative one including: a strategy training; two homogenous experimental groups with different levels of proficiency; and two homogenous control groups. The subjects are 60 Spanish high school students, who have been selected after taking the Oxford Quick Placement-Test. The study aims at investigating the possible relationship between the effect of the strategy training and the subjects' level of proficiency. It is also designed to analyze the effect of the training on the use of communication strategies in the written medium. It is meant to study the effect of the strategy training on the subjects' writing skill in English. The results show that the students' level of proficiency exerts a strong effect on the subjects' use of written communication strategies (CSs and on their strategy preference in written production. They also demonstrate how strategy training improves the subjects' written communication ability.

  13. Teaching strategies for improving reading and writing in English ...

    African Journals Online (AJOL)

    Teaching strategies for improving reading and writing in English First Additional Language for men and women. ... Reading and writing have become one serious national issue in primary schools in South ... AJOL African Journals Online.

  14. Strategy to improve the burden of gestational diabetes in African ...

    African Journals Online (AJOL)

    Strategy to improve the burden of gestational diabetes in African women: Rwandan perspective. Herbert T. Mapira, David K. Tumusiime, Kevin Yarasheski, Nadine Rujeni, Todd W. Cade, Eugene Mutimura ...

  15. Venous thromboprophylaxis in general surgery ward admissions: strategies for improvement.

    Science.gov (United States)

    Galante, Mariana; Languasco, Agustín; Gotta, Daniel; Bell, Soledad; Lancelotti, Tomás; Knaze, Viktoria; Saubidet, Cristián Lopez; Grand, Beatriz; Milberg, Matías

    2012-12-01

    To estimate the adherence to institutional venous thromboprophylaxis clinical practice guidelines (CPGs) in general surgery patients and to assess the effectiveness of a multi-strategy improvement intervention. A prospective before-after study. Two teaching hospitals located in the city of Buenos Aires, Argentina. Prescriptions belonging to patients admitted to the general surgery wards were evaluated. A multi-strategy intervention that included (i) simplification of institutional CPGs for venous thromboprophylaxis using a single drug at a single dose, based on the American College of Chest Physicians recommendations, (ii) distribution of pocket cards with an algorithm for the implementation of new recommendations to both, physicians and nurses, working in the general surgery units, (iii) educational talks, (iv) paper-based reminders and (v) audit and feedback. The adherence of the venous thromboprophylaxis prescription to the institutional recommendations. The prescriptions of 100 admitted patients before and 90 after the intervention were included in the analysis. The initial rate of adherence was 31%. After the intervention this rate rose to 71.1% (P< 0.001). The major improvement observed was the reduction in omitted prophylaxis in patients at risk of venous thromboembolism from 45 to 13.3% (P< 0.001). In the adjusted model, prescribing compliance with CPGs was five times more likely during the second stage than during the first stage (OR = 5.60, 95% CI = 2.92-10.74). Simple and economical interventions such as those described in this study can improve general surgeons compliance with the institutional and international guidelines, thus assuring patient safety and quality of health care.

  16. Strategy to Support Improvement of Healthcare Quality.

    Directory of Open Access Journals (Sweden)

    Ing. Andrea Zejdlova

    2013-01-01

    Full Text Available One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. It is an emerging movement in health insurance (initially in Britain and United States. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services. This is a fundamental change from fee for service payment.Also known as "P4P" or “value-based purchasing,” this payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. Disincentives, such as eliminating payments for negative consequences of care (medical errors or increased costs, have also been proposed. In the developed nations, the rapidly aging population and rising health care costs have recently brought P4P to the forefront of health policy discussions. Pilot studies underway in several large healthcare systems have shown modest improvements in specific outcomes and increased efficiency, but no cost savings due to added administrative requirements. Statements by professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. This article serves as an introduction to pay for performance. We discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care area.

  17. Site descriptive modelling - strategy for integrated evaluation

    International Nuclear Information System (INIS)

    Andersson, Johan

    2003-02-01

    The current document establishes the strategy to be used for achieving sufficient integration between disciplines in producing Site Descriptive Models during the Site Investigation stage. The Site Descriptive Model should be a multidisciplinary interpretation of geology, rock mechanics, thermal properties, hydrogeology, hydrogeochemistry, transport properties and ecosystems using site investigation data from deep bore holes and from the surface as input. The modelling comprise the following iterative steps, evaluation of primary data, descriptive and quantitative modelling (in 3D), overall confidence evaluation. Data are first evaluated within each discipline and then the evaluations are checked between the disciplines. Three-dimensional modelling (i.e. estimating the distribution of parameter values in space and its uncertainty) is made in a sequence, where the geometrical framework is taken from the geological model and in turn used by the rock mechanics, thermal and hydrogeological modelling etc. The three-dimensional description should present the parameters with their spatial variability over a relevant and specified scale, with the uncertainty included in this description. Different alternative descriptions may be required. After the individual discipline modelling and uncertainty assessment a phase of overall confidence evaluation follows. Relevant parts of the different modelling teams assess the suggested uncertainties and evaluate the feedback. These discussions should assess overall confidence by, checking that all relevant data are used, checking that information in past model versions is considered, checking that the different kinds of uncertainty are addressed, checking if suggested alternatives make sense and if there is potential for additional alternatives, and by discussing, if appropriate, how additional measurements (i.e. more data) would affect confidence. The findings as well as the modelling results are to be documented in a Site Description

  18. Improved Droop Control Strategy for Grid-Connected Inverters

    DEFF Research Database (Denmark)

    Abusara, Mohammad; Sharkh, Suleiman; Guerrero, Josep M.

    2015-01-01

    An improved control strategy for grid-connected inverters within microgrids is presented in this paper. The strategy is based on the classical P-ω and Q-V droop method. The improvement in the proposed control strategy is twofold: Firstly, the transient response of the droop controller is improved...... by replacing the traditional method of measuring average power, which is based on using a first order low pass filter, by a real time integration filter. This is shown to reduce the imported transient energy when connecting to the grid. Secondly, the steady state output current quality is improved by utilising...... a virtual inductance, which is shown to reject grid voltage harmonics disturbance and thus improve the output current THD. A small signal model of the inverter based on the transfer function approach is developed to analyse is stability and determine droop gains. Simulation and experimental results...

  19. Development and face validation of strategies for improving consultation skills.

    Science.gov (United States)

    Lefroy, Janet; Thomas, Adam; Harrison, Chris; Williams, Stephen; O'Mahony, Fidelma; Gay, Simon; Kinston, Ruth; McKinley, R K

    2014-12-01

    While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skills through a process involving both medical students and their clinical primary and secondary care tutors. Modified Delphi study with tutors, modified nominal group study with students with moderation of outputs by consensus round table discussion by the authors. 35 hospital and 21 GP tutors participated in the Delphi study and contributed 153 new or modified strategies. After review of these and the 205 original strategies, 265 strategies entered the nominal group study to which 46 year four and five students contributed, resulting in the final list of 249 validated strategies. We have developed a valid and comprehensive set of strategies which are considered useful by medical students. This list can be immediately applied by any school which uses the Calgary Cambridge Framework to inform the content of formative feedback on consultation skills. We consider that the list could also be mapped to alternative skills frameworks and so be utilised by schools which do not use the Calgary Cambridge Framework.

  20. Improved Efficient Routing Strategy on Scale-Free Networks

    Science.gov (United States)

    Jiang, Zhong-Yuan; Liang, Man-Gui

    Since the betweenness of nodes in complex networks can theoretically represent the traffic load of nodes under the currently used routing strategy, we propose an improved efficient (IE) routing strategy to enhance to the network traffic capacity based on the betweenness centrality. Any node with the highest betweenness is susceptible to traffic congestion. An efficient way to improve the network traffic capacity is to redistribute the heavy traffic load from these central nodes to non-central nodes, so in this paper, we firstly give a path cost function by considering the sum of node betweenness with a tunable parameter β along the actual path. Then, by minimizing the path cost, our IE routing strategy achieved obvious improvement on the network transport efficiency. Simulations on scale-free Barabási-Albert (BA) networks confirmed the effectiveness of our strategy, when compared with the efficient routing (ER) and the shortest path (SP) routing.

  1. Evaluation of Sexual Communication Message Strategies

    Science.gov (United States)

    2011-01-01

    Parent-child communication about sex is an important proximal reproductive health outcome. But while campaigns to promote it such as the Parents Speak Up National Campaign (PSUNC) have been effective, little is known about how messages influence parental cognitions and behavior. This study examines which message features explain responses to sexual communication messages. We content analyzed 4 PSUNC ads to identify specific, measurable message and advertising execution features. We then develop quantitative measures of those features, including message strategies, marketing strategies, and voice and other stylistic features, and merged the resulting data into a dataset drawn from a national media tracking survey of the campaign. Finally, we conducted multivariable logistic regression models to identify relationships between message content and ad reactions/receptivity, and between ad reactions/receptivity and parents' cognitions related to sexual communication included in the campaign's conceptual model. We found that overall parents were highly receptive to the PSUNC ads. We did not find significant associations between message content and ad reactions/receptivity. However, we found that reactions/receptivity to specific PSUNC ads were associated with increased norms, self-efficacy, short- and long-term expectations about parent-child sexual communication, as theorized in the conceptual model. This study extends previous research and methods to analyze message content and reactions/receptivity. The results confirm and extend previous PSUNC campaign evaluation and provide further evidence for the conceptual model. Future research should examine additional message content features and the effects of reactions/receptivity. PMID:21599875

  2. The challenge of transferring an implementation strategy from academia to the field: a process evaluation of local quality improvement collaboratives in Dutch primary care using the normalization process theory.

    Science.gov (United States)

    Trietsch, Jasper; van Steenkiste, Ben; Hobma, Sjoerd; Frericks, Arnoud; Grol, Richard; Metsemakers, Job; van der Weijden, Trudy

    2014-12-01

    A quality improvement strategy consisting of comparative feedback and peer review embedded in available local quality improvement collaboratives proved to be effective in changing the test-ordering behaviour of general practitioners. However, implementing this strategy was problematic. We aimed for large-scale implementation of an adapted strategy covering both test ordering and prescribing performance. Because we failed to achieve large-scale implementation, the aim of this study was to describe and analyse the challenges of the transferring process. In a qualitative study 19 regional health officers, pharmacists, laboratory specialists and general practitioners were interviewed within 6 months after the transfer period. The interviews were audiotaped, transcribed and independently coded by two of the authors. The codes were matched to the dimensions of the normalization process theory. The general idea of the strategy was widely supported, but generating the feedback was more complex than expected and the need for external support after transfer of the strategy remained high because participants did not assume responsibility for the work and the distribution of resources that came with it. Evidence on effectiveness, a national infrastructure for these collaboratives and a general positive attitude were not sufficient for normalization. Thinking about managing large databases, responsibility for tasks and distribution of resources should start as early as possible when planning complex quality improvement strategies. Merely exploring the barriers and facilitators experienced in a preceding trial is not sufficient. Although multifaceted implementation strategies to change professional behaviour are attractive, their inherent complexity is also a pitfall for large-scale implementation. © 2014 John Wiley & Sons, Ltd.

  3. Evaluating economic costs and benefits of climate resilient livelihood strategies

    Directory of Open Access Journals (Sweden)

    S. Liu

    2016-01-01

    Full Text Available A major challenge for international development is to assist the poorest regions to achieve development targets while taking climate change into account. Such ‘climate resilient development’ (CRD must identify and implement adaptation strategies for improving livelihoods while also being cost-effective. While the idea that climate resilience and development goals should be compatible is often discussed, empirical evaluations of the economic impacts of actual CRD investments are practically non-existent. This paper outlines a framework to evaluate economic returns to CRD and applies it in two adaptation strategies trialed in Nusa Tenggara Barat Province, eastern Indonesia. The evaluation framework is composed of three models: a household benefit cost model, a diffusion model, and a regional benefit cost model. The models draw upon the impact evaluation, technology diffusion, and risk assessment literatures, respectively. The analyzes are based on expert opinion and locally-derived information, and hence can be applied in data-poor situations typical of developing countries. Our results explore economic costs and benefits at the household and regional scale, and we identify key input variables that greatly influence the economic returns of the strategies. These variables should therefore be a focus of ongoing investment. We also discuss how the framework is more generally applicable, its limitations including challenges in accounting for less tangible social and ecosystem service benefits, potentially leading to the underestimation of impacts, and how the approach should be complemented by qualitative methods.

  4. Market behavior and performance of different strategy evaluation schemes

    OpenAIRE

    Yongjoo Baek; Sang Hoon Lee; Hawoong Jeong

    2010-01-01

    Strategy evaluation schemes are a crucial factor in any agent-based market model, as they determine the agents' strategy preferences and consequently their behavioral pattern. This study investigates how the strategy evaluation schemes adopted by agents affect their performance in conjunction with the market circumstances. We observe the performance of three strategy evaluation schemes, the history-dependent wealth game, the trend-opposing minority game, and the trend-following majority game,...

  5. Optimizing strategies to improve interprofessional practice for veterans, part 1

    Directory of Open Access Journals (Sweden)

    Bhattacharya SB

    2014-04-01

    Full Text Available Shelley B Bhattacharya,1–3 Michelle I Rossi,1,2 Jennifer M Mentz11Geriatric Research Education and Clinical Center (GRECC, Veteran's Affairs Pittsburgh Healthcare System, 2University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 3Albert Schweitzer Fellowship Program, Pittsburgh, PA, USAIntroduction: Interprofessional patient care is a well-recognized path that health care systems are striving toward. The Veteran's Affairs (VA system initiated interprofessional practice (IPP models with their Geriatric Evaluation and Management (GEM programs. GEM programs incorporate a range of specialties, including but not limited to, medicine, nursing, social work, physical therapy and pharmacy, to collaboratively evaluate veterans. Despite being a valuable resource, they are now faced with significant cut-backs, including closures. The primary goal of this project was to assess how the GEM model could be optimized at the Pittsburgh, Pennsylvania VA to allow for the sustainability of this important IPP assessment. Part 1 of the study evaluated the IPP process using program, patient, and family surveys. Part 2 examined how well the geriatrician matched patients to specialists in the GEM model. This paper describes Part 1 of our study.Methods: Three strategies were used: 1 a national GEM program survey; 2 a veteran/family satisfaction survey; and 3 an absentee assessment.Results: Twenty-six of 92 programs responded to the GEM IPP survey. Six strategies were shared to optimize IPP models throughout the country. Of the 34 satisfaction surveys, 80% stated the GEM clinic was beneficial, 79% stated their concerns were addressed, and 100% would recommend GEM to their friends. Of the 24 absentee assessments, the top three reasons for missing the appointments were transportation, medical illnesses, and not knowing/remembering about the appointment. Absentee rate diminished from 41% to 19% after instituting a reminder phone call policy.Discussion: Maintaining the

  6. Teacher’s comprehensive training strategy for improving didactics performance

    Directory of Open Access Journals (Sweden)

    Pozas, W. J

    2014-07-01

    Full Text Available The paper describes a Teacher’s comprehensive training strategy for improving didactics performance, together with its theoretical foundations. The strategy is structured into several dimensions related to teachers’ development (lesson planning, continuing education and research. It is organized into two phases and seven stages intended to improve leadership in the teaching-learning process. The finding are the expression of a comprehensive approach to school organization at Services Polytechnic School “Horacio Cobiellas Domínguez” resulting in teachers’ academic and scientific development and a significant growth of the staff scientific potentials manifested in scientific forum enrolment. The resulting impact should lead to a general use of the proposed strategy in the Polytechnic school web. Key words: professional performance, pedagogic professional performance, didactic professional performance, teachers’ developmental strategy

  7. Evaluation of Sexual Communication Message Strategies

    Directory of Open Access Journals (Sweden)

    Khan Munziba

    2011-05-01

    Full Text Available Abstract Parent-child communication about sex is an important proximal reproductive health outcome. But while campaigns to promote it such as the Parents Speak Up National Campaign (PSUNC have been effective, little is known about how messages influence parental cognitions and behavior. This study examines which message features explain responses to sexual communication messages. We content analyzed 4 PSUNC ads to identify specific, measurable message and advertising execution features. We then develop quantitative measures of those features, including message strategies, marketing strategies, and voice and other stylistic features, and merged the resulting data into a dataset drawn from a national media tracking survey of the campaign. Finally, we conducted multivariable logistic regression models to identify relationships between message content and ad reactions/receptivity, and between ad reactions/receptivity and parents' cognitions related to sexual communication included in the campaign's conceptual model. We found that overall parents were highly receptive to the PSUNC ads. We did not find significant associations between message content and ad reactions/receptivity. However, we found that reactions/receptivity to specific PSUNC ads were associated with increased norms, self-efficacy, short- and long-term expectations about parent-child sexual communication, as theorized in the conceptual model. This study extends previous research and methods to analyze message content and reactions/receptivity. The results confirm and extend previous PSUNC campaign evaluation and provide further evidence for the conceptual model. Future research should examine additional message content features and the effects of reactions/receptivity.

  8. Improving credibility evaluations on Wikipedia

    NARCIS (Netherlands)

    Lucassen, T.; Schmettow, Martin; Wiering, Caro H.; Pieters, Jules M.; Boer, Henk

    2011-01-01

    In this chapter, ongoing research on trust in Wikipedia is used as a case study to illustrate the design process of a support tool for Wikipedia, following the ASCE-model. This research is performed from a cognitive perspective and aims at users actively evaluating the credibility of information on

  9. Analysing and Improving the Sales Strategy and Process

    OpenAIRE

    Kuosa, Samuel

    2017-01-01

    In this thesis the intention is to identify and analyze the sales strategy and sales process of Robert Bosch Oy, which is a subsidiary of the multinational Robert Bosch GmbH. This thesis focuses on the mobility solutions business sector. The reason behind this research is to illuminate the problems the organization faces in implementing their sales strategy and sales process, and then offer improvement ideas on how they could be implemented in the Finnish market. The literature review giv...

  10. Evaluate to Improve: Useful Approaches to Student Evaluation

    Science.gov (United States)

    Golding, Clinton; Adam, Lee

    2016-01-01

    Many teachers in higher education use feedback from students to evaluate their teaching, but only some use these evaluations to improve their teaching. One important factor that makes the difference is the teacher's approach to their evaluations. In this article, we identify some useful approaches for improving teaching. We conducted focus groups…

  11. Evaluating alternative gait strategies using evolutionary robotics.

    Science.gov (United States)

    Sellers, William I; Dennis, Louise A; W -J, Wang; Crompton, Robin H

    2004-05-01

    Evolutionary robotics is a branch of artificial intelligence concerned with the automatic generation of autonomous robots. Usually the form of the robot is predefined and various computational techniques are used to control the machine's behaviour. One aspect is the spontaneous generation of walking in legged robots and this can be used to investigate the mechanical requirements for efficient walking in bipeds. This paper demonstrates a bipedal simulator that spontaneously generates walking and running gaits. The model can be customized to represent a range of hominoid morphologies and used to predict performance parameters such as preferred speed and metabolic energy cost. Because it does not require any motion capture data it is particularly suitable for investigating locomotion in fossil animals. The predictions for modern humans are highly accurate in terms of energy cost for a given speed and thus the values predicted for other bipeds are likely to be good estimates. To illustrate this the cost of transport is calculated for Australopithecus afarensis. The model allows the degree of maximum extension at the knee to be varied causing the model to adopt walking gaits varying from chimpanzee-like to human-like. The energy costs associated with these gait choices can thus be calculated and this information used to evaluate possible locomotor strategies in early hominids.

  12. Assessment of and Improvement Strategies for the Housing of Healthy Elderly: Improving Quality of Life

    Directory of Open Access Journals (Sweden)

    I-Ming Feng

    2018-03-01

    Full Text Available Global population is aging, particularly in developed countries and cities. Through the “Friendly Elderly Cities” and “Aging in Place” initiatives, various countries are making great efforts to improve the welfare and quality of life of the elderly, with the aim of catering to the physical and spiritual health as well as social welfare of the elderly. In this regard, the improvement of the housing environment of the elderly is one of the key factors in their quality of life and health. This study aims to effectively assess and improve the housing environment of the elderly in order to enhance their quality of life; it also aims to contribute the knowledge about improving elderly housing by applying an assessment framework using expert interviews and data collected from relevant literature. Using a mixed Multi-Criteria Decision Analysis model, a combination of the DEMATEL (Decision Making Trial and Evaluation Laboratory-based ANP (Analytic Network Process (DANP and the modified VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR methods, and the investigations and assessments in the case study, this study proposes strategies and directions for improving elderly housing. The study results indicate that, as distinct from using traditional methodologies where the hypothesis criteria are mutually independent, the proposed hybrid model (examining real-life problems by considering the mutual influences of factors identifies a priority sequence wherein emphasis is placed on improving ventilation and air quality rather than adjustment of temperature. The systemic way of thinking shifts the focus from the most apparent problems to the root cause of the problems. Doing so avoids any mismatch of resource allocation in decision-making and thus maximizes the efficiency and sustainability of the improvement.

  13. Soil sampling strategies: Evaluation of different approaches

    International Nuclear Information System (INIS)

    De Zorzi, Paolo; Barbizzi, Sabrina; Belli, Maria; Mufato, Renzo; Sartori, Giuseppe; Stocchero, Giulia

    2008-01-01

    The National Environmental Protection Agency of Italy (APAT) performed a soil sampling intercomparison, inviting 14 regional agencies to test their own soil sampling strategies. The intercomparison was carried out at a reference site, previously characterised for metal mass fraction distribution. A wide range of sampling strategies, in terms of sampling patterns, type and number of samples collected, were used to assess the mean mass fraction values of some selected elements. The different strategies led in general to acceptable bias values (D) less than 2σ, calculated according to ISO 13258. Sampling on arable land was relatively easy, with comparable results between different sampling strategies

  14. Soil sampling strategies: Evaluation of different approaches

    Energy Technology Data Exchange (ETDEWEB)

    De Zorzi, Paolo [Agenzia per la Protezione dell' Ambiente e per i Servizi Tecnici (APAT), Servizio Metrologia Ambientale, Via di Castel Romano, 100-00128 Roma (Italy)], E-mail: paolo.dezorzi@apat.it; Barbizzi, Sabrina; Belli, Maria [Agenzia per la Protezione dell' Ambiente e per i Servizi Tecnici (APAT), Servizio Metrologia Ambientale, Via di Castel Romano, 100-00128 Roma (Italy); Mufato, Renzo; Sartori, Giuseppe; Stocchero, Giulia [Agenzia Regionale per la Prevenzione e Protezione dell' Ambiente del Veneto, ARPA Veneto, U.O. Centro Qualita Dati, Via Spalato, 14-36045 Vicenza (Italy)

    2008-11-15

    The National Environmental Protection Agency of Italy (APAT) performed a soil sampling intercomparison, inviting 14 regional agencies to test their own soil sampling strategies. The intercomparison was carried out at a reference site, previously characterised for metal mass fraction distribution. A wide range of sampling strategies, in terms of sampling patterns, type and number of samples collected, were used to assess the mean mass fraction values of some selected elements. The different strategies led in general to acceptable bias values (D) less than 2{sigma}, calculated according to ISO 13258. Sampling on arable land was relatively easy, with comparable results between different sampling strategies.

  15. Soil sampling strategies: evaluation of different approaches.

    Science.gov (United States)

    de Zorzi, Paolo; Barbizzi, Sabrina; Belli, Maria; Mufato, Renzo; Sartori, Giuseppe; Stocchero, Giulia

    2008-11-01

    The National Environmental Protection Agency of Italy (APAT) performed a soil sampling intercomparison, inviting 14 regional agencies to test their own soil sampling strategies. The intercomparison was carried out at a reference site, previously characterised for metal mass fraction distribution. A wide range of sampling strategies, in terms of sampling patterns, type and number of samples collected, were used to assess the mean mass fraction values of some selected elements. The different strategies led in general to acceptable bias values (D) less than 2sigma, calculated according to ISO 13258. Sampling on arable land was relatively easy, with comparable results between different sampling strategies.

  16. A strategy for improving pump and treat ground water remediation

    International Nuclear Information System (INIS)

    Hoffman, F.

    1992-07-01

    Established pump and treat ground water remediation has a reputation for being too expensive and time consuming, especially when cleanup standards are set at very low levels, e.g., 50 ft below ground surface) widespread ground water contamination. The perceived shortcomings of pump and treat result from the (1) tendency of most contaminants to sorb to formation materials, thus retarding contaminant removal; (2) geologic complexity, which requires detailed characterization for the design of optimal extraction systems within available resources; and (3) failure to apply dynamic well field management techniques. An alternative strategy for improving pump and treat ground water remediation consists of (1) detailed characterization of the geology, hydrology, and chemistry; (2) use of computer-aided data interpretation, data display, and decision support systems; (3) removal of sources, if possible; (4) initial design for plume containment and source remediation; (5) phased installation of the well field; (6) detailed monitoring of the remediation; (7) active ongoing re-evaluation of the operating well field, including redesign as appropriate (dynamic management); (8) re-injection of treated ground water to speed the flushing of contaminants; and (9) setting of appropriate cleanup levels or goals. Use of some or all of these techniques can dramatically reduce the time required to achieve cleanup goals and thus the cost of ground water remediation

  17. Evaluating strategies to reduce urban air pollution

    Science.gov (United States)

    Duque, L.; Relvas, H.; Silveira, C.; Ferreira, J.; Monteiro, A.; Gama, C.; Rafael, S.; Freitas, S.; Borrego, C.; Miranda, A. I.

    2016-02-01

    During the last years, specific air quality problems have been detected in the urban area of Porto (Portugal). Both PM10 and NO2 limit values have been surpassed in several air quality monitoring stations and, following the European legislation requirements, Air Quality Plans were designed and implemented to reduce those levels. In this sense, measures to decrease PM10 and NO2 emissions have been selected, these mainly related to the traffic sector, but also regarding the industrial and residential combustion sectors. The main objective of this study is to investigate the efficiency of these reduction measures with regard to the improvement of PM10 and NO2 concentration levels over the Porto urban region using a numerical modelling tool - The Air Pollution Model (TAPM). TAPM was applied over the study region, for a simulation domain of 80 × 80 km2 with a spatial resolution of 1 × 1 km2. The entire year of 2012 was simulated and set as the base year for the analysis of the impacts of the selected measures. Taking into account the main activity sectors, four main scenarios have been defined and simulated, with focus on: (1) hybrid cars; (2) a Low Emission Zone (LEZ); (3) fireplaces and (4) industry. The modelling results indicate that measures to reduce PM10 should be focused on residential combustion (fireplaces) and industrial activity and for NO2 the strategy should be based on the traffic sector. The implementation of all the defined scenarios will allow a total maximum reduction of 4.5% on the levels of both pollutants.

  18. Adaptive Landing Gear: Optimum Control Strategy and Potential for Improvement

    Directory of Open Access Journals (Sweden)

    Grzegorz Mikułowski

    2009-01-01

    Full Text Available An adaptive landing gear is a landing gear (LG capable of active adaptation to particular landing conditions by means of controlled hydraulic force. The objective of the adaptive control is to mitigate the peak force transferred to the aircraft structure during touch-down, and thus to limit the structural fatigue factor. This paper investigates the ultimate limits for improvement due to various strategies of active control. Five strategies are proposed and investigated numerically using a~validated model of a real, passive landing gear as a reference. Potential for improvement is estimated statistically in terms of the mean and median (significant peak strut forces as well as in terms of the extended safe sinking velocity range. Three control strategies are verified experimentally using a laboratory test stand.

  19. Peer Review as a Strategy for Improving Students' Writing Process

    Science.gov (United States)

    Baker, Kimberly M.

    2016-01-01

    Peer review is an established strategy for improving the quality of students' writing. This study moves beyond the focus on outcomes to assess the peer-review process. In particular, this study focuses on the timing of the peer review, a highly structured feedback form, and student writers' revisions after engaging in peer review. This study draws…

  20. Citizen-based Strategies to Improve Community Security: Working ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Citizen-based Strategies to Improve Community Security: Working with Vulnerable Populations to Address Urban Violence in Medellin ... Water Resources Association, in close collaboration with IDRC, is holding a webinar titled “Climate change and adaptive water management: Innovative solutions from the Global South”.

  1. Strategies for Improving Non-Fiction Reading Comprehension.

    Science.gov (United States)

    Bell, Karen; Caspari, Amy

    This report describes a program for introducing students to strategies for improving their comprehension of non-fiction materials. The targeted population consisted of students of one third grade class in a small, middle class suburb, northwest of a large, midwestern city. Difficulty reading and comprehending non-fiction material was documented…

  2. strategies for improving supervisory skills for effective primary ...

    African Journals Online (AJOL)

    Elizabeth

    certain basic concepts such as inspection and supervision, the responsibility of supervisors, relevant areas in ... Strategies For Improving Supervisory Skills For Effective Primary Education In Nigeria. Enaigbe A. P. 236 ... book, attendance book etc. 6) Managerial Skills: These are skills on time management, good use.

  3. Skills training workshops as a viable strategy for improving ...

    African Journals Online (AJOL)

    Skills training workshops as a viable strategy for improving smallholder and cooperative agribusiness management: A case study of Vhembe District, Limpopo Province, South Africa. ... South African Journal of Agricultural Extension ... Empirical evidence from this study shows that six months after attending the workshops, ...

  4. Strategies for improving students' motivation in the learning of ...

    African Journals Online (AJOL)

    Strategies for improving students' motivation in the learning of French as a foreign language. ... learning should be made fun. The paper recommends that French teachers should give themselves to reading, writing and interaction with colleagues in French and in addition use varieties of methods and materials in teaching.

  5. Identifying strategies to improve the effectiveness of booster seat laws

    Science.gov (United States)

    2008-05-01

    The objective of this project was to identify strategies to improve the effectiveness of booster seat laws. The project explored the possible factors that relate to the use and nonuse of booster seats, and examined the attitudes of law enforcement of...

  6. Oxygen uptake rate (OUR) control strategy for improving avermectin B

    African Journals Online (AJOL)

    Glucose metabolism plays a crucial role in the process of avermectin B1a biosynthesis. Controlling glucose feeding based on oxygen uptake rate (OUR) was established to improve the efficiency of avermectin B1a production. The result showed that avermectin B1a production was greatly enhanced by OUR control strategy.

  7. Strategies to improve clinical management of community-acquired pneumonia

    NARCIS (Netherlands)

    Meijvis, S.C.A.

    2012-01-01

    Despite advances during the last few decades in the prevention, diagnosis and treatment of community-acquired pneumonia (CAP), its incidence remains high. In this thesis, strategies are described for improvement of the quality of clinical management in patients with pneumonia and for the reduction

  8. Coping strategies for managing occupational stress for improved ...

    African Journals Online (AJOL)

    Occupational stress is receiving increasing concern as killer of workers and productivity deterrent. This paper assessed its management and some coping strategies, with a view to improving productivity among workers. The paper adopted literature review approach to x-ray the concept of occupational stress, symptoms of ...

  9. Nature-based strategies for improving urban health and safety

    Science.gov (United States)

    Michelle C. Kondo; Eugenia C. South; Charles C. Branas

    2015-01-01

    Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature...

  10. JCL roundtable: Risk evaluation and mitigation strategy.

    Science.gov (United States)

    Brown, W Virgil; Bramlet, Dean A; Ross, Joyce L; Underberg, James A

    Many factors enter into the decision by the Food and Drug Administration (FDA) to approve a new drug for use by physicians and other health care providers in treating diseases. Initially, the FDA authority was restricted to issues of safety and only later did the documentation of efficacy become part of the review process required for approval. However, all drugs have the potential for causing harm at some dose level to all and at lower doses in certain patients with vulnerability to the particular pharmacology of the agent. As new drugs have been designed to manage disorders that are uncommon, but of significant consequence, they may have adverse effects that are acceptable only because they are so uniquely beneficial to these specific conditions. The risk of these adverse effects may be acceptable since the benefit can outweigh the harm in most patients and the adversity can be predicted and managed. The approval of this category of drugs has grown rapidly since definition of a mechanism of action to manage and modify the risk has been provided by a process known as known as Risk Evaluation and Mitigation Strategy or "REMS." In 2007, the Food and Drug Administration Amendments Act (FDAAA) allowed the FDA to require postmarketing studies and the authority to mandate the implementation of a REMS for drugs with efficacy but documented potential for harm. Two relatively new drugs useful in the management of severe elevations of low-density lipoprotein cholesterol have been approved under a requirement for a REMS. These are lomitapide, an inhibitor of microsomal triglyceride transfer protein and mipomersen, an antisense oligonucleotide which reduces the synthesis of apolipoprotein B. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  11. PERFORMANCE IMPROVEMENT STRATEGIES USED BY MANAGERS IN THE PRIVATE SECTOR

    Directory of Open Access Journals (Sweden)

    Raþiu Patricia

    2013-07-01

    Full Text Available Abstract: There are many situations in professional life when for various reasons we are employed in jobs that do not meet our emotional expectations our professional capabilities, our passions and therefore performance on that job will not be high. Analysis of the causes of under-utilization of human potential and adoption of appropriate strategies according to employee needs help reduce staff turnover costs. The main objective of the present paper consists in identifying managerial strategies which contribute to the improvement of the employees’ performances by stimulating their motivation, and the extent to which they are used in the managerial practice. Based on literature review we realized an integrated model and developed a classification, that present our own vision regarding performance improvement strategies. Our classification divides strategies for improving employees’ performances into four main groups: by employees’ development, by rewarding employees, by modifying the job description, by employee involvement in the organization. Starting from this model, through two types of questionnaires we have made an empirical research among managers as well as among office personnel, in order to capture both perspectives regarding the pursued objectives. For the present paper we will present only research results obtained for performance improvement strategies by employees’ development because support a higher degree of generality and do not depend on the organization characteristics. A quantitative data analize from the two samples show that there are differences between managers and employees perception when it comes to strategies used in their organizations and also manager did not know which determines employees to strive in order to improve their performance and obtain better results. The strategies to improve the employee’s performances, proposed within this article have the role to show the fact that managers cannot

  12. Implications of Continuous Quality Improvement for Program Evaluation and Evaluators.

    Science.gov (United States)

    Mark, Melvin M.; Pines, Edward

    1995-01-01

    Explores the implications that continuous quality improvement (CQI) programs are likely to have for evaluation. CQI, often known as total quality management, offers a structured approach to the analysis of an organization's processes and improvement that should provide advantages to evaluators once they have gained experience with the approach.…

  13. Using an energy management strategy to drive improved business results and improve manufacturing operations

    Energy Technology Data Exchange (ETDEWEB)

    Leroux, Marc

    2010-09-15

    Energy typically represents the single largest controllable cost in manufacturing, and is under constant scrutiny by all levels of management. In this paper we will examine the role and components of an energy management strategy, and focus on the benefits of looking at the strategy from a business perspective. We will then examine the role that an effective program, either existing or new, can play in a collaborative manufacturing environment, and how these improvements can reduce energy requirements while maintaining, or improving productivity.

  14. EXPOSING LEARNERS WITH LEARNING STRATEGIES IN STRATEGY TRAING: ONE OF THE WAYS FOR IMPROVING THEIR STUDY SKILL

    Directory of Open Access Journals (Sweden)

    Kartika Nuswantara

    2009-06-01

    Full Text Available Recognizing our own learning strategies is an effective way to help ourselves to self evaluate for what we have done in our own learning. One among other factors leading to a successful learning is due to the effective learning strategies. However, not all learners are aware of what they have been doing in learning, or they even sometimes do not know how to learn. If this is the problem, learning strategy training can be very beneficial for the learners with this problem. Why should be through strategy training? The answer might lie on the fact that strategy is quite amenable to change, and by nature, teachable as well as learneable (Oxford, 1990. In addition, Nuswantara (2008 also found out that the successful learners (i.e. in learning English were triggered by the courage of using various learning strategies, the more varied the learners are willing to try out, the broader the chance for success. Training is the way that can be selected to present to the learners’ various strategies that they can choose and at the same time employ when learning is taken place. Moreover, by means of training, learners are made aware of the strategy, and they can mend their own strategy, as a result, they become more self - directed rather than dependent. This article attempts to frame out from the perspective of how to bring reading strategies that are applicable for handling various reading content texts to the learners, and present the result of a one-group experimental study. Thus, training is prepared for college learners who are inevitably deal with various English content textbooks and the final aim of the training is to improve learners’ study skills. Then, one group experimental study using correlated sample provides some evidences supporting the effectiveness of the training. Specifying on reading strategies, SQ3R that is joined with other learning strategies involving writing activity, annotating a text and paraphrasing/summarizing is exposed to

  15. Paths to continuous improvement of a CRM strategy

    Directory of Open Access Journals (Sweden)

    Lluís G. Renart

    2008-07-01

    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.

  16. The social strategy cone: Towards a framework for evaluating social media strategies

    NARCIS (Netherlands)

    Effing, Robin; Spil, Antonius A.M.

    2016-01-01

    Social media is growing rapidly. Providing both risks and opportunities for organizations as it does. The social strategy cone is developed for evaluating social media strategies. This framework comprises of seven key elements of social media strategies as based on a systematic literature review and

  17. Evolution of strategies to improve preclinical cardiac safety testing.

    Science.gov (United States)

    Gintant, Gary; Sager, Philip T; Stockbridge, Norman

    2016-07-01

    The early and efficient assessment of cardiac safety liabilities is essential to confidently advance novel drug candidates. This article discusses evolving mechanistically based preclinical strategies for detecting drug-induced electrophysiological and structural cardiotoxicity using in vitro human ion channel assays, human-based in silico reconstructions and human stem cell-derived cardiomyocytes. These strategies represent a paradigm shift from current approaches, which rely on simplistic in vitro assays that measure blockade of the Kv11.1 current (also known as the hERG current or IKr) and on the use of non-human cells or tissues. These new strategies have the potential to improve sensitivity and specificity in the early detection of genuine cardiotoxicity risks, thereby reducing the likelihood of mistakenly discarding viable drug candidates and speeding the progression of worthy drugs into clinical trials.

  18. Mentoring approach improves evaluation capacity of ICTD ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-09

    Jun 9, 2016 ... ... initiative is improving evaluation capacities of researchers studying Information and ... Capacity in ICTD (DECI) provides researchers from five IDRC-funded projects in ... Using technology to deliver quality education in Asia.

  19. A communication strategy to improve nutrition in Indonesia.

    Science.gov (United States)

    Griffiths, M; Nobbe, E

    1985-01-01

    As an experimental project, the Nutrition Communication and Behavior Change Component (NCBC) of the Indonesian Nutrition Development Program (UPGK) showed how social marketing could further the national program's goal of significantly improving the nutrition of Indonesia's young children and pregnant and nursing women. The social marketing approach successfully developed nutrition communication materials that were responsive to the needs, desires, and resources of the communities, particularly of the mothers and volunteer nutrition workers. Between 1977-79 Dr. I.B. Mantra, NCBC Director, established administrative and community infrastructures modeled after UPGK in 5 culturally diverse areas in Indonesia. In mid-1979, with technical assistance from Manoff International, the project departed from the approach of the national plan and embarked upon an unprecedented course with the formative evaluation of educational messages and a communication strategy. The success of the NCBC Component was to be judged by whether education -- as the sole intervention -- could produce significant improvements in the nutritional status of children and the improved nutrient intake of pregnant and lactating women in project communities. The 1st step was to design and execute qualitative research on the health and nutritional problems of children under 3 and pregnant and nursing women, consisting of in-depth household interviews, concept testing with mothers, and focus group interviews with kaders and community opinion leaders. Surveying was based on issues identified earlier by the Ministry of Health as most severe for the population overall. The qualitative investigation identified the need for change or reinforcement in particular nutrition-related behaviors. The target audience of mothers was segmented according to their needs during designated maternal stages and by the age-related dietary needs of their children under 3 years of age. This meant that only the most useful

  20. AN EVALUATION OF RISK MANAGEMENT STRATEGIES FOR DAIRY FARMS

    OpenAIRE

    Bosch, Darrell J.; Johnson, Christian J.

    1992-01-01

    Variability in feed prices and crop yields are important sources of risk to dairy farmers. A simulation model of a representative dairy farm was used to evaluate crop insurance and hedging as risk management strategies. These strategies lowered expected net returns but also reduced risk. The preferred set of strategies at lower levels of risk aversion included hedging and crop insurance, although a base scenario in which no risk management strategies were employed was also efficient. The pref...

  1. Strategies for Evaluating a Freshman Studies Program.

    Science.gov (United States)

    Ketkar, Kusum; Bennett, Shelby D.

    1989-01-01

    The study developed an economic model for the evaluation of Seaton Hall University's freshman studies program. Two techniques used to evaluate the economic success of the program are break-even analysis and elasticity coefficient. (Author/MLW)

  2. THE PUZZLE TECHNIQUE, COOPERATIVE LEARNING STRATEGY TO IMPROVE ACADEMIC PERFORMANCE

    Directory of Open Access Journals (Sweden)

    M.ª José Mayorga Fernández

    2012-04-01

    Full Text Available This  article  presents  an  innovative  experience  carried  out  in  the  subject Pedagogical Bases of Special Education, a 4.5 credit core subject taught at the second year of the Degree in Physical Education Teacher Training (to be extinguish, based on the use of a methodological strategic in accordance with the new demands of the EEES. With the experience we pursue a double purpose: firstly, to present the technique of jigsaw or puzzle as a useful methodological strategy for university learning and, on the other hand, to show whether this strategy improves students results. Comparing the results with students previous year results shows that the performance of students who participated in the innovative experience has improved considerably, increasing their motivation and involvement towards the task.

  3. [Health professionals facing hand hygiene improvement: state-of-the-art strategies versus extended strategies].

    Science.gov (United States)

    Herrera-Usagre, Manuel; Pérez-Pérez, Pastora; Vázquez-Vázquez, Marta; Santana-López, Vicente

    2014-10-01

    The hand hygiene (HH) is one of the preventive practices more .widely and effectively implemented in the control of healthcare associated infections. However, there are several barriers to compliance. To assess which strategy, state-of-the-art strategies (availability of alcohol-based preparations, posters, instructions and training) or extended strategies (feedbacks, formal and informal leadership), are seen as more effective to improve hand hygiene (HH) compliance. Analytical study using a self-completed questionnaire developed by the World Health Organization. 2,068 questionnaires, completed by healthcare professionals (HP) in Andalusia (Spain), were received from 2010 to 2012. Analytical technique: Structural equation modeling and multi group measurement invariance. Once the reliability of the proposed constructs was achieved (Cronbach α=0.73, 0.84, 0.70), it was found that those HP working in centers with the highest level of commitment with HH are those who see extended strategies as more effective (χ2=298.3, df=39, CFI=0.972, TLI=0.961, RMSEA=0.057, SRMR=0.028). Our results have shown that hospitals' HP, compared to primary care HP, see state-of-the-art strategies as more effective, as well as they give less importance to HH, meanwhile nurses, compared to physicians, see effective both strategies. HP contemplate the combination of state-of-the-art and extended strategies as an effective way to improve the HH compliance. In addition, extended strategies are considered more effective amongst the most "advanced" healthcare settings in terms of their commitment to HH. The results highlight the need for commitment at management, collective and individual level in order to maintain patient safety.

  4. IMPROVING STUDENTS’ SKIMMING AND SCANNING IN READING SKILL BY APPLYING METACOGNITIVE STRATEGY

    Directory of Open Access Journals (Sweden)

    Siti Mariam

    2016-07-01

    Full Text Available Reading is one of the main four language skills that a learner needs to master in order to ensure success in learning English. To facilitate students in comprehending a text, the effective strategies should be used. One of the strategies is Meta-cognitive strategies. The objectives of the research are to identify students’ responses during learned process by using Meta-cognitive strategies and to investigate how high students’ improvement of skimming and scanning reading skill after learned by using Meta-cognitive strategies in recount text. Meta-cognitive strategies improve students to reflect on thought processes and to plan, monitor, and evaluate aspects of their learning. The participants were third semester of English department students of Islamic Education and Teacher Training Faculty of Walisongo State Islamic University.The reserch design was Classroom Action Research with 1 preliminary cycle and 2 cycles. This research was conducted from March, 2th 2015 until March, 21th 2015. Data collection technique was tests. Observations were done in each cycle. Tests form was given the students, they should answer 20 questions of multiple choice test. Then, the data were analyzed using mean (descriptive statistics to find out the improvements. Meta-cognitive strategies were applied in the teaching learning process by giving plan (giving task for students, monitoring, evaluating, and problem solving to the students. After collecting the data, the result showed the improvements of the students. Students’ average score in pre cycle test was 60. In the first cycle, the average score increased became 70. This score hadn’t met the minimum standard score yet 75. Therefore, second cycle was conducted. Students’ average score increased became 82.16. Students’ engagements also increased since the first cycle. Consequently, the objectives were reached. Based on the result, it could be concluded that Meta-cognitive strategy can improve the

  5. Improving Students’ Skimming and Scanning in Reading Skill by Applying Metacognitive Strategy

    Directory of Open Access Journals (Sweden)

    Siti Mariam

    2016-07-01

    Full Text Available Reading is one of the main four language skills that a learner needs to master in order to ensure success in learning English. To facilitate students in comprehending a text, the effective strategies should be used. One of the strategies is Meta-cognitive strategies. The objectives of the research are to identify students’ responses during learned process by using Meta-cognitive strategies and to investigate how high students’ improvement of skimming and scanning reading skill after learned by using Meta-cognitive strategies in recount text. Meta-cognitive strategies improve students to reflect on thought processes and to plan, monitor, and evaluate aspects of their learning. The participants were third semester of English department students of Islamic Education and Teacher Training Faculty of Walisongo State Islamic University.The reserch design was Classroom Action Research with 1 preliminary cycle and 2 cycles. This research was conducted from March, 2th 2015 until March, 21th 2015. Data collection technique was tests. Observations were done in each cycle. Tests form was given the students, they should answer 20 questions of multiple choice test. Then, the data were analyzed using mean (descriptive statistics to find out the improvements. Meta-cognitive strategies were applied in the teaching learning process by giving plan (giving task for students, monitoring, evaluating, and problem solving to the students. After collecting the data, the result showed the improvements of the students. Students’ average score in pre cycle test was 60. In the first cycle, the average score increased became 70. This score hadn’t met the minimum standard score yet 75. Therefore, second cycle was conducted. Students’ average score increased became 82.16. Students’ engagements also increased since the first cycle. Consequently, the objectives were reached. Based on the result, it could be concluded that Meta-cognitive strategy can improve the

  6. Improv(ing) the Academy: Applied Improvisation as a Strategy for Educational Development

    Science.gov (United States)

    Rossing, Jonathan P.; Hoffmann-Longtin, Krista

    2016-01-01

    Improvisational theater training (or "improv") is a strategy employed by many business leaders and educators to cultivate creativity and collaboration amid change. Drawing on improv principles such as "Yes, And…" and "Make your scene partners look good," we explore the ways in which educational developers might apply…

  7. Strategies for improved French-language health services

    Science.gov (United States)

    Gauthier, Alain P.; Timony, Patrick E.; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

    2015-01-01

    Abstract Objective To identify strategies to improve the quality of health services for Francophone patients. Design A series of semistructured key informant interviews. Setting Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Methods Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Main findings Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Conclusion Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist. PMID:26505060

  8. Peer Assisted Learning Strategy for Improving Students’ Physiologic Literacy

    Science.gov (United States)

    Diana, S.

