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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. 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.

  3. 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

  4. 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. ...

  5. 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.

  6. 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.

  7. 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.

  8. 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...

  9. 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

  10. 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...

  11. [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.

  12. 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.

  13. 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 ).

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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

  2. 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.

  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. 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...

  5. 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

  6. 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

  7. 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

  8. "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.

  9. 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.

  10. 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

  11. 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

  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. 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.

  14. 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

  15. 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"…

  16. 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.

  17. 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

  18. 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.

  19. 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...

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. [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.

  13. 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.

  14. 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...

  15. 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

  16. 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.

  17. 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

  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 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.

  20. 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.

  1. 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.

  2. 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.

  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. 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...

  5. 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.

  6. 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.

  7. Well-being improvement in a midsize employer: changes in well-being, productivity, health risk, and perceived employer support after implementation of a well-being improvement strategy.

    Science.gov (United States)

    Hamar, Brent; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

    2015-04-01

    To evaluate employee well-being change and associated change in productivity, health risk including biometrics, and workplace support over 2 years after implementation of a well-being improvement strategy. This was an employer case study evaluation of well-being, productivity (presenteeism, absenteeism, and job performance), health risk, and employer support across three employee assessment spanning 2 years. Employee well-being was compared with an independent sample of workers in the community. Well-being and job performance increased and presenteeism and health risk decreased significantly over the 2 years. Employee well-being started lower and increased to exceed community worker averages, approaching significance. Well-being improvement was associated with higher productivity across all measures. Increases in employer support for well-being were associated with improved well-being and productivity. This employer's well-being strategy, including a culture supporting well-being, was associated with improved health and productivity.

  8. 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.

  9. 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.

  10. Value for money of changing healthcare services? Economic evaluation of quality improvement

    Science.gov (United States)

    Severens, J

    2003-01-01

    

 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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....

  16. 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)

  17. 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

  18. 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,...

  19. 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.

  20. 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...

  1. 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.

  2. 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.

  3. 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…

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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. 

  12. 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.

  13. 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)

  14. 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

  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. 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

  17. 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.

  18. 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...

  19. 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.

  20. Explaining the effects of two different strategies for promoting hand hygiene in hospital nurses: a process evaluation alongside a cluster randomised controlled trial.

    Science.gov (United States)

    Huis, Anita; Holleman, Gerda; van Achterberg, Theo; Grol, Richard; Schoonhoven, Lisette; Hulscher, Marlies

    2013-04-08

    There is only limited understanding of why hand hygiene improvement strategies are successful or fail. It is therefore important to look inside the 'black box' of such strategies, to ascertain which components of a strategy work well or less well. This study examined which components of two hand hygiene improvement strategies were associated with increased nurses' hand hygiene compliance. A process evaluation of a cluster randomised controlled trial was conducted in which part of the nursing wards of three hospitals in the Netherlands received a state-of-the-art strategy, including education, reminders, feedback, and optimising materials and facilities; another part received a team and leaders-directed strategy that included all elements of the state-of-the-art strategy, supplemented with activities aimed at the social and enhancing leadership. This process evaluation used four sets of measures: effects on nurses' hand hygiene compliance, adherence to the improvement strategies, contextual factors, and nurses' experiences with strategy components. Analyses of variance and multiple regression analyses were used to explore changes in nurses' hand hygiene compliance and thereby better understand trial effects. Both strategies were performed with good adherence to protocol. Two contextual factors were associated with changes in hand hygiene compliance: a hospital effect in long term (p feedback about their hand hygiene performance (p manager holds team members accountable for hand hygiene performance p < 0.01) correlated positively with changes in nurses' hand hygiene compliance. This study illustrates the use of a process evaluation to uncover mechanisms underlying change in hand hygiene improvement strategies. Our study results demonstrate the added value of specific aspects of social influence and leadership in hand hygiene improvement strategies, thus offering an interpretation of the trial effects. The study is registered in ClinicalTrials.gov, dossier number: NCT

  1. 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.

  2. 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...

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. [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.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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 ...

  13. 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...

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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…

  20. 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.

  1. 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

  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 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.

  4. 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...

  5. 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…

  6. 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…

  7. 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.

  8. 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.

  9. 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.

  10. 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...

  11. 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.

  12. [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.

  13. 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

  14. 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.

  15. 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…

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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)

  5. 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.

  6. 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.

  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. 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”.

  9. 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 ...

  10. 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...

  11. 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.

  12. Evaluating the state of quality-improvement science through evidence synthesis: insights from the closing the quality gap series.

    Science.gov (United States)

    McDonald, Kathryn M; Schultz, Ellen M; Chang, Christine

    2013-01-01

    The Closing the Quality Gap series from the Agency for Healthcare Research and Quality summarizes evidence for eight high-priority health care topics: outcomes used in disability research, bundled payment programs, public reporting initiatives, health care disparities, palliative care, the patient-centered medical home, prevention of health care-associated infections, and medication adherence. To distill evidence from this series and provide insight into the "state of the science" of quality improvement (QI). We provided common guidance for topic development and qualitatively synthesized evidence from the series topic reports to identify cross-topic themes, challenges, and evidence gaps as related to QI practice and science. Among topics that examined effectiveness of QI interventions, we found improvement in some outcomes but not others. Implementation context and potential harms from QI activities were not widely evaluated or reported, although market factors appeared important for incentive-based QI strategies. Patient-focused and systems-focused strategies were generally more effective than clinician-focused strategies, although the latter approach improved clinician adherence to infection prevention strategies. Audit and feedback appeared better for targeting professionals and organizations, but not patients. Topic reviewers observed heterogeneity in outcomes used for QI evaluations, weaknesses in study design, and incomplete reporting. Synthesizing evidence across topics provided insight into the state of the QI field for practitioners and researchers. To facilitate future evidence synthesis, consensus is needed around a smaller set of outcomes for use in QI evaluations and a framework and lexicon to describe QI interventions more broadly, in alignment with needs of decision makers responsible for improving quality.

  13. 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 ...

  14. [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.

  15. 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.

  16. 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.

  17. 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.

  18. 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 ...

  19. 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

  20. 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.

  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. 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

  3. 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.

  4. A Free-Piston Linear Generator Control Strategy for Improving Output Power

    Directory of Open Access Journals (Sweden)

    Chi Zhang

    2018-01-01

    Full Text Available This paper presents a control strategy to improve the output power for a single-cylinder two-stroke free-piston linear generator (FPLG. The comprehensive simulation model of this FPLG is established and the operation principle is introduced. The factors that affect the output power are analyzed theoretically. The characteristics of the piston motion are studied. Considering the different features of the piston motion respectively in acceleration and deceleration phases, a ladder-like electromagnetic force control strategy is proposed. According to the status of the linear electric machine, the reference profile of the electromagnetic force is divided into four ladder-like stages during one motion cycle. The piston motions, especially the dead center errors, are controlled by regulating the profile of the electromagnetic force. The feasibility and advantage of the proposed control strategy are verified through comparison analyses with two conventional control strategies via MatLab/Simulink. The results state that the proposed control strategy can improve the output power by around 7–10% with the same fuel cycle mass.

  5. 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.

  6. 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...

  7. 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

  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. IMPROVING THE STUDENTS’ READING COMPREHENSION ABILITY THROUGH SQ3R STRATEGY

    Directory of Open Access Journals (Sweden)

    Sabarun Sabarun

    2015-12-01

    Full Text Available The study is aimed at improving the students’ reading comprehension ability in reading English class using SQ3R strategy, which refers to a reading technique covering a five step system developed by Francis P Robinson. Each of the steps stands for Survey, Question, Read, Recite, and Review. The study employed Classroom Action Research design. The subjects of the study were four of third semester students of the English Department of Palangka Raya State Islamic College of 2009/ 2010 academic year. The study was carried out in two cycles by following the four steps of action research: planning, implementing, observing, and reflecting. Each cycle consisted of one meeting focusing pre-reading, whilst reading and post reading. The data of the study are taken from the results of observation checklists, field notes, and the students’ reading score. The result of the study showed that SQ3R strategy could improve the students’ reading comprehension ability. It could be seen from the improvement of the students’ reading scores. The students were actively involved in reading class and they were highly motivated to attend the SQ3R reading class. Keywords: improving, SQ3R strategy, reading comprehension ability

  10. 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.

  11. Cloud computing task scheduling strategy based on improved differential evolution algorithm

    Science.gov (United States)

    Ge, Junwei; He, Qian; Fang, Yiqiu

    2017-04-01

    In order to optimize the cloud computing task scheduling scheme, an improved differential evolution algorithm for cloud computing task scheduling is proposed. Firstly, the cloud computing task scheduling model, according to the model of the fitness function, and then used improved optimization calculation of the fitness function of the evolutionary algorithm, according to the evolution of generation of dynamic selection strategy through dynamic mutation strategy to ensure the global and local search ability. The performance test experiment was carried out in the CloudSim simulation platform, the experimental results show that the improved differential evolution algorithm can reduce the cloud computing task execution time and user cost saving, good implementation of the optimal scheduling of cloud computing tasks.

  12. 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...

  13. The Dynamic Evaluation of Enterprise's Strategy Based on Rough Set Theory

    Institute of Scientific and Technical Information of China (English)

    刘恒江; 陈继祥

    2003-01-01

    This paper presents dynamic evaluation of enterprise's strategy which is suitable for dealing with the complex and dynamic problems of strategic evaluation. Rough Set Theory is a powerful mathematical tool to handle vagueness and uncertainty of dynamic evaluation. By the application of Rough Set Theory, this paper computes the significance and weights of each evaluation criterion and helps to lay evaluation emphasis on the main and effective criteria. From the reduced decision table,evaluators can get decision rules Which direct them to give judgment or suggestion of strategy. The whole evaluation process is decided by data, so the results are certain and reasonable.

  14. 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...

  15. Using Formative Research to Design a Behavior Change Strategy to Increase the Use of Improved Cookstoves in Peri-Urban Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Stephanie L. Martin

    2013-12-01

    Full Text Available Household air pollution from cooking with biomass fuels negatively impacts maternal and child health and the environment, and contributes to the global burden of disease. In Uganda, nearly 20,000 young children die of household air pollution-related pneumonia every year. Qualitative research was used to identify behavioral determinants related to the acquisition and use of improved cookstoves in peri-urban Uganda. Results were used to design a behavior change strategy for the introduction of a locally-fabricated top-lit updraft gasifier (TLUD stove in Wakiso district. A theoretical framework—opportunity, ability, and motivation—was used to guide the research and behavior change strategy development. Participants consistently cited financial considerations as the most influential factor related to improved cookstove acquisition and use. In contrast, participants did not prioritize the potential health benefits of improved cookstoves. The theoretical framework, research methodology, and behavior change strategy design process can be useful for program planners and researchers interested in identifying behavioral determinants and designing and evaluating improved cookstove interventions.

  16. 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

  17. 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

  18. 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

  19. 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.

  20. Research on Improved Control Strategy for STATCOM Based on Virtual Matrix Method

    Directory of Open Access Journals (Sweden)

    Wang Xudong

    2016-01-01

    Full Text Available Fast and accurate detection of reactive current is the precondition for the realization of static synchronous compensator (STATCOM reactive power compensation and harmonic suppression. Aiming at deviation and delay of the traditional reactive current detection algorithm with phase-locked loop (PLL and low-pass filter (LPF of STATCOM, a novel improved reactive current detection algorithm without PLL is proposed, in which the virtual matrix (VM is built to replace the original PLL, and improved current average value filter is used to realize the function of LPF, so as to improve the real-time performance and robustness of reactive current detection. The realization process of VM detection method is derived in this paper, and improved control strategy for STATCOM is designed based on the VM detection method. Simulation analysis of the proposed detection algorithm and control strategy is conducted in Matlab platform so as to verify the correctness and effectiveness of the control strategy. The VM detection has the advantages of simple structure, fast response and easy for digital realization, which provides reference for the improvement of reactive power compensation precision for STATCOM.

  1. 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'.

  2. 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.

  3. 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 ...

  4. 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.

  5. Is patient-centredness in European hospitals related to existing quality improvement strategies? Analysis of a cross-sectional survey (MARQuIS study)

    NARCIS (Netherlands)

    Groene, O.; Lombarts, M. J. M. H.; Klazinga, N.; Alonso, J.; Thompson, A.; Suñol, R.

    2009-01-01

    Background: There is growing recognition of patients' contributions to setting objectives for their own care, improving health outcomes and evaluating care. Objective: To quantify the extent to which European hospitals have implemented strategies to promote a patient-centred approach, and to assess

  6. Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries.

    Science.gov (United States)

    Ocampo, Wrechelle; Cheung, Amanda; Baylis, Barry; Clayden, Nancy; Conly, John M; Ghali, William A; Ho, Chester H; Kaufman, Jaime; Stelfox, Henry T; Hogan, David B

    2017-07-01

    To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review

  7. 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

  8. 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

  9. 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

  10. 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, ...

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. A national evaluation of community-based mental health strategies in Finland.

    Science.gov (United States)

    Vähäniemi, Anu; Warwick-Smith, Katja; Hätönen, Heli; Välimäki, Maritta

    2018-02-01

    High-quality mental health care requires written strategies to set a vision for the future, yet, there is limited systematic information available on the monitoring and evaluation of such strategies. The aim of this nationwide study is to evaluate local mental health strategies in community-based mental health services provided by municipalities. Mental health strategy documents were gathered through an online search and an e-mail survey of the local authorities of all Finnish mainland municipalities (n = 320). Out of 320 municipalities, documents for 129 municipalities (63 documents) were included in the study. The documents obtained (n = 63) were evaluated against the World Health Organization checklist for mental health strategies and policies. Evaluation of the process, operations and content of the documents, against 31 indicators in the checklist. Out of 320 Finnish municipalities, 40% (n = 129) had a mental health strategy document available and 33% (n = 104) had a document that was either in preparation or being updated. In these documents, priorities, targets and activities were clearly described. Nearly all (99%) of the documents suggested a commitment to preventative work, and 89% mentioned a dedication to developing community-based care. The key shortfalls identified were the lack of consideration of human rights (0%), the limited consideration of research (5%) and the lack of financial planning (28%) to successfully execute the plans. Of the documents obtained, 60% covered both mental health and substance abuse issues. This study contributes to the limited evidence base on health care strategy evaluations. Further research is needed to understand the potential impact of policy analysis. © The Author(s) 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. A toolbox for safety instrumented system evaluation based on improved continuous-time Markov chain

    Science.gov (United States)

    Wardana, Awang N. I.; Kurniady, Rahman; Pambudi, Galih; Purnama, Jaka; Suryopratomo, Kutut

    2017-08-01

    Safety instrumented system (SIS) is designed to restore a plant into a safe condition when pre-hazardous event is occur. It has a vital role especially in process industries. A SIS shall be meet with safety requirement specifications. To confirm it, SIS shall be evaluated. Typically, the evaluation is calculated by hand. This paper presents a toolbox for SIS evaluation. It is developed based on improved continuous-time Markov chain. The toolbox supports to detailed approach of evaluation. This paper also illustrates an industrial application of the toolbox to evaluate arch burner safety system of primary reformer. The results of the case study demonstrates that the toolbox can be used to evaluate industrial SIS in detail and to plan the maintenance strategy.

  1. 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.

  2. Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study.

    Science.gov (United States)

    Chaisson, Lelia H; Katamba, Achilles; Haguma, Priscilla; Ochom, Emmanuel; Ayakaka, Irene; Mugabe, Frank; Miller, Cecily; Vittinghoff, Eric; Davis, J Lucian; Handley, Margaret A; Cattamanchi, Adithya

    2015-01-01

    Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda. We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC): performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks' duration. The performance feedback evaluation included 1,446 adults; 838 (58%) were evaluated during the pre-intervention period and 608 (42%) during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, pISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47%) were evaluated during the pre-intervention period and 1,043 (53%) during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10% to +18%, pISTC-adherent care. Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries.

  3. 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.

  4. Learning Evaluation: blending quality improvement and implementation research methods to study healthcare innovations.

    Science.gov (United States)

    Balasubramanian, Bijal A; Cohen, Deborah J; Davis, Melinda M; Gunn, Rose; Dickinson, L Miriam; Miller, William L; Crabtree, Benjamin F; Stange, Kurt C

    2015-03-10

    In healthcare change interventions, on-the-ground learning about the implementation process is often lost because of a primary focus on outcome improvements. This paper describes the Learning Evaluation, a methodological approach that blends quality improvement and implementation research methods to study healthcare innovations. Learning Evaluation is an approach to multi-organization assessment. Qualitative and quantitative data are collected to conduct real-time assessment of implementation processes while also assessing changes in context, facilitating quality improvement using run charts and audit and feedback, and generating transportable lessons. Five principles are the foundation of this approach: (1) gather data to describe changes made by healthcare organizations and how changes are implemented; (2) collect process and outcome data relevant to healthcare organizations and to the research team; (3) assess multi-level contextual factors that affect implementation, process, outcome, and transportability; (4) assist healthcare organizations in using data for continuous quality improvement; and (5) operationalize common measurement strategies to generate transportable results. Learning Evaluation principles are applied across organizations by the following: (1) establishing a detailed understanding of the baseline implementation plan; (2) identifying target populations and tracking relevant process measures; (3) collecting and analyzing real-time quantitative and qualitative data on important contextual factors; (4) synthesizing data and emerging findings and sharing with stakeholders on an ongoing basis; and (5) harmonizing and fostering learning from process and outcome data. Application to a multi-site program focused on primary care and behavioral health integration shows the feasibility and utility of Learning Evaluation for generating real-time insights into evolving implementation processes. Learning Evaluation generates systematic and rigorous cross

  5. [Improvement in zinc nutrition due to zinc transporter-targeting strategy].

    Science.gov (United States)

    Kambe, Taiho

    2016-07-01

    Adequate intake of zinc from the daily diet is indispensable to maintain health. However, the dietary zinc content often fails to fulfill the recommended daily intake, leading to zinc deficiency and also increases the risk of developing chronic diseases, particularly in elderly individuals. Therefore, increased attention is required to overcome zinc deficiency and it is important to improve zinc nutrition in daily life. In the small intestine, the zinc transporter, ZIP4, functions as a component that is essential for zinc absorption. In this manuscript, we present a brief overview regarding zinc deficiency. Moreover, we review a novel strategy, called "ZIP4-targeting", which has the potential to enable efficient zinc absorption from the diet. ZIP4-targeting strategy is possibly a major step in preventing zinc deficiency and improving human health.

  6. 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.

  7. 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

  8. A framework provided an outline toward the proper evaluation of potential screening strategies.

    Science.gov (United States)

    Adriaensen, Wim J; Matheï, Cathy; Buntinx, Frank J; Arbyn, Marc

    2013-06-01

    Screening tests are often introduced into clinical practice without proper evaluation, despite the increasing awareness that screening is a double-edged sword that can lead to either net benefits or harms. Our objective was to develop a comprehensive framework for the evaluation of new screening strategies. Elaborating on the existing concepts proposed by experts, a stepwise framework is proposed to evaluate whether a potential screening test can be introduced as a screening strategy into clinical practice. The principle of screening strategy evaluation is illustrated for cervical cancer, which is a template for screening because of the existence of an easily detectable and treatable precursor lesion. The evaluation procedure consists of six consecutive steps. In steps 1-4, the technical accuracy, place of the test in the screening pathway, diagnostic accuracy, and longitudinal sensitivity and specificity of the screening test are assessed. In steps 5 and 6, the impact of the screening strategy on the patient and population levels, respectively, is evaluated. The framework incorporates a harm and benefit trade-off and cost-effectiveness analysis. Our framework provides an outline toward the proper evaluation of potential screening strategies before considering implementation. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. 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.

  10. 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.

  11. [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.

  12. Evaluation of Cost Leadership Strategy in Shipping Enterprises with Simulation Model

    Science.gov (United States)

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

    2009-08-01

    The present study will attempt the evaluation of cost leadership strategy that prevails in certain shipping enterprises and the creation of simulation models based on strategic model STAIR. The above model is an alternative method of strategic applications evaluation. This is held in order to be realised if the strategy of cost leadership creates competitive advantage [1] and this will be achieved via the technical simulation which appreciates the interactions between the operations of an enterprise and the decision-making strategy in conditions of uncertainty with reduction of undertaken risk.

  13. Building evaluation capacity in Ontario's public health units: promising practices and strategies.

    Science.gov (United States)

    Bourgeois, I; Simmons, L; Buetti, D

    2018-03-26

    This article presents the findings of a project focusing on building evaluation capacity in 10 Ontario public health units. The study sought to identify effective strategies that lead to increased evaluation capacity in the participating organizations. This study used a qualitative, multiple case research design. An action research methodology was used to design customized evaluation capacity building (ECB) strategies for each participating organization, based on its specific context and needs. This methodological approach also enabled monitoring and assessment of each strategy, based on a common set of reporting templates. A multiple case study was used to analyze the findings from the 10 participating organizations and derive higher level findings. The main findings of the study show that most of the strategies used to increase evaluation capacity in public health units are promising, especially those focusing on developing the knowledge, skills, and attitudes of health unit staff and managers. Facilitators to ECB strategies were the engagement of all staff members, the support of leadership, and the existence of organizational tools and infrastructure to support evaluation. It is also essential to recognize that ECB takes time and resources to be successful. The design and implementation of ECB strategies should be based on organizational needs. These can be assessed using a standardized instrument, as well as interviews and staff surveys. The implementation of a multicomponent approach (i.e. several strategies implemented simultaneously) is also linked to better ECB outcomes in organizations. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. 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

  15. Improving Language Learning Strategies and Performance of Pre-Service Language Teachers Through a CALLA-TBLT Model

    Directory of Open Access Journals (Sweden)

    Maria Eugenia Guapacha Chamorro

    2017-07-01

    Full Text Available This paper reports an action-research study on language learning strategies in tertiary education at a Colombian university. The study aimed at improving the English language performance and language learning strategies use of 33 first-year pre-service language teachers by combining elements from two models: the cognitive academic language learning approach and task-based language teaching. Data were gathered through surveys, a focus group, students’ and teachers’ journals, language tests, and documentary analysis. Results evidenced that the students improved in speaking, writing, grammar, vocabulary and in their language learning strategies repertoire. As a conclusion, explicit strategy instruction in the proposed model resulted in a proper combination to improve learners’ language learning strategies and performance.