    2017-09-01

    Research about the implementation of the Peer Assisted Learning (PAL) strategy in Plant Physiology lecture has carried out, in which it aims to improve students’ physiologic literacy. The PAL strategy began with a briefing by the lecturers to the students tutor about pretest questions, followed by the interaction between student tutors with their peers to discuss response problems, terminated by answering responsiveness questions individually. This study used a quasi-experimental method, one - group pre-test post-test design. This design includes a group of students observed in the pre-test phase (tests carried out before PAL treatment) which is then followed by treatment with PAL and ends with post-test. The other students group (control) was given the pre-test and post-test only. The results showed that the PAL strategy can increase student’s physiologic literacy significantly. One of the weaknesses of students’ physiologic literacy is that they have not been able to read the graph. The faculties are encouraged to begin introducing and teaching material using a variety of strategies with scientific literacy aspects, for example teaching research-based material. All students respond positively to the PAL strategy.

  9. Competitive Strategies and Improved Performance of Selected Nigeria Telecommunication Companies

    Directory of Open Access Journals (Sweden)

    Waidi Adeniyi Akingbad

    2014-01-01

    Full Text Available Abstract The influence of globalization in telecommunication companies has greatly increased the level of competition in the industry and they are forced to be competitive to survive. Different types of strategies are put in place in order to be profitable and competitive. All these strategies are directed to attract, retain and maintain customers for continuous profitability. However, majority of them hardly measure the impact of their strategic innovation on their customers. The paper seeks to explore the influence of competitive strategies embarked upon by selected telecommunication companies in Nigeria on their performance. The paper also examines how competitive strategies could be implemented for improved customer satisfaction, retention and loyalty. Three null hypotheses were postulated to test the relationship between lower prices and customer satisfaction, uninterrupted trunk services and customer loyalty, and customer complaint handling and retention. Only customers using telephone service were selected as respondents from Lagos State. The state was stratified in to 20 local government council area and questionnaires were distributed to 125 respondents in each of them. The completion rate of the questionnaire in each of them is between 103 and 110. Survey research design was adopted to carry out the study. A structured questionnaire was designed and validated through the construct validity and tested for confirmation using the KMO measure of sampling adequacy. It was also made reliable using Cronbach’s Alpha test. From the study, findings revealed relationship between competitive strategies and customer satisfaction, retention and loyalty. The findings revealed that there is a relationship between competitive strategies, its constituents and performance of telecommunication companies. It is recommended that universal mobile telecommunication services (UMTS operators should adopt the culture of competitive strategies since it can

  10. A systematic review of hand hygiene improvement strategies: a behavioural approach

    Directory of Open Access Journals (Sweden)

    Huis Anita

    2012-09-01

    Full Text Available Abstract Background Many strategies have been designed and evaluated to address the problem of low hand hygiene (HH compliance. Which of these strategies are most effective and how they work is still unclear. Here we describe frequently used improvement strategies and related determinants of behaviour change that prompt good HH behaviour to provide a better overview of the choice and content of such strategies. Methods Systematic searches of experimental and quasi-experimental research on HH improvement strategies were conducted in Medline, Embase, CINAHL, and Cochrane databases from January 2000 to November 2009. First, we extracted the study characteristics using the EPOC Data Collection Checklist, including study objectives, setting, study design, target population, outcome measures, description of the intervention, analysis, and results. Second, we used the Taxonomy of Behavioural Change Techniques to identify targeted determinants. Results We reviewed 41 studies. The most frequently addressed determinants were knowledge, awareness, action control, and facilitation of behaviour. Fewer studies addressed social influence, attitude, self-efficacy, and intention. Thirteen studies used a controlled design to measure the effects of HH improvement strategies on HH behaviour. The effectiveness of the strategies varied substantially, but most controlled studies showed positive results. The median effect size of these strategies increased from 17.6 (relative difference addressing one determinant to 49.5 for the studies that addressed five determinants. Conclusions By focussing on determinants of behaviour change, we found hidden and valuable components in HH improvement strategies. Addressing only determinants such as knowledge, awareness, action control, and facilitation is not enough to change HH behaviour. Addressing combinations of different determinants showed better results. This indicates that we should be more creative in the application of

  11. Development of a tailored strategy to improve postpartum hemorrhage guideline adherence.

    Science.gov (United States)

    de Visser, Suzan M; Woiski, Mallory D; Grol, Richard P; Vandenbussche, Frank P H A; Hulscher, Marlies E J L; Scheepers, Hubertina C J; Hermens, Rosella P M G

    2018-02-08

    Despite the introduction of evidence based guidelines and practical courses, the incidence of postpartum hemorrhage shows an increasing trend in developed countries. Substandard care is often found, which implies an inadequate implementation in high resource countries. We aimed to reduce the gap between evidence-based guidelines and clinical application, by developing a strategy, tailored to current barriers for implementation. The development of the implementation strategy consisted of three phases, supervised by a multidisciplinary expert panel. In the first phase a framework of the strategy was created, based on barriers to optimal adherence identified among professionals and patients together with evidence on effectiveness of strategies found in literature. In the second phase, the tools within the framework were developed, leading to a first draft. In the third phase the strategy was evaluated among professionals and patients. The professionals were asked to give written feedback on tool contents, clinical usability and inconsistencies with current evidence care. Patients evaluated the tools on content and usability. Based on the feedback of both professionals and patients the tools were adjusted. We developed a tailored strategy to improve guideline adherence, covering the trajectory of the third trimester of pregnancy till the end of the delivery. The strategy, directed at professionals, comprehending three stop moments includes a risk assessment checklist, care bundle and time-out procedure. As patient empowerment tools, a patient passport and a website with patient information was developed. The evaluation among the expert panel showed all professionals to be satisfied with the content and usability and no discrepancies or inconsistencies with current evidence was found. Patients' evaluation revealed that the information they received through the tools was incomplete. The tools were adjusted accordingly to the missing information. A usable, tailored

  12. Strategies for Improved Hospital Response to Mass Casualty Incidents.

    Science.gov (United States)

    TariVerdi, Mersedeh; Miller-Hooks, Elise; Kirsch, Thomas

    2018-03-19

    Mass casualty incidents are a concern in many urban areas. A community's ability to cope with such events depends on the capacities and capabilities of its hospitals for handling a sudden surge in demand of patients with resource-intensive and specialized medical needs. This paper uses a whole-hospital simulation model to replicate medical staff, resources, and space for the purpose of investigating hospital responsiveness to mass casualty incidents. It provides details of probable demand patterns of different mass casualty incident types in terms of patient categories and arrival patterns, and accounts for related transient system behavior over the response period. Using the layout of a typical urban hospital, it investigates a hospital's capacity and capability to handle mass casualty incidents of various sizes with various characteristics, and assesses the effectiveness of designed demand management and capacity-expansion strategies. Average performance improvements gained through capacity-expansion strategies are quantified and best response actions are identified. Capacity-expansion strategies were found to have superadditive benefits when combined. In fact, an acceptable service level could be achieved by implementing only 2 to 3 of the 9 studied enhancement strategies. (Disaster Med Public Health Preparedness. 2018;page 1 of 13).

  13. Strategies for addressing barriers to publishing pediatric quality improvement research.

    Science.gov (United States)

    Van Cleave, Jeanne; Dougherty, Denise; Perrin, James M

    2011-09-01

    Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

  14. Strategy for continuous improvement in IC manufacturability, yield, and reliability

    Science.gov (United States)

    Dreier, Dean J.; Berry, Mark; Schani, Phil; Phillips, Michael; Steinberg, Joe; DePinto, Gary

    1993-01-01

    Continual improvements in yield, reliability and manufacturability measure a fab and ultimately result in Total Customer Satisfaction. A new organizational and technical methodology for continuous defect reduction has been established in a formal feedback loop, which relies on yield and reliability, failed bit map analysis, analytical tools, inline monitoring, cross functional teams and a defect engineering group. The strategy requires the fastest detection, identification and implementation of possible corrective actions. Feedback cycle time is minimized at all points to improve yield and reliability and reduce costs, essential for competitiveness in the memory business. Payoff was a 9.4X reduction in defectivity and a 6.2X improvement in reliability of 256 K fast SRAMs over 20 months.

  15. A strategy to improve priority setting in developing countries.

    Science.gov (United States)

    Kapiriri, Lydia; Martin, Douglas K

    2007-09-01

    Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In this paper we argue that priority setting is a value laden and political process, and although important, the available information and tools are not sufficient to address the priority setting challenges in developing countries. Additional complementary efforts are required. Hence, a strategy to improve priority setting in developing countries should also include: (i) capturing current priority setting practices, (ii) improving the legitimacy and capacity of institutions that set priorities, and (iii) developing fair priority setting processes.

  16. Intervention strategies to improve nutrition and health behaviours before conception.

    Science.gov (United States)

    Barker, Mary; Dombrowski, Stephan U; Colbourn, Tim; Fall, Caroline H D; Kriznik, Natasha M; Lawrence, Wendy T; Norris, Shane A; Ngaiza, Gloria; Patel, Dilisha; Skordis-Worrall, Jolene; Sniehotta, Falko F; Steegers-Theunissen, Régine; Vogel, Christina; Woods-Townsend, Kathryn; Stephenson, Judith

    2018-05-05

    The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring. Evidence of the effectiveness of preconception interventions for improving outcomes for mothers and babies is scarce. However, given the large potential health return, and relatively low costs and risk of harm, research into potential interventions is warranted. We identified three promising strategies for intervention that are likely to be scalable and have positive effects on a range of health outcomes: supplementation and fortification; cash transfers and incentives; and behaviour change interventions. On the basis of these strategies, we suggest a model specifying pathways to effect. Pathways are incorporated into a life-course framework using individual motivation and receptiveness at different preconception action phases, to guide design and targeting of preconception interventions. Interventions for individuals not planning immediate pregnancy take advantage of settings and implementation platforms outside the maternal and child health arena, since this group is unlikely to be engaged with maternal health services. Interventions to improve women's nutritional status and health behaviours at all preconception action phases should consider social and environmental determinants, to avoid exacerbating health and gender inequalities, and be underpinned by a social movement that touches the whole population. We propose a dual strategy that targets specific groups actively planning a pregnancy, while improving the health of the population more broadly. Modern marketing techniques could be used to promote a social movement based on an emotional and symbolic connection between improved preconception maternal health and nutrition, and offspring health. We suggest that speedy and scalable benefits to public health might be achieved through strategic engagement with the private sector. Political theory supports

  17. Strategies to improve adherence to treatment in adolescents and young adults with cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Robertson EG

    2015-07-01

    Full Text Available Eden G Robertson,1,2 Claire E Wakefield,1,2 Kate H Marshall,2 Ursula M Sansom-Daly1–3 1Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, University of New South Wales, Kensington, NSW, Australia; 2Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, 3Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, Randwick, NSW, Australia Purpose: Adolescents and young adults (AYAs with cancer have higher rates of nonadherence to treatment relative to younger and older cancer patients. Efforts to improve adherence in this population are therefore increasing. This review aimed: 1 to synthesize recommendations and strategies used to improve treatment adherence in AYAs with cancer, and 2 to summarize the available evidence supporting the efficacy of adherence-promoting strategies for AYAs with cancer.Methods: We conducted a systematic review with two stages: 1 a narrative stage, to analyze expert recommendations, and 2 an evaluative stage, to summarize quantitative evidence for interventions. Four electronic databases were searched for studies involving AYAs, aged 10–39 years, with cancer, published from 2005 to 2015. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines were used to ensure quality of the review. The Delphi list was used to assess study quality.Results: Nine articles were identified in the narrative stage of the review. For the evaluative stage, out of 113 screened abstracts, only one eligible intervention was identified. Common themes of adherence-promoting strategies were grouped into five domains: developmental, communication, educational, psychological well-being, and logistical/management strategies. Strategies to address developmental stage and to improve communication were the most highly recommended to improve adherence. Few strategies focused on the role of the patient in adherence. One

  18. Leading clinical handover improvement: a change strategy to implement best practices in the acute care setting.

    Science.gov (United States)

    Clarke, Christina M; Persaud, Drepaul David

    2011-03-01

    Many contemporary acute care facilities lack safe and effective clinical handover practices resulting in patient transitions that are vulnerable to discontinuities in care, medical errors, and adverse patient safety events. This article is intended to supplement existing handover improvement literature by providing practical guidance for leaders and managers who are seeking to improve the safety and the effectiveness of clinical handovers in the acute care setting. A 4-stage change model has been applied to guide the application of strategies for handover improvement. Change management and quality improvement principles, as well as concepts drawn from safety science and high-reliability organizations, were applied to inform strategies. A model for handover improvement respecting handover complexity is presented. Strategies targeted to stages of change include the following: 1. Enhancing awareness of handover problems and opportunities with the support of strategic directions, accountability, end user involvement, and problem complexity recognition. 2. Identifying solutions by applying and adapting best practices in local contexts. 3. Implementing locally adapted best practices supported by communication, documentation, and training. 4. Institutionalizing practice changes through integration, monitoring, and active dissemination. Finally, continued evaluation at every stage is essential. Although gaps in handover process and function knowledge remain, efforts to improve handover safety and effectiveness are still possible. Continued evaluation is critical in building this understanding and to ensure that practice changes lead to improvements in patient safety, organizational effectiveness, and patient and provider satisfaction. Through handover knowledge building, fundamental changes in handover policies and practices may be possible.

  19. Improving basic math skills through integrated dynamic representation strategies.

    Science.gov (United States)

    González-Castro, Paloma; Cueli, Marisol; Cabeza, Lourdes; Álvarez-García, David; Rodríguez, Celestino

    2014-01-01

    In this paper, we analyze the effectiveness of the Integrated Dynamic Representation strategy (IDR) to develop basic math skills. The study involved 72 students, aged between 6 and 8 years. We compared the development of informal basic skills (numbers, comparison, informal calculation, and informal concepts) and formal (conventionalisms, number facts, formal calculus, and formal concepts) in an experimental group (n = 35) where we applied the IDR strategy and in a Control group (n = 37) in order to identify the impact of the procedure. The experimental group improved significantly in all variables except for number facts and formal calculus. It can therefore be concluded that IDR favors the development of the skills more closely related to applied mathematics than those related to automatic mathematics and mental arithmetic.

  20. Current Strategies to Improve the Bioactivity of PEEK

    Science.gov (United States)

    Ma, Rui; Tang, Tingting

    2014-01-01

    The synthetic thermoplastic polymer polyetheretherketone (PEEK) is becoming a popular component of clinical orthopedic and spinal applications, but its practical use suffers from several limitations. Although PEEK is biocompatible, chemically stable, radiolucent and has an elastic modulus similar to that of normal human bone, it is biologically inert, preventing good integration with adjacent bone tissues upon implantation. Recent efforts have focused on increasing the bioactivity of PEEK to improve the bone-implant interface. Two main strategies have been used to overcome the inert character of PEEK. One approach is surface modification to activate PEEK through surface treatment alone or in combination with a surface coating. Another strategy is to prepare bioactive PEEK composites by impregnating bioactive materials into PEEK substrate. Researchers believe that modified bioactive PEEK will have a wide range of orthopedic applications. PMID:24686515

  1. Navigating towards improved surgical safety using aviation-based strategies.

    Science.gov (United States)

    Kao, Lillian S; Thomas, Eric J

    2008-04-01

    Safety practices in the aviation industry are being increasingly adapted to healthcare in an effort to reduce medical errors and patient harm. However, caution should be applied in embracing these practices because of limited experience in surgical disciplines, lack of rigorous research linking these practices to outcome, and fundamental differences between the two industries. Surgeons should have an in-depth understanding of the principles and data supporting aviation-based safety strategies before routinely adopting them. This paper serves as a review of strategies adapted to improve surgical safety, including the following: implementation of crew resource management in training operative teams; incorporation of simulation in training of technical and nontechnical skills; and analysis of contributory factors to errors using surveys, behavioral marker systems, human factors analysis, and incident reporting. Avenues and challenges for future research are also discussed.

  2. Multicriteria evaluation of demand side management (DSM) implementation strategies in the Indian power sector

    Energy Technology Data Exchange (ETDEWEB)

    Vashishtha, Sanjay [Centre for Renewable Energy and Environmental Development (CREED), BITS, Pilani, Rajasthan 333031 (India); Ramachandran, M. [BITS Pilani Dubai Centre, Dubai (United Arab Emirates)

    2006-09-15

    In recent years, demand side management (DSM) has emerged as an efficient utility planning strategy for reducing capacity shortages and improving system load factors. The Indian government is adopting various policies to implement DSM programs. DSM implementation involves a variety of interests with conflicting objectives, and a range of possible implementation strategies with varying implications for effectiveness, cost, feasibility, efficiency and stakeholder acceptance. This necessitates a critical comparison of the strategies to determine a preferred strategy or combination of strategies from each specific stakeholder's point of view. The present study evaluates DSM implementation strategies from a multiobjective perspective using the Analytic Hierarchy Process (AHP). Eight strategies and six criteria were considered. Forty utility, regulator, and consumer stakeholders were surveyed. The most highly ranked strategies involved creating dedicated funds and providing technical support to end users for effective implementation of DSM. (author)

  3. [Strategies to improve influenza vaccination coverage in Primary Health Care].

    Science.gov (United States)

    Antón, F; Richart, M J; Serrano, S; Martínez, A M; Pruteanu, D F

    2016-04-01

    Vaccination coverage reached in adults is insufficient, and there is a real need for new strategies. To compare strategies for improving influenza vaccination coverage in persons older than 64 years. New strategies were introduced in our health care centre during 2013-2014 influenza vaccination campaign, which included vaccinating patients in homes for the aged as well as in the health care centre. A comparison was made on vaccination coverage over the last 4 years in 3 practices of our health care centre: P1, the general physician vaccinated patients older than 64 that came to the practice; P2, the general physician systematically insisted in vaccination in elderly patients, strongly advising to book appointments, and P3, the general physician did not insist. These practices looked after P1: 278; P2: 320; P3: 294 patients older than 64 years. Overall/P1/P2/P3 coverages in 2010: 51.2/51.4/55/46.9% (P=NS), in 2011: 52.4/52.9/53.8/50.3% (P=NS), in 2012: 51.9/52.5/55.3/47.6% (P=NS), and in 2013: 63.5/79.1/59.7/52.7 (P=.000, P1 versus P2 and P3; P=NS between P2 and P3). Comparing the coverages in 2012-2013 within each practice P1 (P=.000); P2 (P=.045); P3 (P=.018). In P2 and P3 all vaccinations were given by the nurses as previously scheduled. In P3, 55% of the vaccinations were given by the nurses, 24.1% by the GP, 9.7% rejected vaccination, and the remainder did not come to the practice during the vaccination period (October 2013-February 2014). The strategy of vaccinating in the homes for the aged improved the vaccination coverage by 5% in each practice. The strategy of "I've got you here, I jab you here" in P1 improved the vaccination coverage by 22%. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Innovative strategies for nursing education program evaluation.

    Science.gov (United States)

    Story, Lachel; Butts, Janie B; Bishop, Sandra B; Green, Lisa; Johnson, Kathy; Mattison, Haley

    2010-06-01

    Nursing programs are mandated by accreditation bodies to report data significant to program quality and outcomes. The history at one school of nursing in the southern United States revealed the program evaluation committee experienced roadblocks in retrieving such information. Creative approaches were adopted to overcome some of the barriers to program evaluation, including the use of more technological-based approaches to engage alumni who embrace this technology as a way of life. Among the many advantages of these approaches were convenience, ease of administration and analysis, cost effectiveness, and more meaningful data. The advantages far outweighed the few disadvantages incurred, with the most prominent being potential sampling bias. Copyright 2010, SLACK Incorporated.

  5. Behavioral Change Strategies for Improving Complementary Feeding and Breastfeeding.

    Science.gov (United States)

    Osendarp, Saskia J M; Roche, Marion L

    2016-01-01

    Improving infant and young child feeding (IYCF) practices, including breastfeeding and complementary feeding, has been identified as one of the most effective interventions to improve child survival, stunting and wasting. Evidence from randomized controlled trials suggests that effective promotion of breastfeeding and complementary feeding, with or without food provision, has the potential to improve IYCF practices and child nutrition. However, in many countries, breastfeeding practices and complementary feeding practices are still far from optimal. The lack of implementation of available, effective, affordable interventions in scale-up programs is in part attributed to a lack of innovative, creative and effective behavioral change strategies that enable and encourage caregivers. Successful behavioral change strategies should be based on a rigorous situational analysis and formative research, and the findings and insights of formative research should be used to further design interventions that address the identified barriers and enablers, to select delivery channels, and to formulate appropriate and effective messages. In addition, successful behavioral change interventions should a priori define and investigate the program impact pathway to target behavioral change and should assess intermediary behavioral changes and indicators to learn why the expected outcome was achieved or not achieved by testing the program theory. The design of behavioral change communication must be flexible and responsive to shifts in societies and contexts. Performance of adequate IYCF also requires investments to generate community demand through social mobilization, relevant media and existing support systems. Applying these principles has been shown to be effective in improving IYCF practices in Vietnam, Bangladesh and Ethiopia and is recommended to be adopted by other programs and countries in order to accelerate progress in improving child nutrition. © 2016 S. Karger AG, Basel.

  6. Evaluating and Improving Online Intelligence Courses

    Directory of Open Access Journals (Sweden)

    Dr. Alexandra Luce

    2013-08-01

    Full Text Available Civilian, military and government institutions offer a wide range of courses on intelligence and are increasingly doing so online. While evaluation and improvement are critical to ensuring quality training and education, there is little research about how to evaluate and improve online intelligence courses. Based on the author’s experience developing and teaching such courses, this article offers four suggestions to those involved in online intelligence training and education: (1 conduct a key assumptions check; (2 ensure the course presentation embodies the principles of intelligence communication; (3 encourage creative freedom; and (4 build in mechanisms for feedback throughout the course.

  7. Evaluating Executive Strategies (Management Strategies and Teaching-Learning Strategies) of Graduate Curriculum: Case Study in Isfahan University

    Science.gov (United States)

    Rahmanpour, Muhammad; Ahmadi, Mojtaba; Hatami, Mostafa; Mirzaee, Hamzeh

    2017-01-01

    The present study seeks to evaluate executive strategies in graduate Curriculum of Isfahan University from the point of view of management and teaching-learning strategies. This study is an applied survey. The population comprised BA students and faculty members of the University of Isfahan. In order to do so, 141 professors and 278 students were…

  8. Photometric Redshifts with the LSST: Evaluating Survey Observing Strategies

    Science.gov (United States)

    Graham, Melissa L.; Connolly, Andrew J.; Ivezić, Željko; Schmidt, Samuel J.; Jones, R. Lynne; Jurić, Mario; Daniel, Scott F.; Yoachim, Peter

    2018-01-01

    In this paper we present and characterize a nearest-neighbors color-matching photometric redshift estimator that features a direct relationship between the precision and accuracy of the input magnitudes and the output photometric redshifts. This aspect makes our estimator an ideal tool for evaluating the impact of changes to LSST survey parameters that affect the measurement errors of the photometry, which is the main motivation of our work (i.e., it is not intended to provide the “best” photometric redshifts for LSST data). We show how the photometric redshifts will improve with time over the 10 year LSST survey and confirm that the nominal distribution of visits per filter provides the most accurate photo-z results. The LSST survey strategy naturally produces observations over a range of airmass, which offers the opportunity of using an SED- and z-dependent atmospheric affect on the observed photometry as a color-independent redshift indicator. We show that measuring this airmass effect and including it as a prior has the potential to improve the photometric redshifts and can ameliorate extreme outliers, but that it will only be adequately measured for the brightest galaxies, which limits its overall impact on LSST photometric redshifts. We furthermore demonstrate how this airmass effect can induce a bias in the photo-z results, and caution against survey strategies that prioritize high-airmass observations for the purpose of improving this prior. Ultimately, we intend for this work to serve as a guide for the expectations and preparations of the LSST science community with regard to the minimum quality of photo-z as the survey progresses.

  9. Motivation's Influence on English Learning and Strategies for Improving

    Institute of Scientific and Technical Information of China (English)

    陈玢; 张亚铃

    2009-01-01

    The article mainly focuses on the relationship between motivation and English learning,the influence of motivation on English learning(That is,English learning motive may be simply viewed as the reason of learning English;different motives will lead to different learning methods;generally speaking,surface motive does not endure longer than deep motive.;strong motivation can lead to final Success.)and six strategies of improving English learning(That is,developing proper attitudes towards English learning and letting students know the pressure of it;goal and feedback;praise and criticism;contest and cooperation;expectation and appraisement;achievement motive.).

  10. Self-managing teams: a strategy for quality improvement.

    Science.gov (United States)

    Feifer, Chris; Nocella, Kiki; DeArtola, Ignacio; Rowden, Suzanne; Morrison, Stephen

    2003-01-01

    Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room.

  11. Dental Emergencies: Management Strategies That Improve Outcomes [Digest].

    Science.gov (United States)

    Pedigo, Ryan Anthony; Zaurova, Milana

    2017-06-22

    Points & Pearls is a digest of Emergency Medicine Practice . Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.

  12. An investigation to find strategies to improve student nurses' maths skills.

    Science.gov (United States)

    Wright, Kerri

    Being able to perform drug calculations accurately is an essential skill for nurses. Many studies, however, have demonstrated that nurses need to improve this area of their practice and in particular their mathematical skills. Several strategies have been implemented to develop the drug calculation skills of nurses, with mixed success. This article reports on a study that was carried out to investigate whether strategies implemented within a second-year pre-registration course were perceived by students to be helpful in improving their mathematical skills for drug calculations. The results demonstrated that students felt their mathematics and confidence improved as a result of these strategies. The students' evaluation of the learning strategy that they found most helpful in learning drug calculation gave a mixed result, indicating that students have differing learning styles and needs. The study also indicates that student nurses were able to integrate the mathematical skills into their nursing practice by having different strategies that allowed them to develop conceptual, mathematical and practical skills concurrently. The study recommends the implementation of integrated strategies to address drug calculation skills in student nurses, although further research is still required.

  13. Evaluation of strategies for severe accident prevention and mitigation

    International Nuclear Information System (INIS)

    Tokarz, R.

    1989-01-01

    The NRC is planning to establish regulatory oversight on severe accident management capability in the US nuclear reactor industry. Accident management includes certain preparatory and recovery measures that can be taken by the plant operating and technical personnel to prevent or mitigate the consequences of a severe accident. Following an initiating event, accident management strategies include measures to (1) prevent core damage, (2) arrest the core damage if it begins and retain the core inside the vessel, (3) maintain containment integrity if the vessel is breached, and (4) minimize offsite releases. Objectives of the NRC Severe Accident Management Program are to assure that technically sound strategies are identified and guidance to implement these strategies is provided to utilities. This paper will describe work performed to date by Pacific Northwest Laboratory (PNL) and Battelle Memorial Institute (BMI) relative to severe accident strategy evaluation, as well as work to be performed and expected results. Working with Brookhaven National Laboratory, PNL evaluated a series of NRC suggested accident management strategies. The evaluation of these strategies was divided between PNL and Brookhaven National Laboratory and a similar paper will be presented by Brookhaven regarding their strategy evaluation. This paper will stress the overall safety issues related to the research and emphasize the strategies that are applicable to major safety issues. The relationship of these research activities to other projects is discussed, as well as planning for future changes in the direction of work to be undertaken

  14. Evaluation Strategies for EWP Programs: A Marketing Perspective.

    Science.gov (United States)

    Turkewych, Christine

    1986-01-01

    Describes how evaluation strategies can be implemented to increase the effectiveness of English in the Work Place programs. Discusses the design and implementation of the strategy, how to analyze its results and produce a final report, and ways to get the results used. (SED)

  15. New strategies to improve food marketing to children.

    Science.gov (United States)

    Dietz, William H

    2013-09-01

    Federal efforts to address the impact of food marketing on children began more than thirty years ago, when the Federal Trade Commission sought comment on strategies to reduce young children's exposure to food advertising. The food, advertising, and television industries mounted a virulent response, and Congress withdrew the commission's authority to regulate unfair advertising to children. The same industries and Congress responded equally aggressively to the proposed nutrition criteria for food products marketed to children drafted by a working group of federal agencies in 2011. Although federal efforts over the past thirty years have led to modest improvements in food quality and marketing practices, commercial interests have consistently overridden the health concerns of children. Mobilization of parents as a political force to improve standards for food marketed to children, use of social media for counteradvertising, and the development of new technologies to decrease exposure to food advertisements could reduce the impact of food marketing to children.

  16. Strategies for Evaluating Complex Environmental Education Programs

    Science.gov (United States)

    Williams, V.

    2011-12-01

    Evidence for the effectiveness of environmental education programs has been difficult to establish for many reasons. Chief among them are the lack of clear program objectives and an inability to conceptualize how environmental education programs work. Both can lead to evaluations that make claims that are difficult to substantiate, such as significant changes in student achievement levels or behavioral changes based on acquisition of knowledge. Many of these challenges can be addressed by establishing the program theory and developing a logic model. However, claims of impact on larger societal outcomes are difficult to attribute solely to program activities. Contribution analysis may offer a promising method for addressing this challenge. Rather than attempt to definitively and causally link a program's activities to desired results, contribution analysis seeks to provide plausible evidence that can reduce uncertainty regarding the 'difference' a program is making to observed outcomes. It sets out to verify the theory of change behind a program and, at the same time, takes into consideration other influencing factors. Contribution analysis is useful in situations where the program is not experimental-there is little or no scope for varying how the program is implemented-and the program has been funded on the basis of a theory of change. In this paper, the author reviews the feasibility of using contribution analysis as a way of evaluating the impact of the GLOBE program, an environmental science and education program. Initially conceptualized by Al Gore in 1995, the program's implementation model is based on worldwide environmental monitoring by students and scientists around the globe. This paper will make a significant and timely contribution to the field of evaluation, and specifically environmental education evaluation by examining the usefulness of this analysis for developing evidence to assess the impact of environmental education programs.

  17. Evaluating Evaluation Systems: Policy Levers and Strategies for Studying Implementation of Educator Evaluation. Policy Snapshot

    Science.gov (United States)

    Matlach, Lauren

    2015-01-01

    Evaluation studies can provide feedback on implementation, support continuous improvement, and increase understanding of evaluation systems' impact on teaching and learning. Despite the importance of educator evaluation studies, states often need support to prioritize and fund them. Successful studies require expertise, time, and a shared…

  18. Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.

    Science.gov (United States)

    Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

    2014-11-25

    Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada. In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation. Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period. Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership

  19. [Strategies for improving care of oncologic patients: SHARE Project results].

    Science.gov (United States)

    Reñones Crego, María de la Concepción; Fernández Pérez, Dolores; Vena Fernández, Carmen; Zamudio Sánchez, Antonio

    2016-01-01

    Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  20. Evaluation Strategies in Financial Education: Evaluation with Imperfect Instruments

    Science.gov (United States)

    Robinson, Lauren; Dudensing, Rebekka; Granovsky, Nancy L.

    2016-01-01

    Program evaluation often suffers due to time constraints, imperfect instruments, incomplete data, and the need to report standardized metrics. This article about the evaluation process for the Wi$eUp financial education program showcases the difficulties inherent in evaluation and suggests best practices for assessing program effectiveness. We…

  1. Knowledge strategies aiming to improve the intellectual capital of universities

    Directory of Open Access Journals (Sweden)

    Bejinaru Ruxandra

    2017-09-01

    Full Text Available The purpose of this paper is to present a new construct of the intellectual capital structure, based on the multifield theory of knowledge and the concept of nonlinear integrators and to identify the knowledge strategies to enhance the intellectual capital of universities. The paper presents a new approach, based on metaphorical thinking and thermodynamics logic in structuring the intellectual capital, based on the multifield theory of knowledge into its basic building blocks. Considering the two levels of intellectual capital, the paper presents the main knowledge strategies to enhance the university intellectual capital. The basic building blocks of the intellectual capital are: rational, emotional, and spiritual intellectual capital. Each building block is based on the corresponding field of knowledge. There are two significant levels of intellectual capital: potential and operational. Analyzing the university intellectual capital by using this new approach is much more realistic than in the previous approaches. The new approach is based on a thermodynamics paradigm, which means we need to develop new ways of thinking, evaluating, and enhancing the intellectual capital. The paper presents an original approach, based on metaphorical thinking, by considering basic ideas from the energy realm and thermodynamics theory. Also, the paper presents a matrix of possible knowledge strategies to increase the intellectual capital of universities.

  2. Comparing in situ removal strategies for improving styrene bioproduction.

    Science.gov (United States)

    McKenna, Rebekah; Moya, Luis; McDaniel, Matthew; Nielsen, David R

    2015-01-01

    As an important conventional monomer compound, the biological production of styrene carries significant promise with respect to creating novel sustainable materials. Since end-product toxicity presently limits styrene production by previously engineered Escherichia coli, in situ product removal by both solvent extraction and gas stripping were explored as process-based strategies for circumventing its inhibitory effects. In solvent extraction, the addition of bis(2-ethylhexyl)phthalate offered the greatest productivity enhancement, allowing net volumetric production of 836 ± 64 mg/L to be reached, representing a 320 % improvement over single-phase cultures. Gas stripping rates, meanwhile, were controlled by rates of bioreactor agitation and, to a greater extent, aeration. A periodic gas stripping protocol ultimately enabled up to 561 ± 15 mg/L styrene to be attained. Lastly, by relieving the effects of styrene toxicity, new insight was gained regarding subsequent factors limiting its biosynthesis in E. coli and strategies for future strain improvement are discussed.

  3. An evaluation of the Essential Medicines List, Standard Treatment Guidelines and prescribing restrictions, as an integrated strategy to enhance quality, efficacy and safety of and improve access to essential medicines in Papua New Guinea.

    Science.gov (United States)

    Joshua, Isaac B; Passmore, Phillip R; Sunderland, Bruce V

    2016-05-01

    The World Health Organization (WHO) has advocated the development and use of country specific Standard Treatment Guidelines (STGs) and Essential Medicines Lists (EML) as strategies to promote the rational use of medicines. When implemented effectively STGs offer many health advantages. Papua New Guinea (PNG) has official STGs and a Medical and Dental Catalogue (MDC) which serves as a national EML for use at different levels of health facilities. This study evaluated consistency between the PNG Adult STGs (2003 and 2012) and those for children (2005 and 2011) with respect to the MDCs (2002, 2012) for six chronic and/or acute diseases: asthma, arthritis, diabetes, hypertension, pneumonia and psychosis. Additionally, the potential impact of prescriber level restrictions on rational medicines use for patient's living in rural areas, where no medical officer is present, was evaluated. Almost all drugs included in the STGs for each disease state evaluated were listed in the MDCs. However, significant discrepancies occurred between the recommended treatments in the STGs with the range of related medicines listed in the MDCs. Many medicines recommended in the STGs for chronic diseases had prescriber level restrictions hindering access for most of the PNG population who live in rural and remote areas. In addition many more medicines were listed in the MDCs which are commonly used to treat arthritis, high blood pressure and psychosis than were recommended in the STGs contributing to inappropriate prescribing. We recommend the public health and rational use of medicines deficiencies associated with these findings are addressed requiring: reviewing prescriber level restrictions; updating the STGs; aligning the MDC to reflect recommendations in the STGs; establishing the process where the MDC would automatically be updated based on any changes made to the STGs; and developing STGs for higher levels of care. © The Author 2015. Published by Oxford University Press. All rights

  4. Improved rate control for electron-beam evaporation and evaluation of optical performance improvements.

    Science.gov (United States)

    Gevelber, Michael; Xu, Bing; Smith, Douglas

    2006-03-01

    A new deposition-rate-control and electron-beam-gun (e-gun) strategy was developed that significantly reduces the growth-rate variations for e-beam-deposited SiO2 coatings. The resulting improvements in optical performance are evaluated for multilayer bandpass filters. The adverse effect of uneven silica-source depletion on coating spectral performances during long deposition runs is discussed.

  5. Improving evaluation at two medical schools.

    Science.gov (United States)

    Schiekirka-Schwake, Sarah; Dreiling, Katharina; Pyka, Katharina; Anders, Sven; von Steinbüchel, Nicole; Raupach, Tobias

    2017-08-03

    Student evaluations of teaching can provide useful feedback for teachers and programme coordinators alike. We have designed a novel evaluation tool assessing teacher performance and student learning outcome. This tool was implemented at two German medical schools. In this article, we report student and teacher perceptions of the novel tool, and the implementation process. Focus group discussions as well as one-to-one interviews involving 22 teachers and 31 undergraduate medical students were conducted. Following adjustments to the feedback reports (e.g. the colour coding of results) at one medical school, 42 teachers were asked about their perceptions of the revised report and the personal benefit of the evaluation tool. Teachers appreciated the individual feedback provided by the evaluation tool and stated that they wanted to improve their teaching, based on the results; however, they missed most of the preparative communication. Students were unsure about the additional benefit of the instrument compared with traditional evaluation tools. A majority was unwilling to complete evaluation forms in their spare time, and some felt that the new questionnaire was too long and that the evaluations occurred too often. They were particularly interested in feedback on how their comments have helped to further improve teaching. Student evaluations of teaching can provide useful feedback CONCLUSION: Despite evidence of the utility of the tool for individual teachers, implementation of changes to the process of evaluation appears to have been suboptimal, mainly owing to a perceived lack of communication. In order to motivate students to provide evaluation data, feedback loops including aims and consequences should be established. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  6. Evaluation of control strategies in forming processes

    Directory of Open Access Journals (Sweden)

    Calmano Stefan

    2015-01-01

    Full Text Available Products of forming processes are subject to quality fluctuations due to uncertainty in semi-finished part properties as well as process conditions and environment. An approach to cope with these uncertainties is the implementation of a closed-loop control taking into account the actual product properties measured by sensors or estimated by a mathematical process model. Both methods of uncertainty control trade off with a financial effort. In case of sensor integration the effort is the cost of the sensor including signal processing as well as the design and manufacturing effort for integration. In case of an estimation model the effort is mainly determined by the time and knowledge needed to derive the model, identify the parameters and implement the model into the PLC. The risk of mismatch between model and reality as well as the risk of wrong parameter identification can be assumed as additional uncertainty (model uncertainty. This paper evaluates controlled and additional uncertainty by taking into account process boundary conditions like the degree of fluctuations in semi-finished part properties. The proposed evaluation is demonstrated by the analysis of exemplary processes.

  7. Strategies to improve sleep during extended search and rescue operations.

    Science.gov (United States)

    Jenkins, Jennifer Lee; Fredericksen, Kim; Stone, Roger; Tang, Nelson

    2007-01-01

    This study investigated strategies to improve sleeping conditions during search and rescue operations during disaster response. Forty members of the Montgomery County (Maryland) Urban Search and Rescue Team were surveyed for individual sleep habits and sleeping aids used during extended deployments. Team members were also asked to suggest methods to improve sleep on future deployments. The average amount of sleep during field operations was 5.4 hours with a range of 4-8 hours. Eight percent surveyed would prefer another schedule besides the 12-hour work day, all of whom proposed three 8-hour shifts. Fifteen percent of participants were interested in a pharmacological sleeping aid. Fifty percent of search and rescue members interviewed would consider using nonpharmacological sleeping aids. Furthermore, 40% of participants stated they had successfully devised self-employed methods of sleep aids for previous deployments, such as ear plugs, massage, mental imagery, personal routines, music and headphones, reading, and blindfolds. This study suggests that availability of both pharmacological and nonpharmacological sleeping aids to search and rescue workers via the team cache could impact the quantity of sleep. Further investigation into methods of optimizing sleep during field missions could theoretically show enhanced performance through various aspects of missions including mitigation of errors, improved productivity, and improved overall physiological and emotional well-being of search and rescue personnel.

  8. Empowered? Evaluating Japan's national energy strategy under the DPJ administration

    International Nuclear Information System (INIS)

    Valentine, Scott; Sovacool, Benjamin K.; Matsuura, Masahiro

    2011-01-01

    In August 2009, after 54 years of virtually unbroken rule, Japan's Liberal Democratic Party (LDP) was ousted from power by the Democratic Party of Japan (DPJ). The DPJ's campaign platform included a pledge to facilitate extreme reductions in greenhouse gas (GHG) emissions. Yet, at the COP16 meeting in Cancun, Japan announced that it would not accept further emission reduction targets without broader commitment from all nations. This paper seeks to explain this dichotomy by employing a targeted stakeholder evaluation based on surveys with 321 Japanese citizens to assess the extent to which influential stakeholder groups in Japan supports a potentially costly transition to a low-carbon energy infrastructure amidst severe economic challenges that the nation faces. Findings help explain Japan's adversarial role in COP16 negotiations in Cancun, despite the stated GHG reduction ambitions of Japan's current ruling party. The analysis concludes that if the DPJ does embrace aggressive CO 2 reduction targets in the future, the strategic focus will likely mirror the former ruling party's energy policy of bolstering nuclear power generation capacity and promoting energy efficiency improvements while exhibiting lukewarm commitment to supporting capacity development in alternative sources of energy supply such as solar panels and wind turbines. - Research highlights: → Public consensus exists regarding which energy policy goals are important in Japan. → Minor perceptual differences are not of a catalytic nature. → Public consensus does not deviate significantly from past LDP energy policy. → Unlikely that the DPJ will pursue costly energy transition initiatives. → Likely that the DPJ energy strategy will be substantively similar to LDP strategy. → Any differences in strategy will focus on CO 2 reduction magnitude not substance.

  9. Strategies for improving approximate Bayesian computation tests for synchronous diversification.

    Science.gov (United States)

    Overcast, Isaac; Bagley, Justin C; Hickerson, Michael J

    2017-08-24

    Estimating the variability in isolation times across co-distributed taxon pairs that may have experienced the same allopatric isolating mechanism is a core goal of comparative phylogeography. The use of hierarchical Approximate Bayesian Computation (ABC) and coalescent models to infer temporal dynamics of lineage co-diversification has been a contentious topic in recent years. Key issues that remain unresolved include the choice of an appropriate prior on the number of co-divergence events (Ψ), as well as the optimal strategies for data summarization. Through simulation-based cross validation we explore the impact of the strategy for sorting summary statistics and the choice of prior on Ψ on the estimation of co-divergence variability. We also introduce a new setting (β) that can potentially improve estimation of Ψ by enforcing a minimal temporal difference between pulses of co-divergence. We apply this new method to three empirical datasets: one dataset each of co-distributed taxon pairs of Panamanian frogs and freshwater fishes, and a large set of Neotropical butterfly sister-taxon pairs. We demonstrate that the choice of prior on Ψ has little impact on inference, but that sorting summary statistics yields substantially more reliable estimates of co-divergence variability despite violations of assumptions about exchangeability. We find the implementation of β improves estimation of Ψ, with improvement being most dramatic given larger numbers of taxon pairs. We find equivocal support for synchronous co-divergence for both of the Panamanian groups, but we find considerable support for asynchronous divergence among the Neotropical butterflies. Our simulation experiments demonstrate that using sorted summary statistics results in improved estimates of the variability in divergence times, whereas the choice of hyperprior on Ψ has negligible effect. Additionally, we demonstrate that estimating the number of pulses of co-divergence across co-distributed taxon

  10. How high-performance work systems drive health care value: an examination of leading process improvement strategies.

    Science.gov (United States)

    Robbins, Julie; Garman, Andrew N; Song, Paula H; McAlearney, Ann Scheck

    2012-01-01

    As hospitals focus on increasing health care value, process improvement strategies have proliferated, seemingly faster than the evidence base supporting them. Yet, most process improvement strategies are associated with work practices for which solid evidence does exist. Evaluating improvement strategies in the context of evidence-based work practices can provide guidance about which strategies would work best for a given health care organization. We combined a literature review with analysis of key informant interview data collected from 5 case studies of high-performance work practices (HPWPs) in health care organizations. We explored the link between an evidence-based framework for HPWP use and 3 process improvement strategies: Hardwiring Excellence, Lean/Six Sigma, and Baldrige. We found that each of these process improvement strategies has not only strengths but also important gaps with respect to incorporating HPWPs involving engaging staff, aligning leaders, acquiring and developing talent, and empowering the front line. Given differences among these strategies, our analyses suggest that some may work better than others for individual health care organizations, depending on the organizations' current management systems. In practice, most organizations implementing improvement strategies would benefit from including evidence-based HPWPs to maximize the potential for process improvement strategies to increase value in health care.

  11. Soil Quality Indexing Strategies for Evaluating Sugarcane Expansion in Brazil.

    Science.gov (United States)

    Cherubin, Maurício R; Karlen, Douglas L; Cerri, Carlos E P; Franco, André L C; Tormena, Cássio A; Davies, Christian A; Cerri, Carlos C

    2016-01-01

    Increasing demand for biofuel has intensified land-use change (LUC) for sugarcane (Saccharum officinarum) expansion in Brazil. Assessments of soil quality (SQ) response to this LUC are essential for quantifying and monitoring sustainability of sugarcane production over time. Since there is not a universal methodology for assessing SQ, we conducted a field-study at three sites within the largest sugarcane-producing region of Brazil to develop a SQ index (SQI). The most common LUC scenario (i.e., native vegetation to pasture to sugarcane) was evaluated using six SQI strategies with varying complexities. Thirty eight soil indicators were included in the total dataset. Two minimum datasets were selected: one using principal component analysis (7 indicators) and the other based on expert opinion (5 indicators). Non-linear scoring curves were used to interpret the indicator values. Weighted and non-weighted additive methods were used to combine individual indicator scores into an overall SQI. Long-term conversion from native vegetation to extensive pasture significantly decreased overall SQ. In contrast, conversion from pasture to sugarcane had no significant impact on overall SQ at the regional scale, but site-specific responses were found. In general, sugarcane production improved chemical attributes (i.e., higher macronutrient levels and lower soil acidity); however it has negative effects on physical and biological attributes (i.e., higher soil compaction and structural degradation as well as lower soil organic carbon (SOC), abundance and diversity of macrofauna and microbial activity). Overall, we found that simple, user-friendly strategies were as effective as more complex ones for identifying SQ changes. Therefore, as a protocol for SQ assessments in Brazilian sugarcane areas, we recommend using a small number of indicators (e.g., pH, P, K, Visual Evaluation of Soil Structure -VESS scores and SOC concentration) and proportional weighting to reflect chemical

  12. Soil Quality Indexing Strategies for Evaluating Sugarcane Expansion in Brazil.

    Directory of Open Access Journals (Sweden)

    Maurício R Cherubin

    Full Text Available Increasing demand for biofuel has intensified land-use change (LUC for sugarcane (Saccharum officinarum expansion in Brazil. Assessments of soil quality (SQ response to this LUC are essential for quantifying and monitoring sustainability of sugarcane production over time. Since there is not a universal methodology for assessing SQ, we conducted a field-study at three sites within the largest sugarcane-producing region of Brazil to develop a SQ index (SQI. The most common LUC scenario (i.e., native vegetation to pasture to sugarcane was evaluated using six SQI strategies with varying complexities. Thirty eight soil indicators were included in the total dataset. Two minimum datasets were selected: one using principal component analysis (7 indicators and the other based on expert opinion (5 indicators. Non-linear scoring curves were used to interpret the indicator values. Weighted and non-weighted additive methods were used to combine individual indicator scores into an overall SQI. Long-term conversion from native vegetation to extensive pasture significantly decreased overall SQ. In contrast, conversion from pasture to sugarcane had no significant impact on overall SQ at the regional scale, but site-specific responses were found. In general, sugarcane production improved chemical attributes (i.e., higher macronutrient levels and lower soil acidity; however it has negative effects on physical and biological attributes (i.e., higher soil compaction and structural degradation as well as lower soil organic carbon (SOC, abundance and diversity of macrofauna and microbial activity. Overall, we found that simple, user-friendly strategies were as effective as more complex ones for identifying SQ changes. Therefore, as a protocol for SQ assessments in Brazilian sugarcane areas, we recommend using a small number of indicators (e.g., pH, P, K, Visual Evaluation of Soil Structure -VESS scores and SOC concentration and proportional weighting to reflect

  13. Soil Quality Indexing Strategies for Evaluating Sugarcane Expansion in Brazil

    Science.gov (United States)

    Cherubin, Maurício R.; Karlen, Douglas L.; Cerri, Carlos E. P.; Franco, André L. C.; Tormena, Cássio A.; Davies, Christian A.; Cerri, Carlos C.