  16. A Pragmatic Approach to Guide Implementation Evaluation Research: Strategy Mapping for Complex Interventions

    Directory of Open Access Journals (Sweden)

    Alexis K. Huynh

    2018-05-01

    Full Text Available IntroductionGreater specification of implementation strategies is a challenge for implementation science, but there is little guidance for delineating the use of multiple strategies involved in complex interventions. The Cardiovascular (CV Toolkit project entails implementation of a toolkit designed to reduce CV risk by increasing women’s engagement in appropriate services. The CV Toolkit project follows an enhanced version of Replicating Effective Programs (REP, an evidence-based implementation strategy, to implement the CV Toolkit across four phases: pre-conditions, pre-implementation, implementation, and maintenance and evolution. Our current objective is to describe a method for mapping implementation strategies used in real time as part of the CV Toolkit project. This method supports description of the timing and content of bundled strategies and provides a structured process for developing a plan for implementation evaluation.MethodsWe conducted a process of strategy mapping to apply Proctor and colleagues’ rubric for specification of implementation strategies, constructing a matrix in which we identified each implementation strategy, its conceptual group, and the corresponding REP phase(s in which it occurs. For each strategy, we also specified the actors involved, actions undertaken, action targets, dose of the implementation strategy, and anticipated outcome addressed. We iteratively refined the matrix with the implementation team, including use of simulation to provide initial validation.ResultsMapping revealed patterns in the timing of implementation strategies within REP phases. Most implementation strategies involving the development of stakeholder interrelationships and training and educating stakeholders were introduced during the pre-conditions or pre-implementation phases. Strategies introduced in the maintenance and evolution phase emphasized communication, re-examination, and audit and feedback. In addition to its value

  17. Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

    Science.gov (United States)

    Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

    2017-09-07

    While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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…

  3. 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.

  4. 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.

  5. Implementing practice management strategies to improve patient care: the EPIC project.

    Science.gov (United States)

    Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna

    2012-01-01

    Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.

  6. 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

  7. 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

  8. Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study.

    Directory of Open Access Journals (Sweden)

    Lelia H Chaisson

    Full Text Available Tuberculosis (TB remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda.We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC: performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks' duration.The performance feedback evaluation included 1,446 adults; 838 (58% were evaluated during the pre-intervention period and 608 (42% during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, p<0.001 increase in the proportion of patients receiving ISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47% were evaluated during the pre-intervention period and 1,043 (53% during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10% to +18%, p<0.001 increase in the proportion of patients receiving ISTC-adherent care.Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries.

  9. 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.…

  10. 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...

  11. 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

  12. 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.

  13. 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

  14. A novel strategy for evaluating the effects of an electronic test ordering alert message: Optimizing cardiac marker use.

    Science.gov (United States)

    Baron, Jason M; Lewandrowski, Kent B; Kamis, Irina K; Singh, Balaji; Belkziz, Sidi M; Dighe, Anand S

    2012-01-01

    Laboratory ordering functions within computerized provider order entry (CPOE) systems typically support the display of electronic alert messages to improve test utilization or implement new ordering policies. However, alert strategies have been shown to vary considerably in their success and the characteristics contributing to an alert's success are poorly understood. Improved methodologies are needed to evaluate alerts and their mechanisms of action. Clinicians order inpatient and emergency department laboratory tests using our institutional CPOE system. We analyzed user interaction data captured by our CPOE system to evaluate how clinicians responded to an alert. We evaluated an alert designed to implement an institutional policy restricting the indications for ordering creatine kinase-MB (CKMB). Within 2 months of alert implementation, CKMB-associated searches declined by 79% with a corresponding decline in CKMB orders. Furthermore, while prior to alert implementation, clinicians searching for CKMB ultimately ordered this test 99% of the time, following implementation, only 60% of CKMB searches ultimately led to CKMB test orders. This difference presumably represents clinicians who reconsidered the need for CKMB in response to the alert, demonstrating the alert's just-in-time advisory capability. In addition, as clinicians repeatedly viewed the alert, there was a "dose-dependant" decrease in the fraction of searches without orders. This presumably reflects the alerting strategy's long-term educational component, as clinicians aware of the new policy will not search for CKMB when not indicated. Our analytic approach provides insight into the mechanism of a CPOE alert and demonstrates that alerts may act through a combination of just-in-time advice and longer term education. Use of this approach when implementing alerts may prove useful to improve the success of a given alerting strategy.

  15. MARKETING STRATEGIES FOR DEVELOPING AGROTOURISM IN JEMBER REGENCY

    Directory of Open Access Journals (Sweden)

    Tantri Wijayanti

    2015-09-01

    Full Text Available This research was aimed to identify the agrotourism potential in Jember Regency, to identify the condition of internal and external environment of Sukorambi Botanic Garden. The research used the Importance Performance Analysis (IPA method to find out the level of the visitors’ interest and satisfaction. For the internal and external analyses, the Internal Factor Evaluation (IFE method, the External Factor Evaluation (EFE method,  Strength Weakness Opportunity and Threat (SWOT and the Analytic Hierarchy Process (AHP were used to determine the strategies for marketing Sukorambi Botanic Garden. Three resource persons were used by purposive sampling technique. Thirty respondents were used for analytical level of interest by distributing questionnaires to visitors. The results of the research showed that the priorities of marketing Sukorambi Botanic Garden were 1 the strategy to maximize the concept of recreation while studying  such as crop cultivation and animal farming, 2 the strategy to increase the number of outbound games, 3 the strategy to coordinate intensively with stakeholders for improvement and sustainable development, 4 the strategy to get a loan from  a financial institution to increase capital, 5 the strategy to optimize promotion activities, (6  the strategy to improve the quality of community services through improved performance and transportation facilities, 7 the strategy to improve the quality of services through trainings for the employees to improve the company’s management system, 8 the strategy to realize facility development on the remainder of the land  accompanied by improvement of existing facilities, and 9 the strategy to optimize online promotion activities.    Keywords: Agrotourism, marketing development strategy, Sukorambi Botanic Garden, AHP, SWOT

  16. 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

  17. 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

  18. Metagenomic Taxonomy-Guided Database-Searching Strategy for Improving Metaproteomic Analysis.

    Science.gov (United States)

    Xiao, Jinqiu; Tanca, Alessandro; Jia, Ben; Yang, Runqing; Wang, Bo; Zhang, Yu; Li, Jing

    2018-04-06

    Metaproteomics provides a direct measure of the functional information by investigating all proteins expressed by a microbiota. However, due to the complexity and heterogeneity of microbial communities, it is very hard to construct a sequence database suitable for a metaproteomic study. Using a public database, researchers might not be able to identify proteins from poorly characterized microbial species, while a sequencing-based metagenomic database may not provide adequate coverage for all potentially expressed protein sequences. To address this challenge, we propose a metagenomic taxonomy-guided database-search strategy (MT), in which a merged database is employed, consisting of both taxonomy-guided reference protein sequences from public databases and proteins from metagenome assembly. By applying our MT strategy to a mock microbial mixture, about two times as many peptides were detected as with the metagenomic database only. According to the evaluation of the reliability of taxonomic attribution, the rate of misassignments was comparable to that obtained using an a priori matched database. We also evaluated the MT strategy with a human gut microbial sample, and we found 1.7 times as many peptides as using a standard metagenomic database. In conclusion, our MT strategy allows the construction of databases able to provide high sensitivity and precision in peptide identification in metaproteomic studies, enabling the detection of proteins from poorly characterized species within the microbiota.

  19. 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.

  20. 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

  1. 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.

  2. 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

  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. 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…

  5. 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).

  6. MARKETING STRATEGY OF THE UNIVERSITY: FORMATION AND ITS EFFECTIVENESS EVALUATION REALIZATION

    Directory of Open Access Journals (Sweden)

    Natalia К. Shemetova

    2015-01-01

    Full Text Available The study is aimed at developing an algorithm of formation of university’s marketing strategy and the development of evaluating methods of its effectiveness realization. Despite the competitive expansion of the educational services market and the transition to a system of university self-financing, researchers have not paid due attention to the process of developing the marketing strategy of the university and the evaluation of its effectiveness yet. Methods. The applied methods include the method of general systems theory, and the complex of specialized marketing tools (PEST-, SNWand SWOT-analysis. Results. The algorithm of university’s marketing strategy formation and methodology for its effectiveness assessing is given in five fields: economic, informational, social, integration, and demand stage. The set of criteria is worked out for every field listed above. The author has developed a formula for determining the total indicator or general index of the effectiveness of university’s marketing strategy. Scientific novelty. The prospects of using the algorithm of formation of university’s marketing strategy and the system of monitoring and evaluating the effectiveness of marketing in higher vocational education was proved and evaluated by the author in the Ural Institute of Management of RANEPA. Practical significance. The research results can be used by the experts in the field of management of the higher educational institutions, and also as teaching materials while preparing the experts in marketing. 

  7. Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships.

    Science.gov (United States)

    Niolon, Phyllis Holditch; Taylor, Bruce G; Latzman, Natasha E; Vivolo-Kantor, Alana M; Valle, Linda Anne; Tharp, Andra T

    2016-03-01

    This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the "standard of care" strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed. Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research. Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. Hypnosis-Induced Mental Training Programmes as a Strategy to Improve the Self-Concept of Students

    Science.gov (United States)

    De Vos, H. M.; Louw, D. A.

    2009-01-01

    The creation and implementation of strategies that could improve student development is receiving new research interest. The main objective of the research was to establish whether hypnosis-induced mental training programmes as a strategy could alter the self-concept of students which in turn could improve their overall academic functioning. Two…

  14. 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.

  15. 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

  16. Food and beverage price discounts to improve health in remote Aboriginal communities: mixed method evaluation of a natural experiment.

    Science.gov (United States)

    Ferguson, Megan; O'Dea, Kerin; Holden, Stacey; Miles, Eddie; Brimblecombe, Julie

    2017-02-01

    Retrospectively evaluate food price discounts in remote Aboriginal community stores. Four price discount strategies of 10% were designed in 2010, aiming to influence grocery, fruit, vegetables and diet soft-drink sales. This natural experiment across a group of stores was evaluated using an explanatory, sequential mixed method design through analysis of store point-of-sale, document, observation and interview data. The outcome was measured by change in: 1) percentage of grocery sales to total food and beverage; 2) fruit and vegetable sales; and 3) diet soft-drink sales. Qualitative data enabled the interpretation of outcomes through understanding perceived success and benefits, and enablers and barriers to implementation. Eighteen community stores and 54 informants participated. While targeted price discounts were considered important to improving health, no discernible effect was evident, due to inadequate design and communication of discount promotion, and probably inadequate magnitude of discount. Strategy impact on food and beverage sales was limited by promotion and magnitude of discount. Implication for Public Health: This study demonstrates key factors and commitment required to design, communicate, implement and monitor strategies to improve health in this challenging remote retail context. Evaluation of natural experiments can contribute evidence to policy-making. © 2016 The Authors.

  17. 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.

  18. 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.

  19. 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...

  20. Implementation of WHO multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a Traditional Chinese Medicine hospital in Xi'an, China.

    Science.gov (United States)

    Shen, Li; Wang, Xiaoqing; An, Junming; An, Jialu; Zhou, Ning; Sun, Lu; Chen, Hong; Feng, Lin; Han, Jing; Liu, Xiaorong

    2017-01-01

    Hand hygiene (HH) is an essential component for preventing and controlling of healthcare-associated infection (HAI), whereas compliance with HH among health care workers (HCWs) is frequently poor. This study aimed to assess compliance and correctness with HH before and after the implementation of a multimodal HH improvement strategy launched by the World Health Organization (WHO). A quasi-experimental study design including questionnaire survey generalizing possible factors affecting HH behaviors of HCWs and direct observation method was used to evaluate the effectiveness of WHO multimodal HH strategy in a hospital of Traditional Chinese Medicine. Multimodal HH improvement strategy was drawn up according to the results of questionnaire survey. Compliance and correctness with HH among HCWs were compared before and after intervention. Also HH practices for different indications based on WHO "My Five Moments for Hand Hygiene" were recorded. In total, 553 HCWs participated in the questionnaire survey and multimodal HH improvement strategy was developed based on individual, environment and management levels. A total of 5044 observations in 23 wards were recorded in this investigation. The rate of compliance and correctness with HH improved from 66.27% and 47.75% at baseline to 80.53% and 88.35% after intervention. Doctors seemed to have better compliance with HH after intervention (84.04%) than nurses and other HCWs (81.07% and 69.42%, respectively). When stratified by indication, compliance with HH improved for all indications after intervention ( P  Implementing the WHO multimodal HH strategy can significantly improve HH compliance and correctness among HCWs.

  1. 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

  2. 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)

  3. MARKETING STRATEGY OF THE UNIVERSITY: FORMATION AND ITS EFFECTIVENESS EVALUATION REALIZATION

    OpenAIRE

    Natalia К. Shemetova

    2015-01-01

    The study is aimed at developing an algorithm of formation of university’s marketing strategy and the development of evaluating methods of its effectiveness realization. Despite the competitive expansion of the educational services market and the transition to a system of university self-financing, researchers have not paid due attention to the process of developing the marketing strategy of the university and the evaluation of its effectiveness yet. Methods. The applied methods include the m...

  4. Blindfolded Balance Training in Patients with Parkinson’s Disease: A Sensory-Motor Strategy to Improve the Gait

    Directory of Open Access Journals (Sweden)

    M. Tramontano

    2016-01-01

    Full Text Available Aim. Recent evidence suggested that the use of treadmill training may improve gait parameters. Visual deprivation could engage alternative sensory strategies to control dynamic equilibrium and stabilize gait based on vestibulospinal reflexes (VSR. We aimed to investigate the efficacy of a blindfolded balance training (BBT in the improvement of stride phase percentage reliable gait parameters in patients with Parkinson’s Disease (PD compared to patients treated with standard physical therapy (PT. Methods. Thirty PD patients were randomized in two groups of 15 patients, one group treated with BBT during two weeks and another group treated with standard PT during eight weeks. We evaluated gait parameters before and after BBT and PT interventions, in terms of double stance, swing, and stance phase percentage. Results. BBT induced an improvement of double stance phase as revealed (decreased percentage of double stance phase during the gait cycle in comparison to PT. The other gait parameters swing and stance phase did not differ between the two groups. Discussion. These results support the introduction of complementary rehabilitative strategies based on sensory-motor stimulation in the traditional PD patient’s rehabilitation. Further studies are needed to investigate the neurophysiological circuits and mechanism underlying clinical and motor modifications.

  5. 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.

  6. Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Katrina V Deardorff

    2018-02-01

    Full Text Available Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns.We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%, distributor incentives (n = 2, +25.3%, distribution along kinship networks (n = 1, +24.5%, intensified information, education, and communication activities (n = 8, +21.6%, fixed-point delivery (n = 1, +21.4%, door-to-door delivery (n = 1, +14.0%, integrated service distribution (n = 9, +12.7%, conversion from school- to community-based delivery (n = 3, +11.9%, and management by a non-governmental organization (n = 1, +5.8%.Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

  7. [Clinical data that are essential for the primary care clinical records: an experience of evaluation and improvement].

    Science.gov (United States)

    López-Picazo Ferrer, J J; Agulló Roca, F; Villaescusa Pedemonte, M; Cerezo Corbalán, J M

    2002-06-30

    To evaluate and improve the presence of essential clinical data in the clinical records of a primary care management area (PCMA) by means of an intervention programme. Intervention study without a control, using evaluation and improvement-of-quality methods. We chose 4 criteria from the minimum technical standards: personal history (PH), family background (FB), allergies to medicines (AM) and list of problems (LP). We evaluated overall compliance and compliance per primary care team (PCT) through batch quality acceptance of samples (LQAS), designed an intervention to improve the situation, and then re-evaluated. PCMA of Murcia (45 PCTs). Participants. 42 PCTs (3 were excluded because they had poor coverage in their records). These lasted 12 months (October 1999-October 2000) and involved the following: graphic report per PCT; session with the PCT; discussion on results and strategies in the Area Management Council; and inclusion of an explicit objective, with incentives, in the management contracts. Significant improvement of the four criteria of the PCMA (improvements: FB, 48.1%; PH, 51.1%; AM, 55.4%; LP, 50.9%). LQAS analysis: we rejected 24 batches (14.3%) at the 1st evaluation and 15 (9.0%) at the second, with FB being the criterion most rejected in both instances. Defects appeared in 14 PCT (33.3%; 3 PCT accounted for 41.7%) at the 1st evaluation, and 7 PCT at the re-evaluation (16.7%; 2 reaching 46.7%). The presence of essential clinical data in clinical records has improved. LQAS proved to be a rapid and simple method for evaluating, improving and monitoring quality in primary care.

  8. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

    Directory of Open Access Journals (Sweden)

    Christoph Best

    2015-01-01

    Full Text Available Patients with somatoform vertigo and dizziness (SVD disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (QH/V, reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n=28; baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ. Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: QH/V=0.31 versus controls: QH/V=0.38; p=0.022. After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles.

  9. Evaluation of Military Service Youth Advertisements

    Science.gov (United States)

    2002-03-01

    assess levels of support provided by advertising agencies, and to recommend improved marketing strategies . The Eskew-Murphy Advertising Review made a...television advertisements in communicating the strategy . • The strata™ Sample and Evaluated Ads section provides details about the youth interviewed...relevant to understanding how closely the evaluated advertising executions are “on- strategy .” It also reviews the opportunities for improvements to

  10. Teaching quality improvement.

    Science.gov (United States)

    Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula

    2010-08-01

    Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.

  11. 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

  12. 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

  13. 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

  14. Towards a Generic Framework for the Performance Evaluation of Manufacturing Strategy: An Innovative Approach

    Directory of Open Access Journals (Sweden)

    Tigist Fetene Adane

    2018-03-01

    Full Text Available To be competitive in a manufacturing environment by providing optimal performance in terms of cost-effectiveness and swiftness of system changes, there is a need for flexible production systems based on a well-defined strategy. Companies are steadily looking for methodology to evaluate, improve and update the performance of manufacturing systems for processing operations. Implementation of an adequate strategy for these systems’ flexibility requires a deep understanding of the intricate interactions between the machining process parameters and the manufacturing system’s operational parameters. This paper proposes a framework/generic model for one of the most common metal cutting operations—the boring process of an engine block machining system. A system dynamics modelling approach is presented for modelling the structure of machining system parameters of the boring process, key performance parameters and their intrinsic relationships. The model is based on a case study performed in a company manufacturing engine blocks for heavy vehicles. The approach could allow for performance evaluation of an engine block manufacturing system condition. The presented model enables a basis for other similar processes and industries producing discrete parts.

  15. 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

  16. 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...

  17. A guide to understanding and implementing risk evaluation and mitigation strategies in organ transplantation.

    Science.gov (United States)

    Gabardi, Steven; Tichy, Eric M

    2013-03-01

    To review the components of the Congressional mandate for risk evaluation and mitigation strategies (REMS) managed by the Food and Drug Administration and assess their impact on health care providers practicing within the organ transplant arena. A non-date-limited search of MEDLINE and EMBASE (January 2007-June 2012) was conducted by using the following search terms: risk evaluation and mitigation strategies, REMS, and organ transplant, including a query of the individual organs. Information from the Federal Register and the Food and Drug Administration was also evaluated. REMS are strategies implemented to manage known or potential risks associated with medications and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product. Elements of REMS programs may consist of 3 levels: a medication guide, communication plan, and elements to assure safe use. A medication guide is used to help prevent serious adverse events, aid in patients' decision making, and enhance medication adherence. Communication plans help educate health care providers and encourage adherence with REMS. The elements to assure safe use is a restrictive process implemented when it is deemed necessary to ensure safe access for patients to products with known serious risks. In transplant medicine, REMS currently exist for belatacept (medication guide and communication plan) and the mycophenolic acid derivatives (medication guide and elements to assure safe use). REMS are another step in the evolution of the development and marketing of pharmaceutical agents. Use of REMS in solid-organ transplant is becoming common. Transplant clinicians must provide required patient education and become involved with other aspects of REMS implementation to reduce the serious risks of pharmaceuticals and to improve patients' outcomes.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy.

    Science.gov (United States)

    Egeland, Karina Myhren; Ruud, Torleif; Ogden, Terje; Färdig, Rickard; Lindstrøm, Jonas Christoffer; Heiervang, Kristin Sverdvik

    2017-01-01

    The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014.