    2016-01-01

    Increasing demand for biofuel has intensified land-use change (LUC) for sugarcane (Saccharum officinarum) expansion in Brazil. Assessments of soil quality (SQ) response to this LUC are essential for quantifying and monitoring sustainability of sugarcane production over time. Since there is not a universal methodology for assessing SQ, we conducted a field-study at three sites within the largest sugarcane-producing region of Brazil to develop a SQ index (SQI). The most common LUC scenario (i.e., native vegetation to pasture to sugarcane) was evaluated using six SQI strategies with varying complexities. Thirty eight soil indicators were included in the total dataset. Two minimum datasets were selected: one using principal component analysis (7 indicators) and the other based on expert opinion (5 indicators). Non-linear scoring curves were used to interpret the indicator values. Weighted and non-weighted additive methods were used to combine individual indicator scores into an overall SQI. Long-term conversion from native vegetation to extensive pasture significantly decreased overall SQ. In contrast, conversion from pasture to sugarcane had no significant impact on overall SQ at the regional scale, but site-specific responses were found. In general, sugarcane production improved chemical attributes (i.e., higher macronutrient levels and lower soil acidity); however it has negative effects on physical and biological attributes (i.e., higher soil compaction and structural degradation as well as lower soil organic carbon (SOC), abundance and diversity of macrofauna and microbial activity). Overall, we found that simple, user-friendly strategies were as effective as more complex ones for identifying SQ changes. Therefore, as a protocol for SQ assessments in Brazilian sugarcane areas, we recommend using a small number of indicators (e.g., pH, P, K, Visual Evaluation of Soil Structure -VESS scores and SOC concentration) and proportional weighting to reflect chemical

  14. The Work Compatibility Improvement Framework: theory and application of improvement action and intervention strategies.

    Science.gov (United States)

    Genaidy, Ash M; Rinder, Magda M; Sequeira, Reynold; A-Rehim, Amal D

    2009-05-01

    Challenges facing management of manufacturing firms can be transformed into asset gains by giving careful consideration to the worker-work environment interface. The benefits of a 'healthy' interface may lead to sizable reductions in rising health care costs and retention of highly qualified workers. This paper presents a novel approach for the 'improve' phase of the Work Compatibility Improvement Framework. The work tasks of this research consisted of: (a) fundamentals of cognitive-based improvement action and intervention; (b) design concepts and process of improvement action/intervention generation; (c) assessment model of estimated gains in company's assets; (d) application demonstration in the manufacturing sector. The process of improvement action/intervention generation is described, preceded by a description of the fundamentals of cognitive-based improvement action and intervention and system architecture. This is followed by a documentation of estimated asset gains as a result of the improvement plan. The results showed that expert workers were, on average, 78% in agreement with the algorithm-identified improvement actions. Their knowledge was used to update the recommended actions as well as to detail the multiple strategies required to address the improvement actions. As a result, an integrated improvement plan was developed resulting in estimated asset gains of $1.6 million, which was validated by the general manager. The research reported herein documented the theory and application of the 'improve' phase of the Work Compatibility Improvement Framework. The economic assessment of the suggested improvement is also reported and this has proved to be an important driver to secure the firm collaboration of manufacturing enterprise management. An integrated improvement solution plan backed by a detailed economic assessment of suggested improvements is essential to demonstrate the full potential of workplace micro- and macro-ergonomic interventions.

  15. Does supplier evaluation impact process improvement?

    Directory of Open Access Journals (Sweden)

    Shiva Prasad h c

    2016-09-01

    Full Text Available Purpose: The research explores and examines factors for supplier evaluation and its impact on process improvement particularly aiming on a steel pipe manufacturing firm in Gujarat, India. Design/Methodology/approach: The conceptual research framework was developed and hypotheses were stated considering the analysis of literature and discussions with the managers and engineers of a steel pipe manufacturing company in Gujarat, India. Data was collected using in-depth interview. The questionnaire primarily involves the perception of evaluation of supplier. Factors influencing supplier evaluation and its influence on process improvement is also examined in this study. The model testing and validation was done using partial least square method. Outcomes signified that the factors that influence evaluation of the supplier are quality, cost, delivery and supplier relationship management. Findings: The study depicted that quality and cost factors for supplier evaluation are insignificant. The delivery and supplier relationship management have significant influence on evaluation of the supplier. The research also depicted that supplier evaluation has significant influence on process improvement. Research limitations/implications: The study has been made specifically for ABC steel pipe manufacturing industry in Gujarat, India and may not be appropriate to the other industries or any parts of the world. There is a possibility of response bias as the conclusions of this research was interpreted on survey responses taken from the employees of case study company, so it is suggested that future research can overcome this problem by employing various methodologies in addition to surveys like carrying out focus group and in-depth interviews, brainstorming sessions with the experts etc. Originality/value: Many researchers have considered quality, cost and delivery as the factors for evaluating the suppliers. But for a company it is quintessential to have good

  16. Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

    Science.gov (United States)

    Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

    2015-11-01

    Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.

  17. THE EVALUATION AND IMPROVEMENT OF IT GOVERNANCE

    Directory of Open Access Journals (Sweden)

    Patricia Pérez Lorences

    2013-08-01

    Full Text Available The present article aims to propose a general procedure to evaluate and improve the Information Technology (IT Governance in an organization, considering the Business–IT alignment and risk management. The procedure integrates management tools such as business processes management, risk management, strategic alignment and the balanced scorecard. Additionally, to assess the IT Governance level we proposed an indicator based on the process maturity. The concepts and ideas presented here had been applied in four case studies, verifying their implementation feasibility. The results indicate a low level of IT governance and the existence of several problems primarily in the Plan and Organize and Monitor and Evaluate domains.

  18. Developmental theory-driven evaluation: Strategies for course ...

    African Journals Online (AJOL)

    This article focuses on the longitudinal evaluative strategies used in the development of a new teaching approach for a university course with high failure rates. The subject is compulsory for all first year engineering students at our university. The evaluation has been conducted as part of a process of developmental action ...

  19. Idebenone: Novel Strategies to Improve Its Systemic and Local Efficacy

    Directory of Open Access Journals (Sweden)

    Lucia Montenegro

    2018-02-01

    Full Text Available The key role of antioxidants in treating and preventing many systemic and topical diseases is well recognized. One of the most potent antioxidants available for pharmaceutical and cosmetic use is Idebenone (IDE, a synthetic analogue of Coenzyme Q10. Unfortunately, IDE’s unfavorable physicochemical properties such as poor water solubility and high lipophilicity impair its bioavailability after oral and topical administration and prevent its parenteral use. In recent decades, many strategies have been proposed to improve IDE effectiveness in the treatment of neurodegenerative diseases and skin disorders. After a brief description of IDE potential therapeutic applications and its pharmacokinetic and pharmacodynamic profile, this review will focus on the different approaches investigated to overcome IDE drawbacks, such as IDE incorporation into different types of delivery systems (liposomes, cyclodextrins, microemulsions, self-micro-emulsifying drug delivery systems, lipid-based nanoparticles, polymeric nanoparticles and IDE chemical modification. The results of these studies will be illustrated with emphasis on the most innovative strategies and their future perspectives.

  20. Improving Stewardship of Marine Resources: Linking Strategy to Opportunity

    Directory of Open Access Journals (Sweden)

    Franciska von Heland

    2014-07-01

    Full Text Available The need for improved stewardship of coastal and marine resources is evident worldwide. However, complex ecosystem dynamics, institutional inertia, and budgetary constraints impede such action. This study explores how networks of change-oriented individuals or “institutional entrepreneurs” can introduce new types of human-environment interaction. The focus is on investigating the interplay between the strategies of institutional entrepreneurs and broader system dynamics that shape the context in which they are working, and possible impacts of institutional entrepreneurship on marine governance. We explore these issues in the context of Wakatobi National Park in eastern Indonesia. We suggest that creating links between different social spheres, such as between marine resource management and spirituality or between marine resource management and education, may accelerate the development of a new ecosystem stewardship. We further suggest that the use of media has significant power to show alternative futures, but that media may also serve to objectify certain resource users and increase the complexity of marine resource management. In general, institutional entrepreneurs play an important role in capturing and managing opportunity to open up space for experimentation and novel ideas, for example by linking their ideas to broader political priorities. Yet, such strategies bear the risk of institutional capture. Finally, institutional entrepreneurs sometimes have vested interests in certain solutions that may forsake experimentation toward a sustainable future.

  1. Improving marital relationships: strategies for the family physician.

    Science.gov (United States)

    Starling, B P; Martin, A C

    1992-01-01

    Marital conflict and divorce are prevalent in our society, and patients frequently ask family physicians to assist them with marital difficulties. These difficulties are often associated with a decline in health, resulting in additional stress to the marital unit. A MEDLINE search was undertaken using the key words "family medicine," "marital therapy," "marital counseling," "brief psychotherapy," and "short-term psychotherapy." The bibliographies of generated articles were searched for additional references. The authors used the resources of their individual behavioral science libraries, as well as their clinical experiences. With adequate training, many family physicians can include marital counseling skills in their clinical repertoires. Family life cycle theory provides a framework for understanding the common stresses of marital life and also guides the family physician in recommending strategies to improve marital satisfaction. The physician's role is twofold: (1) to identify couples in crisis, and (2) to provide preventive strategies geared to assist couples in achieving pre-crisis equilibrium or higher levels of functioning. For physicians whose practices do not include marital counseling, an understanding of the basic techniques can be beneficial in effectively referring appropriate couples for marital therapy.

  2. Evaluation of different hedging strategies for commodity price risks of industrial cogeneration plants

    International Nuclear Information System (INIS)

    Palzer, Andreas; Westner, Günther; Madlener, Reinhard

    2013-01-01

    In this paper, we design and evaluate eight different strategies for hedging commodity price risks of industrial cogeneration plants. Price developments are parameterized based on EEX data from 2008 to 2011. The probability distributions derived are used to determine the value-at-risk (VaR) of the individual strategies, which are in a final step combined in a mean-variance portfolio analysis for determining the most efficient hedging strategy. We find that the strategy adopted can have a marked influence on the remaining price risk. Quarter futures are found to be particularly well suited for reducing market price risk. In contrast, spot trading of CO 2 certificates is found to be preferable compared to forward market trading. Finally, portfolio optimization shows that a mix of various hedging strategies can further improve the profitability of a heat-based cogeneration plant. - Highlights: • Evaluation of commodity price risk hedging strategies for industrial cogeneration. • Value-at-risk analysis of eight different hedging strategies. • Mean-variance portfolio analysis for determining the optimal hedging strategy mix. • A mix of hedging strategies further improves profitability of heat-based CHP

  3. Pharmacological and physical vessel modulation strategies to improve EPR-mediated drug targeting to tumors.

    Science.gov (United States)

    Ojha, Tarun; Pathak, Vertika; Shi, Yang; Hennink, Wim E; Moonen, Chrit T W; Storm, Gert; Kiessling, Fabian; Lammers, Twan

    2017-09-15

    The performance of nanomedicine formulations depends on the Enhanced Permeability and Retention (EPR) effect. Prototypic nanomedicine-based drug delivery systems, such as liposomes, polymers and micelles, aim to exploit the EPR effect to accumulate at pathological sites, to thereby improve the balance between drug efficacy and toxicity. Thus far, however, tumor-targeted nanomedicines have not yet managed to achieve convincing therapeutic results, at least not in large cohorts of patients. This is likely mostly due to high inter- and intra-patient heterogeneity in EPR. Besides developing (imaging) biomarkers to monitor and predict EPR, another strategy to address this heterogeneity is the establishment of vessel modulation strategies to homogenize and improve EPR. Over the years, several pharmacological and physical co-treatments have been evaluated to improve EPR-mediated tumor targeting. These include pharmacological strategies, such as vessel permeabilization, normalization, disruption and promotion, as well as physical EPR enhancement via hyperthermia, radiotherapy, sonoporation and phototherapy. In the present manuscript, we summarize exemplary studies showing that pharmacological and physical vessel modulation strategies can be used to improve tumor-targeted drug delivery, and we discuss how these advanced combination regimens can be optimally employed to enhance the (pre-) clinical performance of tumor-targeted nanomedicines. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Low-alcohol Beers: Flavor Compounds, Defects, and Improvement Strategies.

    Science.gov (United States)

    Blanco, Carlos A; Andrés-Iglesias, Cristina; Montero, Olimpio

    2016-06-10

    Beer consumers are accustomed to a product that offers a pleasant and well-defined taste. However, in alcohol-free and alcohol-reduced beers these characteristics are totally different from those in regular beer. Therefore, it is important to evaluate and determine the different flavor compounds that affect organoleptic characteristics to obtain a product that does not contain off-flavors, or taste of grass or wort. The taste defects in alcohol-free beer are mainly attributed to loss of aromatic esters, insufficient aldehydes, reduction or loss of different alcohols, and an indeterminate change in any of its compounds during the dealcoholization process. The dealcoholization processes that are commonly used to reduce the alcohol content in beer are shown, as well as the negative consequences of these processes to beer flavor. Possible strategies to circumvent such negative consequences are suggested.

  5. An evaluation approach for alarm processing improvement

    International Nuclear Information System (INIS)

    Kim, Jung-Taek; Lee, Dong-Young; Hwang, In-Koo; Park, Jae-Chang

    1997-01-01

    In light of the need to improve MMIS of NPPs, the advanced I and C research team of KAERI has embarked on developing an Alarm and Diagnosis-Integrated Operator Support System, called ADIOS, to filter or suppress unnecessary or nuisance alarms and diagnose abnormality of the plant process. ADIOS has been built in an object-oriented AI environment of G-2 expert system software tool, as presented in a companion paper. ADIOS then is evaluated according to the plan in three steps; (1) preliminary tests to refine the knowledge base and inference structure of ADIOS in such a dynamic environment, and also to evaluate the appropriateness of alarm-processing algorithms; (2) to ensure correctness, consistency, and completeness in the knowledge base using COKEP (Checker Of Knowledge base using Extended Petri net); and (3) the cognitive performance evaluation using the Simulation Analyzer with a Cognitive Operator Model (SACOM) in the KAERI's Integrated Test Facility (ITF). (author). 5 figs, 1 tab

  6. Educational and evaluation strategies in the training of physician specialists

    Science.gov (United States)

    Gaona-Flores, Verónica Alejandra; Campos-Navarro, Luz Arcelia; Arenas-Osuna, Jesús; Alcalá-Martínez, Enrique

    2017-01-01

    Teaching strategies have been defined as procedures, means or resources that teachers used to promote meaningful learning. Identify teaching strategies and evaluation used by the professor with residents in tertiary hospitals health care. This is a cross-sectional study conducted with full, associate and assistant professors of various medical specialties. A questionnaire was applied to evaluate the strategies used by professors to teach and evaluate students. We included a sample of 90 professors in 35 medical specialties. The most frequent teaching activities were: organizing students to develop presentations on specific subjects, followed by asking questions on previously reviewed subjects, In terms of the strategies employed, the most frequent "always" option was applied to case analyses. The most frequent methods used for the evaluation of theoretical knowledge were: participation in class, topic presentation and exams. Teaching activities were primarily based on the presentation of specific topics by the residents. The most commonly used educational strategies were clinical case analyses followed by problem-based learning and the use of illustrations. Evaluation of the residents' performance in theory knowledge, hinged on class participation, presentation of assigned topics and exams. Copyright: © 2017 SecretarÍa de Salud

  7. Verification and Performance Evaluation of Timed Game Strategies

    DEFF Research Database (Denmark)

    David, Alexandre; Fang, Huixing; Larsen, Kim Guldstrand

    2014-01-01

    Control synthesis techniques, based on timed games, derive strategies to ensure a given control objective, e.g., time-bounded reachability. Model checking verifies correctness properties of systems. Statistical model checking can be used to analyse performance aspects of systems, e.g., energy...... consumption. In this work, we propose to combine these three techniques. In particular, given a strategy synthesized for a timed game and a given control objective, we want to make a deeper examination of the consequences of adopting this strategy. Firstly, we want to apply model checking to the timed game...... under the synthesized strategy in order to verify additional correctness properties. Secondly, we want to apply statistical model checking to evaluate various performance aspects of the synthesized strategy. For this, the underlying timed game is extended with relevant price and stochastic information...

  8. Improved Control Strategy for Microgrid Ultracapacitor Energy Storage Systems

    Directory of Open Access Journals (Sweden)

    Xiaobo Dou

    2014-12-01

    Full Text Available Ultracapacitors (UCs, with their features of high power density and high current charge-discharge, have become the best choice for dynamic power compensation to improve the stability of microgrids and are increasingly being applied in microgrids. This paper presents the control of an energy storage system (ESS based on ultracapacitors in the context of grid-connected microgrids. The ESS is composed of DC/AC and DC/DC converters tied by a dc link. An improved dynamic model for the ESS is proposed. Based on the proposed model a Proportional-Integral-Resonant (PIR DC link voltage controller is proposed to maintain the DC link voltage through the charging-discharging control of ultracapacitors, capable of working properly under all operating conditions. An extra double frequency component is injected into the UC current by a R controller to dynamically compensate for DC instantaneous power and double frequency AC instantaneous power due to unbalanced grid conditions and disturbances. This feature maintains the DC link voltage constant under unbalanced conditions and increases the degrees of freedom of the DC/AC converter and thus facilitates the application of UCs in microgrids. Simulation and experimental results verify the effectiveness of the proposed control strategy.

  9. Biotechnological Strategies to Improve Plant Biomass Quality for Bioethanol Production

    Directory of Open Access Journals (Sweden)

    Julián Mario Peña-Castro

    2017-01-01

    Full Text Available The transition from an economy dependent on nonrenewable energy sources to one with higher diversity of renewables will not be a simple process. It requires an important research effort to adapt to the dynamics of the changing energy market, sort costly processes, and avoid overlapping with social interest markets such as food and livestock production. In this review, we analyze the desirable traits of raw plant materials for the bioethanol industry and the molecular biotechnology strategies employed to improve them, in either plants already under use (as maize or proposed species (large grass families. The fundamentals of these applications can be found in the mechanisms by which plants have evolved different pathways to manage carbon resources for reproduction or survival in unexpected conditions. Here, we review the means by which this information can be used to manipulate these mechanisms for commercial uses, including saccharification improvement of starch and cellulose, decrease in cell wall recalcitrance through lignin modification, and increase in plant biomass.

  10. Strategies to improve self-management in heart failure patients.

    Science.gov (United States)

    Toback, Mehnosh; Clark, Nancy

    2017-02-01

    Heart failure is one of the most common causes of hospitalization, hospital readmission and death. Patients with heart failure have many complications, with multiple co-existing diagnoses which result in polypharmacy. Following instructions provided by many physicians, medication adjustments based on changes in their symptoms are required. Behavioral adjustments concerning diet and exercise regime are recommended. Therefore, the patient plays a crucial role in the management of heart failure. To review the available studies on heart failure self-management, and investigate educational, behavioral and psychosocial strategies that plays an important role to improve patient self-management. A literature review was conducted based upon the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidance. The articles identified through an extensive search using PubMed and UpToDate from 1999 to 2016. Improved self-management will increase compliance, promote patient quality-of-life, advance clinical outcomes, reduce hospital re-admission and will decrease hospitalization costs.

  11. Successful strategy to improve glucose tolerance in Thai obese youth.

    Science.gov (United States)

    Numbenjapon, Nawaporn; Nakavachara, Pairunyar; Santiprabhob, Jeerunda; Kiattisakthavee, Pornpimol; Wongarn, Renu; Likitmaskul, Supawadee

    2010-11-01

    Childhood obesity is an emerging national health problem in Thailand. Our previous study found that one third of obese children and adolescents had impaired glucose tolerance (IGT) and 2.6 percent had already developed type 2 diabetes mellitus. An immediate strategy needs to be established in order to improve these metabolic problems. To determine whether diet and exercise education for lifestyle modification with or without metformin therapy in our diabetes clinic is enable to improve these metabolic problems. Twenty-six Thai obese children and adolescents with IGT, who received at least 6 months of treatment consisting of lifestyle modification alone or lifestyle modification and metformin (combined treatment) were enrolled into this study. Each patient underwent the second 2-hour oral glucose tolerance test (OGTT). Plasma glucose, insulin levels, HbA1C and lipid profiles were measured. The results were compared with historical pre-treatment data. Approximately 1 year after intervention, 19 out of 26 patients with IGT completed the second 2-hour OGTT. Sixteen patients (84.2%) successfully reversed to be normal glucose tolerance whereas 3 patients (15.8%) remained IGT. Body mass index (BMI), BMISDS, 2-hour plasma glucose, basal insulin level, 2-hour insulin level were significantly decreased after treatment in normal OGTT group (Ps youth is a reversible abnormality by lifestyle modification with or without metformin.

  12. Biotechnological Strategies to Improve Plant Biomass Quality for Bioethanol Production

    Science.gov (United States)

    del Moral, Sandra; Núñez-López, Lizeth; Barrera-Figueroa, Blanca E.; Amaya-Delgado, Lorena

    2017-01-01

    The transition from an economy dependent on nonrenewable energy sources to one with higher diversity of renewables will not be a simple process. It requires an important research effort to adapt to the dynamics of the changing energy market, sort costly processes, and avoid overlapping with social interest markets such as food and livestock production. In this review, we analyze the desirable traits of raw plant materials for the bioethanol industry and the molecular biotechnology strategies employed to improve them, in either plants already under use (as maize) or proposed species (large grass families). The fundamentals of these applications can be found in the mechanisms by which plants have evolved different pathways to manage carbon resources for reproduction or survival in unexpected conditions. Here, we review the means by which this information can be used to manipulate these mechanisms for commercial uses, including saccharification improvement of starch and cellulose, decrease in cell wall recalcitrance through lignin modification, and increase in plant biomass. PMID:28951875

  13. INDUSTRIAL EVALUATION OF RE-DRY STRATEGY FOR SOFTWOOD LUMBER

    OpenAIRE

    Elustondo, Diego; Avramidis, Stavros

    2005-01-01

    This paper presents an experimental evaluation of the first commercial scale dry-sort-redry (DSRD) strategy for drying of 2x4 Pacific coast hemlock (PCH) lumber. The DSRD strategy is a methodology designed to reduce final moisture content variability in kiln dried lumber by complementing conventional drying with radio frequency vacuum (RFV) drying technology. The strategy′s objective is to avoid producing over-dried lumber in conventional drying by setting the target moisture content to...

  14. Evaluation of test intervals strategies with a risk monitor

    International Nuclear Information System (INIS)

    Soerman, J.

    2005-01-01

    The Swedish nuclear power utility Oskarshamn Power Group (OKG), is investigating how the use of a risk monitor can facilitate and improve risk-informed decision-making at their nuclear power plants. The intent is to evaluate if risk-informed decision-making can be accepted. A pilot project was initiated and carried out in 2004. The project included investigating if a risk monitor can be used for optimising test intervals for diesel- and gas turbine generators with regard to risk level. The Oskarhamn 2 (O2), PSA Level 1 model was converted into a risk monitor using RiskSpectrum RiskWatcher (RSRW) software. The converted PSA model included the complete PSA model for the power operation mode. RSRW then performs a complete requantification for every analysis. Time dependent reliability data are taken into account, i.e. a shorter test interval will increases the components availability (possibility to e.g. start on demand). The converted O2 model was then used to investigate whether it would be possible to balance longer test intervals for diesel generators, gas turbine generators and high pressure injection system with shorter test intervals for the low pressure injection system, while maintaining a low risk level at the plant. The results show that a new mixture of test intervals can be implemented with only marginally changes in the risk calculated with the risk monitor model. The results indicate that the total number of test activities for the systems included in the pilot study could be reduced by 20% with a maintained level of risk. A risk monitor taking into account the impact from test intervals in availability calculations for components is well suited for evaluation of test interval strategies. It also enables the analyst to evaluate the risk level over a period of time including the impact the actual status of the plant may have on the risk level. (author)

  15. Improving the Process of Student Evaluation

    Directory of Open Access Journals (Sweden)

    Gabriela Neacşu

    2013-12-01

    Full Text Available In this paper we analyzed the process of student evaluation from “Spiru Haret” University. The process under consideration occurs according to a specific Procedure – Process of student evaluation from the Manual of Quality Assurance Procedures, “Spiru Haret” University, Edition 1, 2012. The goal of this procedure, mentioned in the Manual, is to present the student evaluation procedure by using the Blackboard educational platform and other evaluation techniques of quality learning, based on materials developed by teachers of “Spiru Haret” University, as well as corresponding responsibilities, in order to increase the learning process quality and the exigency degree in the examination process, as well as students’ satisfaction measured by accumulated competences. We appreciate that the purpose of this procedure is first and foremost to ensure transparency and objectivity in exam passing decision. After identifying the weaknesses with the “cause - effect” chart, we have sought to improve student evaluation process using PDCA (Plan-Do-Check-Act method, resulting in the design of a new assessment flowchart.

  16. Effectiveness of Quality Improvement Strategies for the Management of CKD: A Meta-Analysis.

    Science.gov (United States)

    Silver, Samuel A; Bell, Chaim M; Chertow, Glenn M; Shah, Prakesh S; Shojania, Kaveh; Wald, Ron; Harel, Ziv

    2017-10-06

    Quality improvement interventions have enhanced care for other chronic illnesses, but their effectiveness for patients with CKD is unknown. We sought to determine the effects of quality improvement strategies on clinical outcomes in adult patients with nondialysis-requiring CKD. We conducted a systematic review of randomized trials, searching Medline and the Cochrane Effective Practice and Organization of Care database from January of 2003 to April of 2015. Eligible studies evaluated one or more of 11 prespecified quality improvement strategies, and prespecified study outcomes included at least one process of care measure, surrogate outcome, or hard clinical outcome. We used a random effects model to estimate the pooled risk ratio (RR; dichotomous data) or the mean difference (continuous data). We reviewed 15 patient-level randomized trials ( n =3298 patients), and six cluster-randomized trials ( n =30,042 patients). Quality improvement strategies reduced dialysis incidence (seven trials; RR, 0.85; 95% confidence interval [95% CI], 0.74 to 0.97) and LDL cholesterol concentrations (four trials; mean difference, -17.6 mg/dl; 95% CI, -28.7 to -6.5), and increased the likelihood that patients received renin-angiotensin-aldosterone system inhibitors (nine trials; RR, 1.16; 95% CI, 1.06 to 1.27). We did not observe statistically significant effects on mortality, cardiovascular events, eGFR, glycated hemoglobin, and systolic or diastolic BP. Quality improvement interventions yielded significant beneficial effects on three elements of CKD care. Estimates of the effectiveness of quality improvement strategies were limited by study number and adherence to quality improvement principles. This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2017_09_06_CJASNPodcast_17_10.mp3. Copyright © 2017 by the American Society of Nephrology.

  17. Market behavior and performance of different strategy evaluation schemes.

    Science.gov (United States)

    Baek, Yongjoo; Lee, Sang Hoon; Jeong, Hawoong

    2010-08-01

    Strategy evaluation schemes are a crucial factor in any agent-based market model, as they determine the agents' strategy preferences and consequently their behavioral pattern. This study investigates how the strategy evaluation schemes adopted by agents affect their performance in conjunction with the market circumstances. We observe the performance of three strategy evaluation schemes, the history-dependent wealth game, the trend-opposing minority game, and the trend-following majority game, in a stock market where the price is exogenously determined. The price is either directly adopted from the real stock market indices or generated with a Markov chain of order ≤2 . Each scheme's success is quantified by average wealth accumulated by the traders equipped with the scheme. The wealth game, as it learns from the history, shows relatively good performance unless the market is highly unpredictable. The majority game is successful in a trendy market dominated by long periods of sustained price increase or decrease. On the other hand, the minority game is suitable for a market with persistent zigzag price patterns. We also discuss the consequence of implementing finite memory in the scoring processes of strategies. Our findings suggest under which market circumstances each evaluation scheme is appropriate for modeling the behavior of real market traders.

  18. Reimbursed Price of Orphan Drugs: Current Strategies and Potential Improvements.

    Science.gov (United States)

    Mincarone, Pierpaolo; Leo, Carlo Giacomo; Sabina, Saverio; Sarriá-Santamera, Antonio; Taruscio, Domenica; Serrano-Aguilar, Pedro Guillermo; Kanavos, Panos

    2017-01-01

    The pricing and reimbursement policies for pharmaceuticals are relevant to balance timely and equitable access for all patients, financial sustainability, and reward for valuable innovation. The proliferation of high-cost specialty medicines is particularly true in rare diseases (RDs) where the pricing mechanism is characterised by a lack of transparency. This work provides an overall picture of current strategies for the definition of the reimbursed prices of orphan drugs (ODs) and highlights some potential improvements. Current strategies and suggestions are presented along 4 dimensions: (1) comprehensive value assessment, (2) early dialogs among relevant stakeholders, (3) innovative reimbursement approaches, and (4) societal participation in producing ODs. Comprehensive value assessment could be achieved by clarifying the approach of distributive justice to adopt, ensuring a representative participation of stakeholders, and with a broad consideration of value-bearing factors. With respect to early dialogs, cross-border cooperation can be determinant to companies and agencies. The cost-benefit ratio of early dialogs needs to be demonstrated and the "regulatory capture" effect should be monitored. Innovative reimbursement approaches were developed to balance the need for evidence-based decisions with the timely access to innovative drugs. The societal participation in producing ODs needs to be recognised in a collaborating framework where adaptive agreements can be developed with mutual satisfaction. Such agreements could also impact on coverage and reimbursement decisions as additional elements for the determination of a comprehensive societal value of ODs. Further research is needed to investigate the highlighted open challenges so that RDs will not remain, in practical terms, orphan diseases. © 2017 S. Karger AG, Basel.

  19. Reinforcement learning improves behaviour from evaluative feedback

    Science.gov (United States)

    Littman, Michael L.

    2015-05-01

    Reinforcement learning is a branch of machine learning concerned with using experience gained through interacting with the world and evaluative feedback to improve a system's ability to make behavioural decisions. It has been called the artificial intelligence problem in a microcosm because learning algorithms must act autonomously to perform well and achieve their goals. Partly driven by the increasing availability of rich data, recent years have seen exciting advances in the theory and practice of reinforcement learning, including developments in fundamental technical areas such as generalization, planning, exploration and empirical methodology, leading to increasing applicability to real-life problems.

  20. [ISMP-Spain questionnaire and strategy for improving good medication practices in the Andalusian health system].

    Science.gov (United States)

    Padilla-Marín, V; Corral-Baena, S; Domínguez-Guerrero, F; Santos-Rubio, M D; Santana-López, V; Moreno-Campoy, E

    2012-01-01

    To describe the strategy employed by Andalusian public health service hospitals to foster safe medication use. The self-evaluation questionnaire on drug system safety in hospitals, adapted by the Spanish Institute for Safe Medication Practices was used as a fundamental tool to that end. The strategy is developed in several phases. We analyse the report evaluating drug system safety in Andalusian public hospitals published by the Spanish Ministry of Health and Consumption in 2008 and establish a grading system to assess safe medication practices in Andalusian hospitals and prioritise areas needing improvement. We developed a catalogue of best practices available in the web environment belonging to the Andalusian health care quality agency's patient safety observatory. We publicised the strategy through training seminars and implemented a system allowing hospitals to evaluate the degree of compliance for each of the best practices, and based on that system, we were able to draw up a map of centres of reference. We found areas for improvement among several of the questionnaire's fundamental criteria. These areas for improvement were related to normal medication procedures in daily clinical practice. We therefore wrote 7 best practice guides that provide a cross-section of the assessment components of the questionnaire related to the clinical process needing improvement. The self-evaluation questionnaire adapted by ISMP-Spain is a good tool for designing a systematic, rational intervention to promote safe medication practices and intended for a group of hospitals that share the same values. Copyright © 2011 SEFH. Published by Elsevier Espana. All rights reserved.

  1. Latent human error analysis and efficient improvement strategies by fuzzy TOPSIS in aviation maintenance tasks.

    Science.gov (United States)

    Chiu, Ming-Chuan; Hsieh, Min-Chih

    2016-05-01

    The purposes of this study were to develop a latent human error analysis process, to explore the factors of latent human error in aviation maintenance tasks, and to provide an efficient improvement strategy for addressing those errors. First, we used HFACS and RCA to define the error factors related to aviation maintenance tasks. Fuzzy TOPSIS with four criteria was applied to evaluate the error factors. Results show that 1) adverse physiological states, 2) physical/mental limitations, and 3) coordination, communication, and planning are the factors related to airline maintenance tasks that could be addressed easily and efficiently. This research establishes a new analytic process for investigating latent human error and provides a strategy for analyzing human error using fuzzy TOPSIS. Our analysis process complements shortages in existing methodologies by incorporating improvement efficiency, and it enhances the depth and broadness of human error analysis methodology. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  2. Improving Eleventh Graders’ Reading Comprehension Through Text Coding and Double Entry Organizer Reading Strategies

    Directory of Open Access Journals (Sweden)

    Rocío Mahecha

    2011-07-01

    Full Text Available In this article we report on an innovation project developed with a group of eleventh graders at a public school in Bogotá. Its aim was to encourage students to improve reading comprehension of texts in English. It was conducted taking into account students' needs, interests and level of English. To do it, we implemented two reading strategies: text coding and double entry organizer. We observed the students' attitudes during two lesson plans, compared their level of comprehension before and after using the reading strategies and asked them to self-evaluate their performance. At the end, we could see their improvement, how they enjoyed doing the activities and became more confident.

  3. Nature-Based Strategies for Improving Urban Health and Safety.

    Science.gov (United States)

    Kondo, Michelle C; South, Eugenia C; Branas, Charles C

    2015-10-01

    Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature and greenery. In this paper, we describe the current understanding of place-based influences on public health and safety. We focus on nonchemical environmental factors, many of which are related to urban abandonment and blight. We then review findings from studies of nature-based interventions regarding impacts on health, perceptions of safety, and crime. Based on our findings, we suggest that further research in this area will require (1) refined measures of green space, nature, and health and safety for cities, (2) interdisciplinary science and cross-sector policy collaboration, (3) observational studies as well as randomized controlled experiments and natural experiments using appropriate spatial counterfactuals and mixed methods, and (4) return-on-investment calculations of potential economic, social, and health costs and benefits of urban greening initiatives.

  4. Evaluation of a pilot police-led suicide early alert surveillance strategy in the UK.

    Science.gov (United States)

    McGeechan, Grant James; Richardson, Catherine; Weir, Kevin; Wilson, Lynn; O'Neill, Gillian; Newbury-Birch, Dorothy

    2017-07-19

    Those bereaved by suicide are at increased risk of psychological harm, which can be reduced with the provision of timely support. This paper outlines an evaluation of a pilot police-led suicide strategy, in comparison to a coroner-led suicide strategy looking at the number, and length of time it takes for deaths to be recorded for each strategy. Additionally, the police-led strategy offers timely contact from support services for bereaved individuals. We examined what impact this offer of support had on the capacity of support services. A mixed methods evaluation compared how long it took for suspected suicides to be recorded using both strategies. The number of referrals received by support services during the pilot strategy were compared with those from previous years. A feedback focus group, and interviews, were held with key stakeholders. The coroner strategy was more consistent at identifying suspected suicides; however, reports were filed quicker by the police. Bereaved individuals were willing to share contact details with police officers and consent for referral to support services which lead to increased referrals. The focus group and interviews revealed that the pilot police strategy needs better integration into routine police practice. This strategy has the potential to deliver a real benefit to those bereaved by suicide; however, there are still aspects which could be improved. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Strategies for Improving siRNA-Induced Gene Silencing Efficiency.

    Science.gov (United States)

    Safari, Fatemeh; Rahmani Barouji, Solmaz; Tamaddon, Ali Mohammad

    2017-12-01

    Purpose: Human telomerase reverse transcriptase (hTERT) plays a crucial role in tumorigenesis and progression of cancers. Gene silencing of hTERT by short interfering RNA (siRNA) is considered as a promising strategy for cancer gene therapy. Various algorithms have been devised for designing a high efficient siRNA which is a significant issue in the clinical usage. Thereby, in the present study, the relation of siRNA designing criteria and the gene silencing efficiency was evaluated. Methods: The siRNA sequences were designed and characterized by using on line soft wares. Cationic co-polymer (polyethylene glycol-g-polyethylene imine (PEG-g-PEI)) was used for the construction of polyelectrolyte complexes (PECs) containing siRNAs. The cellular uptake of the PECs was evaluated. The gene silencing efficiency of different siRNA sequences was investigated and the effect of observing the rational designing on the functionality of siRNAs was assessed. Results: The size of PEG-g-PEI siRNA with N/P (Nitrogen/Phosphate) ratio of 2.5 was 114 ± 0.645 nm. The transfection efficiency of PECs was desirable (95.5% ± 2.4%.). The results of Real-Time PCR showed that main sequence (MS) reduced the hTERT expression up to 90% and control positive sequence (CPS) up to 63%. These findings demonstrated that the accessibility to the target site has priority than the other criteria such as sequence preferences and thermodynamic features. Conclusion: siRNA opens a hopeful window in cancer therapy which provides a convenient and tolerable therapeutic approach. Thereby, using the set of criteria and rational algorithms in the designing of siRNA remarkably affect the gene silencing efficiency.

  6. A new reconstruction strategy for image improvement in pinhole SPECT

    International Nuclear Information System (INIS)

    Zeniya, Tsutomu; Watabe, Hiroshi; Kim, Kyeong Min; Teramoto, Noboru; Hayashi, Takuya; Iida, Hidehiro; Aoi, Toshiyuki; Sohlberg, Antti; Kudo, Hiroyuki

    2004-01-01

    Pinhole single-photon emission computed tomography (SPECT) is able to provide information on the biodistribution of several radioligands in small laboratory animals, but has limitations associated with non-uniform spatial resolution or axial blurring. We have hypothesised that this blurring is due to incompleteness of the projection data acquired by a single circular pinhole orbit, and have evaluated a new strategy for accurate image reconstruction with better spatial resolution uniformity. A pinhole SPECT system using two circular orbits and a dedicated three-dimensional ordered subsets expectation maximisation (3D-OSEM) reconstruction method were developed. In this system, not the camera but the object rotates, and the two orbits are at 90 and 45 relative to the object's axis. This system satisfies Tuy's condition, and is thus able to provide complete data for 3D pinhole SPECT reconstruction within the whole field of view (FOV). To evaluate this system, a series of experiments was carried out using a multiple-disk phantom filled with 99m Tc solution. The feasibility of the proposed method for small animal imaging was tested with a mouse bone study using 99m Tc-hydroxymethylene diphosphonate. Feldkamp's filtered back-projection (FBP) method and the 3D-OSEM method were applied to these data sets, and the visual and statistical properties were examined. Axial blurring, which was still visible at the edge of the FOV even after applying the conventional 3D-OSEM instead of FBP for single-orbit data, was not visible after application of 3D-OSEM using two-orbit data. 3D-OSEM using two-orbit data dramatically reduced the resolution non-uniformity and statistical noise, and also demonstrated considerably better image quality in the mouse scan. This system may be of use in quantitative assessment of bio-physiological functions in small animals. (orig.)

  7. Self-efficacy strategies to improve exercise in patients with heart failure: A systematic review

    Directory of Open Access Journals (Sweden)

    Fatemeh Rajati

    2014-11-01

    Full Text Available BACKGROUND: Despite exercise is recommended as an adjunct to medication therapy in patients with heart failure (HF, non-adherence to exercise is a major problem. While improving self-efficacy is an effective way to increase physical activity, the evidence concerning the relationship between strategies to enhance self-efficacy and exercise among HF has not been systematically reviewed. The objective of this systematic review is to assess the effect of interventions to change the self-efficacy on exercise in patients with HF. METHODS: A systematic database search was conducted for articles reporting exercise self-efficacy interventions. Databases such as PubMed, ProQuest, CINAHL, Scopus, and PsycINFO, and the Cochrane Library were searched with restrictions to the years 2000-June 2014. A search of relevant databases identified 10 studies. Published randomized controlled intervention studies focusing strategies to change self-efficacy to exercise adherence in HF were eligible for inclusion. In addition, studies that have applied self-efficacy-based interventions to improve exercise are discussed. RESULTS: Limited published data exist evaluating the self-efficacy strategies to improve exercise in HF. Dominant strategies to improve patients’ self-efficacy were performance accomplishments, vicarious experience, verbal persuasion, emotional arousal. CONCLUSION: Evidence from some trials supports the view that incorporating the theory of self-efficacy into the design of an exercise intervention is beneficial. Moreover, exercise interventions aimed at integrating the four strategies of exercise self-efficacy can have positive effects on confidence and the ability to initiate exercise and recover HF symptoms. Findings of this study suggest that a positive relationship exists between self-efficacy and initiating and maintaining exercise in HF, especially in the short-term period. 

  8. Self-efficacy strategies to improve exercise in patients with heart failure: A systematic review

    Science.gov (United States)

    Rajati, Fatemeh; Sadeghi, Masoumeh; Feizi, Awat; Sharifirad, Gholamreza; Hasandokht, Tolu; Mostafavi, Firoozeh

    2014-01-01

    BACKGROUND Despite exercise is recommended as an adjunct to medication therapy in patients with heart failure (HF), non-adherence to exercise is a major problem. While improving self-efficacy is an effective way to increase physical activity, the evidence concerning the relationship between strategies to enhance self-efficacy and exercise among HF has not been systematically reviewed. The objective of this systematic review is to assess the effect of interventions to change the self-efficacy on exercise in patients with HF. METHODS A systematic database search was conducted for articles reporting exercise self-efficacy interventions. Databases such as PubMed, ProQuest, CINAHL, Scopus, and PsycINFO, and the Cochrane Library were searched with restrictions to the years 2000-June 2014. A search of relevant databases identified 10 studies. Published randomized controlled intervention studies focusing strategies to change self-efficacy to exercise adherence in HF were eligible for inclusion. In addition, studies that have applied self-efficacy-based interventions to improve exercise are discussed. RESULTS Limited published data exist evaluating the self-efficacy strategies to improve exercise in HF. Dominant strategies to improve patients’ self-efficacy were performance accomplishments, vicarious experience, verbal persuasion, emotional arousal. CONCLUSION Evidence from some trials supports the view that incorporating the theory of self-efficacy into the design of an exercise intervention is beneficial. Moreover, exercise interventions aimed at integrating the four strategies of exercise self-efficacy can have positive effects on confidence and the ability to initiate exercise and recover HF symptoms. Findings of this study suggest that a positive relationship exists between self-efficacy and initiating and maintaining exercise in HF, especially in the short-term period. PMID:25815022

  9. Evaluation of sampling strategies to estimate crown biomass

    Science.gov (United States)

    Krishna P Poudel; Hailemariam Temesgen; Andrew N Gray

    2015-01-01

    Depending on tree and site characteristics crown biomass accounts for a significant portion of the total aboveground biomass in the tree. Crown biomass estimation is useful for different purposes including evaluating the economic feasibility of crown utilization for energy production or forest products, fuel load assessments and fire management strategies, and wildfire...

  10. Geologists' Implicit Persuasive Strategies and the Construction of Evaluative Evidence.

    Science.gov (United States)

    Dressen, Dacia

    2003-01-01

    Describes the basis for the evaluational practices of the field geology community, through a qualitative analysis of geologists' implicit strategies coupled with the situated analysis of the field account part-genre, its past and present disciplinary practices. (Author/VWL)

  11. Assessment of Risk Evaluation and Mitigation Strategies in Oncology: Summary of the Oncology Risk Evaluation and Mitigation Strategies Workshop

    Science.gov (United States)

    Frame, James N.; Jacobson, Joseph O.; Vogel, Wendy H.; Griffith, Niesha; Wariabharaj, Darshan; Garg, Rekha; Zon, Robin; Stephens, Cyntha L.; Bialecki, Alison M.; Bruinooge, Suanna S.; Allen, Steven L.

    2013-01-01

    To address oncology community stakeholder concerns regarding implementation of the Risk Evaluation and Mitigation Strategies (REMS) program, ASCO sponsored a workshop to gather REMS experiences from representatives of professional societies, patient organizations, pharmaceutical companies, and the US Food and Drug Administration (FDA). Stakeholder presentations and topical panel discussions addressed REMS program development, implementation processes, and practice experiences, as well as oncology drug safety processes. A draft REMS decision tool prepared by the ASCO REMS Steering Committee was presented for group discussion with facilitated, goal-oriented feedback. The workshop identified several unintended consequences resulting from current oncology REMS: (1) the release of personal health information to drug sponsors as a condition for gaining access to a needed drug; (2) risk information that is not tailored—and therefore not accessible—to all literacy levels; (3) exclusive focus on drug risk, thereby affecting patient-provider treatment discussion; (4) REMS elements that do not consider existing, widely practiced oncology safety standards, professional training, and experience; and (5) administrative burdens that divert the health care team from direct patient care activities and, in some cases, could limit patient access to important therapies. Increased provider and professional society participation should form the basis of ongoing and future REMS standardization discussions with the FDA to work toward overall improvement of risk communication. PMID:23814522

  12. Effective colonoscopy training techniques: strategies to improve patient outcomes

    Directory of Open Access Journals (Sweden)

    Papanikolaou IS

    2016-03-01

    Full Text Available Ioannis S Papanikolaou,1 Pantelis S Karatzas,2 Lazaros T Varytimiadis,2 Athanasios Tsigaridas,2 Michail Galanopoulos,2 Nikos Viazis,2 Dimitrios G Karamanolis21Hepato-gastroenterology Unit, 2nd Department of Internal Medicine, Attikon University General Hospital, University of Athens, 2Gastroenterology Department, Evangelismos Hospital, Athens, GreeceAbstract: Colonoscopy has substantially evolved during the last 20 years and many different training techniques have been developed in order to improve the performance of endoscopists. The most known are mechanical simulators, virtual reality simulators, computer-simulating endoscopy, magnetic endoscopic imaging, and composite and explanted animal organ simulators. Current literature generally indicates that the use of simulators improves performance of endoscopists and enhances safety of patients, especially during the initial phase of training. Moreover, newer endoscopes and imaging techniques such as high-definition colonoscopes, chromocolonoscopy with dyes spraying, and third-eye retroscope have been incorporated in everyday practice, offering better visualization of the colon and detection of polyps. Despite the abundance of these different technological features, training devices are not widely used and no official guideline or specified training algorithm or technique for lower gastrointestinal endoscopy has been evolved. In this review, we present the most important training methods currently available and evaluate these using existing literature. We also try to propose a training algorithm for novice endoscopists.Keywords: endoscopy, colonoscopy, teaching techniques, simulator, endoscopists, colon, polyps

  13. Effective colonoscopy training techniques: strategies to improve patient outcomes.

    Science.gov (United States)

    Papanikolaou, Ioannis S; Karatzas, Pantelis S; Varytimiadis, Lazaros T; Tsigaridas, Athanasios; Galanopoulos, Michail; Viazis, Nikos; Karamanolis, Dimitrios G

    2016-01-01

    Colonoscopy has substantially evolved during the last 20 years and many different training techniques have been developed in order to improve the performance of endoscopists. The most known are mechanical simulators, virtual reality simulators, computer-simulating endoscopy, magnetic endoscopic imaging, and composite and explanted animal organ simulators. Current literature generally indicates that the use of simulators improves performance of endoscopists and enhances safety of patients, especially during the initial phase of training. Moreover, newer endoscopes and imaging techniques such as high-definition colonoscopes, chromocolonoscopy with dyes spraying, and third-eye retroscope have been incorporated in everyday practice, offering better visualization of the colon and detection of polyps. Despite the abundance of these different technological features, training devices are not widely used and no official guideline or specified training algorithm or technique for lower gastrointestinal endoscopy has been evolved. In this review, we present the most important training methods currently available and evaluate these using existing literature. We also try to propose a training algorithm for novice endoscopists.

  14. Evaluation of sampling strategies to estimate crown biomass

    Directory of Open Access Journals (Sweden)

    Krishna P Poudel

    2015-01-01

    Full Text Available Background Depending on tree and site characteristics crown biomass accounts for a significant portion of the total aboveground biomass in the tree. Crown biomass estimation is useful for different purposes including evaluating the economic feasibility of crown utilization for energy production or forest products, fuel load assessments and fire management strategies, and wildfire modeling. However, crown biomass is difficult to predict because of the variability within and among species and sites. Thus the allometric equations used for predicting crown biomass should be based on data collected with precise and unbiased sampling strategies. In this study, we evaluate the performance different sampling strategies to estimate crown biomass and to evaluate the effect of sample size in estimating crown biomass. Methods Using data collected from 20 destructively sampled trees, we evaluated 11 different sampling strategies using six evaluation statistics: bias, relative bias, root mean square error (RMSE, relative RMSE, amount of biomass sampled, and relative biomass sampled. We also evaluated the performance of the selected sampling strategies when different numbers of branches (3, 6, 9, and 12 are selected from each tree. Tree specific log linear model with branch diameter and branch length as covariates was used to obtain individual branch biomass. Results Compared to all other methods stratified sampling with probability proportional to size estimation technique produced better results when three or six branches per tree were sampled. However, the systematic sampling with ratio estimation technique was the best when at least nine branches per tree were sampled. Under the stratified sampling strategy, selecting unequal number of branches per stratum produced approximately similar results to simple random sampling, but it further decreased RMSE when information on branch diameter is used in the design and estimation phases. Conclusions Use of

  15. A simple clinical coding strategy to improve recording of child maltreatment concerns: an audit study.

    Science.gov (United States)

    McGovern, Andrew Peter; Woodman, Jenny; Allister, Janice; van Vlymen, Jeremy; Liyanage, Harshana; Jones, Simon; Rafi, Imran; de Lusignan, Simon; Gilbert, Ruth

    2015-01-14

    Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE) but there is evidence of substantial under-recording. To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records. Clinical audit of rates of maltreatment-related coding before January 2010-December 2011 and after January-December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code 'Child is cause for concern'. A total of 25,106 children aged 0-18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording. Outcomes were recording of 1) any maltreatment-related codes, 2) child protection proceedings and 3) child was a cause for concern. We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1-1.6), child protection procedures (RR 1.4; 95% CI 1.1-1.6) and cause for concern (RR 2.5; 95% CI 1.8-3.4) after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation. This simple coding strategy improved clinician's recording of maltreatment-related concerns in a small sample of practices with some 'buy-in'. Further research should investigate how recording can best support the doctor-patient relationship. HOW THIS FITS IN: Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE), but there is evidence of substantial under-recording. We describe a simple clinical coding strategy that helped general practitioners to improve recording of maltreatment-related concerns

  16. The effectiveness of strategies to change organisational culture to improve healthcare performance.

    Science.gov (United States)

    Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

    2011-01-19

    abstracts and then to screen the full reports of selected citations. At each stage results were compared and discrepancies solved through discussion. The search strategy yielded 4239 records. After the full text assessment, no studies met the quality criteria used by the EPOC Group and evaluated the effectiveness of strategies to change organisational culture to improve healthcare performance. It is not possible to draw any conclusions about the effectiveness of strategies to change organisational culture because we found no studies that fulfilled the methodological criteria for this review. Research efforts should focus on strengthening the evidence about the effectiveness of methods to change organisational culture to improve health care performance.

  17. A simple clinical coding strategy to improve recording of child maltreatment concerns: an audit study

    Directory of Open Access Journals (Sweden)

    Andrew Peter McGovern

    2015-01-01

    Full Text Available Background Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE but there is evidence of substantial under-recording.Aim To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records.Design and Setting Clinical audit of rates of maltreatment-related coding before January 2010–December 2011 and after January–December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code ‘Child is cause for concern’. A total of 25,106 children aged 0–18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording.Method Outcomes were recording of 1 any maltreatment-related codes, 2 child protection proceedings and 3 child was a cause for concern.Results We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1–1.6, child protection procedures (RR 1.4; 95% CI 1.1–1.6 and cause for concern (RR 2.5; 95% CI 1.8–3.4 after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation.Conclusion This simple coding strategy improved clinician’s recording of maltreatment-related concerns in a small sample of practices with some ‘buy-in’. Further research should investigate how recording can best support the doctor–patient relationshipHow this fits in Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE, but there is evidence of substantial underrecording. We describe a simple clinical coding

  18. Inventory Management Strategies For Productivity Improvement In Equipment Manufacturing Firms

    Directory of Open Access Journals (Sweden)

    T.T Amachree

    2017-08-01

    Full Text Available This study examined and developed Inventory Management Strategies IMS which could be creatively employed for Productivity Improvement in Equipment Firms PIEMF Equipment manufacturing projects suffer from declining productivity and inability to effectively satisfy customized order batch quantity within schedules budgeted cost and quality specifications due to lack of robust and well defined IMS as well as none code classification of vast number of inventory item. Survey and expost-facto research designs were adopted on the four identified IMS in three EMF. The method used for primary data collection and measurement on four IMS and inventory management parameters was questionnaire modelled into likert five point scale from the target respondents being experts in the subject matter. The secondary data was obtained from the computerised inventory status file of the three equipment manufacturing firms. The methods of primary data analysis and test of research used were Pearsons product moment correlation coefficient and oneway. Analysis of variance ANOVA computer software via Statistical Program for Social Science SPSS version 17 ABC analysis and classification of materials was used for code categorization of secondary data also with the aid of Microsoft excel. The results of the analyses highlighted and isolated A class of inventory items which are 137 out of 543 for Siemens Nig. Ltd 154 out of 551 for Dresser-Rand Nig. Ltd and 162 of 551 for Nigerian Engineering Works Ltd. The results of Pearson product moment correlation analysis and test of research hypotheses indicate that Materials Requirements Planning MRP followed by Supply Chain Management SCM are the most significant IMS as they correlate strongly with PIEMF. The study recommends IMS adoption by code classification of materials in which MRP or SCM could be deployed for management of A class of inventories while classical IMS could be used for management B and C classes of inventory items.

  19. Ethiopia's national strategy for improving water resources management

    International Nuclear Information System (INIS)

    Amha, M.

    2001-01-01

    Full text: Ethiopia's current approach to assessing and managing water resources, including geothermal, assigns very high priority to the use of isotope hydrology. Incorporation of this technology into government planning began with a few activities, in local groundwater assessment and in geothermal studies, kicked off by a 1993 National Isotope Hydrology Training Workshop that the IAEA helped arrange. The first results of isotope studies were useful in characterizing the Aluto Geothermal Field, where a 7.2 MW(e) power plant was later built with support from the UNDP and the EEC. And the Government is now hoping to introduce isotope techniques to improve utilization of the field. Isotope hydrology has successfully aided attempts to better understand ground water occurrence, flow and quality problems in arid regions of Ethiopia. These efforts are continuing through studies in the Dire Dawa, Mekelle and Afar regions. Rising water levels in Lake Beseka are threatening to submerge vital rail and highway links. Isotope hydrology made a unique contribution to understanding the surface and subsurface factors responsible, leading to an engineering plan for mitigating the problem. The Government has allocated substantial funding and construction work has begun. A similar success story is emerging at Awassa Lake, where isotope hydrology is proving a very useful complement to conventional techniques. Another promising application of isotope hydrology is taking place as part of the Akaki Groundwater Study near Addis Ababa. Preliminary isotopic results indicate that earlier conclusions based on conventional techniques may have to be revised. If so, there will be significant implications for the exploitation and management strategy of the resource. Based on these encouraging results, the Government is proceeding with the preparation of a project document for the Ethiopian Groundwater Resource Assessment Programme. With the assistance of the IAEA, the U.S. Geological Survey

  20. Forensic Evaluation of Deaf Individuals: Challenges and Strategies.

    Science.gov (United States)

    Pollard, Robert Q; Berlinski, Brian T

    2017-01-01

    Forensic evaluation of deaf individuals presents unique challenges due to many examinees' fund of information deficits, potential for language deprivation, and examiners' frequent lack of creativity regarding communication methods. This article describes challenges most frequently encountered in competency to stand trial and criminal responsibility evaluations and offers strategies for overcoming them. The value of employing multiple communication methods, especially the use of illustrations, is emphasized. Suggestions also are offered regarding preparing evaluation reports and effectively communicating "key deaf fundamentals" to legal personnel. Encouragement is offered for qualified, sign-fluent professionals to engage in forensic work.

  1. Evaluating Patient Activation Measure (PAM) Scores and Readmission Rates Following Implementation of a Nurse-Initiated Multi-Faceted Strategy for Patients on a U.S. Navy Inpatient Oncology Unit: A Quality Improvement Project

    Science.gov (United States)

    2016-06-30

    5b. GRANT NUMBER N/A of a Nurse-Initiated Multi-Faceted Strategy for Patients on a U.S. Navy Inpatient Oncology Unit: A Quality...13. SUPPLEMENTARY NOTES N/A 14. ABSTRACT Background: Chronically ill patients often experience multiple hospitalizations. Oncology patients...have been shown to have more readmissions to the hospital than non- oncology patients. Recent reports estimate a $17.4 billion cost burden is

  2. A robust model predictive control strategy for improving the control performance of air-conditioning systems

    International Nuclear Information System (INIS)

    Huang Gongsheng; Wang Shengwei; Xu Xinhua

    2009-01-01

    This paper presents a robust model predictive control strategy for improving the supply air temperature control of air-handling units by dealing with the associated uncertainties and constraints directly. This strategy uses a first-order plus time-delay model with uncertain time-delay and system gain to describe air-conditioning process of an air-handling unit usually operating at various weather conditions. The uncertainties of the time-delay and system gain, which imply the nonlinearities and the variable dynamic characteristics, are formulated using an uncertainty polytope. Based on this uncertainty formulation, an offline LMI-based robust model predictive control algorithm is employed to design a robust controller for air-handling units which can guarantee a good robustness subject to uncertainties and constraints. The proposed robust strategy is evaluated in a dynamic simulation environment of a variable air volume air-conditioning system in various operation conditions by comparing with a conventional PI control strategy. The robustness analysis of both strategies under different weather conditions is also presented.

  3. Improving the satellite communication efficiency of the accumulative acknowledgement strategies

    Science.gov (United States)

    Duarte, Otto Carlos M. B.; de Lima, Heliomar Medeiros

    The performances of two finite buffer error recovery strategies are analyzed. In both strategies the retransmission request decision between selective repeat and continuous retransmission is based on an imminent buffer overflow condition. These are accumulative acknowledgment schemes, but in the second strategy the selective-repeat control frame is uniquely an individual negative acknowledgment. The two strategies take advantage of the availability of a greater buffer capacity, making the most of the selective repeat, postponing the sending of a continuous retransmission request. Numerical results show a better performance very close to the ideal, but it does not integrally conform to the high-level data link control (HDLC) procedures. It is shown that these strategies are well suited for high-speed data transfer in the high-error-rate satellite environment.

  4. The role of a blue ocean strategy on performance evaluation

    Directory of Open Access Journals (Sweden)

    Mojtaba Tabari

    2014-08-01

    Full Text Available This paper develops a balanced scorecard (BSC in order to prepare a comprehensive tool for performance evaluation. In this way, an experimental test is conducted in the Resorts of Ramsar Green City located in the north of Iran, in which the factors of a blue ocean strategy influence on the dimensions of the BSC. The sample number of this study consists of 90 managers and experts of the employees who work for Resorts of Ramsar Green City. The acquired data are analyzed with using the t-test. The obtained results show that the blue ocean strategy changes in the objects and the scales of the BSC.

  5. Enhancing Islamic Students’ Reading Comprehension through Predict Organize Search Summarize Evaluate Strategy

    Directory of Open Access Journals (Sweden)

    Darmayenti Darmayenti

    2017-02-01

    Full Text Available This paper is a report of an experimental research project conducted in a reading comprehension course for first-year students of the Adab Faculty of the State Institute for Islamic Studies Imam Bonjol Padang, West Sumatera, Indonesia, during the academic year 2015/2016. The “Predict Organize Search Summarize Evaluate” (POSSE is one strategy that can enhance students’ comprehension in reading. Two classes of Arabic and History students chosen through cluster random sampling technique were used as the sample of the research. Reading tests were used to collect the data which was given to both of classes on pre-test and post-test. The result of the research showed that the implementation of Predict Organize Search Summarize Evaluate strategy gave a significant difference in term of the students-learning outcome between the students who were taught through POSSE strategy and by traditional one. The finding of the study showed that teaching reading by using POSSE strategy gave significant effect towards students’ reading comprehension. This strategy could improve the students’ reading component on finding topic. It can be concluded that using POSSE Strategy has improved Indonesian students’ reading comprehension. It is also recommended for English lecturers use POSSE strategy as one of teaching strategies for reading comprehension.

  6. Conservation and Improvement Strategy for Fogera Cattle: A Lesson for Ethiopia Ingenious Cattle Breed Resource

    Directory of Open Access Journals (Sweden)

    Assemu Tesfa

    2017-01-01

    Full Text Available The paper is initiated to design appropriate conservation strategies and breeding scheme for Fogera cattle breed that will be used as a guide for other Ethiopian indigenous cattle breed. Two types of data, on-farm and on-station, were used; the on-farm data was collected from three districts, namely, Fogera, Dera, and Bahir Dar Zuria; those are expected as the home of the breed. A total of 150 farmers, which are knowledgeable and having at least one cattle of Fogera phenotype in their herd, were purposively selected and interviewed. Additionally, farmer’s focus group discussion (FGD was conducted to capture the historical background, population, and distribution of the breed. SPSS (version 16 and index method was used to analyze the quantitative and scoring data’s, respectively. A meeting at national and regional level was also conducted to evaluate the existing conservation strategy and to identify the major stakeholders for the strategy. The main reasons to conserve Fogera breed are due to presence of interrelated constraints, presence of unique traits of the breed, better attitude of farmers, and decreasing population trend of the breed. Community-based in situ conservation strategy, to ensure the participation of the community, was designed for the breed. With the conservation strategy, related activities like feed development, animal health interventions, market linkage, and development of cooperatives will be implemented to improve the working environment. The stakeholders that are identified as an actor in the strategy should realize their honest participation for the sustainability of conservation and improvement of the breed.

  7. Young doctors' problem solving strategies on call may be improved.

    Science.gov (United States)

    Michelsen, Jens; Malchow-Møller, Axel; Charles, Peder; Eika, Berit

    2013-03-01

    The first year following graduation from medical school is challenging as learning from books changes to workplace-based learning. Analysis and reflection on experience may ease this transition. We used Significant Event Analysis (SEA) as a tool to explore what pre-registration house officers (PRHOs) consider successful and problematic events, and to identify what problem-solving strategies they employ. A senior house officer systematically led the PRHO through the SEA of one successful and one problematic event following a night call. The PRHO wrote answers to questions about diagnosis, what happened, how he or she contributed and what knowledge-gaining activities the PRHO would prioritise before the next call. By using an inductive, thematic data analysis, we identified five problem-solving strategies: non-analytical reasoning, analytical reasoning, communication with patients, communication with colleagues and professional behaviour. On average, 1.5 strategies were used in the successful events and 1.2 strategies in the problematic events. Most PRHOs were unable to suggest activities other than reading textbooks. SEA was valuable for the identification of PRHOs' problem-solving strategies in a natural setting. PRHOs should be assisted in increasing their repertoire of strategies, and they should also be helped to "learn to learn" as they were largely unable to point to new learning strategies. not relevant. not relevant.

  8. Tit-For-Tat Strategy for Increasing Medical Student Evaluation Response Rates

    Directory of Open Access Journals (Sweden)

    Matthew G. Malone

    2017-12-01

    Full Text Available Introducation It is essential for faculty to receive feedback on their teaching for the purpose of improvement as well as promotion. It can be challenging to motivate students to provide feedback to preceptors and fill out evaluation forms when not a clerkship requirement. Furthermore, there is concern that making the evaluations a requirement can compromise the quality of the feedback. The objective of this study was to identify an increase in the number of faculty and resident evaluations completed by students rotating through their Emergency Medicine clerkship following the implementation of a tit-for-tat incentive strategy. Method Prior to the implementation of Tit-for-Tat, students rotating through their emergency medicine clerkship were asked to fill out evaluations of residents and faculty members with whom they worked. These were encouraged but voluntary. Beginning in the 2014–2015 academic year, a tit-for-tat strategy was employed whereby students had to complete a resident or faculty evaluation in order to view the student assessment completed by that resident or faculty preceptor. Results Students submitted 1101 evaluations in the control, with a mean of 3.60 evaluations completed per student and 3.77 evaluations received per preceptor. Following the implementation of tit-for-tat, students submitted 2736 evaluations, with a mean of 8.19 evaluations completed per student and 7.52 evaluations received per preceptor. Both the increase in evaluations completed per student and evaluations received per preceptor were statistically significant with p-value <0.001. Conclusion The tit-for-tat strategy significantly increased the number of evaluations submitted by students rotating through their emergency medicine clerkship. This has served as an effective tool to increase the overall number of evaluations completed, the number of evaluations each instructor received on average and the proportion of students that completed evaluations

  9. Secondary side water chemistry pH control strategy improvements

    International Nuclear Information System (INIS)

    Roumiguiere, Fernando-Mario; Fandrich, Joerg; Ramminger, Ute; Hoffmann-Wankerl, Stephan; Drexler, Andreas

    2012-09-01

    Over the years the PWR plant operators were aware of the need of optimizing the pH control strategy in the water-steam cycle with the focus on improvement of steam generator performance with the main goal of reducing the corrosion product ingress into the steam generators and their consequences: SG fouling, SG tube corrosion beneath deposits. To achieve this goal, it becomes necessary to harmonize three requirements: a. High overall pH along the circuit for suppression of general corrosion, requiring a volatile amine to ensure a suitable distribution in steam areas and condenser, and b. High local pH at the water phase of two-phase flow areas, requiring an either rather low volatile amine to ensure high pH in the wet steam water film, or larger amounts of a volatile amine. c. Sufficient amount of hydrazine to ensure reducing conditions in the steam generators. The basic strategy of AREVA NP GmbH (formerly KWU), successfully applied in German nuclear power plants since the late seventies consisted on the achievement of the necessary pH by means of ammonia, as generated by thermal decomposition of hydrazine. By dosing of hydrazine at the necessary amounts to ensure reducing conditions, also sufficient ammonia is generated to achieve a high overall pH along the cycle, being the target pH (25 deg. C) ≥ 9.8 resulting in < 1 ppb Fe in final feed water. This treatment is known as H-AVT (High pH - All Volatile Treatment). Main prerequisite for its application is to have a copper-free system. Eventually, H-AVT started to be applied later at some other western nuclear power plants. In some units, the high condenser exhaust flow rate applied caused a considerable amount of ammonia being removed from the cycle, resulting in too low ammonia concentrations to maintain a sufficiently high pH, making the addition of ammonia necessary. AREVA NP GmbH together with plant operators investigated the possibility of complementing the applied classical H-AVT by addition of an advanced

  10. Regulation for continuous improvements - the new regulatory strategy of SKI

    International Nuclear Information System (INIS)

    Hoegberg, L.; Svensson, G.; Viktorsson, C.

    1998-01-01

    This paper describes the new regulatory objectives and strategy of the Swedish Nuclear Power Inspectorate. Factors that have influenced the development of the regulatory strategy, including an international peer review, are discussed. In addition to general technical requirements for a defence in depth, the new strategy strongly focuses on the quality of plant safety management processes, to be monitored by process-oriented inspections. Also, quality assurance of regulatory activities is stressed. Experience gained so far shows that the regulatory approach chosen in Sweden promotes utility self assessment, quality of safety management and ownership of safety work within the utility staff. (author)

  11. Environmental performance evaluation and strategy management using balanced scorecard.

    Science.gov (United States)

    Hsu, Yu-Lung; Liu, Chun-Chu

    2010-11-01

    Recently, environmental protection and regulations such as WEEE, ELV, and RoHS are rapidly emerging as an important issue for business to consider. The trend of swinging from end-of-pipe control to product design, green innovation, and even the establishment of image or brand has affected corporations in almost every corner in the world, and enlarged to the all modern global production network. Corporations must take proactive environmental strategies to response the challenges. This study adopts balanced scorecard structure and aim at automobile industries to understand the relationships of internal and external, financial and non-financial, and outcome and driving factors. Further relying on these relationships to draw the "map of environment strategy" to probe and understand the feasibility of environmental performance evaluation and environmental strategy control.

  12. Improving Walkability Through Control Strategies at Signalized Intersections

    Science.gov (United States)

    2017-01-01

    As cities and communities nationwide seek to develop Complete Streets that foster livability and accommodate all modes, signal timing control strategies that include pedestrians in the operational decision process are gaining importance. This researc...

  13. Improving offering strategies for wind farms enhanced with storage capability

    DEFF Research Database (Denmark)

    Ding, Huajie; Hu, Zechun; Song, Yonghua

    2015-01-01

    Due to the flexible charging and discharging capability, energy storage system (ESS) is thought of as a promising complement to wind farms (WF) in participating into electricity markets. This paper proposes a reserve-based real-time operation strategy of ESS to make arbitrage and to alleviate...... the wind power deviation from day-ahead contracts. Taking into account the operation strategy as well as two-price balancing market rules, a day-ahead bidding strategy of WF-ESS system is put forward and formulated. A modified gradient descent algorithm is described to solve the formulations. In the case...... studies, the computational efficiency of the algorithm is validated firstly. Moreover, a number of scenarios with/without considering the temporal dependence of wind power forecast error are designed and employed to compare the proposed strategy with other common ones in terms of profit....

  14. Breeding strategy for the improvement of mustard (Brassica Juncea Coss.)

    International Nuclear Information System (INIS)

    Nayar, G.G.

    1980-01-01

    Mutants having desirable agronomic characters were obtained in the high yielding, recommended mustard (B. juncea) varieties Rai 5, RL 9 and Varuna (T 59). Following hybridizations between induced mutants or mutants with other promising varieties, recombinants having superior agronomic traits have been developed. The parent varieties are characterised by open pod arrangement and blackish brown seeds. The mutants and the recombinants have desirable agronomic characters like compact plant type, appressed pods with less shattering nature, yellow seeds, higher oil content and lighter coloured oil. Among the 12 new strains developed at this centre, five have been tested at various locations in the country. At many places, TM-(Trombay Mustard-) cultures outyielded or were at par with the local check varieties. TM-2-11 (Appressed pod mutant) and TM-4 (Yellow bold seeded Mutant) have also been included in the Initial Evaluation Trial of the All India Co-ordinated Research Project in Oilseeds (AICORPO) improvement. Reports so far received from various locations in the country indicate that TM-strains, being relatively early cultures, are suited more for states of Rajasthan, Gujarat, U.P. and Bihar. (author)

  15. [Hospital falls, improvement strategy for reducing their incidence].

    Science.gov (United States)

    García-Huete, M Eloisa; Sebastián-Viana, Tomás; Lema-Lorenzo, Isabel; Granados-Martín, Mónica; Buitrago-Lobo, Nuria; Heredia-Reina, M del Pilar; Merino-Ruiz, Margarita; Ventosa-Hernández, Esther; Gutiérrez-Fernández, Carmen; Mota-Boada, M Luisa

    2016-01-01

    To evaluate the evolution of falls with the implemented measures to improve the attention of patients at risk and to reduce the number of falls. To know the characteristics of patients who have suffered fall-related injuries. All the falls registered between 2008 and 2013 have been analyzed to determine the evolution of these and to describe the implemented measures through the electronic clinical history at University Hospital of Fuenlabrada. The incidence of falls in hospitalized patients has been estimated and the evolution with the chi square test has been studied. The frequencies of the characteristics of patients who fall has been presented: age, length of stay, performed activity, patient companion, mobility level, state of consciousness. 445 registered falls happened. 2009 is the year with the highest number of falls, 86 patients fell of a total of 15,819 discharged patients (0.55%). The statistic drops until 2013, where 55 patients fell out of 15,052 discharged patients (0.37%). This difference was not statistically significant. The deployment of an assessment about fall risk at admission has helped to identify individualized risk factors. Furthermore, the awareness and alerts to the nursing staff have helped to consider fall prevention as a rutinary procedure, hence appropriate measures can be implemented on the most vulnerable patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. Risk evaluation and mitigation strategies: a focus on belatacept.

    Science.gov (United States)

    Sam, Teena; Gabardi, Steven; Tichy, Eric M

    2013-03-01

    To review the elements and components of the risk evaluation and mitigation strategies (REMS) for the costimulation blocker belatacept and associated implications for health care providers working with transplant recipients. The MEDLINE and EMBASE databases (January 1990 to March 2012) were searched by using risk evaluation and mitigation strategies, REMS, belatacept, and organ transplant as search terms (individual organs were also searched). Retrieved articles were supplemented with analysis of information obtained from the Federal Register, the Food and Drug Administration, and the manufacturer of belatacept. REMS are risk-management strategies implemented to ensure that a product's benefits outweigh its known safety risks. Although belatacept offers a novel strategy in maintenance immunosuppression and was associated with superior renal function compared with cyclosporine in phase 2 and 3 trials, belatacept is also associated with increased risk of posttransplant lymphoproliferative disorder and central nervous system infections. The Food and Drug Administration required development of a REMS program as part of belatacept's approval process to ensure safe and appropriate use of the medication and optimization of its risk-benefit profile. Elements of the belatacept REMS include a medication guide that must be dispensed with each infusion and a communication plan. In the management of a complex population of patients, it is essential that those who care for transplant recipients, and patients, recognize the implications of potential and known risks of belatacept. The REMS program aims to facilitate careful selection and education of patients and vigilant monitoring.

  17. An Implementing Strategy for Improving Wildland Fire Environmental Literacy

    Science.gov (United States)

    McCalla, M. R.; Andrus, D.; Barnett, K.

    2007-12-01

    ). The OFCM model for promoting wildland fire environmental literacy, the model's component parts, as well as an implementing strategy to execute the model will be presented. That is, the presentation will lay out the framework and methodology which the OFCM used to systematically define the wildland fire weather and climate education and outreach needs through interdepartmental collaboration within the OFCM coordinating infrastructure. A key element of the methodology is to improve the overall understanding and use of wildland fire forecast and warning climate and weather products and to exploit current and emerging technologies to improve the dissemination of customer-tailored forecast and warning information and products to stakeholders and users. Thus, the framework and methodology define the method used to determine the target public, private, and academic sector audiences. The methodology also identifies the means for determining the optimal channels, formats, and content for informing end users in time for effective action to be taken.

  18. Methodological proposal for the definition of improvement strategies in logistics of SME

    Directory of Open Access Journals (Sweden)

    Yeimy Liseth Becerra

    2014-12-01

    Full Text Available A methodological proposal for defining strategies of improvement in logistics of SMEs is presented as a means to fulfill a specific objective of the project Methodological design on storage logistics, acquisition, ownership of information systems and communication for Colombian SMEs, baker subsector, which currently runs the research group SEPRO, of Universidad Nacional of Colombia and supported by Colciencias. The project corresponds to the completion of the last stage of the base project, and aims to implement the corresponding target, raised in the research project that has been developing the research group SEPRO. To do this, it was made a review of the methodology used during the execution of the basic project, as well as the state of the art of techniques used in similar research for the evaluation and definition of breeding strategies in SMEs logistics. Revised techniques were compared and a proposed methodology was configured, which consists of the techniques that represented the greatest advantages for the research development.

  19. Control and decision strategies in wastewater treatment plants for operation improvement

    CERN Document Server

    Santín, Ignacio; Vilanova, Ramón

    2017-01-01

    This book examines the operation of biological wastewater treatment plants (WWTPs), with a focus on maintaining effluent water quality while keeping operational costs within constrained limits. It includes control operation and decision schemes and is based on the use of benchmarking scenarios that yield easily reproducible results that readers can implement for their own solutions. The final criterion is the effect of the applied control strategy on plant performance – specifically, improving effluent quality, reducing costs and avoiding violations of established effluent limits. The evaluation of the different control strategies is achieved with the help of two Benchmark Simulation Models (BSM1, BSM2). Given the complexity of the biological and biochemical processes involved and the major fluctuations in the influent flow rate, controlling WWTPs poses a serious challenge. Further, the importance of control goal formulation and control structure design in relation to WWTP process control is widely recogniz...

  20. Strategies for improving family engagement during family-centered rounds.

    Science.gov (United States)

    Kelly, Michelle M; Xie, Anping; Carayon, Pascale; DuBenske, Lori L; Ehlenbach, Mary L; Cox, Elizabeth D

    2013-04-01

    Family-centered rounds (FCR) are recommended as standard practice in the pediatric inpatient setting; however, limited data exist on best practices promoting family engagement during rounds. To identify strategies to enhance family engagement during FCR using a recognized systems engineering approach. In this qualitative study, stimulated recall interviews using video-recorded rounding sessions were conducted with participants representing the various stakeholders on rounds (15 parents/children and 22 healthcare team [HCT] members) from 4 inpatient services at a children's hospital in Wisconsin. On video review, participants were asked to provide strategies that would increase family engagement on FCR. Qualitative content analysis of interview transcripts was performed in an iterative process. We identified 21 categories of strategies corresponding to 2 themes related to the structure and process of FCR. Strategies related to the structure of FCR were associated with all five recognized work system elements: people (HCT composition), tasks (HCT roles), organization (scheduling of rounds and HCT training), environment (location of rounds and HCT positioning), and tools and technologies (computer use). Strategies related to the FCR process were associated with three rounding phases: before (HCT and family preparation), during (eg, introductions, presentation content, communication style), and after (follow-up) FCR. We identified a range of strategies to enhance family engagement during FCR. These strategies both confirm prior work on the importance of the content and style of communication on rounds and highlight other factors within the hospital work system, like scheduling and computer use, which may affect family engagement in care. Copyright © 2013 Society of Hospital Medicine.

  1. Effectiveness of a multimodal hand hygiene improvement strategy in the emergency department.

    Science.gov (United States)

    Arntz, P R H; Hopman, J; Nillesen, M; Yalcin, E; Bleeker-Rovers, C P; Voss, A; Edwards, M; Wei, A

    2016-11-01

    Hand hygiene (HH) is essential in preventing nosocomial infection. The emergency department (ED) is an open portal of entry for pathogens into the hospital system, hence the important sentinel function of the ED personnel. The main objective of this study was to assess the effect of a multimodal improvement strategy on hand hygiene compliance in the ED. Our study was a prospective before-and-after study to determine the effect of a multimodal improvement strategy on the compliance of HH in the ED according to the My 5 Moments of Hand Hygiene defined by the World Health Organization. Interventions such as education, reminders, and regular feedback on HH performance and role models were planned during the 3 intervention weeks. In total, 57 ED nurses and ED physicians were observed in this study, and approximately 1,000 opportunities for handrubs were evaluated during the 3 intervention periods. HH compliance increased significantly from baseline from 18% (74/407) to 41% (77/190) after the first intervention and stabilized to 50% (99/200) and 46% (96/210) after the second and third interventions, respectively. Implementing a multimodal HH improvement program significantly improved the HH compliance of ED personnel. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Improving Strategies for Low-Income Family Children's Information Literacy

    Science.gov (United States)

    Zhang, Haiyan; Washington, Rodney; Yin, Jianjun

    2014-01-01

    This article discussed the significance of improving low-income family children's information literacy, which could improve educational quality, enhance children's self-esteem, adapt children to the future competitive world market, as well as the problems in improving low-income family children's information literacy, such as no home computer and…

  3. Efficiency Evaluation of Strategies for Dynamic Management of Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Andrea Verônica González

    2017-01-01

    Full Text Available This paper presents and evaluates dynamic management strategies to improve efficiency in event-triggered wireless sensor networks. We are considering mobility, where nodes move themselves to maximize the coverage, and load balancing state-of-the-art techniques, by which the number of nodes sensing the same area is reduced. To explore mobility, we present a simple method by which nodes can dynamically reorganize themselves based on the force fields approach of mobile robotics. Firstly, the strategies are evaluated separately through experiments with different network configurations and, afterwards, a joint evaluation has been conducted to observe the impact of mobility on the efficiency of load balancing techniques. We show that mobile nodes significantly contribute to keeping the coverage as nodes die in mesh and powerfully improving it in random deployments. Load balancing techniques achieve important results, increasing lifetime and the number of sensed events. However, in random deployments, these techniques lose efficiency and become unsuitable strategies. Combining these strategies with mobility, we observe that PS-based technique keeps its contribution in mesh and random deployments, as well as improving its performance for not so dense networks. Ant-based technique when combined with mobile nodes loses performance significantly in mesh and keeps its good performance in random deployed and less dense networks.

  4. Improving treatment plan evaluation with automation

    Science.gov (United States)

    Covington, Elizabeth L.; Chen, Xiaoping; Younge, Kelly C.; Lee, Choonik; Matuszak, Martha M.; Kessler, Marc L.; Keranen, Wayne; Acosta, Eduardo; Dougherty, Ashley M.; Filpansick, Stephanie E.

    2016-01-01

    The goal of this work is to evaluate the effectiveness of Plan‐Checker Tool (PCT) which was created to improve first‐time plan quality, reduce patient delays, increase the efficiency of our electronic workflow, and standardize and automate the physics plan review in the treatment planning system (TPS). PCT uses an application programming interface to check and compare data from the TPS and treatment management system (TMS). PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user as part of a plan readiness check for treatment. Prior to and during PCT development, errors identified during the physics review and causes of patient treatment start delays were tracked to prioritize which checks should be automated. Nineteen of 33 checklist items were automated, with data extracted with PCT. There was a 60% reduction in the number of patient delays in the six months after PCT release. PCT was successfully implemented for use on all external beam treatment plans in our clinic. While the number of errors found during the physics check did not decrease, automation of checks increased visibility of errors during the physics check, which led to decreased patient delays. The methods used here can be applied to any TMS and TPS that allows queries of the database. PACS number(s): 87.55.‐x, 87.55.N‐, 87.55.Qr, 87.55.tm, 89.20.Bb PMID:27929478

  5. Identifying quality improvement intervention publications - A comparison of electronic search strategies

    Directory of Open Access Journals (Sweden)

    Rubenstein Lisa V

    2011-08-01

    Full Text Available Abstract Background The evidence base for quality improvement (QI interventions is expanding rapidly. The diversity of the initiatives and the inconsistency in labeling these as QI interventions makes it challenging for researchers, policymakers, and QI practitioners to access the literature systematically and to identify relevant publications. Methods We evaluated search strategies developed for MEDLINE (Ovid and PubMed based on free text words, Medical subject headings (MeSH, QI intervention components, continuous quality improvement (CQI methods, and combinations of the strategies. Three sets of pertinent QI intervention publications were used for validation. Two independent expert reviewers screened publications for relevance. We compared the yield, recall rate, and precision of the search strategies for the identification of QI publications and for a subset of empirical studies on effects of QI interventions. Results The search yields ranged from 2,221 to 216,167 publications. Mean recall rates for reference publications ranged from 5% to 53% for strategies with yields of 50,000 publications or fewer. The 'best case' strategy, a simple text word search with high face validity ('quality' AND 'improv*' AND 'intervention*' identified 44%, 24%, and 62% of influential intervention articles selected by Agency for Healthcare Research and Quality (AHRQ experts, a set of exemplar articles provided by members of the Standards for Quality Improvement Reporting Excellence (SQUIRE group, and a sample from the Cochrane Effective Practice and Organization of Care Group (EPOC register of studies, respectively. We applied the search strategy to a PubMed search for articles published in 10 pertinent journals in a three-year period which retrieved 183 publications. Among these, 67% were deemed relevant to QI by at least one of two independent raters. Forty percent were classified as empirical studies reporting on a QI intervention. Conclusions The presented

  6. Improving occupational physicians' adherence to a practice guideline: feasibility and impact of a tailored implementation strategy.

    Science.gov (United States)

    Joosen, Margot C W; van Beurden, Karlijn M; Terluin, Berend; van Weeghel, Jaap; Brouwers, Evelien P M; van der Klink, Jac J L

    2015-04-24

    Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived by occupational physicians (OPs). Feasibility and impact on OPs' barriers were evaluated. OPs received 8 training-sessions in small peer-learning groups, aimed at discussing the content of the guideline and their perceived barriers to adhere to guideline recommendations; finding solutions to overcome these barriers; and implementing solutions in practice. The training had a plan-do-check-act (PDCA) structure and was guided by a trainer. Protocol compliance and OPs' experiences were qualitatively and quantitatively assessed. Using a questionnaire, impact on knowledge, attitude, and external barriers to guideline adherence was investigated before and after the training. The training protocol was successfully conducted; guideline recommendations and related barriers were discussed with peers, (innovative) solutions were found and implemented in practice. The participating 32 OPs were divided into 6 groups and all OPs attended 8 sessions. Of the OPs, 90% agreed that the peer-learning groups and the meetings spread over one year were highly effective training components. Significant improvements (p implementation strategy focusing on perceived barriers and tailor-made implementation interventions is a feasible method to enhance guideline adherence. Moreover, the strategy contributed to OPs' knowledge, attitudes, and skills in using the guideline. As a generic approach to overcome barriers perceived in specific situations, this strategy provides a useful method to guideline implementation for other health care professionals too.

  7. Strategies to Improve Management of Shoulder Dystocia Under the AHRQ Safety Program for Perinatal Care.

    Science.gov (United States)

    McArdle, Jill; Sorensen, Asta; Fowler, Christina I; Sommerness, Samantha; Burson, Katrina; Kahwati, Leila

    2018-03-01

    To assess implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. Mixed-methods implementation evaluation. Labor and delivery units (N = 18) in 10 states participating in the Safety Program for Perinatal Care (SPPC). Shoulder dystocia is unpredictable, requiring rapid and coordinated action. Key informants were labor and delivery unit staff who implemented SPPC safety strategies. The SPPC was implemented by using the TeamSTEPPS teamwork and communication framework and tools, applying safety science principles (standardization, independent checks, and learn from defects) to shoulder dystocia management, and establishing an in situ simulation program focused on shoulder dystocia to practice teamwork and communication skills. Unit staff received training, a toolkit, technical assistance, and unit-specific feedback reports. Quantitative data on unit-reported process improvement measures and qualitative data from staff interviews were used to understand changes in use of safety principles, teamwork/communication, and in situ simulation. Use of shoulder dystocia safety strategies improved on the units. Differences between baseline and follow-up (10 months) were as follows: in situ simulation (50% vs. 89%), teamwork and communication (67% vs. 94%), standardization (67% to 94%), learning from defects (67% vs. 89%), and independent checks (56% vs. 78%). Interview data showed reasons to address management of shoulder dystocia, various approaches to implement safety practices, and facilitators and barriers to implementation. Successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The SPPC strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances. Copyright © 2018 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights

  8. Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy.

    Science.gov (United States)

    McGinty, Emma; Pescosolido, Bernice; Kennedy-Hendricks, Alene; Barry, Colleen L

    2018-02-01

    Despite the high burden and poor rates of treatment associated with mental illness and substance use disorders, public support for allocating resources to improving treatment for these disorders is low. A growing body of research suggests that effective policy communication strategies can increase public support for policies benefiting people with these conditions. In October 2015, the Center for Mental Health and Addiction Policy Research at Johns Hopkins University convened an expert forum to identify what is currently known about the effectiveness of such policy communication strategies and produce recommendations for future research. One of the key conclusions of the forum was that communication strategies using personal narratives to engage audiences have the potential to increase public support for policies benefiting persons with mental illness or substance use disorders. Specifically, narratives combining personal stories with depictions of structural barriers to mental illness and substance use disorder treatment can increase the public's willingness to invest in the treatment system. Depictions of mental illness and violence significantly increase public stigma toward people with mental illness and are no more effective in increasing willingness to invest in mental health services than nonstigmatizing messages about structural barriers to treatment. Future research should prioritize development and evaluation of communication strategies to increase public support for evidence-based substance use disorder policies, including harm reduction policies-such as needle exchange programs-and policies expanding treatment.

  9. Evaluating expansion strategies for startup European Union dairy farm businesses.

    Science.gov (United States)

    McDonald, R; Shalloo, L; Pierce, K M; Horan, B

    2013-06-01

    A stochastic whole-farm simulation model was used to examine alternative strategies for new entrant dairy farmers to grow and develop dairy farm businesses in the context of European Union (EU) milk quota abolition in 2015. Six alternative strategies were compared: remain static, natural growth expansion, waiting until after EU milk quota abolition to expand, a full-scale expansion strategy without milk quotas and not incurring super levy penalties, a full-scale expansion strategy with milk quotas and incurring super levy penalties, and once-a-day milking until EU milk quota abolition, followed by full-scale expansion. Each discrete whole farm investment strategy was evaluated over a 15-yr period (2013-2027) using multiple financial stability and risk indicators, including overall discounted farm business profitability, net worth change, return on investment, and financial risk. The results of this study indicate that, although associated with increased risk, dairy farm expansion will ensure the future profitability of the farm business. Within the context of EU milk quotas until 2015, the most attractive expansion strategy is to increase cow numbers while avoiding super levy fines using once-a-day milking techniques, increasing to the full capacity of the dairy farm once milk quotas are removed. In contrast, the results also indicate that dairy farms that remain static will experience a significant reduction in farm profitability in the coming year due to production cost inflation. Cash flow deficits were observed during the initial year of expansion and, therefore, rapidly expanding dairy farm businesses require a significant cash reserve to alleviate business risk during the initial year of expansion. The results of this analysis also indicate that dairy farm businesses that expand using lower cost capital investments and avoid milk quota super levy fines significantly reduce the financial risks associated with expansion. Copyright © 2013 American Dairy Science

  10. Multi-reception strategy with improved SNR for multichannel MR imaging.

    Directory of Open Access Journals (Sweden)

    Bing Wu

    Full Text Available A multi-reception strategy with extended GRAPPA is proposed in this work to improve MR imaging performance at ultra-high field MR systems with limited receiver channels. In this method, coil elements are separated to two or more groups under appropriate grouping criteria. Those groups are enabled in sequence for imaging first, and then parallel acquisition is performed to compensate for the redundant scan time caused by the multiple receptions. To efficiently reconstruct the data acquired from elements of each group, a specific extended GRAPPA was developed. This approach was evaluated by using a 16-element head array on a 7 Tesla whole-body MRI scanner with 8 receive channels. The in-vivo experiments demonstrate that with the same scan time, the 16-element array with twice receptions and acceleration rate of 2 can achieve significant SNR gain in the periphery area of the brain and keep nearly the same SNR in the center area over an eight-element array, which indicates the proposed multi-reception strategy and extended GRAPPA are feasible to improve image quality for MRI systems with limited receive channels. This study also suggests that it is advantageous for a MR system with N receiver channels to utilize a coil array with more than N elements if an appropriate acquisition strategy is applied.

  11. Using the acid rain advisor to evaluate compliance strategies

    International Nuclear Information System (INIS)

    Stallard, G.S.; Anderson, A.A.

    1991-01-01

    Unlike prior Clean Air Act (CAA) legislation, the most recent amendments will require utilities to reduce SO 2 and NO x emissions for existing operating power station and provides for compliance strategies in which emissions for existing operating power stations and provides for compliance strategies in which emission reductions can be transferred from one unit to another. The Electric Power Research Institute (EPRI), in conjunction with the Department of Energy (DOE), is funding the development of the Coal Quality Expert (CQE), a comprehensive analytical/planning tool to consider the myriad of potential coal purchase decisions now facing the utility, including fuel switching, blending, coal beneficiation, and the installation of retrofit emission controls. The CQE will be built on the foundation of proven, validated computer models to the maximum extent possible, including EPRI's Coal Quality Impact Model (CQIM), a state-of-the-art computer model designed to evaluate cost/performance impacts of fuel switching at existing power plants. In addition, as the CQE development permits, interim computer products will be offered. The first of these products is the Acid Rain Advisor (ARA). The ARA complements the CQIM by providing the ability to rapidly evaluate the system-wide cost and reduction benefits which result from selecting various reduction techniques on various units within the system. Thus, with the ARA, the utility can efficiently combine cost/performance information, view overall system results, and rapidly consider various 'What if' alternatives to ensure that individual unit reduction strategies are consistent with the goals of the utility as a whole. This paper demonstrates the capabilities of the ARA, and by use of a 'sample analysis,' illustrates how a utility might develop and evaluate alternative CAA compliance strategies

  12. Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement.

    Science.gov (United States)

    Abdulmalik, J; Kola, L; Gureje, O

    2016-01-01

    A health systems approach to understanding efforts for improving health care services is gaining traction globally. A component of this approach focuses on health system governance (HSG), which can make or mar the successful implementation of health care interventions. Very few studies have explored HSG in low- and middle-income countries, including Nigeria. Studies focusing on mental health system governance, are even more of a rarity. This study evaluates the mental HSG of Nigeria with a view to understanding the challenges, opportunities and strategies for strengthening it. This study was conducted as part of the project, Emerging Mental Health Systems in Low and Middle Income Countries (Emerald). A multi-method study design was utilized to evaluate the mental HSG status of Nigeria. A situational analysis of the health policy and legal environment in the country was performed. Subsequently, 30 key informant interviews were conducted at national, state and district levels to explore the country's mental HSG. The existing policy, legislative and institutional framework for HSG in Nigeria reveals a complete exclusion of mental health in key health sector documents. The revised mental health policy is however promising. Using the Siddiqi framework categories, we identified pragmatic strategies for mental health system strengthening that include a consideration of existing challenges and opportunities within the system. The identified strategies provide a template for the subsequent activities of the Emerald Programme (and other interventions), towards strengthening the mental health system of Nigeria.

  13. Improving World Health: A Least Cost Strategy. Worldwatch Paper 59.

    Science.gov (United States)

    Chandler, William U.

    Least-cost health strategies designed to attack the world's leading causes of unnecessary death are explored. Section 1 emphasizes the value of primary health-care procedures--midwifery, maternal education on breastfeeding and weaning, vaccinations, oral rehydration of victims of diarrhea, and antibiotics against respiratory infections--in…

  14. Improving text comprehension strategies in reading and listening settings

    NARCIS (Netherlands)

    Brand-Gruwel, S; Aarnoutse, CAJ; van den Bos, KP

    Traditional intervention programs for children with decoding and reading comprehension problems often focus on remediation of the decoding ability. The goal of this study was to determine whether it is possible to teach these children text comprehension strategies. The subjects were fourth-grade

  15. Strategies for Instructors on How to Improve Online Groupwork

    Science.gov (United States)

    Koh, Myung Hwa; Barbour, Michael; Hill, Janette R.