  4. Variable tidal volumes improve lung protective ventilation strategies in experimental lung injury.

    Science.gov (United States)

    Spieth, Peter M; Carvalho, Alysson R; Pelosi, Paolo; Hoehn, Catharina; Meissner, Christoph; Kasper, Michael; Hübler, Matthias; von Neindorff, Matthias; Dassow, Constanze; Barrenschee, Martina; Uhlig, Stefan; Koch, Thea; de Abreu, Marcelo Gama

    2009-04-15

    Noisy ventilation with variable Vt may improve respiratory function in acute lung injury. To determine the impact of noisy ventilation on respiratory function and its biological effects on lung parenchyma compared with conventional protective mechanical ventilation strategies. In a porcine surfactant depletion model of lung injury, we randomly combined noisy ventilation with the ARDS Network protocol or the open lung approach (n = 9 per group). Respiratory mechanics, gas exchange, and distribution of pulmonary blood flow were measured at intervals over a 6-hour period. Postmortem, lung tissue was analyzed to determine histological damage, mechanical stress, and inflammation. We found that, at comparable minute ventilation, noisy ventilation (1) improved arterial oxygenation and reduced mean inspiratory peak airway pressure and elastance of the respiratory system compared with the ARDS Network protocol and the open lung approach, (2) redistributed pulmonary blood flow to caudal zones compared with the ARDS Network protocol and to peripheral ones compared with the open lung approach, (3) reduced histological damage in comparison to both protective ventilation strategies, and (4) did not increase lung inflammation or mechanical stress. Noisy ventilation with variable Vt and fixed respiratory frequency improves respiratory function and reduces histological damage compared with standard protective ventilation strategies.

  5. 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.

  6. 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.

  7. 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

  8. 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…

  9. 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...

  10. Risk evaluation and control strategies for indoor radon: a brief discussion

    International Nuclear Information System (INIS)

    Nero, A.V. Jr.

    1994-01-01

    Average risks of death estimated for radon are larger than those for many exposures in the outdoor environment, but similar to some in industrial settings. However, the indoor environment differs in regard to cost, benefit, responsibility, and distribution of risks from the outdoor and occupational settings, where frameworks for setting risk-limiting objectives and strategies have already been developed substantially. This indicates the need to develop a conceptual framework for evaluating risks in the indoor environment, within which the objectives of radon control strategies can be sensibly chosen. Nevertheless, the range of estimated radon risks and of recent radon control strategies suggest near-term elements of any strategy, i.e. accurate and effective public information, as well as reliable monitoring and control capabilities, and a focus on areas where most high residential levels occur. Developing a conceptual framework for evaluating indoor risks will permit the formulation of suitable aims on average indoor exposures and lower exposure situations. (author)

  11. Performance evaluation of control strategies for power maneuvering event of the KALIMER-600

    International Nuclear Information System (INIS)

    Seong, Seong-Hwan; Kim, Seong-O

    2012-01-01

    Highlights: ► The performance of three power control strategies of the KALIMER-600 was evaluated. ► There are turbine-, reactor- and feedwater-leading strategies in this study. ► For this, a performance analysis code was developed in this study. ► Simulation results show the turbine-leading is the best alternative. ► The feedwater-leading seems to be the second option. - Abstract: A sodium-cooled fast reactor named KALIMER-600 has been under development at KAERI. It is a pool-type reactor with the intermediate loops filled with sodium and has a superheated steam cycle with the once-through steam generators. Since the characteristic of the power control of the KALIMER-600 is expected to be different with that of a conventional power plant, the performance of the turbine-leading, reactor-leading and feedwater-leading control strategies for a power maneuvering event of the KALIMER-600 was evaluated in this study. The turbine-leading and reactor-leading strategies are very similar to those of a conventional water reactor but the feedwater-leading strategy is very similar to that of a fossil plant. Also, a performance analysis code which can analyze the plant dynamics of the KALIMER-600 and simulate the control actions during a power maneuvering event was developed. To evaluate the performance of control strategies, a simple power maneuvering event including a 10% step change and a ramp change with a rate of 5%/min was assumed and simulated. Through the simulation results, the turbine-leading strategy is proven to be very suitable for the KALIMER-600 and the feedwater-leading strategy for power maneuvering seems to be a good alternative for the power control. In further studies, various performance-related events such as the reactor power cutback, turbine runback and some transients will be evaluated and the best control strategy will be suggested.

  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. 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.

  14. A New V2G Control Strategy for Load Factor Improvement Using Smoothing Technique

    Directory of Open Access Journals (Sweden)

    CHANHOM, P.

    2017-08-01

    Full Text Available This paper proposes a new vehicle-to-grid (V2G control strategy for improving the load factor in the power network. To operate the proposed strategy, the available storage capacity of the PEVs’ batteries is considered as a battery energy storage system (BESS for charging and discharging an amount of power corresponding to the V2G power command. Due to the remarkable advantages of the technique so-called simple moving average, it is selected for applying in the proposed V2G control strategy. In this research, for investigating the load factor improvement, the essential data including the daily-load profiles with 7-day and 14-day periods are used for the 3 studied cases. These 3 studied cases present the power network with variation of the PEVs locations for describing the PEVs usage and charging or discharging behavior. The performance of the proposed strategy is simulated and verified by the MATPOWER software. The simulation results show that the load factors of the 3 studied cases are improved. Moreover, the encouragement of energy arbitrage for the PEVs owners is also discussed in this paper.

  15. 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.

  16. Unmet Need: Improving mHealth Evaluation Rigor to Build the Evidence Base.

    Science.gov (United States)

    Mookherji, Sangeeta; Mehl, Garrett; Kaonga, Nadi; Mechael, Patricia

    2015-01-01

    mHealth-the use of mobile technologies for health-is a growing element of health system activity globally, but evaluation of those activities remains quite scant, and remains an important knowledge gap for advancing mHealth activities. In 2010, the World Health Organization and Columbia University implemented a small-scale survey to generate preliminary data on evaluation activities used by mHealth initiatives. The authors describe self-reported data from 69 projects in 29 countries. The majority (74%) reported some sort of evaluation activity, primarily nonexperimental in design (62%). The authors developed a 6-point scale of evaluation rigor comprising information on use of comparison groups, sample size calculation, data collection timing, and randomization. The mean score was low (2.4); half (47%) were conducting evaluations with a minimum threshold (4+) of rigor, indicating use of a comparison group, while less than 20% had randomized the mHealth intervention. The authors were unable to assess whether the rigor score was appropriate for the type of mHealth activity being evaluated. What was clear was that although most data came from mHealth projects pilots aimed for scale-up, few had designed evaluations that would support crucial decisions on whether to scale up and how. Whether the mHealth activity is a strategy to improve health or a tool for achieving intermediate outcomes that should lead to better health, mHealth evaluations must be improved to generate robust evidence for cost-effectiveness assessment and to allow for accurate identification of the contribution of mHealth initiatives to health systems strengthening and the impact on actual health outcomes.

  17. Reported care giver strategies for improving drinking water for young children.

    Science.gov (United States)

    McLennan, John D; Farrelly, Ashley

    2010-11-01

    Care givers may engage in a variety of strategies to try and improve drinking water for children. However, the pattern of these efforts is not well known, particularly for young children in high-risk situations. The objective of this study was to determine care giver-reported strategies for young children with (1) undernutrition and (2) living in an unplanned poor peri-urban community in the Dominican Republic. Practices reported by care givers of young children from a community and clinic group were extracted from interviews conducted between 2004 and 2008 (n = 563). These results were compared to two previous similar samples interviewed in 1997 (n = 341). Bottled water is currently the most prevalent reported strategy for improving drinking water for young children. Its use increased from 6% to 69% in the community samples over the last decade and from 13% to 79% in the clinic samples. Boiling water continues to be a common strategy, particularly for the youngest children, though its overall use has decreased over time. Household-level chlorination is infrequently used and has dropped over time. Care givers are increasingly turning to bottled water in an attempt to provide safe drinking water for their children. While this may represent a positive trend for protecting children from water-transmitted diseases, it may represent an inefficient approach to safe drinking water provision that may place a financial burden on low-income families.

  18. Marketingová strategie VOYO.cz

    OpenAIRE

    Novotná, Markéta

    2012-01-01

    The aim of the diploma thesis is to analyse and evaluate the marketing strategy of VOYO.cz and recommend improvements of the current strategy. Theoretical part is divided into three chapters. The first chapter deals with the basic concept of marketing and the definition of marketing process. Second chapter defines the process of marketing planning and the third chapter offers basic theoretical approaches for the formulation of product, pricing, promotional and distribution strategy, which are...

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. Evaluating Teen Pregnancy Prevention Programs: Decades of Evolving Strategies and Practices

    Directory of Open Access Journals (Sweden)

    Susan Philliber

    2015-09-01

    Full Text Available This paper reviews the changing strategies for both process and outcome evaluations of teen pregnancy prevention programs over the past few decades. Implementation evaluations have emphasized discovery of what program attributes are most effective in reducing teen pregnancy and its antecedents. Outcome evaluations have moved from collecting data to measure knowledge, attitudes, and program satisfaction to measuring behavior change including postponement of sexual involvement, increased used of contraception, or reduction in teen pregnancy. High quality randomized control trials or quasi-experimental designs are being increasingly emphasized, as are sophisticated analysis techniques using multi-variate analyses, controls for cluster sampling, and other strategies designed to build a more solid knowledge base about how to prevent early pregnancy.

  4. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

    Science.gov (United States)

    Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E.; Eckhardt-Henn, Annegret; Dieterich, Marianne

    2015-01-01

    Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles. PMID:26843786

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.)

  10. 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...

  11. 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.

  12. Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results.

    Science.gov (United States)

    Treweek, Shaun; Oxman, Andrew D; Alderson, Philip; Bossuyt, Patrick M; Brandt, Linn; Brożek, Jan; Davoli, Marina; Flottorp, Signe; Harbour, Robin; Hill, Suzanne; Liberati, Alessandro; Liira, Helena; Schünemann, Holger J; Rosenbaum, Sarah; Thornton, Judith; Vandvik, Per Olav; Alonso-Coello, Pablo

    2013-01-09

    Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally.

  13. 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…

  14. 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)

  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. Using a phosphorus loss model to evaluate and improve phosphorus indices.

    Science.gov (United States)

    Bolster, Carl H; Vadas, Peter A; Sharpley, Andrew N; Lory, John A

    2012-01-01

    In most states, the phosphorus (P) index (PI) is the adopted strategy for assessing a field's vulnerability to P loss; however, many state PIs have not been rigorously evaluated against measured P loss data to determine how well the PI assigns P loss risk-a major reason being the lack of field data available for such an analysis. Given the lack of P loss data available for PI evaluation, our goal was to demonstrate how a P loss model can be used to evaluate and revise a PI using the Pennsylvania (PA) PI as an example. Our first objective was to compare two different formulations-multiplicative and component-for calculating a PI. Our second objective was to evaluate whether output from a P loss model can be used to improve PI weighting by calculating weights for modified versions of the PA PI from model-generated P loss data. Our results indicate that several potential limitations exist with the original multiplicative index formulation and that a component formulation is more consistent with how P loss is calculated with P loss models and generally provides more accurate estimates of P loss. Moreover, using the PI weights calculated from the model-generated data noticeably improved the correlation between PI values and a large and diverse measured P loss data set. The approach we use here can be used with any P loss model and PI and thus can serve as a guide to assist states in evaluating and modifying their PI. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  17. INNOVATION STRATEGY TO IMPROVE THE COMPETITIVENESS OF MICRO, SMALL, AND MEDIUM ENTERPRISES OF BANDAR LAMPUNG BANANA CHIPS

    Directory of Open Access Journals (Sweden)

    Hartami Dewi

    2017-01-01

    Full Text Available Innovation is needed by micro, small, and medium enterprises to grow and develop into large businesses. However, that innovations are limited by existing constraints such as limited number of employees, total assets, total revenues and total budget for innovation. Human resources or the entrepreneur is known to be an important factor in improving the performance and innovation of SMEs or UMKM. This research aims to formulate strategies given the constraints of innovation, human resource capacity and opportunities for innovation in improving competitiveness. The analytical method used is confirmed method, the evaluation model of structural equation modeling (SEM and the analytic hierarchy process (AHP. The analysis showed an effect of human resources amounting to 0.761 on the settlement of the constraints and influence of 0.806 to successful innovation. The main obstacle that have to be resolved are human resources, promotion, managerial finance and administration, location, and marketing. The innovation that most influence in purchasing decisions and according to the ability of SMEs are service innovation, organization, business model, supply chain, and marketing. The best strategy formulation that can be done in improving the competitiveness of businesses are participation in exhibitions and entrepreneurship seminars, technical assistance, training and the online marketing promotion, as well as the provision of machinery and appropriate process equipment.Keywords: innovation, competitiveness, structural equation modeling, analytic hierarchy process

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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...

  4. A Dynamically Focusing Cochlear Implant Strategy Can Improve Vowel Identification in Noise.

    Science.gov (United States)

    Arenberg, Julie G; Parkinson, Wendy S; Litvak, Leonid; Chen, Chen; Kreft, Heather A; Oxenham, Andrew J

    2018-03-09

    The standard, monopolar (MP) electrode configuration used in commercially available cochlear implants (CI) creates a broad electrical field, which can lead to unwanted channel interactions. Use of more focused configurations, such as tripolar and phased array, has led to mixed results for improving speech understanding. The purpose of the present study was to assess the efficacy of a physiologically inspired configuration called dynamic focusing, using focused tripolar stimulation at low levels and less focused stimulation at high levels. Dynamic focusing may better mimic cochlear excitation patterns in normal acoustic hearing, while reducing the current levels necessary to achieve sufficient loudness at high levels. Twenty postlingually deafened adult CI users participated in the study. Speech perception was assessed in quiet and in a four-talker babble background noise. Speech stimuli were closed-set spondees in noise, and medial vowels at 50 and 60 dB SPL in quiet and in noise. The signal to noise ratio was adjusted individually such that performance was between 40 and 60% correct with the MP strategy. Subjects were fitted with three experimental strategies matched for pulse duration, pulse rate, filter settings, and loudness on a channel-by-channel basis. The strategies included 14 channels programmed in MP, fixed partial tripolar (σ = 0.8), and dynamic partial tripolar (σ at 0.8 at threshold and 0.5 at the most comfortable level). Fifteen minutes of listening experience was provided with each strategy before testing. Sound quality ratings were also obtained. Speech perception performance for vowel identification in quiet at 50 and 60 dB SPL and for spondees in noise was similar for the three tested strategies. However, performance on vowel identification in noise was significantly better for listeners using the dynamic focusing strategy. Sound quality ratings were similar for the three strategies. Some subjects obtained more benefit than others, with some

  5. Cloud computing strategies

    CERN Document Server

    Chorafas, Dimitris N

    2011-01-01

    A guide to managing cloud projects, Cloud Computing Strategies provides the understanding required to evaluate the technology and determine how it can be best applied to improve business and enhance your overall corporate strategy. Based on extensive research, it examines the opportunities and challenges that loom in the cloud. It explains exactly what cloud computing is, what it has to offer, and calls attention to the important issues management needs to consider before passing the point of no return regarding financial commitments.

  6. 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.

  7. 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.

  8. Feedback Providing Improvement Strategies and Reflection on Feedback Use: Effects on Students' Writing Motivation, Process, and Performance

    Science.gov (United States)

    Duijnhouwer, Hendrien; Prins, Frans J.; Stokking, Karel 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 control feedback condition (n = 41) received…

  9. 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...

  10. 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.

  11. Novel approaches to improve iris recognition system performance based on local quality evaluation and feature fusion.

    Science.gov (United States)

    Chen, Ying; Liu, Yuanning; Zhu, Xiaodong; Chen, Huiling; He, Fei; Pang, Yutong

    2014-01-01

    For building a new iris template, this paper proposes a strategy to fuse different portions of iris based on machine learning method to evaluate local quality of iris. There are three novelties compared to previous work. Firstly, the normalized segmented iris is divided into multitracks and then each track is estimated individually to analyze the recognition accuracy rate (RAR). Secondly, six local quality evaluation parameters are adopted to analyze texture information of each track. Besides, particle swarm optimization (PSO) is employed to get the weights of these evaluation parameters and corresponding weighted coefficients of different tracks. Finally, all tracks' information is fused according to the weights of different tracks. The experimental results based on subsets of three public and one private iris image databases demonstrate three contributions of this paper. (1) Our experimental results prove that partial iris image cannot completely replace the entire iris image for iris recognition system in several ways. (2) The proposed quality evaluation algorithm is a self-adaptive algorithm, and it can automatically optimize the parameters according to iris image samples' own characteristics. (3) Our feature information fusion strategy can effectively improve the performance of iris recognition system.

  12. A 'movement for improvement'? A qualitative study of the adoption of social movement strategies in the implementation of a quality improvement campaign.

    Science.gov (United States)

    Waring, Justin; Crompton, Amanda

    2017-09-01

    Given the difficulties of implementing 'top-down' quality improvements, health service leaders have turned to methods that empower clinicians to co-produce 'bottom-up' improvements. This has involved the adoption of strategies and activities associated with social movements, with clinicians encouraged to participate in collective action towards the shared goal of improvement. This paper examines the adoption of social movement methods by hospital managers as a strategy for implementing a quality improvement 'campaign'. Our case study suggests that, despite the claim of empowering clinicians to develop 'bottom-up' improvements, the use of social movement methods can be more narrowly concerned with engaging clinicians in pre-determined programmes of 'top-down' change. It finds a prominent role for 'hybrid' clinical leaders and other staff representatives in the mobilisation of the campaign, especially for enrolling clinicians in change activities. The work of these 'hybrids' suggests some degree of creative mediation between clinical and managerial interests, but more often alignment with the aspirations of management. The study raises questions about the translation of social movement's theories as a strategy for managing change and re-inventing professionalism. © 2017 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  13. 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…

  14. Evaluation of pig production practices, constraints and opportunities for improvement in smallholder production systems in Kenya.

    Science.gov (United States)

    Mbuthia, Jackson Mwenda; Rewe, Thomas Odiwuor; Kahi, Alexander Kigunzu

    2015-02-01

    This study evaluated pig production practices by smallholder farmers in two distinct production systems geared towards addressing their constraints and prospects for improvement. The production systems evaluated were semi-intensive and extensive and differed in remoteness, market access, resource availability and pig production intensity. Data were collected using structured questionnaires where a total of 102 pig farmers were interviewed. Qualitative and quantitative research methods were employed to define the socioeconomic characteristics of the production systems, understanding the different roles that pigs play, marketing systems and constraints to production. In both systems, regular cash income and insurance against emergencies were ranked as the main reasons for rearing pigs. Marketing of pigs was mainly driven by the type of production operation. Finances, feeds and housing were identified as the major constraints to production. The study provides important parameters and identifies constraints important for consideration in design of sustainable production improvement strategies. Feeding challenges can be improved through understanding the composition and proper utilization of local feed resources. Provision of adequate housing would improve the stocking rates and control mating.

  15. 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

  16. Optimization strategies for improving irrigation water management of lower jhelum canal

    International Nuclear Information System (INIS)

    Rashid, M.U.

    2015-01-01

    The paper includes computing crop water requirement, identification of problems and optimization strategies for improved irrigation water management of a canal command. Lower Jhelum Canal (LJC) System was selected as a case study. Possible strategies for optimization are enhancing irrigation water productivity by high value and high yield crops, adoption of resource conservation interventions (RCIs) at the farm level, improving irrigation system efficiency and its management. Estimation of daily reference evapotranspiration of LJC command was carried out by Penman Montieth -2000 method and metrological data of Sargodha for the period 1999 to 2010 was used. Crop water requirements were computed from reference evapotranspiration, crop coefficients and periods of crops for existing cropping pattern. The comparison of the crop water requirements and available water supplies indicated shortage of more than 51% in Kharif and 54% in Rabi seasons. The gap between requirements and supplies is fulfilled by groundwater in the command. The structural measures identified in the present study for improving canal management include rationalization of canal capacities in keeping with the current water requirements and availability, rehabilitation and remodeling of canal network and lining of distributaries and minors in saline groundwater areas. An array of measures and practices identified for improved water management at the farm level include: improvement and lining of watercourses, proper farm design and layout, adoption of resource conservation technologies involving laser land leveling, zero tillage, and bed-furrow irrigation method. Adopting proper cropping systems considering land suitability and capacity building of farming community in improved soil, crop and water management technologies would enhance the water productivity in an effective and sustainable manner. (author)

  17. 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.

  18. Evaluating the effectiveness of a strategy for teaching neonatal resuscitation in West Africa.

    Science.gov (United States)

    Enweronu-Laryea, Christabel; Engmann, Cyril; Osafo, Alexandra; Bose, Carl

    2009-11-01

    To evaluate the effectiveness of a strategy for teaching neonatal resuscitation on the cognitive knowledge of health professionals who attend deliveries in Ghana, West Africa. Train-the-trainer model was used to train health professionals at 2-3 day workshops from 2003 to 2007. Obstetric Anticipatory Care and Basic Neonatal Care modules were taught as part of Neonatal Resuscitation Training package. American Neonatal Resuscitation Program was adapted to the clinical role of participants and local resources. Cognitive knowledge was evaluated by written pre- and post-training tests. The median pre-training and post-training scores were 38% and 71% for midwives, 43% and 81% for nurses, 52% and 90% for nurse anaesthetists, and 62% and 98% for physicians. All groups of the 271 professionals (18 nurse anaesthetists, 55 nurses, 68 physicians, and 130 midwives) who completed the course showed significant improvement (pfacilities were less likely to achieve passing post-test scores than midwives at secondary and tertiary facilities [35/53 vs. 24/26 vs. 45/51 (p=0.004)] respectively. Evidence-based neonatal resuscitation training adapted to local resources significantly improved cognitive knowledge of all groups of health professionals. Further modification of training for midwives working at primary level health facilities and incorporation of neonatal resuscitation in continuing education and professional training programs are recommended.