    2010-01-01

    Online groupwork is becoming an increasingly popular instructional strategy. Although researchers have questioned the benefits of groupwork in online learning environments, little empirical research has examined the challenges it presents. The purpose of this study was to investigate the experience of students involved in online groupwork to find…

  16. Young doctors' problem solving strategies on call may be improved

    DEFF Research Database (Denmark)

    Michelsen, Jens; Malchow-Møller, Axel; Charles, Peder

    2013-01-01

    The first year following graduation from medical school is challenging as learning from books changes to workplace-based learning. Analysis and reflection on experience may ease this transition. We used Significant Event Analysis (SEA) as a tool to explore what pre-registration house officers (PR...... (PRHOs) consider successful and problematic events, and to identify what problem-solving strategies they employ....

  17. Plant-wide Control Strategy for Improving Produced Water Treatment

    DEFF Research Database (Denmark)

    Yang, Zhenyu; Pedersen, Simon; Løhndorf, Petar Durdevic

    2016-01-01

    This work focuses on investigation and development of an innovative Produced Water Treatment (PWT) technology for offshore oil & gas production by employing the model-based plant-wide control strategy. The key contributions lie in two folds: (i) the advanced anti-slug analysis and control...

  18. Dietary strategies for reduced phosphorus excretion and improved water quality

    NARCIS (Netherlands)

    Maguire, R.O.; Dou, Z.; Sims, J.T.; Brake, J.; Joern, B.C.

    2005-01-01

    Received for publication October 29, 2004. Cost effective feeding strategies are essential to deal with P surpluses associated with intensive animal agriculture and the consequent impact on water quality. Reduction of P overfeeding, use of feed additives to enhance dietary P utilization, and

  19. Improved operating strategies for uranium extraction: a stochastic simulation

    International Nuclear Information System (INIS)

    Broekman, B.R.

    1986-01-01

    Deterministic and stochastic simulations of a Western Transvaal uranium process are used in this research report to determine more profitable uranium plant operating strategies and to gauge the potential financial benefits of automatic process control. The deterministic simulation model was formulated using empirical and phenomenological process models. The model indicated that profitability increases significantly as the uranium leaching strategy becomes harsher. The stochastic simulation models use process variable distributions corresponding to manually and automatically controlled conditions to investigate the economic gains that may be obtained if a change is made from manual to automatic control of two important process variables. These lognormally distributed variables are the pachuca 1 sulphuric acid concentration and the ferric to ferrous ratio. The stochastic simulations show that automatic process control is justifiable in certain cases. Where the leaching strategy is relatively harsh, such as that in operation during January 1986, it is not possible to justify an automatic control system. Automatic control is, however, justifiable if a relatively mild leaching strategy is adopted. The stochastic and deterministic simulations represent two different approaches to uranium process modelling. This study has indicated the necessity for each approach to be applied in the correct context. It is contended that incorrect conclusions may have been drawn by other investigators in South Africa who failed to consider the two approaches separately

  20. Improving Reading Instruction through Research-Based Instructional Strategies

    Science.gov (United States)

    Nash, Vickie Lynn

    2010-01-01

    The diverse population of students in grades 1- 3 at a suburban elementary school has created a challenge for teachers when differentiating instruction in reading. The purpose of this doctoral project study was to explore the lived experiences of these teachers as they have acquired research-based instructional strategies in reading that support…

  1. The process evaluation of two alternative participatory ergonomics intervention strategies for construction companies.

    Science.gov (United States)

    Visser, Steven; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2018-03-26

    To gain insight into the process of applying two guidance strategies - face-to-face (F2F) or e-guidance strategy (EC) - of a Participatory Ergonomics (PE) intervention and whether differences between these guidance strategies occur, 12 construction companies were randomly assigned to a strategy. The process evaluation contained reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change of individual workers. Data were assessed by logbooks, and questionnaires and interviews at baseline and/or after six months. Reach was low (1%). Dose delivered (F2F: 63%; EC: 44%), received (F2F: 42%; EC: 16%) were not sufficient. The precision and competence were sufficient for both strategies and satisfaction was strongly affected by dose received. For behavioural change, knowledge (F2F) and culture (EC) changed positively within companies. Neither strategy was delivered as intended. Compliance to the intervention was low, especially for EC. Starting with a face-to-face meeting might lead to higher compliance, especially in the EC group. Practitioner Summary: This study showed that compliance to a face-to-face and an e-guidance strategy is low. To improve the compliance, it is advised to start with a face-to-face meeting to see which parts of the intervention are needed and which guidance strategy can be used for these parts. ISRCTN73075751.

  2. Evaluating realized genetic gains from tree improvement.

    Science.gov (United States)

    J.B. St. Clair

    1993-01-01

    Tree improvement has become an essential part of the management of forest lands for wood production, and predicting yields and realized gains from forests planted with genetically-improved trees will become increasingly important. This paper discusses concepts of tree improvement and genetic gain important to growth and yield modeling, and reviews previous studies of...

  3. Improving occupational physicians' adherence to a practice guideline : feasibility and impact of a tailored implementation strategy

    NARCIS (Netherlands)

    Joosen, Margot C. W.; van Beurden, Karlijn M.; Terluin, Berend; van Weeghel, Jaap; Brouwers, Evelien P. M.; van der Klink, Jac J. L.

    2015-01-01

    Background: Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived

  4. The Evaluation of Surface Integrity During Machining of Inconel 718 with Various Laser Assistance Strategies

    Directory of Open Access Journals (Sweden)

    Wojciechowski Szymon

    2017-01-01

    Full Text Available The paper is focused on the evaluation of surface integrity formed during turning of Inconel 718 with the application of various laser assistance strategies. The primary objective of the work was to determine the relations between the applied machining strategy and the obtained surface integrity, in order to select the effective cutting conditions allowing the obtainment of high surface quality. The carried out experiment included the machining of Inconel 718 in the conventional turning conditions, as well as during the continuous laser assisted machining and sequential laser assistance. The surface integrity was evaluated by the measurements of machined surface topographies, microstructures and the microhardness. Results revealed that surface integrity of Inconel 718 is strongly affected by the selected machining strategy. The significant improvement of the surface roughness formed during machining of Inconel 718, can be reached by the application of simultaneous laser heating and cutting (LAM.

  5. Can an interprofessional tracheostomy team improve weaning to decannulation times? A quality improvement evaluation

    Science.gov (United States)

    Morrison, Melissa; Catalig, Marifel; Chris, Juliana; Pataki, Janos

    2016-01-01

    BACKGROUND: Percutaneous tracheostomy is a common procedure in the intensive care unit and, on patient transfer to the wards, there is a gap in ongoing tracheostomy management. There is some evidence that tracheostomy teams can shorten weaning to decannulation times. In response to lengthy weaning to decannulation times at Trillium Health Partners – Credit Valley Hospital site (Mississauga, Ontario), an interprofessional tracheostomy team, led by respiratory therapists and consisting of speech-language pathologists and intensive care physicians, was implemented. OBJECTIVE: To evaluate the interprofessional tracheostomy team and its impact on time from weaning off mechanical ventilation to decannulation; and time from weaning to speech-language pathology referral. METHODS: Performance metrics were collected retrospectively through chart review pre- and post-team implementation. The primary metrics evaluated were the time from weaning off mechanical ventilation to decannulation, and time to referral to speech-language pathology. RESULTS: Following implementation of the interprofessional tracheostomy team, there was no improvement in decannulation times or time from weaning to speech-language pathology referral. A significant improvement was noted in the average time to first tracheostomy tube change (36.2 days to 22.9 days; P=0.01) and average time to speech-language pathology referral following initial tracheostomy insertion (51.8 days to 26.3 days; P=0.01). CONCLUSION: An interprofessional tracheostomy team can improve the quality of tracheostomy care through earlier tracheostomy tube changes and swallowing assessment referrals. The lack of improved weaning to decannulation time was potentially due to poor adherence with established protocols as well as a change in mechanical ventilation practices. To validate the findings from this particular institution, a more rigorous quality improvement methodology should be considered in addition to strategies to improve

  6. Evaluating child care in the Family Health Strategy.

    Science.gov (United States)

    da Silva, Simone Albino; Fracolli, Lislaine Aparecida

    2016-01-01

    to evaluate the healthcare provided to children under two years old by the Family Health Strategy. evaluative, quantitative, cross-sectional study that used the Primary Care Assessment Tool - Child Version for measuring the access, longitudinality, coordination, integrality, family orientation and community orientation. a total of 586 adults responsible for children under two years old and linked to 33 health units in eleven municipalities of the state of Minas Gerais, Brazil, were interviewed. The evaluation was positive for the attributes longitudinality and coordination, and negative for access, integrality, Family orientation and community orientation. there are discrepancies between health needs of children and what is offered by the service; organizational barriers to access; absence of counter-reference; predominance of curative and long-standing and individual preventive practices; verticalization in organization of actions; and lack of good communication between professionals and users.

  7. Improving Students' Achievement in Reading Comprehension Through Think Pair Share Strategy

    OpenAIRE

    Handayani, Umami -

    2014-01-01

    This research is designed to improve the students' reading comprehension in English through Think Pair Share strategy. the objective of the research is to develop Think Pair Share to improve the students' reading comprehension. The research was conducted by using classroom action research. The finding showed that Think Pair Share strategy was successful in improving students' reading comprehension. The improvement couls be seen from the increase of students' reading scores. Besides, the fin...

  8. The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review.

    Science.gov (United States)

    Parmelli, Elena; Flodgren, Gerd; Beyer, Fiona; Baillie, Nick; Schaafsma, Mary Ellen; Eccles, Martin P

    2011-04-03

    Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of

  9. Secondary side water chemistry pH control strategy improvements

    Energy Technology Data Exchange (ETDEWEB)

    Roumiguiere, Fernando-Mario; Fandrich, Joerg; Ramminger, Ute; Hoffmann-Wankerl, Stephan; Drexler, Andreas [AREVA NP GmbH, Erlangen (Germany)

    2012-11-15

    When selecting a pH control strategy, plant design and operation characteristics have to be carefully considered. The strategy should be tailored to the plant-specific needs and requirements. Owing to the complexity of the interrelated variables, the best way is to perform a modeling with a suitable computer code. This work investigated the possibility of complementing the classic high pH all-volatile treatment (H-AVT) by addition of an organic amine at low concentrations complementarily to ammonia dosing to locally increase the pH in the water phase of the wet steam areas to counteract flow-assisted corrosion (FAC). Alternative conditioning scenarios were considered and calculated for comparative analysis using a computer code. The results obtained argue for the convenience of using ammonia as the main alkalizing agent whenever possible, avoiding multiple amine concepts and their associated drawbacks. (orig.)

  10. Improving nuclear plant management effectiveness: Aligning strategy, systems, and people

    International Nuclear Information System (INIS)

    Price, K.F.

    1991-01-01

    The effectiveness of any organization requires alignment of the appropriate financial, physical, and human resources. The manager's role is to efficiently utilize the right combination of these resources to achieve organizational objectives. In-depth studies of the nuclear programs of three major investor-owned utilities using a culture assessment process called the communication, values, and rewards (CVR) assessment have shown significant misalignments in those organizations' strategies, systems and people management. The CVR assessment related employees' perceptions of what drives their company's culture with the stated company strategic direction and management philosophies. Specifically, CVR provides a comparison of employee-held work-related values with those desired by management. Data obtained by a CVR assessment can be used to understand organizational misalignment and make changes to bring systems into alignment with corporate strategy and culture

  11. Software Process Improvement: Supporting the Linking of the Software and the Business Strategies

    Science.gov (United States)

    Albuquerque, Adriano Bessa; Rocha, Ana Regina; Lima, Andreia Cavalcanti

    The market is becoming more and more competitive, a lot of products and services depend of the software product and the software is one of the most important assets, which influence the organizations’ businesses. Considering this context, we can observe that the companies must to deal with the software, developing or acquiring, carefully. One of the perspectives that can help to take advantage of the software, supporting effectively the business, is to invest on the organization’s software processes. This paper presents an approach to evaluate and improve the processes assets of the software organizations, based on internationally well-known standards and process models. This approach is supported by automated tools from the TABA Workstation and is part of a wider improvement strategy constituted of three layers (organizational layer, process execution layer and external entity layer). Moreover, this paper presents the experience of use and their results.

  12. Sports Related Riots: Understanding Group Behavior To Improve Police Strategy

    Science.gov (United States)

    2016-03-01

    particular book is more evidence-based, using statistics and academic studies than other references. 4. Policing Strategies The University of Arizona...Research in Crime and Delinquency 7, no. 2 (1970): 123, DOI: 10.1177/002242787000700202. 59 Ibid., 129. 60 Peter Holley, “New Video Shows Texas...games provide more energy to a crowd than unimportant games and contests with a large score differential. When examining the statistics associated

  13. Improvement of business performance in restaurants using innovation strategies

    OpenAIRE

    Gagić Snježana; Tešanović Dragan; Kalenjuk Bojana

    2014-01-01

    Innovation is an important aspect of contemporary business. Rapid change in guests' preferences and expectations significantly affect the restaurant industry. Meeting the diverse hospitality needs implies making innovative programs in all processes such as technical, technological as well as service oriented. Hospitality industry enters into the process of accelerated changes of modern equipment, updated technology, business strategies and hospitality management. The paper will discuss innova...

  14. Web proxy cache replacement strategies simulation, implementation, and performance evaluation

    CERN Document Server

    ElAarag, Hala; Cobb, Jake

    2013-01-01

    This work presents a study of cache replacement strategies designed for static web content. Proxy servers can improve performance by caching static web content such as cascading style sheets, java script source files, and large files such as images. This topic is particularly important in wireless ad hoc networks, in which mobile devices act as proxy servers for a group of other mobile devices. Opening chapters present an introduction to web requests and the characteristics of web objects, web proxy servers and Squid, and artificial neural networks. This is followed by a comprehensive review o

  15. Summary of strategies for planning Productivity Improvement and Quality Enhancement (PIQE)

    Science.gov (United States)

    1986-01-01

    The Summary of NASA Strategies for Productivity Improvement and Quality Enhancement respond to NASA's eighth top goal: Establish NASA as a leader in the development and application of advanced technology and management practices which contribute to significant increases in both Agency and national productivity. The Strategies provide the framework for development of the agency-wide Productivity Improvement and Quality Enhancement (PIQE) Plans.

  16. Using Metacognitive Strategies to Improve Reading Comprehension and Solve a Word Problem

    Directory of Open Access Journals (Sweden)

    Tomo Djudin

    2017-03-01

    Full Text Available This article describes briefly the theories of metacognition and the impacts of metacognitive skills on learning. The differences between cognitive strategy and metacognitive strategy were mentioned. Some strategies to improve students’ meta cognition skills in the classroom explored as well. Based on the theories, two models of metacognitive strategies instruction for deeply understanding in reading textbook and for finding a solution of words physics problem solving were developed. These models will enable students to be independent and strategic learners.

  17. Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children

    OpenAIRE

    Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

    2014-01-01

    Background Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving ...

  18. SCOPE of Pain: An Evaluation of an Opioid Risk Evaluation and Mitigation Strategy Continuing Education Program.

    Science.gov (United States)

    Alford, Daniel P; Zisblatt, Lara; Ng, Pamela; Hayes, Sean M; Peloquin, Sophie; Hardesty, Ilana; White, Julie L

    2016-01-01

    Due to the high prevalence of prescription opioid misuse, the US Food and Drug Administration (FDA) mandated a Risk Evaluation and Mitigation Strategy (REMS) requiring manufacturers of extended-release/long-acting (ER/LA) opioid analgesics to fund continuing education based on a FDA Blueprint. This article describes the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program, an ER/LA opioid analgesic REMS program, and its impact on clinician knowledge, confidence, attitudes, and self-reported clinical practice. Participants of the 3-h SCOPE of Pain training completed pre-, immediate post- and 2-month post-assessments. The primary target group (n = 2,850), and a subset (n = 476) who completed a 2-month post-assessment, consisted of clinicians licensed to prescribe ER/LA opioid analgesics, who care for patients with chronic pain and who completed the 3-h training between February 28, 2013 and June 13, 2014. Immediately post-program, there was a significant increase in correct responses to knowledge questions (60% to 84%, P ≤ 0.02) and 87% of participants planned to make practice changes. At 2-months post-program, there continued to be a significant increase in correct responses to knowledge questions (60% to 69%, P ≤ 0.03) and 67% reported increased confidence in applying safe opioid prescribing care and 86% reported implementing practice changes. There was also an improvement in alignment of desired attitudes toward safe opioid prescribing. The SCOPE of Pain program improved knowledge, attitudes, confidence, and self-reported clinical practice in safe opioid prescribing. This national REMS program holds potential to improve the safe use of opioids for the treatment of chronic pain. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

  19. Evaluation and improvement of dynamic optimality in electrochemical reactors

    International Nuclear Information System (INIS)

    Vijayasekaran, B.; Basha, C. Ahmed

    2005-01-01

    A systematic approach for the dynamic optimization problem statement to improve the dynamic optimality in electrochemical reactors is presented in this paper. The formulation takes an account of the diffusion phenomenon in the electrode/electrolyte interface. To demonstrate the present methodology, the optimal time-varying electrode potential for a coupled chemical-electrochemical reaction scheme, that maximizes the production of the desired product in a batch electrochemical reactor with/without recirculation are determined. The dynamic optimization problem statement, based upon this approach, is a nonlinear differential algebraic system, and its solution provides information about the optimal policy. Optimal control policy at different conditions is evaluated using the best-known Pontryagin's maximum principle. The two-point boundary value problem resulting from the application of the maximum principle is then solved using the control vector iteration technique. These optimal time-varying profiles of electrode potential are then compared to the best uniform operation through the relative improvements of the performance index. The application of the proposed approach to two electrochemical systems, described by ordinary differential equations, shows that the existing electrochemical process control strategy could be improved considerably when the proposed method is incorporated

  20. Evaluation of Differentiation Strategy in Shipping Enterprises with Simulation Model

    Science.gov (United States)

    Vaxevanou, Anthi Z.; Ferfeli, Maria V.; Damianos, Sakas P.

    2009-08-01

    The present inquiring study aims at investigating the circumstances that prevail in the European Shipping Enterprises with special reference to the Greek ones. This investigation is held in order to explore the potential implementation of strategies so as to create a unique competitive advantage [1]. The Shipping sector is composed of enterprises that are mainly activated in the following three areas: the passenger, the commercial and the naval. The main target is to create a dynamic simulation model which, with reference to the STAIR strategic model, will evaluate the strategic differential choice that some of the shipping enterprises have.

  1. Randomized dynamical decoupling strategies and improved one-way key rates for quantum cryptography

    Energy Technology Data Exchange (ETDEWEB)

    Kern, Oliver

    2009-05-25

    noisy preprocessing) followed by the use of a structured block code, higher secure key rates may be obtained. For the BB84 protocol it is shown that iterating the combined preprocessing leads to an even higher gain. In order to speed up the numerical evaluation of the key rates, results of representation theory come into play. If a coherent version of the protocol is considered, the block code used in the preprocessing stage becomes a concatenated stabilizer code which is obtained by concatenating an outer random code with an inner deterministic one. This concatenated stabilizer code is used to compute an improved lower bound on the quantum capacity of a certain quantum channel (the so-called qubit depolarizing channel). (orig.)

  2. Randomized dynamical decoupling strategies and improved one-way key rates for quantum cryptography

    International Nuclear Information System (INIS)

    Kern, Oliver

    2009-01-01

    noisy preprocessing) followed by the use of a structured block code, higher secure key rates may be obtained. For the BB84 protocol it is shown that iterating the combined preprocessing leads to an even higher gain. In order to speed up the numerical evaluation of the key rates, results of representation theory come into play. If a coherent version of the protocol is considered, the block code used in the preprocessing stage becomes a concatenated stabilizer code which is obtained by concatenating an outer random code with an inner deterministic one. This concatenated stabilizer code is used to compute an improved lower bound on the quantum capacity of a certain quantum channel (the so-called qubit depolarizing channel). (orig.)

  3. Agile rediscovering values: Similarities to continuous improvement strategies

    Science.gov (United States)

    Díaz de Mera, P.; Arenas, J. M.; González, C.

    2012-04-01

    Research in the late 80's on technological companies that develop products of high value innovation, with sufficient speed and flexibility to adapt quickly to changing market conditions, gave rise to the new set of methodologies known as Agile Management Approach. In the current changing economic scenario, we considered very interesting to study the similarities of these Agile Methodologies with other practices whose effectiveness has been amply demonstrated in both the West and Japan. Strategies such as Kaizen, Lean, World Class Manufacturing, Concurrent Engineering, etc, would be analyzed to check the values they have in common with the Agile Approach.

  4. Strategies for Improving Learner Metacognition in Health Professional Education

    Science.gov (United States)

    Medina, Melissa S.; Castleberry, Ashley N.

    2017-01-01

    Metacognition is an essential skill in critical thinking and self-regulated, lifelong learning. It is important for learners to have skills in metacognition because they are used to monitor and regulate reasoning, comprehension, and problem-solving, which are fundamental components/outcomes of pharmacy curricula. Instructors can help learners develop metacognitive skills within the classroom and experiential setting by carefully designing learning activities within courses and the curriculum. These skills are developed through intentional questioning, modeling techniques, and reflection. This article discusses key background literature on metacognition and identifies specific methods and strategies to develop learners’ metacognitive skills in both the classroom and experiential settings. PMID:28630519

  5. Improvement of business performance in restaurants using innovation strategies

    Directory of Open Access Journals (Sweden)

    Gagić Snježana

    2014-01-01

    Full Text Available Innovation is an important aspect of contemporary business. Rapid change in guests' preferences and expectations significantly affect the restaurant industry. Meeting the diverse hospitality needs implies making innovative programs in all processes such as technical, technological as well as service oriented. Hospitality industry enters into the process of accelerated changes of modern equipment, updated technology, business strategies and hospitality management. The paper will discuss innovative offer design, molecular gastronomy, modern food presentation technique as well as authentic culinary products offer. By introducing such innovations, restaurants create the image of organisations following current trends as well as responding to the market requirements.

  6. Strategies for Improving Learner Metacognition in Health Professional Education.

    Science.gov (United States)

    Medina, Melissa S; Castleberry, Ashley N; Persky, Adam M

    2017-05-01

    Metacognition is an essential skill in critical thinking and self-regulated, lifelong learning. It is important for learners to have skills in metacognition because they are used to monitor and regulate reasoning, comprehension, and problem-solving, which are fundamental components/outcomes of pharmacy curricula. Instructors can help learners develop metacognitive skills within the classroom and experiential setting by carefully designing learning activities within courses and the curriculum. These skills are developed through intentional questioning, modeling techniques, and reflection. This article discusses key background literature on metacognition and identifies specific methods and strategies to develop learners' metacognitive skills in both the classroom and experiential settings.

  7. Best practices and strategies for improving rail energy efficiency

    Science.gov (United States)

    2014-01-28

    In support of the FRA Energy, Environment, and Engine (E3) program, this study reviews and evaluates technology development opportunities, equipment upgrades, and best practices (BPs) of international and U.S. passenger and freight rail industry segm...

  8. Sarcopenia: assessment of disease burden and strategies to improve outcomes

    Science.gov (United States)

    Liguori, Ilaria; Russo, Gennaro; Aran, Luisa; Bulli, Giulia; Curcio, Francesco; Della-Morte, David; Gargiulo, Gaetano; Testa, Gianluca; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

    2018-01-01

    Life expectancy is increasing worldwide, with a resultant increase in the elderly population. Aging is characterized by the progressive loss of skeletal muscle mass and strength – a phenomenon called sarcopenia. Sarcopenia has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors – in particular, nutritional status and degree of physical activity. According to the operational definition by the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia requires the presence of both low muscle mass and low muscle function, which can be defined by low muscle strength or low physical performance. Moreover, biomarkers of sarcopenia have been identified for its early detection and for a detailed identification of the main pathophysiological mechanisms involved in its development. Because sarcopenia is associated with important adverse health outcomes, such as frailty, hospitalization, and mortality, several therapeutic strategies have been identified that involve exercise training, nutritional supplementation, hormonal therapies, and novel strategies and are still under investigation. At the present time, only physical exercise has showed a positive effect in managing and preventing sarcopenia and its adverse health outcomes. Thus, further well-designed and well-conducted studies on sarcopenia are needed. PMID:29785098

  9. Obesity prevention strategies: could food or soda taxes improve health?

    Science.gov (United States)

    Encarnação, R; Lloyd-Williams, F; Bromley, H; Capewell, S

    2016-03-01

    Evidence shows that one of the main causes for rising obesity rates is excessive consumption of sugar, which is due in large part to the high sugar content of most soda and juice drinks and junk foods. Worryingly, UK and global populations are consuming increasing amounts of sugary drinks and junk foods (high in salt, sugar and saturated fats). However, there is raised public awareness, and parents in particular want something to be done to curb the alarming rise in childhood obesity. Population-wide policies (i.e. taxation, regulation, legislation, reformulation) consistently achieve greater public health gains than interventions and strategies targeted at individuals. Junk food and soda taxes are supported by increasing evidence from empirical and modelling studies. The strongest evidence base is for a tax on sugar sweetened beverages, but in order to effectively reduce consumption, that taxation needs to be at least 20%. Empirical data from a number of countries which have implemented a duty on sugar or sugary drinks shows rapid, substantial benefits. In the UK, increasing evidence from recent scientific reports consistently support substantial reductions in sugar consumption through comprehensive strategies which include a tax. Furthermore, there is increasing public support for such measures. A sugar sweetened beverages tax will happen in the UK so the question is not 'If?' but 'When?' this tax will be implemented. And, crucially, which nation will get there first? England, Ireland, Scotland or Wales?

  10. Mentoring approach improves evaluation capacity of ICTD ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Developing Evaluation Capacity in ICTD (DECI) provides researchers from five IDRC-funded projects in Asia ongoing mentorship to learn and apply the Utilization Focused Evaluation (UFE) approach to their projects. DECI demonstrates the value of mentoring as a training approach, where researchers are coached as they ...

  11. Evaluation of Electric Power Procurement Strategies by Stochastic Dynamic Programming

    Science.gov (United States)

    Saisho, Yuichi; Hayashi, Taketo; Fujii, Yasumasa; Yamaji, Kenji

    In deregulated electricity markets, the role of a distribution company is to purchase electricity from the wholesale electricity market at randomly fluctuating prices and to provide it to its customers at a given fixed price. Therefore the company has to take risk stemming from the uncertainties of electricity prices and/or demand fluctuation instead of the customers. The way to avoid the risk is to make a bilateral contact with generating companies or install its own power generation facility. This entails the necessity to develop a certain method to make an optimal strategy for electric power procurement. In such a circumstance, this research has the purpose for proposing a mathematical method based on stochastic dynamic programming and additionally considering the characteristics of the start-up cost of electric power generation facility to evaluate strategies of combination of the bilateral contract and power auto-generation with its own facility for procuring electric power in deregulated electricity market. In the beginning we proposed two approaches to solve the stochastic dynamic programming, and they are a Monte Carlo simulation method and a finite difference method to derive the solution of a partial differential equation of the total procurement cost of electric power. Finally we discussed the influences of the price uncertainty on optimal strategies of power procurement.

  12. Evaluation of Ventilation Strategies in New Construction Multifamily Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Maxwell, S.; Berger, D.; Zuluaga, M.

    2014-07-01

    In multifamily buildings, particularly in the Northeast, exhaust ventilation strategies are the norm as a means of meeting both local exhaust and whole-unit mechanical ventilation rates. The issue of where the 'fresh' air is coming from is gaining significance as air-tightness standards for enclosures become more stringent, and the 'normal leakage paths through the building envelope' disappear. CARB researchers have found that the majority of high performance, new construction, multifamily housing in the Northeast use one of four general strategies for ventilation: continuous exhaust only with no designated supply or make-up air source, continuous exhaust with ducted make-up air to apartments, continuous exhaust with supply through a make-up air device integral to the unit HVAC, and continuous exhaust with supply through a passive inlet device, such as a trickle vent. Insufficient information is available to designers on how these various systems are best applied. Product performance data are based on laboratory tests, and the assumption is that products will perform similarly in the field. Proper application involves matching expected performance at expected building pressures, but there is no guarantee that those conditions will exist consistently in the finished building. This research effort, which included several weeks of building pressure monitoring, sought to provide field validation of system performance. The performance of four substantially different strategies for providing make-up air to apartments was evaluated.

  13. Evaluation of Ventilation Strategies in New Construction Multifamily Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Maxwell, S. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Berger, D. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Zuluaga, M. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2014-07-01

    In multifamily buildings, particularly in the Northeast, exhaust ventilation strategies are the norm as a means of meeting both local exhaust and whole-unit mechanical ventilation rates. The issue of where the "fresh" air is coming from is gaining significance as air-tightness standards for enclosures become more stringent. CARB researchers have found that most new high performance, multifamily housing in the Northeast use one of four strategies for ventilation: continuous exhaust only with no designated supply or make-up air source, continuous exhaust with ducted make-up air to apartments, continuous exhaust with supply through a make-up air device integral to the unit HVAC, and continuous exhaust with supply through a passive inlet device, such as a trickle vent. Insufficient information is available to designers on how these various systems are best applied. Product performance data are based on laboratory tests, but there is no guarantee that those conditions will exist consistently in the finished building. In this research project, CARB evaluated the four ventilation strategies in the field to validate system performance.

  14. Practice Facilitator Strategies for Addressing Electronic Health Record Data Challenges for Quality Improvement: EvidenceNOW.

    Science.gov (United States)

    Hemler, Jennifer R; Hall, Jennifer D; Cholan, Raja A; Crabtree, Benjamin F; Damschroder, Laura J; Solberg, Leif I; Ono, Sarah S; Cohen, Deborah J

    2018-01-01

    Practice facilitators ("facilitators") can play an important role in supporting primary care practices in performing quality improvement (QI), but they need complete and accurate clinical performance data from practices' electronic health records (EHR) to help them set improvement priorities, guide clinical change, and monitor progress. Here, we describe the strategies facilitators use to help practices perform QI when complete or accurate performance data are not available. Seven regional cooperatives enrolled approximately 1500 small-to-medium-sized primary care practices and 136 facilitators in EvidenceNOW, the Agency for Healthcare Research and Quality's initiative to improve cardiovascular preventive services. The national evaluation team analyzed qualitative data from online diaries, site visit field notes, and interviews to discover how facilitators worked with practices on EHR data challenges to obtain and use data for QI. We found facilitators faced practice-level EHR data challenges, such as a lack of clinical performance data, partial or incomplete clinical performance data, and inaccurate clinical performance data. We found that facilitators responded to these challenges, respectively, by using other data sources or tools to fill in for missing data, approximating performance reports and generating patient lists, and teaching practices how to document care and confirm performance measures. In addition, facilitators helped practices communicate with EHR vendors or health systems in requesting data they needed. Overall, facilitators tailored strategies to fit the individual practice and helped build data skills and trust. Facilitators can use a range of strategies to help practices perform data-driven QI when performance data are inaccurate, incomplete, or missing. Support is necessary to help practices, particularly those with EHR data challenges, build their capacity for conducting data-driven QI that is required of them for participating in practice

  15. Comparing Binaural Pre-processing Strategies I: Instrumental Evaluation.

    Science.gov (United States)

    Baumgärtel, Regina M; Krawczyk-Becker, Martin; Marquardt, Daniel; Völker, Christoph; Hu, Hongmei; Herzke, Tobias; Coleman, Graham; Adiloğlu, Kamil; Ernst, Stephan M A; Gerkmann, Timo; Doclo, Simon; Kollmeier, Birger; Hohmann, Volker; Dietz, Mathias

    2015-12-30

    In a collaborative research project, several monaural and binaural noise reduction algorithms have been comprehensively evaluated. In this article, eight selected noise reduction algorithms were assessed using instrumental measures, with a focus on the instrumental evaluation of speech intelligibility. Four distinct, reverberant scenarios were created to reflect everyday listening situations: a stationary speech-shaped noise, a multitalker babble noise, a single interfering talker, and a realistic cafeteria noise. Three instrumental measures were employed to assess predicted speech intelligibility and predicted sound quality: the intelligibility-weighted signal-to-noise ratio, the short-time objective intelligibility measure, and the perceptual evaluation of speech quality. The results show substantial improvements in predicted speech intelligibility as well as sound quality for the proposed algorithms. The evaluated coherence-based noise reduction algorithm was able to provide improvements in predicted audio signal quality. For the tested single-channel noise reduction algorithm, improvements in intelligibility-weighted signal-to-noise ratio were observed in all but the nonstationary cafeteria ambient noise scenario. Binaural minimum variance distortionless response beamforming algorithms performed particularly well in all noise scenarios. © The Author(s) 2015.

  16. Models for Evaluating and Improving Architecture Competence

    National Research Council Canada - National Science Library

    Bass, Len; Clements, Paul; Kazman, Rick; Klein, Mark

    2008-01-01

    ... producing high-quality architectures. This report lays out the basic concepts of software architecture competence and describes four models for explaining, measuring, and improving the architecture competence of an individual...

  17. Software Maintenance Management Evaluation and Continuous Improvement

    CERN Document Server

    April, Alain

    2008-01-01

    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.

  18. Extreme value analysis for evaluating ozone control strategies.

    Science.gov (United States)

    Reich, Brian; Cooley, Daniel; Foley, Kristen; Napelenok, Sergey; Shaby, Benjamin

    2013-06-01

    Tropospheric ozone is one of six criteria pollutants regulated by the US EPA, and has been linked to respiratory and cardiovascular endpoints and adverse effects on vegetation and ecosystems. Regional photochemical models have been developed to study the impacts of emission reductions on ozone levels. The standard approach is to run the deterministic model under new emission levels and attribute the change in ozone concentration to the emission control strategy. However, running the deterministic model requires substantial computing time, and this approach does not provide a measure of uncertainty for the change in ozone levels. Recently, a reduced form model (RFM) has been proposed to approximate the complex model as a simple function of a few relevant inputs. In this paper, we develop a new statistical approach to make full use of the RFM to study the effects of various control strategies on the probability and magnitude of extreme ozone events. We fuse the model output with monitoring data to calibrate the RFM by modeling the conditional distribution of monitoring data given the RFM using a combination of flexible semiparametric quantile regression for the center of the distribution where data are abundant and a parametric extreme value distribution for the tail where data are sparse. Selected parameters in the conditional distribution are allowed to vary by the RFM value and the spatial location. Also, due to the simplicity of the RFM, we are able to embed the RFM in our Bayesian hierarchical framework to obtain a full posterior for the model input parameters, and propagate this uncertainty to the estimation of the effects of the control strategies. We use the new framework to evaluate three potential control strategies, and find that reducing mobile-source emissions has a larger impact than reducing point-source emissions or a combination of several emission sources.

  19. A novel control strategy to improve the performances of heated wire humidifiers in artificial neonatal ventilation

    International Nuclear Information System (INIS)

    Schena, E; Saccomandi, P; Ramandi, C; Silvestri, S

    2012-01-01

    Controlling thermo-hygrometric conditions of gas delivered in neonatal mechanical ventilation shows some unresolved issues due to the design and control strategies implemented in heated wire humidifiers. We perform an in vitro evaluation of humidifier performances, which use a control strategy based on a single-point temperature as feedback, and propose a novel design of the control which consists in pre-warming the gas upwards in the humidification chamber. The ad hoc developed control approach based on a theoretical model is implemented in vitro with and without pre-warming for comparative purposes. Without pre-warming, gas at the chamber outlet needs further post-warming and, depending on the flow rate, the vapour content condensates along the breathing circuit. Whereas, with pre-warming, the proposed control strategy allows us to considerably improve steady-state thermo-hygrometric conditions (T = 37 ± 1 °C, RH = 96% ± 4%) of gas, reaching the Y-piece near to ideal ones in the whole flow rate range, even though a high inlet chamber temperature is required at low flow rate values. The proposed solution, as theoretically predicted, also allows us to limit the vapour condensation along the circuit. (paper)

  20. Strategies for university improvement: The research profile change ...

    African Journals Online (AJOL)

    Universities worldwide experience continual change in order to achieve what is perceived as improvement. In these changes, there is usually an emphasis on the research function of a university, and the literature contains a number of themes in this regard. We contribute by presenting a detailed case study of a ...

  1. Strategies to Improve Learning of All Students in a Class

    Science.gov (United States)

    Suraishkumar, G. K.

    2018-01-01

    The statistical distribution of the student learning abilities in a typical undergraduate engineering class poses a significant challenge to simultaneously improve the learning of all the students in the class. With traditional instruction styles, the students with significantly high learning abilities are not satisfied due to a feeling of…

  2. Strategies to Improve the Quality of Health Care - Learning from ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Improving access to primary health care and the quality of services in Latin American countries is urgently needed to address high health inequities in the region. ... International Water Resources Association, in close collaboration with IDRC, is holding a webinar titled “Climate change and adaptive water management: ...

  3. Core Self-Evaluations and Individual Strategies of Coping with Unemployment among Displaced Spanish Workers.

    Science.gov (United States)

    Virkes, Tihana; Maslić Seršić, Darja; Lopez-Zafra, Esther

    2017-10-30

    Unemployment has negative but also positive effects on mental health and general well-being depending on which coping strategies the individual use. Our aim was to determine the contribution of core self-evaluations in explaining the coping strategies of job search and job devaluation, as well as to test the potential moderation effect of job search and mediation effect of job devaluation on the relationship between self core-evaluations and both positive and negative experience of unemployment. One hundred seventy-eight individuals who lost their jobs involuntarily for a longer period than one month completed a questionnaire while attending to employment office. Results show that there is a significant relation between core-self evaluations and job devaluation (.37**). Furthermore, core-self evaluations were positively related to positive experience of unemployment (r = .31; p unemployment (r = .60; p unemployment strategies (job devaluation; β = .26; p unemployment. But, individuals with a longer duration of the current period of unemployment and higher core self-evaluations had a more positive experience of unemployment, and job devaluation partially mediated this relation (SE = .002; p = .038). These results imply that programs interventions should include the improvement of core self-evaluations and the positive experience of unemployed people.

  4. An evaluation of management strategies for Atlantic tuna stocks

    Directory of Open Access Journals (Sweden)

    L. T. Kell

    2003-04-01

    Full Text Available International agreements for the International Commission for the Conservation of Atlantic Tunas (ICCAT convention area imply that Atlantic tuna stocks should be managed by strategies based on maximum sustainable yield (MSY; however, there is concern whether this will actually ensure sustainability with sufficiently high probability consistent with the principals of the precautionary approach. Therefore, the performance of MSY management strategies based on current assessment procedures was evaluated using a computer simulation framework. The framework includes the data collection, assessment, prediction, and management processes, as well as the implementation of management regulations. It therefore provides an integrated way to evaluate the relative importance of and the interactions between each component of the system with regard to the overall success of the management strategy. The study elucidates guidelines about assessment and management that are general enough to be applied to all tunas in the Atlantic Ocean. It does so by comparing different hypotheses about management and assessment for three stocks (North Atlantic albacore, Atlantic bigeye and East Atlantic skipjack, which are representative of the variety encountered (i.e. from data rich to poor and tropical to temperate waters in ICCAT stocks. Management performance was especially sensitive to the carrying capacity of the stock. The type of proxy used for MSY was more important to the success of the procedure than the frequency of assessment or the number of indices used in the assessment. Whilst the procedure was successful at achieving the management objectives for albacore, it was only partially successful for bigeye and was too conservative for skipjack.

  5. Novel Strategy to Improve the Performance of Localization in WSN

    Directory of Open Access Journals (Sweden)

    M. Vasim Babu

    2015-01-01

    Full Text Available A novel strategy of discrete energy consumption model for WSN based on quasi Monte Carlo and crude Monte Carlo method is developed. In our model the discrete hidden Markov process plays a major role in analyzing the node location in heterogeneous media. In this energy consumption model we use both static and dynamic sensor nodes to monitor the optimized energy of all sensor nodes in which every sensor state can be considered as the dynamic Bayesian network. By using this method the power is assigned in terms of dynamic manner to each sensor over discrete time steps to control the graphical structure of our network. The simulation and experiment result shows that our proposed methods are better in terms of localization accuracy and possess minimum computational time over existing localization method.

  6. Root Traits and Phenotyping Strategies for Plant Improvement.

    Science.gov (United States)

    Paez-Garcia, Ana; Motes, Christy M; Scheible, Wolf-Rüdiger; Chen, Rujin; Blancaflor, Elison B; Monteros, Maria J

    2015-06-15

    Roots are crucial for nutrient and water acquisition and can be targeted to enhance plant productivity under a broad range of growing conditions. A current challenge for plant breeding is the limited ability to phenotype and select for desirable root characteristics due to their underground location. Plant breeding efforts aimed at modifying root traits can result in novel, more stress-tolerant crops and increased yield by enhancing the capacity of the plant for soil exploration and, thus, water and nutrient acquisition. Available approaches for root phenotyping in laboratory, greenhouse and field encompass simple agar plates to labor-intensive root digging (i.e., shovelomics) and soil boring methods, the construction of underground root observation stations and sophisticated computer-assisted root imaging. Here, we summarize root architectural traits relevant to crop productivity, survey root phenotyping strategies and describe their advantages, limitations and practical value for crop and forage breeding programs.

  7. Root Traits and Phenotyping Strategies for Plant Improvement

    Directory of Open Access Journals (Sweden)

    Ana Paez-Garcia

    2015-06-01

    Full Text Available Roots are crucial for nutrient and water acquisition and can be targeted to enhance plant productivity under a broad range of growing conditions. A current challenge for plant breeding is the limited ability to phenotype and select for desirable root characteristics due to their underground location. Plant breeding efforts aimed at modifying root traits can result in novel, more stress-tolerant crops and increased yield by enhancing the capacity of the plant for soil exploration and, thus, water and nutrient acquisition. Available approaches for root phenotyping in laboratory, greenhouse and field encompass simple agar plates to labor-intensive root digging (i.e., shovelomics and soil boring methods, the construction of underground root observation stations and sophisticated computer-assisted root imaging. Here, we summarize root architectural traits relevant to crop productivity, survey root phenotyping strategies and describe their advantages, limitations and practical value for crop and forage breeding programs.

  8. What are the most effective strategies for improving quality and safety of health care?

    Science.gov (United States)

    Scott, I

    2009-06-01

    There is now a plethora of different quality improvement strategies (QIS) for optimizing health care, some clinician/patient driven, others manager/policy-maker driven. Which of these are most effective remains unclear despite expressed concerns about potential for QIS-related patient harm and wasting of resources. The objective of this study was to review published literature assessing the relative effectiveness of different QIS. Data sources comprising PubMed Clinical Queries, Cochrane Library and its Effective Practice and Organization of Care database, and HealthStar were searched for studies of QIS between January 1985 and February 2008 using search terms based on an a priori QIS classification suggested by experts. Systematic reviews of controlled trials were selected in determining effect sizes for specific QIS, which were compared as a narrative meta-review. Clinician/patient driven QIS were associated with stronger evidence of efficacy and larger effect sizes than manager/policy-maker driven QIS. The most effective strategies (>10% absolute increase in appropriate care or equivalent measure) included clinician-directed audit and feedback cycles, clinical decision support systems, specialty outreach programmes, chronic disease management programmes, continuing professional education based on interactive small-group case discussions, and patient-mediated clinician reminders. Pay-for-performance schemes directed to clinician groups and organizational process redesign were modestly effective. Other manager/policy-maker driven QIS including continuous quality improvement programmes, risk and safety management systems, public scorecards and performance reports, external accreditation, and clinical governance arrangements have not been adequately evaluated with regard to effectiveness. QIS are heterogeneous and methodological flaws in much of the evaluative literature limit validity and generalizability of results. Based on current best available evidence

  9. Evaluation of SO2 compliance strategies at Virginia Power

    International Nuclear Information System (INIS)

    Presley, J.V.; Tomlinson, M.; Ulmer, R.H.

    1992-01-01

    This paper will address the process undertaken by Virginia Power to assess SO 2 control strategies available for complying with the Revised Clean Air Act. In April 1990, in anticipation of the passage of an amended Clean Air Act, Virginia Power assembled a task force of personnel from a wide cross section of the company. This task force was given the responsibility of providing an assessment of the requirements of the new legislation, evaluating compliance alternatives and providing recommendations for implementation of the least cost alternative. Twenty-four potential SO 2 compliance options were identified for evaluation for Phase I. These options included various levels of coal switching, gas co-firing and scrubbing. Each option was evaluated and compared to a base case which assumed no SO 2 control. As a result of our evaluations, the lowest cost and least risk approach to Phase I SO 2 compliance for Virginia Power appears to be to construct a scrubber for one unit (550 MW g ) at our Mt. Storm Power Station

  10. A strategy for improved computational efficiency of the method of anchored distributions

    Science.gov (United States)

    Over, Matthew William; Yang, Yarong; Chen, Xingyuan; Rubin, Yoram

    2013-06-01

    This paper proposes a strategy for improving the computational efficiency of model inversion using the method of anchored distributions (MAD) by "bundling" similar model parametrizations in the likelihood function. Inferring the likelihood function typically requires a large number of forward model (FM) simulations for each possible model parametrization; as a result, the process is quite expensive. To ease this prohibitive cost, we present an approximation for the likelihood function called bundling that relaxes the requirement for high quantities of FM simulations. This approximation redefines the conditional statement of the likelihood function as the probability of a set of similar model parametrizations "bundle" replicating field measurements, which we show is neither a model reduction nor a sampling approach to improving the computational efficiency of model inversion. To evaluate the effectiveness of these modifications, we compare the quality of predictions and computational cost of bundling relative to a baseline MAD inversion of 3-D flow and transport model parameters. Additionally, to aid understanding of the implementation we provide a tutorial for bundling in the form of a sample data set and script for the R statistical computing language. For our synthetic experiment, bundling achieved a 35% reduction in overall computational cost and had a limited negative impact on predicted probability distributions of the model parameters. Strategies for minimizing error in the bundling approximation, for enforcing similarity among the sets of model parametrizations, and for identifying convergence of the likelihood function are also presented.

  11. Improving Student Vocabulary Mastery Using Word Mapping Strategy

    OpenAIRE

    Satuna Indah Wardani

    2015-01-01

    Abstract: The purpose of this study was to find out whether the word mapping strategywas able to improve the students’ vocabulary mastery. The process of masteringis mainly affected by the worst thought of the vocational students who said that English as the most difficult subject to learn and was often tracked into boringcondition since theywere not involved in the process of learning. Thisstudy was conducted by using classroom action research in two cycles and each cycleconsisted of four me...

  12. 77 FR 26292 - Risk Evaluation and Mitigation Strategy Assessments: Social Science Methodologies to Assess Goals...

    Science.gov (United States)

    2012-05-03

    ...] Risk Evaluation and Mitigation Strategy Assessments: Social Science Methodologies to Assess Goals... announcing a public workshop entitled ``Risk Evaluation and Mitigation Strategy Assessments: Social Science... constructive dialogue and information-sharing among regulators, researchers, the pharmaceutical industry...

  13. KNK steam generator leakage, evaluations and improvements

    International Nuclear Information System (INIS)

    Dumm, K.; Ratzel, W.

    1975-01-01

    On September 23, 1972 the KNK reactor was shut down due to a sodium-water reaction. Detection, localisation and possible leak development are described and discussed. Improvements on the KNK steam generator system due to this leak experience are explained. (author)

  14. KNK steam generator leakage, evaluations and improvements

    Energy Technology Data Exchange (ETDEWEB)

    Dumm, K; Ratzel, W

    1975-07-01

    On September 23, 1972 the KNK reactor was shut down due to a sodium-water reaction. Detection, localisation and possible leak development are described and discussed. Improvements on the KNK steam generator system due to this leak experience are explained. (author)

  15. Instructional strategies to improve women's attitudes toward science

    Science.gov (United States)

    Newbill, Phyllis Leary

    Although negative attitudes toward science are common among women and men in undergraduate introductory science classes, women's attitudes toward science tend to be more negative than men's. The reasons for women's negative attitudes toward science include lack of self-confidence, fear of association with social outcasts, lack of women role models in science, and the fundamental differences between traditional scientific and feminist values. Attitudes are psychological constructs theorized to be composed of emotional, cognitive, and behavioral components. Attitudes serve functions, including social expressive, value expressive, utilitarian, and defensive functions, for the people who hold them. To change attitudes, the new attitudes must serve the same function as the old one, and all three components must be treated. Instructional designers can create instructional environments to effect attitude change. In designing instruction to improve women's attitudes toward science, instructional designers should (a) address the emotions that are associated with existing attitudes, (b) involve credible, attractive women role models, and (c) address the functions of the existing attitudes. Two experimental instructional modules were developed based on these recommendations, and two control modules were developed that were not based on these recommendations. The asynchronous, web-based modules were administered to 281 undergraduate geology and chemistry students at two universities. Attitude assessment revealed that attitudes toward scientists improved significantly more in the experimental group, although there was no significant difference in overall attitudes toward science. Women's attitudes improved significantly more than men's in both the experimental and control groups. Students whose attitudes changed wrote significantly more in journaling activities associated with the modules. Qualitative analysis of journals revealed that the guidelines worked exactly as predicted

  16. Gene transfer strategies for improving radiolabeled peptide imaging and therapy

    International Nuclear Information System (INIS)

    Rogers, B.E.; Buchsbaum, D.J.; Zinn, K.R.

    2000-01-01

    Utilization of molecular biology techniques offers attractive options in nuclear medicine for improving cancer imaging and therapy with radiolabeled peptides. Two of these options include utilization of phage-panning to identify novel tumor specific peptides or single chain antibodies and gene transfer techniques to increase the antibodies and gene transfer techniques to increase the number of antigen/receptor sites expressed on malignant cells. The group has focused on the latter approach for improving radiolabeled peptide imaging and therapy. The most widely used gene transfer vectors in clinical gene therapy trials include retrovirus, cationic lipids and adenovirus. It has been utilized adenovirus vectors for gene transfer because of their ability to accomplish efficient in vivo gene transfer. Adenovirus vectors encoding the genes for a variety of antigens/receptors (carcinoembryonic antigen, gastrin-releasing peptide receptor, somatostatin receptor subtype 2 (SSTr2) have all shown that their expression is increased on cancer cells both in vitro and in vivo following adenovirus infection. Of particular interest has been the adenovirus encoding for SSTr2 (AdCMVSSTr2). Various radioisotopes have been attached to somatostatin analogues for imaging and therapy of SSTr2-positive tumors both clinically and in animal models. The use of these analogues in combination with AdCMVSSTr2 is a promising approach for improving the detection sensitivity and therapeutic efficacy of these radiolabeled peptides against solid tumors. In addition, it has been proposed the use of SSTr2 as a marker for imaging the expression of another cancer therapeutic transgene (e.g. cytosine deaminase, thymidine kinase) encoded within the same vector. This would allow for non-invasive monitoring of gene delivery to tumor sites

  17. Strategies for Improving Nursing Students' Mental Health Clinical Rotation.

    Science.gov (United States)

    Kroning, Maureen

    2016-01-01

    Mental illness is a huge problem many people face in the U.S. and around the world. The American Psychiatric Nurses Association indicates there is a shortage of nurses in every level and role in psychiatric-mental health nursing. Raising up a generation of nurses who want to work with the mentally ill is a challenge for nurse educators. The use of role playing and simulation in the learning lab prior to entering the clinical setting and reflective journaling in the clinical rotation can improve undergraduate nursing students' mental health clinical experience.

  18. Emissions and Fuel Consumption Modeling for Evaluating Environmental Effectiveness of ITS Strategies

    Directory of Open Access Journals (Sweden)

    Yuan-yuan Song

    2013-01-01

    Full Text Available Road transportation is a major fuel consumer and greenhouse gas emitter. Recently, the intelligent transportation systems (ITSs technologies, which can improve traffic flow and safety, have been developed to reduce the fuel consumption and vehicle emissions. Emission and fuel consumption estimation models play a key role in the evaluation of ITS technologies. Based on the influence analysis of driving parameters on vehicle emissions, this paper establishes a set of mesoscopic vehicle emission and fuel consumption models using the real-world vehicle operation and emission data. The results demonstrate that these models are more appropriate to evaluate the environmental effectiveness of ITS strategies with enough estimation accuracy.

  19. Evaluation of Corrosion Inhibitors as Lubricity Improvers

    Science.gov (United States)

    1988-07-01

    Whatman, obtained from Alltech Associates). 10 The mobile phase compositions evaluated included blends of methanol, isopropanol, and aqueous buffers...developed takes advantage of the unique properties of the CI components and the ability of RPHPLC to resolve those components. All of the approved CI

  20. Improved methods to evaluate realised energy savings

    NARCIS (Netherlands)

    Boonekamp, P.G.M.

    2005-01-01

    This thesis regards the calculation of realised energy savings at national and sectoral level, and the policy contribution to total savings. It is observed that the results of monitoring and evaluation studies on realised energy savings are hardly applied in energy saving policy. Causes are the lack

  1. Effective intervention strategies to improve health outcomes for cardiovascular disease patients with low health literacy skills: a systematic review.

    Science.gov (United States)

    Lee, Tae Wha; Lee, Seon Heui; Kim, Hye Hyun; Kang, Soo Jin

    2012-12-01

    Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes. Copyright © 2012. Published by Elsevier B.V.

  2. Coating Strategies to Improve Lithium-ion Battery Safety

    Energy Technology Data Exchange (ETDEWEB)

    Travis, Jonathan [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Orendorff, Christopher J. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    This work investigated the effects of Al2O3 ALD coatings on the performance and thermal abuse tolerance of graphite based anodes and Li(NixMnyCoz)O2 (NMC) based cathodes. It was found that 5 cycles of Al2O3 ALD on the graphite anode increased the onset temperature of thermal runaway by approximately 20 °C and drastically reduced the anode’s contribution to the overall amount of heat released during thermal runaway. Although Al2O3 ALD improves the cycling stability of NMC based cathodes, the thermal abuse tolerance was not greatly improved. A series of conductive aluminum oxide/carbon composites were created and characterized as potential thicker protective coatings for use on NMC based cathode materials. A series of electrodes were coated with manganese monoxide ALD to test the efficacy of an oxygen scavenging coating on NMC based cathodes.

  3. Improved district heating substation efficiency with a new control strategy

    International Nuclear Information System (INIS)

    Gustafsson, Jonas; Delsing, Jerker; Deventer, Jan van

    2010-01-01

    In this paper, we describe a new alternative control approach for indirectly connected district heating substations. Simulations results showed that the new approach results in an increased ΔT across the substation. Results were obtained for both ideal and non-ideal operation of the system, meaning that less water must be pumped through the district heating network, and a higher overall fuel efficiency can be obtained in the district heating power plants. When a higher fuel efficiency is achieved, the usage of primary fuel sources can be reduced. Improved efficiency also increases the effective heat transfer capacity of a district heating network, allowing more customers to be connected to an existing network without increasing the heating plant or network capacity. Also, if combined heat and power plants are used to produce the heat, the increased ΔT will result in a further improved overall fuel efficiency, as more electricity can be produced with colder cooling water. The idea behind the new control method is to consider the temperature of the water supplying the district heating substation with heat, often referred to as the primary supply temperature. This represents a logical next step, as currently, the only parameter generally taken into account or measured when controlling the temperature level of the radiator circuit is the local outdoor temperature. In this paper we show how the primary supply temperature together with thermodynamic knowledge of the building can be used to maximize the ΔT across the district heating substation.

  4. Improving Student Vocabulary Mastery Using Word Mapping Strategy

    Directory of Open Access Journals (Sweden)

    Satuna Indah Wardani

    2015-05-01

    Full Text Available Abstract: The purpose of this study was to find out whether the word mapping strategywas able to improve the students’ vocabulary mastery. The process of masteringis mainly affected by the worst thought of the vocational students who said that English as the most difficult subject to learn and was often tracked into boringcondition since theywere not involved in the process of learning. Thisstudy was conducted by using classroom action research in two cycles and each cycleconsisted of four meetings. The subject of the research was the third grade of Accounting Department at State Vocational School 1 Pamekasan whichconsisted of 34 students. The research was carried out for one month.Theinstruments used to obtained primary data and the secondary data were vocabulary test, the students’ observation sheets, and questionnaire of the respondent.The result of test in preliminary until the test in cycle two showed that there was the improvement of the number of students who passed the test. Hopefully, this outcome will certainly be useful for both teachers and students in which its harmony will give the progress for learning English,especially vocabulary mastery. 

  5. Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.

    Science.gov (United States)

    Forman-Hoffman, Valerie L; Middleton, Jennifer Cook; McKeeman, Joni L; Stambaugh, Leyla F; Christian, Robert B; Gaynes, Bradley N; Kane, Heather Lynne; Kahwati, Leila C; Lohr, Kathleen N; Viswanathan, Meera

    2017-07-24

    Some outcomes for children with mental health problems remain suboptimal because of poor access to care and the failure of systems and providers to adopt established quality improvement strategies and interventions with proven effectiveness. This review had three goals: (1) assess the effectiveness of quality improvement, implementation, and dissemination strategies intended to improve the mental health care of children and adolescents; (2) examine harms associated with these strategies; and (3) determine whether effectiveness or harms differ for subgroups based on system, organizational, practitioner, or patient characteristics. Sources included MEDLINE®, the Cochrane Library, PsycINFO, and CINAHL, from database inception through February 17, 2017. Additional sources included gray literature, additional studies from reference lists, and technical experts. Two reviewers selected relevant randomized controlled trials (RCTs) and observational studies, extracted data, and assessed risk of bias. Dual analysis, synthesis, and grading of the strength of evidence for each outcome followed for studies meeting inclusion criteria. We also used qualitative comparative analysis to examine relationships between combinations of strategy components and improvements in outcomes. We identified 18 strategies described in 19 studies. Eleven strategies significantly improved at least one measure of intermediate outcomes, final health outcomes, or resource use. Moderate strength of evidence (from one RCT) supported using provider financial incentives such as pay for performance to improve the competence with which practitioners can implement evidence-based practices (EBPs). We found inconsistent evidence involving strategies with educational meetings, materials, and outreach; programs appeared to be successful in combination with reminders or providing practitioners with newly collected clinical information. We also found low strength of evidence for no benefit for initiatives that

  6. Virtual strategies to improve transversal competences, using wikis in a collaborative work

    Science.gov (United States)

    Guinau, Marta; Playa, Elisabet

    2016-04-01

    A major educational aim in university degrees since the implementation of the European Credit Transfer System (ECTS) on the European universities is the work based on transversal competences. However, the first course students arrive at the Spanish universities with important deficiencies on some of these competences, especially regarding on oral and written expression, time management and collaborative work. The experience of the teachers involved in this work has revealed the coordination difficulty between the students to work in group, important deficiencies on information management and the stress caused by the oral presentations. The results presented here correspond to a teaching innovation project. It is based on: a) the development of works in groups of 3 or 4 students, proposed as flipped classrooms strategy and b) the implementation of a virtual tool (a wiki). This tool helps the students with scientific information management and facilitates the access of all the students belonging to the work group at the information provided by colleagues. The wiki also improves the monitoring and evaluation of the work and contributions of each student by teachers. Each group must develop a topic related to the subject - General Geology and Geochemistry - that the group chose from a list of earth sciences topics proposed by teachers. The resulting works are presented in poster and oral presentations (10 min. per group and 5 min. for questions). Each work is evaluated by teachers using the evidences provided on the wiki and by means of evaluation guides. Moreover, the students must self and co-evaluate the presented works. The implementation of this project has provided information to analyze the impact of these strategies and to quantify it in terms of 'Learning Analytics'.

  7. Do clinical safety charts improve paramedic key performance indicator results? (A clinical improvement programme evaluation).

    Science.gov (United States)

    Ebbs, Phillip; Middleton, Paul M; Bonner, Ann; Loudfoot, Allan; Elliott, Peter

    2012-07-01

    Is the Clinical Safety Chart clinical improvement programme (CIP) effective at improving paramedic key performance indicator (KPI) results within the Ambulance Service of New South Wales? The CIP intervention area was compared with the non-intervention area in order to determine whether there was a statistically significant improvement in KPI results. The CIP was associated with a statistically significant improvement in paramedic KPI results within the intervention area. The strategies used within this CIP are recommended for further consideration.

  8. New evaluation methodology of regenerative braking contribution to energy efficiency improvement of electric vehicles

    International Nuclear Information System (INIS)

    Qiu, Chengqun; Wang, Guolin

    2016-01-01

    Highlights: • Two different contribution ratio evaluation parameters according to the deceleration braking process are proposed. • Methodologies for calculating the contribution made by regenerative brake to improve vehicle energy efficiency are proposed. • Road test results imply that the proposed parameters are effective. - Abstract: Comprehensive research is conducted on the design and control of a regenerative braking system for electric vehicles. The mechanism and evaluation methods of contribution brought by regenerative braking to improve electric vehicle’s energy efficiency are discussed and analyzed by the energy flow. Methodologies for calculating the contribution made by regenerative brake are proposed. Additionally a new regenerative braking control strategy called “serial 2 control strategy” is introduced. Moreover, two control strategies called “parallel control strategy” and “serial 1 control strategy” are proposed as the comparative control strategy. Furthermore, two different contribution ratio evaluation parameters according to the deceleration braking process are proposed. Finally, road tests are carried out under China typical city regenerative driving cycle standard with three different control strategies. The serial 2 control strategy offers considerably higher regeneration efficiency than the parallel strategy and serial 1 strategy.

  9. Strategies for improving participation in diabetes education. A qualitative study.

    Directory of Open Access Journals (Sweden)

    Ingmar Schäfer

    Full Text Available OBJECTIVE: Diabetes mellitus is highly prevalent and can lead to serious complications and mortality. Patient education can help to avoid negative outcomes, but up to half of the patients do not participate. The aim of this study was to analyze patients' attitudes towards diabetes education in order to identify barriers to participation and develop strategies for better patient education. METHODS: We conducted a qualitative study. Seven GP practices were purposively selected based on socio-demographic data of city districts in Hamburg, Germany. Study participants were selected by their GPs in order to increase participation. Semi-structured face-to-face interviews were conducted with 14 patients. Interviews were audiotaped and transcribed verbatim. The sample size was determined by data saturation. Data were analysed by qualitative content analysis. Categories were determined deductively and inductively. RESULTS: The interviews yielded four types of barriers: 1 Statements and behaviour of the attending physician influence the patients' decisions about diabetes education. 2 Both, a good state of health related to diabetes and physical/psychosocial comorbidity can be reasons for non-participation. 3 Manifold motivational factors were discussed. They ranged from giving low priority to diabetes to avoidance of implications of diabetes education as being confronted with illness narratives of others. 4 Barriers also include aspects of the patients' knowledge and activity. CONCLUSIONS: First, physicians should encourage patients to participate in diabetes education and argue that they can profit even if actual treatment and examination results are promising. Second, patients with other priorities, psychic comorbidity or functional limitations might profit more from continuous individualized education adapted to their specific situation instead of group education. Third, it might be justified that patients do not participate in diabetes education if

  10. Strategies for improving participation in diabetes education. A qualitative study.

    Science.gov (United States)

    Schäfer, Ingmar; Pawels, Marc; Küver, Claudia; Pohontsch, Nadine Janis; Scherer, Martin; van den Bussche, Hendrik; Kaduszkiewicz, Hanna

    2014-01-01

    Diabetes mellitus is highly prevalent and can lead to serious complications and mortality. Patient education can help to avoid negative outcomes, but up to half of the patients do not participate. The aim of this study was to analyze patients' attitudes towards diabetes education in order to identify barriers to participation and develop strategies for better patient education. We conducted a qualitative study. Seven GP practices were purposively selected based on socio-demographic data of city districts in Hamburg, Germany. Study participants were selected by their GPs in order to increase participation. Semi-structured face-to-face interviews were conducted with 14 patients. Interviews were audiotaped and transcribed verbatim. The sample size was determined by data saturation. Data were analysed by qualitative content analysis. Categories were determined deductively and inductively. The interviews yielded four types of barriers: 1) Statements and behaviour of the attending physician influence the patients' decisions about diabetes education. 2) Both, a good state of health related to diabetes and physical/psychosocial comorbidity can be reasons for non-participation. 3) Manifold motivational factors were discussed. They ranged from giving low priority to diabetes to avoidance of implications of diabetes education as being confronted with illness narratives of others. 4) Barriers also include aspects of the patients' knowledge and activity. First, physicians should encourage patients to participate in diabetes education and argue that they can profit even if actual treatment and examination results are promising. Second, patients with other priorities, psychic comorbidity or functional limitations might profit more from continuous individualized education adapted to their specific situation instead of group education. Third, it might be justified that patients do not participate in diabetes education if they have slightly increased blood sugar values only and no

  11. Evaluating Internal Model Strength and Performance of Myoelectric Prosthesis Control Strategies.

    Science.gov (United States)

    Shehata, Ahmed W; Scheme, Erik J; Sensinger, Jonathon W

    2018-05-01

    On-going developments in myoelectric prosthesis control have provided prosthesis users with an assortment of control strategies that vary in reliability and performance. Many studies have focused on improving performance by providing feedback to the user but have overlooked the effect of this feedback on internal model development, which is key to improve long-term performance. In this paper, the strength of internal models developed for two commonly used myoelectric control strategies: raw control with raw feedback (using a regression-based approach) and filtered control with filtered feedback (using a classifier-based approach), were evaluated using two psychometric measures: trial-by-trial adaptation and just-noticeable difference. The performance of both strategies was also evaluated using Schmidt's style target acquisition task. Results obtained from 24 able-bodied subjects showed that although filtered control with filtered feedback had better short-term performance in path efficiency ( ), raw control with raw feedback resulted in stronger internal model development ( ), which may lead to better long-term performance. Despite inherent noise in the control signals of the regression controller, these findings suggest that rich feedback associated with regression control may be used to improve human understanding of the myoelectric control system.

  12. Risk evaluation mitigation strategies: the evolution of risk management policy.

    Science.gov (United States)

    Hollingsworth, Kristen; Toscani, Michael

    2013-04-01

    The United States Food and Drug Administration (FDA) has the primary regulatory responsibility to ensure that medications are safe and effective both prior to drug approval and while the medication is being actively marketed by manufacturers. The responsibility for safe medications prior to marketing was signed into law in 1938 under the Federal Food, Drug, and Cosmetic Act; however, a significant risk management evolution has taken place since 1938. Additional federal rules, entitled the Food and Drug Administration Amendments Act, were established in 2007 and extended the government's oversight through the addition of a Risk Evaluation and Mitigation Strategy (REMS) for certain drugs. REMS is a mandated strategy to manage a known or potentially serious risk associated with a medication or biological product. Reasons for this extension of oversight were driven primarily by the FDA's movement to ensure that patients and providers are better informed of drug therapies and their specific benefits and risks prior to initiation. This article provides an historical perspective of the evolution of medication risk management policy and includes a review of REMS programs, an assessment of the positive and negative aspects of REMS, and provides suggestions for planning and measuring outcomes. In particular, this publication presents an overview of the evolution of the REMS program and its implications.

  13. IMPROVEMENT OF MANGOSTEEN FARMING AND POSTHARVEST HANDLING STRATEGIES BASED ON GLOBAL GAP STANDARD AT KIARA PEDES, PURWAKARTA DISTRICT

    Directory of Open Access Journals (Sweden)

    Nanda Erlangga

    2012-09-01

    Full Text Available The objectives of this research were (1 to determine the value chain of mangosteen at Kiara Pedes Sub district, Purwakarta District, (2 to identify the gap between actual condition at Kiara Pedes and Global GAP standard, (3 to identify internal and external factors that can affect the implementation strategy of Global GAP standards, and (4 to develop alternative strategies that can be applied to improve the system of mangosteen cultivation and post harvest handling based on Global GAP standards. The analytical tools being used in this study were value chain analysis, gap analysis, internal and external factor evaluation (IFE, EFE, IE matrix, SWOT analysis, and quantitative strategic planning matrix (QSPM. Identified primary actors in mangosteen value chain were farmers, middlemen, suppliers, exporters, and local and overseas retailers. Based on IE Matrix and SWOT analysis, the strategies to implement Global GAP standards were (a to increase mangosteen productivity and improve its quality by using developed cultivation and postharvest technology, (b to increase productivity, and improve quality and transportation network in accordance with Global GAP standard, (c to improve clean water and post-harvest infrastructure through cooperation with exporters and financial institutions, and (d to improve warehouse and supporting facilities such as packaging and sanitation according to the Global GAP standard for minimizing the environmental constraints. The most priority strategies from the QSPM analysis were improving clean water and post-harvest infrastructure through cooperation with exporters and financial institutions, followed by using the developed cultivation and postharvest technology to increase mangosteen productivity and improve its quality.Keywords: Mangosteen, Global GAP Standard, Value Chain, Improvement Strategies, Farming and Postharvest Handling Practices

  14. Communicating Grammatically: Evaluating a Learner Strategy Website for Spanish Grammar

    Science.gov (United States)

    Cohen, Andrew D.; Pinilla-Herrera, Angela; Thompson, Jonathan R.; Witzig, Lance E.

    2011-01-01

    After a brief introduction to language learner strategies and grammar strategies as a subcategory, it is pointed out that research on the use of grammar strategies by learners of a second language (L2) has been limited. The article then describes the construction of a website with strategies for learning and performing Spanish grammar, with a…

  15. The Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Holmberg, Teresa; Rothmann, Mette Juel

    2015-01-01

    The risk-stratified osteoporosis strategy evaluation study (ROSE) is a randomized prospective population-based study investigating the effectiveness of a two-step screening program for osteoporosis in women. This paper reports the study design and baseline characteristics of the study population....... 35,000 women aged 65-80 years were selected at random from the population in the Region of Southern Denmark and-before inclusion-randomized to either a screening group or a control group. As first step, a self-administered questionnaire regarding risk factors for osteoporosis based on FRAX......(®) was issued to both groups. As second step, subjects in the screening group with a 10-year probability of major osteoporotic fractures ≥15 % were offered a DXA scan. Patients diagnosed with osteoporosis from the DXA scan were advised to see their GP and discuss pharmaceutical treatment according to Danish...

  16. Evaluation of three reagent dosing strategies in a photo-Fenton process for the decolorization of azo dye mixtures

    International Nuclear Information System (INIS)

    Prato-Garcia, D.; Buitrón, Germán

    2012-01-01

    Highlights: ► Dosing strategies for a photo-Fenton process were evaluated. ► The dosing strategy had no effect of on the decolorization. ► The type of strategy influenced SUVA index, toxicity reduction and biodegradability. ► A continuous reagents supply was found to be the most adequate strategy. ► Decolorization as well as a less toxic and biodegradable effluent was produced. - Abstract: Three reagent dosing strategies used in the solar photo-assisted decolorization of a mixture of sulfonated dyes consisting of acid blue 113, acid orange 7 and acid red 151 were evaluated. Results demonstrated that the dosing strategy influenced both reagent consumption and the biodegradability and toxicity of the effluent. In one strategy (E 1 ), the Fenton's reactants were dosed in a punctual mode, while in the other two strategies (E 2 an E 3 ), the reactants were dosed continuously. In the E 2 strategy the reactants were dosed by varying the duration of the injection time. In the E 3 strategy, the reactants were dosed during 60 min at a constant rate, but with different concentrations. All cases showed that feeding the reactor between 40% and 60% of the maximal dose was sufficient to decolorize more than 90% of the mixture of azo dyes. The E 1 strategy was less effective for aromatic content reduction. Conversely, the continuous addition of the reagents (E 2 and E 3 strategies) improved the aromatic content removal. E 3 strategy was substantially more appropriate than E 1 strategy due to improved the effluent quality in two key areas: toxicity and biodegradability.

  17. Prediction of performance and evaluation of flexible pavement rehabilitation strategies

    Directory of Open Access Journals (Sweden)

    Kang-Won Wayne Lee

    2017-04-01

    Full Text Available Five test sections with different additives and strategies were established to rehabilitate a State-maintained highway more effectively in Rhode Island (RI: control, calcium chloride, asphalt emulsion, Portland cement and geogrid. Resilient moduli of subgrade soils and subbase materials before and after full depth rehabilitation were employed as input parameters to predict the performance of pavement structures using AASHTOWare Pavement ME Design (Pavement ME software in terms of rutting, cracking and roughness. It was attempted to use Level 1 input (which includes traffic full spectrum data, climate data and structural layer properties for Pavement ME. Traffic data was obtained from a Weigh-in-Motion (WIM instrument and Providence station was used for collecting climatic data. Volumetric properties, dynamic modulus and creep compliance were used as input parameters for 19 mm (0.75 in. warm mix asphalt (WMA base and 12.5 mm (0.5 in. WMA surface layer. The results indicated that all test sections observed AC top-down (longitudinal cracking except Portland cement section which passed for all criteria. The order in terms of performance (best to worst for all test sections by Pavement ME was Portland cement, calcium chloride, control, geogrid, and asphalt emulsion. It was also observed that all test sections passed for both bottom up and top down fatigue cracking by increasing thickness of either of the two top asphalt layers. Test sections with five different base/subbase materials were evaluated in last two years through visual condition survey and measurements of deflection and roughness to confirm the prediction, but there was no serious distress and roughness. Thus these experiments allowed selecting the best rehabilitation/reconstruction techniques for the particular and/or similar highway, and a framework was formulated to select an optimal technique and/or strategy for future rehabilitation/reconstruction projects. Finally, guidelines for

  18. Gaining the Long View: Reforming Organization and Empowering Knowledge Workers to Improve Strategy and Intelligence

    Science.gov (United States)

    2017-03-31

    core strengths to maintain a competitive advantage in their established field while exploring new opportunities and adopting strategies to overcome...Living in the Futures: How Scenario Planning Changed Corporate Strategy ,” Harvard Business Review (May 01, 2013): 119-127. The authors explain that the...EMPOWERING KNOWLEDGE WORKERS TO IMPROVE STRATEGY AND INTELLIGENCE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Mr

  19. EVALUATION OF COMPETITIVE STRATEGIES OF COFFEE RETAILING IN ASPECT OF MARKET ECONOMY

    Directory of Open Access Journals (Sweden)

    Aslı ÖZTOPÇU

    2017-09-01

    Full Text Available Coffee retailers are trying to improve both their products and services and to increase their market share. Companies are both competing and developing different strategies such as issues production, R&D, business model, customers, and innovations. The aim of this study is to determine the competitive strategies in the coffee retailing aspect of the market economy. For this purpose, firstly, in this sector, the major competitors, suppliers, and customers were researched and the general structure of the sector was determined. Secondly, size of the global market, industry, and demand growth rate and the future status of the coffee retail industry were determined. Finally, the bargaining power of customers and suppliers of the sector were evaluated. According to the evaluation obtained, it was understood that coffee retailing is an attractive, large and dynamic sector. In the analysis according to the study of Porter’s five force model, important information was obtained for coffee retailing.

  20. Role of sectoral and multi-pollutant emission control strategies in improving atmospheric visibility in the Yangtze River Delta, China

    International Nuclear Information System (INIS)

    Huang, Kan; Fu, Joshua S.; Gao, Yang; Dong, Xinyi; Zhuang, Guoshun; Lin, Yanfen

    2014-01-01

    The Community Multi-scale Air Quality modeling system is used to investigate the response of atmospheric visibility to the emission reduction from different sectors (i.e. industries, traffic and power plants) in the Yangtze River Delta, China. Visibility improvement from exclusive reduction of NO x or VOC emission was most inefficient. Sulfate and organic aerosol would rebound if NO x emission was exclusively reduced from any emission sector. The most efficient way to improve the atmospheric visibility was proven to be the multi-pollutant control strategies. Simultaneous emission reductions (20–50%) on NO x , VOC and PM from the industrial and mobile sectors could result in 0.3–1.0 km visibility improvement. And the emission controls on both NO x (85%) and SO 2 (90%) from power plants gained the largest visibility improvement of up to 4.0 km among all the scenarios. The seasonal visibility improvement subject to emission controls was higher in summer while lower in the other seasons. -- Highlights: • Atmospheric visibility in the Yangtze River Delta is modeled and evaluated. • Responses of visibility changes to various emission reduction scenarios are compared. • Sulfate aerosol will increase if only NO x emission is reduced. • The multi-pollutant control strategy is most efficient for improving visibility. -- Responses of visibility changes to various emission reduction scenarios are compared. The multi-pollutant control strategy is most efficient for improving visibility in YRD, China

  1. Overarching goals: a strategy for improving healthcare quality and safety?

    Science.gov (United States)

    Nanji, Karen C; Ferris, Timothy G; Torchiana, David F; Meyer, Gregg S

    2013-03-01

    The management literature reveals that many successful organisations have strategic plans that include a bold 'stretch-goal' to stimulate progress over a ten-to-thirty-year period. A stretch goal is clear, compelling and easily understood. It serves as a unifying focal point for organisational efforts. The ambitiousness of such goals has been emphasised with the phrase Big Hairy Audacious Goal ('BHAG'). President Kennedy's proclamation in 1961 that 'this Nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to earth' provides a famous example. This goal energised the US National Aeronautics and Space Administration, and it captured the attention of the American public and resulted in one of the largest accomplishments of any organisation. The goal set by Sony, a small, cash-strapped electronics company in the 1950s, to change the poor image of Japanese products around the world represents a classic BHAG. Few examples of quality goals that conform to the BHAG definition exist in the healthcare literature. However, the concept may provide a useful framework for organisations seeking to transform the quality of care they deliver. This review examines the merits and cautions of setting overarching quality goals to catalyse quality improvement efforts, and assists healthcare organisations with determining whether to adopt these goals.

  2. Prebiotics and synbiotics: dietary strategies for improving gut health.

    Science.gov (United States)

    Krumbeck, Janina A; Maldonado-Gomez, Maria X; Ramer-Tait, Amanda E; Hutkins, Robert W

    2016-03-01

    A wide range of dietary carbohydrates, including prebiotic food ingredients, fermentable fibers, and milk oligosaccharides, are able to produce significant changes in the intestinal microbiota. These shifts in the microbial community are often characterized by increased levels of bifidobacteria and lactobacilli. More recent studies have revealed that species of Faecalibacterium, Akkermansia, and other less well studied members may also be enriched. We review the implications of these recent studies on future design of prebiotics and synbiotics to promote gastrointestinal health. Investigations assessing the clinical outcomes associated with dietary modification of the gut microbiota have shown systemic as well as specific health benefits. Both prebiotic oligosaccharides comprised of a linear arrangement of simple sugars, as well as fiber-rich foods containing complex carbohydrates, have been used in these trials. However, individual variability and nonresponding study participants can make the outcome of dietary interventions less predictable. In contrast, synergistic synbiotics containing prebiotics that specifically stimulate a cognate probiotic provide additional options for personalized gut therapies. This review describes recent research on how prebiotics and fermentable fibers can influence the gut microbiota and result in improvements to human health.

  3. Strategies for the improvement of rural chicken production in Ghana

    International Nuclear Information System (INIS)

    Awuni, J.A.

    2002-01-01

    Rural poultry production systems in Ghana and in Africa as a whole are based on the scavenging indigenous domestic fowl (Gallus domesticus), the predominant species in the poultry sector. In most African countries scavenging chicken have no regular health control programmes, may or may not have shelter and usually have to scavenge around for their nutritional requirements. In Ghana, the total poultry population is estimated to be over 20 million with 80% of this being rural scavenging chicken. Out of this population, 80% is lost annually due to outbreaks of Newcastle disease and a number of other causes. Reported here are the results of field surveys conducted in the wet and dry seasons in two selected ecological zones (Forest and Coastal) to establish the constraints to improvement of rural chicken production in the country. The survey covered only women farmers who engaged in rural poultry production. During the course of the survey, chicken flocks as well as chicken houses were examined for ectoparasites. Faecal samples were collected for laboratory diagnosis of endo-parasite infestation, as well as serum samples for analysis of antibodies using immunoassay techniques. The survey revealed that Newcastle disease still remains the most important disease of the scavenging rural chickens. (author)

  4. Ergonomic strategies to improve radiographers' posture during mammography activities.

    Science.gov (United States)

    Cernean, Nicolai; Serranheira, Florentino; Gonçalves, Pedro; Sá Dos Reis, Cláudia

    2017-08-01

    To identify alternatives for radiographers' postures while performing mammography that can contribute to reduce the risk of work-related musculoskeletal disorders (WRMSDs). Radiographers' postures to positioning craniocaudal (CC) and mediolateral oblique (MLO) views were simulated without any intervention for three scenarios: radiographer/patient with similar statures, radiographer smaller than patient and radiographer taller than patient. Actions were taken to modify the postures: seated radiographer; patient on a step; seated patient; radiographer on a step. All the postures were analysed using kinovea 0.8.15 software and the angles were measured twice and classified according to European standard EN1005-4: 2005. The non-acceptable angles were measured mainly during MLO positioning when radiographer was taller than the patient: 139° and 120° for arm-flexion and abduction, 72° for trunk and -24° for head/neck-flexion. The introduction of alternative postures (radiographer seated), allowed improvements in posture (60° and 99° for arm flexion and abduction, 14° for trunk and 0° for head/neck flexion), being classified as acceptable. The alternative postures simulated have the potential to reduce the risk of developing WRMSDs when radiographers and patients have different statures. • Radiographers' postures in mammography can contribute to work-related musculoskeletal disorders • Non-acceptable posture was identified for MLO breast positioning (radiographer taller than patient) • Adapting posture to patient biotype reduces the WRMSD risk for radiographers.

  5. Modelling the transport system in China and evaluating the current strategies towards the sustainable transport development

    International Nuclear Information System (INIS)

    Liu, Wen; Lund, Henrik; Mathiesen, Brian Vad

    2013-01-01

    Transport is one of the most challenge sectors when addressing energy security and climate change due to its high reliance on oil products and lack of the alternative fuels. This paper explores the ability of three transport strategies to contribute to the development of a sustainable transport in China. With this purpose in mind, a Chinese transport model has been created and three current transport strategies which are high speed railway (HSR), urban rail transit (URT) and electric vehicle (EV) were evaluated together with a reference transport system in 2020. As conservative results, 13% of the energy saving and 12% of the CO 2 emission reduction can be attained by accomplishing three strategies compared with the reference transport system. However, the energy demand of transport in 2020 with the implementation of three strategies will be about 1.7 times as much as today. The three strategies show the potential of drawing the transport demand to the more energy efficient vehicles; however, more initiatives are needed if the sustainable transport is the long term objective, such as the solutions to stabilise the private vehicle demands, to continuously improve the vehicle efficiency and to boost the alternative fuels produced from the renewable energy sources. - Highlights: • A Chinese transport model was created and three transport strategies were evaluated • Transport is the biggest driver of the oil demand in China not the industry • The energy demand of transport in 2020 will be twice as much as today • Strategies contribute 13% energy saving and 12% CO 2 emission reduction • More initiatives are needed if a sustainable transport is the long-term objective

  6. Strategies and Exemplars for Public Outreach Events: Planning, Implementation, Evaluation

    Science.gov (United States)

    Cobb, W. H.; Buxner, S.; Shipp, S. S.; Shebby, S.

    2015-12-01

    IntroductionEach year the National Aeronautics and Space Administration (NASA) sponsors a variety of public outreach events to share information with educators, students, and the general public. These events are designed to increase interest in and awareness of the mission and goals of NASA. Planning and implementation best practices gleaned from the NASA SMD Education's review of large-scale events, "Best Practices in Outreach Events" will be shared. Outcomes from an event, i C Ceres, celebrating the Dawn mission's arrival at dwarf planet Ceres that utilized these strategies will be shared. Best practices included can be pertinent for all event organizers and evaluators regardless of event size. BackgroundThe literature review focused on identifying evaluations of large-scale public outreach events—and, within these evaluations, identifying best practices. The following criteria for identifying journal articles and reports to potentially include: Public, science-related events open to adults and children. Events with more than 1,000 attendees. Events that occurred during the last 5 years. Evaluations that included information on data collected from visitors and/or volunteers. Evaluations that specified the type of data collected, methodology, and associated results. Planning and Implementation Best PracticesThe literature review revealed key considerations for planning and of large-scale events implementing events. A summary of related best practices is presented below. 1) Advertise the event 2) Use and advertise access to scientists 3) Recruit scientists using these findings 4) Ensure that the event is group and particularly child friendly 5) Target specific event outcomes Best Practices Informing Real-world Planning, Implementation and EvaluationDawn mission's collaborative design of a series of events, i C Ceres, including in-person, interactive events geared to families and live presentations will be shared. Outcomes and lessons learned will be imparted

  7. Improving Inappropriate Social Behavior of Autistic Students Using the LISTEN Intervention Strategy

    Science.gov (United States)

    Al-Shammari, Zaid; Daniel, Cathy; Faulkner, Paula; Yawkey, Thomas D.

    2010-01-01

    A case study was conducted on the development of the LISTEN intervention strategy for use with autistic students to improve inappropriate social behaviors. The study was conducted in a special education classroom in an autism school in Kuwait. Examination of LISTEN Intervention Strategy applications included: duration of targeted behavior; methods…

  8. The 3R study strategy to improve text retention and text comprehension

    NARCIS (Netherlands)

    Reijners, Pauline; Kester, Liesbeth; Wetzels, Sandra; Kirschner, Paul A.

    2013-01-01

    Reijners, P. B. G., Kester, L., Wetzels, S. A. J., & Kirschner, P. A. (2013, 27 August). The 3R study strategy to improve text retention and text comprehension. In B. Klein (Chair), Effective Learning Strategies and their Usage in Self-regulated Training Programs and Computer-Based Learning.

  9. Improving marketing strategies of sea freight forwarding services - Thien Hong Joint Stock company

    OpenAIRE

    Pham, Thanh Huyen

    2015-01-01

    Analyzing and improving marketing strategies of Thien Hong Joint Stock company - a newborn company in the field of sea freight forwarding service in Vietnam. This thesis focused on the 4Ps (product, price, placement, promotion) in marketing strategy, how to apply the theory of services marketing in a business to business company and a special industry effectively.

  10. Novel Formulation Strategy to Improve the Feasibility of Amifostine Administration.

    Science.gov (United States)

    Ranganathan, Kavitha; Simon, Eric; Lynn, Jeremy; Snider, Alicia; Zhang, Yu; Nelson, Noah; Donneys, Alexis; Rodriguez, Jose; Buchman, Lauren; Reyna, Dawn; Lipka, Elke; Buchman, Steven R

    2018-03-19

    Amifostine (AMF), a radioprotectant, is FDA-approved for intravenous administration in cancer patients receiving radiation therapy (XRT). Unfortunately, it remains clinically underutilized due to adverse side effects. The purpose of this study is to define the pharmacokinetic profile of an oral AMF formulation potentially capable of reducing side effects and increasing clinical feasibility. Calvarial osteoblasts were radiated under three conditions: no drug, AMF, and WR-1065 (active metabolite). Osteogenic potential of cells was measured using alkaline phosphatase staining. Next, rats were given AMF intravenously or directly into the jejunum, and pharmacokinetic profiles were evaluated. Finally, rats were given AMF orally or subcutaneously, and blood samples were analyzed for pharmacokinetics. WR-1065 preserved osteogenic potential of calvarial osteoblasts after XRT to a greater degree than AMF. Direct jejunal AMF administration incurred a systemic bioavailability of 61.5%. Subcutaneously administrated AMF yielded higher systemic levels, a more rapid peak exposure (0.438 vs. 0.875 h), and greater total systemic exposure of WR-1065 (116,756 vs. 16,874 ng*hr/ml) compared to orally administered AMF. Orally administered AMF achieves a similar systemic bioavailability and decreased peak plasma level of WR-1065 compared to intravenously administered AMF, suggesting oral AMF formulations maintain radioprotective efficacy without causing onerous side effects, and are clinically feasible.

  11. Promising Strategy To Improve Charge Separation in Organic Photovoltaics : Installing Permanent Dipoles in PCBM Analogues

    NARCIS (Netherlands)

    de Gier, Hilde D.; Jahani, Fatemeh; Broer, Ria; Hummelen, Jan C.; Havenith, Remco W. A.

    2016-01-01

    A multidisciplinary approach involving organic synthesis and theoretical chemistry was applied to investigate a promising strategy to improve charge separation in organic photovoltaics: installing permanent dipoles in fullerene derivatives. First, a PCBM analogue with a permanent dipole in the side

  12. Study on improving rail energy efficiency (E2) : best practices and strategies

    Science.gov (United States)

    2015-03-23

    A recent Volpe Center report [1] for the Federal Railroad Administrations (FRA) Rail Energy, Environment, and Engine (E3) Technology research and development program reviewed rail industry best practices (BPs) and strategies for improving energy e...

  13. Long-term persistence of quality improvements for an intensive care unit communication initiative using the VALUE strategy.

    Science.gov (United States)

    Wysham, Nicholas G; Mularski, Richard A; Schmidt, David M; Nord, Shirley C; Louis, Deborah L; Shuster, Elizabeth; Curtis, J Randall; Mosen, David M

    2014-06-01

    Communication in the intensive care unit (ICU) is an important component of quality ICU care. In this report, we evaluate the long-term effects of a quality improvement (QI) initiative, based on the VALUE communication strategy, designed to improve communication with family members of critically ill patients. We implemented a multifaceted intervention to improve communication in the ICU and measured processes of care. Quality improvement components included posted VALUE placards, templated progress note inclusive of communication documentation, and a daily rounding checklist prompt. We evaluated care for all patients cared for by the intensivists during three separate 3 week periods, pre, post, and 3 years following the initial intervention. Care delivery was assessed in 38 patients and their families in the pre-intervention sample, 27 in the post-intervention period, and 41 in follow-up. Process measures of communication showed improvement across the evaluation periods, for example, daily updates increased from pre 62% to post 76% to current 84% of opportunities. Our evaluation of this quality improvement project suggests persistence and continued improvements in the delivery of measured aspects of ICU family communication. Maintenance with point-of-care-tools may account for some of the persistence and continued improvements. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Combining metabolic and process engineering strategies to improve recombinant glycoprotein production and quality.

    Science.gov (United States)

    Karengera, Eric; Durocher, Yves; De Crescenzo, Gregory; Henry, Olivier

    2017-11-01

    Increasing recombinant protein production while ensuring a high and consistent protein quality remains a challenge in mammalian cell culture process development. In this work, we combined a nutrient substitution approach with a metabolic engineering strategy that improves glucose utilization efficiency. This combination allowed us to tackle both lactate and ammonia accumulation and investigate on potential synergistic effects on protein production and quality. To this end, HEK293 cells overexpressing the pyruvate yeast carboxylase (PYC2) and their parental cells, both stably producing the therapeutic glycoprotein interferon α2b (IFNα2b), were cultured in media deprived of glutamine but containing chosen substitutes. Among the tested substitutes, pyruvate led to the best improvement in growth (integral of viable cell density) for both cell lines in batch cultures, whereas the culture of PYC2 cells without neither glutamine nor any substitute displayed surprisingly enhanced IFNα2b production. The drastic reduction in both lactate and ammonia in the cultures translated into extended high viability conditions and an increase in recombinant protein titer by up to 47% for the parental cells and the PYC2 cells. Product characterization performed by surface plasmon resonance biosensing using Sambucus nigra (SNA) lectin revealed that the increase in yield was however accompanied by a reduction in the degree of sialylation of the product. Supplementing cultures with glycosylation precursors and a cofactor were effective at counterbalancing the lack of glutamine and allowed improvement in IFNα2b quality as evaluated by lectin affinity. Our study provides a strategy to reconcile protein productivity and quality and highlights the advantages of PYC2-overexpressing cells in glutamine-free conditions.

  15. Improving Efl Students' Reading Comprehension And Students' Perception On Metacognitive Reading Strategies

    OpenAIRE

    Linda, Kristina; Regina; Sutapa,, Y. Gatot

    2015-01-01

    The aims of this study were improving EFL students' reading comprehension by using Metacognitive Reading Strategies and finding out the students' perceptions on Metacognitive Reading Strategies. The method of the research was a classroom action research. The research subjects were 29 students majoring in Accounting Program class 3 of Year-10. This research was conducted in three cycles to maximize the students' improvement in comprehending the text. The findings of data collecting revealed th...

  16. Training in Metacognitive Strategies for Students’ Vocabulary Improvement by Using Learning Journals

    Directory of Open Access Journals (Sweden)

    Itala Diaz

    2015-01-01

    Full Text Available This study examined the effects of metacognitive strategies to help beginning young learners with difficulties increasing and retaining vocabulary. This was a qualitative study in which participants first went through metacognitive strategy instruction to provide awareness of learning strategies. Following this instruction, students underwent a set of five interventions based on the cognitive academic language learning approach instructional model. These interventions, together with journaling progress, were used to train them in the use of the metacognitive strategies planning, monitoring, and evaluating. The findings showed that metacognitive strategy training has positively contributed to vocabulary acquisition skills, as participants were able to raise consciousness about some learning strategies and the use of metacognitive strategies to increase their vocabulary learning.

  17. Location decision strategies for improving SMME business performance

    Directory of Open Access Journals (Sweden)

    Shereen Barnard

    2011-12-01

    relationship between electricity tariffs and business performance. Employment and business performance attained the strongest positive relationship; indicating that business owners regarded employment as an important factor to consider when searching for suitable business premises. The relationship between location and business performance obtained the lowest positive correlation. Originality and value of the research: Research on South African SMMEs regarding location decisions and the specific factors identified in this study has not been done previously in South Africa. Therefore, because evidence exists that the macro-environmental factors influence location decisions to varying degrees, this study can provide SMME owners with insight into the factors influencing location choice. It is vital that business owners consider these factors as they could influence business performance, and ultimately, business survival. An increased awareness of the importance of the aspects discussed in this study could consequently lead to improved performance in the SMME sector.

  18. Improved partnering through supplier self-evaluation

    International Nuclear Information System (INIS)

    Owens, R.K.; Cobb, J.R.