  19. 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.

  20. Evaluating the effectiveness of brand-positioning strategies from a consumer perspective

    DEFF Research Database (Denmark)

    Fuchs, Christoph; Diamantopoulos, Adamantios

    2010-01-01

    - The findings should guide brand managers in selecting the most appropriate positioning strategies for their brands in high-involvement markets such as the automobile market. Originality/value - The study sheds initial light on the overall relative effectiveness of major positioning strategies. The study......Purpose - The purpose of the paper is to explore empirically the overall relative effectiveness of alternative positioning strategies from a consumer perspective. Design/methodology/approach - Two studies (within- and between-subjects design) are conducted aimed at evaluating the positioning...... of positioning strategy used affects the positioning success of a brand. More specifically, the study confirms normative arguments about the overall relative effectiveness of main positioning strategies by revealing that benefit-based positioning and surrogate (user) positioning generally outperform feature...

  1. 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...

  2. 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

  3. Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies

    Science.gov (United States)

    2016-01-01

    This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment. PMID:27365998

  4. Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies.

    Science.gov (United States)

    Song, Dae Jong; Choi, Jae Wook; Kim, Kyunghee; Kim, Min Soo; Moon, Jiwon Monica

    2016-07-01

    This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment.

  5. 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

  6. 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

  7. 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

  8. Multi-criteria evaluation of wastewater treatment plant control strategies under uncertainty

    DEFF Research Database (Denmark)

    Flores Alsina, Xavier; Rodriguez-Roda, Ignasi; Sin, Gürkan

    2008-01-01

    The evaluation of activated sludge control strategies in wastewater treatment plants (WWTP) via mathematical modelling is a complex activity because several objectives; e.g. economic, environmental, technical and legal; must be taken into account at the same time, i.e. the evaluation of the alter...

  9. Dosimetric and geometric evaluation of a hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Liu Han; Wu Qiuwen

    2011-01-01

    For prostate cancer patients, online image-guided (IG) radiotherapy has been widely used in clinic to correct the translational inter-fractional motion at each treatment fraction. For uncertainties that cannot be corrected online, such as rotation and deformation of the target volume, margins are still required to be added to the clinical target volume (CTV) for the treatment planning. Offline adaptive radiotherapy has been implemented to optimize the treatment for each individual patient based on the measurements at early stages of treatment process. It has been shown that offline adaptive radiotherapy can effectively reduce the required margin. Recently a hybrid strategy of offline adaptive replanning and online IG was proposed and the geometric evaluation was performed. It was found that the planning margins can further be reduced by 1-2 mm compared to online IG only strategy. The purpose of this study was to investigate the dosimetric benefits of such a hybrid strategy on the target and organs at risk. A total of 420 repeated helical computed tomography scans from 28 patients were included in the study. Both low-risk patients (LRP, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles, SV) were included in the simulation. Two registration methods, based on center-of-mass shift of prostate only and prostate plus SV, were performed for IRP. The intensity-modulated radiotherapy was used in the simulation. Criteria on both cumulative and fractional doses were evaluated. Furthermore, the geometric evaluation was extended to investigate the optimal number of fractions necessary to construct the internal target volume (ITV) for the hybrid strategy. The dosimetric margin improvement was smaller than its geometric counterpart and was in the range of 0-1 mm. The optimal number of fractions necessary for the ITV construction is 2 for LRPs and 3-4 for IRPs in a hypofractionation protocol. A new cumulative index of target volume was proposed

  10. Evaluating alternative management strategies for bigeye tuna, Thunnus obesus, in the Indian Ocean

    Directory of Open Access Journals (Sweden)

    Yuhe Tong

    2013-09-01

    Full Text Available Bigeye tuna (Thunnus obesus support a large commercial fishery in the Indian Ocean. However, explicit management strategies and harvest control rules are yet to be developed for the management of this fishery. We used a stochastic age-structured production model as an operating model to evaluate several potential management strategies under different assumptions of stock productivity. Five management strategies—constant fishing mortality, constant catch, quasi-constant catch, constant escapement, and status-dependent strategies—were evaluated and compared using the performance indicators including average catch, average spawning stock biomass, variation in catch, average fishing mortality and lowest biomass during the time period considered in the simulation. This study shows that (1 for the constant catch strategy, an annual catch of 90000 t would result in a low risk of stock being overfished while obtaining a stable catch; (2 for the constant fishing mortality strategy fishing mortality of 0.3 per year could yield a higher catch, but might have a high probability (64% of stock dropping below the spawning stock biomass (SSB that could achieve maximum sustainable yield (SSBmsy; and (3 for the quasi-constant catch strategy an annual catch of 110000 t was sustainable if the current SSB was higher than SSBmsy. Constant escapement and status-dependent strategies were robust with respect to different levels of virgin recruitment and steepness. This study suggests that it is important to incorporate uncertainties associated with key life history, fisheries and management processes in evaluating management strategies.

  11. [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.

  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. Strategies for online test security.

    Science.gov (United States)

    Hart, Leigh; Morgan, Lesley

    2009-01-01

    As online courses continue to increase, maintaining academic integrity in student evaluation is a challenge. The authors review several strategies, with varying degrees of cost and technology, to improve test security in the online classroom.

  14. Evaluation of bioremediation strategies of a controlled oil release in a wetland

    International Nuclear Information System (INIS)

    Mills, Marc A.; Bonner, James S.; Page, Cheryl A.; Autenrieth, Robin L.

    2004-01-01

    A controlled petroleum release was conducted to evaluate bioremediation in a wetland near Houston, Texas. The 140-day study was conducted using a randomized, complete block design to test three treatments with six replicates per treatment. The three treatment strategies were inorganic nutrients, inorganic nutrients with an alternative electron acceptor, and a no-action oiled control. Samples were analyzed for petroleum chemistry and inorganic nutrients. These results are discussed in the context of our related research involving toxicology and microbiology at the site during the experiment. To evaluate biodegradation, the targeted compounds were normalized to the conservative compound C 30 17α, 21β-[H]hopane, thus reducing the effects of spatial heterogeneity and physical transport. The two biostimulation treatments demonstrated statistically-higher rates of biodegradation than the oiled no-action control. For the majority of the experiment, target nutrient levels were maintained. Further research may be warranted to optimize these bioremediation strategies as well as evaluating additional treatment strategies for wetlands and other shoreline systems

  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. Multi-criteria evaluation of wastewater treatment plant control strategies under uncertainty.

    Science.gov (United States)

    Flores-Alsina, Xavier; Rodríguez-Roda, Ignasi; Sin, Gürkan; Gernaey, Krist V

    2008-11-01

    The evaluation of activated sludge control strategies in wastewater treatment plants (WWTP) via mathematical modelling is a complex activity because several objectives; e.g. economic, environmental, technical and legal; must be taken into account at the same time, i.e. the evaluation of the alternatives is a multi-criteria problem. Activated sludge models are not well characterized and some of the parameters can present uncertainty, e.g. the influent fractions arriving to the facility and the effect of either temperature or toxic compounds on the kinetic parameters, having a strong influence in the model predictions used during the evaluation of the alternatives and affecting the resulting rank of preferences. Using a simplified version of the IWA Benchmark Simulation Model No. 2 as a case study, this article shows the variations in the decision making when the uncertainty in activated sludge model (ASM) parameters is either included or not during the evaluation of WWTP control strategies. This paper comprises two main sections. Firstly, there is the evaluation of six WWTP control strategies using multi-criteria decision analysis setting the ASM parameters at their default value. In the following section, the uncertainty is introduced, i.e. input uncertainty, which is characterized by probability distribution functions based on the available process knowledge. Next, Monte Carlo simulations are run to propagate input through the model and affect the different outcomes. Thus (i) the variation in the overall degree of satisfaction of the control objectives for the generated WWTP control strategies is quantified, (ii) the contributions of environmental, legal, technical and economic objectives to the existing variance are identified and finally (iii) the influence of the relative importance of the control objectives during the selection of alternatives is analyzed. The results show that the control strategies with an external carbon source reduce the output uncertainty

  17. Management strategies to effect change in intensive care units: lessons from the world of business. Part II. Quality-improvement strategies.

    Science.gov (United States)

    Gershengorn, Hayley B; Kocher, Robert; Factor, Phillip

    2014-03-01

    The success of quality-improvement projects relies heavily on both project design and the metrics chosen to assess change. In Part II of this three-part American Thoracic Society Seminars series, we begin by describing methods for determining which data to collect, tools for data presentation, and strategies for data dissemination. As Avedis Donabedian detailed a half century ago, defining metrics in healthcare can be challenging; algorithmic determination of the best type of metric (outcome, process, or structure) can help intensive care unit (ICU) managers begin this process. Choosing appropriate graphical data displays (e.g., run charts) can prompt discussions about and promote quality improvement. Similarly, dashboards/scorecards are useful in presenting performance improvement data either publicly or privately in a visually appealing manner. To have compelling data to show, ICU managers must plan quality-improvement projects well. The second portion of this review details four quality-improvement tools-checklists, Six Sigma methodology, lean thinking, and Kaizen. Checklists have become commonplace in many ICUs to improve care quality; thinking about how to maximize their effectiveness is now of prime importance. Six Sigma methodology, lean thinking, and Kaizen are techniques that use multidisciplinary teams to organize thinking about process improvement, formalize change strategies, actualize initiatives, and measure progress. None originated within healthcare, but each has been used in the hospital environment with success. To conclude this part of the series, we demonstrate how to use these tools through an example of improving the timely administration of antibiotics to patients with sepsis.

  18. 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.

  19. 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.

  20. Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops.

    Science.gov (United States)

    Brueton, Valerie; Stenning, Sally P; Stevenson, Fiona; Tierney, Jayne; Rait, Greta

    2017-08-01

    To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs). Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified. Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow

  1. Towards a benchmark simulation model for plant-wide control strategy performance evaluation of WWTPs

    DEFF Research Database (Denmark)

    Jeppsson, Ulf; Rosen, Christian; Alex, Jens

    2006-01-01

    The COST/IWA benchmark simulation model has been available for seven years. Its primary purpose has been to create a platform for control strategy benchmarking of activated sludge processes. The fact that the benchmark has resulted in more than 100 publications, not only in Europe but also...... worldwide, demonstrates the interest in such a tool within the research community In this paper, an extension of the benchmark simulation model no 1 (BSM1) is proposed. This extension aims at facilitating control strategy development and performance evaluation at a plant-wide level and, consequently...... the changes, the evaluation period has been extended to one year. A prolonged evaluation period allows for long-term control strategies to be assessed and enables the use of control handles that cannot be evaluated in a realistic fashion in the one-week BSM1 evaluation period. In the paper, the extended plant...

  2. A systematic review of the implementation of recommended psychological interventions for schizophrenia: Rates, barriers, and improvement strategies.

    Science.gov (United States)

    Ince, Paul; Haddock, Gillian; Tai, Sara

    2016-09-01

    A systematic review of the literature exploring if the UK recommendations for psychological interventions for schizophrenia were being met was carried out. Rates of implementation for cognitive behavioural therapy (CBT) and family intervention (FI) were compared. The barriers against implementation and described strategies aimed at improving implementation were reviewed. A literature search of electronic bibliography databases (Psychinfo, Medline, Pubmed, AMED, CINHAL, and EMBASE), reference and citation lists, the Evaluation and Review of NICE Implementation (ERNIE) database, a manual search of Clinical Psychology Forum, governmental reports, charity, and service user group reports was conducted. Twenty-six articles met the inclusion criteria, 11 provided data on implementation rates, 13 explored the barriers to implementation, and 10 gave information about improvement strategies. Rates of implementation varied from 4% to 100% for CBT and 0% to 53% for FI, and studies varied in the methodology used and quality of the articles. Previously reported barriers to implementation were found, with organisational barriers being most commonly followed by barriers met by staff members and service users. Implementation strategies discovered included training packages for CBT, FI, and psychosocial interventions as well as empirical evidence suggesting methods for engagement with service users. Rates of implementation for CBT and FI are still below recommended levels with wide variation of rates found. This suggests inequalities in the provision of psychological interventions for schizophrenia are still present. Previously identified barriers to implementation were confirmed. Attempted implementation strategies have been met with modest success. Inequalities in the provision of psychological therapies for schizophrenia persist. Good quality cognitive behavioural therapy and FI training do not ensure implementation. Collaboration at all levels of healthcare is needed for

  3. THE ACCURACY AND BIAS EVALUATION OF THE USA UNEMPLOYMENT RATE FORECASTS. METHODS TO IMPROVE THE FORECASTS ACCURACY

    Directory of Open Access Journals (Sweden)

    MIHAELA BRATU (SIMIONESCU

    2012-12-01

    Full Text Available In this study some alternative forecasts for the unemployment rate of USA made by four institutions (International Monetary Fund (IMF, Organization for Economic Co-operation and Development (OECD, Congressional Budget Office (CBO and Blue Chips (BC are evaluated regarding the accuracy and the biasness. The most accurate predictions on the forecasting horizon 201-2011 were provided by IMF, followed by OECD, CBO and BC.. These results were gotten using U1 Theil’s statistic and a new method that has not been used before in literature in this context. The multi-criteria ranking was applied to make a hierarchy of the institutions regarding the accuracy and five important accuracy measures were taken into account at the same time: mean errors, mean squared error, root mean squared error, U1 and U2 statistics of Theil. The IMF, OECD and CBO predictions are unbiased. The combined forecasts of institutions’ predictions are a suitable strategy to improve the forecasts accuracy of IMF and OECD forecasts when all combination schemes are used, but INV one is the best. The filtered and smoothed original predictions based on Hodrick-Prescott filter, respectively Holt-Winters technique are a good strategy of improving only the BC expectations. The proposed strategies to improve the accuracy do not solve the problem of biasness. The assessment and improvement of forecasts accuracy have an important contribution in growing the quality of decisional process.

  4. 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...

  5. 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.

  6. 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…

  7. Improved spectral absorption coefficient grouping strategy of wide band k-distribution model used for calculation of infrared remote sensing signal of hot exhaust systems

    Science.gov (United States)

    Hu, Haiyang; Wang, Qiang

    2018-07-01

    A new strategy for grouping spectral absorption coefficients, considering the influences of both temperature and species mole ratio inhomogeneities on correlated-k characteristics of the spectra of gas mixtures, has been deduced to match the calculation method of spectral overlap parameter used in multiscale multigroup wide band k-distribution model. By comparison with current spectral absorption coefficient grouping strategies, for which only the influence of temperature inhomogeneity on the correlated-k characteristics of spectra of single species was considered, the improvements in calculation accuracies resulting from the new grouping strategy were evaluated using a series of 0D cases in which radiance under 3-5-μm wave band emitted by hot combustion gas of hydrocarbon fuel was attenuated by atmosphere with quite different temperature and mole ratios of water vapor and carbon monoxide to carbon dioxide. Finally, evaluations are presented on the calculation of remote sensing thermal images of transonic hot jet exhausted from a chevron ejecting nozzle with solid wall cooling system.

  8. 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.)

  9. 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.)

  10. Improvement of workíng environment - from a grass-root strategy to institutionalized professionalism

    DEFF Research Database (Denmark)

    Jacobsen, Thomas

    2002-01-01

    Improvement of working environment as a tool to promote sustainable development - from a grass-root strategy to institutionalized professionalism. It is now more than 25 years since substitution of organic solvents started to be considered as a meaningful way in Denmark to reduce harmful effects...... on workers. During that period different groups of actors have been involved, new institutions to improve working environment have emerged, and legislation has been changed. The paper will describe the development from a grass-root strategy to improve working environment to a much more complex situation...... where working environment professionals play an important role, and where the concept of ‘cleaner technology’ is generally accepted as a tool to promote sustainable development in the Danish society. The paper will also discuss the necessity of incorporation of working environment considerations...

  11. 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.

  12. A novel strategy for evaluating the effects of an electronic test ordering alert message: Optimizing cardiac marker use

    Directory of Open Access Journals (Sweden)

    Jason M Baron

    2012-01-01

    Full Text Available Background: Laboratory ordering functions within computerized provider order entry (CPOE systems typically support the display of electronic alert messages to improve test utilization or implement new ordering policies. However, alert strategies have been shown to vary considerably in their success and the characteristics contributing to an alert′s success are poorly understood. Improved methodologies are needed to evaluate alerts and their mechanisms of action. Materials and Methods: Clinicians order inpatient and emergency department laboratory tests using our institutional CPOE system. We analyzed user interaction data captured by our CPOE system to evaluate how clinicians responded to an alert. We evaluated an alert designed to implement an institutional policy restricting the indications for ordering creatine kinase-MB (CKMB. Results: Within 2 months of alert implementation, CKMB-associated searches declined by 79% with a corresponding decline in CKMB orders. Furthermore, while prior to alert implementation, clinicians searching for CKMB ultimately ordered this test 99% of the time, following implementation, only 60% of CKMB searches ultimately led to CKMB test orders. This difference presumably represents clinicians who reconsidered the need for CKMB in response to the alert, demonstrating the alert′s just-in-time advisory capability. In addition, as clinicians repeatedly viewed the alert, there was a "dose-dependant" decrease in the fraction of searches without orders. This presumably reflects the alerting strategy′s long-term educational component, as clinicians aware of the new policy will not search for CKMB when not indicated. Conclusions: Our analytic approach provides insight into the mechanism of a CPOE alert and demonstrates that alerts may act through a combination of just-in-time advice and longer term education. Use of this approach when implementing alerts may prove useful to improve the success of a given alerting

  13. A two-magnet strategy for improved mixing and capture from biofluids

    Science.gov (United States)

    Doyle, Andrew B.; Haselton, Frederick R.

    2016-01-01

    Magnetic beads are a popular method for concentrating biomolecules from solution and have been more recently used in multistep pre-arrayed microfluidic cartridges. Typical processing strategies rely on a single magnet, resulting in a tight cluster of beads and requiring long incubation times to achieve high capture efficiencies, especially in highly viscous patient samples. This report describes a two-magnet strategy to improve the interaction of the bead surface with the surrounding fluid inside of a pre-arrayed, self-contained assay-in-a-tube. In the two-magnet system, target biomarker capture occurs at a rate three times faster than the single-magnet system. In clinically relevant biomatrices, we find a 2.5-fold improvement in biomarker capture at lower sample viscosities with the two-magnet system. In addition, we observe a 20% increase in the amount of protein captured at high viscosity for the two-magnet configuration relative to the single magnet approach. The two-magnet approach offers a means to achieve higher biomolecule extraction yields and shorter assay times in magnetic capture assays and in self-contained processor designs. PMID:27158286

  14. A Teaching Strategy with a Focus on Argumentation to Improve Undergraduate Students’ Ability to Read Research Articles

    Science.gov (United States)

    Lacum, Edwin B. Van; Goedhart, Martin J.

    2014-01-01

    The aim of this study is to evaluate a teaching strategy designed to teach first-year undergraduate life sciences students at a research university how to learn to read authentic research articles. Our approach—based on the work done in the field of genre analysis and argumentation theory—means that we teach students to read research articles by teaching them which rhetorical moves occur in research articles and how they can identify these. Because research articles are persuasive by their very nature, we focused on the rhetorical moves that play an important role in authors’ arguments. We designed a teaching strategy using cognitive apprenticeship as the pedagogical approach. It was implemented in a first-year compulsory course in the life sciences undergraduate program. Comparison of the results of a pretest with those of the posttest showed that students’ ability to identify these moves had improved. Moreover, students themselves had also perceived that their ability to read and understand a research article had increased. The students’ evaluations demonstrated that they appreciated the pedagogical approach used and experienced the assignments as useful. On the basis of our results, we concluded that students had taken a first step toward becoming expert readers. PMID:26086657

  15. 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

  16. 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.

  17. Management of remanent lifetime. Short-term benefits of the maintenance evaluation and improvement programme

    International Nuclear Information System (INIS)

    Sainero Garcia, J.

    1993-01-01

    Remanent Lifetime Management, which is scientifically based on knowing the degradatory phenomena associated with aging, today allows us to optimize plant life through a long-term maintenance strategy combining preventive maintenance and condition monitoring programmes. Within a project for Remanent Lifetime Management (RLM), the determination of methods of control and mitigation of degradations due to aging depends on the programme of Maintenance Evaluation and Improvement (MEI). This programme, underpinned by the analysis of degradatory phenomena to which plant components are subjected, evaluates current maintenance practices and defines the complementary actions which would facilitate establishment of a long-term strategy to control aging. Together with this main objective of the RLM project, the MEI programme achieves short-term benefits since, right from the beginning, it offers solutions to mitigate and guard against degradations in crucial plant components, and generally sets out a programme to control aging. The MEI programme further serves as a tool to reach the final objectives of the new 10CFR50.65 rule, 'Requirements for Maintenance Programs for NPPs'. The MEI always offers the option should the Utility Owner decide to extend plant life. (author)

  18. 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....