    1993-01-01

    Early in 1989, the Virginia Power purchasing department decided that a different approach was needed for resolving supplier partnering issues and to motivate the supplier to perform as promised to purchase order requirements. Purchasing formed task teams composed of purchasing personnel and requested that they investigate and evaluate alternative methods of order administration and supplier communications. The task teams were asked to research the feasibility of using a reward/penalty approach or to suggest an alternative method to motivate results. The task teams determined that the root cause of the problems for the identified areas of concern was that purchasing personnel and supplier personnel neither communicated well nor fully understood the effect that their actions or inactions had on each other

  19. Thermo economical evaluation of retrofitting strategies in air conditioning systems

    Energy Technology Data Exchange (ETDEWEB)

    Tribess, Arlindo; Fiorelli, Flavio Augusto Sanzogo; Hernandez Neto, Alberto [Sao Paulo Univ., SP (Brazil). Escola Politecnica. Dept. de Engenharia Mecanica]. E-mail: atribess@usp.br; fiorelli@usp.br; ahneto@usp.br

    2000-07-01

    In a building project, several subsystems are designed, among them the air conditioning system. Electrical energy consumption profiles show that this subsystem is responsible for 40 to 50% of total consumption in a commercial building. Besides the study of technical aspects that should be considered in order to assure the thermal comfort of the occupants as well the temperature and humidity conditions for an efficient equipment operation, an economical evaluation of this subsystem should be also made. In retrofit projects, the economical aspect is also critical for such projects in order to assure bigger efficiency in an economically attractive way. This paper analyses some strategies that might be adopted in retrofitting an air conditioning system installed in a commercial building with mixed occupation. By mixed we mean that some floors have a typical office occupation profile and other floors are mainly occupied by electronic equipment. This analysis includes both technical and economical evaluation. The proposed solutions performance are compared to the old system, which allows to verify the retrofitting impact in energy consumption reduction and its economical feasibility. (author)

  20. A TOTAL MANUFACTURING SOLUTIONS TECHNIQUE TO SELECT APPROPRIATE IMPROVEMENT STRATEGY: CASE STUDY OF A FOOTWEAR FACTORY

    Directory of Open Access Journals (Sweden)

    Gezahegn Tesfaye

    2014-09-01

    Full Text Available The Government of Ethiopia is promoting the manufacturing sector to join the global market in a large scale. Due to its comparative advantages, the Ethiopian leather and leather products industry have been given due attention. To fully utilize such advantages, the country shifted its export items from hides/skins to footwear products. Nevertheless, the performance of the leather sector in general and footwear sub-sector in particular is far below the desired standards. The improvement strategies applied hitherto were mainly to tackle a small portion of their total problems. If the Ethiopian footwear companies have to become globally competitive, their entire business spectrum has to be assessed and appropriate improvement strategies must be selected. In this research, we used a Total manufacturing solutions (TMS technique to identify areas of improvement and improvement strategy of one of Ethiopian footwear companies. For this purpose, we conducted two surveys using structured questionnaire. The first survey was to test the TMS technique against the context of footwear industry. The result proved that the original TMS model can be used to measure the performance of footwear companies. The second survey was done to identify company's total problems, map its current position and select appropriate improvement strategy. The result revealed that the company has company-wide problems and its current position is a plodder. For plodders which have company-wide problems, the improvement strategy must include aggressive application of BPR; and the implementation of best practices to develop workers skills that encourages networking and promotion, a market-led manufacturing strategy, employee involvement and team work cultures. According to the findings of this research, we suggested that a BPR technique followed by a continuous improvement programme could be an appropriate improvement strategy for this company. The company requires long-term improvement

  1. Evaluating Options for Improving California's Drought Resilience

    Science.gov (United States)

    Ray, P. A.; Schwarz, A.; Wi, S.; Correa, M.; Brown, C.

    2015-12-01

    Through a unique collaborative arrangement, the University of Massachusetts (UMass) and the California Department of Water Resources (DWR) have together performed a baseline climate change analysis of the California state (State Water Project) and federal (Central Valley Project) water systems. The first step in the baseline analysis was development of an improved basinwide hydrologic model covering a large area of California including all major tributaries to the state and federal water systems. The CalLite modeling system used by DWR for planning purposes allowed simulation of the system of reservoirs, rivers, control points, and deliveries which are then used to create performance metrics that quantify a wide range of system characteristics including water deliveries, water quality, and environmental/ecological factors. A baseline climate stress test was conducted to identify current vulnerabilities to climate change through the linking of the modeling chain with Decision Scaling concepts through the UMass bottom-up climate stress-testing algorithm. This procedure allowed the first comprehensive climate stress analysis of the California state and federal water systems not constrained by observed historical variability and wet-dry year sequences. A forward-looking drought vulnerability and adaptation assessment of the water systems based on this workflow is ongoing and preliminary results will be presented. Presentation of results will include discussion of the collaborative arrangement between DWR and UMass, which is instrumental to both the success of the research and the education of policy makers.

  2. Selection of Strategy Positioning and Formulation Strategies for Improving Business Performance of Bakery XYZ

    OpenAIRE

    Siregar, Yigal Allon; Toha, Mohamad

    2012-01-01

    Economic growth will increase competition among companies in industry, and it happen in Bandung area, with current growth in economic and tourism industry also influence competition level in culinary business in Bandung. Bakery XYZ, that already in Bandung since 1991 affected of the current competition in culinary business. Currently Bakery XYZ is facing decreasing sales volume due to increasing competitors. To improve its business performance, is required to analysis Bakery XYZ's business s...

  3. A discussion of approaches to transforming care: contemporary strategies to improve patient safety.

    Science.gov (United States)

    Burston, Sarah; Chaboyer, Wendy; Wallis, Marianne; Stanfield, Jane

    2011-11-01

    This article presents a discussion of three contemporary approaches to transforming care: Transforming Care at the Bedside, Releasing Time to Care: the Productive Ward and the work of the Studer Group(®). International studies of adverse events in hospitals have highlighted the need to focus on patient safety. The case for transformational change was identified and recently several approaches have been developed to effect this change. Despite limited evaluation, these approaches have spread and have been adopted outside their country of origin and contextual settings. Medline and CINAHL databases were searched for the years 1999-2009. Search terms included derivatives of 'transformation' combined with 'care', 'nursing', 'patient safety', 'Transforming Care at the Bedside', 'the Productive Ward' and 'Studer Group'. A comparison of the three approaches revealed similarities including: the foci of the approaches; interventions employed; and the outcomes measured. Key differences identified are the implementation models used, spread strategies and sustainability of the approaches. The approaches appear to be complementary and a hybrid of the approaches such as a blend of a top-down and bottom-up leadership strategy may offer more sustainable behavioural change. These approaches transform the way nurses do their work, how they work with others and how they view the care they provide to promote patient safety. All the approaches involve the implementation of multiple interventions occurring simultaneously to affect improvements in patient safety. The approaches are complementary and a hybrid approach may offer more sustainable outcomes. © 2011 Blackwell Publishing Ltd.

  4. Self-management as a strategy to improve the classroom behavior of adolescents with ADHD.

    Science.gov (United States)

    Shapiro, E S; DuPaul, G J; Bradley-Klug, K L

    1998-01-01

    This article reports on the application of a self-management strategy for improving the classroom behavior of students with attention-deficit/hyperactivity disorder (ADHD). Based on the work of Rhode, Morgan, and Young (1983), the intervention focuses on teaching students to systematically rate their own behavior according to the rating of their teacher. Although, historically, self-management strategies based on cognitive control have not been found to be effective for students with ADHD, strategies based on contingency management have not been widely reported in the literature. A description of the intervention and two case study illustrations are provided. Potential limitations and implications for research in using this strategy are discussed.

  5. Understanding risk evaluation and mitigation strategies in organ transplantation.

    Science.gov (United States)

    Gabardi, Steven

    2011-07-01

    The United States Food and Drug Administration (FDA) Amendments Act of 2007 mandated that Risk Evaluation and Mitigation Strategies (REMS) be required of manufacturers. These REMS are strategies implemented to manage known or potential risks associated with drugs and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product, including once the product becomes available as generic. The elements of an individual REMS program consist of three levels: medication guide or patient package insert, communication plan, and elements to assure safe use (ETASU). A medication guide or patient package insert is used to help prevent serious adverse events, aid in patient decision making, and enhance drug adherence. Communication plans are used to educate health care providers and to encourage their compliance with REMS. The ETASU is a restrictive process that is implemented when it is deemed necessary to ensure that patients have safe access to products with known serious risks that would otherwise be unavailable. To review the components of REMS and specifically assess their impact on health care providers practicing within the organ transplantation arena, a literature search of the MEDLINE database (January 2007-December 2010) was performed, and published materials from the FDA and its Web site were also reviewed. In transplantation, REMS programs exist for both everolimus (medication guide and communication plan) and sirolimus (medication guide). The FDA has stated that all mycophenolic acid derivatives will be subject to a proposed REMS that has not yet been approved; however, both branded mycophenolic acid agents already have approved medication guides. The REMS are a permanent fixture in the development and marketing of pharmaceutical agents, and their further implementation in solid organ transplantation is inevitable. Transplantation providers should take a proactive role in patient education and implementation of REMS within the therapeutic area

  6. Evaluation of targeted influenza vaccination strategies via population modeling.

    Directory of Open Access Journals (Sweden)

    John Glasser

    Full Text Available BACKGROUND: Because they can generate comparable predictions, mathematical models are ideal tools for evaluating alternative drug or vaccine allocation strategies. To remain credible, however, results must be consistent. Authors of a recent assessment of possible influenza vaccination strategies conclude that older children, adolescents, and young adults are the optimal targets, no matter the objective, and argue for vaccinating them. Authors of two earlier studies concluded, respectively, that optimal targets depend on objectives and cautioned against changing policy. Which should we believe? METHODS AND FINDINGS: In matrices whose elements are contacts between persons by age, the main diagonal always predominates, reflecting contacts between contemporaries. Indirect effects (e.g., impacts of vaccinating one group on morbidity or mortality in others result from off-diagonal elements. Mixing matrices based on periods in proximity with others have greater sub- and super-diagonals, reflecting contacts between parents and children, and other off-diagonal elements (reflecting, e.g., age-independent contacts among co-workers, than those based on face-to-face conversations. To assess the impact of targeted vaccination, we used a time-usage study's mixing matrix and allowed vaccine efficacy to vary with age. And we derived mortality rates either by dividing observed deaths attributed to pneumonia and influenza by average annual cases from a demographically-realistic SEIRS model or by multiplying those rates by ratios of (versus adding to them differences between pandemic and pre-pandemic mortalities. CONCLUSIONS: In our simulations, vaccinating older children, adolescents, and young adults averts the most cases, but vaccinating either younger children and older adults or young adults averts the most deaths, depending on the age distribution of mortality. These results are consistent with those of the earlier studies.

  7. Delivering step change improvements to UK low level waste strategy - 16188

    International Nuclear Information System (INIS)

    Dean, Jason; Rossiter, David

    2009-01-01

    The UK Nuclear Industry continues to produce significant quantities of Low Level Waste (LLW) as decommissioning projects generating waste become more prevalent. Current infrastructure and projected increasing waste volumes will deliver a volumetric shortfall of storage capacity in the near future. Recently established as a standalone site licence company, the Low Level Waste Repository (LLWR) near Drigg, in West Cumbria (formerly operated and owned by British Nuclear Group) is tasked with managing the safe treatment and disposal of LLW in the UK, on behalf of the Nuclear Decommissioning Authority (NDA). The problem is complex involving many stakeholders with potentially different priorities. Previously, most nuclear waste generators operated independently with limited integration with other similar organisations. However, the current financial, programme and technical pressures require collaborative working to facilitate a step-change improvement in LLW management. Achieving this quickly is as much of a challenge as delivering robust cost effective technical solutions. NDA is working in partnership with LLWR to develop a LLW Strategy for the Nuclear Industry and has in parallel commissioned a number of studies by the National Nuclear Laboratory (NNL), looking at opportunities to share best practice. A National Strategy Group has been established to develop a working partnership between the Nuclear Decommissioning Authority, LLW Repository Ltd, Regulators, Stakeholders and LLW Consignors, promoting innovation, value for money, and robust implementation of the waste hierarchy (avoid-reduce-re-use-recycle). Additionally the LLWR supported by the NNL have undertaken a comprehensive strategic review of the UK's LLW management activities. Initial collaborative work has provided for the first time a detailed picture of the existing strategic baseline and identified significant national benefits from improving the way LLW is forecasted, characterised, segregated, and

  8. Faculty verbal evaluations reveal strategies used to promote medical student performance

    Directory of Open Access Journals (Sweden)

    Lowell Tong

    2011-05-01

    Full Text Available Background: Preceptors rarely follow medical students’ developing clinical performance over time and across disciplines. This study analyzes preceptors’ descriptions of longitudinal integrated clerkship (LIC students’ clinical development and their identification of strategies to guide students’ progress. Methods: We used a common evaluation framework, reporter-interpreter-manager-educator, to guide multidisciplinary LIC preceptors’ discussions of students’ progress. We conducted thematic analysis of transcripts from preceptors’ (seven longitudinal ambulatory preceptors per student quarterly group discussions of 15 students’ performance over one year. Results: All students’ clinical development progressed, although most experienced obstacles. Lack of structure in the history and physical exam commonly obstructed progression. Preceptors used templates for data gathering, and modeling or experiences in the inpatient setting to provide time and solidify structure. To advance students’ knowledge acquisition, many preceptors identified focused learning topics with their students; to promote application of knowledge, preceptors used reasoning strategies to teach the steps involved in synthesizing clinical data. Preceptors shared accountability for helping students advance as the LIC allowed them to follow students’ response to teaching strategies. Discussion: These results depict preceptors’ perceptions of LIC students’ developmental continuum and illustrate how multidisciplinary preceptors can use a common evaluation framework to identify strategies to improve performance and follow students’ performance longitudinally.

  9. Evaluation of a pooled strategy for high-throughput sequencing of cosmid clones from metagenomic libraries.

    Science.gov (United States)

    Lam, Kathy N; Hall, Michael W; Engel, Katja; Vey, Gregory; Cheng, Jiujun; Neufeld, Josh D; Charles, Trevor C

    2014-01-01

    High-throughput sequencing methods have been instrumental in the growing field of metagenomics, with technological improvements enabling greater throughput at decreased costs. Nonetheless, the economy of high-throughput sequencing cannot be fully leveraged in the subdiscipline of functional metagenomics. In this area of research, environmental DNA is typically cloned to generate large-insert libraries from which individual clones are isolated, based on specific activities of interest. Sequence data are required for complete characterization of such clones, but the sequencing of a large set of clones requires individual barcode-based sample preparation; this can become costly, as the cost of clone barcoding scales linearly with the number of clones processed, and thus sequencing a large number of metagenomic clones often remains cost-prohibitive. We investigated a hybrid Sanger/Illumina pooled sequencing strategy that omits barcoding altogether, and we evaluated this strategy by comparing the pooled sequencing results to reference sequence data obtained from traditional barcode-based sequencing of the same set of clones. Using identity and coverage metrics in our evaluation, we show that pooled sequencing can generate high-quality sequence data, without producing problematic chimeras. Though caveats of a pooled strategy exist and further optimization of the method is required to improve recovery of complete clone sequences and to avoid circumstances that generate unrecoverable clone sequences, our results demonstrate that pooled sequencing represents an effective and low-cost alternative for sequencing large sets of metagenomic clones.

  10. Feedback providing improvement strategies and reflection on feedback use: Effects on students' writing motivation, process, and performance

    NARCIS (Netherlands)

    Duijnhouwer, H.; Prins, F.J.; Stokking, K.M.

    2012-01-01

    This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students’ writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the

  11. IMPROVING THE STUDENTS’ EFL WRITING ABILITY THROUGH “PUT YOURSELF IN THE PICTURE” STRATEGY

    Directory of Open Access Journals (Sweden)

    Muhammad Lukman Syafii

    2015-09-01

    Full Text Available Abstract: This Action research was intended to improve the students’ EFL writing ability through “Put Yourself in the Picture” strategy. This research involved 33 first year managemen major of students A of Muhammadiyah University of Ponorogo in the academic year 2015/2016. This research was conducted in two cycles by following the procedures of the action research, namely, planning, implementing, observing, and reflecting. Each cycle of the research encompassed three meetings. The data of the research were gathered through observation checklists, field notes, questionnaire, and portfolio. The findings of research showed that “Put Yourself in the Picture” strategy has proven effectively to improve the student’ writing ability. The improvement could be seen from the increase of the students’ average writing score. Besides, “Put Yourself in the Picture” strategy can increase the students’ participation during the process of writing. Key words: “Put Yourself in the Picture” strategy, writing ability

  12. Practical recommendations for the evaluation of improvement initiatives

    Science.gov (United States)

    Parry, Gareth; Coly, Astou; Goldmann, Don; Rowe, Alexander K; Chattu, Vijay; Logiudice, Deneil; Rabrenovic, Mihajlo; Nambiar, Bejoy

    2018-01-01

    Abstract A lack of clear guidance for funders, evaluators and improvers on what to include in evaluation proposals can lead to evaluation designs that do not answer the questions stakeholders want to know. These evaluation designs may not match the iterative nature of improvement and may be imposed onto an initiative in a way that is impractical from the perspective of improvers and the communities with whom they work. Consequently, the results of evaluations are often controversial, and attribution remains poorly understood. Improvement initiatives are iterative, adaptive and context-specific. Evaluation approaches and designs must align with these features, specifically in their ability to consider complexity, to evolve as the initiative adapts over time and to understand the interaction with local context. Improvement initiatives often identify broadly defined change concepts and provide tools for care teams to tailor these in more detail to local conditions. Correspondingly, recommendations for evaluation are best provided as broad guidance, to be tailored to the specifics of the initiative. In this paper, we provide practical guidance and recommendations that funders and evaluators can use when developing an evaluation plan for improvement initiatives that seeks to: identify the questions stakeholders want to address; develop the initial program theory of the initiative; identify high-priority areas to measure progress over time; describe the context the initiative will be applied within; and identify experimental or observational designs that will address attribution. PMID:29447410

  13. Strategies for improving chemotherapeutic delivery to solid tumors mediated by vascular permeability modulation

    Science.gov (United States)

    Roy Chaudhuri, Tista

    An essential mode of distribution of blood-borne chemotherapeutic agents within a solid tumor is via the micro-circulation. Poor tumor perfusion, because of a lack of functional vasculature or a lack of microvessels, as well as low tumor vascular permeability, can prevent adequate deposition of even low molecular-weight agents into the tumor. The modulation of tumor vascular function and density can provides numerous strategies for improving intratumor deposition of chemotherapeutic agents. Here we investigated strategies to improve drug delivery to two tumor types that share in common poor drug delivery, but differ in the underlying cause. First, in an angiogenesis-driven brain tumor model of Glioblastoma, the vascular permeability barrier, along with poorly-functional vasculature, hinders drug delivery. A strategy of nanoparticle-based tumor 'priming' to attack the vascular permeability barrier, employing sterically stabilized liposomal doxorubicin (SSL-DXR), was investigated. Functional and histological evaluation of tumor vasculature revealed that after an initial period of depressed vascular permeability and vascular pruning 3--4 days after SSL-DXR administration, vascular permeability and perfusion were restored and then elevated after 5--7 days. As a result of tumor priming, deposition of subsequently-administered nanoparticles was enhanced, and the efficacy of temozolomide (TMZ), if administered during the window of elevated permeability, was increased. The sequenced regimen resulted in a persistent reduction of the tumor proliferative index and a 40% suppression of tumor volume, compared to animals that received both agents simultaneously. Second, in a hypovascular, pancreatic ductal adenocarcinoma model, disruption of tumor-stromal communication via sonic hedgehog (sHH) signaling pathway inhibition mediated an indirect vascular proliferation and a more than 2-fold increase in intratumor nanoparticle deposition. Enhanced delivery of SSL-DXR in tumors pre

  14. The Role of Evaluation in the School Improvement Process

    Science.gov (United States)

    Lindahl, Ronald A.; Beach, Robert H.

    2013-01-01

    Although evaluation serves many purposes in education, there is virtually unanimous agreement that evaluation is a critical component of all school improvement processes. Hamilton et al. (2003) asserted that "assessment and evaluation should be built into reform programs from the outset" (p. 26). Kimball, Lander, and Thorn (2010)…

  15. Evaluating sampling strategies for larval cisco (Coregonus artedi)

    Science.gov (United States)

    Myers, J.T.; Stockwell, J.D.; Yule, D.L.; Black, J.A.

    2008-01-01

    To improve our ability to assess larval cisco (Coregonus artedi) populations in Lake Superior, we conducted a study to compare several sampling strategies. First, we compared density estimates of larval cisco concurrently captured in surface waters with a 2 x 1-m paired neuston net and a 0.5-m (diameter) conical net. Density estimates obtained from the two gear types were not significantly different, suggesting that the conical net is a reasonable alternative to the more cumbersome and costly neuston net. Next, we assessed the effect of tow pattern (sinusoidal versus straight tows) to examine if propeller wash affected larval density. We found no effect of propeller wash on the catchability of larval cisco. Given the availability of global positioning systems, we recommend sampling larval cisco using straight tows to simplify protocols and facilitate straightforward measurements of volume filtered. Finally, we investigated potential trends in larval cisco density estimates by sampling four time periods during the light period of a day at individual sites. Our results indicate no significant trends in larval density estimates during the day. We conclude estimates of larval cisco density across space are not confounded by time at a daily timescale. Well-designed, cost effective surveys of larval cisco abundance will help to further our understanding of this important Great Lakes forage species.

  16. A strategy for field shape evaluation in digital portal imaging

    International Nuclear Information System (INIS)

    Vos, P.H.; Quist, M.; Weistra, J.; Vossepoel, A.M.

    1995-01-01

    Digital portal imagers allow accurate measurement of the field shape in radiotherapy. A strategy is introduced to determine origin and magnitude of discrepancies between the prescribed and measured field outline. After measurement of the actual detector position relative to the beam a conversion is made from pixels in the image matrix to mm in the plane of the isocenter, without using information from the imaged field. Using a distance transform a quick check is performed: the outline is accepted if all outline points deviate less then a predefined minimum (usually 5 mm). Subsequent evaluation starts if somewhere in the outline this minimum is exceeded. The collimator defined parts in the field outline are discriminated from the shielding blocks using an enclosing rectangle of the portal outline. This rectangle is found by minimization of the area as a function of rotation. If more than one solution is available, minimization of the entropy of the field outline projections determines which rectangle corresponds best to the field outline. A check for the validity of the determined collimator parts is performed with a separate linear fit through these parts. An outline part is accepted as a collimator outline part if it is longer than a predefined length. Using this procedure the position for each of the collimator jaws can be individually measured and compared with its prescription, thus allowing discrimination between symmetric and asymmetric collimator set-ups. Using the distance transform again, for each of the detected (secondary) shielding blocks the largest discrepancy or the area giving underdosage or overdosage can be computed to evaluate their shape and position. Parameter(s) and criteria that should be used to evaluate the field set-up are specified in clinical protocols. For standard shielding blocks usually only a maximum tolerated difference is specified, whereas for mantle fields also maximum allowed over- and underdose areas are specified. The

  17. Design strategy for improving the energy efficiency in series hydraulic/electric synergy system

    International Nuclear Information System (INIS)

    Ramakrishnan, R.; Hiremath, Somashekhar S.; Singaperumal, M.

    2014-01-01

    Battery is a vital subsystem in an electric vehicle with regenerative braking system. The energy efficiency of an electric vehicle is improved by storing the regenerated energy in an electric battery, during braking, and reusing it during subsequent acceleration. Battery possesses a relatively poor power density and slow charging of regenerated energy, when compared to hydro-pneumatic accumulators. A series hydraulic/electric synergy system – an energy efficient mechatronics system is proposed to overcome the drawbacks in the conventional electric vehicle with regenerative braking. Even though, electric battery provides higher energy density than the accumulator system, optimal sizing of the hydro-pneumatic accumulator and other process parameters in the system to provide better energy density and efficiency. However, a trade-off prevails between the system energy delivered and energy consumed. This gives rise to a multiple objective problem. The proposed multi-objective design optimization procedure based on an evolutionary strategy algorithm maximizes the energy efficiency of the system. The system simulation results after optimization show that, the optimal system parameters increase the energy efficiency by 3% and hydraulic regeneration efficiency by 17.3%. The suggested design methodology provides a basis for the design of a series hydraulic/electric synergy system as energy efficient and zero emission system. - Highlights: • Dynamic analysis of SHESS to investigate energy efficiency. • Optimization of system parameters based on multi-objective design strategy. • Evaluation of improvements in system energy efficiency and hydraulic regeneration energy. • Identification of conditions at which hydraulic regenerative efficiency is maximized for minimum energy consumption. • Results confirm advantages of using SHESS

  18. Estimation of cost per severe accident for improvement of accident protection and consequence mitigation strategies

    International Nuclear Information System (INIS)

    Silva, Kampanart; Ishiwatari, Yuki; Takahara, Shogo

    2013-01-01

    To assess the complex situations regarding the severe accidents such as what observed in Fukushima Accident, not only radiation protection aspects but also relevant aspects: health, environmental, economic and societal aspects; must be all included into the consequence assessment. In this study, the authors introduce the “cost per severe accident” as an index to analyze the consequences of severe accidents comprehensively. The cost per severe accident consists of various costs and consequences converted into monetary values. For the purpose of improvement of the accident protection and consequence mitigation strategies, the costs needed to introduce the protective actions, and health and psychological consequences are included in the present study. The evaluations of these costs and consequences were made based on the systematic consequence analysis using level 2 and 3 probabilistic safety assessment (PSA) codes. The accident sequences used in this analysis were taken from the results of level 2 seismic PSA of a virtual 1,100 MWe BWR-5. The doses to the public and the number of people affected were calculated using the level 3 PSA code OSCAAR of Japan Atomic Energy Agency (JAEA). The calculations have been made for 248 meteorological sequences, and the outputs are given as expectation values for various meteorological conditions. Using these outputs, the cost per severe accident is calculated based on the open documents on the Fukushima Accident regarding the cost of protective actions and compensations for psychological harms. Finally, optimized accident protection and consequence mitigation strategies are recommended taking into account the various aspects comprehensively using the cost per severe accident. The authors must emphasize that the aim is not to estimate the accident cost itself but to extend the scope of “risk-informed decision making” for continuous safety improvements of nuclear energy. (author)

  19. Alternative strategies to improve the beneficial effects of exercise throughout life : dietary and physiological aspects

    NARCIS (Netherlands)

    R.T. Mankowski (Robert Tomasz)

    2015-01-01

    markdownabstractAbstract It is certain that the aging process leads to death, but decreasing the levels of pathology throughout life improves the quality of life and extends life span. Therefore, this dissertation focuses on alternative strategies that may contribute to improving the aging

  20. Results-Oriented Evaluations: Their Uses, Their Limits and How They are Driving Implementers‘ Coping Strategies

    Directory of Open Access Journals (Sweden)

    Michel Leroy

    2015-01-01

    Full Text Available While the use of monitoring and evaluation (M&E by media development implementers is well documented, organizations’ coping strategies to adapt to new environments in media and development still remain a relatively unexplored area. The article aims at showing how the theoretical lessons learnt by the industry have been put into practice and how a successful change can be driven within an organization using outside experts. A results-oriented culture of performance and service has been enforced since the 1990s in the EU. Evaluation systems have been a powerful catalyst in driving the transition from media support to media development and in making the latter more independent from broadcasters and donors. In recent years, changes in media assistance procedures and aims have profoundly modified the traditional landscape. This article will not question these changes, their origin and motivations. It will focus on implementers’ coping strategies to adapt (or not to these new procedures and aims and how results-oriented evaluations can drive the shift from outputs to outcomes in a changing media development sector. Can capitalizing on experience be considered a learning process that prepares for change and improves the design and implementation of projects? To what extent can it help to empower the operator as an organization? Referring to various concrete case studies from British, French and German media assistance, the article will focus on virtuous change – the circumstances that encourage structures, as well as donors who fund them, to better define and operationalize their strategies.

  1. Leadership for health improvement--implementation and evaluation.

    Science.gov (United States)

    Carr, Susan M; Carr, Sue; Lhussier, Monique; Reynolds, Joanna; Hunter, David J; Hannaway, Catherine

    2009-01-01

    The purpose of this paper is to present a co-authored reflection on the health improvement leadership development programme and the key evaluation messages derived from piloting in an English National Health Service region. It highlights the specific attributes of this approach to health improvement leadership development and clarifies health improvement development issues. Appreciative inquiry and soft systems methodology are combined in an evaluation approach designed to capture individual as well as organisation learning and how it impacts on leadership in specific contexts. The evaluation exposes the health improvement leadership needs of a multi-organisation cohort, offers some explanations for successful achievement of learning needs while also exposing of the challenges and paradoxes faced in this endeavour. There are limited reported templates of how to develop leadership for health improvement. This paper details a whole systems approach, acknowledging the impact of context on leadership and an approach to evaluating such complex initiatives.

  2. The opportunity and strategy for quality and health-system improvement now and in the future.

    Science.gov (United States)

    Sherar, Michael; Maley, Oonagh

    2015-01-01

    Since 2004, Cancer Care Ontario (CCO) has played a leadership role in linking funding to quality of care, and in using evidence and administrative and clinical data to drive performance and quality improvement. This article describes how CCO has used its cancer and renal health system strategies to establish an environment of continuous health system improvement. The article also describes how CCO's Corporate Strategy is driving organizational improvement: evolving CCO's capacity and capability to drive quality and value across healthcare settings, and its ability to advance broader health system transformation in support of cancer and renal patients. Copyright © 2014 Longwoods Publishing.

  3. Mycophenolate fetal toxicity and risk evaluation and mitigation strategies.

    Science.gov (United States)

    Kim, M; Rostas, S; Gabardi, S

    2013-06-01

    The mycophenolic acid (MPA) preparations are one of the most commonly used immunosuppressants in the United States. However, these agents carry a black box warning regarding their use during pregnancy due to an association with increased risk of miscarriage and congenital defects. To ensure that the benefits of MPA outweigh the risks, the Food and Drug Administration (FDA) required all manufacturers of MPA products to propose risk evaluation and mitigation strategies (REMS). Four years after initially calling for proposals, the FDA approved a single shared REMS system in September 2012. The elements of the MPA REMS include a medication guide and elements to assure safe use (ETASU). The medication guide, which was previously FDA-approved in 2008, should continue to be distributed to patients, and the ETASU requires physicians to complete training and obtain patient signatures on the "Patient-Prescriber Acknowledgement Form." A single, national, voluntary pregnancy registry is available, and pregnant patients should be encouraged to participate. Although the impact of the MPA REMS on clinical practice is not clear, it is a step toward increasing the understanding of fetal risks with MPA products among patients and possibly practitioners. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

  4. A strategy for optimizing staffing to improve the timeliness of inpatient phlebotomy collections.

    Science.gov (United States)

    Morrison, Aileen P; Tanasijevic, Milenko J; Torrence-Hill, Joi N; Goonan, Ellen M; Gustafson, Michael L; Melanson, Stacy E F

    2011-12-01

    The timely availability of inpatient test results is a key to physician satisfaction with the clinical laboratory, and in an institution with a phlebotomy service may depend on the timeliness of blood collections. In response to safety reports filed for delayed phlebotomy collections, we applied Lean principles to the inpatient phlebotomy service at our institution. Our goal was to improve service without using additional resources by optimizing our staffing model. To evaluate the effect of a new phlebotomy staffing model on the timeliness of inpatient phlebotomy collections. We compared the median time of morning blood collections and average number of safety reports filed for delayed phlebotomy collections during a 6-month preimplementation period and 5-month postimplementation period. The median time of morning collections was 17 minutes earlier after implementation (7:42 am preimplementation; interquartile range, 6:27-8:48 am; versus 7:25 am postimplementation; interquartile range, 6:20-8:26 am). The frequency of safety reports filed for delayed collections decreased 80% from 10.6 per 30 days to 2.2 per 30 days. Reallocating staff to match the pattern of demand for phlebotomy collections throughout the day represents a strategy for improving the performance of an inpatient phlebotomy service.

  5. A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes.

    Science.gov (United States)

    Kagawa-Singer, Marjorie; Kassim-Lakha, Shaheen

    2003-06-01

    Encounters between physicians and patients from different cultural backgrounds are becoming commonplace. Physicians strive to improve health outcomes and increase quality of life for every patient, yet these discordant encounters appear to be a significant factor, beyond socioeconomic barriers, in creating the unequal and avoidable excess burden of disease borne by members of ethnic minority populations in the United States. Most clinicians lack the information to understand how culture influences the clinical encounter and the skills to effectively bridge potential differences. New strategies are required to expand medical training to adequately address culturally discordant encounters among the physicians, their patients, and the families, for all three may have different concepts regarding the nature of the disease, expectations about treatment, and modes of appropriate communication beyond language. The authors provide an anthropological perspective of the fundamental relationship between culture and health, and outline systemic changes needed within the social and legal structures of the health care system to reduce the risk of cross-cultural miscommunication and increase the likelihood of improving health outcomes for all populations within the multicultural U.S. society. The authors define the strengths inherent within every culture, provide a guideline for the clinician to evaluate disease and illness within its cultural context, and outline the clinical skills required to negotiate among potential differences to reach mutually desired goals for care. Last, they indicate the structural changes required in the health care setting to enable and support such practice.

  6. Thermal-hydraulics technological strategy roadmap for LWR safety improvement and development

    International Nuclear Information System (INIS)

    Nakamura, Hideo; Arai, Kenji; Oikawa, Hirohide

    2015-01-01

    New version of the Thermal-Hydraulics Safety Evaluation Fundamental Technology Enhancement Strategy Roadmap (TH-RM) was developed by the Atomic Energy Society of Japan (AESJ) for LWR safety improvement and development. The 1st version of TH-RM was prepared in 2009 under collaboration of utilities, vendors, universities, research institutes and technical support organizations (TSO) for regulatory body. The revision was made by three sub-working groups (SWGs) by considering the lessons learned from the Fukushima Daiichi Accident. The 'safety assessment' SWG pursued development of computer codes for safety assessment. The 'fundamental technology' SWG pursued safety improvement and risk reduction via accident management (AM) measures by referring the technical map for severe accident (SA) established by the 'severe accident' SWG. Phenomena and components for counter-measures and/or proper prediction are identified by going through SA progression in both reactor and spent-fuel pool of PWR and BWR. Twelve important technology development subjects were identified, which include melt coolability enhancement to maintain integrity of containment vessel. Fact Sheet was developed to describe each of identified and selected R and D subjects. External hazards are also considered how to cope with from thermal-hydraulic safety point of view. This paper summarizes the revised TH-RM with several examples and future perspectives. (author)

  7. Strategies for Improving the Quality of Polling Service in Wireless Metropolitan Area Network

    Directory of Open Access Journals (Sweden)

    Yang Zhi-Jun

    2017-01-01

    Full Text Available Four kinds of service types are defined in IEEE 802.16. In order to provide the Quality of Service (Qos for different services, the system must use a reasonable resource allocation method and scheduling algorithm to efficiently and fairly allocate bandwidth resources. Although in the IEEE 802.16 MAC, for the uplink real-time polling service (rtPS and non-real-time polling service (nrtPS business type of data transmission are used to polling, but do not provide business-based services. In this paper, the distinction between priority service of rtPS and nrtPS is carried out, and the simulation experiment is used to analyze the performance characteristics of the protocol under the distinction of high and low priority. Wherein the theoretical values of the average delay and the information packets are compared with the experimental values. The average query cycle and throughput are also evaluated. Which proves the validity of the improved service strategy and improves the service characteristics of the system.

  8. Using Linked Survey Paradata to Improve Sampling Strategies in the Medical Expenditure Panel Survey

    Directory of Open Access Journals (Sweden)

    Mirel Lisa B.

    2017-06-01

    Full Text Available Using paradata from a prior survey that is linked to a new survey can help a survey organization develop more effective sampling strategies. One example of this type of linkage or subsampling is between the National Health Interview Survey (NHIS and the Medical Expenditure Panel Survey (MEPS. MEPS is a nationally representative sample of the U.S. civilian, noninstitutionalized population based on a complex multi-stage sample design. Each year a new sample is drawn as a subsample of households from the prior year’s NHIS. The main objective of this article is to examine how paradata from a prior survey can be used in developing a sampling scheme in a subsequent survey. A framework for optimal allocation of the sample in substrata formed for this purpose is presented and evaluated for the relative effectiveness of alternative substratification schemes. The framework is applied, using real MEPS data, to illustrate how utilizing paradata from the linked survey offers the possibility of making improvements to the sampling scheme for the subsequent survey. The improvements aim to reduce the data collection costs while maintaining or increasing effective responding sample sizes and response rates for a harder to reach population.

  9. On e-business strategy planning and performance evaluation: An adaptive algorithmic managerial approach

    Directory of Open Access Journals (Sweden)

    Alexandra Lipitakis

    2017-07-01

    Full Text Available A new e-business strategy planning and performance evaluation scheme based on adaptive algorithmic modelling techniques is presented. The effect of financial and non-financial performance of organizations on e-business strategy planning is investigated. The relationships between the four strategic planning parameters are examined, the directions of these relationships are given and six additional basic components are also considered. The new conceptual model has been constructed for e-business strategic planning and performance evaluation and an adaptive algorithmic modelling approach is presented. The new adaptive algorithmic modelling scheme including eleven dynamic modules, can be optimized and used effectively in e-business strategic planning and strategic planning evaluation of various e-services in very large organizations and businesses. A synoptic statistical analysis and comparative numerical results for the case of UK and Greece are given. The proposed e-business models indicate how e-business strategic planning may affect financial and non-financial performance in business and organizations by exploring whether models which are used for strategy planning can be applied to e-business planning and whether these models would be valid in different environments. A conceptual model has been constructed and qualitative research methods have been used for testing a predetermined number of considered hypotheses. The proposed models have been tested in the UK and Greece and the conclusions including numerical results and statistical analyses indicated existing relationships between considered dependent and independent variables. The proposed e-business models are expected to contribute to e-business strategy planning of businesses and organizations and managers should consider applying these models to their e-business strategy planning to improve their companies’ performances. This research study brings together elements of e

  10. Improved fuel design economics - a new evaluation tool

    International Nuclear Information System (INIS)

    Aboudara, J.L.

    1987-01-01

    Advanced fuel design technology is now beginning to be implemented with new reload regions for large pressurized water reactors. Until recently there has not been an integrated computer modeling product that would allow easy assessment of the economics of various advanced fuel design alternatives now available to utilities. The Fuel Cycle Scoping System (FCSS) was designed to fill this need. The FCSS is a personnel computer (PC) software package that is used to evaluate alternative strategies for supplying and using nuclear fuel in nuclear power reactors. The FCSS is an extremely flexible package that permits evaluation of in-core and out-of-core fuel management strategy options. For each strategy option, unit and reactor operating assumptions and assumptions for uranium supply, conversion, enrichment, fabrication, and spent fuel disposal can be made

  11. Evaluating environmental and economic consequences of alternative pest management strategies: results of modeling workshops

    Science.gov (United States)

    Johnson, Richard L.; Andrews, Austin K.; Auble, Gregor T.L.; Ellison, Richard A.; Hamilton, David B.; Roelle, James E.; McNamee, Peter J.

    1983-01-01

    The U.S. Environmental Protection Agency (EPA) needs a comprehensive method to evaluate the human health and environmental effects of alternative agricultural pest management strategies. This project explored the utility of Adaptive Environmental Assessment (AEA) techniques for meeting this need. The project objectives were to produce models for environmental impact analysis, improve communications, identify research needs and data requirements, and demonstrate a process for resolving conflicts. The project was structured around the construction (in an initial 2 1/2-day workshop) and examination (in a second 2 1/2-day workshop) of a simulation model of a corn agroecosystem.

  12. Strategy on biological evaluation for biodegradable/absorbable materials and medical devices.

    Science.gov (United States)

    Liu, Chenghu; Luo, Hongyu; Wan, Min; Hou, Li; Wang, Xin; Shi, Yanping

    2018-01-01

    During the last two decades, biodegradable/absorbable materials which have many benefits over conventional implants are being sought in clinical practices. However, to date, it still remains obscure for us to perform full physic-chemical characterization and biological risk assessment for these materials and related devices due to their complex design and coherent processing. In this review, based on the art of knowledge for biodegradable/absorbable materials and biological risk assessment, we demonstrated some promising strategies to establish and improve the current biological evaluation systems for these biodegradable/absorbable materials and related medical devices.

  13. What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review.

    Science.gov (United States)

    Siron, Stéphanie; Dagenais, Christian; Ridde, Valéry

    2015-11-01

    This study describes the current state of research on knowledge transfer strategies to improve public health in low-income countries, to identify the knowledge gaps on this topic. In this scoping review, a descriptive and systematic process was used to analyse, for each article retained, descriptions of research context and methods, types of knowledge transfer activities and results reported. 28 articles were analysed. They dealt with the evaluation of transfer strategies that employed multiple activities, mostly targeting health professionals and women with very young children. Most often these studies used quantitative designs and measurements of instrumental use with some methodological shortcomings. Results were positive and suggested recommendations for improving professional practices, knowledge and health-related behaviours. The review highlights the great diversity of transfer strategies used, strategies and many conditions for knowledge use. The review provides specific elements for understanding the transfer processes in low-income countries and highlights the need for systematic evaluation of the conditions for research results utilization.

  14. Improving Writing Quality: Evaluation Report and Executive Summary

    Science.gov (United States)

    Torgerson, David; Torgerson, Carole; Ainsworth, Hannah; Buckley, Hannah; Heaps, Clare; Hewitt, Catherine; Mitchell, Natasha

    2014-01-01

    Self-Regulated Strategy Development (SRSD) is a writing process model in which students are encouraged to plan, draft, edit, and revise their writing. In this evaluation 23 primary schools and their Year 6 teachers in the Calderdale area of West Yorkshire were randomly allocated to receive training in the SRSD approach from an external consultant.…

  15. Evaluation of the National Teenage Pregnancy Strategy: final synthesis report

    OpenAIRE

    Wellings, Kaye; Wilkinson, Paul; Kane, Ros

    2005-01-01

    The Teenage Pregnancy Strategy in England, published in June 1999, is a multifaceted strategy that includes action to both halve the under 18 conception rate by 2010 and provide support to teenage parents to reduce the long term risk of social exclusion by increasing the proportion in education, training and employment. The Strategy has four major components: 1) a national media awareness campaign via independent radio and teenage magazines, 2) joined up action to ensure that ...

  16. Mechanism analysis and evaluation methodology of regenerative braking contribution to energy efficiency improvement of electrified vehicles

    International Nuclear Information System (INIS)

    Lv, Chen; Zhang, Junzhi; Li, Yutong; Yuan, Ye

    2015-01-01

    Highlights: • The energy flow of an electric vehicle with regenerative brake is analyzed. • Methodology for measuring the regen brake contribution is discussed. • Evaluation parameters of regen brake contribution are proposed. • Vehicle tests are carried out on chassis dynamometer. • Test results verify the evaluation method and parameters proposed. - Abstract: This article discusses the mechanism and evaluation methods of contribution brought by regenerative braking to electric vehicle’s energy efficiency improvement. The energy flow of an electric vehicle considering the braking energy regeneration was analyzed. Then, methodologies for measuring the contribution made by regenerative brake to vehicle energy efficiency improvement were introduced. Based on the energy flow analyzed, two different evaluation parameters were proposed. Vehicle tests were carried out on chassis dynamometer under typical driving cycles with three different control strategies. The experimental results the difference between the proposed two evaluation parameters, and demonstrated the feasibility and effectiveness of the evaluation methodologies proposed

  17. [Evaluation of the organization of health services as a strategy for the prevention and control of visceral leishmaniasis].

    Science.gov (United States)

    Barbosa, Miriam Nogueira; Guimarães, Eliete Albano de Azevedo; Luz, Zélia Maria Profeta da

    2016-01-01

    to evaluate the organization of health services as a strategy for the prevention and control of visceral leishmaniasis (VL) in Ribeirão das Neves, Minas Gerais, Brazil, from 2010 to 2012. this was a case study evaluation of the degree of implementation of a strategy for the integration of health care services, control of zoonosis and epidemiological surveillance; it consisted of observing the work process, interviewing health professionals and analysing secondary data from information systems. implementation was partially adequate (84%); in terms of structure, the human resources component had the worst evaluation (64%) whilst in terms of work process, evaluation was 80% for reorganization of care and 77% for surveillance; in the period 2010-2012 there was a 20% increase in reported cases of VL and a 20% reduction in the time interval between reporting a case and starting treatment. the strategy contributed to the improvement of the organization of VL prevention and control actions.

  18. Milestone-specific, Observed data points for evaluating levels of performance (MODEL) assessment strategy for anesthesiology residency programs.

    Science.gov (United States)

    Nagy, Christopher J; Fitzgerald, Brian M; Kraus, Gregory P

    2014-01-01

    Anesthesiology residency programs will be expected to have Milestones-based evaluation systems in place by July 2014 as part of the Next Accreditation System. The San Antonio Uniformed Services Health Education Consortium (SAUSHEC) anesthesiology residency program developed and implemented a Milestones-based feedback and evaluation system a year ahead of schedule. It has been named the Milestone-specific, Observed Data points for Evaluating Levels of performance (MODEL) assessment strategy. The "MODEL Menu" and the "MODEL Blueprint" are tools that other anesthesiology residency programs can use in developing their own Milestones-based feedback and evaluation systems prior to ACGME-required implementation. Data from our early experience with the streamlined MODEL blueprint assessment strategy showed substantially improved faculty compliance with reporting requirements. The MODEL assessment strategy provides programs with a workable assessment method for residents, and important Milestones data points to programs for ACGME reporting.

  19. Improving Numeracy and Literacy: Evaluation Report and Executive Summary

    Science.gov (United States)

    Worth, Jack; Sizmur, Juliet; Ager, Rob; Styles, Ben

    2015-01-01

    The project, "Oxford Improving Numeracy and Literacy Programme," was delivered by Oxford University Department of Education. This evaluation tested two different initiatives with Year 2 children: "Mathematics and Reasoning" and "Literacy and Morphemes." The "Mathematics and Reasoning" programme aimed to…

  20. Analysis of strategies for improving uranium utilization in pressurized water reactors. Annual technical progress report for FY 1980

    International Nuclear Information System (INIS)

    Sefcik, J.A.; Driscoll, M.J.; Lanning, D.D.

    1981-01-01

    Systematic procedures have been devised and applied to evaluate core design and fuel management strategies for improving uranium utilization in Pressurized Water Reactors operated on a once-through fuel cycle. A principal objective has been the evaluation of suggested improvements on a self-consistent basis, allowing for concurrent changes in dependent variables such as core leakage and batch power histories, which might otherwise obscure the sometimes subtle effects of interest. Two levels of evaluation have been devised: a simple but accurate analytic model based on the observed linear variations in assembly reactivity as a function of burnup; and a numerical approach, embodied in a computer program, which relaxes this assumption and combines it with empirical prescriptions for assembly (or batch) power as a function of reactivity, and core leakage as a function of peripheral assembly power. State-of-the-art physics methods, such as PDQ-7, were used to verify and supplement these techniques

  1. Evaluation of three lidar scanning strategies for turbulence measurements

    DEFF Research Database (Denmark)

    Newman, Jennifer F.; Klein, Petra M.; Wharton, Sonia

    2016-01-01

    Several errors occur when a traditional Doppler beam swinging (DBS) or velocity-azimuth display (VAD) strategy is used to measure turbulence with a lidar. To mitigate some of these errors, a scanning strategy was recently developed which employs six beam positions to independently estimate the u,...

  2. Evaluation of Advanced Data Centre Power Management Strategies

    NARCIS (Netherlands)

    Postema, Björn F.; Haverkort, Boudewijn R.