  19. Oral formulation strategies to improve solubility of poorly water-soluble drugs.

    Science.gov (United States)

    Singh, Abhishek; Worku, Zelalem Ayenew; Van den Mooter, Guy

    2011-10-01

    In the past two decades, there has been a spiraling increase in the complexity and specificity of drug-receptor targets. It is possible to design drugs for these diverse targets with advances in combinatorial chemistry and high throughput screening. Unfortunately, but not entirely unexpectedly, these advances have been accompanied by an increase in the structural complexity and a decrease in the solubility of the active pharmaceutical ingredient. Therefore, the importance of formulation strategies to improve the solubility of poorly water-soluble drugs is inevitable, thus making it crucial to understand and explore the recent trends. Drug delivery systems (DDS), such as solid dispersions, soluble complexes, self-emulsifying drug delivery systems (SEDDS), nanocrystals and mesoporous inorganic carriers, are discussed briefly in this review, along with examples of marketed products. This article provides the reader with a concise overview of currently relevant formulation strategies and proposes anticipated future trends. Today, the pharmaceutical industry has at its disposal a series of reliable and scalable formulation strategies for poorly soluble drugs. However, due to a lack of understanding of the basic physical chemistry behind these strategies, formulation development is still driven by trial and error.

  20. Evaluation of strategies for end storage of high-level reactor fuel

    International Nuclear Information System (INIS)

    2001-01-01

    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

  1. 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

  2. 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)

  3. An improved charging/discharging strategy of lithium batteries considering depreciation cost in day-ahead microgrid scheduling

    International Nuclear Information System (INIS)

    Zhang, Zhong; Wang, Jianxue; Wang, Xiuli

    2015-01-01

    Highlights: • A quantitative depreciation cost model is put forward for lithium batteries. • A practical charging/discharging strategy is applied to battery management. • The depth of discharge of the battery storage is scheduled more rationally. • The proposed strategy improves the cost efficiency of lithium batteries in MGs. - Abstract: An energy storage system is critical for the safe and stable operation of a microgrid (MG) and has a promising prospect in future power system. Economical and safe operation of storage system is of great significance to MGs. This paper presents an improved management strategy for lithium battery storage by establishing a battery depreciation cost model and employing a practical charging/discharging strategy. Firstly, experimental data of lithium battery cycle lives, which are functions of the depth of discharge, are investigated and synthesized. A quantitative depreciation cost model is put forward for lithium batteries from the perspective of cycle life. Secondly, a practical charging/discharging strategy is applied to the lithium battery management in MGs. Then, an optimal scheduling model is developed to minimize MG operational cost including battery depreciation cost. Finally, numerical tests are conducted on a typical grid-connected MG. Results show that the depth of discharge of storage is scheduled more rationally, and operational cost is simultaneously saved for MG under the proposed management strategy. This study helps to improve the cost efficiency and alleviate the aging process for lithium batteries.

  4. [National strategy in the battle against scorpion stings and envenomations. Application and evaluation].

    Science.gov (United States)

    Soulaymani Bencheikh, R; Faraj, Z; Semlali, I; Ouammi, L; Badri, M

    2003-11-01

    Scorpion stings represent the first cause of poisoning with an incidence of 30 to 50% of all declared cases in the Centre Anti Poison of Morocco (CAPM). Aware of this increasing problem, the CAPM paid special attention to this pathology. Thanks to its retrospective and prospective studies, the scorpion species mapping has been determined as well as the demographic features of stung patients, the nature and the chronology of clinical events in scorpion envenimation, and the epidemiological, clinical and therapeutical factors of severity. On this basis, the CAPM worked out a national strategy to struggle against scorpion stings whose aim was to decrease the morbidity and mortality caused by stings of scorpion as well as to rationalise economic expenses. The components of this strategy were based on the training of the medical and paramedical staff, on information, education, communication involving different sectors, on identification of needs and on follow-up and assessment. A nationwide campaign was implemented to change the population and health-care staff's behaviour regarding this pathology. Its evaluation permitted to improve the compilation of cases with census of 14104 cases, to reduce lethality rate and to rationalise expenses while banishing some medicines and avoiding useless hospitalization.

  5. 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.

  6. 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.

  7. Biobjective Optimization and Evaluation for Transit Signal Priority Strategies at Bus Stop-to-Stop Segment

    Directory of Open Access Journals (Sweden)

    Rui Li

    2016-01-01

    Full Text Available This paper proposes a new optimization framework for the transit signal priority strategies in terms of green extension, red truncation, and phase insertion at the stop-to-stop segment of bus lines. The optimization objective is to minimize both passenger delay and the deviation from bus schedule simultaneously. The objective functions are defined with respect to the segment between bus stops, which can include the adjacent signalized intersections and downstream bus stops. The transit priority signal timing is optimized by using a biobjective optimization framework considering both the total delay at a segment and the delay deviation from the arrival schedules at bus stops. The proposed framework is evaluated using a VISSIM model calibrated with field traffic volume and traffic signal data of Caochangmen Boulevard in Nanjing, China. The optimized TSP-based phasing plans result in the reduced delay and improved reliability, compared with the non-TSP scenario under the different traffic flow conditions in the morning peak hour. The evaluation results indicate the promising performance of the proposed optimization framework in reducing the passenger delay and improving the bus schedule adherence for the urban transit system.

  8. 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.

  9. Defining a strategy to evaluate cervical cancer prevention and early detection in the era of HPV vaccination.

    Science.gov (United States)

    Howlett, Roberta I; Miller, Anthony B; Pasut, George; Mai, Verna

    2009-05-01

    The purpose of this paper is to outline the short-, medium- and long-term requirements of a strategy to evaluate the impact of HPV immunization and to define a framework to facilitate planning and evaluation. This strategy was developed in Ontario from January to August 2008. Literature review was completed to assess existing material relevant to vaccine evaluation, and HPV vaccine specifically. Scientists and epidemiologists within our organization attended meetings to brainstorm and identify key requirements for vaccine evaluation. Other selected internal and external experts were consulted to review preliminary lists of potential indicators and questions for inclusion in an evaluation strategy. Results are reported in three sections--literature review, proposed evaluation framework and data requirements. The first vaccine evaluation strategy that integrates primary and secondary prevention of cervical cancer is presented. Among women who are neither screened nor immunized, customized interventions will be required to ensure that they are aware of potential risks and benefits. This evaluation strategy may serve as a useful outline for jurisdictions in Canada and elsewhere. This new paradigm of combined primary and secondary intervention will encourage cooperation for effective evaluation of an integrated approach for control of cervical cancer and other HPV-related disease.

  10. 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.

  11. Multiple strategies to improve sensitivity, speed and robustness of isothermal nucleic acid amplification for rapid pathogen detection

    Directory of Open Access Journals (Sweden)

    Lemieux Bertrand

    2011-05-01

    Full Text Available Abstract Background In the past decades the rapid growth of molecular diagnostics (based on either traditional PCR or isothermal amplification technologies meet the demand for fast and accurate testing. Although isothermal amplification technologies have the advantages of low cost requirements for instruments, the further improvement on sensitivity, speed and robustness is a prerequisite for the applications in rapid pathogen detection, especially at point-of-care diagnostics. Here, we describe and explore several strategies to improve one of the isothermal technologies, helicase-dependent amplification (HDA. Results Multiple strategies were approached to improve the overall performance of the isothermal amplification: the restriction endonuclease-mediated DNA helicase homing, macromolecular crowding agents, and the optimization of reaction enzyme mix. The effect of combing all strategies was compared with that of the individual strategy. With all of above methods, we are able to detect 50 copies of Neisseria gonorrhoeae DNA in just 20 minutes of amplification using a nearly instrument-free detection platform (BESt™ cassette. Conclusions The strategies addressed in this proof-of-concept study are independent of expensive equipments, and are not limited to particular primers, targets or detection format. However, they make a large difference in assay performance. Some of them can be adjusted and applied to other formats of nucleic acid amplification. Furthermore, the strategies to improve the in vitro assays by maximally simulating the nature conditions may be useful in the general field of developing molecular assays. A new fast molecular assay for Neisseria gonorrhoeae has also been developed which has great potential to be used at point-of-care diagnostics.

  12. Design, monitoring and evaluation of a direct payments approach for an ecotourism strategy to reduce illegal hunting and trade of wildlife in Lao PDR

    Science.gov (United States)

    Johnson, Arlyne; Duangdala, Sivilay; Hansel, Troy

    2018-01-01

    Ecotourism as a strategy for achieving biodiversity conservation often results in limited conservation impact relative to its investment and revenue return. In cases where an ecotourism strategy has been used, projects are frequently criticized for not providing sufficient evidence on how the strategy has reduced threats or improved the status of the biodiversity it purports to protect. In Lao PDR, revenue from ecotourism has not been directly linked to or dependent on improvements in biodiversity and there is no evidence that ecotourism enterprises have contributed to conservation. In other developing countries, direct payments through explicit contracts in return for ecosystem services have been proposed as a more cost-effective means for achieving conservation, although further research is needed to evaluate the impact of this approach. To address this need, a new model was tested in the Nam Et-Phou Louey National Protected Area (NPA) in Lao PDR using a direct payments approach to create ecotourism incentives for villagers to increase wildlife populations. Over a four-year period, we monitored along a theory of change to evaluate assumptions about the linkages between intermediate results and biological outcomes. Preliminary results show a negative correlation between ecotourism benefits and hunting infractions in target villages; no increase in hunting sign in the ecotourism sector of the NPA relative to a three-fold increase in hunting sign across the NPA’s non-tourism sectors; and an overall increase in wildlife sightings. This case provides key lessons on the design of a direct payments approach for an ecotourism strategy, including how to combine threat monitoring and data on wildlife sightings to evaluate strategy effectiveness, on setting rates for wildlife sightings and village fees, and the utility of the approach for protecting very rare species. PMID:29489821

  13. Design, monitoring and evaluation of a direct payments approach for an ecotourism strategy to reduce illegal hunting and trade of wildlife in Lao PDR.

    Science.gov (United States)

    Eshoo, Paul Frederick; Johnson, Arlyne; Duangdala, Sivilay; Hansel, Troy

    2018-01-01

    Ecotourism as a strategy for achieving biodiversity conservation often results in limited conservation impact relative to its investment and revenue return. In cases where an ecotourism strategy has been used, projects are frequently criticized for not providing sufficient evidence on how the strategy has reduced threats or improved the status of the biodiversity it purports to protect. In Lao PDR, revenue from ecotourism has not been directly linked to or dependent on improvements in biodiversity and there is no evidence that ecotourism enterprises have contributed to conservation. In other developing countries, direct payments through explicit contracts in return for ecosystem services have been proposed as a more cost-effective means for achieving conservation, although further research is needed to evaluate the impact of this approach. To address this need, a new model was tested in the Nam Et-Phou Louey National Protected Area (NPA) in Lao PDR using a direct payments approach to create ecotourism incentives for villagers to increase wildlife populations. Over a four-year period, we monitored along a theory of change to evaluate assumptions about the linkages between intermediate results and biological outcomes. Preliminary results show a negative correlation between ecotourism benefits and hunting infractions in target villages; no increase in hunting sign in the ecotourism sector of the NPA relative to a three-fold increase in hunting sign across the NPA's non-tourism sectors; and an overall increase in wildlife sightings. This case provides key lessons on the design of a direct payments approach for an ecotourism strategy, including how to combine threat monitoring and data on wildlife sightings to evaluate strategy effectiveness, on setting rates for wildlife sightings and village fees, and the utility of the approach for protecting very rare species.

  14. Fed-Batch Feeding Strategies for Enzymatic Biodiesel Production

    DEFF Research Database (Denmark)

    Price, Jason Anthony; Nordblad, Mathias; Woodley, John

    2014-01-01

    of the differences in the interfacial and bulk concentrations of the enzyme. The model is then used to evaluate various feeding strategies to improve the enzymatic biodiesel production. The feeding strategies investigated, gave insight into how the methanol should be fed to potentially mitigate enzyme deactivation...... while improving the biodiesel yield. The best experimental results gave a yield of 703 .76 g FAME L-1 and a reactor productivity of 28.12 g FAME L-1 h-1. In comparison, to reach the same yield, the optimised two step feeding strategy took 6.25 hours less, which equates to an increase the reactor...

  15. 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

  16. Evaluating the effect of three teaching strategies on student nurses' moral sensitivity.

    Science.gov (United States)

    Lee, Hsiao Lu; Huang, Shu-He; Huang, Chiu-Mieh

    2017-09-01

    The Taiwan Nursing Accreditation Council has proposed eight core professional nursing qualities including ethical literacy. Consequently, nursing ethics education is a required course for student nurses. These courses are intended to improve the ethical literacy. Moral sensitivity is the cornerstone of ethical literacy, and learning moral sensitivity is the initial step towards developing ethical literacy. To explore the effect of nursing ethics educational interventions based on multiple teaching strategies on student nurses moral sensitivity. Based on the visual, auditory and kinaesthetic model, three strategies were developed for determining the programme components and corresponding learning styles. This was a quasi-experimental study. A total of 234 junior-college student nurses participated in this study. All participants were aged 18-19 years. Ethical considerations: The study protocol was approved by the institutional review boards of Kaohsiung Veterans General Hospital. Only the participants who signed an informed consent form took part in the study. The participants were permitted to withdraw from the study at any point if they wished to do so without affecting their academic score. The scores of Modified Moral Sensitivity Questionnaire for Student Nurses were significantly improved after the intervention of integrating multiple teaching strategies ( p = .042). Significant relationships were observed between the satisfaction scores of two teaching strategies and moral sensitivity. The results indicated that using multiple teaching strategies is effective for promoting nursing ethics learning. This strategy was consistent with the student nurses' preferred learning style and was used to correct their erroneous ethical conceptions, assisting in developing their ethical knowledge.

  17. 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

  18. 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.

  19. Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy

    Directory of Open Access Journals (Sweden)

    Harris Meredith G

    2006-08-01

    Full Text Available Abstract Background Early detection and treatment of mental disorders in adolescents and young adults can lead to better health outcomes. Mental health literacy is a key to early recognition and help seeking. Whilst a number of population health initiatives have attempted to improve mental health literacy, none to date have specifically targeted young people nor have they applied the rigorous standards of population health models now accepted as best practice in other health areas. This paper describes the outcomes from the application of a health promotion model to the development, implementation and evaluation of a community awareness campaign designed to improve mental health literacy and early help seeking amongst young people. Method The Compass Strategy was implemented in the western metropolitan Melbourne and Barwon regions of Victoria, Australia. The Precede-Proceed Model guided the population assessment, campaign strategy development and evaluation. The campaign included the use of multimedia, a website, and an information telephone service. Multiple levels of evaluation were conducted. This included a cross-sectional telephone survey of mental health literacy undertaken before and after 14 months of the campaign using a quasi-experimental design. Randomly selected independent samples of 600 young people aged 12–25 years from the experimental region and another 600 from a comparison region were interviewed at each time point. A series of binary logistic regression analyses were used to measure the association between a range of campaign outcome variables and the predictor variables of region and time. Results The program was judged to have an impact on the following variables, as indicated by significant region-by-time interaction effects (p Conclusion We believe this is the first study to apply the rigorous standards of a health promotion model including the use of a control region to a mental health population intervention. The

  20. Do strategies to improve quality of maternal and child health care in lower and middle income countries lead to improved outcomes? A review of the evidence.

    Science.gov (United States)

    Dettrick, Zoe; Firth, Sonja; Jimenez Soto, Eliana

    2013-01-01

    Efforts to scale-up maternal and child health services in lower and middle income countries will fail if services delivered are not of good quality. Although there is evidence of strategies to increase the quality of health services, less is known about the way these strategies affect health system goals and outcomes. We conducted a systematic review of the literature to examine this relationship. We undertook a search of MEDLINE, SCOPUS and CINAHL databases, limiting the results to studies including strategies specifically aimed at improving quality that also reported a measure of quality and at least one indicator related to health system outcomes. Variation in study methodologies prevented further quantitative analysis; instead we present a narrative review of the evidence. Methodologically, the quality of evidence was poor, and dominated by studies of individual facilities. Studies relied heavily on service utilisation as a measure of strategy success, which did not always correspond to improved quality. The majority of studies targeted the competency of staff and adequacy of facilities. No strategies addressed distribution systems, public-private partnership or equity. Key themes identified were the conflict between perceptions of patients and clinical measures of quality and the need for holistic approaches to health system interventions. Existing evidence linking quality improvement strategies to improved MNCH outcomes is extremely limited. Future research would benefit from the inclusion of more appropriate indicators and additional focus on non-facility determinants of health service quality such as health policy, supply distribution, community acceptability and equity of care.

  1. 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.

  2. 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.

  3. Learning strategies in the planning and evaluation phase of image production

    International Nuclear Information System (INIS)

    Larsson, W.; Aspelin, P.; Lundberg, N.

    2013-01-01

    This paper identifies, describes and analyses radiographers' learning strategies in practice. These strategies are particularly important in the light of the great changes in radiology departments and the role of radiographers during the past two decades. With increased responsibility for quality assurance and diagnostic work, radiographers need to develop specific skills over time, which requires learning strategies in practice. The aim of this study is to identify, describe and analyze the learning strategies of novice and experienced radiographers in the planning and evaluation phase of image production. This study found that novice radiographers; use memorization combined with logical reasoning, apply focused observation, selective reading and information-seeking, communicate through: active and attentive listening, asking questions, receiving feedback, discussing problems and speak out loud. Experienced radiographers; use memorization in combination with logical reasoning and predicting, observe discriminating, read selectively, validate information and perform information-seeking. They communicate through: listening analyzing and demanding way, answering questions and providing feed-back and discussing problems. This study concludes that the difference between the learning strategies of novice and experienced radiographers is in the way they apply the strategies rather than the strategies themselves

  4. Strategie firmy podnikající v oblasti prodeje (sortiment oděvy)

    OpenAIRE

    Vítek, Martin

    2008-01-01

    Evaluation of business strategy of the company New Yorker. Analysis of the theoretical aspects of the business strategy and comparison with the real situation. Recommendations for actual business strategy improvement.

  5. 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.

  6. Search Improvement Process-Chaotic Optimization-Particle Swarm Optimization-Elite Retention Strategy and Improved Combined Cooling-Heating-Power Strategy Based Two-Time Scale Multi-Objective Optimization Model for Stand-Alone Microgrid Operation

    Directory of Open Access Journals (Sweden)

    Fei Wang

    2017-11-01

    Full Text Available The optimal dispatching model for a stand-alone microgrid (MG is of great importance to its operation reliability and economy. This paper aims at addressing the difficulties in improving the operational economy and maintaining the power balance under uncertain load demand and renewable generation, which could be even worse in such abnormal conditions as storms or abnormally low or high temperatures. A new two-time scale multi-objective optimization model, including day-ahead cursory scheduling and real-time scheduling for finer adjustments, is proposed to optimize the operational cost, load shedding compensation and environmental benefit of stand-alone MG through controllable load (CL and multi-distributed generations (DGs. The main novelty of the proposed model is that the synergetic response of CL and energy storage system (ESS in real-time scheduling offset the operation uncertainty quickly. And the improved dispatch strategy for combined cooling-heating-power (CCHP enhanced the system economy while the comfort is guaranteed. An improved algorithm, Search Improvement Process-Chaotic Optimization-Particle Swarm Optimization-Elite Retention Strategy (SIP-CO-PSO-ERS algorithm with strong searching capability and fast convergence speed, was presented to deal with the problem brought by the increased errors between actual renewable generation and load and prior predictions. Four typical scenarios are designed according to the combinations of day types (work day or weekend and weather categories (sunny or rainy to verify the performance of the presented dispatch strategy. The simulation results show that the proposed two-time scale model and SIP-CO-PSO-ERS algorithm exhibit better performance in adaptability, convergence speed and search ability than conventional methods for the stand-alone MG’s operation.

  7. 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.).

  8. An improved power control strategy for hybrid AC-DC microgrids

    DEFF Research Database (Denmark)

    Baharizadeh, Mehdi; Karshenas, Hamid Reza; Guerrero, Josep M.

    2018-01-01

    This paper presents a new droop-based control strategy for hybrid microgrids (HMG) with improved power sharing. When ac microgrids (AC-MG) and dc microgrids (DC-MG) are present in a distribution grid, there is an opportunity to interconnect them via an interlinking converter (IC) and form a HMG......, the possibility of participation of IC in AC-MG reactive power adds some complexity to a HMG control system. In this paper, a new decentralized control strategy is presented for a HMG which relies on regulating the voltage magnitude of a common bus in each microgrid. In this regard, new droop characteristics...... for sources across both microgrids as well as IC are proposed. The proposed droop characteristics result in better active/reactive power sharing across both microgrids and at the same time results in better voltage regulation. The derivation of new droop characteristics is thoroughly discussed in this paper...

  9. Helping hands: A cluster randomised trial to evaluate the effectiveness of two different strategies for promoting hand hygiene in hospital nurses

    Directory of Open Access Journals (Sweden)

    Hulscher Marlies

    2011-09-01

    Full Text Available Abstract Background Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygiene in hospital nurses. Methods/design This study is a cluster randomised controlled trial with inpatient wards as the unit of randomisation. Guidelines for hand hygiene will be implemented in this study. Two strategies will be used to improve the adherence to guidelines for hand hygiene. The state-of-the-art strategy is derived from the literature and includes education, reminders, feedback, and targeting adequate products and facilities. The extended strategy also contains activities aimed at influencing social influence in groups and enhancing leadership. The unique contribution of the extended strategy is built upon relevant behavioural science theories. The extended strategy includes all elements of the state-of-the-art strategy supplemented with gaining active commitment and initiative of ward management, modelling by informal leaders at the ward, and setting norms and targets within the team. Data will be collected at four points in time, with six-month intervals. An average of 3,000 opportunities for hand hygiene in approximately 900 nurses will be observed at each time point. Discussion Performing and evaluating an implementation strategy that also targets the social context of teams may considerably add to the general body of knowledge in this field. Results from our study will allow us to draw conclusions on the effects of different strategies for the implementation of hand hygiene guidelines, and based on these results we will be able to define a preferred implementation strategy for hospital based nursing. Trial registration The study is registered as a Clinical Trial in ClinicalTrials.gov, dossier number: NCT

  10. Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

    Science.gov (United States)

    Siegfried, Alexa; Heffernan, Megan; Kennedy, Mallory; Meit, Michael

    To identify the quality improvement (QI) and performance management benefits reported by public health departments as a result of participating in the national, voluntary program for public health accreditation implemented by the Public Health Accreditation Board (PHAB). We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments when they completed 3 different milestones in the PHAB accreditation process. Leadership from 324 unique state, local, and tribal public health departments in the United States. Public health departments that have achieved PHAB accreditation reported the following QI and performance management benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality; used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported implementation of QI strategies and use of information from QI processes to inform decision making was greater among recently accredited health departments than among health departments that had registered their intent to apply but not yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1 year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently accredited. PHAB accreditation has stimulated QI and performance management activities within public health departments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be reported at a higher level, even 1 year after the accreditation decision.

  11. Road accident rates: strategies and programmes for improving road traffic safety.

    Science.gov (United States)

    Goniewicz, K; Goniewicz, M; Pawłowski, W; Fiedor, P

    2016-08-01

    Nowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20-50 million sustain severe injuries, the majority of which require long-term treatment. The objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles. The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.

  12. Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania

    Directory of Open Access Journals (Sweden)

    Erin Hetherington

    2017-02-01

    Full Text Available Abstract Background Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Methods Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. Results The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of

  13. Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania.

    Science.gov (United States)

    Hetherington, Erin; Eggers, Matthijs; Wamoyi, Joyce; Hatfield, Jennifer; Manyama, Mange; Kutz, Susan; Bastien, Sheri

    2017-02-07

    Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of community members participating in school-based events

  14. Evaluation of a Tailored Direct-Mail Marketing Strategy for Recruiting the 19- to 23-Year-Old Market.

    Science.gov (United States)

    1983-05-01

    17AD-A12.9 860 EVALUATION OF A TAILORED DIRECT-MAIL MARKETING STRATEGY 1/ FOR RECRUITNG TH.U) WESAT INC ROCKVILLE MD K FERNANDES ET AL MAY 83 NPRDC...STANDARDS-1963-A EVALUATION OF A TAILORED DIRECT-MAIL MARKETING STRATEGY FOR RECRUITING THE 19- TO 23-YEAR-OLD MARKET APPRVEDFORPUBLIC RELE AnE [B...EVALUATION OF A TAILORED DIRECT-MAIL MARKETING STRATEGY FOR RECRUITING THE 19- TO 23-YEAR-OLD MARKET Kathleen Fernandes Navy Personnel Research and

  15. Evaluation of Coolant Injection Procedure in the Severe Accident Management Strategy of APR1400

    International Nuclear Information System (INIS)

    Cho, Yongjin; Lim, Kukhee; Song, Sungchu; Lee, Sukho; Hwang, Taesuk

    2013-01-01

    A coolant injection strategy in the severe accident management guideline (SAMG) of APR1400 relates to immediate coolant injection into RCS (Reactor Coolant System) or injection following the recovery of secondary coolant inventory. This strategy could play important role in accident mitigation and radiological consequences. In this study, appropriateness of the strategy was evaluated using MELCOR1.8.6 and several sensitivity studies of the key parameters were performed. Analysis for APR1400 using MELCOR 1.8.6 was performed to evaluate the effectiveness of accident management strategies and the following conclusions were identified. Sequential operation of secondary and RCS injection may not be the best strategy and the simultaneous injection of secondary and RCS injection could be more preferable. At least, the RCS injection should start before complete drainage of water in the safety injection tank using mobile pumps. In this study, the effectiveness of timing of operator action has been examined and the amount of injection flowrate needs to be studied in the future

  16. The Digitisation of Welfare – a Strategy towards improving Citizens’ Self-care and Co-management of Welfare

    DEFF Research Database (Denmark)

    Thualagant, Nicole; From, Ditte-Marie

    2018-01-01

    (SKAD) analysis, this chapter scrutinizes central documents on the strategy of digital welfare. Our exploration provides a critical insight in the current digitisation of health care by illustrating how new virtues of citizenship are demanded in the digital era in relation to digital health......Government strategy of Digital Welfare 2016-2020 in regards to health and discusses how this strategy encourages self-measurement and self-improvement through discourses of improvement at both state and citizen levels. By illustrating how performativity is embedded in current conceptions of health, this chapter...... emphasize how strategies of digitisation lean on a bio-citizenship where individuals with poor health capacities become depended, not on a supporting welfare system, but paradoxically on own self-management skills in order to receive health services. Based on the sociology of knowledge approach to discourse...

  17. 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

  18. 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.

  19. Evaluation and proposal of improvement for the measurement system in ATLAS

    International Nuclear Information System (INIS)

    Cho, Dong Woo; Kim, Jong Rok; Park, Jun Kwon

    2007-03-01

    The project independently evaluated the validities and reliability of measurement system in ATLAS, then proposed plans to improve the measurement system from evaluated results. For this objectives, we evaluated the design, technical backgrounds, verifying data of measurement system in ATLAS. From this evaluation, we proposed plans for improvement on parts which need improvement

  20. 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.

  1. Evaluating the value chain model for service organisational strategy: International hotels.

    OpenAIRE

    Choi, Keetag.

    2000-01-01

    Strategic models like Porter's (1985) value chain have not been fully evaluated in the strategy literature and applied to all industries. To theoretically redefine the value chain technique, this research evaluates the value chain's use with various strategic issues by applying it to a specific aspect in the service field, namely the hotel industry. The study defines five key questions by which to evaluate a strategic model and the value chain model is examined using them. This research is a ...

  2. Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial.

    Science.gov (United States)

    Vlemmix, Floortje; Rosman, Ageeth N; Rijnders, Marlies E; Beuckens, Antje; Opmeer, Brent C; Mol, Ben W J; Kok, Marjolein; Fleuren, Margot A H

    2015-05-01

    To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Cluster randomized controlled trial. Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands. Singleton breech presentation from 32 weeks of gestation onwards. We randomized clusters to a client strategy (written information leaflets and decision aid), a care-provider strategy (1-day counseling course focused on knowledge and counseling skills), a combined client and care-provider strategy and care-as-usual strategy. We performed an intention-to-treat analysis. Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt. The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8-95%. Neither the client strategy (OR 0.8, 95% CI 0.4-1.5) nor the care-provider strategy (OR 1.2, 95% CI 0.6-2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3-1.4 and OR 2.0, 95% CI 0.7-4.5). Neither a client nor a care-provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  3. The use of influence diagrams for evaluating severe accident management strategies

    International Nuclear Information System (INIS)

    Jae, M.; Apostolakis, G.E.

    1992-01-01

    In this paper, the influence diagram, a new analytical tool for developing and evaluating severe accident management strategies, is presented. Influence diagrams are much simpler than decision trees because they do not lead to the large number of branches that are generated when decision trees are used in realistic problems; furthermore, they show explicitly the dependencies between the variables of the problem. One of the accident management strategies proposed for light water reactors, flooding the reactor cavity as a means of preventing vessel breach during a short-term station blackout sequence, is presented. The influence diagram associated with this strategy is constructed. Finally, the advantages of using influence diagrams in accident management are explored

  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. 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

  6. 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…

  7. Improving patient emotional functioning and psychological morbidity: evaluation of a consultation skills training program for oncologists.

    Science.gov (United States)

    Girgis, Afaf; Cockburn, Jill; Butow, Phyllis; Bowman, Deborah; Schofield, Penelope; Stojanovski, Elizabeth; D'Este, Catherine; Tattersall, Martin H N; Doran, Christopher; Turner, Jane

    2009-12-01

    To evaluate whether a consultation skills training (CST) program with oncologists and trainees would improve skills in detecting and responding to patient distress, thereby improving their patients' emotional functioning and reducing psychological distress. Randomized-controlled trial with 29 medical and radiation oncologists from Australia randomized to CST group (n=15) or usual-care group (n=14). The CST consisted of a 1.5-day face-to-face workshop incorporating presentation of principles, a DVD modelling ideal behaviour and role-play practice, and four 1.5h monthly video-conferences. At the CST conclusion, patients of participating doctors were recruited (n=192 in CST group, n=183 in usual-care group), completing telephone surveys at baseline, 1 week and 3 months to assess quality of life, anxiety, depression and unmet psychosocial needs. Despite high patient functioning at baseline, anxiety significantly improved at 1-week follow-up in the CST group, compared to the control group. There were no statistically significant differences in emotional functioning, depression or unmet supportive care need between the groups. Consistent trends for greater improvements were observed in intervention compared to control group patients, suggesting the CST program deserves wider evaluation. Video-conferencing after a short training course may be an effective strategy for delivering CST.

  8. Strategies to Improve Regeneration of the Soft Palate Muscles After Cleft Palate Repair

    Science.gov (United States)

    Carvajal Monroy, Paola L.; Grefte, Sander; Kuijpers-Jagtman, Anne Marie; Wagener, Frank A.D.T.G.

    2012-01-01

    Children with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. These patients are unable to separate the nasal from the oral cavity leading to air loss during speech. Although surgical repair ameliorates soft palate function by joining the clefted muscles of the soft palate, optimal function is often not achieved. The regeneration of muscles in the soft palate after surgery is hampered because of (1) their low intrinsic regenerative capacity, (2) the muscle properties related to clefting, and (3) the development of fibrosis. Adjuvant strategies based on tissue engineering may improve the outcome after surgery by approaching these specific issues. Therefore, this review will discuss myogenesis in the noncleft and cleft palate, the characteristics of soft palate muscles, and the process of muscle regeneration. Finally, novel therapeutic strategies based on tissue engineering to improve soft palate function after surgical repair are presented. PMID:22697475

  9. 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.

  10. Evaluation of an accident management strategy of emergency water injection using fire engines in a typical pressurized water reactor

    Directory of Open Access Journals (Sweden)

    Soo-Yong Park

    2015-10-01

    Full Text Available Following the Fukushima accident, a special safety inspection was conducted in Korea. The inspection results show that Korean nuclear power plants have no imminent risk for expected maximum potential earthquake or coastal flooding. However long- and short-term safety improvements do need to be implemented. One of the measures to increase the mitigation capability during a prolonged station blackout (SBO accident is installing injection flow paths to provide emergency cooling water of external sources using fire engines to the steam generators or reactor cooling systems. This paper illustrates an evaluation of the effectiveness of external cooling water injection strategies using fire trucks during a potential extended SBO accident in a 1,000 MWe pressurized water reactor. With regard to the effectiveness of external cooling water injection strategies using fire engines, the strategies are judged to be very feasible for a long-term SBO, but are not likely to be effective for a short-term SBO.

  11. Evaluation of an accident management strategy of emergency water injection using fire engines in a typical pressurized water reactor

    International Nuclear Information System (INIS)

    Park, Soo Yong; Ahn, Kwang Il

    2015-01-01

    Following the Fukushima accident, a special safety inspection was conducted in Korea. The inspection results show that Korean nuclear power plants have no imminent risk for expected maximum potential earthquake or coastal flooding. However long- and short-term safety improvements do need to be implemented. One of the measures to increase the mitigation capability during a prolonged station blackout (SBO) accident is installing injection flow paths to provide emergency cooling water of external sources using fire engines to the steam generators or reactor cooling systems. This paper illustrates an evaluation of the effectiveness of external cooling water injection strategies using fire trucks during a potential extended SBO accident in a 1,000 MWe pressurized water reactor. With regard to the effectiveness of external cooling water injection strategies using fire engines, the strategies are judged to be very feasible for a long-term SBO, but are not likely to be effective for a short-term SBO

  12. Evaluation of an accident management strategy of emergency water injection using fire engines in a typical pressurized water reactor

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soo Yong; Ahn, Kwang Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    Following the Fukushima accident, a special safety inspection was conducted in Korea. The inspection results show that Korean nuclear power plants have no imminent risk for expected maximum potential earthquake or coastal flooding. However long- and short-term safety improvements do need to be implemented. One of the measures to increase the mitigation capability during a prolonged station blackout (SBO) accident is installing injection flow paths to provide emergency cooling water of external sources using fire engines to the steam generators or reactor cooling systems. This paper illustrates an evaluation of the effectiveness of external cooling water injection strategies using fire trucks during a potential extended SBO accident in a 1,000 MWe pressurized water reactor. With regard to the effectiveness of external cooling water injection strategies using fire engines, the strategies are judged to be very feasible for a long-term SBO, but are not likely to be effective for a short-term SBO.

  13. 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.

  14. Strategy for improving instrumentation and control in operating nuclear power plants

    International Nuclear Information System (INIS)

    Abad Bassols, L.; Nino Perote, R.

    1996-01-01

    There are three basic reasons why nuclear power plants need to systematically upgrade their instrumentation and control equipment: Obsolete instrumentation and lack spares Little capacity of flexibility for extension Possibility of attaining better systems integration and improving systems-operations interface This article shows how to approach these issues using the following strategies: Use of distributed control systems and PLCs for control, signalling, command, communications, etc, in both nuclear and conventional applications Upgrading of process instrumentation equipment, sensors, transmitters, etc Upgrading of alarm-signalling systems In each group of equipment items consideration should be given to: Aspects regarding manufacturers-suppliers Effects on design, adaptation and documentation of operating plants Effects on the training and handling skills of operation and maintenance staff Strategy for incorporating the new system into the Plant with minimum impact on operation (Author)

  15. An Adaptive Particle Weighting Strategy for ECG Denoising Using Marginalized Particle Extended Kalman Filter: An Evaluation in Arrhythmia Contexts.

    Science.gov (United States)

    Hesar, Hamed Danandeh; Mohebbi, Maryam

    2017-11-01

    Model-based Bayesian frameworks have a common problem in processing electrocardiogram (ECG) signals with sudden morphological changes. This situation often happens in the case of arrhythmias where ECGs do not obey the predefined state models. To solve this problem, in this paper, a model-based Bayesian denoising framework is proposed using marginalized particle-extended Kalman filter (MP-EKF), variational mode decomposition, and a novel fuzzy-based adaptive particle weighting strategy. This strategy helps MP-EKF to perform well even when the morphology of signal does not comply with the predefined dynamic model. In addition, this strategy adapts MP-EKF's behavior to the acquired measurements in different input signal to noise ratios (SNRs). At low input SNRs, this strategy decreases the particles' trust level to the measurements while increasing their trust level to a synthetic ECG constructed with the feature parameters of ECG dynamic model. At high input SNRs, the particles' trust level to the measurements is increased and the trust level to synthetic ECG is decreased. The proposed method was evaluated on MIT-BIH normal sinus rhythm database and compared with EKF/EKS frameworks and previously proposed MP-EKF. It was also evaluated on ECG segments extracted from MIT-BIH arrhythmia database, which contained ventricular and atrial arrhythmia. The results showed that the proposed algorithm had a noticeable superiority over benchmark methods from both SNR improvement and multiscale entropy based weighted distortion (MSEWPRD) viewpoints at low input SNRs.

  16. Supporting Learning from Illustrated Texts: Conceptualizing and Evaluating a Learning Strategy

    Science.gov (United States)

    Schlag, Sabine; Ploetzner, Rolf

    2011-01-01

    Texts and pictures are often combined in order to improve learning. Many students, however, have difficulty to appropriately process text-picture combinations. We have thus conceptualized a learning strategy which supports learning from illustrated texts. By inducing the processes of information selection, organization, integration, and…

  17. Response to Intervention and Continuous School Improvement: How to Design, Implement, Monitor, and Evaluate a School-Wide Prevention System, 2nd Edition

    Science.gov (United States)

    Bernhardt, Victoria L.; Hébert, Connie L.

    2017-01-01

    Experts Bernhardt and Hébert's latest book demonstrates strategies to ensure your entire staff works together to design, implement, monitor, and evaluate a schoolwide prevention system with integrity and fidelity. Each step in this important resource is designed to help administrators, teachers, and other educators improve the learning of every…

  18. Near-misses are an opportunity to improve patient safety: adapting strategies of high reliability organizations to healthcare.

    Science.gov (United States)

    Van Spall, Harriette; Kassam, Alisha; Tollefson, Travis T

    2015-08-01

    Near-miss investigations in high reliability organizations (HROs) aim to mitigate risk and improve system safety. Healthcare settings have a higher rate of near-misses and subsequent adverse events than most high-risk industries, but near-misses are not systematically reported or analyzed. In this review, we will describe the strategies for near-miss analysis that have facilitated a culture of safety and continuous quality improvement in HROs. Near-miss analysis is routine and systematic in HROs such as aviation. Strategies implemented in aviation include the Commercial Aviation Safety Team, which undertakes systematic analyses of near-misses, so that findings can be incorporated into Standard Operating Procedures (SOPs). Other strategies resulting from incident analyses include Crew Resource Management (CRM) for enhanced communication, situational awareness training, adoption of checklists during operations, and built-in redundancy within systems. Health care organizations should consider near-misses as opportunities for quality improvement. The systematic reporting and analysis of near-misses, commonplace in HROs, can be adapted to health care settings to prevent adverse events and improve clinical outcomes.

  19. Time management strategies for research productivity.

    Science.gov (United States)

    Chase, Jo-Ana D; Topp, Robert; Smith, Carol E; Cohen, Marlene Z; Fahrenwald, Nancy; Zerwic, Julie J; Benefield, Lazelle E; Anderson, Cindy M; Conn, Vicki S

    2013-02-01

    Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

  20. Evaluation of Wild Lentil Species as Genetic Resources to Improve Drought Tolerance in Cultivated Lentil

    Directory of Open Access Journals (Sweden)

    Linda Y. Gorim

    2017-06-01

    Full Text Available Increasingly unpredictable annual rainfall amounts and distribution patterns have far reaching implications for pulse crop biology. Seedling and whole plant survival will be affected given that water is a key factor in plant photosynthesis and also influences the evolving disease spectrum that affects crops. The wild relatives of cultivated lentil are native to drought prone areas, making them good candidates for the evaluation of drought tolerance traits. We evaluated root and shoot traits of genotypes of cultivated lentil and five wild species grown under two water deficit regimes as well as fully watered conditions over a 13 week period indoors. Plants were grown in sectioned polyvinyl chloride (PVC tubes containing field soil from the A, B, and C horizons. We found that root distribution into different soil horizons varied among wild lentil genotypes. Secondly, wild lentil genotypes employed diverse strategies such as delayed flowering, reduced transpiration rates, reduced plant height, and deep root systems to either escape, evade or tolerate drought conditions. In some cases, more than one drought strategy was observed within the same genotype. Sequence based classification of wild and cultivated genotypes did not explain patterns of drought response. The environmental conditions at their centers of origin may explain the patterns of drought strategies observed in wild lentils. The production of numerous small seeds by wild lentil genotypes may have implications for yield improvement in lentil breeding programs.

  1. 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

  2. Improving Language Learning Strategies and Performance of Pre-Service Language Teachers through a CALLA-TBLT Model

    Science.gov (United States)

    Guapacha Chamorro, Maria Eugenia; Benavidez Paz, Luis Humberto

    2017-01-01

    This paper reports an action-research study on language learning strategies in tertiary education at a Colombian university. The study aimed at improving the English language performance and language learning strategies use of 33 first-year pre-service language teachers by combining elements from two models: the cognitive academic language…

  3. A Proportional Resonant Control Strategy for Efficiency Improvement in Extended Range Electric Vehicles

    Directory of Open Access Journals (Sweden)

    Xiaoyuan Wang

    2017-02-01

    Full Text Available The key to control the range extender generation system is to improve the efficiency and reduce the emissions of the electric vehicle (EV. In this paper, based on the purpose of efficiency optimization, both engine and generator are matched to get a public high efficiency region, and a partial power following control strategy was presented. The engine speed is constant in the defined power range, so the output power regulation of the range extender is only realized by the adjustment of the torque of the generator. Engine speed and generator torque were decoupled. An improved proportional resonant (PR controller is adopted to achieve fast output power regulation. In order to ensure the response characteristics of the control system and to improve the robustness, the impacts on system’s characteristics and stability caused by PR controller and parameters in the inner-current loop were analyzed via frequency response characteristics. A pre-Tustin with deviation compensation is proposed for PR controller’s discretization. A stable and robust power following control method is obtained for the range extender control system. Finally, simulation and experiment of the proposed control strategy illustrated its feasibility and correctness.

  4. Feasibility of an implementation strategy for the integration of health promotion in routine primary care: a quantitative process evaluation.