    2018-01-01

    In recent work, we proposed a new specification language for power management strategies as an extension to our AnyLogic-based simulation framework for the trade-off analysis of power and performance in data centres. In this paper, we study the quality of such advanced power management strategies

  3. An integrated approach to place Green Infrastructure strategies in marginalized communities and evaluate stormwater mitigation

    Science.gov (United States)

    Garcia-Cuerva, Laura; Berglund, Emily Zechman; Rivers, Louie

    2018-04-01

    Increasing urbanization augments impervious surface area, which results in increased run off volumes and peak flows. Green Infrastructure (GI) approaches are a decentralized alternative for sustainable urban stormwater and provide an array of ecosystem services and foster community building by enhancing neighborhood aesthetics, increasing property value, and providing shared green spaces. While projects involving sustainability concepts and environmental design are favored in privileged communities, marginalized communities have historically been located in areas that suffer from environmental degradation. Underprivileged communities typically do not receive as many social and environmental services as advantaged communities. This research explores GI-based management strategies that are evaluated at the watershed scale to improve hydrological performance by mitigating storm water run off volumes and peak flows. GI deployment strategies are developed to address environmental justice issues by prioritizing placement in communities that are underprivileged and locations with high outreach potential. A hydrologic/hydraulic stormwater model is developed using the Storm Water Management Model (SWMM 5.1) to simulate the impacts of alternative management strategies. Management scenarios include the implementation of rain water harvesting in private households, the decentralized implementation of bioretention cells in private households, the centralized implementation of bioretention cells in municipally owned vacant land, and combinations of those strategies. Realities of implementing GI on private and public lands are taken into account to simulate various levels of coverage and routing for bioretention cell scenarios. The effects of these strategies are measured by the volumetric reduction of run off and reduction in peak flow; social benefits are not evaluated. This approach is applied in an underprivileged community within the Walnut Creek Watershed in Raleigh, North

  4. Risk evaluation and mitigation strategies (REMS): educating the prescriber.

    Science.gov (United States)

    Nicholson, Susan C; Peterson, Janet; Yektashenas, Behin

    2012-02-01

    The US FDA Amendments Act of 2007 was signed into law on 27 September 2007. A provision of this law granted the FDA new powers to enhance drug safety by requiring the pharmaceutical industry to develop Risk Evaluation and Mitigation Strategies (REMS). REMS are deemed necessary when a question exists as to whether the benefits of a drug outweigh its risks. REMS constitute a safety plan with several potential components, including a medication guide, a communication plan, elements to ensure safe use and an implementation system to help guide the prescribers, pharmacists and patients. This applies to existing drugs on the market, new drug applications (NDAs), abbreviated NDAs (generics) and biologics licence applications. REMS represent an 'upgrade' from previously required risk minimization action plans, based on the strengthening of FDA powers of authority and enforceability to incur monetary penalties against individuals representing the pharmaceutical industry who fail to comply. For illustrative purposes, we chose the drug romiplostim (Nplate®) to present an REMS, as all components were utilized to help assuage risks associated with the drug. Romiplostim is an FDA-approved drug used to treat thrombocytopenia in patients with chronic immune (idiopathic) thrombocytopenic purpura that has a significant adverse safety profile based on the risk of changes in bone marrow reticulin formation and bone marrow fibroses, and other associated risks. This review of current REMS policy is intended to provide the prescriber with a better understanding of current modalities in FDA-mandated drug safety programmes, which will impact day-to-day healthcare provider practices.

  5. Research on the control strategy of distributed energy resources inverter based on improved virtual synchronous generator.

    Science.gov (United States)

    Gao, Changwei; Liu, Xiaoming; Chen, Hai

    2017-08-22

    This paper focus on the power fluctuations of the virtual synchronous generator(VSG) during the transition process. An improved virtual synchronous generator(IVSG) control strategy based on feed-forward compensation is proposed. Adjustable parameter of the compensation section can be modified to achieve the goal of reducing the order of the system. It can effectively suppress the power fluctuations of the VSG in transient process. To verify the effectiveness of the proposed control strategy for distributed energy resources inverter, the simulation model is set up in MATLAB/SIMULINK platform and physical experiment platform is established. Simulation and experiment results demonstrate the effectiveness of the proposed IVSG control strategy.

  6. Implementation and evaluation of critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses.

    Science.gov (United States)

    Simpson, Elaine; Courtney, Mary

    2008-12-01

    The purpose of this study was to develop, implement and evaluate critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses. Critical thinking strategies such as questioning, debate, role play and small group activity were developed and used in a professional development programme, which was trialled on a sample of Middle Eastern nurses (n = 20), to promote critical thinking skills, encourage problem solving, development of clinical judgment making and care prioritization in order to improve patient care and outcomes. Classroom learning was transformed from memorization to interaction and active participation. The intervention programme was successful in developing critical thinking skills in both the nurse educators and student nurses in this programme. This programme successfully integrated critical thinking strategies into a Middle Eastern nursing curriculum. Recommendations are as follows: (1) utilize evidence-based practice and stem questions to encourage the formulation of critical thinking questions; (2) support the needs of nurse educators for them to effectively implement teaching strategies to foster critical thinking skills; and (3) adopt creative approaches to (i) transform students into interactive participants and (ii) open students' minds and stimulate higher-level thinking and problem-solving abilities.

  7. Strategy for improved frequency response of electric double-layer capacitors

    Science.gov (United States)

    Wada, Yoshifumi; Pu, Jiang; Takenobu, Taishi

    2015-10-01

    We propose a strategy for improving the response speed of electric double-layer capacitors (EDLCs) and electric double-layer transistors (EDLTs), based on an asymmetric structure with differently sized active materials and gate electrodes. We validate the strategy analytically by a classical calculation and experimentally by fabricating EDLCs with asymmetric Au electrodes (1:50 area ratio and 7.5 μm gap distance). The performance of the EDLCs is compared with that of conventional symmetric EDLCs. Our strategy dramatically improved the cut-off frequency from 14 to 93 kHz and this improvement is explained by fast charging of smaller electrodes. Therefore, this approach is particularly suitable to EDLTs, potentially expanding the applicability to medium speed (kHz-MHz) devices.

  8. Strategies to improve homing of mesenchymal stem cells for greater efficacy in stem cell therapy.

    Science.gov (United States)

    Naderi-Meshkin, Hojjat; Bahrami, Ahmad Reza; Bidkhori, Hamid Reza; Mirahmadi, Mahdi; Ahmadiankia, Naghmeh

    2015-01-01

    Stem/progenitor cell-based therapeutic approach in clinical practice has been an elusive dream in medical sciences, and improvement of stem cell homing is one of major challenges in cell therapy programs. Stem/progenitor cells have a homing response to injured tissues/organs, mediated by interactions of chemokine receptors expressed on the cells and chemokines secreted by the injured tissue. For improvement of directed homing of the cells, many techniques have been developed either to engineer stem/progenitor cells with higher amount of chemokine receptors (stem cell-based strategies) or to modulate the target tissues to release higher level of the corresponding chemokines (target tissue-based strategies). This review discusses both of these strategies involved in the improvement of stem cell homing focusing on mesenchymal stem cells as most frequent studied model in cellular therapies. © 2014 International Federation for Cell Biology.

  9. Economic evaluation of an implementation strategy for the management of low back pain in general practice.

    Science.gov (United States)

    Jensen, Cathrine Elgaard; Riis, Allan; Petersen, Karin Dam; Jensen, Martin Bach; Pedersen, Kjeld Møller

    2017-05-01

    In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.

  10. Does the EUA Institutional Evaluation Programme Contribute to Quality Improvement?

    Science.gov (United States)

    Tavares, Diana Amado; Rosa, Maria Joao; Amaral, Alberto

    2010-01-01

    Purpose: This paper aims to reflect on the relevance of the Institutional Evaluation Programme (IEP) of the European University Association (EUA) to universities' quality improvement. It aims to analyse IEP follow-up reports to determine whether the programme contributes to the development of a quality improvement culture.…

  11. An evaluation of the Australian Football League Central Australian Responsible Alcohol Strategy 2005-07.

    Science.gov (United States)

    Mentha, Ricky; Wakerman, Johne

    2009-12-01

    In 2004, the Australian Football League Central Australia (AFLCA) implemented the Responsible Alcohol Strategy (RAS), which aimed to decrease alcohol consumption at matches, and to promote healthy lifestyle messages to the youth of Central Australia participating in Australian Rules football. The evaluation adopted a pre- and post-implementation design to monitor a number of performance indicators. The evaluation analysed routinely collected data from AFLCA, its Security Company, Alice Springs Police Department and Alice Springs Hospital; we surveyed AFLCA staff, club officials and umpires; and undertook direct observation at AFLCA events. The volume of alcohol sold at matches decreased. Survey data indicate decreased alcohol related violence, improved spectator behaviour and decreased spectator attendances. Police data suggest declining alcohol-related and violent behaviours, but trends were not statistically significant. Alice Springs Hospital injury admission data indicate a non-significant interaction between year and season effect. In a community context of high alcohol consumption and high rates of interpersonal violence, the strategies implemented were successful in decreasing alcohol consumption and related undesirable behaviours at football games. However, these measures have resulted in unintended consequences: decreased numbers of spectators attending games, decreased canteen sales and falling sponsorship. The decreased revenue has raised serious issues about sustainability of the alcohol intervention, and stimulated discussions with government and others about strategies to maintain this important alcohol reduction policy.

  12. Process Improvement Teams: A TQM Strategy for Improving Community College Systems.

    Science.gov (United States)

    Needham, Robbie Lee; And Others

    The three principle elements of Total Quality Management (TQM) are a focus on customers; an attitude of continuous improvement of a system; and the involvement of everyone within an organization. At Delaware County Community College (DCCC) in Media, Pennsylvania, the first phase of implementing TQM focused on educating top management for the…

  13. Evaluation and comparison of New 4DCT based strategies for proton treatment planning for lung tumors

    International Nuclear Information System (INIS)

    Wang, Ning; Patyal, Baldev; Ghebremedhin, Abiel; Bush, David

    2013-01-01

    To evaluate different strategies for proton lung treatment planning based on four-dimensional CT (4DCT) scans. Twelve cases, involving only gross tumor volumes (GTV), were evaluated. Single image sets of (1) maximum intensity projection (MIP3) of end inhale (EI), middle exhale (ME) and end exhale (EE) images; (2) average intensity projection (AVG) of all phase images; and (3) EE images from 4DCT scans were selected as primary images for proton treatment planning. Internal target volumes (ITVs) outlined by a clinician were imported into MIP3, AVG, and EE images as planning targets. Initially, treatment uncertainties were not included in planning. Each plan was imported into phase images of 4DCT scans. Relative volumes of GTVs covered by 95% of prescribed dose and mean ipsilateral lung dose of a phase image obtained by averaging the dose in inspiration and expiration phases were used to evaluate the quality of a plan for a particular case. For comparing different planning strategies, the mean of the averaged relative volumes of GTVs covered by 95% of prescribed dose and its standard deviation for each planning strategy for all cases were used. Then, treatment uncertainties were included in planning. Each plan was recalculated in phase images of 4DCT scans. Same strategies were used for plan evaluation except dose-volume histograms of the planning target volumes (PTVs) instead of GTVs were used and the mean and standard deviation of the relative volumes of PTVs covered by 95% of prescribed dose and the ipsilateral lung dose were used to compare different planning strategies. MIP3 plans without treatment uncertainties yielded 96.7% of the mean relative GTV covered by 95% of prescribed dose (standard deviations of 5.7% for all cases). With treatment uncertainties, MIP3 plans yielded 99.5% of mean relative PTV covered by 95% of prescribed dose (standard deviations of 0.7%). Inclusion of treatment uncertainties improved PTV dose coverage but also increased the ipsilateral

  14. Meeting the Pepsi Challenge: Preparing Evaluation Programs for Scholastic Improvement.

    Science.gov (United States)

    Hopkins, Mona S.

    This document provides guidelines for preparing evaluation programs for scholastic improvement. The philosophy underlying assessment and accountability is discussed, with specific reference to the positive and negative aspects of assessment. The design of a curriculum evaluation model is presented, including goal identification, data gathering,…

  15. Adapting Job Analysis Methodology to Improve Evaluation Practice

    Science.gov (United States)

    Jenkins, Susan M.; Curtin, Patrick

    2006-01-01

    This article describes how job analysis, a method commonly used in personnel research and organizational psychology, provides a systematic method for documenting program staffing and service delivery that can improve evaluators' knowledge about program operations. Job analysis data can be used to increase evaluators' insight into how staffs…

  16. Evidence-based evaluation of treatment strategy for multiple sclerosis

    Directory of Open Access Journals (Sweden)

    LI Meng-qiu

    2012-04-01

    Full Text Available Objective To formulate the best treatment plan for multiple sclerosis (MS patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Key words were defined as multiple sclerosis, immunomodulatory therapy and therapy, etc. We searched MEDLINE, Cochrane Library, Wanfang data bases for Scientific Journals in China and National Knowledge Infrastructure for Chinese Scientific Journals Database. Additionally, we applied manual searching and screened out conference paper and academic dissertation, etc, from various references. After that we obtained and evaluated by Jadad scales on systematic reviews, randomized controlled trials, controlled clinical trials and observational study cases about glucocorticoids, plasmapheresis, intravenous immunoglobulin, IFN-β, glatiramer acetate, mitoxantrone, natalizumab, fingolimod. Results After screening, all seventeen selected resources included systematic reviews 6 articles, randomized controlled trials 7 articles, controlled clinical trials 2 articles, observational study cases 2 articles, among which fifteen articles were proved to be high quality (according to Jadad scoring system, five score 4, six score 5, four score 7, two chapters were judged to be low quality scoring 3. Finally, we summerize that: 1 The first choice of treatment for acute relapses is glucocorticoids and we suggest that plasmapheresis or intravenous immunoglobulin may be tried as an alternative therapy in acute MS relapse, especially in case of contraindications to intravenous methylprednisolone. 2 Immunomodulatory or immunosuppressive treatment (IFN-β, glatiramer acetate, mitoxantrone, natalizumab can be an option to prevent new relapses and progression of disability. 3 Fingolimod is an oral treatment for multiple sclerosis to improve treatment adherence. Conclusion Using evidence-based medicine methods can provide us best clinical evidence on MS treatment.

  17. Management systems improvement strategy for the Office of Civilian Radioactive Waste Management

    International Nuclear Information System (INIS)

    Shelor, D.E.

    1991-01-01

    To achieve the goal of permanent disposal of spent nuclear fuel and high-level radioactive waste, the US DOE's Office of Civilian Radioactive Waste Management (OCRWM) is implementing a Management Systems Improvement Strategy (MSIS). This MSIS is structured around the systems engineering approach that separates the program mission into system and programmatic functions. OCRWM believes that this strategy will significantly improve the program and provide the framework needed to ensure successful implementation of the activities necessary to fulfill the mandate of the Nuclear Waste Policy Act, as amended

  18. Improved Control Strategy for T-type Isolated DC/DC Converters

    DEFF Research Database (Denmark)

    Liu, Dong; Deng, Fujin; Wang, Yanbo

    2017-01-01

    T-type isolated DC/DC converters have recently attracted attention due to their numerous advantages, including few components, low cost, and symmetrical operation of transformers. This study proposes an improved control strategy for increasing the efficiency of T-type isolated DC/DC converters....... Under the proposed strategy, the primary circulating current flows through the auxiliary switches (metal–oxide–semiconductor field-effect transistors) instead of their body diodes in free-wheeling periods. Such feature can reduce conduction losses, thereby improving the efficiency of T-type isolated DC...

  19. Aspects you should consider in your action plan when implementing an improvement strategy

    DEFF Research Database (Denmark)

    Carstensen, Peter; Vinter, Otto

    2017-01-01

    Both ISO/IEC 15504 (SPICE) and ISO/IEC 33014 include a step in their improvement process called: Develop action plan. But which actions should you include, and are you sure that these actions cover all aspects? We have performed a thorough study of the change strategy literature that is the found......Both ISO/IEC 15504 (SPICE) and ISO/IEC 33014 include a step in their improvement process called: Develop action plan. But which actions should you include, and are you sure that these actions cover all aspects? We have performed a thorough study of the change strategy literature...

  20. Embracing technology? Using change management strategies to improve the use of continuous lateral rotation therapy.

    Science.gov (United States)

    Cybulski, Pamela; Zantinge, Johanna; Abbott-McNeil, Deanna

    2006-01-01

    The purpose of this quality improvement initiative was to improve the utilization of continuous lateral rotation therapy (CLRT) in a nine-bed community hospital ICU within the context of a nurse-driven protocol. Nursing focus groups, analyzed using a strength, weakness, opportunity, threat (SWOT) approach, resulted in the implementation of four interventions over seven weeks. Change management strategies guided all aspects of the project. Results showed a modest increase in the utilization of CLRT. This initiative demonstrates that change management strategies may assist with the incorporation of technology into nursing practice by increasing empowerment and creating an attachment to and responsibility for outcomes.

  1. Evaluation of strategies for end storage of high-level reactor fuel; Vurdering av strategier for sluttlagring av hoeyaktivt reaktorbrensel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This report evaluates a national strategy for end-storage of used high-level reactor fuel from the research reactors at Kjeller and in Halden. This strategy presupposes that all the important phases in handling the high-level material, including temporary storage and deposition, are covered. The quantity of spent fuel from Norwegian reactors is quite small. In addition to the technological issues, ethical, environmental, safety and economical requirements are emphasized.

  2. Process Evaluation and Continuous Improvement in Community Youth Programs

    Directory of Open Access Journals (Sweden)

    Jennifer V. Trachtenberg

    2008-06-01

    Full Text Available A method of using process evaluation to provide improvement plans in order to promote community youth programs is described. The core elements of this method include the following: (1 collection and analysis of baseline data, (2 feedback provided to programs describing their strengths and limitations, (3 programs provided with assistance in preparing improvement plans in regard to their baseline data, and (4 follow-up evaluation assessed program changes based on their improvement plans and baseline data. A case study of an inner-city neighborhood youth center is used to demonstrate this method.

  3. Evaluation of three coding schemes designed for improved data communication

    Science.gov (United States)

    Snelsire, R. W.

    1974-01-01

    Three coding schemes designed for improved data communication are evaluated. Four block codes are evaluated relative to a quality function, which is a function of both the amount of data rejected and the error rate. The Viterbi maximum likelihood decoding algorithm as a decoding procedure is reviewed. This evaluation is obtained by simulating the system on a digital computer. Short constraint length rate 1/2 quick-look codes are studied, and their performance is compared to general nonsystematic codes.

  4. Strategy for 90% autoverification of clinical chemistry and immunoassay test results using six sigma process improvement.

    Science.gov (United States)

    Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

    2018-06-01

    Six Sigma involves a structured process improvement strategy that places processes on a pathway to continued improvement. The data presented here summarizes a project that took three clinical laboratories from autoverification processes that allowed between about 40% to 60% of tests being auto-verified to more than 90% of tests and samples auto-verified. The project schedule, metrics and targets, a description of the previous system and detailed information on the changes made to achieve greater than 90% auto-verification is presented for this Six Sigma DMAIC (Design, Measure, Analyze, Improve, Control) process improvement project.

  5. Evaluation strategy of regenerative braking energy for supercapacitor vehicle.

    Science.gov (United States)

    Zou, Zhongyue; Cao, Junyi; Cao, Binggang; Chen, Wen

    2015-03-01

    In order to improve the efficiency of energy conversion and increase the driving range of electric vehicles, the regenerative energy captured during braking process is stored in the energy storage devices and then will be re-used. Due to the high power density of supercapacitors, they are employed to withstand high current in the short time and essentially capture more regenerative energy. The measuring methods for regenerative energy should be investigated to estimate the energy conversion efficiency and performance of electric vehicles. Based on the analysis of the regenerative braking energy system of a supercapacitor vehicle, an evaluation system for energy recovery in the braking process is established using USB portable data-acquisition devices. Experiments under various braking conditions are carried out. The results verify the higher efficiency of energy regeneration system using supercapacitors and the effectiveness of the proposed measurement method. It is also demonstrated that the maximum regenerative energy conversion efficiency can reach to 88%. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  6. Novel strategy to improve vanillin tolerance and ethanol fermentation performances of Saccharomycere cerevisiae strains.

    Science.gov (United States)

    Zheng, Dao-Qiong; Jin, Xin-Na; Zhang, Ke; Fang, Ya-Hong; Wu, Xue-Chang

    2017-05-01

    The aim of this work was to develop a novel strategy for improving the vanillin tolerance and ethanol fermentation performances of Saccharomyces cerevisiae strains. Isogeneic diploid, triploid, and tetraploid S. cerevisiae strains were generated by genome duplication of haploid strain CEN.PK2-1C. Ploidy increments improved vanillin tolerance and diminished proliferation capability. Antimitotic drug methyl benzimidazol-2-ylcarbamate (MBC) was used to introduce chromosomal aberrations into the tetraploid S. cerevisiae strain. Interestingly, aneuploid mutants with DNA contents between triploid and tetraploid were more resistant to vanillin and showed faster ethanol fermentation rates than all euploid strains. The physiological characteristics of these mutants suggest that higher bioconversion capacities of vanillin and ergosterol contents might contribute to improved vanillin tolerance. This study demonstrates that genome duplication and MBC treatment is a powerful strategy to improve the vanillin tolerance of yeast strains. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Improving the basic skills of teaching mathematics through learning with search-solve-create-share strategy

    Science.gov (United States)

    Rahayu, D. V.; Kusumah, Y. S.; Darhim

    2018-05-01

    This study examined to see the improvement of prospective teachers’ basic skills of teaching mathematics through search-solve-create-share learning strategy based on overall and Mathematical Prior Knowledge (MPK) and interaction of both. Quasi experiments with the design of this experimental-non-equivalent control group design involved 67 students at the mathematics program of STKIP Garut. The instrument used in this study included pre-test and post-test. The result of this study showed that: (1) The improvement and achievement of the basic skills of teaching mathematics of the prospective teachers who get the learning of search-solve-create-share strategy is better than the improvement and achievement of the prospective teachers who get the conventional learning as a whole and based on MPK; (2) There is no interaction between the learning used and MPK on improving and achieving basic skills of teaching mathematics.

  8. Dosimetric evaluation of three adaptive strategies for prostate cancer treatment including pelvic lymph nodes irradiation.

    Science.gov (United States)

    Cantin, Audrey; Gingras, Luc; Lachance, Bernard; Foster, William; Goudreault, Julie; Archambault, Louis

    2015-12-01

    The movements of the prostate relative to the pelvic lymph nodes during intensity-modulated radiation therapy treatment can limit margin reduction and affect the protection of the organs at risk (OAR). In this study, the authors performed an analysis of three adaptive treatment strategies that combine information from both bony and gold marker registrations. The robustness of those treatments against the interfraction prostate movements was evaluated. A retrospective study was conducted on five prostate cancer patients with 7-13 daily cone-beam CTs (CBCTs). The clinical target volumes (CTVs) consisting of pelvic lymph nodes, prostate, and seminal vesicles as well as the OARs were delineated on each CBCT and the initial CT. Three adaptive strategies were analyzed. Two of these methods relied on a two-step patient positioning at each fraction. First step: a bony registration was used to deliver the nodal CTV prescription. Second step: a gold marker registration was then used either to (1) complete the dose delivered to the prostate (complement); (2) or give almost the entire prescription to the prostate with a weak dose gradient between the targets to compensate for possible motions (gradient). The third method (COR) used a pool of precalculated plans based on images acquired at previous treatment fractions. At each new fraction, a plan is selected from that pool based on the daily position of prostate center-of-mass. The dosimetric comparison was conducted and results are presented with and without the systematic shift in the prostate position on the CT planning. The adaptive strategies were compared to the current clinical standard where all fractions are treated with the initial nonadaptive plan. The minimum daily prostate D95% is improved by 2%, 9%, and 6% for the complement, the gradient, and the COR approaches, respectively, compared to the nonadaptive method. The average nodal CTV D95% remains constant across the strategies, except for the gradient approach

  9. Dosimetric evaluation of three adaptive strategies for prostate cancer treatment including pelvic lymph nodes irradiation

    International Nuclear Information System (INIS)

    Cantin, Audrey; Gingras, Luc; Archambault, Louis; Lachance, Bernard; Foster, William; Goudreault, Julie

    2015-01-01

    Purpose: The movements of the prostate relative to the pelvic lymph nodes during intensity-modulated radiation therapy treatment can limit margin reduction and affect the protection of the organs at risk (OAR). In this study, the authors performed an analysis of three adaptive treatment strategies that combine information from both bony and gold marker registrations. The robustness of those treatments against the interfraction prostate movements was evaluated. Methods: A retrospective study was conducted on five prostate cancer patients with 7–13 daily cone-beam CTs (CBCTs). The clinical target volumes (CTVs) consisting of pelvic lymph nodes, prostate, and seminal vesicles as well as the OARs were delineated on each CBCT and the initial CT. Three adaptive strategies were analyzed. Two of these methods relied on a two-step patient positioning at each fraction. First step: a bony registration was used to deliver the nodal CTV prescription. Second step: a gold marker registration was then used either to (1) complete the dose delivered to the prostate (complement); (2) or give almost the entire prescription to the prostate with a weak dose gradient between the targets to compensate for possible motions (gradient). The third method (COR) used a pool of precalculated plans based on images acquired at previous treatment fractions. At each new fraction, a plan is selected from that pool based on the daily position of prostate center-of-mass. The dosimetric comparison was conducted and results are presented with and without the systematic shift in the prostate position on the CT planning. The adaptive strategies were compared to the current clinical standard where all fractions are treated with the initial nonadaptive plan. Results: The minimum daily prostate D 95% is improved by 2%, 9%, and 6% for the complement, the gradient, and the COR approaches, respectively, compared to the nonadaptive method. The average nodal CTV D 95% remains constant across the strategies

  10. A Strategy for Detection of Inconsistency in Evaluation of Essay Type Answers

    Science.gov (United States)

    Shukla, Archana; Chaudhary, Banshi D.

    2014-01-01

    The quality of evaluation of essay type answer books involving multiple evaluators for courses with large number of enrollments is likely to be affected due to heterogeneity in experience, expertise and maturity of evaluators. In this paper, we present a strategy to detect anomalies in evaluation of essay type answers by multiple evaluators based…

  11. Development of soft scaffolding strategy to improve student’s creative thinking ability in physics

    Science.gov (United States)

    Nurulsari, Novinta; Abdurrahman; Suyatna, Agus

    2017-11-01

    Student’s creative thinking ability in physics learning can be developed through a learning experience. However, many students fail to gain a learning experience because of the lack of teacher roles in providing assistance to students when they face learning difficulties. In this study, a soft scaffolding strategy developed to improve student’s creative thinking ability in physics, especially in optical instruments. The methods used were qualitative and quantitative. The soft scaffolding strategy developed was called the 6E Soft Scaffolding Strategy where 6E stands for Explore real-life problems, Engage students with web technology, Enable experiment using analogies, Elaborate data through multiple representations, Encourage questioning, and Ensure the feedback. The strategy was applied to 60 students in secondary school through cooperative learning. As a comparison, conventional strategies were also applied to 60 students in the same school and grade. The result of the study showed that the soft scaffolding strategy was effective in improving student’s creative thinking ability.

  12. [Guidance of FDA risk evaluation and mitigation strategy and enlightenment to drug risk management of post-marketing Chinese medicine].

    Science.gov (United States)

    Li, Yuanyuan; Xie, Yanming

    2011-10-01

    The FDA risk evaluation and mitigation strategy (REMS) aims to drugs or biological products known or potential serious risk management. Analysis with the example of the content of the Onsolis REMS named FOCOS. Our country can be reference for the analysis of relevant experience and establish a scientific evaluation mechanism, strengthen the drug risk consciousness, promote the rational drug use, organic combined with the before-marketing and post-marketing evaluation of traditional Chinese medicine, and promote the evaluation of risk management of the drug development and improvement.

  13. Strategies for improving memory: a randomized trial of memory groups for older people, including those with mild cognitive impairment.

    Science.gov (United States)

    Kinsella, Glynda J; Ames, David; Storey, Elsdon; Ong, Ben; Pike, Kerryn E; Saling, Michael M; Clare, Linda; Mullaly, Elizabeth; Rand, Elizabeth

    2016-01-01

    Governments are promoting the importance of maintaining cognitive health into older age to minimize risk of cognitive decline and dementia. Older people with amnestic mild cognitive impairment (aMCI) are particularly vulnerable to memory challenges in daily activities and are seeking ways to maintain independent living. To evaluate the effectiveness of memory groups for improving memory strategies and memory ability of older people, especially those with aMCI. 113 healthy older adults (HOA) and 106 adults with aMCI were randomized to a six-week memory group or a waitlist control condition. Outcome was evaluated through knowledge and use of memory strategies, memory ability (self-report and neuropsychological tests), and wellbeing. Assessments included a six-month follow-up. Using intention to treat analyses, there were intervention effects for HOA and aMCI groups in strategy knowledge (HOA: η2= 0.20; aMCI: η2= 0.06), strategy use (HOA: η2= 0.18; aMCI: η2= 0.08), and wellbeing (HOA: η2= 0.11; aMCI: η2= 0.05). There were also intervention effects in the HOA group, but not the aMCI group, in self-reported memory ability (η2= 0.06) and prospective memory tests (η2= 0.02). By six-month follow-up, gains were found on most HOA outcomes. In the aMCI group gains were found in strategy use, and by this stage, gains in prospective memory were also found. Memory groups can engage older people in techniques for maintaining cognitive health and improve memory performance, but more modest benefits are seen for older adults with aMCI.

  14. Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa.

    Science.gov (United States)

    Allegranzi, Benedetta; Sax, Hugo; Bengaly, Loséni; Richet, Hervé; Minta, Daouda K; Chraiti, Marie-Noelle; Sokona, Fatoumata Maiga; Gayet-Ageron, Angèle; Bonnabry, Pascal; Pittet, Didier

    2010-02-01

    To assess the feasibility and effectiveness of the World Health Organization hand hygiene improvement strategy in a low-income African country. A before-and-after study from December 2006 through June 2008, with a 6-month baseline evaluation period and a follow-up period of 8 months from the beginning of the intervention. University Hospital, Bamako, Mali. Participants. Two hundred twenty-four healthcare workers. The intervention consisted of introducing a locally produced, alcohol-based handrub; monitoring hand hygiene compliance; providing performance feedback; educating staff; posting reminders in the workplace; and promoting an institutional safety climate according to the World Health Organization multimodal hand hygiene improvement strategy. Hand hygiene infrastructure, compliance, healthcare workers' knowledge and perceptions, and handrub consumption were evaluated at baseline and at follow-up. Severe deficiencies in the infrastructure for hand hygiene were identified before the intervention. Local handrub production and quality control proved to be feasible, affordable, and satisfactory. At follow-up, handrubbing was the quasi-exclusive hand hygiene technique (93.3%). Compliance increased from 8.0% at baseline to 21.8% at follow-up (P appreciation of each strategy component by staff. Multimodal hand hygiene promotion is feasible and effective in a low-income country. Access to handrub was critical for its success. These findings motivated the government of Mali to expand the intervention nationwide. This experience represents a significant advancement for patient safety in developing countries.

  15. Strategies towards Evaluation beyond Scientific Impact. Pathways not only for Agricultural Research

    Directory of Open Access Journals (Sweden)

    Birge M. Wolf

    2013-12-01

    Full Text Available Various research fields, like organic agricultural research, are dedicated to solving real-world problems and contributing to sustainable development. Therefore, systems research and the application of interdisciplinary and transdisciplinary approaches are increasingly endorsed. However, research performance depends not only on self-conception, but also on framework conditions of the scientific system, which are not always of benefit to such research fields. Recently, science and its framework conditions have been under increasing scrutiny as regards their ability to serve societal benefit. This provides opportunities for (organic agricultural research to engage in the development of a research system that will serve its needs. This article focuses on possible strategies for facilitating a balanced research evaluation that recognises scientific quality as well as societal relevance and applicability. These strategies are (a to strengthen the general support for evaluation beyond scientific impact, and (b to provide accessible data for such evaluations. Synergies of interest are found between open access movements and research communities focusing on global challenges and sustainability. As both are committed to increasing the societal benefit of science, they may support evaluation criteria such as knowledge production and dissemination tailored to societal needs, and the use of open access. Additional synergies exist between all those who scrutinise current research evaluation systems for their ability to serve scientific quality, which is also a precondition for societal benefit. Here, digital communication technologies provide opportunities to increase effectiveness, transparency, fairness and plurality in the dissemination of scientific results, quality assurance and reputation. Furthermore, funders may support transdisciplinary approaches and open access and improve data availability for evaluation beyond scientific impact. If they begin to

  16. Improving Reading Comprehension Skills through Reading Strategies Used by a Group of Foreign Language Learners

    Directory of Open Access Journals (Sweden)

    Nancy Gómez Torres

    2009-12-01

    Full Text Available A research study included the examination and implementation of a variety of strategies in order to improve students’ reading comprehension skills in a foreign language. Reading is the process of identification, interpretation and perception of written or printed material. Comprehension is the understanding of the meaning of written material and involves the conscious strategies that lead to understanding. The reading strategies are conscious techniques or unconscious processes employed by readers in their attempt to make sense of the written text (Barnett as cited by Gascoigne, 2005. Thus, the main goal of this piece of research was to implement some reading strategies in 2 elementary courses in EFL in order to obtain better results in the middle and long term in class and on ECAES, MICHIGAN, MELICET and PET tests.

  17. Improved Control Strategy for DFIG-based Wind Energy Conversion System during Grid Voltage Disturbances

    DEFF Research Database (Denmark)

    Zhu, Rongwu

    electromagnetic torque during grid faults. Therefore, the virtual damping flux based strategy not only can help the DFIG achieve the LVRT requirement, but also can reduce the mechanical stress on the drive train. On the other hand, on the basis of the decaying characteristic of the stator flux, the passive...... flux based active damping strategy and the stator series resistance based passive damping strategy can help the DFIG to fulfill the LVRT requirement, and improve the DFIG performances. Besides the previous active and passive damping strategies, the modified power converter and DFIG configurations...... of the stator voltage can cause the transient stator flux, and then the transient stator flux may be enlarged due to the effects of the initial value. The amplitude of the transient flux is determined by both the instant and depth of stator voltage variation, and the decaying characteristic of the transient...

  18. Improving the Green Building Evaluation System in China Based on the DANP Method

    Directory of Open Access Journals (Sweden)

    Qi-Gan Shao

    2018-04-01

    Full Text Available Against the background of sustainable development, green building practices could be part of the strategy for solving environmental and energy problems in developing countries. The aim of this paper is to explore a system for the assessment of green buildings in China that provides the government and stakeholders with ways to improve their strategies for green building development. We apply a hybrid model, developed by integrating the Decision-Making Trial and Evaluation Laboratory and Analytical Network Process (called DANP method, to build an influential network relationship map (INRM between assessment systems and to derive the criterion weights. The INRM and derived weights can help us to understand this complex assessment system and to set improvement priorities for green building development. The results demonstrate that indoor environment, materials, and smart facilities are the top three critical factors for green building evaluation. Finally, we discuss some management implications based on an actual case study with solutions provided using this model.

  19. Implicit strategies to improve work and well-being: the social dimensions of organizational excellence

    NARCIS (Netherlands)

    Zwetsloot, G.I.J.M.; Scheppingen, A.R. van

    2010-01-01

    Significant improvements in health and well-being can be created as implicit by-products of activities from agents other than health professionals, with each of these agents having their own prime (i.e. parallel) interests. For this reason, more relevant strategies and interventions for promoting

  20. Effective Strategies To Improve the Employment of SSI/SSDI Participants.

    Science.gov (United States)

    Radtke, Jean, Ed.

    This document is for administrators, rehabilitation counselors, and other professionals who support the employment of Social Security Disability Insurance (SSDI) beneficiaries and Supplemental Security Income (SSI) recipients with disabilities. It contains strategies for vocational rehabilitation (VR) programs to improve an SSI or SSDI…

  1. Aspects you should consider in your action plan when implementing an improvement strategy

    DEFF Research Database (Denmark)

    Carstensen, Peter; Vinter, Otto

    2017-01-01

    Both ISO/IEC 15504 (SPICE) and ISO/IEC 33014 include a step in their improvement process called: Develop action plan. But which actions should you include, and are you sure that these actions cover all aspects? We have performed a thorough study of the change strategy literature that is the found...

  2. Food for rumination : developing novel feeding strategies to improve the welfare of veal calves

    NARCIS (Netherlands)

    Webb, L.E.

    2014-01-01

    Summary of thesis entitled: “Food for Rumination – Developing novel feeding strategies to improve the welfare of veal calves”, Laura Webb

    Veal calves are typically fed high levels of milk replacer supplemented with solid feed, which tends to contain a relatively small roughage component.

  3. Colocation as a hybrid ICT sourcing strategy to improve operational agility

    DEFF Research Database (Denmark)

    Beck, Roman; Pahlke, Immanuel; Vykoukal, Jens

    2016-01-01

    a hybrid ICT sourcing strategy called colocation that allows firms to operate their own ICT resources in facilities of special-ized data center providers. Grounded in the theory of dynamic capabilities, we theorize and empirically ex-amine how colocation and top management support enable firms to improve...... their operational agility in the presence of environmental turbulence....

  4. Using the Think-Pair-Share Strategy to Improve Students' Speaking Ability at STAIN Ternate

    Science.gov (United States)

    Usman, Abdurrahman Hi

    2015-01-01

    This research was conducted to improve students' English speaking ability by using the think-pair-share strategy designed in CAR. The findings in Cycle 1 was unsuccessful because the students' average scores was 74.18 and classroom atmospheres were "mid" that did not meet the criteria of success. Therefore, the implementation of the…

  5. Serotonin Transporter Knockout Rats Show Improved Strategy Set-Shifting and Reduced Latent Inhibition

    Science.gov (United States)

    Nonkes, Lourens J. P.; van de Vondervoort, Ilse I. G. M.; de Leeuw, Mark J. C.; Wijlaars, Linda P.; Maes, Joseph H. R.; Homberg, Judith R.

    2012-01-01

    Behavioral flexibility is a cognitive process depending on prefrontal areas allowing adaptive responses to environmental changes. Serotonin transporter knockout (5-HTT[superscript -/-]) rodents show improved reversal learning in addition to orbitofrontal cortex changes. Another form of behavioral flexibility, extradimensional strategy set-shifting…

  6. A NEW STRATEGY FOR IMPROVING FEATURE SETS IN A DISCRETE HMM­BASED HANDWRITING RECOGNITION SYSTEM

    NARCIS (Netherlands)

    Grandidier, F.; Sabourin, R.; Suen, C.Y.; Gilloux, M.

    2004-01-01

    In this paper we introduce a new strategy for improving a discrete HMM­based handwriting recognition system, by integrating several information sources from specialized feature sets. For a given system, the basic idea is to keep the most discriminative features, and to replace the others with new

  7. Detective Questions: A Strategy for Improving Inference-Making in Children With Mild Disabilities

    Science.gov (United States)

    Jiménez-Fernández, Gracia

    2015-01-01

    One of the most frequent problems in reading comprehension is the difficulty in making inferences from the text, especially for students with mild disabilities (i.e., children with learning disabilities or with high-functioning autism). It is essential, therefore, that educators include the teaching of reading strategies to improve their students'…

  8. Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

    Science.gov (United States)

    Comin, Arianna; Stegeman, Arjan; Marangon, Stefano; Klinkenberg, Don

    2012-01-01

    In recent years, the early detection of low pathogenicity avian influenza (LPAI) viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms) was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h)). The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h) reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control). Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier), whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus introduction

  9. Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

    Directory of Open Access Journals (Sweden)

    Arianna Comin

    Full Text Available In recent years, the early detection of low pathogenicity avian influenza (LPAI viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h. The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control. Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier, whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus

  10. Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

    Science.gov (United States)

    Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

    2015-01-01

    While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

  11. Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes.

    Science.gov (United States)

    Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

    2015-10-01

    While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Nanotechnology knowledge diffusion: measuring the impact of the research networking and a strategy for improvement

    Science.gov (United States)

    Liu, Xuan; Jiang, Shan; Chen, Hsinchun; Larson, Catherine A.; Roco, Mihail C.

    2014-09-01

    Given the global increase in public funding for nanotechnology research and development, it is even more important to support projects with promising return on investment. A main return is the benefit to other researchers and to the entire field through knowledge diffusion, invention, and innovation. The social network of researchers is one of the channels through which this happens. This study considers the scientific publication network in the field of nanotechnology, and evaluates how knowledge diffusion through coauthorship and citations is affected in large institutions by the location and connectivity of individual researchers in the network. The relative position and connectivity of a researcher is measured by various social network metrics, including degree centrality, Bonacich Power centrality, structural holes, and betweenness centrality. Leveraging the Cox regression model, we analyzed the temporal relationships between knowledge diffusion and social network measures of researchers in five leading universities in the United States using papers published from 2000 to 2010. The results showed that the most significant effects on knowledge diffusion in the field of nanotechnology were from the structural holes of the network and the degree centrality of individual researchers. The data suggest that a researcher has potential to perform better in knowledge creation and diffusion on boundary-spanning positions between different communities and when he or she has a high level of connectivity in the knowledge network. These observations may lead to improved strategies in planning, conducting, and evaluating multidisciplinary nanotechnology research. The paper also identifies the researchers who made most significant contributions to nanotechnology knowledge diffusion in the networks of five leading U.S. universities.

  13. Statistical evaluation and measuring strategy for extremely small line shifts

    International Nuclear Information System (INIS)

    Hansen, P.G.

    1978-01-01

    For a measuring situation limited by counting statistics, but where the level of precision is such that possible systematic errors are a major concern, it is proposed to determine the position of a spectral line from a measured line segment by applying a bias correction to the centre of gravity of the segment. This procedure is statistically highly efficient and not sensitive to small errors in assumptions about the line shape. The counting strategy for an instrument that takes data point by point is also considered. It is shown that an optimum (''two-point'') strategy exists; a scan of the central part of the line is 68% efficient by this standard. (Auth.)

  14. Evaluating Persuasion Strategies and Deep Reinforcement Learning methods for Negotiation Dialogue agents

    OpenAIRE

    Keizer, Simon; Guhe, Markus; Cuayáhuitl, Heriberto; Efstathiou, Ioannis; Engelbrecht, Klaus-Peter; Dobre, Mihai; Lascarides, Alexandra; Lemon, Oliver

    2017-01-01

    In this paper we present a comparative evaluation of various negotiation strategies within an online version of the game “Settlers of Catan”. The comparison is based on human subjects playing games against artificial game-playing agents (‘bots’) which implement different negotiation dialogue strategies, using a chat dialogue interface to negotiate trades. Our results suggest that a negotiation strategy that uses persuasion, as well as a strategy that is trained from data using Deep Reinforcem...

  15. Quality improvement strategies and tools: A comparative analysis between Italy and the United States.

    Science.gov (United States)

    Villa, Stefano; Restuccia, Joseph D; Anessi-Pessina, Eugenio; Rizzo, Marco Giovanni; Cohen, Alan B

    2018-01-01

    Italian and American hospitals, in two different periods, have been urged by external circumstances to extensively redesign their quality improvement strategies. This paper, through the use of a survey administered to chief quality officers in both countries, aims to identify commonalities and differences between the two systems and to understand which approaches are effective in improving quality of care. In both countries chief quality officers report quality improvement has become a strategic priority, clinical governance approaches, and tools-such as disease-specific quality improvement projects and clinical pathways-are commonly used, and there is widespread awareness that clinical decision making must be supported by protocols and guidelines. Furthermore, the study clearly outlines the critical importance of adopting a system-wide approach to quality improvement. To this extent Italy seems lagging behind compared to US in fact: (i) responsibilities for different dimensions of quality are spread across different organizational units; (ii) quality improvement strategies do not typically involve administrative staff; and (iii) quality performance measures are not disseminated widely within the organization but are reported primarily to top management. On the other hand, in Italy chief quality officers perceive that the typical hospital organizational structure, which is based on clinical directories, allows better coordination between clinical specialties than in the United States. In both countries, the results of the study show that it is not the single methodology/model that makes the difference but how the different quality improvement strategies and tools interact to each other and how they are coherently embedded with the overall organizational strategy.

  16. Review and Evaluation of Reservoir Management Strategies for Harmful Algal Blooms

    Science.gov (United States)

    2017-07-28

    Abstract The purpose of this report is to review and evaluate available infor- mation regarding reservoir operation strategies for management of...12 3 Operations Management Examples ............................................................................ 16...report is to review and evaluate available information regarding reservoir operation strategies for management of harmful algal ERDC/EL TR-17-11 2

  17. Evaluation of plant-wide WWTP control strategies including the effects of filamentous bulking sludge

    DEFF Research Database (Denmark)

    Flores Alsina, Xavier; Comas, J.S.; Rodríguez Roda, I.

    2009-01-01

    The main objective of this paper is to evaluate the effect of filamentous bulking sludge on the predicted performance of simulated plant-wide WWTP control strategies. First, as a reference case, several control strategies are implemented, simulated and evaluated using the IWA Benchmark Simulation...

  18. Instructional scaffolding to improve students' skills in evaluating clinical literature.

    Science.gov (United States)

    Dawn, Stefani; Dominguez, Karen D; Troutman, William G; Bond, Rucha; Cone, Catherine

    2011-05-10

    To implement and assess the effectiveness of an activity to teach pharmacy students to critically evaluate clinical literature using instructional scaffolding and a Clinical Trial Evaluation Rubric. The literature evaluation activity centered on a single clinical research article and involved individual, small group, and large group instruction, with carefully structured, evidence-based scaffolds and support materials centered around 3 educational themes: (1) the reader's awareness of text organization, (2) contextual/background information and vocabulary, and (3) questioning, prompting, and self-monitoring (metacognition). Students initially read the article, scored it using the rubric, and wrote an evaluation. Students then worked individually using a worksheet to identify and define 4 to 5 vocabulary/concept knowledge gaps. They then worked in small groups and as a class to further improve their skills. Finally, they assessed the same article using the rubric and writing a second evaluation. Students' rubric scores for the article decreased significantly from a mean pre-activity score of 76.7% to a post-activity score of 61.7%, indicating that their skills in identifying weaknesses in the article's study design had improved. Use of instructional scaffolding in the form of vocabulary supports and the Clinical Trial Evaluation Rubric improved students' ability to critically evaluate a clinical study compared to lecture-based coursework alone.

  19. Identification and evaluation of PWR in-vessel severe accident management strategies

    International Nuclear Information System (INIS)

    Dukelow, J.S.; Harrison, D.G.; Morgenstern, M.

    1992-03-01

    This reports documents work performed the NRC/RES Accident Management Guidance Program to evaluate possible strategies for mitigating the consequences of PWR severe accidents. The selection and evaluation of strategies was limited to the in-vessel phase of the severe accident, i.e., after the initiation of core degradation and prior to RPV failure. A parallel project at BNL has been considering strategies applicable to the ex-vessel phase of PWR severe accidents

  20. Evaluation Methods Basis of Strategy Development Effectiveness of the Enterprise

    Science.gov (United States)

    Zotova, Anna S.; Kandrashina, Elena A.; Ivliev, Andrey D.; Charaeva, Marina V.

    2016-01-01

    The urgency to study the problem is caused by the necessity to make management decisions in terms of reducing goods life cycle, reducing profitability of production, increasing speed of technological progress. In this context, this article aims to identify and elaborate the tools for integrated diagnostic of strategy efficiency, taking into…