    Science.gov (United States)

    Sanchez, Alvaro; Grandes, Gonzalo; Cortada, Josep M; Pombo, Haizea; Martinez, Catalina; Corrales, Mary Helen; de la Peña, Enrique; Mugica, Justo; Gorostiza, Esther

    2017-02-17

    Process evaluation is recommended to improve the understanding of underlying mechanisms related to clinicians, patients, context and intervention delivery that may impact on trial or program results, feasibility and transferability to practice. The aim of this study was to assess the feasibility of the Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable") implementation strategy for enhancing the adoption and implementation of an evidence-based health promotion intervention in primary health care. A descriptive study of 2-year implementation indicators for the PVS clinical intervention was conducted in four primary health care centers. A multifaceted collaborative modeling implementation strategy was developed to enhance the integration of a clinical intervention to promote healthy lifestyles into clinical practice. Process indicators were assessed for intervention reach, adoption, implementation, sustainability and their variability at center, practice, and patient levels. Mean rates of adoption by means of active collaboration among the three main professional categories (family physicians, nurses and administrative personnel) were 75% in all centers. Just over half of the patients that attended (n = 11650; 51.9%) were reached in terms of having their lifestyle habits assessed, while more than a third (33.7%; n = 7433) and almost 10% (n = 2175) received advice or a printed prescription for at least one lifestyle change, respectively. Only 3.7% of the target population received a repeat prescription. These process indicators significantly (p implementation period within centers. The implementation strategy used showed moderate-to-good performance on process indicators related to adoption, reach, and implementation of the evidence-based healthy lifestyle promotion intervention in the context of routine primary care. Sources of heterogeneity and instability in these indicators may improve our understanding of factors required to

  5. Evaluating the Sharing Stories youth theatre program: an interactive theatre and drama-based strategy for sexual health promotion among multicultural youth.

    Science.gov (United States)

    Roberts, Meagan; Lobo, Roanna; Sorenson, Anne

    2017-03-01

    Issue addressed Rates of sexually transmissible infections among young people are high, and there is a need for innovative, youth-focused sexual health promotion programs. This study evaluated the effectiveness of the Sharing Stories youth theatre program, which uses interactive theatre and drama-based strategies to engage and educate multicultural youth on sexual health issues. The effectiveness of using drama-based evaluation methods is also discussed. Methods The youth theatre program participants were 18 multicultural youth from South East Asian, African and Middle Eastern backgrounds aged between 14 and 21 years. Four sexual health drama scenarios and a sexual health questionnaire were used to measure changes in knowledge and attitudes. Results Participants reported being confident talking to and supporting their friends with regards to safe sex messages, improved their sexual health knowledge and demonstrated a positive shift in their attitudes towards sexual health. Drama-based evaluation methods were effective in engaging multicultural youth and worked well across the cultures and age groups. Conclusions Theatre and drama-based sexual health promotion strategies are an effective method for up-skilling young people from multicultural backgrounds to be peer educators and good communicators of sexual health information. Drama-based evaluation methods are engaging for young people and an effective way of collecting data from culturally diverse youth. So what? This study recommends incorporating interactive and arts-based strategies into sexual health promotion programs for multicultural youth. It also provides guidance for health promotion practitioners evaluating an arts-based health promotion program using arts-based data collection methods.

  6. 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.

  7. An evaluation of multi-annual management strategies for ICES roundfish stocks

    DEFF Research Database (Denmark)

    Kell, L.T.; Pilling, G.M.; Kirkwood, G.P.

    2006-01-01

    to observe, monitor, assess, and control them. Strategies were evaluated in terms of risk (measured as the probability of spawning-stock biomass falling below a biomass threshold for the stock) and cumulative yield. In general, bounds on interannual TAC change of 10% and 20% affected the ability to achieve......Current scientific management objectives for ICES roundfish stocks are to ensure conservation of the biological resource and do not explicitly consider economic or social objectives. For example, there are currently no objectives to maximize the sustainable yield or to reduce variability in total...... allowable catches (TACs). This is despite the fact that the current system can result in wide annual fluctuations in TAC, limiting the ability of the fishing industry to plan for the future. Therefore, this study evaluated management strategies that stabilized catches by setting bounds on the interannual...

  8. Evaluation of the Strategy Management Implementation in Project- Oriented Service Organizations

    Directory of Open Access Journals (Sweden)

    Abolfazl Sherafat

    2014-02-01

    Full Text Available Although developing strategic and operational plans is a difficult and complicated process, their successful implementation is much more difficult. Many organizations fail in the full implementation of their strategies. This is not due to the partial definition of strategies and organization‘s operational plan, but this is likely due to the lack of strong framework for creating alignment between employees and operational process and the organizational goals. To implement strategies effectively and to develop a comprehensive management system and to improve the performance, Robert Kaplan and David Norton introduced a modern management system which is Balanced ScoreCard. Likewise they introduced five main criteria: leadership, translation, alignment, every day process and ongoing process for a strategy oriented organization. This paper is intended to offer a systematic approach for measuring the effectiveness and efficiency of the strategic plan performance. For this study the questionnaire was distributed in a project- orientated service organization and after collection, by the use of statistical. Analysis especially factor analysis the grouping of sub-criteria under the five main criteria was confirmed. The statistical analysis showed that, two criteria of alignment and every day work had the lowest scores in terms of both implementation and effectiveness in the organization‘s senior and executive manager‘s point of view. With deep interview, studying of scorecards and meeting of the strategic committee of the studied organization, the two dimension of alignment and every day work were further examined and after identifying upgradeable areas, some suggestions for improving the effectiveness and efficiency of the studied organization were presented.

  9. Designing and Evaluating Tutoring Feedback Strategies for digital learning environments on the basis of the Interactive Tutoring Feedback Model

    Directory of Open Access Journals (Sweden)

    Susanne Narciss

    2013-06-01

    Full Text Available This paper describes the interactive tutoring feedback model (ITF-model; Narciss, 2006; 2008, and how it can be applied to the design and evaluation of feedback strategies for digital learning environments. The ITF-model conceptualizes formative tutoring feedback as a multidimensional instructional activity that aims at contributing to the regulation of a learning process in order to help learners acquire or improve the competencies needed to master learning tasks. It integrates findings from systems theory with recommendations of prior research on interactive instruction and elaborated feedback, on task analyses, on error analyses, and on tutoring techniques. Based on this multi-dimensional view of formative tutoring feedback methodological implications for designing and investigating multiple effects of feedback under multiple individual and situational conditions are described. Furthermore, the paper outlines how the implications of the ITF-model have been applied in several studies to the design and evaluation of tutoring feedback strategies for digital learning environments (e.g., Narciss, 2004; Narciss & Huth, 2006; Narciss, Schnaubert, Andres, Eichelmann, Goguadze, & Sosnovsky, 2013.

  10. 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

  11. 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

  12. 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.…

  13. 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.

  14. Memory support strategies and bundles: A pathway to improving cognitive therapy for depression?

    Science.gov (United States)

    Dong, Lu; Lee, Jason Y; Harvey, Allison G

    2017-03-01

    Therapist use of memory support (MS) alongside treatment-as-usual, with the goal of enhancing patient recall of treatment contents, has been of recent interest as a novel pathway to improve treatment outcome. The memory support intervention (MSI) involves treatment providers' using 8 specific MS strategies to promote patient memory for treatment. The present study examines to what extent therapist use of MS strategies and bundles improves patient recall of treatment contents and treatment outcome. The data were drawn from a pilot RCT reported elsewhere. Participants were 48 adults (mean age = 44.27 years, 29 females) with major depressive disorder (MDD), randomized to receive 14 sessions of either CT + Memory Support (n = 25) or CT-as-usual (n = 23). Therapist use of MS was coded using the Memory Support Rating Scale. Patient memory and treatment outcomes were assessed at baseline, midtreatment (patient recall only), posttreatment, and 6-month follow-up. Participants in CT + Memory Support received significantly higher amount of MS relative to CT-as-usual. Although not reaching statistical significance, small-to-medium effects were observed between MS strategies and patient recall in the expected direction. Although MS variables were not significantly associated with changes in continuous depressive symptoms, MS was associated with better global functioning. MS also exhibited small to medium effects on treatment response and recurrence in the expected direction but not on remission, though these effects did not reach statistical significance. These results provide initial empirical evidence supporting an active method for therapists to implement MS strategies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Factors influencing change in clinical practice: A qualitative evaluation of the implementation of the quality improvement in colonoscopy study.

    Science.gov (United States)

    Rajasekhar, Praveen T; Rees, Colin J; Nixon, Catherine; East, James E; Brown, Sally

    2016-01-01

    The quality improvement in colonoscopy study was a region wide service improvement study to improve adenoma detection rate at colonoscopy by implementing evidence into routine colonoscopy practice. Implementing evidence into clinical practice can be challenging. The purpose of this paper is to perform a qualitative interview study to evaluate factors that influenced implementation within the study. Semi-structured interviews were conducted with staff in endoscopy units taking part in the quality improvement in colonoscopy study, after study completion. Units and interviewees were purposefully sampled to ensure a range of experiences was represented. Interviews were conducted with 11 participants. Key themes influencing uptake of the quality improvement in colonoscopy evidence bundle included time, study promotion, training, engagement, positive outcomes and modifications. Areas within themes were increased awareness of quality in colonoscopy (QIC), emphasis on withdrawal time and empowerment of endoscopy nurses to encourage the use of quality measures were positive outcomes of the study. The simple, visible study posters were reported as useful in aiding study promotion. Feedback sessions improved engagement. Challenges included difficulty arranging set-up meetings and engaging certain speciality groups. This evaluation suggests that methods to implement evidence into clinical practice should include identification and empowerment of team members who can positively influence engagement, simple, visible reminders and feedback. Emphasis on timing of meetings and strategies to engage speciality groups should also be given consideration. Qualitative evaluations can provide important insights into why quality improvement initiatives are successful or not, across different sites.

  16. 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)

  17. Improved quantum-behaved particle swarm optimization with local search strategy

    Directory of Open Access Journals (Sweden)

    Maolong Xi

    2017-03-01

    Full Text Available Quantum-behaved particle swarm optimization, which was motivated by analysis of particle swarm optimization and quantum system, has shown compared performance in finding the optimal solutions for many optimization problems to other evolutionary algorithms. To address the problem of premature, a local search strategy is proposed to improve the performance of quantum-behaved particle swarm optimization. In proposed local search strategy, a super particle is presented which is a collection body of randomly selected particles’ dimension information in the swarm. The selected probability of particles in swarm is different and determined by their fitness values. To minimization problems, the fitness value of one particle is smaller; the selected probability is more and will contribute more information in constructing the super particle. In addition, in order to investigate the influence on algorithm performance with different local search space, four methods of computing the local search radius are applied in local search strategy and propose four variants of local search quantum-behaved particle swarm optimization. Empirical studies on a suite of well-known benchmark functions are undertaken in order to make an overall performance comparison among the proposed methods and other quantum-behaved particle swarm optimization. The simulation results show that the proposed quantum-behaved particle swarm optimization variants have better advantages over the original quantum-behaved particle swarm optimization.

  18. A Comprehensive Strategy to Evaluate Compatible Stability of Chinese Medicine Injection and Infusion Solutions Based on Chemical Analysis and Bioactivity Assay.

    Science.gov (United States)

    Li, Jian-Ping; Liu, Yang; Guo, Jian-Ming; Shang, Er-Xin; Zhu, Zhen-Hua; Zhu, Kevin Y; Tang, Yu-Ping; Zhao, Bu-Chang; Tang, Zhi-Shu; Duan, Jin-Ao

    2017-01-01

    Stability of traditional Chinese medicine injection (TCMI) is an important issue related with its clinical application. TCMI is composed of multi-components, therefore, when evaluating TCMI stability, several marker compounds cannot represent global components or biological activities of TCMI. Till now, when evaluating TCMI stability, method involving the global components or biological activities has not been reported. In this paper, we established a comprehensive strategy composed of three different methods to evaluate the chemical and biological stability of a typical TCMI, Danhong injection (DHI). UHPLC-TQ/MS was used to analyze the stability of marker compounds (SaA, SaB, RA, DSS, PA, CA, and SG) in DHI, UHPLC-QTOF/MS was used to analyze the stability of global components (MW 80-1000 Da) in DHI, and cell based antioxidant capability assay was used to evaluate the bioactivity of DHI. We applied this strategy to assess the compatible stability of DHI and six infusion solutions (GS, NS, GNS, FI, XI, and DGI), which were commonly used in combination with DHI in clinic. GS was the best infusion solution for DHI, and DGI was the worst one based on marker compounds analysis. Based on global components analysis, XI and DGI were the worst infusion solutions for DHI. And based on bioactivity assay, GS was the best infusion solution for DHI, and XI was the worst one. In conclusion, as evaluated by the established comprehensive strategy, GS was the best infusion solution, however, XI and DGI were the worst infusion solutions for DHI. In the compatibility of DHI and XI or DGI, salvianolic acids in DHI would be degraded, resulting in the reduction of original composition and generation of new components, and leading to the changes of biological activities. This is the essence of instability compatibility of DHI and some infusion solutions. Our study provided references for choosing the reasonable infusion solutions for DHI, which could contribute the improvement of safety

  19. Developments in weather responsive traffic management strategies.

    Science.gov (United States)

    2011-06-01

    This report provides a comprehensive overview of weather-responsive traffic management practices. It focuses on what WRTM strategies exist, where they have been used, the benefits realized, what improvements are needed, and how to implement and evalu...

  20. 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

  1. 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.

  2. Partnered Evaluation of a Community Engagement Intervention: Use of a “Kickoff” Conference in a Randomized Trial for Depression Care Improvement in Underserved Communities

    Science.gov (United States)

    Mendel, Peter; Ngo, Victoria K.; Dixon, Elizabeth; Stockdale, Susan; Jones, Felica; Chung, Bowen; Jones, Andrea; Masongsong, Zoe; Khodyakov, Dmitry

    2013-01-01

    Community partnered research and engagement strategies are gaining recognition as innovative approaches to improving healthcare systems and reducing health disparities in underserved communities. These strategies may have particular relevance for mental health interventions in low income, minority communities in which there often is great stigma and silence surrounding conditions such as depression and difficulty in implementing improved access and quality of care. At the same time, there is a relative dearth of evidence on the effectiveness of specific community engagement interventions and on the design, process, and context of these interventions necessary for understanding their implementation and generalizability. This paper evaluates one of a number of community engagement strategies employed in the Community Partners in Care (CPIC) study, the first randomized controlled trial of the role of community engagement in adapting and implementing evidence-based depression care. We specifically describe the unique goals and features of a community engagement “kickoff” conference as used in CPIC and provide evidence on the effectiveness of this type of intervention by analyzing its impact on: 1) stimulating a dialogue, sense of collective efficacy, and opportunities for learning and networking to address depression and depression care in the community, 2) activating interest and participation in CPIC’s randomized trial of two different ways to implement evidence-based quality improvement (QI) programs for depression across diverse community agencies, and 3) introducing evidence-based toolkits and collaborative care models to potential participants in both intervention conditions and other community members. We evaluated the effectiveness of the conference through a community-partnered process in which both community and academic project members were involved in study design, data collection and analysis. Data sources include participant conference evaluation

  3. Evaluation of Simulation Models that Estimate the Effect of Dietary Strategies on Nutritional Intake: A Systematic Review.

    Science.gov (United States)

    Grieger, Jessica A; Johnson, Brittany J; Wycherley, Thomas P; Golley, Rebecca K

    2017-05-01

    Background: Dietary simulation modeling can predict dietary strategies that may improve nutritional or health outcomes. Objectives: The study aims were to undertake a systematic review of simulation studies that model dietary strategies aiming to improve nutritional intake, body weight, and related chronic disease, and to assess the methodologic and reporting quality of these models. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the search strategy with studies located through electronic searches [Cochrane Library, Ovid (MEDLINE and Embase), EBSCOhost (CINAHL), and Scopus]. Study findings were described and dietary modeling methodology and reporting quality were critiqued by using a set of quality criteria adapted for dietary modeling from general modeling guidelines. Results: Forty-five studies were included and categorized as modeling moderation, substitution, reformulation, or promotion dietary strategies. Moderation and reformulation strategies targeted individual nutrients or foods to theoretically improve one particular nutrient or health outcome, estimating small to modest improvements. Substituting unhealthy foods with healthier choices was estimated to be effective across a range of nutrients, including an estimated reduction in intake of saturated fatty acids, sodium, and added sugar. Promotion of fruits and vegetables predicted marginal changes in intake. Overall, the quality of the studies was moderate to high, with certain features of the quality criteria consistently reported. Conclusions: Based on the results of reviewed simulation dietary modeling studies, targeting a variety of foods rather than individual foods or nutrients theoretically appears most effective in estimating improvements in nutritional intake, particularly reducing intake of nutrients commonly consumed in excess. A combination of strategies could theoretically be used to deliver the best improvement in outcomes. Study quality was moderate to

  4. Evaluation of Strategies to Reducing Traction Energy Consumption of Metro Systems Using an Optimal Train Control Simulation Model

    Directory of Open Access Journals (Sweden)

    Shuai Su

    2016-02-01

    Full Text Available Increasing attention is being paid to the energy efficiency in metro systems to reduce the operational cost and to advocate the sustainability of railway systems. Classical research has studied the energy-efficient operational strategy and the energy-efficient system design separately to reduce the traction energy consumption. This paper aims to combine the operational strategies and the system design by analyzing how the infrastructure and vehicle parameters of metro systems influence the operational traction energy consumption. Firstly, a solution approach to the optimal train control model is introduced, which is used to design the Optimal Train Control Simulator(OTCS. Then, based on the OTCS, the performance of some important energy-efficient system design strategies is investigated to reduce the trains’ traction energy consumption, including reduction of the train mass, improvement of the kinematic resistance, the design of the energy-saving gradient, increasing the maximum traction and braking forces, introducing regenerative braking and timetable optimization. As for these energy-efficient strategies, the performances are finally evaluated using the OTCS with the practical operational data of the Beijing Yizhuang metro line. The proposed approach gives an example to quantitatively analyze the energy reduction of different strategies in the system design procedure, which may help the decision makers to have an overview of the energy-efficient performances and then to make decisions by balancing the costs and the benefits.

  5. A systematic review and economic evaluation of diagnostic strategies for Lynch syndrome.

    Science.gov (United States)

    Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

    2014-09-01

    Lynch syndrome (LS) is an inherited autosomal dominant disorder characterised by an increased risk of colorectal cancer (CRC) and other cancers, and caused by mutations in the deoxyribonucleic acid (DNA) mismatch repair genes. To evaluate the accuracy and cost-effectiveness of strategies to identify LS in newly diagnosed early-onset CRC patients (aged strategies for individuals in whom LS is identified. Systematic reviews were conducted of the test accuracy of microsatellite instability (MSI) testing or immunohistochemistry (IHC) in individuals with CRC at risk of LS, and of economic evidence relating to diagnostic strategies for LS. Reviews were carried out in April 2012 (test accuracy); and in February 2012, repeated in February 2013 (economic evaluations). Databases searched included MEDLINE (1946 to April week 3, 2012), EMBASE (1980 to week 17, 2012) and Web of Science (inception to 30 April 2012), and risk of bias for test accuracy was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) quality appraisal tool. A de novo economic model of diagnostic strategies for LS was developed. Inconsistencies in study designs precluded pooling of diagnostic test accuracy results from a previous systematic review and nine subsequent primary studies. These were of mixed quality, with significant methodological concerns identified for most. IHC and MSI can both play a part in diagnosing LS but neither is gold standard. No UK studies evaluated the cost-effectiveness of diagnosing and managing LS, although studies from other countries generally found some strategies to be cost-effective compared with no testing. The de novo model demonstrated that all strategies were cost-effective compared with no testing at a threshold of £20,000 per quality-adjusted life-year (QALY), with the most cost-effective strategy utilising MSI and BRAF testing [incremental cost-effectiveness ratio (ICER) = £5491 per QALY]. The maximum health benefit to the

  6. 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

  7. Systematic Evaluation Strategies for Innovative Programs in Health Professions Education: Need, Function and Components.

    Science.gov (United States)

    Taft, Thomas B., Jr.; Logan, Nelson S.

    As change occurs in various health sciences programs, evaluational strategies should be developed so that adaptive decisions may be made. Evaluation models taking into account inputs, methodology, and outputs (Stake, 1967, and Astin and Panes, 1971) need examination. Alternative measurement instruments for formative and summative evaluations,…

  8. An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies: a randomised controlled trial.

    Science.gov (United States)

    Armstrong, G; Blashki, G; Joubert, L; Bland, R; Moulding, R; Gunn, J; Naccarella, L

    2010-11-05

    Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy). A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. 40 Melbourne-based (Australia) social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97%) completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group). The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02) on the 66 point Cognitive Therapy Scale) and in subjective confidence (mean improvement of 1.28 (0.84-1.72) on a 5 point Likert scale). On average, the intervention group improved from below to above the base competency threshold on the Cognitive

  9. An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies: A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Moulding R

    2010-11-01

    Full Text Available Abstract Background Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy. Methods A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. Results 40 Melbourne-based (Australia social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97% completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group. The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02 on the 66 point Cognitive Therapy Scale and in subjective confidence (mean improvement of 1.28 (0.84-1.72 on a 5 point Likert scale. On average, the intervention group improved from below to above

  10. An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies: A randomised controlled trial

    Science.gov (United States)

    2010-01-01

    Background Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy). Methods A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. Results 40 Melbourne-based (Australia) social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97%) completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group). The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02) on the 66 point Cognitive Therapy Scale) and in subjective confidence (mean improvement of 1.28 (0.84-1.72) on a 5 point Likert scale). On average, the intervention group improved from below to above the base competency

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

    Energy Technology Data Exchange (ETDEWEB)

    Valentine, Scott, E-mail: valentine@pp.u-tokyo.ac.j [Graduate School of Public Policy (GraSPP), University of Tokyo, 620 Administration Bureau Building No. 2, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Sovacool, Benjamin K., E-mail: bsovacool@nus.edu.s [Lee Kuan Yew School of Public Policy, National University of Singapore, 02-03J Oei Tiong Ham Building, 469C Bukit Timah Road, Singapore 259772 (Singapore); Matsuura, Masahiro, E-mail: matsuura@pp.u-tokyo.ac.j [Graduate School of Public Policy (GraSPP), University of Tokyo, 620 Administration Bureau Building No. 2, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan)

    2011-03-15

    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{sub 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: {yields} Public consensus exists regarding which energy policy goals are important in Japan. {yields} Minor perceptual differences are not of a catalytic nature. {yields} Public consensus does not deviate significantly from past LDP energy policy. {yields} Unlikely that the DPJ will pursue costly energy transition initiatives. {yields} Likely that the DPJ energy strategy will be substantively similar to LDP strategy. {yields} Any differences in strategy will focus on CO{sub 2} reduction magnitude not substance.

  12. An integrated approach for developing a technology strategy framework for small- to medium-sized furniture manufacturers to improve competitiveness

    Directory of Open Access Journals (Sweden)

    Lourens, A.S.

    2013-05-01

    Full Text Available Low-technology firms, such as those found within the furniture manufacturing industry, have no framework or methodology to guide them successfully to acquire and integrate technology that enables them to operate more competitively. The aim of this article is to illustrate the development of a technology strategy framework for small- to medium-sized furniture manufacturers to assist them to improve their competitiveness. More specifically, this article presents an integrated technology strategy framework that enables management to integrate their business strategy with their technology requirements successfully, thus improving competitiveness.

  13. Strategies to Help ESL Students Improve their Communicative Competence and Class Participation: A Study in a Middle School

    Directory of Open Access Journals (Sweden)

    Claudia Gómez Palacio

    2010-12-01

    Full Text Available This article examines a qualitative study carried out at a middle school in North Carolina, the United States of America. The main purpose of the study was to find effective strategies that teachers can use to help ESL students improve their speaking skills and class participation. Results indicated that both communicative and social strategies as well as exposure to independent reading help ESL students improve their communicative skills and class participation.

  14. Evaluating Effect of Knowledge Management Strategy on Human Resource Management Performance Using BSC Approach

    Directory of Open Access Journals (Sweden)

    Hossein Mansoori

    2012-02-01

    Full Text Available This research provided a model for evaluating the effect of knowledge management strategy on human resource management performance in higher education institutes and academic libraries. This research was a descriptive survey. According to the research literature and expert opinions, in human resource level, 38 indicators were produced for evaluating KM, then these indicators were classified in 10 total factors in terms of balanced scorecard approach. The results of evaluating knowledge management in Yazd academic libraries showed that, this strategy on customer perspectives, internal processes, learning and growth perspective had a good performance. But in terms of financial and Labor productivity indicators and training programs it did not have a good outcome for Yazd academic libraries.

  15. 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...

  16. How do NHS organisations plan research capacity development? Strategies, strengths, and opportunities for improvement.

    Science.gov (United States)

    Gee, Melanie; Cooke, Jo

    2018-03-22

    Research that is integral into a 'learning healthcare system' can promote cost effective services and knowledge creation. As such, research is defined as a 'core function' in UK health service organisations, and is often planned through research and development (R&D) strategies that aim to promote research activity and research capacity development (RCD). The discussion focuses around the content of ten R&D strategies for healthcare organisations in England and Scotland, with respect to RCD. These organisations were engaged with a research interest network called ACORN (Addressing Organisational Capacity to do Research Network) that included two Scottish Health Boards, four community and mental health trusts, two provincial district hospitals, and two teaching hospitals. We undertook a thematic documentary analysis of the R&D strategies which identified 11 'core activities' of RCD. The potential for building research capacity in these 'core activities' was established by reviewing them through the lens of a RCD framework. Core activities aimed to 'hard wire' RCD into health organisations. They demonstrated a complex interplay between developing a strong internal organisational infrastructure, and supporting individual career planning and skills development, in turn enabled by organisational processes. They also included activities to build stronger inter-organisational relationships and networks. Practitioner, manager and patient involvement was a cross cutting theme. The potential to demonstrate progress was included in plans through monitoring activity across all RCD principles. Strategies were primarily aimed at research production rather than research use. Developing 'actionable dissemination' was poorly addressed in the strategies, and represents an area for improvement. We describe strengths of RCD planning activities, and opportunities for improvement. We explore how national policy and research funders can influence health systems' engagement in research.

  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. The Value of a Well-Being Improvement Strategy: Longitudinal Success across Subjective and Objective Measures Observed in a Firm Adopting a Consumer-Driven Health Plan.

    Science.gov (United States)

    Guo, Xiaobo; Coberley, Carter; Pope, James E; Wells, Aaron

    2015-10-01

    The objective of this study is to evaluate effectiveness of a firm's 5-year strategy toward improving well-being while lowering health care costs amidst adoption of a Consumer-Driven Health Plan. Repeated measures statistical models were employed to test and quantify association between key demographic factors, employment type, year, individual well-being, and outcomes of health care costs, obesity, smoking, absence, and performance. Average individual well-being trended upward by 13.5% over 5 years, monthly allowed amount health care costs declined 5.2% on average per person per year, and obesity and smoking rates declined by 4.8 and 9.7%, respectively, on average each year. The results show that individual well-being was significantly associated with each outcome and in the expected direction. The firm's strategy was successful in driving statistically significant, longitudinal well-being, biometric and productivity improvements, and health care cost reduction.

  19. 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.

  20. Improving early cycle economic evaluation of diagnostic technologies.

    Science.gov (United States)

    Steuten, Lotte M G; Ramsey, Scott D

    2014-08-01

    The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increase the return on investment as well as patient and societal impact. This paper describes examples of 'early cycle economic evaluations' as applied to diagnostic technologies and highlights challenges in its real-time application. It shows that especially in the field of diagnostics, with rapid technological developments and a changing regulatory climate, early cycle economic evaluation can have a guiding role to improve the efficiency of the diagnostics innovation process. In the next five years the attention will move beyond the methodological and analytic challenges of early cycle economic evaluation towards the challenge of effectively applying it to improve diagnostic research and development and patient value. Future work in this area should therefore be 'strong on principles and soft on metrics', that is, the metrics that resonate most clearly with the various decision makers in this field.

  1. Strategies for Improving the Performance of Sensors Based on Organic Field-Effect Transistors.

    Science.gov (United States)

    Wu, Xiaohan; Mao, Shun; Chen, Junhong; Huang, Jia

    2018-04-01

    Organic semiconductors (OSCs) have been extensively studied as sensing channel materials in field-effect transistors due to their unique charge transport properties. Stimulation caused by its environmental conditions can readily change the charge-carrier density and mobility of OSCs. Organic field-effect transistors (OFETs) can act as both signal transducers and signal amplifiers, which greatly simplifies the device structure. Over the past decades, various sensors based on OFETs have been developed, including physical sensors, chemical sensors, biosensors, and integrated sensor arrays with advanced functionalities. However, the performance of OFET-based sensors still needs to be improved to meet the requirements from various practical applications, such as high sensitivity, high selectivity, and rapid response speed. Tailoring molecular structures and micro/nanofilm structures of OSCs is a vital strategy for achieving better sensing performance. Modification of the dielectric layer and the semiconductor/dielectric interface is another approach for improving the sensor performance. Moreover, advanced sensory functionalities have been achieved by developing integrated device arrays. Here, a brief review of strategies used for improving the performance of OFET sensors is presented, which is expected to inspire and provide guidance for the design of future OFET sensors for various specific and practical applications. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. A Variable Interval Rescheduling Strategy for Dynamic Flexible Job Shop Scheduling Problem by Improved Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2017-01-01

    Full Text Available In real-world manufacturing systems, production scheduling systems are often implemented under random or dynamic events like machine failure, unexpected processing times, stochastic arrival of the urgent orders, cancellation of the orders, and so on. These dynamic events will lead the initial scheduling scheme to be nonoptimal and/or infeasible. Hence, appropriate dynamic rescheduling approaches are needed to overcome the dynamic events. In this paper, we propose a dynamic rescheduling method based on variable interval rescheduling strategy (VIRS to deal with the dynamic flexible job shop scheduling problem considering machine failure, urgent job arrival, and job damage as disruptions. On the other hand, an improved genetic algorithm (GA is proposed for minimizing makespan. In our improved GA, a mix of random initialization population by combining initialization machine and initialization operation with random initialization is designed for generating high-quality initial population. In addition, the elitist strategy (ES and improved population diversity strategy (IPDS are used to avoid falling into the local optimal solution. Experimental results for static and several dynamic events in the FJSP show that our method is feasible and effective.

  3. Spin-off strategies for the improvement of the performance national nuclear R and D project

    International Nuclear Information System (INIS)

    Lee, T. J.; Kim, H. J.; Jung, H. S.; Yang, M. H.; Choi, Y. M.

    1998-01-01

    In the light of the strategic utilization of the national R and D projects, this paper is to induce the spin-off strategies to improve the national R and D effectiveness through analyzing the spin-off characteristics of nuclear technologies, the spin-off status of the advanced countries and the case study of Korean nuclear spin-offs. Spin-off process is viewed as a three-stage operation, such as preparation stage, implementation stage and maintenance stage. In order to find the correlation between the influencing factors and spin-off effectiveness, the Spearman's correlation coefficient was employed as a specific statistical technique. By integrating this correlation, spin-off process and spin-off strategies, this paper presents an efficient frame work to improve the spin-off effectiveness

  4. Dual peptide conjugation strategy for improved cellular uptake and mitochondria targeting.

    Science.gov (United States)

    Lin, Ran; Zhang, Pengcheng; Cheetham, Andrew G; Walston, Jeremy; Abadir, Peter; Cui, Honggang

    2015-01-21

    Mitochondria are critical regulators of cellular function and survival. Delivery of therapeutic and diagnostic agents into mitochondria is a challenging task in modern pharmacology because the molecule to be delivered needs to first overcome the cell membrane barrier and then be able to actively target the intracellular organelle. Current strategy of conjugating either a cell penetrating peptide (CPP) or a subcellular targeting sequence to the molecule of interest only has limited success. We report here a dual peptide conjugation strategy to achieve effective delivery of a non-membrane-penetrating dye 5-carboxyfluorescein (5-FAM) into mitochondria through the incorporation of both a mitochondrial targeting sequence (MTS) and a CPP into one conjugated molecule. Notably, circular dichroism studies reveal that the combined use of α-helix and PPII-like secondary structures has an unexpected, synergistic contribution to the internalization of the conjugate. Our results suggest that although the use of positively charged MTS peptide allows for improved targeting of mitochondria, with MTS alone it showed poor cellular uptake. With further covalent linkage of the MTS-5-FAM conjugate to a CPP sequence (R8), the dually conjugated molecule was found to show both improved cellular uptake and effective mitochondria targeting. We believe these results offer important insight into the rational design of peptide conjugates for intracellular delivery.

  5. Strategies for improving the nutritional quality of Phaseolus beans through gene engineering

    Directory of Open Access Journals (Sweden)

    Kapila J.

    1999-01-01

    Full Text Available Although Phaseolus species are still difficult to transform, progress in this field now opens the way to engineering beans with a higher nutritional value. The opportunities for gene engineering in nutritional quality improvement, the strategies which canbe adopted and the constraints we are still facing are briefly outlined, using the enhancement of the seed methionine content and the reduction in antinutritional factors as examples.

  6. Evaluation of operation strategies of hybrid systems; Avaliacao de estrategias de operacao de sistemas hibridos

    Energy Technology Data Exchange (ETDEWEB)

    Hauschild, Luciano; Zilles, Roberto [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Inst. de Eletrotecnica e Energia. Lab. de Sistemas Fotovoltaicos]. E-mail: lucianoh@iee.usp.br

    2006-07-01

    This article evaluates the operation strategies of photovoltaic-eolic-diesel hybrid systems used for the rural area applied to two cases studies placed at the Cardoso Island, SP. The operation strategies evaluation is performed by simulation using data collected at the Cardoso Island such as electric power consumption profile and the solar and wind potential. With those data, simulation have been done considering different operation strategies and different levels of renewable energies penetration in the total energy produced by the system, in order to obtain system operation results such as Diesel oil consumption and depth of average discharge of the battery banks. From the simulation results an economic analysis have been done by using elements data from the cost of life average cycle (LAC) for determining which strategy is the most adequate for operation the electric power supply hybrid system.

  7. 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.

  8. ASAMPSA-E guidance for level 2 PSA Volume 3. Verification and improvement of SAM strategies with L2 PSA

    International Nuclear Information System (INIS)

    Rahni, N.; Raimond, E.; Jan, P.; Lopez, J.; Loeffler, H.; Mildenberger, O.; Kubicek, J.; Vitazkova, J.; Ivanov, I.; Groudev, P.; Lajtha, G.; Serrano, C.; Zhabin, O.; Prosek, Andrej; Dirksen, G.; Yu, S.; Oury, L.; Hultqvist, G.

    2016-01-01

    For each NPP, severe accident management (SAM) strategies shall make use of components or systems and human resources to limit as far as possible the consequences of any severe accident on-site and off-site. L2 PSA is one of the tools that can be used to verify and improve these strategies. The present report (deliverable D40.5 of the project ASAMPSA-E) provides an opportunity for a comparison of objectives in the different countries in terms of SAM strategies verification and improvement. The report summarizes also experience of each partner (including potential deficiencies) involved in this activity, in order to derive some good practices and required progress, addressing: - SAM modeling in L2 PSA, - Positive and negative aspects in current SAM practices, - Discussion on possible criteria related to L2 PSA for verification and improvement: risk reduction (in relation with WP30 activities on risk metrics), reduction of uncertainties on the severe accident progression paths until NPP stabilization, reduction of human failure conditional probabilities (depending on the SAM strategy, the environmental conditions...), - Review with a perspective of verification and improvement of the main SAM strategies (corium cooling, RCS depressurization, control of flammable gases, reactivity control, containment function, containment pressure control, limitation of radioactive releases,...), - SAM strategies to be considered in the context of an extended L2 PSA (as far possible, depending on existing experience), taking into account all operating modes, accidents also occurring in the SFPs and long term and multi-unit accidents. The deliverable D40.5 is developed from the partners' experience. Many of the topics described here are beyond the common practices of L2 PSA applications: in some countries, L2 PSA application is limited to the calculations of frequencies of release categories with no formal requirement for SAM verification and improvement. (authors)

  9. 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'…

  10. 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)

  11. Strategy of Quality Improvement of Pond Shrimp Post Harvest Management (Penaeus monodon Fabricius in Mahakam Delta (Case Study

    Directory of Open Access Journals (Sweden)

    Andi Noor Asikin

    2012-10-01

    Full Text Available Mahakam Delta area, which is situated in Kutai Kartanegara Regency, has become a pond center that gives a significant contribution to shrimp export of East Kalimantan Province. Pond-produced shrimps, however, do not always accord to the intention of cold storage companies at expected price. The companies even sometimes reject the request due to poor quality of the product. The decreasing shrimp quality may be due to maintenance process by the pond farmers as well as the improper collectors. In the other hand, importing countries have decided more and more restricted requirements for the imported fishing products. This study was held in Muara Jawa, Anggana, and Muara Badak Districts using techniques of data collection of in-depth interview with twelve respondents. In order to improve shrimp quality, farmers or the producers have to formulate a strategy towards the improvement of the post harvest shrimps from the pond using an Analytical Hierarchy Process (AHP. Results of the AHP consist of as follows: (1 application of pond shrimp post harvest technology and improvement of facilities and accommodation that support the quality improvement of the pond shrimps, (2 human resource quality improvement of pond farmers, collectors, and field instructors, (3 development of pond culture by applying best practices principle and local policies in order to improve the quality of the pond shrimps, and (4 improvement of interagency coordination, monitoring, and evaluation to enhance the pond shrimp quality

  12. Evaluation of a severe accident management strategy for boiling water reactors -- Drywell flooding

    International Nuclear Information System (INIS)

    Yu, D.; Xing, L.; Kastenberg, W.E.; Okrent, D.

    1994-01-01

    Flooding of the drywell has been suggested as a strategy to prevent reactor vessel and containment failure in boiling water reactors. To evaluate the candidate strategy, this study considers accident management as a decision problem (''drywell flooding'' versus ''do nothing'') and develops a decision-oriented framework, namely, the influence diagram approach. This analysis chooses the long-term station blackout sequence for a Mark 1 nuclear power plant (Peach Bottom), and an influence diagram with a single decision node is constructed. The node probabilities in the influence diagram are obtained from US Nuclear Regulatory Commission reports or estimated by probabilistic risk assessment methodology. In assessing potential benefits compared with adverse effects, this analysis uses two consequence measures, i.e., early and late fatalities, as decision criteria. The analysis concludes that even though potential adverse effects exist, such as ex-vessel steam explosions and containment isolation failure, the drywell flooding strategy is preferred to ''do nothing'' when evaluated in terms of these consequence measures

  13. Use of a fuzzy decision-making method in evaluating severe accident management strategies

    International Nuclear Information System (INIS)

    Jae, M.; Moon, J.H.

    2002-01-01

    In developing severe accident management strategies, an engineering decision would be made based on the available data and information that are vague, imprecise and uncertain by nature. These sorts of vagueness and uncertainty are due to lack of knowledge for the severe accident sequences of interest. The fuzzy set theory offers a possibility of handling these sorts of data and information. In this paper, the possibility to apply the decision-making method based on fuzzy set theory to the evaluation of the accident management strategies at a nuclear power plant is scrutinized. The fuzzy decision-making method uses linguistic variables and fuzzy numbers to represent the decision-maker's subjective assessments for the decision alternatives according to the decision criteria. The fuzzy mean operator is used to aggregate the decision-maker's subjective assessments, while the total integral value method is used to rank the decision alternatives. As a case study, the proposed method is applied to evaluating the accident management strategies at a nuclear power plant

  14. 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.

  15. A 7-Step Strategy for the Implementation of Worksite Lifestyle Interventions: Helpful or Not?

    Science.gov (United States)

    Wierenga, Debbie; Engbers, Luuk H; Van Empelen, Pepjin; van Mechelen, Willem

    2016-05-01

    The aim of this study was to evaluate the use of and adherence to a 7-step strategy for the development, implementation, and continuation of a comprehensive, multicomponent lifestyle program. Strategy use and adherence was assessed with 12 performance indicators. Data were collected by combining onsite monitoring with semi-structured interviews at baseline and follow-up (6, 12, and 18 months). Not all performance indicators were met so partial strategy adherence was obtained. The strategy could be improved on the following aspects: support among management, project structure, adaptation to needs of employees, planning, and maintenance. The results of this evaluation indicate that strategy adherence facilitated structured development and implementation. On the basis of the qualitative data, this study suggests that when improvements will be made on both the content and performance, the 7-step strategy could be an effective tool to successfully implement a multicomponent WHPP.

  16. Power Flow Distribution Strategy for Improved Power Electronics Energy Efficiency in Battery Storage Systems: Development and Implementation in a Utility-Scale System

    Directory of Open Access Journals (Sweden)

    Michael Schimpe

    2018-03-01

    Full Text Available Utility-scale battery storage systems typically consist of multiple smaller units contributing to the overall power dispatch of the system. Herein, the power distribution among these units is analyzed and optimized to operate the system with increased energy efficiency. To improve the real-life storage operation, a holistic system model for battery storage systems has been developed that enables a calculation of the energy efficiency. A utility-scale Second-Life battery storage system with a capacity of 3.3 MWh/3 MW is operated and evaluated in this work. The system is in operation for the provision of primary control reserve in combination with intraday trading for controlling the battery state of charge. The simulation model is parameterized with the system data. Results show that losses in power electronics dominate. An operational strategy improving the energy efficiency through an optimized power flow distribution within the storage system is developed. The power flow distribution strategy is based on the reduction of the power electronics losses at no-load/partial-load by minimizing their in-operation time. The simulation derived power flow distribution strategy is implemented in the real-life storage system. Field-test measurements and analysis prove the functionality of the power flow distribution strategy and reveal the reduction of the energy throughput of the units by 7%, as well as a significant reduction of energy losses in the units by 24%. The cost savings for electricity over the system’s lifetime are approximated to 4.4% of its investment cost.

  17. 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.

  18. Evaluation of an Adoption Strategy for a Healthy Diet Programme for Lower Vocational Schools

    Science.gov (United States)

    Bessems, Kathelijne M. H. H.; van Assema, Patricia; Paulussen, Theo W. G. M.; de Vries, Nanne K.

    2011-01-01

    This paper describes the evaluation of an adoption strategy for the school-based healthy diet programme Krachtvoer. Health promotion (HP) professionals from five Regional Public Health Services (RPHSs) in The Netherlands were asked to recruit a total of 25 schools to adopt the Krachtvoer programme in accordance with this strategy. Afterwards, they…

  19. New strategy for evaluating grain cooking quality of progenies in dry bean breeding programs

    Directory of Open Access Journals (Sweden)

    Bruna Line Carvalho

    2017-04-01

    Full Text Available The methodology available for evaluating the cooking quality of dry beans is impractical for assessing a large number of progenies. The aims of this study were to propose a new strategy for evaluating cooking quality of grains and to estimate genetic and phenotypic parameters using a selection index. A total of 256 progenies of the 13thcycle of a recurrent selection program were evaluated at three locations for yield, grain type, and cooked grains. Samples of grains from each progeny were placing in a cooker and the percentage of cooked grains was assessed. The new strategy for evaluating cooking quality was efficient because it allowed a nine-fold increase in the number of progenies evaluated per unit time in comparison to available methods. The absence of association between grain yield and percentage of cooked grains or grain type indicated that it is possible to select high yielding lines with excellent grain aspect and good cooking properties using a selection index.

  20. 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